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HomeMy WebLinkAbout0135 HIGHLAND DRIVE - Health 135 Highland Avenue Centerville F/R A = 190 057 UPC 12534 No. 2�153LpR aDo5t.G0�J�� HASTINGS, MN Do s � a Y6 b ' y � e K. mow, r '' .y ;y yr x . , .. y•_ i W s JI •� ` � . =�� }'a�.� �'� �'� ��. ,°:o-, ����' �u '�` � 4� s r.'a b' fir' ' �.. � r's= }"iz a , .•�.: e "! '' 44 �,,, $ q. � Et. q��k •u$. ,,, ' .. r ., a. �' ��s �, r.ti e:�'h� A . 4> ._1 Town of Barnstable Health Inspector FtHE Regulatory Services Office Hours o �ti g. y 8:30—9:30 �.� Thomas F.Geiler,Director 3:30—4:30 RARNWABLE, Public Health Division M 1639n.�A � Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT.— SEPTIC QUESTIONNAIRE Date: June 13,2012 1. General Information: Size of Property.75 acre Address:t13511iighland`Dr Centervllle'MA 02632 Map 190 Parcel 057 .� ---- 63 Name:David F.&Mary J.Noonan Phone#: 508-771-0248 2a. How many bedrooms exist at your property now?3 2b. Are you planning to add any bedrooms?NO If yes,how many? 0 2c. How many bedrooms total are proposed at this property(including the amnesty,unit)? 1 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewer? NO If the dwelling is connected to public sewer,skip questions#4 through#9 below. � C3 , 4. Location of dwelling is INSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is OUTSIDE a Zone of Contribution to public supply wells? 6. Is the dwelling connected to an PUBLIC WATER? R--j 7. Is a disposal works construction permit on file? YES or NOrn -y 8. If yes,how many bedrooms were approved according to this permit? Bedrooms. 9. Were any building permits obtained for construction of additional bedrooms? YES or NO 10. Is there an engineered septic system plan on file at the Health Division? YES or NO 11. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO ------------------=------------------------------------------------------------------------------------------------ FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property. Special Conditions: Signed: Date: Town of Barnstable Geographic Information System June 14,2012 ..................................... ..................... .................... ................. ................... .....................:.................... ........ .................. ..................... ................. ............. :::"j*,*,**.....*....** ................. ::.:::\?.......... ......................................... ................ .... .............. ................ ................. ....... ....... ............................... ...... ........... ............... ............... .....................:::::: ::::: :: ............... ...... .... .......... ..................... ...... ....... .......................... .......................::::::............ ............... .......... ................. ........ ..................... ......... .............*,..* .......... .......................... .......... ............... .......... ................... ..................................... ........... . ..................................................... ................. .. .................. ...... .... .... ... .............. ....... ......... ........... .............. ...........*............... ........... ................— ...... .......... .......... ..................... ................. .... ............... ................... ... ..................... ......... ......... ............ ................................ ... . ........... . ........ .................... ...................... 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DISCLAIMERS:This map is for planning purposes only. It Is not adequate for legal Map:190 Parcel:057 Selected Parcel boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:NOONAN,DAVID F&MARY J Total Assessed Value:$244400 1"=100'may not meet established map accuracy standards. The parcel lines on this map are only graphic representations of Assessor's tax parcels. They are not true property Co-owner: Acreage:0.34 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:135 HIGHLAND DRIVE Buffer such as building locations. 1 } Pao �; ___'•`_.