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HomeMy WebLinkAbout0011 VISTA CIRCLE - Health 11 Vista Circle Centerville- P A = 193 254 c Commonwealth of Massachusetts Title 5 Official Inspection Form ;:0 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle V Property Address + -+ Janice Lariviere r rI Owner Owner's Name / information is required for every Centerville V Ma 02632 2-22;-19 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:When filling out forms A. Inspector Information .# /23(12 on the computer, Brett Hickey use only the tab key to move your Name of Inspector cursor-do not B&B Excavation use the return Company Name key. 374 Route 130 ry Company Address Sandwich Ma 02563 City/Town State Zip Code (508)477-0653 S113747 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this inspection I have determined that the system: 1. ❑■ Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails Brett Hickey "`g�°°�""�" � �.� .%'OZIo:301803.3613:3a:1a LSYIP -22-19 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 16 c Commonwealth of Massachusetts �n ,p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle Property Address Janice Lariviere Owner Owners Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: The system was in working order at the time of inspection. 2) 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): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 11 Vista Circle Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form le Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle v Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ a Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ❑ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 I - - c Commonwealth of Massachusetts Title 5 Official Inspection Form I nsp r Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle �V Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ El Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ El Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow ❑ ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ El Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ 0 Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ 0 Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. ❑ 0 Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ El 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 2000 gpd- 10,000 gpd. ❑ 0 The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) 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 CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle v Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no" for each of the following for all inspections: Yes No Q ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ El Were any of the system components pumped out in the previous two weeks? El ❑ Has the system received normal flows in the previous two week period? ❑ a Have large volumes of water been introduced to the system recently or as part of this inspection? 0 ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ❑ El Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ Was the site inspected for signs of break out? 0 ❑ Were all system components, excluding the SAS, located on site? 0 ❑ 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? ❑ El 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: 0 ❑ 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)] t5insp.doc-rev.726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form ~ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments I 11 Vista Circle Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: 3 Number of bedrooms(design): Number of bedrooms(actual): 3 330/gpd DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes 0 No Does residence have a water treatment unit? ❑ Yes RI No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes 0 No information in this report.) Laundry system inspected? ❑ Yes 0 No Seasonal use? ❑ Yes No Water meter readings, if available(last 2 years usage(gpd)): See below Detail: 2018- 131,000gallons 2017- 111,000gallons Sump pump? ❑ Yes ❑■ No Last date of occupancy: Current Date t5insp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form gal Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle Property Address Janice Lariviere Owner Owners Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: NA 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: 'Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Owner- last pumped 5+ years ago Was system pumped as part of the inspection? ❑ Yes ❑■ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts UV,1p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 11 Vista Circle Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: El Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: 1999 per plans Were sewage odors detected when arriving at the site? ❑ Yes ❑■ No 5. Building Sewer(locate on site plan): 4' Depth below grade: feet Material of construction: ❑ cast iron ❑■ 40 PVC ❑other(explain): Distance from private water supply well or suction line: Town waterfeet Comments(on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 18 c� Commonwealth of Massachusetts �n Title 5 Official Inspection Form I s Subsurface Sewage Disposal System Form Not for Voluntary Assessments 9 P Y rY 11 Vista Circle L Property Address Janice Lariviere Owner Owners Name information is Centerville Ma 02632 2-22-19 required for every page.e. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): 3' Depth below grade: feet Material of construction: 0 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 1 Dimensions: 500gallons 7" Sludge depth: 2519 Distance from top of sludge to bottom of outlet tee or baffle 3" Scum thickness 611 Distance from top of scum to top of outlet tee or baffle 13" Distance from bottom of scum to bottom of outlet tee or baffle measured How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank was in working order at the time of inspection. The tank is in need of pumping at this time and should be pumped every two years for maintenance. t5insp.doc•rev.7/26/2018 Tile 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form gal Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap(locate on site plan): NA 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 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): NA Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle v Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. Distribution Box if resent must be opened) locate on site plan): � P P ) ( P ) 0rr Depth of liquid level above outlet invert 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. 9 � :) The d-box was in working order at the time of inspection. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle r u Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑• No" Alarms in working order: ❑ Yes ❑Q No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): NA * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: (4)hi cap infiltrators 0 leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/262018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts �d Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle V Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The leaching was in passing condition. Infiltrators had 1" of standing water when viewed. 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): NA 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 Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments v 11 Vista Circle Property Address Janice Lariviere Owner Owner's Name information is required for every Centerville Ma 02632 2-22-19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. Privy(locate on site plan): NA Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts i� ,o Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle v� Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑■ hand-sketch in the area below ❑ drawing attached separately Rear A B Al-29' 61.30'10" A2.42' B2.21' A3.358" 83.46' A4.48'8" B4-28'6'• (D 0 2 [310 1 0 10 19 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 t c� Commonwealth of Massachusetts Title 5 Official Inspection Form °I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 Vista Circle ,V Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ❑■ Check Slope ❑■ Surface water M Check cellar ❑■ Shallow wells Estimated depth to high ground water: No GW @ 144"feet Please indicate all methods used to determine the high ground water elevation: El Obtained from system design plans on record Dec-22-99 If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: A plan on file with the Board of Health was used. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form I s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 9 P Y rY 11 Vista Circle v Property Address Janice Lariviere Owner Owner's Name information is Centerville Ma 02632 2-22-19 required for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: A. Inspector Information: Complete all fields in this section. ❑■ B. Certification: Signed & Dated and 1, 2, 3, or 4 checked �■ C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4(Failure Criteria)and 6(Checklist)completed ❑■ D. System Information: For 8: TighWolding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc-rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 s OP �EqR/NG N 76'06'37"W 219.66 eG O 64.7 fr 77.2 amb ' cnc» r� -o qy - -°orn _ o Zx � 00 J j > CA z Of ?S 9, 10 CA SS3� CA3 , 76'06'37"E 80.00 7' ECOJECH RECEIVED Environmental JUL 0 9 www.eco-tech.us 20U3 TOWN THIS FORM IS A FACSIMILE OF THE STANDARD SEPTIC INSPECTION FORM ISSUED BY HE MA ��%DffA TMENT OF ENVIRONMENTAL PROTECTION(revised 6/15/2000) EPT. TITLE 5 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 11 Vista Circle 1� Centerville Owner's Name: William Feder MAP AA Owner's Address: 11 Vista Circle PARCEL Z Centerville,MA 02632 LOT '�O Date of Inspection: July 8, 2003 Name of Inspector: (Please Print) David D. Coughanowr,R.S. Company Name: Eco-Tech Environmental Mailing Address: 43 Triangle Circle Sandwich,MA 02563 Telephone Number: (508)364-0894 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 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: X Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority Fails 'Ins ectors Signature QJ - v A g e �� a)• �fi�'Y--- O S Date: � t / q, 2063 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 NOTES AND COMMENTS Inspector's Note==> A septic system is deemed to pass this Real Estate Transfer Inspection if it does not trigger any of the failure criteria listed below. The septic system has been evaluated according to the conditions observed on the day it was inspected. No estimate or guarantee of system longevity is made or implied by a passing determination. ****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 sane or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 f Page 2 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 11 Vista Circle Centerville Owner: William Feder Date of Inspection: July 8,2003 INSPECTION SUMMARY: Check A,B,C,D or E/ALWAYS complete all of section D: A] System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 5.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. COMMENTS: B] System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health, will pass. Answer yes, no, or not determined(Y,N,or ND). in the_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. ND explain: Observation of sewage backup or breakout or lugh static water level 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 Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced. ND explain 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 ND explain 2 Page 3 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 11 Vista Circle Centerville Owner: William Feder Date of Inspection: July 8, 2003 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 and 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 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 by a DEP certified laboratory, 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,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form 3) OTHER 3 f Page 4 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION continued Property Address: 11 Vista Circle Centerville Owner: William Feder Date of Inspection: July 8, 2003 D)System Failure Criteria applicable to all systems: You must indicate either"yes" or"no" to each of the following for all inspections: 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 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 X Any portion of the SAS,cesspool or privy is below high groundwater elevation. X Any portion of 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 1 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.(This system passes if the well water analysis, performed by a DEP certified laboratory, 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,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form) No (Yes/No)The system fails.I have detennined 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 1.0,000 gpd to 15,000 gpd 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) yes no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well. If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in section D above the large system has failed.The owner or operator of any large system considered a significant threat under section E or failed under section D shall upgrade the system in accordance with 310 CUR 15.304.The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 11 Vista Circle Centerville Owner: William Feder Date of Inspection: July 8,2003 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 Were any of the system components pumped out in the last two weeks? X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available as N/A) X _ Was the facility or dwelling inspected for signs of sewage back-up? X _ Was the site inspected for signs of breakout? X _ Were all system components,excluding the SAS. located on site? X Were the septic tank manholes uncovered, opened,and the interior of the septic tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge and depth of scum.? X _ Was the facility owner(and occupants,if different from owner) provided with information on the proper maintenance of subsurface disposal systems? For information on the proper maintenance of subsurface disposal systems please go to: WWW.ECO-TECH.US The size and location of the Soil Absorption System(SAS) on the site has been determined based on: X _ Existing information.For example,Plan at the Board of Health. _ X Determined in the field(if any of the failure criteria related to part C is at issue,approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] 5 Page 6 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 11 Vista Circle Centerville Owner: William Feder Date of Inspection: July 8,2003 FLOW CONDITIONS RESIDENTIAL 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 gpd Number of current residents 1 Does the residence have a garbage grinder(yes or no): no Is laundry on a separate sewage system(yes or no): no :(If yes, separate inspection requiredl Laundry system inspected (yes or no): n/a Seasonal use(yes or no): no Water meter readings,if available(last two year's usage(gpd): 221 gpd Sump Pump(yes or no): no Last date of occupancy: current COMMERCIAL/IND U S TRIAL: Type of establishment: Design flow(based on 310 CMR 15.203):: gpd Basis of design flow(seats/persons/sqf/etc.): Grease trap present: (yes or no)_ Industrial waste holding tank present: (yes or no): Non-sanitary waste discharged to the Title 5 system: (yes or no) Water meter readings, if available: Last date of occupancy/use:_ OTHER: (Describe): GENERAL INFORMATION PUMPING RECORDS Source of information: System not pumped in recent past(Owner) Was system pumped as part of the inspection: (yes or no) No If yes,volume pumped: gallons--How was quantity pumped deternuned? Reason for pumping: 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) Innovative/Alternate technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe) APPROXIMATE AGE of all components,date installed(if known)and source of information: Age: 2+years Certificate of Compliance issued 2/28/01 (BOH permit#2000-495) Were sewage odors detected when arriving at the site: (yes or no) no 6 Page 7 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 11 Vista Circle Centerville Owner: William Feder Date of Inspection: July 8, 2003 BUILDING SEWER_(Locate on site plan) Depth below grade: 1 ft Material of construction:_cast iron X 40 PVC_other(explain) Distance from private water supply well or suction line 20+feet Comments: (on condition of joints,venting,evidence of leakage, etc.) Sewer is vented through roof and appears structurally sound with no evidence of leakage or backup into dwelling_ SEPTIC TANK: X (locate on site plan) Depth below grade: 36 inches Material of construction:_concrete—metal—fiberglass X polyethylene other(explain) If tank is metal,list age_ Is age confirmed by Certificate of Compliance_(yes or no):_(attach a copy of certificate) Dimensions: 143"1 x 56"w x 66"h (1500 gallon) Sludge depth: 3 in Distance from top of sludge to bottom of outlet tee or baffle: 31 in Scum thickness: 1 in Distance from top of scum to top of outlet tee or baffle: 9 in Distance from bottom of scum to bottom of outlet tee or baffle: 14 in How dimensions were determined: Specification sheet Comments: (on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage, etc.): Pumping not required at this time,but maintenance pumping is recommended every 2 years Liquid level at outlet invert.Tank and tees appear structurally sound and functioning as intended No evidence of leakage in or out GREASE TRAP: none (locate on site plan) Depth below grade: 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: Comments: (on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 11 Vista Circle Centerville Owner: William Feder Date of Inspection: July 8,2003 TIGHT OR HOLDING TANK: none (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/day Alarm present(yes or no):_ Alarm level: _ Alarm in working order(yes or no) pumping: Date of last pung: Comments:(condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: X (if present must be opened) (locate on site plan) Depth of liquid level above outlet invert: at outlet inverts Comments:(note if box is level and distribution to outlets is equal,any evidence of solids carryover,any evidence of leakage into or out of box, etc.) D-box appears structurally sound with no evidence of leakage in or out Effluent level at outlet inverts Few solids in tank. PUMP CHAMBER: none (locate on site plan) Pumps in working order: (yes or no) Alarms in working order: (yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 11 Vista Circle Centerville Owner: William Feder Date of Inspection: July 