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HomeMy WebLinkAbout0447 SEA VIEW AVENUE - Health 447 Sea View AveG�� OSterville a 1 A= 138-026 - a d �` 1 - a , " r ^ o � , "r t a t ; t r o ,e 4 , u a � , . q � e e , x m , Er. _ v e .e a - ' y _ F r� a' n , F . e , a ° a a i x f 3 a a ro a - a jt m: Ao- � � a� i y , � e °u r o - m , o. L "w � e h ' m .♦ a Y��^ ^ 4 . c i , y s, 9 , a , � a C s , . Y Fee iso t THE�COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplitation for Mishsaf&pStrm Construction Permit Application for a Permit to Construct( ) Repair( ) t� ade andon( ) ❑Complete System ❑Individual Components Location Address or Lot No. l�gr f 7 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 133 Installer lame,Address,and Tel.No. Designer's Name,Address,and Tel.No. J-i/'ec Q LC.CG�ti is ��i Yo�j ���1 MjhCQrro L 8"L'4b ST- OSTcn%.t� ssd p S -y -3s�( Type of Building: Dwelling No.of Bedrooms (ID Lot Size 'f l� 7Z_ sq.ft. Garbage Grinder(A4 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided ���p gpd Plan DateD&,e„j6,r jam, 7_pi` Number of sheets Revision Date Title !j&_ -9 6A.\rpox av{—n a Size of Septic Tank t�®C Type of S.A.S. Description of Soil l{L 13,SQZ 0—W L II-*3(p CI LANkt It U116 40 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board 0Health. ed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No._ /� Date Issued / --------------------------------------------------------------------------------------------------------------------------------------- `--- LEK - c r y, No: t t i Fee ��5 o THE CQMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplitatlon for Vs` 'oBaYs6pBtem Construction Permit Application for a Permit to Construct( ) Repair( ) U�p ade( Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. T, / ��cw, Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel 138 -OZ(p �n� z z, i"' Installer's-Name Address,and Tel. es gner's Name Address,and Tel.No. v t� l`1 c,t c_l l', ,1 r' U '3V Ved�n &n r,cer� � ` i 1 - O s\c• \Irr�Vt� Type of Building: Dwelling No.of Bedrooms Lot Size `t3i S 7Z sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �b® - gpd Design flow provided `P�1� gpd Plan Datet)CLeAAZ� U, Z01k Number of sheets Revision Date Title 'D�ke '?1,^�W(7oxj Size of Septic Tank 600 Type of S.A.S. 5"�0� ,� Che„�,�Q�(�i^ 1 Zito �50t" Description of Soil rkrL 13,S aZ 0'ti< L Uky\ 3�4;2 z (IA�t Z.S�i �I`t Mel d Nature of Repairs or Alterations(Answer when applicable) y z 't Date last inspected: �y 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 Health. i. ed �4GG � Au I Date Application Approved by Date Application Disapproved by Date for the following reasons r Permit No. f 3 `'� Date Issued /C-4- c THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that thee-On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(--r Abandoned( )by .5�«'r /_I r'C G h J7t at 4�7 �et, y�GJ Ni has been constructed in accordance ) with the provisions of Title 5 and the for DisposalSystem Construction Permit N /�. dated l/ Installer �Jv'VCc 1 (C�G�����/�� Designer #bedrooms Approved design flow 66�J gpd The issuance of this peFmit sh" o e co strued as a guarantee that the syste w..functio6as"d e . Date Inspector - -----------------------------------------------------------------------------------------------"------------------------------------ No.C�)C/ f 3 1 Feel (� PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS ]Disposal 6pstem Cvnstruttion Pffmit Permission is hereby granted to Construct( ) Repair( ) Upgrade() Abandon( ) System located at U�GU N"P— 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 mu t be completed within three years of the date of this permit. Date Z / Approved by S TOWN OF BARNSTABLE LOCATION 7 7 / 5ciivreo hvc_ SEWAGE# pZOI/' L132 (VILLAGE C),5(1VAC A�SSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. p Gcc . c• :5 SEPTIC TANK CAPACITY /5-00 6141 arc( /ff—�C� LEACHING FACILITY:(type).00 6AIlol f -.