------'-- �—' ,, '� a,: �`,r 1r. i - -•'• .. I "Or. ' I I , I +� i, �O r i f y r I I -- . R° G5 Fl rV a � 1 ST FLOOR -b Lill r t f ^e a . r t i McKean, Thomas From: McKean, Thomas Sent: Monday, January 09, 2012 9:46 AM To: Dabkowski, Cindy Subject: RE: Accessory Affordable Apartment Program The submitted floor plans show rooms that are not labeled. We are not able to process the application due to this insufficient information submitted. -----Original Message----- From: Dabkowski,Cindy Sent: Monday,January 09, 2012 9:23 AM To: McKean,Thomas Subject: Accessory Affordable Apartment Program Hello Mr. McKean Were you able to review the request for AAAP site located at 135 Highland Drive Centerville, MA 02632 (Noonan) Mr. and Mrs. Noonan are interested in moving forward and I need your comments. Please let me know if you need additional information Thank you Cindy Dabkowski Affordable Accessory Apartment Coordinator Growth Management Department 367 Main St Hyannis, MA 02601 508-862-4743 1 *own of Barnstable • Health Inspector � FTME r Regulatory Services Office Hours g y ces 8:30—9:30 Thomas F.Geiler,Director 3:30—4:30 1 B,RNSrAB Public Health Division v MA SM 039. a`0� Thomas McKean,Director �ArFD MA'S 200 Main Street,Hyannis,MA 02601 G$8 y s' Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE Date: October 28,2011 1. General Information: Size of Property.75 acre Address: 135 Highland Dr Centerville,MA 02632 Map 190 Parcel 057 Name: David F. &Mary J.Noonan Phone#: 508-771-0248 2a. How many bedrooms exist at your,property now? 3 2b Are you planning to add any bedrooms?NO If yes,how many? 0 2c. How many bedrooms total are proposed at this property(including the amnesty unit)?3 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3:,Is the dwelling connected to public sewer? NO --.If the dwelling is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is INSIDE a Saltwater Estuary Protection Zone? 5 . Location of dwelling is INSIDE or OUTSIDE Zone of Contribution to public supply wells? 6. Is the dwelling connected to an PUBLIC WATER? eV T Is a disposal works construction permit on file? YES oL NO N40 8. If yes,how many bedrooms were approved according to this permit? e ooms. 9. Were any building permits obtained for construction of additional bedrooms? YES o NO `0. m 10. Is there an engineered septic system plan on file at the Health Division? YES or NO t� 11. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NOW -----------------------------=------------------------------------------------------------------------------------- FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property. Special Conditions: Signed: Date: r pzo � � pzo e s I _ a � I 1 : e. I 1 I Ali Ilk- 10- t I i , - F r _ _ to _ : I 9 3 - I YO- 1'0' - 6'0" ,.„,,..,ws• so-�,�,.. v M J s4otr C 1 bcp-b.3 -- e : .- 60 ....8.0` t 1ST FLOOR + Ll F- -F__T fel-e-LI J T T t .i I UYT=_ IWO pl TL L T T4. T- '1 ONN.a 0f Barnstable, oealth!�Inspector F4He R ttlat®� Services Office Hours �o �o g y $ 36-9:30 Thomas F.Geiter,Director 3 30—4;30 BmwgrABL$, - Public�Health]Division MASS. i6391- �°�. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 i Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT— SEPTIC QUESTIQNNAMi Date.October 28;2011. 1. General lnformation: Size of Proper"ty".75 acre Address; 135 Highland Dr Centerville,MA 02632 Map'190 Parcel.057 Name:David F. &Mary J.Noonan Phone#:508-771-0248' l 2a. H6w many bedrooms.exist at your property now?"3 -2b:. Are you planning to-add any-bedioa'ms?N.O If yes;low many? 0 € } 2c. How rnaiiy bedrooms total are proposed at this property(including.the amnesty unit)?� 2d.,Please include a copy of tbe:foor`plans for the entiae property. Neatly use a straight-edge: Show all:existing,ro.oms in`the, home and the propos.ed.amnes.ty apartment. Provide width measurements of any open doorways. Please�label"each room clearly...,., � 3. Is the dwelling connected to public sewer? NO Tf fhe dwelling is connected to public sewer,.skip questions#4 through'#9 Below. 4. Location of dwellings INSIDE a Saltwater Estuary Protection Zone? 5 . ,Location of dwelling is INSIDE or OUTSIDE. Zone of Contributionao public supply wells? 6. Is the:dwelling connected to an PUBLIC WATER? 