The URL can be used to link to this page

Home My WebLink About0035 MAIN STREET (CENT.) - Health 35 Main Street, Centerville 4s R UPC 12534 ' No.2_ 1�_R %�u„ MASTMOS IIN �O d Q j- , r r i 1A GAN 00 - .. � .. .. a .-.• .-. ..- �'' o Y • • S r' 4 e' r ° e t f A Commonwealth of Massachusetts \�� .Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28 2011 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the computer,use 1. Inspector: � 70 only the tab key to move your David B. Mason cursor-do not Name of Inspector use the return key. David B. Mason Company Name rQ 4 Glacier path Company Address East Sandwich MA 02537 City/Town State Zip Code 508-833-2177 S1287 Telephone Number License Number B. Certification UJI CN cz 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: U_ - ® `Passes ❑ Conditionally Passes ❑ Fails E ❑ `Needs Further Evaluation by the Local Approving Authority March 28, 2011 Inspec s Signat Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and.under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. -I /II t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disp at System•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 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: Existing 1000 gallon H10 Septic Tank to 1000 gallon leach pit. Information in this inspection report represents the condition of the system on March 28, 2011 at 6:30 PM and cannot be used to predict the operation of the system in the future. Increase in occupancy may result in failure of the system. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28 2011 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4M 35 Main Street SVO Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for.fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve-a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone 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 CMR 15.304.The system owner should contact the appropriate regional office of the Department. t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. Cityfrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ❑ Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 220 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information Description: 1 Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 years usage d yes Detail: 2008- 75,000 gallons and 2009 111,000 gallons Sump pump? ❑ Yes ® No Last date of occupancy: currentDate Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc:): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts WTitle 5 Official Inspection on Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28 2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: 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)and a copy of latest inspection of the I/A system by system operator under contract ® Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: February 6, 1986 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet . Material of construction: cast iron 4 PV❑ ® 0 C Elother(explain): Distance from private water supply well or suction line: Not Applicable feet Comments (on condition of joints, venting, evidence of leakage, etc.): Appears in working order Septic Tank(locate on site plan): Depth below grade: 2 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) 1000 gallon tank If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts ti W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 36 Scum thickness 4 Distance from top of scum to top of outlet tee or baffle even Distance from bottom of scum to bottom of outlet tee or baffle 6 How were dimensions determined? scour stick Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank appears in adequate condition. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons � Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Level with 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.): No evidence of solids carryover. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No . Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Leach pit exposed and there there is 4 feet of standing effluent in the pit with 2 feet of effective leaching area remaining. No staing above the effluent level has been observed. t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation;etc.): The leach pit is a 6 foot by 6 foot pit with 4'of effluent standing in the pit with 2' of effective leaching remaining. No indication of overflow or damp surface soil. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28 2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28 2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 28 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: March 2005 Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health-explain: Engineered plan on file ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Used engineered plan on file based on test hole data. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 35 Main Street Property Address Alice Berkeley Owner Owner's Name information is required for Centerville MA 02632 March 28, 2011 every page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 • New Page 1 Page 1 of 1 Vol 4 L0CAT10 SEW.AGE PERMIT 140. VI `LAGF. tHSTALytR'S NAME w ADOAESS G U I L D I; R� OR OWHjR _ 1)14CG rr, CMA _ �•� fi__� _._ _ IDATE PERMIT ISSUED ` DAT E C 0 M P L I A N C E ISSUED Cr- 1 33 http://www.town.bamstable.ma.us/assessing/2011/HMdisplay.asp?mappar=228173&seq=1 3/29/2011 • Barnstable Assessing Search Results Page 1 of 2 2011 Property Assessment Lookup fi . Home:Departments:Assessors Division:Property Assessment Search Results New Search . New Interactive Maus» i_ Owner: 2011 Assessed Values: BERKELEY,ALICE M 35 MAIN STREET(CENT.) 2011 Appraised Value 2011 Assessed Value Past Comparisons Map/Parcel/Parcel Extension Building Value: $106,600 $106,600 Year Total Assessed Value 228 /173/ Extra Features: $5,600 $5,600 2010-$303,600 Outbuildings: $3,000 $3,000 2009-$301,800 Mailing Address Land Value: $181,600 $181,600 2008-$356,000 BERKELEY,ALICE M 2007-$355,400 2011 Totals $296,800 $296,800 2006-$329,900 35 MAIN ST Residential Exemption Received=$90,000 Questions about your Assessed Value CENTERVILLE,MA.02632 2011 REAL ESTATE Tax Information: Tax Rates:(per$1,000 of valuation) Community Preservation Act Tax $49.94 Fire District Rates Town Residential Barnstable FD-All Classes $2.31 $8.05 C.O.M.M.-All Classes $1.33 Town Commercial C.O.M.M.FD Tax(Residential) $394.74 Cotuit FD-All Classes n/a $7.28 Hyannis-Residential $2.04 Town Tax(Residential) $1,664.74 Hyannis-Commercial $3.24 W Barnstable-Residential $2.65 W Barnstable-Commercial $2.34 Community Preservation Act 3%of Town Tax Total: $2,109.42 Construction Details Building Property Sketch &ASBUILT Cards Building value $106,600 Interior Floors Carpet Property Sketch Legend Style Ranch Interior Walls Drywall Model Residential Heat Fuel Gas EF 3ly:r, Grade Average Heat Type Hot Water = K Stories 1 Story AC Type None — -- --- , Exterior Walls Wood Shingle Bedrooms 2 Bedrooms 0 a Tgt Roof Structure Gable/Hip Bathrooms 2 Full 4HR. Roof Cover Asph/F GIs/Cmp Living Area sq/ft 996 Replacement Cost $117,117 Year Built 1985 Atli Depreciation 9 Total Rooms Land Gross Area sq/ft 2,192 CODE 1010 Lot Size(Acres) 0.23 As Built Cards:! Appraised Value $181,600 http://www.town.bamstable.ma.us/assessing/2011/displayparcelll map.asp?mappar=228173 3/29/2011. Barnstable Assessing Search Results Page 2 of 2 Assessed Value $181,600 �''� - s s View Interactive Maps>> Sales History: Owner: Sale Date Book/Page: Sale Price: BERKELEY,ALICE M Jan 30 1998 12:00AM 11197/142 $124,200 KEVORKIAN,JOYCE Dec 15 1995 12:OOAM 9973/013 $1 MELLO,JOYCE Aug 15 1985 12:OOAM 4662/266 $100 ST,PIERRE FRANK P 31111422 $0 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value SHED Shed 80 $800 $800 FPLG Gas Fireplace-Direct Vent 1 $1,500 $1,500 BFA Bsmt Fin-Aver 300 $4,100 $4,100 WDCK Wood decking w/railings 200 $2,200 $2,200 Property Sketch Legend BAS First Floor,Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/2011/displayparcelll map.asp?mappar=228173 3/29/2011 Commonwealth of Massachusetts Executive Office of Envirolunental Affairs Dept. of Environmental Protection .titl One winter Street'Boston Ma. 02108 Septic D.C.P. Titlee V S Septic Inspector kv P.O. Box2119 Teaticket, MA 02536 WILLIAM F.WELD (508)564-6813 Governor ARGEO PAUL CELLUCCI Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION PfCE I' 0o NO F/7 Property Address: 35 Main St.Centerville Address of Owner: Date of Inspection. 