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Home My WebLink About0243 TOWER HILL ROAD - Health 23 Tower Hill.Road Osterville A = 118 042 ; 1 i I r Town of Barnstable 'tK B Inspectional Services Department MASS.�" M � Public Health Division y ASS. �. 1639. 'OrF ram" 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7021 0350 0000 1549 3631 June 21, 2021 LOVERIDGE, JANET M 243 TOWER HILL ROAD OSTERVILLE, MA 02655 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 243 Tower Hill Road, Osterville, MA was inspected on 05/26/2021 by Frank Nunes III, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Conditionally Passes" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • H-10 distribution box in driveway. See attached policy. You are ordered to repair or replace the distribution box within two (2)years from the date you receive this notification. Failure to repair/replace the distribution box within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Conditionally Passes Letters\243 Tower Hill Road Osterville.doc Town of Barnstable ABLE. ellt 9A MAS r Inspectional Services Depai t)CI1 \lFD►+►nr' Public Health Division 200 Main Street, llyannis MA 0260I i Nli.c 1 iiomay A NI(K 11 5(iS 862 Iba 1 l I II I AX 508-790-t,3p4 Feb 6; 2007 Rev. 4/26/19 DEADLINES TO REPAIR FAILED SYSTEMS ('l own Code §360-44 and Title V: 310 ('MR 15-.00()) , An "x' marked in the o is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA o Discharge or ponding of effluent to the surface. of the ground pumping more than 4 times during the last year not due to clogged or obstructed pipe. I:1 use due to an overloaded or clogged SAS or cesspool Backup of sev��age into the ho o Structurally unsound septic tank or SAS ONE 1 YEAR DEADLINE CRITERIA Static liquid level in the distrihulio1 boa is abo'e the outlet invert due to an overloaded or clogged SAS or cesspool A portion of the SAS. cesspool. or privy is below the high groundwater elevation A portion of the cesspool is located \Vlthin a Lone I to a public well A portion i�I'the cesspool is located �N-ithin 50 lest of a P assee if tl e �`atater pr>an I�Isis wilh no acceptable \\later qualil� analysis. (this hl 1 p indicates the \Well is free from pollution}. 7'V1'U 2 YEAR DEADLINE CRITERIA o. Single Cesspool And •conditionally passed systems (broken cover, relocation n of a pipe. relocatio of a driveway due to I'-'O components. etc) I.ei1Cl11ng laclhty �1'llh tilanding Ilgllld level at or ahove the ins CIA pipe (per I own Code 360-20 h) OTHER ea�S Repair Inc 0 .SEPTIC\.DEADLINES 10 REPAIR FAILED SYSTEI',1S doc Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r u 243 Tower Hill Road Property Address Loveridge Owner Owners Name information is required for every Osterville MA 02655 5/26/21 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. A. Inspector Information sly (19yf3v Frank Nunes III Name of Inspector saa Company Name Box 841 Company Address East Falmouth MA 02536 City/Town State Zip Code 508.272.6433 13010 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ❑ Passes 2. ® Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 5/26/21 Inspect 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osterville MA 02655 5/26/21 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) 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): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments u 243 Tower Hill Road Property Address Loveridge Owner information is Owners Name required for every Osterville MA 02655 5/26/21 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 D-box is of H-10 construction and is in a gravel driveway ❑ 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 FIND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 L r - Commonwealth of Massachusetts ro Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 243 Tower Hill Road Property Address Loveridge Owner information is Owners Name required for every Osterville MA 02655 5/26/21 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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: 9 ❑ 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. c. Other: 4) 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts (P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Tower Hill Road Property Address Loveridge Owner Owner's Name information is required for