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0086 OAK STREET (CENT./W.BARN) - Health
86 lak_Street (Centerville) A=173-011 UPC 10259 No. H__0R �,,,_�o��`�` HASTINGS.MN iFASSACHUSETTS fFeeTHE COMMONWEAL Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes NpliLation for Misposal bpstrm Const union Permit Application for a Permit to Construct( ) Repair( ) Upgrade�K) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. &to a4ie_ S-rr-ecr r>ad► Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 1 "7 S — O 1 1 Innsstaller's Name,Address,and Tel.No. r J'; Designer's Name,Address,and Tel.No. C 414„ 1,+ f;nkp iks CLL ` �grs �KSiu.e.c, �t/avC lc f H'11-S 3 13 Type of Building: r Dwelling No.of Bedrooms j Lot Size t 14 Y-a sq.ft. Garbage Grinder( ) Other Type of Building $,236,L {wti.,�r No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �{Ll a gpd Design flow provided 9 Z gpd Plan Date -Z-'z�Z— 2014 Number of sheets 3 Revision Date Title$1. r44, a- i Size of Septic Tank /0 D O Gat Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) ?O t L G ( Lr_igcS- he G 47 q1.r,ilea T6 e11 cP (.J K-. 1 ` 6 f I) N-a g.AxA j 5 rvze �o� e4 �►•vYt�u Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. S' ned Date I ►J Application Approved by Date g I LI Application Disapproved by Date for the following reasons Permit No. Q '�� �"$ Date Issued ` !,: st 4, Fee Q V F THE COMMONWEALH OF�MASSACHUSETTS Entered in computer: ' PUBLIC HEALTH DIVISION - TOWN OF'BARNSTABLE, MASSACHUSETTS Yes 2pplicatlon for Disposal *pstem Construction Permit I Application for a Permit to Construct( ) Repair( ) Upgrade V) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. $fo 04� S-rree r- w4�„�, Owner's Name,Address,and Tel.No. Assessor's Map/Parcel "7 3 C 1 ! &IA6ng 73 L j ✓j C Installer's Name,Address,and Tel.No. i r Gu...,.,,.. ,�bt. Designer's Name,Address,and Tel.No. �8�;; f, y WU-t.k) q??- Type of Building: Dwelling No.of Bedrooms Lot Size LI q 4 Ya sq.ft. Garbage Grinder( ) Other Type of Building S,�,. f „� No.of Persons Showers( ) Cafeteria( ) Other Fixtures i Design Flow(min.required) gpd Design flow provided L/119. 'Z, gpd Plan Date -7 -Z'j— to t y Number of sheets Revision Date s Title$:s. ask 4- 1 Size of Septic Tank /0 p p Cj41 Type of S.A.S.�/:4 w_ n,dC/—S Ott Description of Soil i Nature of Repairs or Alterations(Answer when applicable) Ao o I Le— —(, L P✓I c�-i k G �...�x/1 t.-F0 1!5 n J L4J , t,, nk� 32<0 4� Date last inspected: t Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of r Compliance Has been issued by this Board of Health. o S' ned Date a ' -' 0 1 J Application Approved by Date g ( L)- Application Disapproved by. Date for the following reasons Permit No. �GI'� I �' ""y Date Issued I L) --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliante THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(X) Abandoned( )by 1!,_� &.- (; n.,ri,sa S C t .c at 2 G h 4 K S i`('e e_T has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Zy�S gdted P P Y � Installer C, A 4-- F A %N I e�. Designer #bedrooms Approved design flow gpd The issuance of this permit shal ((not b�cyyonsAed as a guarantee that the system wilhfixn ttc omas'c�esi�ed. t Date {� �(1 f 1 ~/ Inspector -------.-------------------------------------------------------------------------------------------------------------------------------- No. ,�o I L—I _0_S q Fee 0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ) Upgrade(Y) Abandon( ) System located at (o 6 A I4 `D-r r t'cT <bA l e S-c- a r,,< ova C��:• and as described in the above Application for Disposal System,Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be-colplete)lt 'n t ee years of the date of this permDate ( r Approved by F� 1' Engineering Works, Inc. 6 OAK STREET S.A.S. EXPANSION 12 West Crossfield Road, Forestdole, MA 02644 WEST BARNSTABLE, MA (508) 477-5313 Prepared for: Capewide Enterprises 53 Commercial St Mashpee, MA 02632 Date: 7/18/14, Job no. 186-13 exp x 68,20 Ex�sTiNG HOUSE(#86) TBM T.0.F.=67.45f ORANGE PAINT CONC. PORCH EL. =66.83 HED PATIO 65.56 O •Z 66.04 INGROUND 0 O SWIMMING PO OL -0 / _ .56 70 TBM1 Q 6 .83 -- --- 65.3 65,23 �763.10 64,21 0+ r _.x:..: :N: S TONE` { Rl l/EWA Y: 62:6e 3.06 PROPOSED EXPANSION / = INSPECTION 1 ; 63,19 � � of Mgss9c MANHOLE 3. fTl�;:':': 63.22 o PETER T. ti� 62.39 x I x.t :'..:;.: o McENTEE cn CIVIL 1• No. 35109 (A (D �/D A fGISj 1 U). S 0.00 Scale: 1 =20 63,22 uP PAGE 1 OF 3 r Engineering Works, Inc. 86�OAK STREET S.A.S. EXPANSION 12 West Crossfield Road, Forestdole, MA 02644 Y.. WEST BARNSTABLE, MA (508) 477-5313 Prepared for: Capewide Enterprises 53 Commercial St Mashpee, MA 02632 Date: 7/18/14, Job no. 186-13 exp F.G. EL.=MATCH EXISITNG r -- 2" LAYER OF 1/8" ® ® TO 1/2" DOUBLE 12" EFF. DEPTH SIM ! I WASHED STONE �— (OR APPROVED FILTER FABRIC) 4' 3' 4' 3/4"-1 1 /2" EFFECTIVE WIDTH = 11' DOUBLE WASHED STONE LEACHING SYSTEM SHORT SECTION USE ADD 1 LC-6 LEACHING CHAMBER TO THE END WITH WITH 1 ' OF DOUBLE WASHED STONE BETWEEN END CHAMBER AND NEW CHAMBER WITH 4' OF DOUBLE WASHED STONE ON AND ON THE END H-20 RATED —BREAKOUT �a ® g ® ® ® ® ® ® ® 61 .5 ELEV.= MATCH EXISTING � ® I ® ® EO ® ® ® ® I BOTTOM ELEVATION EFFECTIVE LENGTH = 45' LEACHING SYSTEM LONG SECTION PAGE 2 OF 3 Engineering Works, Inc. 6 OAK ED AET. EXPANSION 12 West Crossfield Road, Forestdale, MA 02644 : , WEST BARNSTABLE, MA (508) 477-5313 Prepared for: Capewide Enterprises 53 Commercial St Mashpee, MA 02632 Date: 7/18/14, Job no. 186-13 exp DESIGN CRITERIA NUMBER OF BEDROOMS: 3 EXIST. + 1 PROPOSED = 4 TOTAL SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: 3 MIN/IN DAILY FLOW: 440 GPD DESIGN FLOW: 440 GPD GARBAGE GRINDER: NO-AND NOT PERMITTED WITH THIS DESIGN EXISTING SEPTIC TANK: 1000 GALLON CAPACITY LEACHING AREA REQUIRED: (440 GPD) = 594.6 SF .74 GPD/SF USE ADD 1 LC-6 LEACHING CHAMBER TO THE END WITH WITH 1 ' OF DOUBLE WASHED STONE BETWEEN END CHAMBER AND NEW CHAMBER WITH 4' OF DOUBLE WASHED STONE ON AND ON THE END SIDEWALL AREA: (11 .0' + 45.0') x 2 x 1 ' = 112.0 SF BOTTOM AREA: 11 .0' x 45.0' = 495.0 SF TOTAL AREA:........................................................... 607.0 SF DESIGN FLOW PROVIDED: 0.74 GPD/SF(607.0 SF) = 449.2 GPD PAGE 3 OF 3 08/07/2014 08:38 5084775313 ENGINEERING WORKS PAGE 01 Town of Barnstable Re.gulatbry Services Richard V. Scali, Interim Director Public Health Division rFp 7 s,0g 'I'ho;tnas McKean, Director 200 Main Street,Hyannis,MA 02601 Fax: 508-790-6304 Office: 508-862-4644 Installer & Designer Certification Form Date: (�� Sewage Permit-4 R of — 2��Assessor's yiap`Pareel ) 73—a 0 �a 1•w Me �Me 1��` Installer: Designer: ' -�'^ •S'� n — Address; !2 W. sselC,l Address: 1.