11/14197 (If different) V 8 .lgg� to 1p Name of Inspector. John Graci Kevorkian N orggRn�S I am a DEP approved system inspector pursuant to Section 15.340 of Title%(310 CMR 15.000) V, �i.49AI TAB(f Company Name,Address and Telephone Number: Co CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: x Passes This Inspection Is based on criteria defined In Tftle V Condition i P code 310 CMR 16.303.My findings are of how the system is y es performing at the time of the Inspection.My Inspection does _ Needs F ther valuation By the Local Approving Authority not Impyany warranty or guarantee of the longevity ofthe Fails septic system and any of Its components useful life. Inspector's Signature: Date: 11114/97 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspections. 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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving authority. INSPECTION SUMMARY: Check A, B, C,or D: A] SYSTEM PASSES: x I have not found any information which indicates that the system violates any of the failure criteria defined as in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B] SYSTEM CONDITIONALLY PASSES: One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. Indicate yes, no, or not determined(Y, N, or ND). Describe basis of determination in all instances. If "not determined",explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank,whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised=7)97) One Winter Street • Boston,Massachusetts 02108 is FAX(617)556-1049 a Telephone(617)292-5500 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 35 Main St.Centerville Owner: Kevorkian Date of Inspection:11114197 _ Sew.aae backup or.breakout or high static water level observed.in.the distribution box is due to a broken. or obstructed pipe(s)or due to broken,settled or uneven distribution box.The system will pass inspection if (with approval of the Board of Health). Describe observations: broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced —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 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 the public health,safety and the environment. i) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface of water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public watersupply well. The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presense of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method usedto determine distance (approximation not valid) 3)Other D] SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined 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 Backup of sewage in facility or system component due to an 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 cesspool. SAS is in hydraulic failure. (revised 04127197) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 35 Main St.Centerville Owner: Kevorklan Date of Inspection:11114197 D]SYSTEM FAILS(continued) Yes No Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Numbers of times pumped Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"as to each of the following: The following criteria apply to large systems in addition to the criteria: The system serves a facility with a design flow of 10.000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04127)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECLIST Property Address: 35 Main St.centervllle Owner: Kevorklan Date of Inspection:17H4197 Check if the following have been done:You must indicate either PYes"or"No"as to each of the following: _c_ — Pumping information was requested of the owner, occupant,and Board of Health. x None of the system components have been pumped for at least two weeks and the and the system has been receiving normal — flow rates during that period. Large volumes