8,2003 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan;excavation not required) If SAS not located,explain why: Type: _leaching pits,number _leaching chambers,number X leaching galleries,number 1 _leaching trenches,number,length _leaching fields,number,dimensions _overflow cesspool,number —innovative/alternate system Type/name of Technology Comments: (note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.) Soils above leaching gallery appeared unsaturated. No evidence of surface ponding breakout lush vegetation or other evidence of hydraulic failure was observed. CESSPOOLS: none (cesspool must be pumped at time 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 or no): Comments: (note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation, etc.): PRIVY: none (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.): Page 10 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 11 Vista Circle Centerville Owner: William Feder Date of Inspection: July 8, 2003 SKETCH OF SEWAGE DISPOSAL SYSTEM: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100'(Locate where public water supply enters the building) LOCATIONS A B 1 29 ft 31 ft 2 42 f t 21 Ft 3 35.5 f t 46 Ft EXISTING 4 48.5 f t 28.5 f t DWELLING WATER LINE W # I I U A B U SEPTIC o 0 2 TANK ❑ D-BOX 31 1 n LEACHING GALLERY HILLSIDE DRIVE NOT TO SCALE 10 Page 11 of 11 OFFICIAL INSPECTION FORM_NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 11 Vista Circle Centerville Owner: William Feder Date of Inspection: July 8, 2003 SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to ground water: 35+ feet Please indicate(check)all methods used to determine high ground water elevation: X Obtained from system design plans on record-If checked. date of design plan reviewed 2/28/01 (compliance) Observed Site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of health-explain: Checked local excavators,installers-attach documentation) X Accessed USGS database You must describe how you established the high ground water elevation. Approved design plan on file with Board of Health showed bottom of field to be 11 ft above bottom of witnessed test pit in which no groundwater was observed. Town of Barnstable GIS Department records indicate that the groundwater table lies over 35 feet belowthe surface of the lot. 11 TOWN OF BARNSTABLE �FTHETO OFFICE OF H9HHSTABL i BOARD OF HEALTH bAS& op 039. `gym 367 MAIN STREET �oMaY�" HYANNIS, MASS.02601 March 15, 2000 Joseph Polcaro 3111 Falmouth Road Osterville, MA 02655 RE: Lot 16, Hillside Drive, Centerville Dear Mr. Polcaro: You are granted a variance from 310 CMR 15.214, restricting sewage flows to one bedroom for every 10,000 square feet of land within Zone II districts. You are granted permission to construct an onsite sewage disposal system at Lot 16, Hillside Drive, Centerville, with the following conditions: (1) No more than three (3) bedrooms are authorized. Dens, study rooms, finished attics, sleeping lofts and similar-type rooms are considered "bedrooms" according to the Massachusetts Department of Environmental Protection. (2) The applicant shall record a properly-worded deed restriction at the Barnstable County Registry of Deeds limiting the dwelling the number of bedrooms authorized. The deed restriction shall be signed by the property owner. A copy of the recorded deed restriction shall be submitted to the Board of Health rEior to obtaining a disposal works construction permit. This variance was granted because it meets the Board's policy to approve three (3) bedrooms on lots of more than 18,000 square feet in size. This lot is 18,955 square feet. Sincerely yours, Susan G. k, R.S. Chairperson Board of Health Town of Barnstable SGR/bcs polcaro BK1 1 89 P�; 133 S 10 r r 00- 18-2000 e 10206 DEED RESTRICTION WHEREAS, BETTY L. WILLIAMS, TRUSTEE OF VISTA CIRCLE REALTY TRUST, under a Declaration of Trust dated November 1, 1988 recorded in the Barnstable Registry of Deeds in Book 6504 Page 78, of Centerville, Barnstable County, Massachusetts is the owner of Lot 16, located at 55 Hillside Drive, Barnstable (Centerville), Barnstable County, Massachusetts (hereinafter referred to as Lot 16) and being shown on a plan entitled "Plan of Land in BARNSTABLE (Centerville), MA. For R. ARTHUR & BETTY L. WILLIAMS" dated June 2, 1984, drawn by Baxter & Nye, Inc., Registered Land Surveyors, Osterville, MA recorded in the Barnstable County Registry of Deeds in Plan Book 386 Page 27. WHEREAS, BETTY L. WILLIAMS, TRUSTEE as aforesaid, as the owner of said lot has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre- condition to obtaining a variance from the State Environmental Code, 310 CMR 15.21.A and to obtaining a building permit for this lot; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting the variance from the State Environmental Code, 310 CMR 15.21.A and authorizing the issuance of a building permit for the construction of a single family home on this lot is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document. NOW, THEREFORE, BETTY L. WILLIAMS, TRUSTEE as aforesaid, does hereby place the following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 1. Until such time as technology changes and the Barnstable Board of Health changes its regulations or otherwise grants permission, Lot 16, 55 Hillside Drive, Centerville, Massachusetts may have constructed upon the lot a house containing no more than three (3) bedrooms BETTY L. WILLIAMS, TRUSTEE as aforesaid, agrees that this shall be a permanent deed restriction affecting Lot 16, 55 Hillside Drive, Centerville, Massachusetts, and being shown on the plan recorded in Plan Book 386 Page 27. For title of BETTY L. WILLIAMS, TRUSTEE as aforesaid see deed in Book 5206 Page 177. LAW OFFICES OF JOHN R.ALGER,P.C. 886 MAIN STREET- P.0.BOX 449 OSTERVILLE,MA 02655-0449 1. THE UNDERSIGNED TRUSTEE HEREBY WARRANTS AND REPRESENTS THAT THE VISTA CIRCLE REALTY TRUST SET FORTH ABOVE IS STILL IN FULL FORCE AND EFFECT, HAS NOT BEEN AMENDED IN ANY WAY, THAT THE BENEFICIARIES ARE OF FULL AGE AND ARE NOT UNDER DISABILITY, AND THAT THE TRUSTEE HAS BEEN AUTHORIZED BY THE BENEFICIARIES OF SAID TRUST TO EXECUTE AND DELIVER THIS RESTRICTION. WITNESS my hand and seal this 17 day of ��c� `' 2000 VISTA CIRCLE REALTY TRUST Bett ; . Williams, Trustee STATE OF COUNTY OF / DATE: Then personally appeared the above-named Betty L. Williams, Trustee as aforesaid and acknowledged the foregoing to be her free act and deed, before me N ARY PUBLIC f y Commission Expires: C%� TOWN OF BARNSTABLE TOE 0. OFFICE QF BOARD OF HEALTH � D,d1DlT e 16At1 �639• 367 MAIN STREET HYANNIS,MASS.42601 March 15, 2000 Joseph Polcarc 3111 Faimouth Roan Osterville, MA 02655 RE. Lot 16, Kiiside Drive, Centerville Dear Mr. Poicaro: You are granted a variance from 31 G CMR 15.214, restricting sewage .lows to one bedroom for every 10,000 square feet of land rvitnin Zone 11 districts. You are granted permission to construct an onsite sewage disposal system at Lot 16.. Hidside Drive: Centerville, with the following conditions: (1) No more thar, three (3 bedrooms are authorized. Dens, sUdy rooms, finished attics, sleeping lofts and simiiar-type roorris are considered `bedrooms" according to the Massachusetts Department of Environmentai Protection. (2} The applicant shall record a properly-wordea deed restriction at the Barnstable County Registry of Deeds limiting the swelling the number of bedrooms authorized. The deed restriction shall be signed by the property owner. A copy of the recorded deed restriction shalt be submitted to the Board of Healtn prior to obtaining a disposal works construction permit. This variance was granted because it meets Vie Board's policy to approve three ;3} bedrooms cn lots of more than 18.000 square feet in size. This lot is 18,955 square feet. Sincerely yours, 'V v2,s'�- Susan G. F�k R S. Chairperson Board of Health Town of Barnstable SG R!bcs pcicaro TOWN OF B ST LE N JI Vs Ar voa - cV9. LOCATION G S AGE # 15 2 VILLAGE (' 2vt Le/v;11t ESSOR'S MAP O 11 3 1 INSTALLER'S NAME&PHONE NO. R�,Agy4QC2&4 Cory. S-33 -VP99 SEPTIC TANK CAPACITY /SCJO *c/ l/�iG A-1 LEACHING FACILITY: (type) -10 � .l A (size) JJ x 33 X.l o NO.OF BEDROOMS -3 ( A7; C BUILDER OR( N�ER ? &-�:k Evc.e�e,/ longS' PERMIT DATE: _ �d ©e COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leachin facility) Feet Furnished by /•! A''g U `C, � m „ 3o *0 ya Z 3 .. s 3 ,/ L�_ y a o o y C� 3 V� l m Fee THE COMMONWEALTH OF MASSACHUSETTS En4d in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS i ion r igogar bpgtem� Congtruction permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address andTel.No. Assessor's Map/Parcel !Q 2 /A �C'Z1, I t/t f - -Y 11 ;J(L"�'T" � V Installer's Name,Address,and Tel.No. Desi ner's Name,Address and Tel.No. k4A96rnrItl &V to Type of Building: 4 Dwelling No.of Bedrooms Lot Size `yi sq.ft. Garbage Grinder Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow it gallons per day. Calculated daily flow 38`i gallons. Plan Date t tid 144 4{Q Number of sheets Revision Date Title on, Of Size of Septic Tank_ Lrb 0� Type of S.A.S. Lt �K Description of Soil: F q(O/ T 1/ 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 accordance with the provisions of itle 5 of the Environmental Code and not to place the sys m in operation until a Certifi- cate of Compliance has been issued is Bo o AHth. , AG Signed Date o%r oil Application Approved by Date." 2rsrs� Application Disapproved for the following reasons ——Permit No. Gib n1� Date Issued -------------------------- ————— — -- — F .9"•I.f -r l AC : ate � i7 Fee .y r ►{ THE COMMONWEALTH OF MASSACHUSETTS Ent�ed in computer: es -' '.PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS tore or Mtopool *proem Cow6tructto11"Permit /A Application for a Permit to Construct(✓)Repair U grade( )Abandon( ) ❑Complete System ❑Individual Components r Location Address or Lot No.LVT I to ti Owner's Name,Address and Tel.No. Assessor's MapTarcel +C� J!