-)-D (size) /J /bG �CJ6 Y NO.OF BEDROOMS T OWNER �e J�(F - �Y�t�J yY0 '_SeAU ce 0 PERMIT DATE: COMPLIANCE DATE: z- 13 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 Z4AI POT ',_PcCa6.1a°l/ Ie dfw � o P�6 G I jJWN OF,RARNSTABLE LOCATION �� PLG1i' A±L SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I LEACHING FACILITY: (type) f (size) NO.OF BEDROOMS _ BUILDER OR OWNER � PERMITDATE: 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 Leaghing Facility(If any w!Pnds exist within 300 feet le ty) Feet Furnished by r a ,m O ` A � t t � 9 � o f/J Se AV/eW * -Rfie Town of Barnstable ,►> , = Regulatory Services NOMNAMThomas F.Geiler,Director , s639. Public.Health Division Thomas-McKean,Director 200 Main Street,Hyannis,MA 02601 _ . Office: 508-862-4644 Fax: 508 790-6304' v__.Installer__&Designer Certification Form Dater Sewage Perm i- 3 Assessor's Map�Farcel 13� 02,E -- -- - Designe InsWir: wee d A d ress: U $�, 6Z6 Address: 8°� 16 448 Os�crti��lc On U ZSS I � cc� _�l s (� was issued a permit to install a- ( ate) (installer) septic system at 44-7 �e�Ur�u _based on a design drawn by address dated IZ 2(0 (designer) 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. 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. { � H OF Mgs (Installer's Signature) s9cy �o JO HNC . GJ O LEA. . . .._ CiVIL No.481.63 90. �FGISTE��� Ll (De per's`Signature) (Affix.Designers Stamp.Here),. CE WILL NOT BE ISSUED UNTIL BOTH Tffi5— — CERTIFICATE OF ---- �L . E RERN-T COMPLIAN FORM AND AS-BUILT CARD ARE - RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.THANK YOU. Q:Health/Septic/Desiper Certification,Form 3-26-04.doc Town of Barnstable P# 1 J © Department of Regalatory Services public MOM Division:.. Date ' 200 Main Sty Hyannis MA 02601 ♦- - .. Date Scheduled �� Q Tuna Nee Pd.. Soil SW Mbi#0 Assessmeld or Se a Disposal Performed By (I iv. d"::"4=h-1 1 e P/j'iG; 1( Witnessed By: LUCATIdht�i tENERAL I1�FORIVIATION Iaeadon Address /7 A 2 e� ow 4,Is Nance ��'Alh :,6�s,Tr P o $DX a7%d y 'Y li" Address : E'Qeuxer'is, C© 4 3� Assessor's M iPaicel. oa aP /✓�� C� Engineer'BNatlle54 v UI NEW CONSTRUCTION - �'REPAIRV ; TelepHona# Land Use � iei�l t Slopes(%) ./�.. Surface Stones:./ Distances ttom:: Open Water Body O R " Possible Wet Ares. It DrinkingWster Well 8 Drainage Way h . R Property Lino 0 R Other.:Ab� ,tt 'SKETCH:.(sheet name,dit4asions orlot enact locations ot•test holes et pare tests,locate wetlands in proximity to holes)' g2 j i . i:: 17e to Bedrock : Parent . (geo,ogic) ' 7: pth ; Depth to Groundwater Standing Watet in Hole:c One Weepl4 ttom Pit Faco Estimated Seasonal Hight3rouadwater �3° Sl CL 1alsYe�t �c 1�F1Z�S� D `I'E AE 1 �1t S ASCIMAL in $WATER TABbE, Method Used:N Depth.Observes standing in obs.hole in. De to soil mottles in. Depth to;weepIng fmin sidai ol'obs:hole: f E in Q undwater Adjustment Index Well# Readirig Date:!. inlet Well`level AdJ.factor Adj.Groundwater Level -I�k`�RCO�TION TES Bate l '.gib Time l�' Observation ... Hole# , , Time at 9" t-c D of PeteTtme o Time(97-6")" Sw Pre-soak Time® i FAd Pre-soak r^n ?