of water have not been Introduced Into the system recently or as part of this inspection. x As built plans have been obtained and examined. Note if they are not available with N/A. x — The facility or dwelling was inspected for signs of sewage back-up. x — The system does not receive non-sanitary or industrial waste flow. _X— — The site was inspected for signs of breakout. x All system components, excluding the Soil Absorption System,have been located on the site. x The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction,dimensions,depth of liquid,depth of sludge,depth of scum. x _ The size and location of the Soil Absorption System on the site has been determined based on The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal Systens. x Existing information.'Ex. Plan at B.O.H. x Determined in the field(if any failure criteria related to Part C is at issue, approximation of distance is unacceptable)(15.302(3)(b)] (revleed 0412V97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 35 Main St.Centerville Owner: Kevorkian Date of Inspectlon:11114197 FLOW CONDITIONS RESIDENTIAL: Design flow: 220 g•p•d./bedroom for S.A.S. Number of bedrooms: 2 Number of current residents: 2 Garbage grinder(yes or no): No Laundry connected to system(yes or no): Yes Seasonal use(yes or no): No Water meter readings,if available:(last two(2)year usage(gpd): nfa Sump Pump(yes or no): No Last date of occupancy: nla COMMERCIAL/INDUSTRIAL: Type of establishment: nla Design flow:o gallons/day Grease trap present: (yes or no) No Industrial Waste Holding Tank present:(yes or no) No Non-sanitary waste discharged to the Title 5 system:(yes or no) No Water meter readings, if available: nra Last date of occupancy: nra OTHER:(Describe) nla Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: System was last pumped last year by Hickey. System pumped as part of inspection: (yes or no)No If yes,volume pumped:0 gallons Reason for pumping: nla TYPE OF SYSTEM x Septic tank/distribution box/soil absorptions system Single cesspool Overflow cesspool Privy Shared system(yes or no) ( if yes, attach previous inspection records, if any) 1/A Technology etc. Copy of up to date contract? Other: APPROXIMATE AGE of all components, date Installed(if known)and source Information: 1986 Sewage odors detected when arriving at the site:(yes or no) No pevlsed 04r17197) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 35 Main St.Centerville Owner: Kevorkian Date of Inspection:111114197 SEPTIC TANK: x (locate on site plan) Depth below grade: 16" Material of construction:x concreate_metal FRP_Polyethylene_other(explain) If tank is metal, list age o . Is age confirmed by Certificate of Compliance No—(Yes/No) Dimensions: L8'6"H5'7"W4'10" Sludge depth:2" Distance from top of sludge to bottom of outlet tee or baffle: 25" Scum thickness:e Distance from top of scum to top of outlet tee or baffle:S" Distance form bottom of scum to bottom of outlet tee or baffle:U How dimensions were determined: Meausured Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) Septic tank and all components are Structurally sound.Recommend pumping system every two years for malntsnance. GREASE TRAP: (locate on site plan) Depth below grade: nla Material of construction: _concrete_metal_FRP_Polyethylene_other(explain) Dimensions: rda Scum thickness:tva Distance from top of scum to top of outlet tee or baffle:nla Distance from bottom of scum to bottom of outlet tee or baffle: nia Date of last pumpingn'ta Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) rda BUILDING SEWER: (Locate on site plan) Depth below grade: 2*6" Material of construction:_cast iron x 40 PVC_other(explain) Distance from private water supply well or suction line?— Diameter: 4"_ Qmments:(conditions of joints,venting,evidence of leakage, etc.) (reylsed 04127)97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 35 Main St.Centerville Owner: Kevorkian Date of Inspection:11114197 TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: rda Material of construction:_concrete_metal_FRP_Polyethylene_other(explain) Dimensions: rda Capacity: nla gallons Design flow: rda gallons/day Alarm level:_nra Alarm in working order?