1 i 7. Is a disposal works construction permit on file? YES'' or NO 8. If yes,bow many bedrooms were.approved according to this permit? Bedrooms. 9. Were any building permits obtained for construction ofadditional bedrooms? YES or NO I0. Is there an engineered septic system plan on file:at the Health Division? YES or' NO _ t H. Has the septic system been inspected by a DFP certified inspector within the last two years? YES or Aro 1 ------------------------------------ -------- ---- - - ------------------- ------------------------------ - - FOR OFFICE USE ONLY The Public Health Division has no o 'ection to bedrooms at this property. Special Conditions: Signet: Date: I l 1 Z ` y McKean, Thomas From: McKean, Thomas Sent: Tuesday, January 10, 2012 2:19 PM To: Dabkowski, Cindy Subject: RE: Accessory Affordable Apartment Program There are two (2) living rooms within the new proposed apartment? Both rooms appear to be enclosed with privacy, which meets the MA DEP "bedroom": definition. Should we send a housing inspector over to take a look at this? -----Original Message----- From: Dabkowski,Cindy Sent: Monday,January 09, 2012 10:14 AM To: McKean,Thomas Subject: RE: Accessory Affordable Apartment Program Attached floor plans for 135 Highland Dr CV File: 135 Highland CV 2.pdf>> -----Original Message----- From: McKean,Thomas Sent: Monday,January 09,2012 10:09 AM To: Dabkowski,Cindy Subject: RE: Accessory Affordable Apartment Program Please label the rooms on page 2 and page 4. -----Original Message----- From: Dabkowski,Cindy Sent: Monday,January 09, 2012 10:07 AM To: McKean,Thomas Subject: RE:Accessory Affordable Apartment Program Please review these plans << File: 135 Highland Dr CV plans.pdf>> Cindy Dabkowski Affordable Accessory Apartment Coordinator Growth Management Department 367 Main St Hyannis, MA 02601 508-862-4743 -----Original Message----- From: McKean,Thomas Sent: Monday,January 09, 2012 9:46 AM To: Dabkowski,Cindy Subject: RE:Accessory Affordable Apartment Program The submitted floor plans show rooms that are not labeled. We are not able to process the application due to this insufficient information submitted. -----Original Message----- From: Dabkowski,Cindy Sent: Monday,January 09,2012 9:23 AM To: McKean,Thomas Subject: Accessory Affordable Apartment Program Hello Mr. McKean Were you able to review the request for AAAP site located at 135 Highland Drive Centerville, MA 1 I 02632 (Noonan) Mr. and Mrs. Noonan are interested in moving forward and I need your comments. Please let me know if you need additional information Thank you Cindy Dabkowski Affordable Accessory Apartment Coordinator Growth Management Department 367 Main St Hyannis, MA 02601 508-862-4743 2 + *, i Lis CNUZ eel E • Jp1 t k �7 - 4q.. 1ST OO s b,eMal ?' ��'..`' '.�� �°, l�Mt '. N��?� 'mot y,-x �� -• � �`; .� 4 �� �.:. � � � J� Ij- # s 14� s It tEIJI I YD aft � •F �+. `���e � �,�� �,� $ r� 3 k X'� ,tr" °�';�.. t ;EE ; oS _ ` � • _ � AVII r: r � � Q -------------- ell pb 3• , f t s TOWN OF BARNSTABLE LOCATION r3,.7 5 SEWAGE VILLAGE C .v 9 2 y f 1'1< ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. AkGM SEPTIC TANK CAPACITY / S a 4 LEACHING FACILn Y: (type !Asize)3 Y 2 NO.OF BEDROOMS 3 ,, � BUILDER OR OWNER l��U (/,,(/oo d✓i9 i✓ PERMIT DATE: / COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet '.Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r �� �� / (�G moo,� r ,, D� � 3d` � �3 .v3 � " J, - - _ v:� /�� 3� ' :� r�� �� (�� �3 �- �o �"`-� 3' 77 No. Fee—`� d �� ,' �in co7n�ter: THE COMMONWEALTH OF MASSACHUSETTS Entere es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pplica.tion for 30,izpool *pgtem Con.5truction Permit Application for a Permit to Construct( - Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address pV Tel.No. Assessor's Map/Parcel a Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Cp -S AUF- !