�. a RateMmlWc(r 1 . I i f Ir �i I1� Site Failed "Additional Testing Needed(Y/fi) Site Suitability Assessment• SW passed ; original: Public Health Division i. Obsdrvation Hole Data o Be Completed on Back----------- ***If percolation test is to b conducted within.1009 of wetland,you must first notify the: Barnstable Conservation Division slit least one(1)week prior to beginning. 0ASEPU0PERCFORM.DOC IMP OBSE1tVA't'fO1 HOY: 1LQ�G Hole 1# _ Depth from Soil Horizon Soil!Texime. Sod Color Soil Olher Surface(in.) (USDA), —(Munsell) ottling (Struc o,Sto116,Boulders.' ons ste' e J_ 1 y I 1 li I DEEP CS +` ZV' 'f`I0.4 Hb �,C�t Depth fmm Soil Honzori So' 'texture Sod Color 30ll. Other Surface(in.) (USDA). Nursed) Mottling (Structure.Stones,Boulders. Cousietencv aravell o4" Lo 0-3� L� C, L I I 7 7- IDE 1�b R ATIO HO E LC�(1 Hole# Depth from ! .Sod Horizon;; Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) avlottling (Structure;Stones,Boulders. 'Consistency, 1/0 Gravel) I i ! i . E DE I�bBSERVA-1`0 HOLD LOB $ole y... .. Depth from SOiI Horizon Soil T�xtrue Sod, ' Soil Other Surface(in.) f iISDA) j (Mansell) Mottling : (Structure,Stones,Boulders, I Consistence "�Ctrsvell I Flood Ins rafice:Rate:Ma : II �i Above�500:yetut ofidlio�Jn ditvo Yes` i Within 500 year boundary No I Yes I ' t5 t )''Jr"(� Withrn 100 year ffood,b--Uh Jwy.1�10 Yet 10 nv;t- I � il h Of I�atur ail Otenrrr�d I ehio Is Matehal De t t the throu ghout Does at lirast our feet ofjna f1ly'bct ' g perl'ious material exis�in all areas observed t area proposedlforahe soll;itb b iot�s}is If ntrt .what isithe depth df n t �ly!bcc g p�rvtous material? i ertlfication. e C 66db ,th tion a r t1 3 date have sed;the soil e�!al atop examine ._ pp Y Lcertily that oft:, i 1i bepafttnent vEnv o eh 11�cvtettto acid tti t the above anal is was erl~ormed by me consistent with y p i... I !I1�,.. .. :. .::. e Jai Xp: 310 Cji R 15.017. the regttited t aintng, tti a 'erica d schhed ifi I I 'I II Signature Date 1 Z2 -1 Q:\SEpTiCTERCEORM.DOC /3 Y DATE: 3/26/98 PROPERTY ADDRESS:--447 Seaview Ave Osterville,Mass . --------------------- ------------------------ ------------------------ On the above date, I inspected the septic system at theJabove address. This system consists of the following: F. 1 . 2-6,'x6 ' block cesspools. APR 9 1998 or Based on my inspection, I certify the following condition 6 8 2 . This is not a title five septic system. -- This is a sewage syste system that is 35-40 years old. 3 . The sewage .system is presently dry. 4 . The sewage system is in proper working order at the present time. SIGNATUR Name: J. P. Macomber Jr. Company:Josgg] PJ_ 4.gQM gX _� Son, Inc. Address:__BQx 6-L____—__—____ Phone:— 508-775-3338 -------------------- THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. Tan ks-Cesspools-LeachfleIds Pumped & Installed Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 775-3338 775-6412 i S\ COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON, MA 02108 617.292•�500 H W'ILLIA.10 F WELD TR 'DY C Govcmor SC,' ARGEO PAUL CELLUCCI D.