_Yes___,.No Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) rda DISTRIBUTION BOX: (locate on site plan) Depth of liquid level above outlet invert: nla Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box etc.) Ma PUMP CHAMBER: (locate on site plan) Pumps in working order:(yes or no)No Alarms in working order(yes or no)_Ye: Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) rda (revised 04127)97) ;.; SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 35 Main St.Centerville Owner: Kevorklan Date of Inspection:1111114197 SOIL ABSORPTION SYSTEM(SAS):x (locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Na Type: leaching pits,number: Boo gallon leach pit leaching chambers, number:Na leaching galleries,number: Na leaching trenches, number,length: rda leaching fields,number,dimensions:rda overflow cesspool, number:We Alternate system: Na Name of Technology:_tv Comments: (note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.) The leach pit Is structurally sound and functioning properly.Ptt had TV of water In It CESSPOOLS: (locate on site plan) Number and configuration: Na Depth-top of liquid to inlet invert: Na Depth of solids layer: rda Depth of scum layer: rda Dimensions of cesspool: Na Materials of construction: rda Indication of groundwater: No inflow(cesspool must be pumped as part of inspection) Na Comments: (note condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation, etc.) Na PRIVY:_ (locate on site plan) Materials of construction: We Dimensions: Na Depth of solids: rda Comments: (note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.) Na (revised 007/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 35 Main St.Centerville Kevorkian 11114197 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references, landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) d rcn� AA Ae 4a � any Page f of 10 (revised O4l27197) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) 35 Main St.Centerville Kevorkian 11114197 Depth of groundwater 12 Please indicate all the methods used to determine High Groundwater Elevation: Obtained from design plans on record. Observation of Site(Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of Health Check FEMA Maps Check pumping records Check local excavators, installers x Use USGS Data Describe in your own words how you established the High Groundwater Elevation.(MUST be completed) USGS Maps and Charts (revised04)27197) page 10 of 10 - _Z ZT P 03 No..... a:-D THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............Town....-"'--..._0F...............Barnstable.......................................... A ppliraa#ion for llhipos al Works Tunstrnrtiun amit Application is hereby made for a Permit to Construct ( X) or Repair ( ) an Individual Sewage Disposal System at: ........Lot #2 North Main S t re e t .......... �lxt rY.i.�,le..JAA................................................. "'Location-Address or Lot No. Joyce__Mello .........8A Cr.QJDMeII....CaurI...11y nmta......---•----... Owner Address W Steve Lebel Installer Address Type of Building Size Lot_41,5 Q..........Sq. feet Dwelling—No. of Bedrooms........3.................................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building Cape No. of persons............................ Showers 1 — Cafeteria a' Other fixtures ............................... .. W Design Flow........55..............................gallons per person per day. Total daily flow._._....._000.........................gallons. WSeptic Tank—Liquid capacity 000 gallons Length.$.'-.0'...... Width..4._'_.l.Q' Diameter________________ Depth.5!.8.11.... x Disposal Trench—No..................... Width.................... Total Length................. Total leaching area....................sq. ft. Seepage Pit No..................... Diameter----------- ._..... Depth below inlet.......4........... Total leaching area.2.64........sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by...... ldredge_.MIZi-ae r1mg.._Ca. Elam........A_ug......ao.r_...1985 a a Test Pit No. I.......4......minutes per inch Depth of Test Pit........12....... Depth to ground waterNone...Znc'ountere fi, Test Pit No. 2.......4._....minutes per inch Depth of Test Pita------12....... Depth to ground waterNone---Frleountere P4 -----------------------------------------------------------•-•------------------------ -........... .........