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HomeMy WebLinkAbout0110 ZENO CROCKER ROAD - Health 110 ZENO CROCKER RD., CENT. A=170-133_r._— _ llll UPC 12543No. 53LOR a HASTINGS MN F� No. � ee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: of PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplieation for Bisposal .*pstem Construction Permit Application for a Permit to Construct( ) Repair)() Upgrade( ) Abandon( ) [:]Complete System [�/ndividual Components Location Address or Lot No.e iG�Q z��l�acr�`, e n Ow?p jj j me,Qddreesps,and Tel.No. 9 O� b 1 Assessor's Map/Pazcel .,. p►Q e Idler' N e,A s,and rNo. �' Dest ne 's Name,Address,and Tel.No. {� eN �-�� ��� /t', 74* Type of Building: ` - cl� )Lot Dwelling No.of Bedrooms Size sq.ft. Garbage Grinder( ) r Other Type of Building / No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required)' gpd Design flow provided gpd -Man Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) A- Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance the afore described on-site sewage disposal system in accordance with the provisions of Title 5 o o nt a and n t o place the system in operation until a Certificate of Compliance has been issued by this and of He Signe Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued 6 1-1 1 ja f :i .. ,..�-rc: T s� ry t•,.✓.n... ` ,, e..I•. •c.,' e���- �rytb',�. . 1 lL .i t,.�.. .. ... No. _ rol Fee ../ THE COM�ONWEALTH OF MASSACHUSETTS. Entered in computer: ✓ Yes C ­ PUBLIC,HEALTH DIVISION -•TOWN OF BARNSTABLE, MASSACHUSETTS ftpiication for Zispasaf 6pstem Construction i3ermit Application for a Permit to Construct( ) Repair(X) Upgrade( ) Abandon( ) ❑Complete System i [�/,dividual Components Location Addressor Lot No. Owner's Name, ddress,and Tel.No. . Assessor's Map/Parcel .7 D //0 ���,� �Q�• �'� r ; � I Ile r' Name,A dr ss,and;VA.'No. Desi ner's Name,Ad Tel.No. + ' i 71 ; pe of Ty Building: �-7! ) Dwelling. No.of Bedrooms Lot Si zeC sq.ft.. Garbage Grinder( ) '4 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plaq Date Number of sheets Revision Date ~ Title F q. Size of Septic Tank >QjQ Type of S.A.S. Description of Soil 3 '' ,,Nature of-Repairs'or Alterations(Answer when applicable) /on IA'e ems► �� / � Date last inspected: ' Agreement: The undersigned agrees to ensure the construction and maintenance �f the afore described on-site sewage disposal system in accordance with the provisions of Title 5 o he-En k o nt l*C de and not fo place the system in operation until a Certificate of Compliance has been issued by this Ward of Hea z S. /"'� Date ti Application Approved by `� Date.<' t Application Disapproved by t 1 Date for the following reasons ` Permit No. Date Issued /l ,. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance ' THIS IS TO CERTIFY,tha the On-site Sewage Disposal system Constructed( ) Repaired( () ' Upgraded( ) d. — � Abandoned( )by �u v_0 a<- - at //p ��/t,O � � has been constructed in accordance with the provislMIA�of Titllee55 and �the forbispdosal System onstruction Permit No.���l' dated Installer 5f l / (4 fa 10 ; v­ I G :7 / 0 X)Designer r #bedrooms Al�/� Approved design flow �j i,gpd } _The issuance of this-permi,hall"n6t be construed as a guarantee that the system.will ond designed. r Date p �� Z ( Inspector .1i ------------------------------- - ----------------------- --------­­­=�­­�--------------- ^0 2. �,Z r No. 1 I Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction permit Permission is'hereby granted to Construct( ) Repair( j(� �jUpgrade( ) Abandon( ) ,,�^ System located at &12 ,C � k9 Q Cnp r f*+ L ►— �i ( 'x 1^ I.,/f 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. R Provided:Construction must be completed within three years of the date of this permit. Q Date Approved byfl/ /35.1.5 • i )A r � • 1 •` C2V 7 s L-XIsT Foun[o. VIA 35 14- aZ �4Z ZoT /a 5.49 R= 97' . �P�' N OF Af � WILLIA ' M. � W On the.baeis of my knowledge, information and belief 9 .I certify to The Town of Barnstable, /UN,0ATAW.CEeTIFI,�2-101%1 :.. The Boston'Five Cents Savings Bank and Ticor Title Insurance, Co. that as a..r_esult. of a survey made on the ground on 3o a , I find r L07- � that: The shown.structure (s) are located on the site as • i 'l//LLB;..!'