/Gi ZV Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank % /�U v Type of S.A.S. ® G . % ge 2_Y- Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued h is Board ealth. Sig e _ Date /la Application Approved by Date 6 1l 0 Application Disapproved for the following reasons Permit No. ca-Cc-'3 3'7"2 Date Issued 14. r v o zi I rntete i m, et:'—_ - .; THE COMMONWALTH OF MASSACHUSETTS �, es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS Yicatiott for po�ar *pgtem Con.5tructton V.ermit «$Application for a Permit to Construct �Re pair U rade Abandon ❑Complete System ❑Individual Com onents (�'1 P � ( ) Pg ( ) ( ) P Y P Location Address or Lot No. Owner's Name,Address e Tel.No. 1 .7 3' /�/s11 .yr c�' /�Q �C i e A//Pl�i tr D A (/ICV A100 ^10'It-' Assessor'sMap/Pazcel '5 . V Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 2 G /-I !p ..- S % b'Mt 40-4 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow \' d gallons per day. Calculated daily flow '5eo' y� gallons. Plan Date Number of sheets Revision Date Title l Size of Septic Tank /# -D d Type of S.A.S. '3 S G A// Description of Soil y ! a W '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 Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued ,y .•s Board of..Health. Sig a /�� i Date F,.40 Application Approved by Date .* Application Disapproved for the following reasons Permit No; a 3 -- �� Date Issued f\ I THE COMMONWEALTH OF MASSACHUSETTS r BARNSTABLE, MASSACHUSETTS ' Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed(Repaired ( )Upgraded( ) Abandoned( )by 'Q e,�' �c r 5 T at. / .3 .S �'�r �� �+-r ' f'.Pi ?4 as been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 1-003-3 T7 dated Installer 2 -� Designer f -The'issuance of this permit shall not be construed as a guarantee that the system ff, ctio s sig IF 2(v - 3 Date Inspector No. O``�.� �j "3 � / ----------Fee 5 © r_ THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mi5pogar *pgtem Cottgtruction Permit Permission is hereby granted to Construct( Repair( )Upgrade( )Abandon( ) System located at / 3-5- /7/, e 4 ye 1.1Z W y.-2 c.zo 4-10 0 4.-A •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 condition Provided: Construction must be completed within three years of the da a of this p t. r Date: �/ I� Approved by n , 5? TROY WILLIAMS - S_( SEPTIC INSPECTIONS Certified by MA Department of Environmental Protection (508) 385-1300 19 Hummel Drive South Dennis, MA 02660 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE, OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION "rITLE 5 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM -)K& I 1�E® PART A CERTIFICATION MAY 2 12002 PropertN Address: 135 Highland Drive Centerville,MA TOWN OF BARNSTABLE Owner's Name: Mary&David Noonan HEALTH DEPT. Owner's Addres,. 135 Highland Drive V Centerville,MA 02632 MAP Date of Inspection: May 9,2002 �..� PARCEL Name of Inspector: Troy M. Williams LOT S Company Name: Troy Williams Septic Inspections Mailing Address: 19 Hummel Drive South Dennis,MA 02660 FAILED INSPECT_ ION Telephone Number: (508)385-1300 /1 IN SPEC A ��1 CERTIFICATION STATEMENT f I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The sv­,tem- Passes Conditionall\- Passes Needs Further Evaluation by the Local Approving Authunt) Fails Inspector's Signature:. ' %��� Date: s/9/o.7, The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of I lealth 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 once of the DEP. The original should be sent to the system owne, and copies sent to the buyer, if applicable, and the approving authority. = Notes and Comments Although system meets the minimum requirements set forth by the Massachusetts Department of Environmental Protection,certification is not to be construed as a guarantee of future working condition of system;piping or components. This inspection represents the conditions of the system on the Date of Inspection noted above. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. l his inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 pace I S P Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 135 Highland Drive Owner: Centerville,MA Date of Inspection: Mary&David Noonan May 9,2002 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates th anv of the failure criteria described in 310 CMR 15.303 or to 310 CMR 15.304 exist. Any failure criteria t t evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to a replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Boa of Health,will pass. Answer yes. no or not determined(Y,N,ND)in the___ for the following statemen . If"not determined"please explain. The septic tank is metal and over 20 years old* or the septic tank( ether metal or not)is structurally unsound, exhibits substantial infiltration or exftltration or tank failure is ' minent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved b e Board of Health. •A metal septic tank will pass inspection if it is structurally sound of 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 break out high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or even distribution box.System will pass inspection if(with approval of Board of Health): brok pipe(s)are replaced ob ction is removed tstribution box is leveled or replaced ND explain: The system req . ed pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(w' 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: 135 Highland Drive Owner: Centerville,MA Date of Inspection: Mary&David Noonan May 9,2002 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System Hill pass unless Board of Health determines in accordance with 310 CMR 15.303 )(b)that the system is not functioning in a manner which will protect public health,safety and the vironment: _ 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 arsh 2. System will fail unless the Board of Health(and Public War Supplier,if any)determines that the system is functioning in a manner that protects the public he ,safety and environment: _ The system has a septic tank and soil absorption s tem(SAS)and the SAS is within 100 feet of a surface %s ater supple or tributary to a surface water ppiy. — The system has a septic tank and SAS the SAS is within a Zone 1 of a public water supply. The system has a septic tank and S and the SAS is ithin 50 feet of a private.water supply well. _ The system has a septic tan -. nd SAS and the SAS is less than 100 feet but 50 feet or more front a private water supply well'". thod used to determine distance "This system passes if a well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile ganic compounds indicates that the well is free from pollution from that facility and the presence of onia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria a triggered.A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 135 Highland Drive Centerville,MA Owner: Mary&David Noonan Date of Inspection: May 9,2002 Y D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: e Yes No , ✓ _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool pm Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ _ Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow —Z Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone 1 of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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 S ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this forma ��=5 (Yes/No)The system fails. 1 have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303. therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a sign flow of 10,000 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 crit ►a above) yes no — _ the system is within 400 feet of a surface drink' water supply _ the system is within 200 feet of a tributary a surface drinking water supply _ the system is located in a nitrogen s sitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply ell if you have answered"yes"to any stion in Section E the system is considered a significant threat,or answered "yes"in Section D above the lar ystem has failed.The owner or operator of any large system considered a significant threat under Sectio or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner ould contact the appropriate regional office of the Department. 4 Page 5 of l l OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 135 Highland Drive Owner: Centerville,MA Date of Inspection: Mary&David Noonan May 9,2002 Check if the followinc have been done.You must indicate'yes"or"no"as to each of the followine: Yes No .✓ _ P..;,npin�; information was provided by the owner, occupant,or Board of I leald, Were any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? _ lil Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? ✓ _ Was the site inspected for signs of break out ? Were all system components,excluding the SAS, located on site '.) Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction,dimensions, depth of liquid,depth of sludge and depth of scum? ✓ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems'! The sue and location of the Soil Absorption System(SAS)on.the site has been determined based on: Yes no ✓ Existing information. For example,a plan at the Board of Health. _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)) 5 Page 6 of I I OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 135 Highland Drive Owner: Centerville,MA Date of inspection: Mary&David Noonan May 9,2002 • FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_�__ Number of bedrooms(actual): y DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 'I,/o Number of current residents: .3 Does residence have a garbage grinder(yes or no): wv Is laundn on a separate sewage system (yes or no):y1 f (if yes separate inspection re uired Laundry system inspected(yes or no)-N- ��4�'-d-y > SY +�-� - 1. H�� Mire- N Seasonal use: (yes or no): ,yo f Water meter readings,if available(last 2 yearslrsage(gpd)): ,v/, Sump pump(yes or no): No Last date of occupancy: y�",,;—A COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 syst (yes or no):_ Water meter readings, if available: _ Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): AD If yes,volume pumped: gallons-- How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM _Septic tank,distribution box,soil absorption system _Single cesspool Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of the DEP approval _Other(describe):. Approximate age of all components. date installed(if known)and source of information: 0r; t -�- �. 6„ i� 4 w 30 s Were sewage odors detected when arriving at the site(yes or no): cro 6 Page 7 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 135 Highland Drive Owner: Centerville,MA Date of Inspection: Mary&David Noonan May 9,2002 BUILDING SEWER(locate on site plan) Depth belu��grade: 1 t3"+ Materials of construction: cast iron _40 PVC other(explain): Dkianc;• fron-. private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass_polyethyl e —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Co lance(yes or no):'_(attach a copy of certificate) Dimensions: __ Sludge depth Distance from top of sludge to bottom of outlet tee or ba e: Scum thickness: Distance from top of scum to top of outlet tee or b• e: _ Distance from bottom of scum to bottom of ou t tee or baffle: Flow were dimensions determined: Comments(on pumping recommendatio inlet and out tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence o eakage, etc.): GREASE TRAP:_(locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_fiberglass_polye ylene_other (explain): _ Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom Xinletd affle: Date of last pumping: Comments(on pumping recommendationt tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leak 7 Page 8 of 1 I OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 135 Highland Drive Owner: Centerville,MA Date of Inspection: Mary&David Noonan May 9,2002 TIGHT or HOLDING TANK: (tank must be pumped at time of inspe on)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass olyethylene other(explain): Dimensions: Capacity: gallons Design Flog+ gallons/day Alarm present(yes or no): Alarm level: Alarm in working order s or no): Date of last pumping: Comments(condition of alarm and float s tches,etc.): DISTRIBUTION BOX: (if present must be opened)(lo a on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution too eis equal,any evidence of solids carryover, any evidence of leakage into or out of box,etc.): PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condipien of Xpumps and appurtenances,etc.): 8 Page 9 of I 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: - 135 Highland Drive Owner: Centerville,MA Date of Inspection: Mary&David Noonan May 9,2002 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: leaching fields,number,dimensions: _ T overflow cesspool,number: I innovative/altemative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): / QV ✓ 7"�J c.J _C s..)S �1�U ( 1.✓u.t 'T"a i ..( 7`'3t / c.•....