�3 Cis -e-Xoh► �S� (' S� stall a On �" "f ``�4—`� ' �'�`' `� was issued a permit to o�roor�. (date) (installer) A rVS a '3 septic system at S k Aj t�� � based on a design drawn by (address) �►11-e� E dated ?) 1 (designer) eC I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e, greater than, 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system.) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in comph with the terms of the INA approval letters (if applicable) ��tk OF , PrTER T. PAcENTEE r 2t—aller'S Sl 9=(1Z)esi�pe Signature) ix Designer's PLEASE RETURN TO B STABLE PUBLIC BYA H D SAS FORM CERTIFICATE OF COMPLIANCE �JILL NOT BE XSSUEID BUILT CARD ARE RECEIVED BY 'pI-IE I3AR1riSTABLE —IT HEAL H DIVISION. THANK YOU, Q:\Scp6c\Dcsigncr Cerification Form Rcv 8-]4-13.doc Town o Barnstable �oF I H E r ti ` Board of Health BARNsrABLE. # 200 Main Street - Hya=s MA 02601 9 MASS. g Qoo 039. lFD MA't�' Agreement to Extend Time Limit for Acting Upon a Variance Request In the Matter of a variance request form received on the Petitioner(s), regarding the property at the petitioners) and the Board of Health agree that the Board of Health has until (� (insert date) to act upon the Petitioners' completed application for a variance. In executing this Agreement, the Petitioner(s) hereto specifically waive any claim for a constructive grant of relief based upon time limits applicable prior to the execution of this Agreement. Petitioner(s): Board of Health: S i g n a tu r e: IV,9 L,1XVj1 Signature: eh over( "or Petitioners epresentative Chairman Print: , Print: Wayne Miller, M.D. Date:. Date: Address of Petitioner(s)or Petitioner's Representative Town of Barnstable Board of Health Public Health Division 200 Main .Street Hyannis, MA 02601 . Phone: (508) 862-4644 Fax: (508) 790-6304 nie q:extend.dcc A 2� e No. � 2,©1 O- 9f 7 FeeJ / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0[ppliLation for Disposal *pstem Construction Permit Application for a Permit to Construct( ) Repair()o Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 8"(Q OAK Ski' CajVW Q Owner's Name,Address,and Tel.No. OAP t Assessor'sMap/Parcel IrIZ Q( Q 6 k S r Te;:—k - e4ur-gmuC Installer's Name,Address,and Tel.No. S®1E-41Z 1-9'%-?1 Designer's Name,Address,and Tel.No.502-4-11 -5313 Cdlptm f cC�rep-p" rSkc dP �lci�Wc- dec►.Sc�r-/t L� Type of Building: Dwelling No.of Bedrooms Lot Size `f`fy -f sq.ft. Garbage Grinder( ) Other Type of Building (Z (�f /Tt�_ No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ,?j gpd Design flow provided 3 k 1 ,9, gpd Plan Date 7- 19-elp -5 Number of sheets Revision Date Title 2(o nke__ 5-ne6asT L/(J_ Size of Septic Tank ( (`2 aQ 6344.L a Type of S.A.S. ('- ) LC_-!� Lod CAv w6ys Description of Soil +%1 o s $A410 cp� Nature of Repairs or Alterations(Answer when applicable) 0 S E &_-C(sT(06, L Ono 64L,=00 S emc— bF hoc- too ArL. S'tneet., Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health Signed Date ;LoO Application Approved by ` Date Application Disapproved by Date for the following reasons Permit No. 9-0 f 3 Date Issued 3 - J No. �© - Fee I THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN-OF BARNSTABLE, MASSACHUSETTS Yes 2ppiication for'Disposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair X) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 8G OAK ST Cew_r/w 3 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel (r(3 ®I � bZ £ D�RA DWY E g a K ST T At&C-W3vC Installer's Name,Address,and Tel.No.S plE-(411—n 1 1 Designer's Name,Address,and Tel.No.Sog.4-11 S3(3 CdPc �� Cj-ree pkls€*, L,c ca.)OPxs z&,c, r :TT- lay W, LG_ Type of Building: 2 j Dwelling No.of Bedrooms .3 Lot Size cl cf,4 q o ¢ sq.ft. Garbage Grinder Other Type of Building Q§ES(ba!% t I H No.of Persons Showers( ) Cafeteria( ) r Other Fixtures Design Flow(min.required) 330 gpd Design flow provided gpd Plan Date 7 1 oi- Number of sheets//�� a• Revision Date ` Title� �� S-De IAA= " &Qwg w Size of Septic Tank I Qc)p 604g c nK j Type of S.A.S. Description of Soil r 1 W F_ S&/j, b r I--LI C ED-- D t-A y-- Nature of Repairs or Alterations(Answer when applicable) O S C C' ".. b F4Mp W Fay ,) AAA_ 5(n Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in - t* >v accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health Signed Date Application Approved by Date Application Disapproved by Date for the following reasons `3 Permit No. go l 3 Date Issued 93 — ( ------------------------------------------------------- TICE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CCERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(X) Upgraded( ) Abandoned( )by 0A0S,_.) D E at W(E5T73Awgyy.,Lg has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.dO I 3 -2&"?" dated _ 13 Installer ( JKfQ_rDG �pQIS ES (_( � Designer E ti&(�(-_-au IJG, WORKS --ruC • Approved design #bedrooms A flow f 3��'a� /1�. gpd The issuance of this pe �t sh 1 not be construed as a guarantee that the system wit ction as d/esiggned. Date / Inspector , t:�t1 ----------------------------------------------------------------------------------------------------(---/-------------------------------- No. 19013 _;6 � Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair(x) Upgrade( ) Abandon( ) System located at IN 0415. ':Zk Rk-kZr ( A1 0T itJSZ14 Cls' and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permi� Date 3 Approved by / 00 !08/02/2013 07:34 5084775313 ENGINEERING WORKS PAGE 01 ■ ■ oM Town o BariuUMe f °rY Services nog=@ F.Geiler,Director P Hie ih Dividen Tomas.lam,Director 200Wn.Stme Hynnub,MA 02401 Moo: 508-862-4644 Pax: 508.790.6304 Date: Zs t f Sewage PeM## 2osl -2- Asaeasor's Mafmarvol 013 J(9 1 I r D in er Cer>tif ce him Desigaw: A&d:!n,V b w o,r 4 s� lac , Installer: C✓t 5�►`� Addrm: lz W. eta=s ►al '2d- . Address: t5'3 — T 1 on 7-2 3 -7 0 t 3 1.Q Nrr (f J%4w issued a permit to Install a ate ins ' er septic system at �� Qq(C S f W 6 based on a design drawn by N c (4% P�_ (address) &1i 4n ee el n !&! kCdated • ( esigner I certify that the septic system referenced above was installed substatttialJy accordin to the design, which may include minor approved changes such as lateral relocation o?the distribution box and/or septic tank, Stripout (if required) was inspected and the soils .were found satisfactory. I certify that the 'septic system referenced above was Installed with major changes (i.e. greater tlisJfi 10' lateral relocation of the SAS or any vertical relocation of any component of'the septic system) but in accordance with State& Local Reputation. Plan revision or certified as-built by deaigner to follow. Stripout (if required) wa: ' ted and the soils woo found satisfactory. .. -R'EttsR T. Onftger •f1�E.NYEf+ '9 igna ) C. IL 9.No.96to8 a • I�t3er 3 Ignature Inv RECEEM T CE WELL NOT BE B AM Y TUP RARNSTABLEP THMK YOU. C q:lofifoo formsldosiparoenffloadon fb m.doo ni 'q fA 10 01 - -7 1 1 (52) L-11-- i' 3L 2y A !u V-0 ------ .......... C5 -LTI ------------- I i ----------- 1z, � 'V,�('111` �� I I � I i I I i i '.. ! -.'