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HomeMy WebLinkAbout0024 LONGVIEW DRIVE - Health 24 Longview Drive Hyannis P u ff A" = 252 075 I P r a Town AR: arnstable e# Depae tment otRegnlatory Services .nw,mr�ars Public k�[8a1fh�Dlvis><ou Hate. Date Sehew", au, y! Ttme FeelPd.' � A tON e Disposal s Peifotmed BY 3 - a Witnessed'By.. t ,a, LOCATIOI & NEAL IlVFORMAxION �" " I.oasttonAddress v fi �� g";r ChvnersName ��J�)r..I�� c ^ Addtess' Assausot s MapPacce! � a Engineer s Namt �' �� e NEW CONST UC a wr4 REPAIR Telephone t and Use, S(opes ,�yq 5lutaee Stones D statxes tiom: Opea Water Body tk._ Paxvhle VVet Aiea7tV ft 'Dnnklilg Wafer Wettff .; �" Iha,nage Way Lr?,�tC I'ropetty(;tne ..�v 'R' 'Other A «' SKETCf (Street name dimeiisiotls of lot ersoi locatrore oGtest Notes&-pert tests;torate'v etlarids m proaruity to hailer) ' W AF _ .3 x �,' • ...a w.,.,r .T,.,.,. 6 .• ti ^ 3 E w T ,> 6 $ � r s � ��� -- — " q._ Parent matenat{geologlb � Depth 3?,edtook Depth to Groundwater Stan& Water m Hole 4V"Pns from Pat Face. ;-A )~sumated5easoraaiHighGriiFmdwater � !y �� nawm s" - DETERMINA TI©N It SEASdNAil I3IGH WATER;TABL Method Used ?r z u Depth Obsen'ed standing m obs hole m D to smi mottles' m Depth to wasp ng frwaside of obe hole _ to Gm mdweterAdlttsttttent R ,. - IudoxWelllt Reading Date. Indexttreille�rl :,AdI factory Adj 6&ia�Uw I Observation � � E �_ � '^ Hala�r- � Ttme'at 9" v�'Y►l DepthofPero ; l '� ` Tiiae at b _�_i1'h( c E�Pre soak V a a y Rate�Mina7ncli �, x�°•' 'y � r r� � y � `� 5rietiSwtablhty_Assessment'.SRa Passed Sale t ided Addrtiatal TeshnE Neetled'(Y/M) . i ? 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A � � , Ccrhficatwn Lcerttfy,that an `� tJ Z {date)I have messed the soil.a ,tor vminination approved by th ' Department o..Env:t)nm tat`Ezotcction and that.the above analysis ryas perftirinei!bj me cansisoent vnth .,".,�I.I-,.I,7�r�'.1.,.���.,.'­'.� �.._Z.".,:1.,P',:-r.�.,..1.,-I 1 I1I­r,�Ir"l,�.I:,"I":I,.r.'-""%rt.I,'��:Ir..I_:�I..I-rr'�:.�,I the iegtiued trainvig; tYise"and experience desCribedt m 3I0 CNIlt'I S':01x7- Signature, bate . y � II� ��,.r,':.;; r, 1:.�:. rr I:�.::�. �: r;,.. ',,:�1 :,'I` �I I11, r. .�"-�/' _ , ,.�_,:,,:1I.,_�,'1�"�I.I,..r I:'�".I 1.�-_,'�..—:1.I Ift,II..:,,.­rr;�1..'�'.,,r,r.I_I��''1.::,,�r�,��,...",..k�'.�I_..r,,�-,,.-�II.r:1"',�'gI,­..,—7,:,I I."­Ir..­1�.��,.��_"II—�,-.�r.y I','-1;1II .:Q .r r..._' QF iCtPERCFORMDOC a COMMONWEALTH OF MASSACHUSETTS ..�. . , ,. A PAS 1'ASLE °"' EXECUTIVE OFFICE OF ENVIRONMENTAL f� 'AS d DEPARTMENT OF ENVIRONMENTAL P"XFAWI44N PM 3: 43 Y H ,B.David B Mason RS,Certified e Inspector, - - d Title V It 5088332177 Sye TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION 2 HY A N N% 5 ',P --�-- Property Address:24 Longview Drive,E MEF ille,MA ,ARC'—CL Owner's: Greg Hamm pp; Owner's Address: 120 Buttonwood Lane,West Barnstable,MA 1C C Date of Inspection: March 21,2005 Name of Inspector: (please print)David B.Mason Company Name:—N.A. Mailing Address:4 Glacier Path East Sandwich,MA 02537 Telephone Number:508-833-2177 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes _Conditionally Passes _ Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signatur . L"-ate: c3 105 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments: System as inspected appears to have operated based on occupancy level. Increase in occupancy may cause hydraulic failure. The information as identified represents only the condition of the system on March 21,2005 at 4:00 PM. ****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. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:24 Longview Drive Owner: Hamm Date of Inspection:March 21,2005 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _X_ I have not found any information which indicates that any of the failure criteria described in 310 CMR 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. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection ifthe existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or 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 obstruction is removed distribution box is leveled or replaced (THIS IS REQUIRED TO BE COMPLETED) ND explain: 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 obstruction is removed ND explain: OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS Page 3 of 11 PART A CERTIFICATION(continued) Property Address: 24 Longview Drive Owner:Hamm Date of Inspection:March 21,2005 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 2. System will fail unless the Board of Health y (and Public Water Supplier,if an determines that the PP � Y) system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: The primary cesspool is not a typical configuration for a cesspool. It appears to be a pipe cylinder with an inlet pipe and outlet pipe with tee connected to a pre-cast 4'deepz6'diameter leach pit with stone. Permit on file with the BOH for the pre-cast leach pit. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Page 4 of 11 PART A CERTIFICATION(continued) Property Address:24 Longview Drive Owner:Hamm Date of Inspection: March 21,2005 D. System Failure Criteria applicable to all systems: 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 %2 day flow X— Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped X_ Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. _X Any portion of a cesspool or privy is within 50 feet of a private water supply well. —X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] _No_(Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes—no.: the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone R 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. Page 5 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 24 Longview Drive Owner:Hamm Date of Inspection: March 21,2005 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? 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) X _ Was the facility or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS,located on site. _X_ _ 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? 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 _X _ Existing information.For example,a plan at the Board of Health. X Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Page 6 of 11 PART C SYSTEM INFORMATION Property Address: 24 Longview Drive Owner: Hamm Date of Inspection: March 21,2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 (per assessors records)Number of bedrooms(actual):4 septic design DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): (440 gpd capacity) Number of current residents: Does residence have a garbage grinder(yes or no):NO(Not Allowed) Is laundry on a separate sewage system(yes or no):NO [if yes separate inspection required]Per owner Laundry system inspected(yes or no):NA Seasonal use: (yes or no):NO Water meter readings,if available(last 2 years usage(gpd)): 2004:54,000 gal. 2003;68,250gal. Sump pump(yes or no):No Last date of occupancy: current COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CUR 15.203): ON Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM X Septic tank,distribution box, soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information:Approx.2001 Were sewage odors detected when arriving at the site(yes or no):NO OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Page 7 of 11 PART C SYSTEM INFORMATION(continued) Property Address:24 Longview Drive Owner: Hamm Date of Inspection: March 21,2005 BUILDING SEWER(locate on site plan) Depth below grade:Approximate; 14 Inches ' Materials of construction:_cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line:_NA Comments(on condition of joints,venting,evidence of leakage,etc.): Appears in good condition. No evident leakage. SEPTIC TANK:N.A.(locate on site plan) Depth below grade:2 inches Material of construction: X_concrete_metal_fiberglass _polyethylene_other(explain)_ If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: Typical 1500 gallon tank Sludge depth: II" Distance from top of sludge to bottom of outlet tee or baffle: 14" Scum thickness: 10 inches Distance from top of scum to top of outlet tee or baffle: 15" Distance from bottom of scum to bottom of outlet tee or baffle: 12.5" How were dimensions determined: Actual measurements with tape and scour stick. Condition of tank(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.) PVC inlet tee in good condition,PVC outlet tee in good condition,Effluent level with outlet pipe. In need of Maintenance Pumping. No evident structural issues GREASE TRAP: N.A. Depth below grade:_ Material of construction:_concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Page 8 of 11 PART C SYSTEM INFORMATION(continued) Property Address:24 Longview Drive Owner: Hamm Date of Inspection:March 21,2005 TIGHT or HOLDING TANK:—N.A.—(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX:_X (if present must be opened)(locate on site plan) Depth of liquid level even with outlet invert: liquid level even with outlet 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.): Indication of solids carryover. D-box 26 inches below grade. PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition.of pumps and appurtenances,etc.): OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Page 9 of 11 PART C SYSTEM INFORMATION(continued) Property Address:24 Longview Drive Owner:Hamm Date of Inspection:March 21,2005 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: Type _leaching pits,number _X_leaching chambers,number:4 _leaching galleries,number: leaching trenches,number,length: —leaching fields,number,dimensions_: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etch Four H2O 330 Cultecs with stone around. There was a five foot overdig at time of installation based on plan. 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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: N.A._(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.): OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Page 10 of 11 PART C SYSTEM INFORMATION(continued) Property Address:24 Longview Drive Owner: Hamm Date of Inspection: March 21,2005 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. Q 07 z3 53 o 0 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Page 11 of 11 PART C SYSTEM INFORMATION(continued) Property Address:24 Longview Drive Owner:Hamm Date of Inspection: March 21,2005 SITE EXAM Slope Surface water Check cellar (crawl space) Shallow wells Estimated depth to ground water_15_feet Please indicate(check)all methods used to determine the high ground water elevation: _X_Obtained from system design plans on record-If checked,date of design plan reviewed: _X_Observed site(abutting property/observation hole within 