� - �.. �. P w✓ c. i y�; CESSPOOLS: ✓(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: opt Depth—top of liquid to inlet invert. Depth of solids layer: — Depth of scum la\er: — Dimensions of cesspool: 5—_w s Materials of construction: et s���,, Indication of groundwater inflow(yes or no): Ali Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: _ Dimensions: Depth of solids: Comments(note condition of soil,signs of hydrZicfailure, level of ponding,condition of vegetation,etc.): 9 ` Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 135 Highland Drive Centerville,MA Owner: Mary&David Noonan Date of Inspection: May 9,2002 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 feet. Locate where public water supply enters the building. w�t1 I I pq--, D 1L p'jw>Gl i. 3�u tit U-y e l l -h 6— k,. ` Page 1 I of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 135 Highland Drive Owner: Centerville,MA Date of Inspection: Mary&David Noonan May 9,2002 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water Meet Adjusted high ground water elevation 13. feet Please indicate(check)all methods used to determine the high ground �%ater elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: S o w 'z r Z -z._,t You must describe how you established the high ground water elevation: yS c, S +t G N J 4J U 4- } e ff t +i 30 . ti ��`" �.� �. C r�:- r..^ w:,-�._✓ 1.c.v y/. �'-._—.ems c.:.f�u c�...� 1 / _ \ ' I - y8 , 11 __ I a : , I , i I . 1 1, Jf i 1 d br Aa f WON St r y i r'' L i r t I ST FLOOR y �Pat 4 "8 , t w� � ° r »� ' 'a �G ., � �•.{ a�i�_ ro d$r �, � ���' k y - ,r. � }. r 3 � � � � ,� sF „�,, ..Sri+:. ' '� _ 9 - •r ,� �» rA '•iF.aa Y V i ,� �4 `rb- pa - �ryt %h.. & 4"i"^ `�'� Y �•��" � :1 � � JY�. �•' R i(C^k' ?�t.•ei't" .. '+'.A+' a s r w� F • - 'to-- �e��. ,�� A4-1 it ' I ':�. ,�„�,....�.—,• ,.�•-c �,: - &Y� ia r r . , } f t Town of Barnstable Regulatory Services * BARNSTABLE, 9 MASS. $ Thomas F. Geiler, Director �A 1639. ♦0 lFDMA�A Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 29, 2003 RE: 135 Highland Drive, Centerville Vent for newly installed septic system { On Tuesday, August 26, 2003 I inspected the newly installed septic system at 135 Highland Drive, Centerville. After noticing that the vent had not been installed, I informed Wayne Archambeault (Arch Const.) that the vent was required because of the depth of the system, not to mention that it was required on the plan. The vent was installed and I signed off on the Certificate of Compliance. The next day, Arch explained that the owner did not want the vent because of its looks and asked Arch if he could remove it. Arch stated to him "I don't care what you do once I leave the jobsite." Arch stated the owner sounded as if he would be removing the vent. s Samuel H. White, R.S. Health Inspector y Px , &xPa Xi -PA- 4_... , 4 f j � 1 r i fijt 6 ► It �j♦ �OfIIL �I i 144 f f. 3 V 1 �c Df ov, < C o TOP OF FOUNDATION EL ► "p ,00-77 - �7r D GROUND SURFACE EL- `,U sT __ - N � 1 L S A ND A' 1 L D NO T ES i GROUND SURFACZ E.L e-,,-q __ w 1 Go u r,,_ t MIN 1 ^j 1) THIS PLAN IS FOR THE INSTALLATION OF A SEPTIC SYSTEA1. rt OUTLET PIPE LEVEL FIRST TWO FLEET VENT REQUIRED 3 10 !fit tj 2) ALL INSTALLATION PROCEDURES AND MATERMLS SHALL CONFORM TO 310 CMR 15,000, TWEE STATK- AWWRONMEArTAL CODE, LIQUID LE'VFL TOP EL coy r��uP ( ,� TITLE 5, AND THE TOWN OF _ � _; `; SUBSURFACE DISPOSAL REGULATIONS. 1, Ml ie' LAYER DOUBLE WASHED 3) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE' OF A VACLABLE PROPERTY INFORMATION WITH RECORDED DEEDS INVERT EL 10" 14" \ — _ _ _ _ _ _ _ ,1-z" x 12's 1�` ' OR ZONING REGULATIONS. //��,, EFFECTIVE � — - Go+�•JG• 4) TOWN WATER SERVICES THIS PROPERTY. 15 �2 C) GAS BAFFLE AT OUTLET INVERT EL e" S?t'1NI B.9s a r SIDEWALL 5) THERE ARE NO KNOWN PRIVATE WELLS ON THIS PROPERTY OR WITHIN 100E OF THE PROPOSED SOIL ABSORPTION SYSTEM. INVERT EL INVERT EL 6) ALL COVERS OF SYSTEM COMPONENTS SHALL BE BROUGHT TO WITHIN 12" OF FINISHED GRADE, WITH O-VE COVER OF THE 9 310 D - Box GI Z ,' e zy � �={' Go�� SEPTIC TANK BROUGHT WITHIN 6" OF GRADE. 