.: The title .line's and lines of occupation of the ' site are as shown hereon. The site is situated .in ..FlQo.d.-Zone Community_1'_a LelSLo. Date: _...--...............-•_--.. Date: R7 ., _ . ... . . , • !/'i/ 1:Gt�.�Fr'N//GK_¢�.r955aG., //VG William M. Warwick, LS � �X �� No F,4'LHo07 Yj N1X-5, t� Coammohwealth of Massachusetts _ - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 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: only the tab key to move your MICHAEL O'LOUGHLIN cursor-do not Name of Inspector use the return key. Company Name 714 MAIN STREET Company Address YARMOUTH PORT MA 02675 City/Town State Zip Code 508-362-4942 577 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to,,,,$ection 11,5-40 0.5 Title 5(310 CMR 15.000). The system: N` :rr ® Passes ❑ Conditionally Passes ❑ Fails," "" 1 ❑ Needs Further Evaluation by the Local Approving Authority(2) LA/i ''. 3, 3 5/20/14 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. J MvUrface t5ins-3/13 Title 5 Official Insp Sewage Disp6sal System-Page 1 of 17 Commofiwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh (Sins•3/13 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 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the 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 '/2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commoriwealth of Massachusetts 4 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 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 CM 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. Cityrrown 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): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commoriwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. Cityfrown State Zip Code Date of Inspection D. System Information Description: 1,000 GAL. TANK INSTALLED 1985 , D-BOX AND LEACHING 12.5'x25'x2'WITH TWO 500 GAL DRYWELLS AND STONE WERE INSTALLED IN 1997. nt residents: UNKNOWN Number of current Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Detail: 2013/66,000 GALS. 2012/57,000 GALS. Sump pump? ❑ Yes ® No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commorfwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. Cityfrown 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: OWNER TANK PUMPED IN 11/2012 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ❑ No Building Sewer(locate on site plan): Depth below grade: 1.5' + feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 30' feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): 1' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1,000 GALS. 8" Sludge depth: 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ,.•'' 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. CitylTown 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 25" Scum thickness 6" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 11" How were dimensions determined? TAPE MEASURE Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): APPEARS TO BE IN GOOD WORKING ORDER , DOES NOT NEED TO BE PUMPED AT THIS TIME. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M y 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. Cityrrown 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 t5ins•3/13 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 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISO.N Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): APPEARS TO BE IN GOOD WORKING ORDER, THERE IS SOLID CARRYOVER FROM TANK. ~ Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: (1) 12.5'x25'x2' ❑ 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.): APPEARS TO BE IN GOOD WORKING ORDER , EXISTING EFFLUENT LEVEL IS 5" FROM THE BOTTOM OF LEACHING , THERE IS SOME SOLID CARRYOVER AND NO SIGNS OF HYDRAULIC FAILURE. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts L W Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 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-3/13 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 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 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 A D a 3-7' � Olt® t5ins•3113 Title 5 Official Inspection Foam:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts L Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ' 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. Cityrrown 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: 10' +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: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: BARNSTABLE GIS MAPS. You must describe how you established the high ground water elevation: GIS MAPS SHOW A 50'CONTOUR AND WATER TABLE CONTOUR OF 33'. BOTTOM OF LEACHING IS 64" BELOW GRADE. Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 110 ZENO CROKER RD. CENTERVILLE Property Address BRENDA MORRISON Owner Owner's Name information is required for BARNSTABLE MA. 02632 5/19/14 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ❑ System Information— Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 i r No. `� .� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN 09 BARNSTABLE, MASSACHUSETTS Yes 01ppYication for Digaar *pgtem Construction permit Application for a Permit to Construct( )Repair( )Upgrade(/Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. !la Z e/ID G�'vG,L'err Owner's Name,Address andTel.No. Assessor's Map/Parcel ewl, �'(/fA ,_�i/O� Rio -ewe fro ew Ce�rYir�/� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 001-XP Xe�1 7 7/-1 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder('�1e Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 gallons per day. Calculated daily flow 332P gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. ®�Ow . ti G �vj�rrS Description of Soil Nature of epai`s or Altgrations(Answer/when ppli able) 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 issue t i o of He Signed Date Application Approved by _ Date Application Disapproved for the following reasons Permit No. " i ' Date Issued No. 9 Fee THE COMMONWEALTH OF MASSACHUSETTS 'Entered in computer: Yes PUBLIC HEALTH DIVISION - T01bg 0P BARNSTABLE., MASSACHUSETTS Rpp_Yication for Mi5pogar *pgtem Con.5truction Permit,- Application for a Permit to Construct( J.Repair( )Upgrade{ Abandon( ) ❑Complete System ❑•Individual Components Location Address or Lot Now��D ,P fJ�C/DC,�P/'i'C Owner's Name,Address and Tel.No. J"i Assessor's Map/Parcel i Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ®r o Za/y1 Ca�� 7 Type of Building: Dwelling Na.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder('12W Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow o�;3� gallons per day. Calculated daily flow 3M -.-.gallons. Plan Date Number of sheets Revision Date tf X Title ' Size of Septic Tank l®d®aDf Type of.S.A.S. Description of Soil l Nature of epai or Alterations(Answer when applicable)4 Ld.:i75/ '�D�' 7����/e! 1 m& 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 i o of Health- Signed Date Application Approved by Date SZ 2!7 jam.' Application Disapproved for the following reasons Permit No. s Date Issued THE COMMONWEALTH OF MASSACHUSETTS /,,}j' BARNSTABLE, MASSACHUSETTS Certificate of Compliance "T THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded,(,.,I, Abandoned( )by : e7 X at /Ja 2 e has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit A.92 _dated 7K7—� Installer. gel y~ 4o ?,�/ �, 5�; Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector ! 7 No. --------------- / �C/ / �j3 ---Fee eq�.