-------•-•-----•-----•----•••------.........-•-- 0 Description of Soil............. ...-...41.... Qa 4 tfn..&_..taISo11. •--•--......---•----•----------------------- ----- -�2 ---. ne--sand---sSlme ...etQn.e................_........................................................ V W V Nature of Repairs or Alterations—Answer when applicable............................................................................................... -----------•--------------------•--...-----•-----------------------------------•---......-------------------••---------------------------------------------------._......---------------•--•-•••---•---. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITA U 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compli ce has be shed by the board of health. Signed•------- -• ...... . .. . ..........................- Date Application Approved By...... •-- ----I �t!b .................................................... ---------- Date Application Disapproved f o t e following reasons:................................................................................................................ ............................................................................................................................................ ------------------ Date PermitNo..................................•------•....._...._... Issued-....................................................... Date Xg- 1-73 Fmn;.Oro THE COMMONWEALTH OF MASSACHUSETTS BOARD OF` HEALTH ---------Towii.................OF..............p rj�rrrst-a-bl-.t-------------------------------------------- Appliratiott,, for Disposal Works Tonstrurtion ramit Application is hereby made.for a Permit to Construct (X) or Repair an Individual Sewage Disposal System at: ........La—#2---+,',0T+ &t-re-e-t----------------------- --------GL-n-t-e-rN-444-e...?,A r .......................................... to-cation- ddress ork ....... -----------------------------------------------......----- .........8"A...Graruwc--14....GAjyt-t---4!-y-a*in4-&.................. Owner resr ---------- ----------......... Installer- ----------------------------------------- ----------------------------------- Addre.s........................................... s PQ 4 Type of Building Size Lot43,.54r1...........Sq. feet U Dwelling—No. of Bedrooms--------3..................................Expansion Attic Garbage Grinder Other—Type of Building ..ra.pe............... No. of persons_______.__.__----___.-__.__. Showers Cafeteria Otherfixtures ..............................................I........................................................................................................ Design Flow.........9.5...............................gallons per person per day. Total daily flow----------3 ..........................gallons. 9 Septic Tank—Liquid capacityj..a(;14.gallons Length fp-Gii.... Width.4_L.j,0j_t_ Diameter---------------- Depthc,.t.s.ty..... Disposal Trench—No. .--:.___-__._______. Width____________________ Total Length__--._______________ Total leaching area....................sq. ft. Seepage Pit No......I.............. Diameter...........:......... Depth below inlet......4........... Total leaching area.2C)-A..........sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed by......E, -1-dredge--- --- INF-;-------Azut-:-;-----a(31-j----4985 Test Pit No. 1.......4......minutes per inch Depth of Test Pit........+�....... Depth to ground Ovate -incountere, 934 Test Pit No. 2-------A__.-._minutes per inch Depth of Test Pit........1-2....... Depth to ground waterjj.