3/4'- 1 1/2 DOUBLE INVERT EL (7wplcal) C P A nt 3� "� W' `{ S• bl"L WASHED STONE 7 ALL SYSTEM COMPONENTS SHALL REMAIN ACCESSIBLE FOR INSPECTION. NO STRUCTURES SHALL BE LOCATED DIRECTLY 6" STONE BASE INVERT EL � ) Gal Septic Tank ( (� 5� U.S UPON OR ABOVE THE COMPONENT ACCESS LOCATIONS, WHICH WOULD INTERFERE WITH THE PERFORMANCE, ACCESS, INSPECTION BOTTOM EL r' (Typical) PUMPING OR REPAIR. �� EE �`� 5 8) NO DRIVEWAY, PARKING OR TURNING AREA, OR OTHER IMPERVIOUS AREA SHALL BE LOCATED ABOVE A SOIL ABSORPTI ON BOTTOM OF TEST HOLE SYSTEM, EXCEPT WHEN VENTING HAS BEEN PRO VIDEO. i 33 s t 9) SEPTIC TANKS, GREASE TRAPS, DOSING CHAMBERS AND DISTRIBUTION BOXES SHALL BE PLACED ON A 6" STONE BASE TO ENSURE STABILITY AND PREVENT SETTLING. 10) OUTLET DISTRIBUTION LINES SHALL REMAIN LEVEL FOR A MINIMUM OF THE FIRST TWO FEET OF THEIR LENGTH. 11) ALL SYSTEM COMPONENTS SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 1 D' f OF DRIVEWAYS OR PARKING OR TURNING AREAS, IN WHICH CASE H-20 COMPONENTS SHALL BE USED. 12) ALL BUILDING SEWER LINES SHALL HAVE AN INNER DIAMETER OF 4" AND SHALL BE CAST—IRON OR SCHEDULE 40 PVC. 13) THE DEPTH OF THE TOP OF ALL SYSTEM COMPONENTS SHALL NOT EXCEED 36'" UNLESS VENTING HAS BE i ��,�. ,�,.� az��r�rar.�_�€va,xao�Q��,�.-��-,�-�7�L--�rs�,�vc$-aF�'--- BEEN PROVIDED, 14) IN THE AREAS OF EXCAVATION, EXISTING GRADES SHALL BE REESTABLISHED UNLESS NOTED AS PROPOSED CONTOURS. s x�trrax 15) IF SOILS ARE ENCOUNTERED DURING THE EXCAVATION OF THE SOIL ABSORPTION SYSTEM, THAT DIFFER NOTABLY FROM THE DEEP OBSERVATION HOLE LOG, CONTACT THE ENGINEER BEFORE PROCEEDING. � �nm+� �/+� l]IlmnN l� Cl7D 6sl nis nS "aim js, 4s= OF anQ��— �o7'oa„� x xrae 16) CONTRACTOR TO VERIFY LOCATION OF' ALL UNDERGROUND UTILITIES. eS-I$-DRY ti I� �Aread ���. DESIGN DA TA DEEP OBSERVATION Pump and fill Number of Bedrooms: HOLE LOG existing its as Garbage Grinder: r required g 1 v 0 Test Hole #1 Wooded Design Flow: � (EL y� Depth ev Soil Soil Soil / v (Cn) Tit) Horizon Texture Color Area � \ (110 Gal/BR/Day x Number of BR) (USDA) (Munsell) 8 , 7 ��Hof /o YR 3/z t v Yk 5l2 �J ti Septic Tank: ro - 3�, �,i".p 13� Loam+ , -7 SAN /o yr{ 4/0., b l _ Minimum = Design Prop 1, 500 Gal `° ` ( g Flow x z00%) t,. 3�-�t�;. s c.► c M y s.�� s err s��, 134o f�.R �' ' '' :.''._ y6--tZ Cdl �nA vR2rE�R?luwJ Sept ' Tank : �� (^q� o`� Leaching Area: 7Z -/z� 88 s caZ co^ w�, ►~r P `� PROPOSED LEACHING FACILITY Si 6ANd sAPo� Y� / f dewall: tz�- ���f �� .5 L Ma w. zas Y1 ►Three: 4.`V' x. 8. 5E x 24 " deep q) �,j • n -.) Test Z Sldewalls x ----Ft x ---Ft) + u " Deep Obe Hole Data:r "? P /t? j o concrete chambers (or similar) soil Evaluator: to sv"u^>nr� p Pit 'z Endwalls x I t .4, Ft x _ Z" _Ft) ' Witnessed B cYQ ` :: ` , , _ With 4' stone...,-_. y: •1,1�, qq•2 (� _ . . _ .•. _ _ ,. , (t Z Z r Pero Survey G" Z +1/t It",I� R _, - Bottom: Soil Description: CAR E !� sf�a � � j� \ _ �� __ . _. (Total Ares _ �� 5 x 1,2. 6 Geologic MateriaL• OUTWASH q� 3 .SFt x 12 ,0: Ft) (a v(� � , gi ! I ! Prop C, 1 1j' /"e t G lZ'.> ---- Depth ttoo Standing Wateen NA J Long Term Acceptance Rate (LTAR): 0, >4 Depth to Mottling(Color): NA Est Seasonal High OW. NA h I N�iT n� Lr" USGS Observation Well; NA �! ! T`� OQ� —BD Leaching Area Design Capacity: f, L/ ! ! 0� �iJ1� �/ g g p lty �[ ! Date of Last Measurement NA Comments: Pump and fill (Sidewall. Area + Bottom Area) $ LTAR � ,�, c,� existing pits as ! / ' po required � J r t R = 115,00' l �0 L = 50.85E f fig+ NAL. �S? PROJECT LOCATION / -5 f r ti 4� 01 7f' cCN-r��V/ l E j 5' ASSESSORS MAP LOT ,\ o C� APPLICANT.' ,'�),j v'� �r�� rJ Aa rr) . s, /3 5 f�������•� fir', ti _- PREPARED EY t T A & M Land Service, 15 Sunset Drive A h/ South Yarmouth, MA 00664 (508) 394-2723 SCALE / �= Zo LDATE.' ���- 63 /0'5 REV. LOCUS MAP N t ts� D WG. NO: 30(50 SHEET 1 OF / .wr": _ :}Ma•.'Yw`RrNMMww...a.44+.&f.w.sM'r.'wm lr,vuw!�.w.+iM+two.aw.nwMna+..V/'.h'•FwP'.w.M�'+/'•c"M'aMr.rr+M,•^^•••+I•-n..w:.rwr..r++n�.,sww.saw•w..v+.�ww4.'•.:N..►.a..ra.► Ts'pI!vn:+nni,r.sw•%.4r•.a.M.wa a%.�v'.ii'W...wW.MMw4.w.u.Mrt�.Mw•..m.•..q.kr,:..n.w»..rww w.,,•..r.x...........w. .xw"y e.....s .r....ir..e.•.-••w . a "-^'^ti•-n.:w..M.,w.r.-rwT:M'..,r ..tl^.mr ..T.... .....Iw.... ., +-•. ....... ._.. —...,w......«v w+. ..- ... w.+-r..rq..rrwvxa,JYy.,r..-y, '�w.m ...,... '+.r"yyww++4ww+isM1s+.iM'w�a.aWK`LwwwrwWM-•'sal••t.4CV'w+vRt. -