�'j THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migw5ar *pMem Congtruc ion Permit Permission is hereby granted to Construct( )Repair( ' )Upgrad ( Abandon( ) System located at Ile ZC/I r i�r//rah and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this p,eimit. Date: Approved b `To'7" NOTICE: This For>lxll Is To Be Used For the Repair Of Failed Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORDS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I. �Gel't,Z A©l-��kWl . hereby certify that the application for disposal works construction permit signed by me dated s concerning the property located at 1/&-2j7DGG,�Bsd'/'� meets all of the following criteria: ,�,/There are no wetlands within 300 feet of the proposed septic system here are no private wells within 150 feet of the proposed septic system The observed Groundwater table is 14 feet or treater below the bottom of the leachinv faciiity v n There is no increase to Clow and,or chan_e m use pro�osea 1� T _Here are no variances requested or needed. SIGNED : DATE: /- /,::; 7 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 submitted]. q:health folder:cert b tV 0 �1 CA 1. b5 p � TOWN OF BARNSTA.BLE �J LOCATION, M Z�j'IO C/'vG' el- /'DW SEWAGE # VILLAGE en>'e/'v'/'/�� _ASSESSOR'S MAP&LOT /70-/33 : .'INSTALLER'S NAME&PHONE NO. /�% 0� / .�/15 7����j9� 'SEPTIC TANK CAPACITY '>LEACHING FACILITY: (type) 2.—S�dDg/ 6! �Z'PIiJ. (size)S/d 3.X 2J ex � NO.OF BEDROOMS 3 BUILDER OBC"._" PERMITDATE: S�� 9 7 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) 'v (/ Feet Furnished by f e'10- yqX. O 3s, so' O TOWN OF BARNSTABLE V �y10 /"OG el' 144° SEWAGE # 'des?? LOGATIO �f� C ASSESSOR'S MAP & LOT '7Vg33 INSTALLER'S NAME&PHONE NO. � � SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 2 —�� � lL'�G"`'"(size)5/,�10, as�xa NO. OF BEDROOMS 3 BUILDER Oog;a PERMITDATE: S-/ `l7 COMPLIANCE DATE: S" - I,�-_ Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ea 31 36, S0, WN OF BARNSTABLE LOCATION /�' "/` � SEWAGE #?,)!S LI VILLAGE; � � ASS SOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table,to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by I Lam.. 1 2 I t 5y 170 -pT LOCATION SEWAGE PERMIT NO. tA10(o zcA)o Crab--e4 ato 5s-5'7, VILLAGE INSTALLER'S NAME i ADDRESS T �B U I L D E R. OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED t�` �. _ _ ., q t,�,�, �� �.'• ` � � � `fir. t � ,. s E z No d' >' Fss. .�........ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH yam' .................. ..._.....----------..OF.... ,gyp irFatilan for Bispos al Works Tnnitrnrtinn Prrmit Application is hereby made for a Permit to Construct N) or Repair ( ) an Individual Sewage Disposal System at: � . Location Addr s O t 10 1.�._._ '`r... �. t 1 SS -.. ... .. ....................... Own (,,,,�(� `: •!�� 1. .mod'� 1® Installer Address U Type of Buildi g -� Size Lot_- ?-4J.7.-�---�-...Sq. feet .-� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures, ------•---------•-------------------------------------------------------------------------------•---------••--•------------------------------------- W Design Flow.................. gallons per person per day. Total daily flow._._.__...__.. ..............gallons. WSeptic Tank—Liquid capacity..Jii i?.gallons Length..SF Width________________ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length--------,............Total leaching area____.__.___......_:sq. ft. it Seepage Pit No_____________I--•-•-- iameter.........__ .'1lDepth below inlet___._1_�z...___. Total leaching area-.��:.9sq. ft. Z Other Distribution box ( Dosin tank ( ) Percolation Test Results Performed by.UVIV = _ _ Lam, Date._ fit.. a -. _. ..._..__-•--. Date.... Test Pit No. 1..... _L minutes per inch Depth of Tes Pit--_-___J Z�._ Depth to ground water----------- rZ4 Test Pit No..2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ............... .............•--------- ----- ----- Description of Soil............ _ _ ._..: _ ... .1?�.� _� _" 20ii� Csc �L f -+ —t ' W ------------------------------------- __= -'' — •t •-.-----P'� - - . .i�1-.