-N�ID B STR Lt.Govcmor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Corr.miss PART A CERTIFICATION Sullivan & Worcester Property Address: 447 Seaview Ave Osterville MA Address of bwPost Office Square Date of Inspection: 3/26/98 (If different) BOStOn,MaSS. Name of Inspector: Joseph P.Maeomber Jr 02109 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: J.P.Macomber & Son Inc. Mailing Address: Rnx 66 rPnt-ervi 1 1 P.,MaSS _ 02632 Telephone Number: r�0$ 15 3 3 3 2 CERTIFICATION STATEMENT I cenify that I have personally inspected the sewage disposal system at this address and that the information reported below is uue. accura and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function an( maintenance of on-site sewage disposal systems. The system: /Passes Conditionally Passes — Needs Further Evaluation By the Local Approving Authority _ Fails Inspector's Signature: Date: /7(! The System inspector all submit a copy of this inspection report to the Approving Authority within thirty (30) days of comoleting tn,s 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 sF.all subm the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to me system owi and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, Of D: AI SYSTEM PASSES: 4 have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CmR 15.30 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, up completion of the replacement or repair, as approved by the Board of Health, will pass. Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If "not determined', expla-n -.shy ,not The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Ceriiicate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspect,on, the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or ekfiltration. or car failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming t,, +jc Lanr as approved by the Board of Health. (revised 04/25/97) Page 1 of 10 DEP on the World Wide Web: nrtp:/Iwww.magnet.state.ma us/oep Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 447 Seaview Ave Osterville,Mass . Owner:Date of Inspection:Estate Of Jean B. Tweedy 3/26/98 BJ SYSTEM CONDITIONALLY PASSES (continued) ZIVA�.P- Sewage backup or breakout or high static water level observed in the distribution box is due to broken or pipe(s) or due to a broken, settled or uneven distribution box. The system will pass Inspection if (with apprc�a; ne Board of Health). Describe observations: broken pipes) are replaced obstruction is removed distribution box is levelled or replaced I' The system required pumping more than four times a year due to broken or obstructed pipers; The system inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing ;o prc.t ci me public.health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A .10ANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: 3 Cesspool or 1) rY is within 50 feet of a surface water / Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETER.,,iINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 fee; to a surface water tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a privale water suopl we! The system has a septic tank and soil absorption system and the SAS is less than 100 feet but SO feel or more iron a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds j')c c3:es tnat the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nuroger, is eticai !o or less than 5 ppm. Method used to determine distance _*(approximation not valid). 3) OTHER tr•visod 04/2S/17) page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 447 Seaview Ave Osterville,Mass . Owner: Estate Of Jean B. Tweedy Date of Inspection3/2 6/9 8 D) SYSTEM FAILS: You must indicate ei;•.er "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 Ch1R 15.303. The bass for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to corTeez the failure. Yes No „ Backup of sewage into facility or system component due to an overloaded or clogged 5A5 or cesspool. Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged S.-\S or cesspool. �JOA"0" Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspoo� Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s) Number of limes pumped _. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supp ti Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, aaach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: lip— The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safery and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area • IWPA) or a mapped Zone l o; a public water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/75/P7) Pay• 3 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 447 Seaview Ave Osterville,Mass. Owner: Estate Of Jean B. Tweedy Date of Inspection:3/2 6/9 8 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. _ The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout. &Z _ All system components,eluding the Soil Absorption System, have been located on the site. x/ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location-of the Soil Absorption System on the site has been determined based on: _ The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of / .Sub-Surface Disposal System. !� Existing information. Ex. Plan at B.O.H. _ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (15.302(3)(b)) (revised 04/25/97) Page 4 of 10 �1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION 47 Property Address: 447 Seaview Ave Osterville,Mass. Owner: Estate Of Jean B. Tweedy Date of Inspection: 3/2 6/9 8 FLOW CONDITIONS RESIDENTIAL: Design flow: p.d./bedroom for S.A.S. Number of bedrooms: Number of current resident §ye's Garbage grinder (yes or no): Laundry.connected to syste or no):� Seasonal use (yes or no):� �3 4 ) �X 61, 12 2 Water meter readings, if available (last two (2) year usage (gpd): 17 fr iQIra G3l��k�7/�Zi q9. n Sump Pump (yes or no):_Qa /l���v"��'D ( � A,rjJ (PO' y9 19•P)o Last date of occupancy: djul COMMERCIAUINDUSTRIAL: Type of establishment: Design flow: Z,4gallons/day Grease trap present: (yes or no)A2,4 Industrial Waste Holding Tank present: (yes or no).&d Non-sanitary waste discharged to the Title S system: (yes or no) Water meter readings, if available: rj1f� Last date of occupancy: ll OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source f information: tby k Rv411j0' ,� 7 System pumped as part of inspection: (yes or no)—& If yes, volume pumped: ,W_gallons Reason for pumping: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system ciZ Single cesspool' A7al Overflow cesspool W Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) VA Technology etc. Copy of up to date contract? Other /14 APPROXIMATE AGE of all components, date installed (if known) and source of information: Sewage odors detected when arriving at the site: (yes or no) (revised 04/25is7) pay• 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 447 Seaview Ave Osterville,Mass. Owner: Estate Of Jean B. Tweedy Date of Inspection: 3/26/98 BUILDING SEWER: (Locate on site plan) r/ Depth below grade: Material of constructioanAWA _ cast iron _ 40 PVC _ other (explain) : Distance from 1priva a water supply well or suction line J ,_ Diameter �" Comm nts: (condition of joints, venting, evidence of leakage, etc.) ak T4 — I SEPTIC 7ANK:A)ewle- (locate on site plan) Depth below grade:A1�4 Material of construction x&lconcrete!