every Osterville MA 02655 5/26/21 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow ❑ ® 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 water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA 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 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 L - Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a v 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osterville MA 02655 5/26/21 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered"yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes" or"no"for each of the following for au inspections: 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)] I t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 l— Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �o u 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osterville MA 02655 5/26/21 page. Cityfrown State Zip Code Date of Inspection D. System Information 1. 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 Description: 3 bedroom permit and plan on file at BOH Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: 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 ears usage d 284 GPD 9 ( Y 9 (gp ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Occupied Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts (P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osterville MA 02655 5/26/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Pumped May 2018 per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 I— Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 243 Tower Hill Road Property Address Loveridge Owner Owner's Name information is required for every Osterville MA 02655 5/26/21 page. CityTTown State Zip Code Date of Inspection D. System Information (cont.) 4. 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): System has pump chmaber Approximate age of all components, date installed (if known) and source of information: 2001 per BOH record Were sewage odors detected when arriving at the site? ❑ Yes ❑ No 5. Building Sewer(locate on site plan): 18" Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: >10'feet Comments (on condition of joints, venting, evidence of leakage, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts ,F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osteryille MA 02655 5/26/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 12"feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) H-10 tank appears to be structurally sound If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500g Sludge depth: 8" Distance from top of sludge to bottom of outlet tee or baffle >12" 2" Scum thickness >2„ Distance from top of scum to top of outlet tee or baffle >211 Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping suggested every 3yrs to prolong the life of the system t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osterville MA 02655 5/26/21 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. 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 t5insp.doc•rev-7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 L Commonwealth of Massachusetts �v ,F Title 5 Official Inspection Form I' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osteryille MA 02655 5/26/21 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 9. Distribution Box(if present must be opened) (locate on site plan): Oil Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): H-10 D-box is in the driveway, it is not designed for vehicle loading, it is 20" below grade, no adverse conditions observed, use caution when digging there is an irrigation line over part of the cover t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 4yi a 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osterville MA 02655 5/26/21 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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.): No adverse conditions observed * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 1, 464 sq ft ED overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osterville MA 02655 5/26/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The leach field was video inspected, the pert pipe laterals were in very good condition„ bottom o they were dry with no high staining or muck present, no indication of past hydraulic failure 12. 