� 1' ( -----•--------- -----------------------•----------•-------•--•. x -•-------------------•------•--•---•--•-----------•••-••-----------•••••-------•----------------•--•--•-------•------•--•••---••-••-------•••----•-••------------------•-•......---••----•--•-••------•- U Nature of Repairs or Alterations—Answer when applicable................................................................................................ 4heis --•-•--•-••----------••-----•--•--•••--•-----••--••••••-•-•....-----•.....•-------••-----•-•---•••---•---•••••-•------••---••-••----.............. .......................... ' rsigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with of TITLE 5 of the State Sanitary Code— The un rsigned further agrees not to place the system in a Certificate of Compliance has been ' s by he oar health. lciz ned......•• ... ----• lP-- te Application Approved BY :.14,4 �_.................•.... .. �. .. ..................... Date Application Disapproved for the following reasons---------------------•---------••-----------------------•---------------------------------•......----•--••---•... ........---•--••---------------•-•--------....------------------•--------••------•------.....------•----••----•-•••-•-•---...-••----------•-•---•-•-----------•-•-•----•-------•----•-••-------••..----- Date Permit No -- - f -• --...----••--- r No.c7: Fps.. .... THE COMMONWEALTH OF MASSACHUSETTS BOA RD�-7OF HEALTH ............. ...._..-..-------......OF.-.!.4. . .��..-_:I.'`-4-?.�'��' ............................ Applirtttinn for Dispntitti 10orkii Tnnitrnrtiun ramit Application is.`hereby made for a Permit to Construct ( r Repair ( ) an Individual Sewage Disposal System at: ....`..................�....... _ 2-.......` � t.... .-c1�..... . � t ....... ' = C v 1 L L Location-Address or Lot No LLQ�C•l �_�__c rcy `� !C, kc.. f?r. � ~L_ t r� r ��S / C . ' ! V Owner --..... - _ Add . ........................ Installer Address i v dType of Building Size Lot__..____d_________________Sq. feet aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) p I Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) P' Other fixtures _.. d -----------------------------•-------------------------------•---•-----------------•------- W Design Flow..................._�;_.................... per person per day. Total daily flow..__._.__.____���®..............gallons. WSeptic Tank—Liquid capacity._(tl0_gallons Length_ !` _ _:_ Width................ Diameter---------------- Depth................ x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area............__... sq. ft. Seepage Pit No_____________ _______ Diameter............ Depth below inlet....A.:�:.�..... Total leaching area__7 _ sq. ft. Z Other Distribution box Dosing tank ( ) '-' Percolation Test Results Performed b .i�_ � `?�---__________ __ Date.... ZG aTest Pit No. 1....... minutes per inch Depth of Test Pit_______1 __. Depth to ground water......:^'—____-_. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ -------------------------------.....................-.............................................------------------`--------...--••-----•--...........--- O Description of Soil ='--------�Z?_�%_°._a=:-'_i>__�,�_c� s L'_:: z�- �/� t..3 � 4 C"V'-i`•.,V��- V i W ••--------------------------•---•-•-••-•----•------••--•--•--.._..-•-•-•----•-.._._.------•.-•--•-•-------•---.._...--•-•------.._-----------••--•---------------._._.._..-•-••••-•••.._........_..._. U Nature of Re airs or Alterations—Answer when applicable............................................................................................... ------•-------•- -•-- ......-......................................................................................................................................................................... Agree n -. e t ersigned agrees to install.the aforedescribed Individual Sewage Disposal System in accordance with the vis is of TITLE 5 of the State Sanitary Code—The and rsigned further agrees not to place the system in e ion til a Certificate of Compliance has been is,a by he oar o health. ned 1 =" _________________________ __ff .._.