_ I � ' L. .. ........ ........... ^Jf BED. 28265 F'� 1.90 31.284. Q -1 GJ DEED RESTRICTION 111: 0-• cr) 3> s a WHEREAS, Daniel A. Dwyer and Debra A. Dwyer, of 86 Oak Street, West Barnstable, CD CA Massachusetts 02668, are the owners of the property known and numbered 86 Oak Street, West Cn Barnstable, Massachusetts 02668 and described in a deed recorded with the Barnstable County Registry Deeds in Book 13879, Page 303; WHEREAS, Daniel A. Dwyer and Debra A. Dwyer, as the owners of said property, have agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any principal dwelling located on said property as a pre- condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; and WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.000, State Environmental Code, Title V, Minimum Requirements for Subsurface Disposal of Sanitary Sewage, are requiring the restriction on the number of bedrooms in the principal dwelling constructed on the property be put on record with the Barnstable County Registry of Deeds by recording this document; NOW THEREFORE, Daniel A. Dwyer and Debra A. Dwyer do hereby place the following restriction on said property in accordance with their agreement with the Town of Barnstable Board of Health and Town of Barnstable Building Department, which restriction shall run with the land and be binding upon all successors in title: 86 Oak Street, W. Barnstable, MA may construct upon the lot a principal dwelling that contains four (4) bedrooms. Daniel A. Dwyer and Debra A. Dwyer agree that this shall be a permanent deed restriction affecting the property located at 86 Oak Street, West Barnstable, MA, more particularly described in a deed recorded in Book 13879, Page 303. The foregoing restriction shall remain in force only so long as the property is serviced by a private septic system, and said restriction shall terminate and be of no force and effect upon connection of the property to a public sewer system. r Executed under seal this_LL day of July, 2014. Daniel A. Dwyer Debra A. Dwyer COMMONWEALTH OF MASSACHUSETTS Barnstable County On this '', day of. 2014, before me, the undersigned notary public, personally appeared Daniel A Dwyer and Debra A. Dwyer and proved to me through satisfactory evidence of identification, which was H& I �c o a �_. to be the persons whose names are signed on the preceding or attached document, and acknowledged to me that they signed it voluntarily for its stated purpose. ATHERINE DAUPHINAIS VANBUREN r Notary Public Massachusetts Notary Public Q Commission Expires Aug 3.2018 r My commission expires: �/ U 1 BARNSTABLE REGISTRY OF DEEDS I EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES ON 5/13/14: A. Debra Dwyer, owner— 86 Oak Street, Centerville/West Barnstable line, Map/Parcel 173-011, 44,440 square feet parcel, house renovation, needs five bedrooms to allow medical help to live on premise. Debra Dwyer explained that when she took out the building permit in 2001, she was told by the Health Department that there was no restriction on the number of bedrooms allowed on their property as long as they remained 100 feet from the creek. This was not a problem as they own over to the other side of the creek and have kept the building more than 100 feet away from the creek. She and her husband have both had strokes and have three children living at home. The oldest has returned home to help with the upkeep of the house and needs his own living space. She is looking for the ability to have five bedrooms. Dr. Miller said the recent septic has been designed for three bedrooms. If five bedrooms are desired, she will have to increase the system to a five bedroom design. The current system is located in the Estuary Protection Zone which would allow a maximum of a four bedroom design. This can probably be done by adding two more components. Dr. Miller explained that to have five bedrooms, either change the system to one of the systems which remove nitrogen to a greater degree (which would be very expensive); or, add another separate leaching field outside the Estuary Protection Zone. The current septic tank is 1,000 gallons. A 1,500 gallon tank would be required for five bedrooms. Debra said she and her husband require separate bedrooms for care and the three children each need a bedroom. They can not afford additional cost to the septic and her son came back home to help save the cost of repairs on the house. The Board advised the best thing to do would be to go back and speak with the engineer for design suggestions because without a plan, the Board has nothing to vote on. Upon a motion duly made by Dr. Miller, seconded by Dr. Canniff, the Board voted to continue this for three months until August 19, 2014 meeting to allow applicant more time. Applicant may return in August to request another extension, if needed. (Unanimously, voted in favor.) Q:\MINUTES\EXCERPT OF MINUTES\Excerpt BOH May 13 2014 86 Oak St Cent.doc T w o << JAL 7r Department of Regtilatory-Services F {Public Health Division gate. .. � ' 204 MaintStreet,Hyannis MA 0Z601 /S 2 _rr jjs 4 Data Scheduled ' ,Tune ► o u ubil . A ses ' ' �� . Performed•By: ,P Ct s- ' 15` .Z. .Witnessed By. Location AddiM Ownet's Name D�i�-l-p sea .pcvYER ON (.,/. T Address 0* . Asacsaor ;Map/Parcel: /. l I ' Bhgmeer's Nam,e �y}p 1zJ jt �. . ` . NBW,CONTMUCTION REPAIR _ ... . . . .Tele-hone# Iaad Use;— / s '. �,. Slopes 96 2— p ( )� Surface Stones Distanceb*om: Open WaterBod 2" ft Possible.•Wei Area © ' P Y;Z, �/ 'Oft �Drinking Water Well ft Dndha Wa ('ICI p rtY �" ge,: y�..1:_ft Pro a Line ft `OtherETCH :'(sheet name,dimensions-of lot,-exact locadons�of test;holes&:pert tescs;;locate ivctlands n'":proxitnity to holes) . TP'' r,.�� (� t'�rentmateriil;(geologic)' � _,:, . T Depth toBedrock xDepth Co Oronrlvater 'Standing Water in Hole `{ Weeping from Pit Free '"' a Se r`Bstirnated S 1lgh(Irnundwater _ .. : (( DETERMINATION FOR SEASONAL HILT WATTS TABLE "� Method Usedz- Depth Observed standing in obs.hole: In, Depth,to solllrhottiw' . In. Depth to weeping from side of bs.hole: In, Groundwater Adjustment fiE. Index Well# Reading Date: Index Well levol Acj::flctor Act dt .itndwnterxlnval„� �, Z � (; PERCOLATION TEST bate a Observation � / Hole# Tintn at 9" V/ Depth of Pereme At Start Pre-soak 71me 0 i l 1 'limo 0.611) (\ � End Pro-soak I'©: 1 i Reis MinnJlnchJ jn�.I1 �lvt �. Site Suitability Assessment: Site Passed_/ Site Failed: Addidonal testing Needed(Y" Original: Public Health Division Obseva ion Hole Data To Be Completed on Back-------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable.-Conservation Division at least one(1) week prior to beginning. OAS1"10PERCFORM.DOC 1 DEEP.OBF,� 'V`A01kHrE 'OG Hole Depth=from Soil Horizon Soil Texture Sdil Color Soil Other Surface(in.) (f�SDA} (Minitii)n Mottlin '` Stoned;Boulders. 16964 D © ;�ERVATIOI'"T�$4 ,E x.OG Hole# Depth from Soli'F{ori�on Boll Texture` " x So Color Boll p r Surface(in) . (USDA) Munsell Mottling ( ) g_ (Structure,Stone18,.Bob lders. n �S td DE71 OB�SEIVATION HOL `LOG fYole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. DEEP OBSERVATION HOLE LOG Mole# Depth from.. Soil Horizon: Soil Texture. Soil Color Soil other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones',Boulders. Consistency: Crayel)Flood Insurari¢e Rate lNi U Abovei00 year•flood boundary No Yes Witltia<S00yearboundary Within.100yearfloadboundary Depth of Naturally Occurring,Pt~rvious Matt�rlal Does at'least four fen of naturally occurring perviou Material exist in all areas observed throughout the area proposed.for the.soil absorption system? If not,what is the depth of naturally occurring pervious matorial? ...,.. Certion I certify that on �, \�Q� (date)I have passed the soil evaluator�examtnation approved by the Department of;Envlronmental.Protection andrthat the above;attalysts ywag'petfolimed by me consit3tent with the required trarang,expertise and experience descnbed in 1 10 CMR 1S 017 Datt: a3 Sr nature --=--�— . !; Q:\SEP'1'iC1PERCFORM.LDOC I JUL-28-2003 01:43 FROM: Iu;DUt (IJUI 'Vf r. 1. J Ut—Ctf CY_uOJ 1 y•WD auU 1 riCrva 1 CTNII xnsl]J%-r:-L. ,rcry.Zvi u.r 1 . .c l a•v. ..�.�, _... . .. . ,. _...:... . . _ . . ... . _ ..... ._._. : ., .. .. ,.._ -,. : .. _.. 'Fyn' ', •.._ ilu Pap sit �dyarri�ia� :�4 03�1•!;.1- . , . to .60 ? • • - Gow•tY- 4.: w..: 1 ....•y..�•.may .� . . 1. ' •. .5�(_f� �.._�.+ _TT; �.. . . ...w. , 1`r = ; -•.w.J .t.w , r •..� �•. •lwir.�� �' •C i .: �O '�j"'^J!'��M7j)�. .� t r T • 1 • ►t I •'� ilk,• Imo• ,.r:� )z Ran o f Xaad in f�Lew�i.ZLe� Ma.: ' \��5�'r , S, Enge a tot of taga aa. 4how a ous rs a • sided iA bk- 310 pf. 48:. .. aiz4e.y r, .tt Cm " 2-26-79. foundation &wwo as xl,&& ptm U. :Ql d on:� fkomd G& Aowa zhew* C l (2 C ateu t a icrr� cqu.�e'.ea{e+�td"o file !fit u t o� 9d*A4tdbt0, rm , ,. . . ... � .. ...�- ... . . ... ._�.R .. •arc - =A[ P-GN Y COMMONWEALTH OF MASSACHUSETTS EXEC,UTIVE OFFICE OF ENVIRONMENTAL AFFAIRS C' DEPARTMENT OF ENVIRONMENTAL PROTECTI 1 s yi TITLE 5 '`' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION y _ Property Address: 86 OAK ST CENTERVILLE,MA 02632 0 I Owner's Name: JIM FENNER s;1' Owner's Address: 86 OAK ST.W. BARNSTABLE MA.02668 �' ` Date of Inspection:3/12/01 { JOHN GRACI Name of Inspector: (please print), Company Name: 'SEPTIC INSPECTIONS Mailing Address: RO.BOX 2119 TEATICKET,MA.02536 Telephone Number: 508-564-6813 FAX 508-564-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of 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 I inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: r X Passes Conditionally Passes _ Needs Furt Evaluation by the Local Approving Authority ` s _ Fails Inspector's Signature: ' Date: 3/12/01 The system inspector shall subm' 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 1, s{, l; sent to the system owner and copies sent,to*the buyer, if applicable,and the approving authority. Notes and Comments 4_}" THE SYSTEM PASSES TITLE V INPECTION..RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. ****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. j Title S Incr�n�tinn Frnm A/1 V')O n Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS f I� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A *,9° CERTIFICATION (continued) f Property Address: 86 OAK ST CENTERVILLE,MA 02632 Owner: JIM FENNER Date of Inspection: 3/12/01 22.7 Inspection Summary: Check A B C D or E/ALWAYS complete all of Section D Insp y A. System Passes: X I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 r` CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. B. System Conditionally Passes:': o _ 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. µ j' Answer yes,no or not determined(Y,N,ND){in the for the following statements. if"not determined"please explain. Y.�i� Y n/a The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits } ' i. substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: n/a n/a 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 _,obstruption is removed distribution box is leveled or replaced ` t ND explain: n/a n/a 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 pipes)are replaced _obstruction is removed '' , s ND explain: n/a A ss -j hk# iy. is Page 3 of I 1 t .a OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS s SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' PART A CERTIFICATION(continued) Property Address: 86 OAK ST CENTERVILLE,MA 02632 Owner: JIM FENNER Date of Inspection: 3/12/01 C. Further Evaluation is Required ey 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 enviromnent. 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 bordering vegetated wetland or a salt marsh 'A i 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 n/a ; "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indica«es"that the well is free from pollution from that facility and the presence of ammonia i n, nitrogen and nitrate nitrogen is equal.to or less than 5 ppm,provided that r o other failure criteria are triggered.A copy i of the analysis must be attached to this form. ,.I z h Y' r 3. Other: n/a r Page 4 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 86 OAK ST CENTERVILLE,MA 02632 Owner: JIM FENNER ' Date of Inspection: 3/12/01 '� ' D. System Failure Criteria applicable to ail systems: '�t You must indicate"yes"or"no"to each of the following for all-inspections: ` Yes No X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than'/z day flow X Required pumping more than 4 times in the last year NDMdue to clogged or obstructed pipe(s).Number of times pumped nLa. X Any portion of the SAS,cesspool or privy is below high ground water elevation. r; _ X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. !. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. f k'3. X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with m' no acceptable water quality analysis. [This system passes if the well eater analysis,performed at a DEP r certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be _a" attached to this form.] _ t. a _ (Yes/No)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 t6 system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no,"9to each of the following: (The following criteria apply to large systems in addition to the criteria above) 1' S yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply _ X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well 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 had 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. '' t Page 5 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS :<vt' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B , CHECKLIST ' Property Address: 86 OAK ST CiNTERVILLE,MA 02632 ' ^; Owner: JIM FENNER t' Date of Inspection: 3/12/01. { Check if the following have been done'-You must indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information was'provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? it X _ Has the system received normal flows in the previous two week period? X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) F . 4 X _ Was the facility or dwelling inspected for signs of sewage back up? p . X _ Was the site inspected for signs of break out? F. I •sU',r W... X _ Were all system components,excluding the SAS,located on site? r X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the b baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? t : i X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems, The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no .1 } X _ Existing information. For example,a plan at the Board of Health. X _ Determined in the field(if any o`f ilie failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] :yy *r e1b• • e J 5 15 t fJ-, 5 , Page 6 of 11 I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 86 OAK ST CENTERVILLE,MA 02632 Owner: JIM FENNER Date of Inspection: 3/12/01 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):330 Number of current residents: 5 Does residence have a garbage grinder(yes or no): NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no): NO Seasonal use: (yes or no): NO Water meter readings, if available(last 2 years usage(gpd)): n/a r:.1 Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIALANDUSTRIAL Type of establishment: n/a Design flow(based on 310 CMR,15.203): n/agpd Basis of design flow(seats/persons/sqft,etc.): n/a Grease trap present(yes or no): NO' Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title`5 system(yes or no): NO Water meter readings, if available: n/a Last date of occupancy/use: n/a ' OTHER(describe): n/a GENERAL INFORMATION Pumping Records ' Source of information: n/a t Was system pumped as part of the inspection(yes or no): NO If yes,volume pumped: n/agallons--How was quantity pumped determined? n/a Reason for pumping: n/a rh,a TYPE OF SYSTEM X Septic tank,distribution box,soit absorption system _Single cesspool t _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): n/a Approximate age of all components,date installed(if known)and source of information: NEW FIELD IN 96/ORIGINAL SYSTEM 88 't , Were sewage odors detected when arriving`at the site(yes or no): NO I Page 7 of 11 ;a c OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM q PART C •i SYSTEM INFORMATION(continued) Property Address: 86 OAK ST CENTERVILLE,MA 02632 Owner:JIM FENNER Date of Inspection: 3/12/01 BUILDING SEWER(locate on site�plan) Depth below grade: 18" Materials of construction:_cast iron _40.PVC Xother(explain):20 PVC Distance from private water supply well''or suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER 0 SEPTIC TANK: X(locate on site plan) Depth below grade: 12" Material of construction: Xconcrete metal fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance es or no): NO attach a copy of certificate Dimensions: 1000G L 8' 6" H 51711 W 4' 10"" Sludge depth: 1" Distance from top of sludge to bottom of outlet tee or baffle:33" ,± Scum thickness: 1 Distance from top of scum to top of outlet tee or baffle:6" ;s; Distance from bottom of scum to bottom of outlet tee or baffle: n/a How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): ',s THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. GREASE TRAP:_(locate on.site plan) Depth below grade: n/a Material of construction: concrete`_metal_fiberglass polyethylene_other(explain): n/a ^i Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a { Date of last pumping: n/a �r Comments(on pumping recommendation s,.,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related ; to outlet invert,evidence of leakage,etc.): n/a rC 4 7 I Page 8 of 11 ix OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACtSEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 86 OAK ST CENTERVILLE,MA 02632 s; Owner: JIM FENNER Date of Inspection: 3/12/01 TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a ' ' Material of construction: concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons Design Flow: n/a gallons/day Alarm present(yes or no): N/A .? Alarm level:N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:X(if present;must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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.): THE DISTRIBUTION BOX IS STRUCTURALLY SOUND. iC PUMP CHAMBER:_(locate on site plan) I.' .4 Pumps in working order(yes or no):NO Alarms in working order(yes or no):NO A< Comments(note condition of pump chamber,,condition of pumps and appurtenances,etc.): n/a o n :I j' R Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r PART C SYSTEM INFORMATION(continued) , x Property Address: 86 OAK ST CENTERVILLE,MA 02632 6, Owner: JIM FENNER Date of Inspection: 3/12/01 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) i If SAS not located explain why: n/a Type n/a leaching pits, number: n/a FLOW DIFFUSERS leaching chambers, number: 4 n/a leaching galleries, number: n/a n/a leaching trenches, number, length: n/a n/a leaching fields, number: n/a E n/a overflow cesspool, number: n/a '' n/a ; innovative/alternative system K'; Type/name of technology: nla 5 ,F. Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): THENEW LEACH FIELD APPEARS TO BE FUNCTIONING PROPERLY,THE SYSTEM SHOWS NO SIGNS OF FAILURE. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a v, F PRIVY: (locate on site plan) Materials of construction: n/a r Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): { n/a 4 Page 11 of 1 l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C f SYSTEM INFORMATION(continued) Nr Property Address: 86 OAK ST CENTERVILLE,MA 02632 Owner: JIM FENNER Date of Inspection: 3/12/01 g ' SITE EXAM _Slope t . _Surface water _Check cellar Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan,reviewed: n/a NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators', installers-(attach documentation) YES Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: USGS MAPS AND CHARTS- 12+FEET' .c a e e f r j Page 10 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ',i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) sg . '1 N� Property Address: 86 OAK ST CENTERVILLE,MA 02632 Owner: JIM FENNER Date of Inspection: 3/12/01 Ni'R SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. t Locate all wells within 100 feet.Locate where public water supply enters the building. ' e t , <sr rrlf�; T ; I t. peg ' A814b AC 45 a A Sy p �a�•�l EIq c ik gp N y a YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in the Town (WHICH YOU MUST DO according to M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1" FI., 367 Main St., Hyannis, MA 02601 and get the Business Certificate that is required by law. (Town Hall) s 7 DATE �� i/ Fill in please: /, APPLICANT'S YOUR NAME/CORPORATE NAME �GZ.