�S /'Installer's Name,Address,and Tel.No. ` V Desi ner's Name,Address and Tel.No.C- ,�'.0 . F'�►P�t�-ro +o�v�o�-+— Vt�.•t. -tr44i.. KA AA51-C-1 5 AA-c I.LS Type of Building: ` Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder(� Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow �O gallons per day. Calculated daily flow' � gallons. Plan Date 0` 2 Z Number of sheets Revision Date Title Size of Septic Tank (Soo Type of S.A.S. j� �Gt � ✓� ' Description of Soil 1 q�+' Nature of Repairs-or Alterations(Answer when applicable) 4 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 sys ern in operation until a Certifi- cate of Compliance has been issued�y this B Signe �' Date ���r/ �✓� Application Approved b gfe&Ad Date 9 r ,Z z Z Application Disapproved for the following reasons Permit No. - Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS f (Certificate of Compliance THIS IS TO CERIWY,that the 0 'tSewage Disposal System Constructed( )Repaired( )Upgraded( ) Abandoned( ) y at f LG has been constructed in accordance with the prov dons of Title 5 and the for Disposal System Construction Permit NaI�S� ��dated '✓ Installer 410�`�� Designer The issuance of this permit shall not be construed as a guarantee that the/s• will function as esi pe Date �i 4 ""' d J Inspect6r" r � �a✓' �f/ ------------------------------------/--�, — No. ��� ` ` Fee L — THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS 1=t!5 poga1 bpztem Con!6tructton Permit Permission is hereby granted to Consstri -t h` Repair( )Upgrade( )Abandon( ) t System located at t,! 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:Constructio must be completed within three years of the date of!ffkY4,e,_ t. Date: 2 2�ZO / Approved by e , �� �_ 9 i COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Received by(Please Prin ) B. D e of elivery item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. C. Si azure ■ Attach this card to the back of the mailpigi;e,- _ ❑ gent or on the front if space permits. ❑Addresse! D. Is d very address different from item 1? ❑Yes 1. Article Addressed to: 'If YES,enter delivery address below: ❑ No S 6-1 I'k 6 2- 3 3. Service Type 1�1 eYU� ❑Certified Mail ❑Express Mail ❑Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. , I i PS 102595-99-M-1789 ii v • UNITED STATES POSTAL SERVIC �p ;Nth` FirsLClass Mail _ "Postage•&Fees Paid USp$ n • 't 'yo r�a ,' , address, end SIP 4wr�phis"�iox • Sender: Please pri '.,,,-;�''• �� vas.»mom.. „„... Sos c . Q SX 46-? mo,rtt�ns 1,-S M 64 COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Received by(Please Print Clearly) rDate of Delivery item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. C. Signature ■ Attach this card to the back of the mailpiece,'`x3�" fi Agent X or on the front if space permits. � ❑Addressee 1. Article Addressed to D. Is delivery address different from item 1? ❑Yes ffIf YES,enter delivery address below: ❑ No N55o 3. Service TypeQr�- J (/�'� � � � V--�t(fv-,;,)�e- (vl/`� a�3 2 ece ❑Certified:Mailerx aij ❑ Registeited 4 ❑Re u n\ ipt for Merchandise ❑ Insured Mail., ❑G 0 b� 4. Restricted DeliveryT..(Exlra-FEe) ❑Yes 2. Article Number(Copy from service label) II!! l p 19 s x P y rm 3$l;li,July:,1999 i+ Domestic�Return Receipt' 102595-99-M-1789 Y UNITED STATES POSTAL SERVIC first-CTass Mail •"— oPosfage`-&Fees Paid LISPS Permit No..G19 — • ender: Please print y l4 me, address, arid-z4P±4.-an-this-box 0 2— �s . C • �t��o i O � ox 45'7 i COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Received by(Please Print Clearly) B. Da of eliv ry item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse . so that we can return the card to you. ona ■ Attach this card to the back of the mailpiec�r'.; ❑Agent or on the front if space permits. ❑Addressee ress different from R Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No UGn'ke I �), Io�)e p n a 3. Service Type CCY1�-e Y,U `\ 1 \l 1 6 2 3�— ❑Certified Mail ❑ Express Mail ❑Registered ❑ Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee)_ ❑Yes 2. r : i PS , 1 102595-99-M-1789 v UNITED STATES POSTAL SERVIC c-' N14\ ----,., ,first-Class Mail VO G'ti Postage&,Fees Paid LISPS Permit No.G-10 • Sender: Please print yotkrne, address, and ZIP+4 in this box • a,, C - Q� C, '-6 �ox 4- �`'� d 2- 0 COMPLETE SECTION ■ Complete items 1,2,and 3.Also complete A. Receive (Please Print Clearly) B. Dat f Delivery item 4 if Restricted Delivery is desired. f D ■ Print your name and address on the reverse 4�- ign ure so that we can return the card to you. ❑Agent ■ Attach this card to the back of the mailpiece, or on the front if space permits. ❑Ad ressee D. Is el Yes 1, Article Addressed to: If YES, nter delivery address below: ❑No ( 1 Y P CC1���A C( Ct Y-J e 3. Service Type Ce �`�f p 2 6 Z ❑Certified Mail ❑Express Mail ❑ Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes i PSI 1102595-99-M-1789 v UNITED STATES POSTAL SERVICE Firs- lass•AA it 3 5 a. "Rostage&,Fees Paid •Pertmt No.G 10 w•- Sender: Please prinoLy address, arifP+4 rn this box'„ - - I 6 Sox ;L5T7 MaVs�tn.s ('Tt-is �� 62� � i 9 COMPLETE • COMPLETE • ON DELIVERY ■ Complete items 1,2,and4-Alsg complete A. Received by(Please Print Clearly) B. Date f D iv ry item 4 if Restricted Delivery is desired. ■ Print your name and address on the reverse so that we can return the card to you. C. Si at ■ Attach this card to the back of the mailpiece, ❑Agent or on the front if space permits. ❑Addressee D. Is ivery ad ress different from item ? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No �r t` 3. Service Type Y' ❑Certified Mail ❑Express Mail p C 2 ❑Registered ❑ Return Receipt for Merchandise LYl�2Yv �`� tyl 1 0 Z(o3 Z ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Ar ,PS F !02595-99-M-1789 i y UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • Town of Barnstable Public Health Division 200 Main Street Hyannis; MA 02601 Ir,11111ju�r11„I.t„tii, qif1l1111,Jill)-14141ril,11,1111141 r Date ®®0 �Peg AJ5-- GyiL.c,ta-�s � L Dear I am writing to inform you of our request for variances from the State Environmental Code Title V, and from local Board of Health Regulations in Ka ds to our new septic system which will be installed at M�7_#/& #jam/—� C- /¢SSEWAS /VAP •—M.3 A4AC— — .2Z-4 We are requesting a variance from A4. Z / `7� COIrJS 25,&OC,T Spa° 7-1 C S° 73 S"V1C r 6U2r All - f�•r .� �" ���.v�.�-�®ems ���a c.�r:�, ��`�� AGO-, � AQ`7 ,Sl,�/�edo 7' The Board of Health meeting will be held on MOAMAY, P F—A, I L at or as soon thereafter as practicable at the' Floor Conference Room, /1S T The letter is to serve as an official notification to abuttor(s). Sincerely yours, 44. ame Q:health\wpfiles\abbutor L February 2, 2000 Dear The meeting of the Barnstable Board of Health originally scheduled for Thursday, February 17, 2000 for which you previously received an Abutto-r's Notice, has been cancelled and rescheduled to: MONDAY, FEBRUARY 14, 2000 AT 10:30 am This meeting will be held in the first floor Conference Room at the School Administration Building located at 230 South Street, Hyannis, next to Town Hall. A new Abuttor's Notice is enclosed. Sincerely yours, rJosdeph' C:. Polcaro enc. t Op THE 1pw (� 1 DATE: 1 2 2'llr q, + sax MASS. E FEE: : b� % nsnss 9�p 039. 0g,, c REC. BY� wn of Barns able ti.�1rIEO SCHED. DATE: p F G 2 8 1999 Board of Health -0z6'rc "Joe- (gal al-v TOWNDFBARNSTABLE E�7 Main Street, Hyannis MA 02601 HEALTH DEPT. Office: 508-790-6`2 Susan G.Rask,R.S. FAX: 508-790-6304 ! ' Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION Property Address: Aj T &L L�S/,Q Al� Assessor's Map and Parcel Number: � Size of Lot: 1 Wetlands Within 300 Ft. Yes Subdivision Name: No Business Name: APPLICANT CONTACT PERSON nn Name: � W I LL I "I � Name: 0/OS. / 'O Address: AfL11 LA" Ak/tl4 C�11T Address: ��// �/�L✓`jQf/?i�/� 0 • ArWW11* Phone: � 3602 ��`D 3 Phone: FAX: FAX: S/L1i4-1-S VARIANCE FROM REGULATION(List Rey.) REASON FOR VARIANCE(May attach if more space needed) &0 Get /�'�� P�r�1v�s��ilir� � AE-4 Checklist(to be completed by office staff-person receiving variance request application) Four(4)copies of plan submitted(including septic system plans and/or restaurant floor plans) t� Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variances only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/leasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G. Rask, R.S., Chairman NOT APPROVED Sumner Kaufman, M.S.P.H. REASON FOR DISAPPROVAL Ralph A. Murphy, M.D. Q:/WP/VARIREQ NO. THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH OF , ,A�_ APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct � Repair ( ) Upgradc ( ) Ahandon ( ) - Complete System ❑Individual Components Lion Owner's Nan c NI P i 9 �i9 ('oc,l ?fit 27 1401 U`'�y i R, „11 vT�� &2G �n Map/Parcel H fddless a^ e Lot P v//a•/(J`,,"T't1ry{.I�cphoi e` Insstallet's Namc Deslg�crs Nam Address Address Telephone N Telephone H Type of Building: 'P&PdS� fl% 2� Lot Size �' Sq.feet Dwelling—No.of Bedrooms Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min. required). 