150 feet of SAS) _X_Checked with local Board of Health-explain:Recent Test Holes, Existing engineer records with BOH _X_Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Utilized existing site design information on file with the Board of Health. Additionally,existing site and abutting site topography does not indicate ground water to be within 5 feet of bottom of leaching facility. Engineered plan on file with the Board of Health prepared by Sweetser Engineering on August 1,2001 does not indicate ground water as an issue of design. a " TOWN OF BARNSTABLE LCACA'I'ION L.© SEWAGE # �� G VILLAGE ASSESSOR'S MAP & LOT��� ' INSTALLER'S NAME&PHONE NO. J?CsS© SEPTIC TANK CAPACITY LEACHING FACILITY: (type) e-/ " A/90 `�,C o f T4rX$ (size) NO. OF BEDROOMS BUILDER OR OWNER PERMIT DATE: is I COMPLIANCE:DATE: Separation Distance Between-the: Maximum Adjusted Groundwater Tables he Bottom of Leaching Facility Feet Private Water Supply Well Leaching Facility-(If any wells exist on site or within 200 feet of I Ching facility) Feet Edge of Wetland and Leachin Facility(If any wetlands exist within 300 feet of leaching facility) Feet . Furnished by r r. `o Y 1 {I��/\y ��, '� \I S3, i s ;, w °� i w No. Fee$50 / _ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppricatton for Mtgogal *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )0 Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 24 Lon-gvilew Dr. , Centerville Steve Bates Assessor's Map arce Z Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service Sweetser Engineering P O Box 1089, Centerville P O Box 713, S Dennis Type of Building:. Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 2QS_ No. of Persons Showers( ) Cafeteria( ) Other Fixtures ,'� Design Flow -17' 7 c) gallons per day. Calculated daily flow 'yam Z4 gallons. Plan Date Number of sheets Revision Date Title 6. Size of Septic Tank 5 M Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Title-5 septic System to the plans of Sweetser Engineering, dated 8-1 -01 , # 5190-00. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by thisAvarp6f Health. Signed �'�a/ d = DateJ Application Approved by Date (7 Application Disapproved for the following reasons Permit No. 7. )/—��-� Date Issued �6 a0 M v No. 6 ' Fee 1 5 0 / 1 ✓ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBL-fe HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0(ppitcatton for Dtgoal 6p$tem Cow6tructton J)ermtt Application for a Permit to Construct( )Repair( )0 Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 24 Longview Dri, Centerville Steve Bates Assessor's Map arcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service Sweetser Engineering P O Box 1089, Centerville P O Box 713, S Dennis Type of Building: I Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building S No.of Persons Showers( ) Cafeteria( ) Other Fixtures ~Design Flow gallons per day. Calculated daily flow "I'=>y tl� gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank M66 Type of S.A.S.-13W 2 CO{ tQ D IX Es�_Wj Description of Soil Nature of Repairs or Alterations.(Answer when applicable) Title-5 septic syttem to the plans of Sweetser Engineering, dated 8-1 -01 , # 5190-00. 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 Environment 1 Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this az cf Health. ' Signed / 1 Date Application Approved by Date d Application Disapproved for the following reasons Permit No. 7,ed / S Z'' Date Issued �. ---------------------------------- —————— . r THE COMMONWEALTH OF MASSACHUSETTS Bates BARNSTABLE, MASSACHUSETTS Certificate of Comphance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( X )Upgraded( ) Abandoned( )by Wm. E. Robinson Sept ip-iservice at 24 Lan qv i eta Dr..