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 Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 f Commonwealth of Massachusetts (P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments •�, 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osterville MA 02655 5/26/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts �d Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 243 Tower Hill Road Property Address Loveridge Owner Owner's Name information is required for every Osterville MA 02655 5/26/21 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. 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 r` 0 510 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 L Commonwealth of Massachusetts ,ip Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osterville MA 02655 5/26/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15. 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: 2001 Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: 4'seperation per 2001 compliance ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: TOPO mapping shows the site at 42'msl and nearby surface water at 10'msl You must describe how you established the high ground water elevation: See above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 f J Commonwealth of Massachusetts ,F Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 243 Tower Hill Road Property Address Loveridge Owner information is Owner's Name required for every Osterville MA 02655 5/26/21 page. City(Town State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. t ® B. Certification: Signed & Dated and 1, 2, 3, or checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist)completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included 4 t5insp.doc-rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 NEON 0 ■■s,■O■OOOM■■■■■N■■■■r■■■■■■■■■MOON■■■A was■■■■■■NONE■oil i■ ■■ONE O■MEN N■MEMO NE■■MMMM■M■OO■■■■■■■■■clNM■■■■■■■MEMO NNI■■■ O■OO II�0 ONO MMEN■MN■in■■■■■■■IEEN\!i Mom■■i"eMAN■■■■■■Mil■■■■M 0 MIN 41■NMEN■iMEN■■Ri■■1M■■■■■■■■i ONE i■■mom Fli■a■■■■OMEN ilk■■■M 0 I■■i a IEEE■r moons!i1►■r NIMMEM■■■IEEE■r■■E■ UNNE■■■■■■Ili■■■a Lim ii7■■mom■ii■■milli■■■■■■■■■i mom;, Ir■■■ii■iMEMO■■■■■■i\�■■■1\i■ ■1■i■■i■■■■%■■EEi�i■■■■■■■■■■iw . 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ON■■■M ONE■Nmom■■Nmom■MMINOR■OMEMO NO■■■■OM■■NI■■■■■■!.'NEON■MN NONE MM■N■NNOM■M■(�FSI■O mom■r■N■O■O■■NNIO NONE MCMENEMN■ Noun l�IsN■M■E■■■N mom■Mmom:I■Omom M■ONE■ONOOO■IO■NN■■MWOMEN MII ME mom■MMillion iNEON MNONE■OONE■r■■■■■O■MM■IMMMM■[IM1i:1■■■N11 ■■OiOMN■■■MNEON M■M■M■■■■NO mom ONONE MOO■■■■IO■■■!NNNo ME MEN OMEN MOEN mommoomm NO�I■■■OI/ No mom ME WERE■O■■O■■■■■■■O■■■1/■i■N■MM■N■M■■■ i OWN OF BASNSTABLE �� ✓� LOCATION S YVA"3 o�c2 SEWAGE # dC)1"683 VILLAGE S l>`st. c ASSESSOR'S MAP & LOT "A a INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /S GO GA 4 ' LEACHING FACILITY: (type)' J,-/)c c-t f e�a (size) �6�� ✓� NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: b r 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 t 2�1 -�0 �' r ! t 06 � , No. s Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _Zt,/ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Z(ppYiration for Ziopoar *pztem Con!5trurtiou Permit Application for a Permit to Construct( )Repair( ✓'bpgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 24Z —COWS R bit — Po b Owner's Name,Addriss and Tel.No. 05 Rv1t.LG,v►1A wlllicm 64rpen r Assessor's Ma /Parcel P•0. BM IVA p Il809z /u.rAlm ati, �IPt Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. sNURsuJUE CoubTRuCtta tJ SuttV E PrbWjEER11•Nto 87 PoMb 5!. 7%KV(SP. RD. P.O.pox c.Scl 0skt"'4e, mh yz8 sszq 04ecv ,MA _So8 yZ8-'S34y Type of Building: 1 1%n �a 364 Dwelling No.of Bedrooms 1 ! d Lot Size -3�Ac- sue#. Garbage Grinder V& ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 314 3 gallons per day. Calculated daily flow Z Z O gallons. Plan Date OC.kob2e- t5- ZOO 1 Number of sheets l Revision Date Title 50ML svSTEn'1 REPA0, 10P(oRADE Size of Septic Tank 1500 Type of S.A.S. %45F L.LA h1VG BGb Description of Soil:D-Z" O Tot?SOIdLo&M Z-141% E BRDw N UAt2St SItNb I0WR513 ►4-416" (2, STRONle SttN MIkRSS S624-0 %,-14" C.I YC- WL-xlM t1AN CON& t SAM- ►OR 5/9 74-12o Cz L+ yELU jW BKM C0&% ' A-AM LNR b/4 -AM wPxe(4, 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 Certifi- cate