3�,LD gpd Calculated design flow_3S'( gpd Design flow provided gpd Plan: Date 9`1 Number of sheets 7 Revision Date Title s r Description of Soil(s) "-0 C a/_ 30,134 V,_ .Pr Cl r1!y " e& ,S,9&, Soil Evaluator Form No. Name of Soil Evaluator , S/J d,9 Date of Evaluation DESCRIPTION OF REPAIRS OR ALTERATIONS The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued b the Board of Health. Signed Date Inspections FORM I - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 -----------------------------------------------------------------------.-- No. THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No. dated Approved Design Flow (gpd) Installer Designer: Inspector Date The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 ------------------------------------------------------------------------- No THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) an individual sewage disposal system at as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of this permit. All local conditions must be met. Date Board of Health FORM 2 - DSCP DEP APPROVED FORM 5/96 FORM 1255 (REV 5/96) H&W HOBBSB WARREN TM PUBLISHERS - BOSTON ! THE CO,1N O WEALTH OF MASSACHUSETTS FEE 0_e{ t 1 L BP O f EALkt +OF APPLICATION FOR#,DISPOSAL SYSTEM ONSTRUCTION PERMIT Application for a Permit to Construct ( } Repair ( ) upgrade ( ) Abandon ( ) -XCompletc System ❑Individual Components U-smd 1 N17� AtAur �I i a 1yS �= Location Owners Nance CAI? 'M PArmL Z� u��y �"„ �110 , M � a Mnh/,PaccrlAddress t K, �C. Installer's Name Designer's Nam -_,,. 2,00 MA Ivu s.T Am CQsWa Address Acldress Telephone H Telephone H Type of Building: PaPd 2w y*dzC Lot Size JR. q-4357 Sq.feet Dwelling—No.of Bedrooms 3 Garbage Grinder Other—Type of Building No.of persons ` Showers ( ), Cafeteria ( ) s Other fixtures _ Design Flow(min. re uired)��Q gpd Calculated design flow3�gpd Design flov�provided gpd .- Plan: Date �q Number of sheets Revision Date Title ^Description of Soil(s) Dt ii-0 �� t� b�_ rr C ��-/t/ " 0• SAN .. Soil Evaluator Form No. Name of Soil Evaluator -5;4V9 Date of Evaluation _ �b *" DESCRIPTION OF REPAIRS`OR ALTERATIONS "9 Y' t The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of ' TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date `z' Aw .»4 Inspection_s FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 r ----- No. THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Descript*n of Work: ❑ Individual Component(s) ❑Complete System r The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired( ),Upgraded( ),Abandoned( ) by: i. at has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as'Fuilt plans relating to application No. dated Approved Design Flow (gpd) Installer Designer: Inspector Date The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 r No. THE COMMONWEALTH OF MASSACHUSETTS FEE BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair ( ) Upgrade Abandon �( ) an individual sewage' disposal system at r as described in the application for Disposal System Construction Permit No. dated Provided: Construction shall be completed within three years of the date of tliis perrhit. All local conditions must be met. Date "'"" Board of Health F r DSCP DEP APPROVED FORM 5/96 FORM 1255 (RE\;5/96) H&W HOBBS&WARREN?M ; PUBLTSHERS- BOSTON V a 5=5360 mE 088 I, Anthony S. Scibelli, 76251 of Cheater in the State of New Jersey ,K 11 for tile full consideration of $1.00 paid N grout to M ark'L—Scibelli— I � of of Barnstable, (Centerville), Barnstable County, Massachusetts .a all my right, title and interest in with t1111fr191111 roorllatlfathe land►tax together with the buildings thereon, situate in Barnstable, (Centerville), Barnstable County, Massachusetts, described as follows: UBeing shown as LOT 21 on plan of land entitled, "Plan of Land in Centerville, Barnstable, Mass., Scale: 1 in. - 60 ft. Date: Aug. 21, 1973, Charles N. Savery, cInc., Registered Engineers, Surveyors, Hyannis, Mass." which said plan is duly a recorded with Barnstable County Registry of Deeds in Plan Book 277, Page 98. N e ro Said lot is subject to an easement to New England Telephone and Telegraph Company C ;� at al dated October 31, 1973 and recorded in said Registry of Deeds in Book 1964, ' e a Page 69. Subject to a Lien and Guarantee Revenue to New Bedford Gas 6 Edison Light Company dated January 18, 1974 and recorded in Book 199, Page 168, insofar i G as the same is in force and applicable. Subject to a water easement in Centerville osterville Fire District dated July 16, 1974 and recorded in Book 2087, n Page 37. rn The above described lot is conveyed together with a right of way over the ways shown on said plan for all purposes for which ways are commonly used in the Town of i Barnstable in common with all others now or hereafter entitled thereto. For my title see deed recorded with Barnstable County Registry of Deeds, Book 3924, f Page 173. I u, f Subject to a first mortgage hold by Plymouth Savings Bank, dated September 29, 1986 and recorded on October 2, 1986 as Instrument No. 72216. .a w w 0 o T,xecuted as a sealed instrument this f 29th fo tho S r STATE OF NEW JERSEY I aa. COUNTY OF ESSEX September 29, 1986 t AJ!/ 'Then peraonnlly appeared the above named Anthony S. Scibelli } + and acknowledged the foregoing Inatruntent to he hi frae a t nd deed, �: 1 (� ,�•?� B�0T17"e' L SL'LE A. 0'C0NNELL A Notary Public of New J�7`iey My commtuton expires Dec.-.2: 9pQ _1N ;A . .... t ���i;UkDEO.act zi a6 1 � 52129 P. ARTHUR WILLIAMS, INC. , a Massachusetts Corporation: having its usual place of business in Barnstable (Centerville) , Barnstable County, Massachusetts, for consideration of One k, ( 1 .001) Dollar, Paid, grants to R. ARTHUR WILLIAMS and 3F.TT'; i.. 1N, 1.1T1.].IA1'S and those people claiming hy, through or under 0 am by instrurient,� of record, all of its right, title and interesr and i.ncludins. any right of way in and to all of the land shown on a plan of land entitled, "Plan of Land in P.a: ,Isr.ahlr (fencer �:e) , Massachusetts For R. Arthur Williams and Betry V i.. 1••'i 11 i:.ms dated July ? 1984, _.drawn by -Baxter & Eye" and Irecorded in�Plan"Boo4: 386` Pal i and 28.es 2 'r, WTTNFSS 11HE1lrOF, R. Arthur l'i 11=:n Inc. has caused nctae presents to be signed, sealed, ci:ne- ,edged and �� deliverer', in irs name by P. Arthur. WiT amr, ir., r` .,,ident- arc' Treasurer, •luly authorized, this a�" day I,' .'u. 1986. R. ARTHUR Wr].LTA!'.;:, '^1C. r�l � By: ,7 L_ - 12- esrr. ur rri Preseri' R. Ar!•:lttr ., is m,6 Ireas rc'. COITIO UEA1.T11 OF '!.A '"'t o` SETTS F,arnst 111E e, ss. .H:1 v,�)3, :hen nersonally appeare !:•e above par., .' �rr.hur hi lliara:; arc' acknow]edged the F1.. ^oi inat. n^enT e the free a<:+. anti flecd of R. Arthur Tnc c c � , iv Crimmi ssi or, Expires ALGER Q SCHILLING ATTORNEYS AT LAW SSS MAIN BT.-T P.O. BOX 449 OSTERVILLe. MASS. n)Lr1 I. oxess•ooea IILUVII�' iUL 23 86 1 50OK5133PAGE 252 We, Albert E. Webb, of Iyanough Road, Hyannis, MA 02601, and Sandra Webb, of 350 Capt. Lijah's Road, Centerville, MA 02632, husband and wife, as tenants by the entirety, xxC*ftYrctttdYldO1NUAH1xxx in consideration of complying with a Divorce Separation Agreement as filed in the Barnstable Probate Court being Docket 684D-0547-D1 i grant to Sandra Wabl of 350 Capt. Lijah's Road, Centerville, MA 02632 with gtttttlaim CiYagnants the land irk situate in Barnstable (Centerville)Barnstable, County, Massachusetts, bounded and described as follows: NORTHERLY by Lot 19, as shown on plan hereinafter mentioned, there measuring Ninety-seven and 90/100 (97.90) feet; EASTERLY_ by.land now or formerly of R.-Arthur William!1at ux, there measuring One hundred thirty-nine.and 06/100 (139.06)_f,eet; SOUTHERLY by Lot 21, on said plan, there measuring One hundred twenty-one and_, 76/100 (121.76) feet; and WESTERLY by Cap'n Lijah's Road, so called, there measuring One hundred thirty- seven (137) feet. Being shown as LOT'20-and.containing 15,647 squnra feat end being shown on a plan of - l` land entitledt -"Plan of Land in Centerville, Mass. for Charles•'F.*Stanle Scalet 1 in. - 60 ft._Datet Aug. 21, 1973 Charles N. Savery, Inc. Registered Engines s Surveyors Hyannis, Maas.", which said plan is duly filed in the Barnstable County Registry of Deeds in Plan Book 277, Page 98. See Land Court Petitioner's Plan 38069. Together with a right of way for all purposes for which ways are commonly used over the ways as shown on said plan. Subject to an easement in favor of the New England Telephone and Telegraph Company et al dated October 31, 1973 and being recorded in the said Registry in Book 1964, Page 69. Subject also to an easement in favor of the Centerville-Osterville Fire District dated July 16, 1974 gnd being duly record d in said Registry in Book 2087 Page 37. (�y f1c'c' �f AIJC! (n e <N Ar f� /ji1 F j':' o�y Edtsr/tij �,r.nrydy�: 11u.s/,v/,u. /'va. GEa. 3lbuk For title,/deed from Albert E. Webb to us recorded in Barnstable County Registry of Deeds in Book 2322 Page 152. Executed as a sealed instrument this day of 1,41_y 19 44 }u�Z�iCll4! r�4r� Mile (Qonutton(neultil of ;Museatilusette Ss. Ao L SO, 19ee then personally appeared the ubove named /f��iPv� Ci Wlbh and ucknowledged the foregoing instrument to be /7/u' 4,Do Before ate. ,, Nowy Pahllr j lwN&r.