/metal iberglass,�PolyethyleneiY�other(explain) If tank is metal, list age _42d Is age confirmed by Cenificate of Compliance/Vg (Yes/No) Dimensions >/V Sludge depth: '10 Distance from top of sludge to bonom of outlet tee or baffle: Scum thickness:_IVA Distance from top of scum to top of outlet tee or baffle:,�� Distance from bonom of scum to bosom of outlet tee or baffler how dimensions were determined: X14 Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outle: invert, su e r integrity, evidence of leakage, etc.) 'Air.' 16 mP7 GREASE TRAP: 1v (locate on site plan) Depth below grade: Material of construct ion:Nflconcrete ,*meta WA Fiberglass oV 4 Polyethylene4h4other(explain) 1001 Dimensions: AIA Scum thickness:�'�4 Distance from top of scum to top of outlet tee or baffler! _ Distance from bosom of scum to bottom of outlet tee or baffler' Date of last pumping: AW Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet nveri, ur.c r integrity, evidence of leakage, etc.) (r•v18.d Y&y• 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 447 Seaview Ave Osterville,Mass . Owner: Estate Of Jean Tweedy Date of Inspection:3/26/98 TIGHT OR HOLDING TANK:V,�ihe(Tank must be pumped prwr to, or at time, of inspection) (locate on site plan) Depth below grade:L Ma(erial of construaion:4)A concrete ahmetaiAl/fFiberglass.VAPol�,ethyleneL4other(explain) N Dimensions: d,/d Capacity. ,414 gallons Design flow. gallons/day Alarm level Alarm In working orde(VA Yes;.UA Nu Date of prev,ous pumping. A_ Comments (condition of inlet tee, condition of alarm and float switches, etc ) DISTRIBUTION BOX:'1,bCV (locate on site plan) Deptn a l-c.A level above outlet inven:�� Commer:s (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) i l/ row PUMP C H ASA 8 E R:.ALoe, (locate on site plan) Pumps n working order: (Yes or No)_01lip Alarms in ,orking order (Yes or No)—A� Comments incite condition of pump chamber, condition of pumps and appunenances, etc.) lr.vs..c 0�/2S/97) P.g• 7 of 10 I II SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:447 Seaview Ave Osterville,Mass . Owner: Estate Of Jean Tweedy Date of Inspection3/2 6/9 8 SOIL ABSORPTION SYSTEM (SAS): —���� !�r/ C LESfj4� (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: Q leaching chambers, number: leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note conditi n of soil, signs of hydraulic f ' ure, level f pondlrig, condition of ve etation, etc.) � l CESSPOOLS: (locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: .2 41 Depth of scum layer: 19 Dimensions of cesspool: Xlvi Materials of construction: Indication of groundwater: inflow (c sspool mW be p mped part of inspe ion) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) r 'so, _ PRIVY:2'L lV e_ (locate on site plan) Materials of constructio : &6? Dimensions: Depth of solids: /U� Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) ` . (revised 04/25/97) Peg* B of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Properiy Address: 447 Seaview Ave Osterville,Mass . Owner: Estate Of Jean B. Tweedy Date of Inspection: 3/2 6/98 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) / O 0 r 9}. 