().n,6...Dnc-'Ojinter6 ------------------------------------------------------*-------------I----------------------------------------------------------"--------------------- 0 Description of Soil............0-t---—---4A-----letavt--- 4,c rjs�ol-1---------------------------------------------------------------------------------------------- UW .............................................V---—-_I-2A f-1-ne &a-n-d----Some---s-taiw---------------------------------------------------------------------------- W Z -------------------------------------------*--------------------------------------------**------------------------------------------------------------------*------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance h s been itsued by the board of health. ..Signe . ; - _Z`/.-�, .... ....................... �2 Date Application Approved By... -- = I. ................................... ..................... ........ Date Application Disapproved f r the following reasons:................................................................................................................ ........................................................................................................................................................................................................ Date PermitNo. -- Issued....................................................... ry Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............TolvnOX....Ba9r1S,t-b;h1'iDB-t.ab-1.e............................................... Trrtffiratr of Toutpliana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired by............v ---------------------------------------------------------------------------------------------------7-------------------------------------------------------- Installer ........................................................................ at-------------L' t---#2---Nartti...12'al-n---ptruel--- F kl� has been instilled"in accordancete provisions e State Sanitary Code as described in the application for Disposal Works Construction Permit No.......................................... dated------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONST UED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFA9TORY. , L '. + DATE........... ......................... .61..V.....6............. Inspector.................. ... ................. ....... . .................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . .........Town.....................OF................. .................................... No'44 t� Disposal I Works Tonotrudin-it 'phrutit FEE .................. Permission is hereby granted......__--.at e x P_---L ............................................................................................. to Construct ( X) or Repair an Individual Sewage Disposal System atNo.--LGt---#2...NGr-t-h---94t-0 t r ek------ ................................................................... treet as shown on the application for Disposal Works Construction Permit No_____________________ Dated_______.----.._____.._.___....____._..._.. .................................. .. -Ir ------------------------ _e�d f 1;6;a"lt DATE..................la- / I ............................................................. FORM 1255 A. M. SULKIN, INC., BOSTON 0 . i rid fi G� { ' i i xr� /f t F i b; ;; D '1 f r l 3 / N rter �s �tL d,i •.y f \ �� j f rK� ;�*.ti a' ti _�TZ-OPT S c"�DZLt✓r r I sal �^`. 4 : r �61/fi-T"'7EF2.. V t� ra sT �izArk� 'Q ' Fq f4r} fnL P` rmt16 �>w,F `4�i�° t q P af. r f r- NP 77 p t'rp " • ,h` '`' ;Na?•L�'� •,C�.S su�,.�. Gc)� Pr .c°J. '�-\ Q� �' �. - P ti OF MqS COti�/`��+,/lip o , w ALFA. dj#Y. rn vc 1G5 ��; MORSE T No.10951 Q of %3f f'n •4 � �' ` I IAJ - ! I ro LEGEND s r—_--- s i �. -=; DERTi IEDw PLOT PLAN I z' FEXI�T.ONG SPOT ELEVATION 0„^ ;, EXISTING. CONTOUR ---- 0 -;- 2 - Z, r cA°� 6;0,!�1- /77, PG .I Yg" F.INISH.ED:: SPOT ELEVATION " � J, r: �T �� ( && / FINISHED CONTOUR 0 v+ ' ELDREDGE co a6f °a-" � IN ARPRQVED = BOARD OF HEALTH '� No. ��" r .` �� aa Wlis ° f. : a/ , . , DAT'E. AGENT SCALE= =zc DATE = 0 b DREDGE ENGINEERING CO. INCCLIENT I CERTIFY THAT THE PROPOSED 't EGISTERE REGISTERED J08 N0. 