(-,l,rd4wr My commisSi xpires Aja,�/� 3J 19 d'7 I i 'RECORD[U JUN 16 86 f' T� ao W PAGE 139 i I 18'78f; WE, R. ARTHUR WILLIAMS and BETTY L. WILLIAMS both of Barnstable (Centerville) , Barnstable County, Massachusetts., for consideration paid and in full .cons iderat-ion_of_Sixty Thousand ! ($60,000,00) Dollars, grant to KIRK DAVID WILLIAMS o'f 27 Haviland Way, Barnstable t(Centerville), Barnstable County, Massachusetts, with QUITCLAIM COVENANTS, a ceratin parcel of land situated on Hillside Drive, Barnstable (Centerville), Barnstable County, Massachusetts, shown as- LOT 15 onya plan of land entitled "Plan of Land in Barns tabl.e_Men-Lervi'Ile), Mass. for R. Arthur and Betty L. Williams" dated June 2, 1984, drawn by Baxter & Nye, Inc., Registered Land Surveyors, Osterville, Mass. , and filed in the Barnstable Registry of Deeds in Plan Book 386, Pages 27 and 28. I So much of said premises as are included within the sidelines of Hillside Drive are subject to the rights of all �r�^Illll�i persons in and over the same. mSaid premises are conveyed subject to an easement in favor of the Cape and Vineyard Electric Company, et al, dated June 30, 1959, recorded in Barnstable Deeds Book 1046, Page 75, insofar as now in force and applicable. 2�L._IIIII LL ��� Said premises are conveyed subject to an easement in favor Cf:li ) of the New England Telephone and Telegraph Company, et al, V dated November 30, 1984, recorded in Book 4340, Page 226. Said premises are conveyed together with a right of way in z~ common with all others now or hereafter entitled thereto over "" Hillside Drive, to and from Shoot Flying Hill Road, a public as conveyed way. There is also appurtenant to the above 0 Y Y PP � described parcel desc tb parcel a right of way over the reserved p rce as shown on a plan entitled "Lakeville Estates, a residential subdivision at Wequaquet Lake, Centerville, Mass.. developed by R. Arthur Williams et ux" dated December, 1957, drawn by Ed 3�evl ; Kellogg, Civil Engineer, Osterville, and filed in the ! Barnstable County Registry of Deeds in Plan Book 143, Page 133. P Said reserve parcel being located Wequaquet Lake, and said i 1� right to be used in common with others who are now or may ® hereafter be entitled thereto for beach and bathing purposes only. i Reserving to the Grantors, the right to grant similar rights of ways for land now owned, or hereafter acquired, by the Grantees and land of others. For title, see deed recorded in Book 5206, Page 179. i ALGER G SCHILLING I ATTORR{V{AT LAW •{{HAIR{T.- i 1.O.\OX OBTCRVILL{, MABB. � 0{BBB•0006 �I I L t anon 6212 PAGE 140 L _-----WITNESS our hands and seals this 15th day of Decemberj'� �I 1987.-- J. , _ _ ',j �7 'e J� �Gdnco Ca44ONWEALTH OF MASSACHUSETTS Barnstable, as. December 15, 1987 Then personally appeared the above named R. Arthur Williams and acknowledged the foregoin�i� str en t t V�behh' II free act and deed, before me I Po—a u lic ;I My Commission Expires: i I� I i; it i I� I' �� REC�RGEQ APR 1168 i i I l—_ 1 BOOK5206 F-1 E Zvi 9 I - i 52131 I'F, R. ARTHUR WILLIAMS and BETTY L. WILLIAMS, husband and wife, both of Barnstable (Centerville) , Barnstable County, tiassachusetts, for consideration paid and in full consideration �-of-FIFTY-FIVE-TliOltSAilp.-_(S55,000.00) DOLLARS, grant toLWILLIAII" j F. MICHOLAS--and 'BERYL..--S. -NICNOLAS,C'husband and wife, as tenants by the entirety, both of. 71 Peach Orchard RCAQ Burlington, Massachusetts 018n3, with QUITCLAIM COVENANTS, a certain parcel of land situated at Hillside Drive, Barnstable .(Centerville) , Barnstable County, ifassachusetts, shown as LOT 17 on a plan entitled "Plan of Land in Barnstable, (Centerville) , Mass. for R. Arthur and Betty L. Williams" dated June 2, 1984, drawn by i Baxter & Nve, Inc. , Registered Land SurvevorsI Osterville, Hass. , and filed in the Barnstable Registry of Deeds in Plan Honk. 186, Page ')7. So much of said premises as are included within the sidelines of Hillside Drive and Vista Circle are subject to the rights of all persons in and over the same. Sairi premises are conveyed subject to a fifteen (15) fnor riehi of way for the benefit. of Lot 16 on said plan in common wish the owners from time to time of Lot 17. Said promises is subject to rights of others in the "traveled way" a:; show-,! on said plan. `;aid premises are conveyed subject_ to an easement in f;tvor o!' the Cape and Vineyard Electric Company, et al, dated .'une 30, 1959, recorded in Barnstable Deeds Book 1046, Page 75, i.r.solrr as now in force and applicable. Sai.d Premises are conveyed subject to an easement in avor of the New England Telephone and Televraph Company, et al, datcc Nnvember 30, 1984, recorded in Book 4340, Page 226. Said nrenises are conveyed together with a right of way in common with all others now or hereafter entitled thereto over. Hillside Drive and Vista Circle, to and from Shoot Flying Hill Pond, a public way. There is also conveyed as appurtenant to the above described parcel a right of wav over the reserved parcel as shourn on a plan entitled "Lakeville Estates, a residential subdivision at Wequaguet Take, Centerville, Mass. develoned by R. Arthur Williams et ux" dated December, 1957, drawn by Ed Kellogp, Civil Engineer, Osterville, and filed in the Barnstable County Registry of Deeds in Plan Book 143, Page 133. Said reserve parcel being located Wequaquet Take, and said right to be used in common with others who are now, or may hereafter he entitled thereto for beach and bathing purposes only. Reserving to the Crantors, the right to grant similar ALGER O SCHILLING rights of ways for land now owned, or hereafter acquired, by ATTORNEYS AT LAW the Grantees and land of others. 999 MAIN [TR[LT P.O. !Ox 499 OeTL RVILLL. MASS. 7 aooK5206 P:cG 1W For title, see deed of Mav Cowan Crosby dated May 10, 1968, recorded in Book 1400, Page 12, and see deed of John F. Shields, dated March 3, 1958, recorded in Book 998, Page 104. __�-- WITNESS our hands and seals this-23r`d day of July R. ARTHUR WILLIAMS i COMMONWEALTH OF MASSACHUSETTS Barnstable, ss. July 23, 1986 Then personally appeared the above named R. ARTHUR WILLIAMS and acknowledged the foregoing 'instrument to be his free act and deed, before me ar u i My Commission. Expires: CANCELLRD 1.1 RUk tij jUL 23 86 f s . i At E B=512&AE 282 39745 ;.j I We, R. ARTHUR WILLIAMS and BETTY L. WILLIAMS, husband and it E wife, both of Barnstable (Centerville) , Barnstable County, Mass- achusetts, for consideration paid and in consideration of ONE HUNDRED THIRTY-ONE THOUSAND and 00_/100, ($131,000.00) DOLLARS grant to DANIEL D. DODGE and ANNE MARIE,DODGE husband and wife, both of/L!2 • 1— racn, Barnstable (Centerville)? -Boarnstable County, Massachusetts, as tenants by the entirety and not as tenants in common, with QUITCLAIM COVENANTS a certain parcel of land together with the buildings and improvements thereon, situ- ated in Barnstable (Centerville) , Barnstable County, Massachu- setts, and shown as LOT 18 on 'a plan entitled "Plan of Land in Barnstable (Centerville) ; Mass. for R. Arthur and Betty L. Williams", dated June 2, 1984, drawn by Baxter & Nye, Inc., Registered Land Surveyors, Osterville, Mass., and filed in the w Barnstable Registry of Deeds in Plan Book 386, Page 27. So much �• of the premises as lies within the sidelines of Vista Circle is c� subject to the rights of all others now or hereafter entitled thereto. Said premises are conveyed subject to an easement in favor of the New England Telephone and Telegraph Company et al, dated November 30, 1984, recorded in Book 4340, Page 226. Said premises are conveyed together with a right of way in common with all others now or hereafter entitled thereto over Hillside �. Drive, to and from Shoot Flying Hill Road, a public way. There P. - is also conveyed as appurtenant to the .above described parcel a right of way over the reserved parcel as shown on a plan en- titled "Lakeview Estates, a residential subdivision at Wequaquet Lake, Centerville, Mass. developed by R. Arthur Williams et ux" dated December, 1957, drawn by Ed Kellogg, Civil Engineer, Osterville, and filed in the Barnstable County Registry of Deeds in Plan Book 143, Page 133. Said reserve parcel being r located on Wequaquet Lake, and said right to be used in common ALGER A OCMILLINO ATT011N tTt AT NW tat MAIN aT11997 Page 1 of 2 P.O.SOX AIt OaT[RVILLa.MAaa. catst•oota 1 I t ' e. BOOK5126PACE 283 with others who are now, or may hereafter be entitled thereto for beach and bathing purposes only. For title, see deed of May Cowan Crosby dated May 10, 1968, recorded in Book 1400, Page 72, and see deed of John F. Shields, dated March 3, 1958, recorded in Book_998-,_Page_10'"44. WITNESS our hands and seals this r 6 day ofif 198b• -- -- _ R ARTHUR WILLIALK� _v,(iLc UGC.tnGc BETTY/L. WILLIAMS I i i COMMONWEALTH OF MASSACHUSETTS i Barnstable, ss. �V 1986 `Then personally appeared the above named R. ARTHUR WIL i L- IAMS and acknowledged the foregoing instrument to be his free act and deed, before me Notao Public My commission expires ALDER O.CNILLINO ATTOYNYY.AT LAW .e.»AIN eTee[T Page 2 of 2 O.T(11YILLY.NAe.. RECORD JUN 1186 oa.ee.00ee r Kirk D. Williams c/o Leroy N. Cobb Jr. 47 Hillside Drive Centerville MA 02632 Daniel D. Dodge 15 Vista Circle Centerville MA 02632 v Walter P. Christian rIPA6.q 5 Vista Circle WA- P. AS d" Centerville MA 02632 FYI. S .NtGNo�!