of Compliance has been issu_ad by th)9= Signed Date �SA Application Approved by PK)- Date U Application Disapproved for the following reasons Permit No. �C)� s C,g,3 Date Issued �(�� '(p� �1�1 a� r7. ltJJ No. . - Feel , , ✓✓ 1 jvTHE COMMONWEALTH OF MASSACHUSETTS ' Entered in computer: Yes -PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0(ppYicat%owfor Mi0pont Opotent Con,5truction permit Application for a Permit to Construct( . )Repair( ✓)Upgrade( )`Abandon( ') ❑Complete System El Individual Components Location Address or Lot No. 24 -COWr-Z ti%u_ KoAD Owner's Name,Address and Tel.No. Assessor'sMap/Parcel 118oyZ P_o. CSC( 15(,,4 e Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 5N0R'6C.I,VE ',vWVAN is NC�INEE�IN� 6-7 PoN� $t. 7�AR\�EK Rb. two.Sox Cr5S d 0stecv',11e (Y1A �IZ13 SSz y o ,�f'cU;\1e , Y111�" Sod �IZ`3 33y� Type of Building: Dwelling No.of Bedrooms Z Lot Size -'� Ac— sq=&. Garbage.Grinder(No ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 39 3 gallons per day. Calculated daily flow Z z O gallons. Plan Date 0666e- 15 E Oo I Number of sheets 1 Revision Date _ Title Sc-t'TrL SvSTC=fn R E P A i k /UPeRFri)E n Size of Septic Tank 150o Type of S.A.S. s r L Al to i1JG 13E6 Description of Soil O-Z" () 10_ �i(_ItoRM Z-I 132,01J10 QARSt SANb Io`I�t5�3 STRoN(, 3gN CoARSL SANS Wtc-1y` et tiEUouvSN W CoA{ZS� �iJ� 1�`IR S/d `74-126' Cz L+ JF_W-tSN 3R�) COP&Se SA»i iNq\ (c/y N4 W+�TtR 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 Certifi- cate of Compliance has been issucli by this Board of Realtk. / Signed Date Application Approved by -_Dlun3l, lU- Date 10,12 5�1):_l Application Disapproved for the following reasons - Permit No. -20( Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY.t the On-�}t,�sewage Disposal System Constructed( )Repaired f)Upgraded( ) Abandoned( )by gG= at Zy 3 TOW C& VA KI RU Aa has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. '�001 493 dated. (U) 9-5,/ dtJ 1 Installer Designer The issuance of this permit shall not be construed as a guarantee that the syst will function a�sdesigned. Date 01 I x 112 ao 1 Inspector .1n+�1_� No. �w iI'b0 3 - Fee 5b THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mi5po5al *p5tem Conotruction Verntit Permission is hereby granted to Construct( )Repair( ,I/,Upgrade( )Abandon( ) System located at Zy_5 70wC R 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 th'sy ermit. Date: O/jam"' `""� ox Approved 11 x W x� ' ,�� hv _ �INrz `_ , LOCA'T'�O l c2SE VII.LAGE G^g l C� : t i ASSESSOR'S MA 8 LOT U' INS 'LLER'S NAME&PHONE:NO _ Ck;C C l•s l:c r 4�€-Sa.�t ....= SEPTIC TANK:CAPACITY /}SG•O, CA ... a k �. ;• LEACHING FACILITY (t�'pe) /Cnc J-� �i e Jo (size) �6z1f F/l NO. OF BEDROOMS �- - BUILDER OR OWNER PERMTTDATE. II /5-: /`. COMPLIANCE-DATE. Lt I�}I{`�� '.P rf F '' -1• � -...;r^� s ti �•:A - .{; -,.:,3. . t }�.. 3 c. .! 3 s +.:i °i f }.�s.. t A t 4t-f r• Separation Distance Between the Maximum Adjusted•Groundwater Table to the Bottom of Leachngi Fac. 1 Felt` Private Watei Supply Well and LeachingtaPli`fi (If any wells exist S ' ! on stte or'wttlun.200 feet of leactung faciLty Feet Edge.of Wetland and Leaching 1~aciLry(If any wetlands exist t 3 within 300 fee[`of Ieactu'ng facility) ;.-Feet: ' Furnished by ti• s> t ( P'> i,T ) rg 'tF -!� i {.1 t r � SkIH t W-t h• +F' L -. .. • .... ...... ... ..: :• '� it t 1 t u F F i �� t E 3 - �•_-3 � 1rk �..i It �.d.4.3 ...J+t'{t+.M rr } f .. } '• I��f I 31{ N Sr t i i J HI }t C. ii�. L if i C f ' �� ... �-.. :. .. •-. '. -. .r,--- _ _� .. _. . _•.. _ — -a-c�-'rck''T*'t'Cf+14�TA' ' Z.t. & $ON Box 651- Centerville,MA 02632 _ (508)428-8685 November 27,2001 Department of Health Town of Barnstable 367 Main Street Hyannis,MA 02601 Re:234 Tower Hill Road,Osterville,MA 02655 Dear Sirs, I have wired and tested the new sewer pump plus tank alarm at 243 Tower Hill Road,Osterville,MA. All components are in working order. Yours truly, Robert P.Hinckley&Son,Inc. Dana J.Hinckley President Lic#A16531 s Mikah POI no r r� �/Josh " `oe ,S 4, n LEACHING BEp ��' AREA � 464 S.F �3 � / - r ^,Ro• w `�/ 'F�`� , Hi �( W / O Property Line as Shown p,� •�: 1 : i -,. <o o�P / :B/bH on Abutters Plan ( 1711151) ; •wNG er 5' S� Sams Pond /• / ' ' '1 a'r: � j. (E1=163.2' Assumed) 00, -9 ri, .� �' �( .•' �' e '1I11�'" j.