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0045 OREO LANE - Health
x 55 ®reo Lane Centerville A = 246 - 043 No. 4210 1/3 ORA rendaf lex' 10% TOWN OF BARNSTABLE LC.-C-RTION ofi p o Z".9 SEWAGE VILLAGE `� i' '- ASSESSOR'S MAP & LOTA -- `,'.-3 INSTALLER'S NAME&PHONE NO.Aoeel/y 6 d SEPTIC TANK CAPACITY S o LEACHING FACILITY: (type f 6),Y C421;v F 1174,0 r 02s(size)�,a X e6�X NO.OF BEDROOMS BUILDER OR OWNER ^a GC fj�L PERMIT DATE: d 2- 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 B �G = - ° C .B A rFl _ f f xco C6FA+�ouT RIECp�=r, SEp 0 August 20, 2003 TO 5 wOF 13ARIVSr HEAL H DEPTABLt r{ Sam White Barnstable Health Department 20a Main Street Hyannis, MA 02601 Re: McCarthy Property—P Oreo Lane, Centerville, MA Dear Mr. White, Based on the questions involving the septic system installation at the above referenced property, I have completed an evaluation of the wetland water elevation. This was conducted at the suggestion of Tom McKean, Health Agent, as an alternative to determining the groundwater elevation on the property. Mr. McKean stated that if the wetland is within 300 feet of the area of concern, the water level of that wetland could be used as the groundwater elevation. Below are the measured elevations of concern: Top of Foundation(Temporary Benchmark): 20.20 assumed Bottom of Leaching: 16.17 Wetland (Lowest Point)(Dry) 8.0 Based on these elevations, the bottom of leaching is at least 8.17 feet above any potential ground water on the property, and in my opinion satisfies the 5-foot separation from leaching to groundwater required by 310 CMR 15.212. If you have any questions or concerns, please feel free to contact me any time at (508) 362-2922. VjN OF M,40 Sincerely, ,�n`� DARREN cyGN M. 1 /I MEYER U No. 1140 Paff M. Meyer s S T 1:p'� Registered Sanitarian gNITAR\P' cc: Finn McCarthy, property owner file August 20, 2003 i Sam White Barnstable Health Department 200 Main Street Hyannis, MA 02601 Re: McCarthy Property—45 "Oreo Lane, Centerville, MA 1 Dear Mr. White, Based on the questions involving the septic system installation at the above referenced property, I have completed an evaluation of the wetland water elevation. This was conducted at the suggestion of Tom McKean, Health Agent, as an alternative to determining the groundwater elevation on the property. Mr. McKean stated that if the wetland is within 300 feet of the area of concern, the water level of that wetland could be used as the groundwater elevation. Below are the measured elevations of concern: Top of Foundation(Temporary Benchmark): 20.20 assumed Bottom of Leaching: 16,17 Wetland (Lowest Point) (Dry) 8.*0 Based on these elevations, the bottom of leaching is at least 8.17 feet above any potential ground-water on the property, and in my opinion satisfies the 5-foot separation from leaching to groundwater required by 310 CMR 15.212. If you have any questions or concerns, please feel free to contact me any time at (508) 362-2922. Sincerely, �-jH OF MgSsq DARREN cyGNm o MEYER f M. Meyer No. 1140 Registered Sanitarian �o C�STE� cc: Finn McCarthy, property owner SgN�TAR�PN file " No. e��0as 6 0 4� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Migpoo �pgtem �Congtru tion Permit Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) Complete System ❑Individual Components Loc ddressopr Lot No./f Owner' Name,Address and Tel No. sessor's Map/Parcel EZ Installer's Name,Address,and /Tel.No. Designer's Name,Address and Tel.No. JC- 4.1 Type of Building: Dwelling No.of Bedrooms_ Lot Size sq.ft. Garbage Grinder Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow ell",5;z� gallons. Plan Date C1 2 Number of sheets Revision Date Title 4129 2.127 k -,' 2_ Size of Septic Tank / —S-00 6�.4 4/d tis Type of S.A.S.(� /�� �AG'� i •✓�=� T�Z�T� Description of Soil: Nature of Repairs or Alterations(Answer when apylicable) -- ��� /�� <<'�� /r✓Y �Y2AT!>2S f.�.� �.S7a,✓� t' .,� r""-✓�� Pd ;, A�s9��� 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 issuedAW this Board ealth. _.,.._. _ Signed �' Date /S`/w Application Approved by Date 0 a. Application Disapproved for the following reasons Permit No. 9no? Date Issued 7A k7 No. �_ (Q 1 'tvti j Fee S`�) i THE COMMONWEALTH OF MASSACHUSE Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLI�/MASSACHUSETTS 0[pplication for Migpogal *pgtem Construction Permit Application for a Permit to Construct( )Repair( Upgrade Abandon( ) CL7 omplete System ❑Individual Components L2jgian4ddress or Lot No. Owner's Name,Address and Tel.No. sessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. -57 Sa � -25 /-3d.2 e S i' © �i3 Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder(c Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date d 7 /d Number of sheets Revision Date Title DA-L J2� � ! ,G�%� 2 Size of Septic Tank //y,c s Type of S.A.S.l�,.) /i rA ) /414.17 e5- Description of Soil Nature of Repairs or Alterations(Answer when apylicable) o &5-% A--e9�+/G�(✓ r ti.t' A ,:T � �✓� N7r d v Date last inspected: Agreement: < The undersignedagrees 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 this Board of-Health. Signed <=-`'' Date Application Approved_by :Date. i! s., .. ; Application Disappro'., .for the following reasons� S Permit No. nn7-�liio7 Date Issued 7 ------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired (/)Upgraded( ) Abandolted( )by at SS `&9;5- 0 A/% has been constru ted in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No ) .)