-S " /Mark L. Scibelli _►• 336 Capt. Li j ahs Road 14JAAs4• Centerville MA 02632 Sandra Webb CA 350 Capt. Lijahs Road A4484 Centerville MA 02632 'E ly9 M•A�-,fig Is5 BARNSTABLE, MASSACHUSETTS ASSESSORS MAPS <�O e � 2 oP°v , / aLIYT•Y O 111 �yr,,M ,�. 1 3.39 tc ?o �',l0 65. 234. 11 (7 yd1►C/ d! M•- '• 34r.4. m i• 111 Y �{{ p �Os w u Is v 15 .61 AC on �,r 38—.r rw a �tr1/ �C 1 sty' 'fie O ((bvb r'Cwvo wSq) '414e ,J238 7Zwer cl ° c '4 0 39 /J- . .3S /9 .I)4C O n 17, ,O ,33 4C Z,iZ •� J o ® `yam fv 0, 29 .20 AczeD cc I r ?Z j' 4 1t r � • � O/u 9 ¢6 % 'SAG ZR$ QP P ✓• S i ro ? e► O ,p3 y °oJ _ .y0 39 ,p but&, Vf PI 9 0 44 7 t y \ 9 .I/t O p4LMaNT ZQ7 �6 Vo .f LIZ trg O %I ors" • 4 ® • 1 L Js .L O `y 9 .47qcp p qC ?sQ J o © WEOUAOUET AL 11 \® � r .S3AC•5 � ® Q Z 19 ,. `axft ® So �s Oy , Z M► A\ �u• AT, 2fl , SO 45 t,6 d , L\� 57.E bl 7a711i 21S s ip 74 y 4 9L •1 WA _ L', �J © 42 /00 © O .p1 AttM4i 49� �.p f �3 Za1 w V ZDo O 220 S6 LOv •7n urur► IS'4a� d 21a i SO.wC �J 43 ac 24 lt-2 R-'s A .40,, .68 t°'rW yO : o $ .47 AC ® ® ® , tp a9 2 45 •4S Ns.V 7tiwL 'd .724, �. �74a •.IA 7a S9 /.OS 1. .J1nc J1ga 7/ °q 4a1 p •>S.k y22. 7 d N AS IAN6 Q• t 0 x •��o` a 226 � L2a © r 46 lI APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS Uis_& LOCATION LAKEVIEW J! = 3 �� ` [�� NO. �7 VILLAGE CENTERVILLE DATE APPLICANT R. ARTHUR WILLIAMS, INC. FEE 9-35.0 ADDRESS # 2 OAK STREET. CENTERVILLE TELEPHONE NO. 428-5217 (Non-refundable) ENGINEER BAXTER & NYE _TELEPHONE NO._428-9131 DATE SCHEDULED JANUARY 8. 1986 0930 'A (Applicant' s signature) • • • • • • o • • • • s o • o • e e e e o s s o o • • • e e o • o 0 0 • • • • • • o • . • o • • • e • • • • o 0 0 0 • • • • • • • o • o • • • o o • o • • • • • • SOIL LOG SUB-DIVISION NAME LAKEVIEW DATE JANUARY 8, 1986 TIME EXPANSION AREA: YE5.ANO v��V AtA �.Q� ENGINEER 't TOWN WATER_2L_PRIVATE WELL ���/(LI� � BOARD OF HEALTH ALFRED FUT.T.F:R EXCAVATOR SKETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) \ �Z� NOTES: L LoT�S Slo? 71 PERCOLATION RATE: Lz.V-k Ly0 ?HQ_ t VVGfA TEST HOLE NO: ELEVATION: TEST HOLE NO: ELEVATION: 2 LOA ." 2 2 4 � � 4 - 5 C 5 8 8 9 9 10 10 12 K6 t1 Z 12 13 13 14 LI S& - 14 I 15 1�- �Gl( FO 15 16 QTP_DL 4� 16 SUITABLE FOR SUB-SURFACE S , AGE: LEACHING FIELDDLLEACHING PITS LEACHING TRENCHES V_ UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS: KI Y^T- i NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P. E• AND RETURNED TO BOARD OF HEALTH COPY: RETAINED BY APPLICANT PAST_J� R 15 �Ll ^1 Srit._ tY� � .bNy Ga e�Dt+TD P \ r�Y MAP .. ^OI:L��/PaCE.`,�._' `s. / D4v5D w.Aar Li �p _ ��ay.A noV so.oai�.. .- -� - 4 I ,� a pp p Z oe 5'�'Zo'E+ �P D.Mc AyP Q/_S.De..?:..'i Z,—1?c v P°rG g 1 4g9n a Q. La%-'o •• �. - I I / AV1q•,Ay te'yyCTNq Mr.a w•9M ,lDo' 7F cyp I I/ / wN.r T Nf.LELE/CmAe A-- +4'�.w.3.u.MMV '*c,..rr.. + ./ T�.crcz L4FiJDAu c.occ, i 5:,6 pie c \.A ow.o.Sn• R. ' a• S C .1. f - �� 7 �< I Z S w �x'�. /IA�� \\` 2+o.v Z' ., E d��. `• � N�Ey REryE 6.,ue Y.o%+rs•� -"Y� �� ��, - F '� I4.C>;ySF\\ IT' 10 ➢� ne.�. .S i'1�DeeTPs... /a"`wec 7 3 d C off. Itt Z.dc•� qa..l -J . - eeA "'6ee ac"TMr F 7� ES,ID6 IF Co. z IQ dI �-18.5-tS k:r. 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T 1 O O O r LU in BEDROOP•1 #2 (���J LINEN W Wco m 1� — — -� MASTER & SKUttLE I W�� i0 BTTIC EDROOM o AND. 2446 - 2 , [01 . OPEN 70--� ——— ——— AND. 2446 tr r LBELOW INE OF CEILING-C IP ABOVE —__—� r_—_—___ —_--_ C4.A O - -_ . --- - -- __ 4' KNEE WALL D. 4424' _ bND. 2 21 I —`—r..—._:. SEAT :_ - ___:- -- •-— — = - W FLOATI DOR ER _ — . CTN26-2 - - 28310-2 _ Q - - J -I oc lL tu 7'-O" ------- 20'-0'- --- T_Or 34'-0u Ib'_Op F SWEET SECOND FLOOR PLAN AA , SCALE: 1/4" 1'-0" JOB: 0101 DRAWN BY: K,W DATE: 2/19/01 50'-0" —4-8r 12'-4' II'-2M-- -- --- a ® Nm ' DECK O — — ND. 2432 ANDI 2432 . 6Q a LITE - - ® 2b tc s DINING KITCHEN 00 A N/ AUN W W U � U -- 23-2 3'-4 3'-6' 3'-11 0 3 5J2 o m_ AND. 2446-2 ISLAND > 1-FLD .cV REF. p Ir O i 2� ' - 2� �' N'�� 20 FIR AND. 2446 (3) 9 1/4' LVL's ABOVE FLU5N ON 1� RAT GARAGE -—-—-—- -- - CONCRETE 5LAB h 4'-0" R Q PITGN TO DOOR . LOS tV h o - .LJ Oi I IN �' BI-FLD 1 iv Is BEDROOM UP 12'-b' LU 7'r9' O.N. DOOR y 3 Q 2 Q. 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' . . with`DRtLL'HOLE : �A I,..... ,I...I III: . : o . M , . - I.A�.1�.1.�.. ,.�...,1�.���.�,., N13*52 24 E FOUND I II,I.+a.-I...I .I 1.1I�:�I I.�1).a��.' .�.1.1. -/. 1 I l�r.��.4e Ik�I,p.-. .I.1-1-....,I I1.�.I�,1I.I.-.���1� I..I..III-,I..-.�� II I I�..II-I I I 1 I..I�.1 I..I /,.I I-1.�I . �° • . . ; j ' 42.42. - • ' _ t Q . - _ : i - .. ,� `. , -t� . . - `���- ram,. `. . . / . '� BENCHMARK ,� > �c. - , . CONCRETE BOUND - 1 � . / J Q _ . 2 : P - . / . with DRILL HOLE Q� . ,�` t< FOUND 4F. \Q� , . J` ELE V.=50:00 . • 7 ,� LOT16 fti F AGE .2 I ; 6A . P - 0 386 � ,, 18,955 S.F. f ,:�' jd1- . Z ooK � s . N B ,: �. : LOT 19 PLA r , 1:. ./� ��� - . . . o .�o LOT 18. .. t to , , . . ` Ir � . ,: 1 -A . Y ,% . / Q l ! .. .. . �O <. io' M N. :.' .: LOCUS MAP . 22 t- 24.d x . 3 ;'' Aa o 54 SCALE: 1„`2000' . _.- , . E I E . :`' GARAGE :. - .. ,° ' CLEARrN p co . ^5'.' -� ' Q r`" . N - �, o W 2�5 �23» h ;.:.. p. 11 1. E �cO . : I. �"A . - 4.0' i ''JPp DE U-POLE 11' I. io `�L , 0 1' -- SEO. �R! Y W #1600/1 . w . V N . �; - "" .15. LOT 20 o • . . U'- ° 4 D , EbCE of Rj. . of W • W . - . . � PROPOSEO '• .. �� •� Y A . HOUSL . f b� k A . FF=52 0 o . 4 HIGH CAPACITY INFILTRATORS '-__.._/ .-'/ x ,` � - 1 ­.� 4 ! _ T 1 WITH 4 FT. OF STONE ALL AROUND ,% 111 m A, QO � L0 2 : AND 1 FT. OF STONE BELOW. �� Q 52't ' ._. ', QQ . � Z z 10',-`: MIN. 1' CONCRETE BOUND - SURFACE VENT LOCATION TO - " __ with DRILL HOLE :� CONCRETE BOUND � a 1500 GAL. � / ,r / FOUND".. BE DETERMINED INFIELD. a .. 8 .` � ,, V„ with DRILL HOLE r^ G SEPTIC`TANK I . � S . • FOUND () V/ 28. z .,. _ . ;- N Z ,z -e - LOT 15 d _ ,- ------- `. . _ LOT 17 VISTA CIRCLE -­ 10 MIN• 33,0- � I . r 19't"' O .. - ___�---'' - _ j s 42 ca , fy,,,,,,, o ,Pz , . . . I i _.._ + . . , �� . _ , � _ : Ad` (off.- _ . CONCRETE BOUND ,-- ~ ����� with DRILL HOLE LOT 22 _ -- o h . ENCROACHMENT THE' CONTRACTOR SHALL EXCAVATE 5' ALL AROUND _ ..--- _ Mj ` \ GRAVEL DRIVEWAY : FOUND , . THE LEACHING FACILITY AND DOWN TO THE MEDIUM SAND LAYER " -- .___-�- h -1 .,: ^raw` �. /w � \. � _ 4 , . LAYER C4 IN TP #1 & LAYER C2 IN TP #2. , ,;.}- _ "/ / - f _ REMOVE ALL UNSUITABLE MATERIAL AND REPLACE WITH �: -_.__ `- -------'--`--- _- ! CONCRETE BOUND CLEAN GRANULAR SAND CONFORMING TO THE SPECIFICATIONS .-..._ --.- - BENCHMARK with DRILL HOLE SET FORTH 7N 310 CMR 15.255 (3). �._-1 �- �:._._ r \ FOUND LNG V., CONCRETE BOUND . `�` �p with DRILL HOLE - -: F G FOUND ___ Q, O ELEV.=28.69 G_ CONCRETE BOUND` Fp . .with, DRILL HOLE R4 t S13'S3 23 ,-' _ -_ - - -- - FOUND - �..•- 71.2 U-POLE . _" ....� � ., _ c 8 2/24/00 REVISIONS REQUESTED BY BOARD OF HEALTH .TMS U-POLE - _-._.-.___•_._..... G "---- - # 573 9 . -# / . • . DATE DESCRIPTION Drawn Necked I . - f . DRIVE 1, ; f (PRIVATE '_ 40' WISE) R E V . S N S /'HILLSIDE, 1 ; PLOT "PLAN v .ti , Y N. - . - _ ;` NT OF PROPOSED SEWAGE DISPOSAL SYSTEM M - OF PAVEME . EDGE - PREPARE FOR •D 0 - ,.. NOTES - JOSEPH POLCARO FOR LOT 16, HILLSIDE DRIVE p 1. '`HOUSE ,NUMBER: 55 �- VARIANC : IN .. ES REQUIRED. -. , o6' 2. ASSESSORS NUMBER: MAP: 193 PARCEL 254 - - CENTERVILLE MA 3. ZONING DISTRICT. RC BARNSTABLE 81 _ 1 10 M - _ _ 1, 4 ) 3 C R 15.214 - .30,000. S.F LOT :FOR , 1 . FLOOD_ HAZARD ZONES. C GRAPHIC SCALE . . „ ., . . _ OF REc , A 3 B b 0 I 1 5. BENCHMARK: . SEE `PLAN E R OM SYSTEM. .ACTUAL SIZE , SCALE: 20 DATE. DEG. 22, 1999 . OF LOT iS 18 955 S.F. , zo 10 0 = f. T P P .- 20 s o / AEL f3 - .._ , . . , 0 OGRA HIC INFORMATION COMPILED ;FROM AN Q Cn eS art 'C>'1 C I'CI, ICI C �' ;= �I� TH � • _: 2) ,310 .CMR 15.22'1' 7 TOP -OF SYSTEM SHALL BE 1, _. ON THE GROUND INSIRUM NT R C ) , • , P�L.IVI � � E SU VEY civil en ineers and lan surve rs cI�,L NO MORE .THAN 3 `FT 0 9 Y'o : , 7. BEL W FIN SHED GRADE. ... �.w ELEVATIONS :SHOWN ARE: BASED ON `TNE- NA ONA r ,�1s ,- T> L a• >Ir> > : . 200 main street 508 548 3564(PHo 1 ACTAU PTH T .L.DE BELOW FINISHED GRADE A.>, . . GEODETIC VERTICAL..DATUM. i uicn 20 . rl , Cr : , HIGH POINT IS 5 FT. a mou ma. 02540 508 : 548 9672 FAX 8. R R N EFE E CE PLAN BOOK 3 6 P _ 8 AGE .' 7 .-, , • , ,. TM , DRAWN. s : CHECKED. . � - . : . .. • 99502PP.DWG JOB .N0. 99502 DWG. NO.:" 74-1-27 SHEET 1 "OF 2 I. I , • , - _. , .. , Finish grade above and adjacent to system shall slope away at a min. of 2%. 4" diom. cast iron. or Schedule 40 PVC pipe (tight joints). DEEP OBSERVATION HOLE LOG NO. 1 20' min. distance (building to.edge of leaching system) OTHER SOIL . SOIL TEXTURE SOIL COLOR SOIL (slsuclvars. 10' min. distance DEPTH ELEV. HORIZON (USDA) (Munsell) MOTTLING Sim om THE CONTRACTOR SHALL EXCAVATE 5' ALL AROUND THE LEACHING FACILITY AND DOWN TO THE SAND LAYER. 0" 40.0 First floor REMOVE ALL UNSUITABLE MATERIAL AND REPLACE WITH Elev. = 52.00 4-Removable covers ithin CLEAN GRANULAR SAND CONFORMING TO THE SPECIFICATIONS 39.5 D/� gg of finished grgde rif Necessary) SET FORTH IN 310 CMR 15.255 (3). Accesg Holes.irT Tank to be 20 in Diameter 6=14" 38.8 B SANDY LOAM lOYR 5/8 i Dist. box 14=28" 37.7 Cl LOAMY SAND 10YR 7/8 28=48' 36.0 C2 MEDIUM SAND 2.5Y 7/4 s=0.02 s=0.06 2' s= VARIES Clean Bockfiil 3 lev.= 41.3 tnv. level 0.08 MIN. 48=60" 35.0 C3 LOAMY SAND 2.5Y 6/6 5Z' GRA NFL r i ! MAX 2" layer of 1/8" to _ 1/2" washed stone 0"-120" 30.0 C4 MEDIUM SAND 2.5Y 7/6 a N SEPTIC TANK " Foundation + 1500 GAL $ � 4 ft. of 3/4- to 1 1/2" washed design A stone all around infiltrator and by others >y o' p i e N 1 ft. below. Elev.