0 (revised 0//25/97) Page 9 of 10 �J SUBSURFACE SENVAGE DISP; t SYSTEM INSPECTION FORM I . C SYSTEM INFOI: • :ION (continued) Property Address: 447 Seaview Ave Osterville,Mass . Owner: Estate Of Jean B. Tweedy Date of Inspection:3/2 6/98 Depth to Groundwater /6 Feet Please indicate all the methods used to determine High GroundwaiGr EIL ation: Obtained from Design Plans on record Observation of Site (Abuning property observation hole, basernerl*s,mp etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data { Describe in your own words how you established the High Ground xer E levat ion. Must be completed) Used transit. Shot- from surface of water to the bottom- of the dry cesspool., Cesspool is about 3 ' off the water table. lz•vl••C 0�/75/97) P•c, 100f 10 .tT�n1'Tf�.'TT—tr1r�JRf'PT4"fR1n'tiTT.IT.ttl`.1'�1TIl1T9TTifiTttT�fLT.'JS'I Ti't"C'rr;'"C'tTT.TT"e'�T`^'t`- � .. TOWN OF Barnstable BOARD OF HEALTH SUUSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D •- CENTIFICATIUy �_ �:-•rn-r••.-•.:.-r.Ir.-.-rnrrm`rtrrr-�mstrrir'rrr'�'f+,vrn�arntvr-�a�crnrnrsrms-s+rnr� mnn�r*nrr.rtrv�trr+.r+r.:—..-rr r� ._... i -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 447 Seaview Ave Osterville,Mass. ASSESSORS MAP , BLOCK AND PARCEL OWNER' s NAME Estate Of (Jean B. Sweeney PART D - CERTIFICATION NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J.P.Macomber & Sdr7 Inc. COMPANY ADDRESS Box 66 Centerville,Mass. 02632 Street Town or City S t a t 9 LIP COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX ( 508 790 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and complete as of the time of .-inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my traini jig .and. experience in the proper function and maintenance of on- site sewageldisposai systems . Check one: _Zsysteai PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public IiealLh or the environment as defined in 310 CMR 15 - 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA sectioll of this form . System FAILED* The inspection which I have con ticted has found that the system fails to Protect the ptiblic health and the environment in accordance with Title 5 , 3.10 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature Date One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF ItEAL1'I(. * If the inspection FAILED, the owner or•I"operator shall upgrade within one year of the date of the inspection , unless allowed ort required he m otherwise as provided in 3.10 CMR 15 . 305 . partd • doc -r DO 7 !� ti THE CON11MONWEi ALTH OF MA.SS.A.CIMSETTS DEPARTMMNT OF ENYIZONNTENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERT � � D TITLES SYSTEM INSPECTOR as provided in 310 CMR 15.340 and Section 13 of Chapter 21A of the General Laws - Issued by Tl-ie Department of Environmental Protection . ----�-it--ra -- A( tmA Oltccto( of the �S cSuort v( \VIIC( 1'oUuticin Cc>ntir)I i i T - . . . .. ,- ry . . _ - ._ 1 - - _ - - . . . . .-,, , I .. ' .._ :,_ , . , •r - .. 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LRo sq t, Zone B & 'A13 (see plan) ° Community Panel No. 1 TH-1 �APPro>G #250001 0016 D / ie%tt July 2, 1992 J stay PRO � D—S . LOCATION MAP. Iy .� � �"`� pRo. Scale. 1 = 2000 f W w SEP7%C W a TANK Lot 6 ASSESSORS REF.: a 43,572 S.F. ° Mop 138, Parcel 26 4 teW o j I OVERLAY DISTRICT: o o `° �� / ,��,�QA a / y AP — Aquifer.Protection District ~` peer / lJ��y ,0, ° As Shown on Plan Entitled "Revised Groundwater Protection Overlay Districts" — April, 1993 03 A,wGOJ�' -- atafi — I 14 coQ�c� DIRECTIONS: From Hyannis — Take Route 28 towards Osterville, A� At the lights by White Hen Pantry take a left onto �o P Cc rd Az Osterville West Barnstable Road and follow to the end; PROVIDE CATCH Take o left onto Main Street; In the Village bear right BASIN & DRYWELL onto Wianno Avenue; At the end follow to the right FOR DRIVEWAY RUNOFF as it turns into Sea View Avenue, House is on the left, #447. VOTE: '� Fti�Q,� 511 / 1.) The property line information shown was 14-. 