__ Application Approved -.. Date Application Disapproved for the following reasons:.............................................................................................................. ....---•-----------------------------------------------------•-------------------------•---------------...--•.-.--.--.--...------•------------------------------------ ----------------••------- Date PermitNo......................................................... Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH OF............ ,.................................................... . C�rr�ifirtt�e laf �unt�littnrr THI I C hFY T h IIp vidual Sewa e `isposal System constructed or Repaired ( ) f by....-- � ----- �•„-, -•----------•---._..... y- S .---•--------;,�.:,------- -----•------ ------------- at `y -- '/0 f 0 ` j_ r� tat �C . � � p �/ has been installed in accordance with the provisions of TILT r of to SanitaryCod dese ib d in the Works for Disposal orks Construction Permit No. -- ------•--•-- dated--------- _ 4 - ---- ................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTR ® AAA ARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................. ............................. Inspector............ •-•------- THE COMMONWEALTH OF MASSACHUS S BOARD' HEALT NLl FEE........................ T-Ln tr on Vrrmit 4 s Permission is hereby granted---- _---f ----------''' !' 1 to Cons ug, � ) or.F,.ep r cc an I vldual-Seiva Dis osal System _ Street fr y! f f "- as shown on the application for Disposal Works Construction Permit.No. .""_•___.._______ D'ated_._ (.:............................. +" t DATE..............- ----------4.............. Board of Health FORM 1255 HOSES & WARREN, INC.. PUBLISHERS Vic: ,,t.• ._---- --- ------ - - _..------_ __--- -----.._..------..__ ------.....__.. �4 .r;., SITE PLAN sHEEr I of 2 SCALE: 7. Vp ,.8 t 1l ap laoo G+A.L,_g.Ke,pT q-- rA iJ K - - .. _._._ O _O 4 SL • 1.c�•,-Z.-1 � . ,� _ . � I I F s , a � Wt►AJAM v •:. 1877 �o , 90Nfss REG1gTE��gJQ L%Ci ��c�t`cJ • FOR �r;'.REG/STEREO.LAND SURVEYOR • . ��.� ��� � G�v���,� Ryl�,f3 ZONE I�G _G 1 si.1t" ��/t u•,� A�.�i Li, :PLAN REF DATE 5 / =iBENCH MARK MARK DATUM ..ic—L1 'D 5✓ `� ' 1 WM. M. 'WARW/CK 8 ASSOC., INC. ��OOMESTIC WATER SOURCE _tZ:lk)t wA,TBOX 80/ - . NORTH FA MOUTH zt :. .• fL000`ZONE— AZA.tzT7 �L� MASS.;02556 - (6/TJ 563 -2638 a_ I- e. G. k; LEACHING 8AS/N SECTION NOT TO SCALE Shcel 2 '� Z 24C.I.MH COVER. RTH FILL EA BRICK AND MORTAR COURSES AS REOD• TO BRING - q"• _.r•s: COVER TO GRADE 4.. B FLOW LINE INLET _i_ 2 y"r0 "WASHED PEASrONE FREE. OFIRONS, P/PE T; FINES AND DUST IN PLACE "J N ' r'• 4 OPEN/NG WITH 4%B" if 1 •I •' 44" r0 /%2"WASHED CRUSHED STONE, FREE OF .OUTER D/AMETER IRONS, FINES AND DUSr /N PLACE ANO / /q„INS/OE .. DIAMETER I. CONCRETE TO BE 4000 PSI 28 DAYS • 2. REINFORCED WITH 6"x6° N0. 6 GA. W.W.M. 3. 2'AND 4' SECTIONS ARE AVAILABLE FOR I GREATER DEPTH REQUIREMENTS 40" �-- 3'=--+---6`0"--�-�--� --� 4, NUMBER OF PITS REQUIRED ZWE MIN. I IER EFFECTIVE DIAMETER NOTE: EXCAVATE TO ELEVATION 39-4-OR (NOT TO EXCEED 3 TIMES EFFECTIVE DEPTH; LOWER AS REQUIRED TO REMOVE ALL WATER TABLE - LOAM AND CLAY BENEATH PIT. REPLACE EXCAVATED MATERIAL WITH CLEAN TYPICAL PROFILE GRAVEL TO DESIGNED GRADE. 1✓L•la�` 93• /8"STD. LT. WGT. C.I.My COVER 2 a 51•y 51 I.PIPE ; 4"B/T,FIBER PIPE pUTLET LEVEL DWELL/NG FLOW LINE T/GNT JOINT o TO FIRST JOINT -- -•Y. ,_.,.: T _• 14" O O 1 I 0 vO 0 1.1 c.I. rEE 41. 4l 6 S' I I o 1 0 0 1 1 "-i l 1 0 0 0 0 0 f i l l 4' 4-7• T0, PRECAST CONC. ,3 D/ST. BOX TO BE 4 . 