-, form i-A''ry i 11 e --U7 S--'-- has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit Noted/-S-6 Z--dated V"16-G 1 Installer Wm. E. Robinson Sr. Designer Sweetser Engineering The issuance of this permit shall not be construed as a guarantee that the s3ste//will function a4s,,desig ed. n Date �`? J�)i Inspector �C � G .'�1/��r 7),, i No. ���� Fee $5 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION --BARNSTABLE} MASSACHUSETTS . Bates lwi5po5al *p5tem Conttructton Vertu Permission is hereby ranted to Construct( )Repair(X )Upgrade( )Abandon( ) ISystem located at �L4 Longview Dr. , Centerville I 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 rrjost be completed within three years of the date of this e it. Date: Approved by A Ju,T-13.70'1 ,LZ..Z4 BARNSTABLE HEALTH [7EPT 5087906304 5125101 NOTICE:Th&Eora rs T&Be Used For the Repair Orr a Ted Septic SSysWms Only- ERCOLATION TEST AND7 SOIL EVALUATION EXEMMON' FORM I, Robin- w:. Wilcox hereby.certify that the engineered-plan-signed by me- dated:. August: 1, 2001' concerning the: property locatedat 2.4 Longview Drive,,. Centervilie meets- alf of the following criteria:_ This,failed system-is connected to a residential dwelling only.. There are no commercial or-business,uses:associated with.the:dwelling: • The soil'is classified as:CLASS L and:the°percolation-rate is.less.than orequal.to 5 minutes.per inctr:- The:applicant may use historical data to conclude:thin fact or may conduct preliminary tests at:thesite:without.a.health-.agent present. There:is no increase°:irt flow'andlor change:ini use-proposed �► There are no.variances-requested'orneede& . • The bottom:ofthe,proposed.leaching facility will not be.located less than fourteen (14)feet above ther maximum adjusted groundwater table elevation. [Adjust the- groundwater table-using the Frimptor method when applicable:]. Pleasecompletethe Folrowing A) Top:-of Ground Surface:Elevation:(using.GIS,information)- B.) G-.W. Elevation: +adj'ustment:for high.G.W. _ • O Cc G DIFFERENCE BETWEEN A:andB �✓ � Z Z BU SIGNED. DATE: NOTICE: Based upon the:above information. a.repair permit will beissued.for bedrooms maximum.. No additional.bedrooms are:authorized in-they future without:engineered. septic system plans: y:heaWfoWer rump. 77' TOWN.OF BARR"!,E LOCATION 4�� LOCA L SEWAGE # y. VILLAGE I ASSESSOR'S MAP & LOT-S � _7-75r; . INSTALLER'S NAME &PHONE NO. -9-1 -7' 4 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) Z-X'� (size) NO.OF BEDROOMS BUILDER OR OWNER C PE : ITD' COMPLIANCE kM A .DATE:; 7. Separation Distance Between the: MaXimurn Adjusted Groundwatet table e Bottom of Leaching Facility, Feet Private Water Supply Well the (If any wells exist n Feet on Site or within 2001eet of I Ching:facility) c i�ta c e Edge-'of Wetland and Lew i Facility(lfanyw wetlands exist within 300 feet of leaching facility) Feet Furnish ed'by :q. q, 7 L .moo , -Ze / V- 7� "SST 20 FROM "CELLAR SOIL FT. MINIMUM ' TOP OF FOUNDATION DATE',OPtO4L JEST Ju�� 26-god-1 ELtV.