85oQ9 BUILDING SHOWN ON THIS PLAN f ,` . CIVIL ` AND CONFORMS TO THE ZONING LAWS " EPIGINEER LSURVEYORJ DR.BY= OF BARNSTABLE IIASS.6-Q 1 712 MAIN STREET . CH. By: HYANNlS . MASS — I . z -SHEET L_ A E EG. LAND SURVEYOR _ .._. ..::. :`::a;kant�"+� ru;.:taa'+PCs#ck:;�R«.,:x::rt..+in.�.i.x�i§+A'u.a.:ac;�.,.a�,�>8an�faw -�• r .... ...w. .. wa...s «�;«...,�.,,.s..... xn'zmsi.� 'L..^,4u:Kalvr +'MM'�xb:sMAee..x+v. ww u.cwJ..- .sx '6'r..�d .eN:ei 1r�mwfhmx.i+.v:f hxw4n�arF 20 FT. .MIN ,a /Y07F /F E/TNER THE SEPTIC TAN/C OR ��.:EAGs,I/NG ?/T ARE MORF ,.TNA.•/'/2"BELOrV r 24 :p/A M E TER G'ONCR'E TE COVER , SFNA'LL BE BROUGHT TO GRA DE- CONCRCTE` q'PYC:`P/PLr j�►EAV y CA ST,/RO/Y C o NER Sf/A L.L DE USE. W M/N. P/TCX' /F/N DR/✓EWR Y EG g 8 o co vEies /B PFR FT •._ CONCRETE • _ 2 M/N. cr of CO CL ✓ER EAN SANO .&ACx 7 L L LIQUID LEYEL r _ 4:: "CAS ', 2 LAYER j IRON. P/PE .' `f7 c-U- v o o e _ b MIN.P/TCN GAL. e t • • • • • • • • e •e {ti/A.-SNFO 57JNE . y /4'Pc�c.r�r; � SEPTIC` . TANK � , s , • . . • • , s • . • .. " BOX v • t $ • • . • • � �•• • • . • •. + ' a; v � � t , •EFFECT/VC ' � . • 314 s e • • . DEPTH • • , '�. v o 1' A5,YE0 STOiYE Q • • • • • • • o o • PREG45T SEE,Pi4aE . lNYe�t'�' ELEY�tT/o�°;rs; �/rcer��T�:.4�� °`��`l a �a r • •- s .• • • • a o P/T OR EVU/✓. INYZAT AT ffV1LD/N6 �S. FT. 3 4. l 2• 'FT. D/AM. C SEE TAJ414- fTION� ., �lNL ET SEPTIC'TANK 9 4:_FT �` . .. OtlTLET SEPTIC.TANK INLET D/STR/8UT/ON BOX 91 4- SECT/ON aF GRouNO NrATER Tsi9LE O/ITLETD/STi%/,9vr1ON BOIL '3JZ FT /NLET;LFACN7NG./3/?' 9Z-$ F.T.. SWAGE L7I3POSAL SYSTEM TABULATID/V LEACHING PIT • r D/MENS/ON A SCALE :,�4 _ / -.0 DES/GN CRITER/A 'G/�►l.ENS/ON $�_FT. NIJJKBER OF BEDRaOMS "3 D/MFNS/ON C—F T./111 of GAR45AGE01SPO-"LUNIT// niE SO/L LOG SOIL TEST NUMBER OF •acttlnrG.PIT.S--�— •' L TEST / SOIL 7=S72 TOTAL E.1'TIA$4 46D FLOW :33 GAG.1DAY -'SO EL�Y. 9 S- -ELFY gG g PATE OF SO/L_ TEST. -7, S/OF RES[/LTS 1'i//TNE5SEG dY OO TTOM LEy9C/f/NG PER:P/T /3 $Q. FT L--o A-�( c L�A , f PtR COL AT/ON /LATE I L�s"r Ml N�II NCI! TOT.1L:LEACH/NG .4RE,r4 y&,f si FT.. Sv/3S4/� �� 5�/�so/�- PWArCOLAr/ON RA7,F �'N y�MlN.�IJr/CN R ESERYEGEACNl/y6 AREA ZG�f SQ Fj S/L� Y FirJE: ?� 7 P -4-5�3 7 j k �* S� OF, Z /�AoTI F r�I�4 t�v ss ALKRT % 0�` ,,R08ERT A ��..•:.-.. '. .N; �Ss•l.�' t _ �?.^. - RSE ELDREDQE > , Y No. 1s3sZ.. R �' 4i _ R XG_GO''%NG w �,,. � � EGOREDGE ENiGIIVE / �4 ',;L &.�:�sL. A^. ...♦ -�. _ v1.I _ 'i2 ..e/ .. - Q x ,��k.tFE ,.a.+. . .an Y+. .s.x.?Y......v ...'G ='�.'8`�J. j^:. C°'. - .j•✓ !`-.. "3.t... r-- r. F ,: �•-� ,/ �. � E61$TER +� �,Y.. , .��-�.- ;..•:3� ,<.;: � �•.,W� ,, .-�_: �,,, _-�• Q r,.. f. ��7t2:"N,'!%t/K S-T r"� /IYRN !Q GF „",..� 3 y a, ,kT r7i•4 �..4 E ;�{ L a�TiOJ a4t� _ wy ,�i�'`:. .,.ICJ �:.3:�..:• -; � .':.:�b. :`.^Sf�- 5'.'.. -.m.' � "�: .e.G- Mj ..�•.+.--d Y,4.Y' �_,,�". `'h5 `,"z4 ys.�'� §=f. f• ►..� !E/►tX' r=~ =�� - < :.:,,, . ;;. , ;,��Kid G�[OflX�;,-yY �x -_�x�°«�sx�•s.h �•�v= - •� .:b+•-. �-.3,';t'C 4:;bra.` .; - F� �a;-q,., : ' .- *,. :,. -.; .:�Wr• "'fir: {}.-" ..t- '�' ..Ac�'E- `3:: d`- q.g, -,ta �. ,r...��,, n?�i:,.» - �� ' v "�+.:r .'�+.+tt"'y3:.t�"�'i -...woe:. :+'�,. a�,'��"i�,._,...G- �-'_E'.��i.' ,=.��..:��v..w`�'��a��s$��•..a�..� �wze7i��,.��'C ,i >- a-.. # +��Ls��.3:.�.3 �,.r.,.... ue;br..r... �",a _:�'�. ,.: .!f- � C .. .... _ 3 .Y 3G"✓`.��$.-'^�'...' "'�-L� °-� "+{'�-S`y�``•�-aa. .:%-` r >� .xhr_r�y.�, ..,:.r.. < times.:=' .� -.,.�a: .-,c .<::. =e:;4 '?Sw .r<',x _ '; •" '-'>a-�'r.t -w�`F ,,.Y- - .,..A. a #•,-. =..'o,'4L'F7,-;,.atC'.a ...'*�..�.,..��.,te��e��i,+�• .c�--"'f _��'��"�..ri.�"'.:.�'"�'.•.a�..:�•a..r�. �7.t, M ..,gi •a ' ta�4 ,s*s ._?� � - tiY lr�'tt, atr' r" •,as ::ti a- 0 z PIS-- 0 It C .4 T i " StWAGE PERMIT NO. LoT At, V3, E L AG F. 5 T A 1. F R s NA ..Al Z A D 0 R E i S ez- ax a u I L D i R OR OWN kR% 'IDA T E P ERAUT ISSUED OAT E C 0 M P L I A N C E I S 5 U I D �_ _ _ / _ � !Y �d /� Z , � 3� �: AsBuilt Page 1 of 1 L 0 C A T ;0 H SEVIAGE PERMIT NO. VILLAGE. _-- ! NSTB, I �ERIS NAME w ADORESS _ A G U I L D F R OP OWII klw ,10ATE PERMIT ISSUED -7 DAT E C 0 M P L I A N C E ISSUED ls/ C d z �3 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=228173&seq=1 11/12/2014