-Y� r� ec 15 erle S — -eto I �/>/� �, l y' BUSINESS YOUR HOME ADDRESS: IAi (i __ _- a -r�S f at r -ylil f} _ - - - TELEPHONE # Home Telephone Number 5o CS 24, S/ O NAME OF NEW BUSINESS C_l c(,,, ,,? Fi51.i i es TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES NO Ft`5 h'�v,a Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS CecA v S" p .S pt,.��'� MAP/PARCEL NUMBER When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you .have the appropriate permits and licenses required to legally operate your business in this town. . I. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 2. BOARD OF HEALTH This individual ha been infor f he er, it requirements that pertain to this type of business. Authorized S' nature** COMMENTS: 3. CONSUMER AFFAIRS ( ICENSING AUTHORITY) This individual has en ' fo�dfe licensing requirements that pertain to this type of business. Authorized Signatu e** COMMENTS: Fee No. s 70 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIPP ication for Mt5posW *p5tem Cow5trurtton VCrmtt Application is hereby made for a Permit to Construct( )or Repair(V<n On-site Sewage Disposal System at: Location Address or Lot No. �o �'� Owner's Name,Address and Tel.No. V Dok sr. Nil l�l� 11; 6 Installer's Name Addre s and el.No. 7J /�z�/' Designer's Name,Address and Tel.No. �3 (�ov�"s�" rrrr// JJ � Type of Building: Dwelling No.of Bedrooms 3 Garbage Grinder(-tille 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 Description of Soil Sege r) Nature of Repairs��'Al r ions(Ans er when licable) 01 2 /��� ��� Cl /'✓` DlldGt�' 1✓ �!2s�D� 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 t B of U01th. Signed Date Application Approved by a Application Disapproved for the following reasons Permit No. Date Issued M. —.------------------------------- ————————— Ar-''1 �e. �.4. I t.. .. -- N'„—. .... /'ill. ! ti.'• h....J. .. .I _l ([ WSJ v No. - ae+x. 41 Fee— �. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS. ` 1 01pp iratton for-Mtopo5al *pgtem Con6tructton ermit-v Application is hereby made fora Perrrr t to Construct( "")or.Repair( an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. I,v. lgrhs)`o � .A Installer's Nam/ee,__Addre and Tel.No. y y fix�y Designer's Name,Address and Tel.No. P Type of Building: Dwelling No.of Bedrooms Garbage Grinder Other Type of Building_ if No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1/40 gallons per day. Calculated daily flow er gallons. Plan Date Number of sheets Revision Date Title Description of Soil S&e.1A01e19 Nature of Repairs or Alterations(An er when plicable '4-4 6 , V 3 �. ..5for� ' ;'_K 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 t ' Boar of alth. Signed Application Approved bye Application Disapproved for the following reasons Permit No. Date Issued• 1 THE COMMONWEALTH OF MASSACHUSETTS ) 73—e' ll PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,tY}at the On-site ewage Disposal System installed( )or repaired/replaced(�)on by Dr o G4 f o�1S }1/l/G7`�'f�r 7~4►r+J�' �'/��'r�'y'' as T6 O0i� 411e6z' �4,I)f07tPkIe- e has epuconstructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. C, dated Use of this system is conditioned on compliance with the provisions set forth belo No. Fee v THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migotal *p5tem Conotruction Permit Permission is hereby granted o Or to construct( )repair(✓�n On-site Sewage System located at rx 40 and as described in the above Application for Disposal System Construction Permit.The applicant re ognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction 3MU s a co =ple d within two years of the date below. Date: a` ` Approved by X� (� CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUC LION I,Eltlltl'l' (1V1'I'I(OU'1'I)ESIGNED PLANSI I, pdkf�+' �' f�'o�foL� � , hereby certify that the application for disposal works construction permit signed by me dated �/ZS��6 , concerning the property located at 51 40,k meets all of the following criteria: /There are no wetlands within 300 feet of the proposed septic system /There are no private wells within ISO feet of the proposed septic system �✓ 'he observed groundwater fable is 14 feet or greater below the bottom or the leaching facility There is no increase in flow and/or change in use proposed /There are no variances requested or needed. SIGNED: DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER (Attach a sketch plan of the proposed system. Also if the licensed Installer posesses a certified plot plan, this plan should be submittcdl. r' clj Z 4 AsBuilt Page 1 of 1 TOWN OF BARNSTABLE / LOCATION V O WAGE # VILLAGE �' 'VVSESSOR'S MAP& LOT17 INSTALLER'S NAME&PHONE NO. X0fie7Za A SEFTIC TANK CAPACITY LEACHING FACILITY: (type) A or,S l r�� (size) /-9 J(AV�X NO.OF BEDROOMS 3 BUILDER OR OWNER a022 el^ PERMITDATE: 3��fd1 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility y Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet OF Edge of Wetland and Leaching Facility(If any wetlands exist lee Feet within 300 feet of leaching facility) Furnished by_ � (• �� i` O � http://issgl2/intranet/propdata/prebuilt.aspx?mappar=173011&seq=1 5/29/2013 TOWN OF BARNSTABLE LOCATION (p OAk4 S 1 SEWAGE# G I L� �rrvTlrRv� VILLAGE'WES i b UE ASSESSOR'S MAP&PARCEL ( 1`3 Ol r INSTALLER'S NAME&PHONE NO. WC-WtD& EN`T �f�1S C -c'�7� SEPTIC TANK CAPACITY CRA LEACHING FACILITY.(type) f 1p 1..�'.(n 9';c� �(size) NO.OF BEDROOMS 4 r A t t,)6t l G0A#1-aGP, w r 5Taie OWNER D 4a3�f�lZ PERMIT DATE: �Lo j k COMPLIANCE DATE: 9-(Q---L014 Separation Distance Between the: �1 Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility —[ A® 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) (p O s Feet FURNISHEDBY CAIDGWMF E6)TW1,Ai5;E5 LLc .a ' g A-1 1Z1 3, A I © A-z= t9.z 2 O �� g-z 2�l•s s 4-3= SS 43` 3 ® C—lP 4`1 TOWN OF BARNSTABLE LOCATION96 Qk SEWAGE# 20(7>` Z(0-1 VILLAGE We S S OR'S MAP&PARCEL Al'L_ C1' -o INSTALLER'S NAME&PHONE NO.C.mw;• c ,C`nIc,raime-, LLC'. ff-IM-7 77 SEPTIC TANK CAPACITY MW LEACHING FACILITY:(type) -T J (size) " 1t NO.OF BEDROOMS OWNER an j'e t A + De by-ci A DW TE K PERMIT DATE: 2®i 3 COMPLIANCE DATE: ihy 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) IV IA Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY 64D t en S es 4,i-- MIN 8-4e 43 , TOWN OF BARNSTABLE / SEWAGE # J — l1 IVA i II:LAGE __SESSOR'S MAP & LOT 7 �11 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY )�DOO L / LEACHING FACILITY: (type) (size) /Z X NO.OFBEDROOMS 3 BUILDER OR OWNER) 155COn e1"" PERMTTDATE: 1 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) lee- Feet Furnished by �:� / - t y�3�b .19 , 7NA TOWN OF BARNSTABLE �' ']" � SEWAGE # oillE �/�(�� ASSESSOR'S MAP & LOT 'S NAME & PHONE NO.NK CAPACITYFACILITY:(type) (size) ` NO. OF BEDROOMS PRIVATE WELL O C WATE BUILDER OR OWNER i DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 5 a �1-9 a No.... ..... FEs....S..