* '10 FT. MINIMUM FROM SLAB OR CRAWL SPACE 10 FT.' MINIMUM CLEAN SAND SOIL 'TEST DONE BY SAEETSE81INIGINEERING (ASSUMED) CONCRETE COVERS AM AND SEED ELtv. 92.40 LO OBSERVATION HOLE 1 .4* SCHEDULE 40 PVC PIPE LAYER OF DEPTH HORIZ TEXTURE COLOR MOTT. OTHER, -7, TO 1/2 LEGEND: ASHED STONE 0-13 FILL MAX., 92.90 MAX 4 ' CAST IRON PIPE VENT. EXISTING SPOT ELEVATION oo,6 NO MAX. W.65 MIN. NOT REQUIRED Do---- (OR EQUAL)•MINIMUM EXISTING CONTOUR A PITCH 1/4- PER FT. r_/ 9 1 CU. FT, OF FINAL SPOT ELEVATION 1.3-20 A LOAMY SAND IDYR6/6 ROOTS CONCRETE FINAL CONTOUR TEE SOIL TEST LOCATION ANCHOR 20-36 8 LOAMY SAND 2.5Y6/4 ROOTS SLAB ELEV. 22-60- FLOW LINE 89.90 UTILITY POLE -0- TOWN WATER -W-- MIN, 36-132 C FINE MEDIUM 2.5Y6/4 lot COBBLES ELEV, 10" CATCH BASIN SAN GAS LINE 10* 815.57 ELEV. - \-ELEV. H-W44", 6, LNEL ELEV. u 4mp ELEV. 0 CLEAN OUT 0 0 0 0 BAFFLE 0 0 0 0 0 14" o CESSPOOL C.P. 0 $7.40 DISTRIBUTION ELEV. 0 ELEV, iFQUTID OUTLET P H TEE (TO BE PLACED ON FIRM BASE) BOX 4 FEET 14 INCHES TO BE WATER 'TESTED 4 HIGH CAPA TYINFILTRATORS WITH 5 FEET 19 INCHES IF MORE THAN ONE OUTLET SONS 0 6 FEET 241NCHES 1500 . GALLON (TO BE PLACED ON FIRM BASE) NE IN AN WELL N/A NO WATER ENCOUNTERED AT 132", ELEV, __W_4D_ 7 FEET 29 INCHES 8 FEET 34 INCHES SEPTIC TANK 1191 39 X 2' 1 TRENCH FORMATION 6-00 ZONE 3/4- TO 1 1/2- CLEAN INDEX DOUBLE WASHED STONE SOIL ABSORPTION ADJUST FREEOF FINES &,SILT DESIGN CALCULATIONS SYSTEM (SAS) 4 NUMBER OF BEDROOMS zrl SEWAGE DISPOSAL SYSTEM PROFILE GARBAGE DISPOSAL UNIT no NOT TO SCALE TOTAL,ESTIMATED FLOW USGS PROBABLE WATER TABLE ELEV. ( 110 GAL/W/bAY X 4 OR.) _M0_ GAL/DAY OBSERVED WATER TABLE ELEV. REQUIRED ,SEPTIC TANK CAPACITY GAL. BOTTOM OF TEST HOLE ELEV. ACTUAL SIZE OF SEPTIC TANK 0 GAL SOIL CLASSIF1 CATION DESIGN PERCOLATION RATE ;j,j7 MIN./IN. F. j EFFLUENT LOADING RATE 0.71 GAL./DAY/S LEACHING AREA SO. FT. (1108)+(40 LEACHING CAPACITY AREA X RATE GAL DAY 114.00 X 0.74 X 101.2 RESERVE,LEACHING CAPACITY A91CV ,GAL./DAY . x 10 8 NOTES: 1. ALL'WORKMAN$HtP AND -MATERIALS, skA R LL OONFO M 70,01-P. 1DOA f TITLE 5 AND THE.TOWN OF RULES AND REGULATIONS,fOR THE SUBSURFACE DISPOSAL OF-SEWAGE. 2. ALL, COVERS-TO SANITARY:UNITS SHALL BE BROUGHT x 1 11.0 WITHIN 6" OF FINISHED GRADE. 7,5 P 3 ALL COMPONENTS OF THE SANITARY' SYSTEM SHALL BE CA ABLE OF WITHSTANDING H-10 LOADING UNLESS THEY-ARE UNDER.OR.-WITHIN 10 FT, OF DRIVES OR PARKING AREAS.-H-20,LOADING SHALL BE USED UNDER OR WITHIN 10 FT. OF,DRIVES,�OR PARKING AREAS. 4. ANY,MASONARY UNITS USED TO BRING COVERS',,TO' GRADE,SHALL v 4p BE MORTARED IN PLACE., 5. NO DETERMINATION HAS �BEEN MADE AS TO COMPLIANCE W, -REGULATIONS., OWNER, APPUCANT IS JQ - DEEDED OR ZONING OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 6. UTILITIES SHOWN �ARE APPROXIMATE ONLY, EXCAVA71ON CONTRACTOR,, IS TO CALL DIG SAFE AT 1-888 344-7233,AT LEAST 72,HOURS w PRIOR TO COMMENCING WORK ON SITE. X 1co.9 IS TO VERIFY GRADES AND:ELEVATIONS AS WELL.As 7. CONTRACTOR 98.94. NS PRIOR TO COMMENCING WORK-ON.SITE. ANY 'VAIRIATION ITE.CONDITIO IS TO BE BROUGHT TO THE I:ATTENTION OF THE 'DESIGN ENGINEER, 96,7 IMMEDIATELY. PL06D ZONE C. X 98.7 8. PARCEL IS IN 9. LOTJS SHOWN 'ON ASSESSORS MAP AS PARCEL 10, EXISTING CESSPOOLS 'IS TO BE PUMPED AND BACKFILLED., 11. ALL UNSUITABLE. MATERIAL 'SHALL BE'RWOVED 'FROM UNDER AND FOP' A MINIMUM OF.-5' AROUND soiL-ABsoRpnow AND BE D'.,-'REPLACE-SYSTEM FDIN310R 5.255 (3).NTH SAND AS SPECI M t��t�OF y 'As's ROD[ N GALLON 98,0 _00 GA x DUMAS X 95.4 D. BOX 93.4 SEPTIC TANK vr HEALTH 93.1 !1341 APPROVED, BOARD : AN x 93.1 21 3. V14X AGEDATE N Im, L 'DESIGN , pf _TEST P"^'m^SED '-,SEPT1C :`, FOR LIMIT OF Ou 5' OVERDIG B SA S.A iri A x 91�.o PROJECT LOCATION mvTS 6 a 'D cil 24 T ^W11 AREA SWUM= k 90.8 16s773 SQ. FT. 235 GREAT WESTERN ROAD BOX 713 ' j 508-, SOUTH DENNIS, .MAtS. ­3922 398 DATE LE TEAUG , t 0 1 , 2001 1 2 x 86.9 'NO. REVISED 51 00 FRASED LOCATION . - MAP ENC;INL C:,\S8\FROJ 5190-00\DWG\5190-00-DWG , 02001 SWEEMR_ ENGIN G -,L