1447 compiled from available record information. Benchmark: 4;s,� wooDdollromed Top of C8/dh found "?•r / 2.) The topographic information was obtained Elev.= 14.04' (NGVD 2s) GUY \ s �FA�w� from an on the ground survey performed on l� Pal y // F 13/SEP/02. Ce/dn Ind 3.) The datum used is NGVD '29, a fixed mean sea level datum. ,-13 e Guy 1K SEPTIC NOTES wrro ` /' °�� / 1.Loosda dUtIlnWwwoouThisPkaAnAppeoz.At Lem 72Hoins PdortoAsyB:avad=ForMd@ftcft t*eComsaaSbanudoe DESIGNDATA ft Regeind NodfiestloetoDIS316(14b"44-72 Sio&F-Ey 2.TboCaatra- isR&pk dtoSwnAwwpbbPetmi h=Tben .N ® '�3 7v1e[ev�Soown CmnW er LmaBALmarsesY r/ f Told zb@pQMw tr-t60f1'D Beaarha'lsaoMbalsOYiaaesoPlposodShdbeWdwTabdio Usea1300adSepoTmlc ArsoreWslettlShmess h¢C�mav,WaeerLimaShaGbeCotpttoAadis / �41 CoordiedonWI&COMM Watsr,sndSharibebAamdseoe LEACHINQr AREA Whb 248 CMR L0o.7.00 dk 31oC1dR is as .� r / / _ 0) b e1 4.A oots"ofCoMbRegoireditABCmVmms 660OFD10.74(LTAR)- 5.ABSuetoaFeMSbecd n .'0S1dewat-2(M10+ 06'0-253SF tovebledermtobexm1000%ubusaBogW's �� o Bo#=A=-(17•1Vz3a-61-6QSF Recammmddaomre"AhnmbeUeed TablPtovided-901SP 6.lasullWmdyhtRbasaodCevmtoWWa6'ofFto bWGnde Ova SepbT=k1ddaedaadat,D4kz, ndtaaeLaddoschmdm 7.SepoSysumoobeheshtiediaAaooNsoosWhb310Ct4RL&W& / ) O V LEACHING CHAMBER DESIGN 0c�.S' THE- 248ChlxI.00-7.00LatatRavldona.d>beTatvnofBatmuble � � All ftes to be Sehedale40.Uee Bond omewft Regdadaos. / k1 5.5000aL IowhhtgMambets in &AU POW to beSdt.40PM N _1T-1y'z50'-6•W4ebedS0mFiddnShann. 9.D•BaotShYl Revs AMh>imlmideDhnemianoti2",aadaMfdomm 7 UtNlty lVASepsadonDiftowBetnam toSq*TakLelebaod // pole 0 t 00'Buffer Zone Corer BdowdeFbWLi 4=dndboBq*WWi&&GnBala 10 /A A5 6 PERC TEST: 13,502 / / / / / / / 4 PERFORMED BY:MM OVRA,PB-SULLIVAN PNOINBBR NGA7 \ SOIL BVALUATORNO.2911 0 "� / i 1 W1TN SEDBY:DONALDDBSMARAIS R.S.-TOWN OFBARNSTABLB DBCBMBBR16,2011 Met;6Tode 4 TEST HOLE-1 EL!s o TEST HOLE-2 EL is o / h/ / // Ae , a' loll / / / Fobfk +Aj A9 IV And/Or QLLAYBR 10YR sl8 01 LAYBR tOYR s18 i t/8•_Stone 1/e, YELLOWWA BROWN YBLLOWISHBROWN H-20 Pao NZD b=.SAND LEACHING ooubTs t 1 // / / / / A2 2 0ALLCMOOMINSML 7 CHAMBER sic" Piot �• f/ // // C2LAYER2. " CS LAYER2"6F4 4'_ fo• � // / /� Ata t LtOHT BROWN L10HT BROWN�YELLOWISH �'— f2=10• --� / / r / 50, Buffer Zone / / -o�At NO GROUNDWATERBNC0UNUM NO GROMMATERENCOIRtIiGti� CROSS SECTION OF CHAMBER SrM PASSED NOT TO SCALE �' ' / / 1 / / Al2 At3 Sea Note 0(t)p.) F.C.EL. 14.5 1/ Edge of Vegetated Wetlands EL 11.7 ,r-"A°s R j c� DeA14 Flagged by ENSR (8127102) Installer To Con&M Poor (T To Any Work 15 Tnn ft15o 0 as•a N L H-20 Flood Zone from FEMA Map To B.kutalbd on / ( ,im a) �`( Community-Panel No. 25001 0016 D o s eeddh,y,'t'a Map Revised: July 2, 1992 � . � Inepeatr Part, {,. as Per 77005 n SULLIVAR n° 297 DEVELOPED PROFILE OF SYSTEM P.r Twat ►. (UnniM.sad� Per Ad)oant Peroe . • NOT TO SCALE 1aso4(cat ►iest) m 84.57' 10,941 (Let Eat)0 ,von o�� N 86'53'11" H W TI TLE. PREPARED FOR. PREPARED BY- Site Plan i Proposed Improvements Jean B. Hynes, Trs. Sullivan Engineering, Inc. CapeSury rri 447 Sea View Realty Trust PO Box 659 b 7 Parker Road —� At f.o. BOX 7�$y Osterville, MA 02655 Osterville MA 02655 447 Sea View Avenue Edwards, CO 8�632 (508)428-3344 (508)428-9617 fax (508)420-3994 (508)420-3995 fax capesurvOcapecod.net Barnstable,(Osterville) Massachusetts 20 0 10 20 40 60 Comp./Draft: JOD Field: WHK/MDH DATED@CemlJer 26, 201 SCALE: 11$ _ 20' Review. PS Comp./Draft: MDH Proj # 22040 Drawing C393-5G1