©.. THE COMMONWEALTH OF MASSACHUSETTS -�-� BOARD OF� H�EALTH ,.V ..............OF........ M". _� :.. Appliration for Dispas al Works Tnntrnr#iun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at �>'rr£R V 1�t.F zfj Lo ation-A dress or Lot No. .....................f�.l. ! !�- .........U-Ab/.•-• t z.l? .) -_--__-----•---_- - .......----.......-•---... Owner / Address a � _t�..E_•••--AR__-�N_ v!1...) !•4�.......... ............................................ Installer Address UType of Building Size Lot____A_49:10 o___Sq. feet Dwelling—No. of Bedrooms............__________________________Expansion Attic ( ) Garbage Grinder (N)q- 04 Other—Type of Building _R�_______DA.;EL No, of persons____________________________ Showers ( ) — Cafeteria ( ) a' Other fixtures __________________________________ ____- W. Design Flow............ ___________________gallons per person per day. Total daily flow......3_a.0.......................gallons. 9 Septic Tank—Liquid capacity.(IM._gallons Length `"_._ Width_.. . . �____ Diameter________________ Depth................ x Disposal Trench—No. ...........A....... Width......C I......... Total Length..... ._.___.__ Total leaching area____`I_�.......sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-" Percolation Test Results Performed by__________________........................................................ Date___-.._..._________......._____________. 1.41 a Test Pit No. I_._.G.a__..minutes per inch Depth of Test Pit_____ ___________ Depth to ground water.... .......... Li, Test Pit No. 2......G.a_minutes per inch Depth of Test Pit.....t9........... Depth to ground water-------&kA......... (. S-••-----• 'f O Description of Soil................. . -------- ? -----__. V ...............•----.._...-•-••••-•..__.._.....V-s•at•------•---- q.r••••--•••------•--...----•-•----------•-----....--•----•••••-•---•------....._..-•-r..J.....----•-.._..-------------- W VNature 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 f Co c has been - u d by the board of health. ignd........%..""""""? .... ......Z Z. ......... =---•----------------•- .......2 I. .... � .•••- te AXpplica Approved BY .... ....... ••----. .. .._. ••-••-•••----•-- ----- . Dat Application Disapproved for the following r asons:-•••----••-•--••-••------------•----•••--••-•------•--•-•---•-•--•---•------•-•---- .......... -........... ..--•------------------•-•----•---•-.....-•••-----------•-_•---- --••-----•-•••-•-------•-•••----••---•-------••--_---- Date Permit No............... ..:� ................... Issued. - Date 0 Upper Cape Engineering P.O. BOX 616, EAST SANDWICH, MASSACHUSETTS 02537 (617)362-6281 Oct 10 , 1986 Board of Heal th Town of Barnstable Hyannis, Mass. Dear sir : We have caused to inspect sewage system #85-1154 for Karen Fenner on lot 11 Oak Street Centerville , and it was found to conform with the plan submitted by All Cape Engineering Co. liThank you ohn Jacobi —BOCLCA-6-�A,e.4,l c� Bcor -54(e . jj O vN_7J�' 85r �c2tne._b3O4Yd •Q_ _ �._s- lu.� we .s__w I_ d st_y.m- e_ 4, C e, 1ni5 i�s _•_ Ip�;s. . e—,^o r ���C'o�s Luc-�-�o� c�.c��s r��� v� C'a k�w v_CAQJ, 1 5_eJ SQ,v�-o v► Co van vv.� o t �c�c e _ova In ov ev.0.�Unc?r —C ea_l u v►�d 5�'�'�a�,le i Vk_ Cv P 1 � vac,✓ V 5 rl d 4; wv( r c e C� C�5 _� �D cc�� 2 (pv_►!�/lo_U_5�.—�c_.�=°��t ��C-�rP w►e co✓+�f l/- I �U_e` UV1r• 0 a_U._1�IS_�K re�_c�c_��_�c� ++�r e Co16.iARre P c, L^Q f k e v h g-.��h Q e!��p We r ..No. W124- IFSF as4 z. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. ... ................OF...... N ^...'P .- ` ...... .. Appliratiun for Bispaoal Works Toustrur#iutt Vrrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at:� .-•----..... .... ---- •••--- -•} [ �`•S—� , C,£V�£R V 1 1.F (� ation- dr ss or•Lot No. oil - --------------- ------------------------------- --------- ..... ...........................Address w w� N ....................--....-•--•---...... . ........•----•-•------------•------•....--•-••.................................................. Installer Address Type of Building Size Lot._.4:.4- -400 S feet --- 1-, Dwelling—No. of Bedrooms............... _.._..._....Expansion Attic ( ) Garbage Grinder (N a ......... Other—Type of Building R �?V4L No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures Design Flow........... c=....................gallons per person per day. Total daily flow..... .3. ....__..................gallons. WW Q� -f. .. <s' d Septic Tank—Liquid ca.pacityj..........gallons Length..:............. Width................ Diameter................ I�enrh...._.-......--_ Disposal Trench—No...........!........ Width_...h: ......... Total Length 2-c7 I x gt .................... Total leaching area-------------------sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.....-............... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.................................................. ---- Date..................... ,4........... Test Pit No. I....L..�._.minutes per inch Depth of Test Pit....g. ........ Depth to ground water.... b.. _......... r� Test Pit No. 2......L.a.minutes per inch Depth of Test Pit....."9........... Depth to ground water......�. ......... x --------------- -- ---------•---• -------••-- _--- Description of Soil..... r 0 + S t ..3loin! ........... c., --------------- ........................ -vs---...----•_` ;1,1 ."........------------.....-----------------------...----------------------------------.......---......--•------------ w UNature 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 Compl' "rl has been y' ued the b and of h lth. 1 d - ... .. ....._.... .......... y� P XApplicatidn"Approved By............................ ..... ---.!:..�............... ... I � �t � Application Disapproved for the followin easons:..................••--•-...........................__. _........._ ........Da....__...__»_ ---•---•------------------•-•-----•-•--.....Date--•-----...._. PermitNo--------------C S•-••--..�......4 Issued--•--•---....-•..................