= 39.06 0 DEEP.OBSERVATION HOLE LOG N0. 2 > H-10 a v c _c' c' 11 t SOIL SOIL TEXTURE SOIL COLOR SOIL (OsnaTclu M, 6" LAYER OF CRUSHED COMPACTED STONE - Bottom of Test Hole Elev.= 28.0 DEPTH ELEV. HORIZON (USDA) (Munsell) MOTTLING' sTa s.9MIL S, PROFILE 6"' LAYER OF CRUSHED 'COMPACTED STONE os�siorcr.sau Not to Scale 0" 40.E O'-4" 39.7 0/E 4"-36" 37.0 B SANDY LOAM IOYR 5/8 GENERAL NOTES "-50" 35.8 C1 MEDIUM SAND 2.5Y 6/6 1) No change to this system shall be made unless SOIL TEST 0=144" 28.0 C2 MEDIUM SAND 2.5Y 7/4 GRAVEL approved in writing by holmes and mcgrath, Inc. 2) Subject to inspection during construction by the �►1I+,1 CRITERIA Date Of Soil test: 12/16/99 Board of Health and hofines and mcgrath, inc. DESIGN CR� 1 GR�A Test taken by. S.SILVA 3) Heavy construction equipment shall not travel Results witnessed by. D.MIORANDY over disposal system during or after construction.4) Percolation rate: <2 min, inch Disposal system to be constructed In /'accordance Number of bedrooms: 3 Equivalent to 330 gal.'s day with Title 5 of the State Environmental Code. Garbage disposal unit: No Ground water NONE ENCOUNTERED 5) A copy of these plans must be kept on the site during the time of construction. Leaching area - capacity required: 330 gal.'s/day 6) A copy of,these plans must be fumished to the Side. area proposed: 168 sq. ft. contractor constructing the disposal system. Bottom area proposed: 357 sq. ft, 7) Before backfilling, the contractorshall notify Total area -proposed: 525 sq. ft. r holmes and mcgrath, inc., and the Board of Health Proposed leaching capacity. 389 gal.'s/day INSPECTION HOLE INSPECTION HOLE Agent to inspect the system as constructed. 8) If the contractor encounters any variation between Water supply Town ' the existing conditions shown on the plan and the Precast concrete units: H-10 loading design conditions encountered on the site, or.any soli condition different than shown on the soil log, or any adverse soil, the contractor shall immediately 16" contact hotmes and mcgrath, Inc. Holmes and mcgrath, inc. will examine the soil condition 11" and report to the owner any suggested revisions. 10' -6" 34" V-3" ' 3-20" Diameter Access Holes /^ \ ALL ACCESS MANHOLE COVERS FOR TYPICAL HIGH CAPACITY INOLTRATOR tH 20 LOADING INLET `. \ ` OUTLET SEPTIC TANK, DISTRIBUTION BOX, NOT TO SCALE \ \ AND LEACHING STRUCTURE SET MORE THAN 6". BELOW FINISHED GRADE, M SHALL BE RAISED TO -WITHIN 6" OF NOTICE ' IL FINISHED GRADE WITH RISERS. Unless and until such time as the original (red) stamp of the ` -7 !77 -7-7'7 responsible Professional Engineer, or Professional Land Surveyor FRAME do COVER appears on this plan: -STEEL REINFORCED PRECAST CONCRETE OVER "T'S" WHERE REQUIRED. (A) no person or persons, including any municipal or other public officials, may rely upon the information contained herein; and PLAN VIEW (B) this plan remains the property of Holmes & McGrath, Inc. PRECAST CONCRETE REMOVA LE COVERS 3" TANK RISER WHERE 3- REQUIRED DATE DESCRIPTION Drawn hecked • - 4 INSTALL TUFTITE SPEED LEVELERS ' ALL OUTLET PIPES FROM THE ON ALL OUTLET PIPES R E V I S O N S 150 3" min. clearance required INLET DISTRIBUTION BOX SHALL BEINLET2" mina Inlet to outlet E SET LEVEL FOR AT LEAST 2 FT. 12 CONCRETE COVER - OUTLET ;", E c PLOT PL AN LAN DETAILS / E 3 - 5" OUTLET 2" S. -7- p Liquid level L 5' -7" `� :: KNOCKOUTS PROPOSED OF P POSED SEWAGE DISPOSAL SYSTEM n , o TUF-TITS 15.5" INLET 12" : v GAS BAFFLE ' J OUTLET . PREPARED. FOR JOSEPH POLCARO 2� 16, HILLSIDE DRIVE FOR LOT . ... .. 10•-0" 5. _8" IN 15.5" 1.�5• CENTERVILLE BARNSTABLE MA C_--SECTION END--SECTION PLAN SECTION CROSS-SECTION , 3 HOLE DISTRIBUTION BOX SCALE. AS SHOWN DATE: DEC. 22, 1999 TYPICAL 1500 GALLON SEPTIC TANK NOT To 'SCALE holmeS and mC rCtth, Inc. o GcCii NOT TO SCALE - -civil - . g CIVIL _ engineers and .land surveyors � 200 main street falmouth, ma. 02540 DRAWN: "TMs� . - CHECK 99502DET.DWG JOB NO: 99502 DWG.- NO.. 74--1-27 SHEET: 2 01` 2 . I • z- le icy `u A � G O� C-0 o C7 Q a to m n E p� < I eok-On 5'- 4" i 7'- On Drop foundo4 ion &" for W}bulkhead 1 1 , ------------------------------------------=--� ---------- ---------------- 1 . -------------' -._ ----------------------------------------------- I 1 , � ; 2XiO's 2 iOs 1 0' t " l !v"oz. 1 1 , i to o.G. t 1 ' 1 ' O ' 1 7'- 4" 7'- 4" 7'- 4" V- 4" 7'-- 4" 1 1 1 --- ------- -------- --------------- 1 1 co V i Gd"x fd'bLam �i/ x t O's eon x eo"bdam N 1 I N 1 1 2 % i O'•s ---------------------------------- r 1 t m t --------- ---- --- -------------- L---------------------------- - 1 1 1 1 L ---------------------------------------------------------------- ' .. 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Hwk a+'�vsnfisd drip sdrys T.O. !nd Pl oar ..1 t/ 1 7/4•x 1 1 7/O•)-vV*lw I x It Pins firnn tfiyPJ w/.biefi-hwn'sra i x 1 O i`Iser Jeiafia• 1 G'e.a .O. 1 afi F4 Wall !1 {{��` •p v 1/4" A! V 1/t xG 64wPbewrd(fro"+eny) N oR y Wb owsrvea IFAIAncs of houas \ V Ty`iske heuaswrAr(fiyr.) �+ < f/t•OtsbTM Qwafi" X 0 0 !x 4 b#ud w At:• 9 I/!•I+,aulAtwn•)e.- 1 b t4yrJ � � L V 9/4-T.f4 474+b auMoor ^ p� r 'lusd wndnw�sdl fiyP. LL ^ (v\. b f/!•inau)wtion r--f 9(+"j t x f O f`lesr Jeiate• f G-e.a !x 10 t9oor Joi4+*• 1 G•e.& To'-11 1 9�/4'r J t xb P.T.tiudail t#yp.) MAO` 1!a mudaitt wnafior(fiyr.) T O.t'oundwfiion b•x 714&•roured cencrsfis foundAfiien 9/t x 1 t'a jrF A4rM+fowA44,lwn+safer ..j W 0 ! t/!•m+Feed/usw�s�rF aurrerF 9•rowed uoncrsfisali A4rhAt'sKnifea 1 = t'-G-x t roursd uancrs}s foofilnoj W.G. 07"/W. -' ---- Q 4 1/9 I xb coI Ar file+!4'o.e, 1 ItGDX rywood 1 G•x 1 O•poured cancrs}s fsetn+�j \ b 0.f oundA}u n / " I O"In yulAi wn• -90 Oyr.) It ' z • 1 !xb usilin�j JoNrfia• 1 G"o.c. � C V I C 1%•! Pins trim(fiyr.) , N �' rlwafisr<fiyrJ � � M 1 r/!•�.ir+rats ,' .. O � � b 1/!•H.v.inaulwfiiee•�-9 0(fiyr.) O cefihsdrAl csifm'a only Nick•+ 9/4"T.f 4 OFlbti''+aubf lour(fiYP) � • f++vsnfisd drip sobs(fiyr.) t x t O floor Jo�afie• 1 G"e.u. !x 10 floor Joiafia• f G"e.c. Q K f x•! Pins firrm(tyr.) ( ] 0 { v m f/t xQr UArfsowrd(front only) - (Wa 41lin4l"bA AIWa of hours) /s•Otob�'+aheAthin�j /► t x44fiud wail• I G'o.c.(4yr.) 9 r/t`h+aulwfibn• Jc--1 y(4yr.) 9/4•T.14 O*abTM aulrFloer oyr) 5 r/t Inauiwfiion• R--r 40 tyP•) LA !xG P.T.)yudaill(#yP.1 !x 10 floor Joia4'4i,- 1 Gr"o.o. t x f O floor JoNrfia• 1 G"o.c. MAP 1!a"Achill An4 wr 0-yr.) a� \O•x 7'b•poured cenursfis foundation � w4 i r-,rhAlfi fom&U4r en"Aar j 9 1/!"6i afissl/usmsnfi aurrorF !OLl�'iOn[�1'AW IIlAj4 i 9•rowed conarsfisatal► !'G"x !'G•'roured aoncrefis fooFinj IJ r G"x 1 0"poured cencrsfis feefih+j IS 1 a A 1, 0 h4 00 `jGale: 1 /4" = t '-0" 3 � : y_ W z `o c s+ 0 s cc IL mw + c aL � i ------ _ -------=-=-------� .. -- ------------------------------- � -------------------- -- ------------------- --1---- - L------- -1 J t r5i-e-V t �ot.�T f� �'- GAT T �l . t.�oo Gal e: 7/ i lo" = i '-O" V Z � � c W � N M Q o � V m o � � a r----- -- -------------- ------- i ——————————————— -----�i ------ ----------------------------------- L----------__—.__•—_—=— I------ —+- ----------------'1 L-- CID p < FLIP- et^CVATtoN �-u 711 ��h5oo / t to , �IdEj6 Vant (Zoof rsinforGing h+ron, -+At4e.,J4-r,-sm?nWy T.O.1W1 s 2 x 4 htub rafters ' o Item: DssGrip+ion: Q ,24sphalt shine�les '� °� Pottom Cord 2 x 4 continuous.member nailad ti'ide tioni'ars 2 x 12 continuous mambar nailad+hrcueh 1. o t ---_ I x Dollar tie- ? 3 +he sida alon6+he+op 4 bo++om+o the +op t /2" GDX plywood �'rft Q 4 1 /9 4 bottom chord units 12 z Top!.horde 2 x 4's solid bloekln,�snu.�fit ba+waan+ha ridge hee,in ion note, t 2 2 x 4 stud wall support a i G"o.c.' -support studs -,fella+ [7 leiGng,joists S xbs continuous members wall nailad+o+he front and rear rafters. 1 0" In-WIA+ion • 90(typJ � Af+ersa++ins side members,using temporary-Support--,,raisa+he Gan+er `� 2 xb Gsilinei Kok+i. • ( moo" o.G. - - ��, -j',O.2 nd.{=1,lA/all of the-,panto install a positive I/2" Gambsr in the unit and than install t 7'-9" -,nug top chord blocking.Af+er fully nailing 4-ha 466ambly.raleasa+ha temp- ' OrAry-wppor+s. - Air space 2 x I O rafters • I fo"oz. ' t /2"plaster(+yp.) 8 r /2" H.D.insulation• j�-9 O (typ.) cathedral csilinais only 9/4"T.44 OhP-s.ubfloor (glued and nail") +yp. Hick`-s.TM vented drip ad9e T.O. 2 nd Moor 2/ I 9/4" x r f 7/8"L�/t '•sTM 2 x t o Ploor (oi5,+s • t !o" o c. 9 -& r 2 11 x+2 pins 4-rim(+yp') w/,Joist-hangars T.O. t st M.WAII r 8'-D t /4" r /2 xlo clapboard(front•only) ti CMG shineilas balance of house ti Tyvakdq hvusawrap( typ.) r /2" Oyl7r+-shsa th in9 ; i h � y y ti y 2 x 4 h+ud wall • I eon o.c.(typ.) ; ti 9 I /2"In-sulation •j'-- 15(typ.) h y 114"T.44. Ohh s.ubfloor Z ao y (e)luad and nailad) typ. N y T.O. I st.floor " u n i 9 (t ) " " 0'- r t 9/4" 5 I /2 In latio j-- yp 2 x r 0 Floor jokt-s• t to o.c. 2 x t 0 Moor Joasts• r !v oz. � 'A M 2 xlo p,T.Mudsill(typ.) T.O.Foundation MAP 15 mudsill anchor(typ.) O \ Z 9/ 2 12's ep"x 7Yo" poured roncreta foundation x 4 in \ Asphalt foundat ion scalar O < X "n m 9 t /2" d�steel/ umant-support � p I"poured wont re+e Slab CL 2 x4 h+ud support-wall 2'-e0" x 2'-4V poured aonzre+a footing h V.foundation r lo" x r O"poured concrate footing 2 x4 solid blocking between studs \ \ \ Gontinuou-s 2 x r 2'-s A- c Gontinuou-s 2 x 4 plate A,4 o t Gale: t / 4 " - t '_o" r��" ct •ki Gontinuou-S 2x8Geiliong.joists q ci CA'4'[_E '` s � Y 3595 T�f�f 9Volid blvl-Wng between W e\ m ,VUPPOr-T WALL I-7r,-F cIL o �