�'000 l l/ 'V �s7_ o LOCUS PLAN %>,� ox Wetland Resource Line9. s p d II as flaged by ENSR III •��' A3 '�`• // // /' 2J // / `S`j9, Scale: I""= 2000' LEACHING BED 0310Cr/o1 // 00,, Assessors n1 12 / Parcel 092 Scale I = 10" �'\' _ _ a2 / Property Line By Deed (7911578) Zoning District : RC 1, ranaeet-t _ _ / / // // // y & Plan. Setbacks: Front 20' ' Side 0 Rear i0' // /�• / / //, / �j // / �j y �9 1s Groundwater Overlay:WP � AV / 9lb 4'0 Sch.40 PVC Finished Ag From Septic Tank Grade _ -�� _ ( .• / / / / �/ / / / �.•�.0 / i / �99 24'0 1! // / // / / / y i / r �.a ._ 1/2'h Galy.Pipe For Opening Above For M.H. 1 '�•.,� /• // ///// / / .•j �� // From 6Cover. I; .4% ,`4ov 9v Float Support Conduit Thru Chamber Galy. • �n . .. / �Q I / I I // / . jB�DH \ l / / // / / �•. For Power8"Float �+\ c To D B x I / v o ,: � 2 r Emergency Storage Cables. Chain ;: • �0�. \ . I ! ' / // / v �� i� M' Volume 330 Gal. y ;? Min.2'Cover Pump Power B Float Control To D Box / '�\ `� / // // / / /�. 0 0 /,'� omE 186.3 g Cables Installed in Accordance / With Local Bld 8 Elec.Codes. \\ 'j- / / / ®.�°� 0q / Mercury Float .r 2`�0 Sch.40 PVC -• 9 ,G Pump on El.185.8 y q Threaded Pipe 0 u ^ / / 0 �\` OB ? Switchs 3Re 'd /// / Co P D a 4"0 From.Septic �'• y w d� C cF I Pump off EL 185.3 Check Valve Precast Pump • /, .� / � � OA � yo Tank.Sch.40 PVC .per -T• / 0 0 q�. Oct �� ` Bottom of Cat To Chamber Chamber S J Bottom of Chamber fi-0'" O � '• O � c � , IVT Bottom El. 184.3 s I� o• a. 4 0 \ �I I oo �rN ' '^ r 6 Wool 7 S p i A e r Stone Min. '.eP. e,.': :.'e..• o� i CA ,�, 0 .:s e r TION ` '•• 6J PLAN �4e ?. / In/ `� •' fa`i ` �� r O 6 ' PUMP CHAMBER DETAIL. 7 'cover Not to Scale "�, �7 -Ilk / Cp / b �1g9 ` a �a o i / Finish Grade Nl 9, 10 / // O �A DESIGN DATA OYE- x l p - Filter 40 Perforated Compacted Fill O _ Fabric PVC Pipe Single Family-3 Bedroom(exisIting) N I/8"-I/2" PLAN VIEW // / I I /��• Qri' With no Garbage Grinder Daily Flow=110x3 =330 gpd "" " Pea Stone / •\ Septic Tank:330 gpd x 200%=660 gpd Scale: I = 20 Use a 1500 Gallon Septic Tank. 3/4"-1 I/2" 4- Double Washed L.OT AREA 0.3 AL' LEACHING AREA Stone G \ ? r • 330 gpd/0.74=446 s.f.Required Q ` 47/O� Use Bottom Area Only.Bottom Area=464 s.f. / t ly 9- I See Plan View For Layout. Varies See Plan � q + ' LEACHING BED DESIGN All Pipes tribe Schedule 40 PVC Perforated CROSS SECTION OF LEACH ING BED With Capped Ends.Use 4' 0 Distribution Lines in a 464 s.f.Washed Stone Bed as Shown, Not to Scale (((,,` 4 ; � '.. o�eri O TEST HOLE TH� EL., 19 8.0 I/2 HP Pump by Myers L'� / rvaA° 0°� 2. o TOPSOIL�LOAM ' NOTES of Approved Equal Vent F.G. 198.0 <1, ly \ ,�e Zj 6 estowN COARSe. 541 I. Water Supply For Thi s Lot is Mu nic i pa I Water. F.G.191.0 194.5 Top E1.195.0 41 O ly�t IoYR S/3 2.Location of Utilities Shown on This Plan Are Approx. ot.E I. 19.4.0 STRONG BRN, CoARse B B - At Least 72 Hours Prior to Any Excavation For This e I 4 L•" SAN p 10 y R 3/6 Project The Contractor Shalt Make The Required 194.7 I yEL ISH. BRN. COARSE? Notification toDIG SAFE-I-888-344-7233. 188.5 6'0 / " GI' 5AIl IoYR 5/8 ° 3.The Contractor is Required to Secure Appropriate 1500 Gallon Pump Baffle or Tee Brit.T.H. Elev. 188.0 OR-98.0' / 74' Permits From Town Agencies For Construction 188.3 Septic Tank Chamber No Ground Water / / C L-r. Yr- 1 t- 51-I BRN Defined by This Plan. 0 / I Zan 2 COARSE SAt+D 10` ?, 4.Install Risers as Required to Within 12"of Finished Grade. Bedding as r BRB NO HOLE Qy ATER- 5.All Structures Buried Four Feet(4)or More or Per Title 5 Fnd S.E.T_ to/zy/ol Subject to Vehicular tobe H-20 Loading. DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM O R-9z8• ✓ 6.Septic System to be Installed in Accordance With + ' 310 CMR 15.00 Latest Revision And The Town of Barnstable Board of Health Regulations. Not to Scale' ,O 7. All Piping tube Sch.40 PVC. OO rtle: PREPARED BY- PREPARED FOR: Notes/Revision LO SEPTIC SYSTEM REPAIR/ UPGRADE o DON L. CARPENTER 243 TOWER HILL ROAD Sullivan ]Engineering, Inc. C a p� i i r v P0. BOX 1364 of OST E R V I L L E , MASS. Po Box 659 7 Parker Road N. FALMOUTH MASS. Osterville, MA 02655 Osterville MA 02655R.o�� Rlc RD y� yy AN (508)428-3344 (508)428-3115 fox (508)420-3994 (508)420-,995 fax LHEUR'EUX in No.M33 No.M12 rA CIVIL ' - 20 p 10 20 40 80 Field: MOH/WHK Draft: RRL • Date: Scale. - - - Comp.: MDH/RRL Review: PS 47 October 15, 2001 1 =20 Prof• # Drawing # C347_1gl