0 1 1( 1 0O 00 11 i �QQQGAL.SEPTIC TANK. INSTALLED ON LEVEL, 1 1 1 0 0 0 00 01% I I • "' STABLE BASE 1 1 1100100 00 ;, 00 NSEPTIC TANK TO BE 1 11 /0 0 0 0 I It INSTALLED 0 LEVEL 1 1 f 1001 0 0 1 1 1 ; STABLE BASE. 1 1 1 0 0 0 0 0 1 11 1 1110010 0 1 1 1 1 LEACHING BASIN i 1 I f 80 O O D l i BASE TO BE LEVEL i i I 0 00 1 SOIL AND PERC. DATA Z 0 TEST PIT NO.. P 3 7,.q 0' TEST PIT NO. 2 PERC. RATE MIN. /IN. , \ TEST BY"� - �'�-U�� � e-L-D � 157A Q C> &q A,v�� WITNESSED. BY TEST PIT GR. EL. 61 . 11 AA �D l UM SAhI D DATE o 2 S `p I�' �l,'�j• q.l� (,�Iz.ov 1.1 p w,cam•-r��. DESIGN DATA GENERAL NOTES BEDROOMS NO HEAVY EQUIPMENT TO RUN OVER SYSTEM. DISPOSAL IJ o Q L SEPTIC TANK, DIST. BOX AN LEACHING BASINS TO BE STANDARD EST. TOTAL DAILY EFFL.t3fGPD. PRECAST REINFORCED CONCRETE UNITS. SEPTIC TANK I odo GAL, ALL .SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE . TO REVISED TITLE '5 OF THE STATE ENVIRONMENTAL CODE SIDEWALL AREA Z­2GAL./SQ.FT. . MINIMUM REQUIREMENTS FOR THE .SUBSURFACE DISPOSAL OF I BOTTOM AREA _GALAQ,FT. . _ SANITARY. SEWAGE EFFECTIVE ON JULY I , 1977. ,.LEACHING REQUIRED ZUn SQ.FT., ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD ACTUAL LEACHING AREA OF HEALTH. S42 Q.FT, • •,.::AT -COMPLETION OF CONSTRUCTION, PRIOR TO BACKFILLING, THE BOARD OF HEALTH SHALL BE NOTIFIED FOR INSPECTION. PITCH ALL SEWER LINES 'A" / FT. UNLESS INDICATED OTHERWISE. . 511 OFF1\` • o�� 9ci SEWAGE DISPOSAL .SYSTEM MARTIN' 'c 4 (✓ mil �y l�L-o�S v MORAN rn W 1 6 �-� p G G 123417$ � � �� 1L�� '�o_Jll"[7 s/o/rnL;� SCALE AS INDICATED DATE s 3 va WM. M. WARWICK 8-ASSOC., INC. BOX 801 - NORTH FAL MOUTH ` MASS 02556 - 16171563-26.39 PROFESSIONAL EN61NEER Y 3B'-B' — — — — — - �m ` CIIII/ - - - - I � Y g N A � � 4 �1 Ewsrus!sr F�on 4T rw v - 8'rt1DY Q � a P4 O N CWJ .o r. :era OCTOBE 21, 2005 C'A i �-1 Pn000scw 2.�o F oon f A 1 { � a O W W � 0 isw E�s.�sTwu WW �ao r F w I/ U � I W � FI] U 9 o z / GNU i ,: A2 OOF 25 Y— ASP�+ALr 5"IW4LES I• M ¢ WAMIZ MEMBRAfJE C� s 5/8° CDX PLYWOOD POOP—A—VFL BAFFLE 2x8 ¢AFrE¢s, 16' O.C. SIMPSON .42.5 CLIPS i� Q S O a WALL $cFFx vE�r CEILIWCq o Q o W W.C. SNAJyLES S FxPOSVRE C 2 8 joisrs 16�' O.C. rvvE�c uouSEw¢AP U x �� ¢-30 FBRyL5. D.iSV-. W ;A 1/2 mx PLY. ? 1/2° S.+EEr¢acx �D O a 2x4 srVrs 16" O.C. n Q q o rz-13 FB¢yLS. WSVIL. 1/2 SUEEr¢oac _ F w E-4 2x8 rLoo¢sr¢uo-u¢� b1 z o SECTION I W 0 i Qua o z N U w o s A3 SLt s2 52 .. F-1 F E%TERIOR PULL NOTE5: 17 Slill Brook Road New eweMr wale b be Ddr $oulh Va—th,MA 02664 /—�'R-21 Inwbtbn W v�or baniu KITCHEN / 10,11y oG Phone:(774)212-0938 FAX:(508)398-0550 is S.rr' _ / ufil���r�i�� email:infOQcavinfRnl.COm 15•-6-r7• �1 F, W W W.CAV I NCENT.COM H.Ra�As 9eaan sE�oacoasmaanea n a BATH Add.... BATH KITOMEN I I T Rcmwe edsling walls end uu LVL a.t .a.tt taE PhonT8112' FAX: v7aHmil: 'ESORO e Consultant: Address: Phone: \, FAX: mail: Address JJJJ Adtlress: 51 Phone: il: Rcmwe c#stlrg 4od and acme cued--ird Consultan,: LIVING Address: B3 DROOM 1a 3.1sH Phone: LIVING FAX: OFFILE -mail: UP t>s 5ta.' C-1tant Address: P Ph- FAX 1 st Floor Existing 1 st Floor Proposed CD ,rdi,.saner,beaan�-B�bal,aal,�ala.'bebwa�e . � {� 6 5 r -- -- -- ———— — -- -- — -- ——— - 4. r _---= --- — ------------ -°=------- T -----`:' I Rat sru—Table I I I I n w Gra bpa e I I No. Desm lion Data Fred Bione ESSCrq Fa,rWetlon 110 Zeno Crocker Road I I I I Centerville.MA i l li{'I I I W I 1 st Floor Plan I' l II 1 1 Irl Date: 728/2014 I I I< I Da.n er CAV I � — -- ------1 I I clad Br CAV L-------- Foundation Scale: 17 Still Brook Road South Yarmouth,MA 02664 Phone:(774)212-0938 FAX:(508)398-0550 email:intaQa cavincent.mm W W W.CAVINCENT.COM Conaeuant: Address: Phone: FAX: e-mail: Consultant: Address: Mane: FAX: email: Consultant: Address: Phone: FAX: email: FB-MWOH Cah-U.nt: Adtlress. Phone: FAX: mail: Consultant: Address: Phone: FAX: BATH email: BATH 5TU- �r.iT.sa OLOSET BEDROOM tsx.las HALL BEDROOM 53.T5 ON O]Ex6i�ta W OPEn BELOW ATTIC 5 4 A LNING AR- ReAslon Table No. Description Date LIVING AREA 2nd Floor Existing 2nd Floor Proposed Fred o 110 Zeno Crocker Road Centerville,MA 2nd Floor Plan Dace: 7/2 812 01 4 Pruleal R as m eY CAV taa By. CAV - A-2 Scale: 7/4•=V