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD Q.F, �EALTH Trrtifirab of Tuutphana THIS IS TO CERTIFY, That the Ind*vidual Sewage Disposal System constructed (� or Repaired ( ) by............................ ..---....i.L,,F( C'rD 1 �i T t(Z V c r a i -•----•----•---------------------------••-------•--•-----•--•--.....------•--•------.......----..................---....---.....---.._....._......_ at-------------------••--�c�. .----- -o l� j nstaller C IvTIE R J1- L • --------------------------•----------•---•---•--•--•----••-----......----....------..-.--. -------- has been installed in accordance with the provisions of TIC �5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No............--a....J-115it.y-..... dated.--..1. �� .lc�-�................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTI N S/ TISFACTORY. DATE...................... ................ ..� ,......................... Inspector .... ..... p ...... ........ ..........---•••....... D £SrG.t'v'rivo THE COMMONWEALTH OF MASSACHUSETTS l�ivS-f OfY Ft7�/ `€M0460- SvPF_ RQ15E BOARD O HEAL - f-lc vh {,vvvS -f H1E �d`�1PtL�+'1'r'l�N , t --- O� 'Fh€ 5Y5 {v►1� h f -r J s 2 SSt. . No....... z.. .._..... ` . ..........................................OF.' �`•'............ ......... Fes. SG7�.. ........... Poposal Varks Tunu#r ur#iu rani# Permission is hereby granted. .1-c...... ..: W--•...... .......................................................,.... to Construct ( j,'or Repair ( ) an Individual Se age DI sal S, t�nv LGf atNo..........- f1�...... ....l.l_..... 1 .�� ................. af_0...................----Street d ...... .. ....... -_. - '�s�//S9" �''Z � ,• as shown on the application for Disposal Works Construction Permit No................. d.... 3 te .- ..................................... .:.. ........................---•--.--------_ 7 - Board of Health DATE..............• - FORM 1255 A. M. SULKIN, INC., BOSTON II 20 FT Mik TOP OF FOUND EL 10 FT MIN. CONCRETE 4" SCH. 40 PVC —CLEAN SAND COVERS PIPE- MIN, PITCH 1/8" PER FT PRECAS T FLOWDIFFUSOR 2" ��,R OF CAST IRON 12"MAX. 1/8'- WASHED PIPE - MIN. PITCH F_ 1/4" PER FT STONE FLOW LINE z 0 ' EL.= I to P� MIN. EL ^a 0 c E,L EL 219-0 0 EL.= EL. n 0.8 0 D ED ED EL.= EL.= LOCATION MAP DI ST, 3/4'- 1 1/2"___x20 BOX WASHED STONE 0 0 SEPTIC GROUND WATER TABLE EL. s-S� 0: v TANK 5 17, ZZ S PROFILE OF SEWAGE DISPOSAL SYSTEM NOT TO SCALE 4,00 CESIGN CALCULATIONS SOIL TEST NUMBER' 'C'F wEDROOMS ..... .... .... ... x DATE OF SOIL TESTT_ GARBAGE MSPOSAL UNIT... ... • TOTAL ESTIMATED FLOW WITNESSED BY L 62 GAL/ BR./DAY x _7� BR ) . . . . .. . . 13 0 GAL./DAY PERCOLATION RATE MIN./ INCH REQUIRED ScPTfC TANK CAPACITY.... ... GAL. OBSERVATION HOLE I OBSERVATION HOLE 2 -Z ACTUAL SIZE7 OF SEPTIC TANK .... GAL, ELEVATION 3 3' ELEVATION LEACHING AREA REQUIREMENTS 0 GAL./S.F. L SIDEWALL AREA BOTTOM AREA Z GAL./S.F. s So! S014 LEACHING CAP�iCITY ( BOTTOM SIDEWALL) GAL. 01 RESERVE LEACHING CAPACITY. .. . .. .. . . . , 14E P� w,-.GAL. v,-L lz :1/. 7 NOTES VI,-?7-5R �_'z C�j 6- )AIA�IE le @ 20 7 LALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO DEQ,E. TITLE 5 AND THE TOWN OF RULES AND REGULATIONS FOR SUBSURFACE DISPOSAL i OF SANITARY SEWAGE iq 2. COMPLIANCE WITH ZONING REGULATIONS SHALL BE DETERMINED BY BUILDING INSPECTOR OR BUILDING BUILDING SETBACK REGULATIONS PER BUILDING f COMMISSIONER INSPECTOR OR BUILDING COMMISSIONER MIN FRONT SETBACK 3 EXISTING 4ND FINAL GRADES SHALL REMAIN ESSENTIALLY MIN REAR SETBACK THE SAME MIN SIDE SETBACK } �' j j ,;? M!� ✓ F"�r;P / F 24vn '� APPROVED : BOARD OF HEALTH DATE AGENT �;A/ D `57�41_-)kvv 0^1 3 _�s PROJECT LOCATION, 0,e.S7 A\ 7 _4 f APPLICANT H y:D IAF14/1 7 /00 C- cn,I SCALE: , ,, OR BY: E LEGEND 6. . I -)I or H. EXISTING SPOT ELEVATIONS 00 X0 _ -ZC�I JOB NO.: APPD. BY: REV. ,T �..., qT� EXISTING CONTOUR 00- -- -- - 2 AL LA l! FINAL SPOT ELEVATIONS oho 0:00— R. J. 0 HEARN INC DRAWING F!NAL CONTOUR REG. LAND SURVEYORS REG. SA1V!rAR!41V5 r. SITE PLAN SOIL TEST LOCATION 1348 ROUTE 134 P 0 BOX 1263 W SCALE : EAST DENNIS, MASS OF :f i Clat)epr 81, 4KTW 3S _ f 89 q _ a �17 U I- au 57 it i Y (/ i• � !�� � � �•�� � !f i� � - �4 � . v?' �L�e� ate.. i. L� � � - f7.r+•• TOP 0 F F�:1�S�6�J. �' - .,M...«•,�.-.�--•�,�:..�r,�& .r EL:. 10 F 1. MiN. CONCRETE 44 COVERS CAS.L IRON PIPE - MIN. PITCH 12 X. i.Q.: I/4° PER FT 1 FLOW LINE" EL., low No, 'LOCATION MAC GAL,,. SEPTIC TANK c • r,( 1 n P u° 1 tw 4Y x SEWAGE ` IL NUy*E,Rl- Of DEC GARBAGEr- TaTai_ F.. . ,,,N ,EACi 3 Na . oll RESERVE U�: LALL WORKl l OF SANITAi 2.COMPLIANCE ETA 1 + 1 S M ' W 100 r Y 1 oLr ,C�+' f�°'!. { t { `••{ J� ' - .ate t. ..?'!'w : µ 1iX 'Fil'aAlA i - N;2,L i s .. R3 C A, E r .4 'xt '4, SCH. 40 ,PVC - f, "LEAN SAND , PIP ,I�t:k PITCH ` r t/.8, PER T f PRECAST • � F1 { K y � FLOWDIFFUSOR .. Z E --- _�� STONE' ' n ' r� 4 CD d `J, /f S �X EL DI ST. WASHED STOfvE `s. 1 ,El k,Ni GROUND WATER TABLE �,:�!' ? r �3sr�a � . 5 ,FILE OF POSAL SYSTEM , e TO SCALE a 3 AL ULAT1�} S SOIL TEST k �: EDROOMS _ Y OS AL UNIT-___.. . lyrlrr,� DATE OF SOIL TEST ! EO FLOW WIT14ESSED BY ��'A� OR,JUAY x 2 8R. ) .3 0 GAL./DAY ' .. PERCC,Lea T ION RATE I�w,/,JNCH` ' ?'IAN' rt. CrAPAt :,,; _ ...� .- _ G... UCR.�tw �° i! � r! �- i1t ?: jf ! ION LP0`7 <. ,,., -.` �61� e+i� ,y i�`,. V...t� i u 1..+'.,.) ;1 ffi T°t t { s A t:tiJ •,F SEPTIC TANK o" _GAL. ELEVATION 1=LEVATION !c'31,.: `, REQUIREMENTS . ti AREA .:. GAL,/S. f f Z r✓� YEA _.? '� .GAL./S.F. CITY ( BOTTOM SIDEWHLL) _ �'�:� vI.L. / Q�.. :>,t P, 1 ykl6;tom . _ ':. j t 1p4, I !✓ ��FXI�s rid ,f. A. •W. ff 4... ',.�f PJf'L!` N'd" ..^ -P' F •y,pA HING CAPACITY........... GAL.. I r e' Sry I ,!SHIP -AND MATERIALS SHALL CONFORR+? ! ' ' 17 _ r. ITLI" 5 AND, THE TOWN OF L;. d . ?GULATIONS FOR SUBSURFACE DISPOSAL SEWAGE : x ,.'iTH 4ONiNG REGULATIONS SHALL BE ` BY BUILDING INSPECTOR OR BUILDING BUILDING SETBACK REGULATIONS PER BULL DING INSPECTOR OR BUILDING COMMISSIONER PMIIV FRONT SETBACK f FINAL GRADES. SHALL REMAIN ESSENTIALLY .t MIN, REAR SETBACK . ., 'Il f._ _ MIN. SIDE SETBACK - J ter+ Y F/9c.,=��n:'� DATE . •''e'-f 4.w aY'�rJ'..af �"l''� f'.'ar'ICY 'C:./.�.I• j{��,,.,,,13/'F', (..l Y�`�� -w' ,r C,...+ �.,..�._.-.,..�..�...�....-...�_-._�...:__ s _ l ....r.. a...-�. r.+ ' y`3 PROJECT LOCATI q.` _ ry C. , f" tJ ,+C'� j'.'l"4 '. C^a "k..1*G �,+'" i•.. + ,r� «:. 5 . APPLICANT w E V o� RICHARD r4 y����t 5,. SC,�I E _ r t'j ; C3P Y 1 t I ' . ° J. Y `" F� ,, RICHARD, ,T 'EL EVAT KJ f30,xO EARN r^ v O'•H ME5 JOB K . JA _, r. APPD. gt'; .TOUR -. _. �'. .» _ .. %. No.278 O K6RN I n 6 _ 73 70 o �> E:LEVA"ExQNS f / 4 +•... .� Ski iN 1 .�.�F�i/ ✓�U Y ` ae�. . ap�� a 3' _ `! - _.. +•S!-: ROC', W; 3r- 541V7gn�rx�: -S J �r, FAST Oe-h"Nl5-, - .. r ..,_y.m. a;.,.�a.+--'ram-^.:^^,.,.^+.T rra+'^ -.:.+-.•. - Try -`��, sN C .V c.'�". F..