- a dated 5 ;b Installer Designer .� 1 , ly The issuance of this pe 't sh '1 not be ons. ed as a guarantee that the system will functiops/,designed. Date Inspector E911,140,4 O�, ✓111�11_i F77 -- --n--^--/,�,-------------------------------�—'l— No. +'t 0007-yor1 Fee e)�y THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS li.opoOal *p5tem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade(e-�Abandon( System located at � SS0 4- z y G 4// /G> 2 - � 4 -t. 7 A 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:Constru tion must be completed within three years of the date of th' ermit. e Date: U Approved by 41/ , t a LlMassachusetts Department of Environmental Protection Bureau of Resource Protection—Wastewater Management Program Form 9B -Local Upgrade Approval Issued Pursuant to 310 CMR 15.404 and 15.405 This form is to be completed by the local Board of Health and a signed copy provided to the system owner. The system owner shall provide a copy of this local upgrade approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Division of Watershed Management, upon issuance by the local approving authority and before commencement of construction. A. Facility Information Important. When filling out 1. Facility Name and Address , forms on the computer,use n/a only the tab key Name to move your 45 Oreo Lane cursor-do not Street Address use the return key. Hyannis MA 02601 -city State Zip Code eo- 2. Owner Name and Address: Helen &Finn McCarthy 45 Oreo Lane Name Street Address Hyannis MA City State 02601 508-862-0162 Zip Telephone Number 3. Type of Facility(check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Design flow per 310 CMR 15.203: 440 9pd Darren M. Meyer ❑ PE ® R S. System Designer: Name 43 Vine Street Duxbury MA, 02332 Address Cityfrown State,ZIP B. Approval 1. Local Upgrade Approval is granted for: Reduction in setback(s)—specify: leaching 6'from dwelling vs. required 20', septic tank 5'from dwelling vs. required 10', septic tank 4' from property line vs required 10' ❑ Percolation rate for 30 to 60 min./inch: minfinch ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction 45oreolaneform9b.doc•rev.5/02 Local Upgrade Approval* Page 1 of 1 Massachusetts Department of Environmental Protection Bureau of Resource Protection -Wastewater Management Program Form 913 Local Upgrade Approval Issued Pursuant to 310 CMR 15.404 and 15.405 B. Approval (continued) ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft Percolation rate min.rnch Depth to groundwater ❑ Relocation of water supply well (explain): List local variances granted not requiring DEP approval per 310 CMR 15.412(4): leaching 6'from dwelling vs. required 20', septic tank 5'from dwelling vs. required 10', septic tank 4' from property line vs. required 10'. List variances granted requiring DEP approval: Approved by the Barnstable Board of Health: Pnnt or Type Name and Title 54nature Date 45oreolaneform9b.doc•rev.5/02 Local Upgrade Approval* Page 2 of 2 LlMassachusetts Department of Environmental Protection Bureau of Resource Protection —Wastewater Management Program Form 9A - Application for Local Upgrade Approval Required by 310 CMR 16.403(1) Form 9A is to be submitted to the Local Board of Health for the upgrade of a failed or nonconforming septic system with a design flow of less than 10,000 gpd,where full compliance, as defined in 310 CMR 5.404(1), is not feasible. System upgrades that cannot be performed in accordance with 310 CMR 15.404 and 15.405, or in full compliance with the requirements of 310 CMR 15.000, require a variance pursuant to 310 CMR 15.410 through 15.417. NOTE: Local upgrade approval shall not be granted for an upgrade proposal that includes the addition of a new design flow to a cesspool or privy, or the addition of a new design flow above the existing approved capacity of a septic system constructed in accordance with either the 1978 Code or 310 CMR 15.000. A. Facility Information Important: When filling out 1. Facility Name and Address forms on the n/a computer,use only the tab key Name to move your 45 Oreo Lane cursor-do not Street Address use the return key. Hyannis MA 02601 City state Zip Code 2. Owner Name and Address: Helen &Finn McCarthy 45 Oreo Lane Name Street Address Hyannis MA City state 02601 508-862-0162 Zip Telephone Number 3. Type of Facility(check all that apply): ® Residential ❑ Institutional ❑ Commercial ❑ School 4. Describe Facility: 4 Bedroom Residence 5. Type of Existing System: ❑ Privy 0 Cesspool(5) ❑ Conventional ❑ Other(describe below): 6. Type of soil absorption system (trenches, chambers, leach field, pits, etc): . 2- Existing 1,000 gallon cesspools 45oreolaneform9A.doc-rev.5102 Application for Local Upgrade Approval, Page 1 of 1 � p LlMassachusetts Department of Environmental Protection Bureau of Resource Protection—Wastewater Management Program Form 9A - Application for Local Upgrade Approval Required by 310 CMR 16.403(1) A. Facility Information (continued) 7. Design Flow per 310 CMR 15.203: Design flow of existing system: 440 9pd Design flow of proposed upgraded system 440 Wd Design flow of facility "0 gpd B. Proposed Upgrade of System 1. Proposed upgrade is(check one): ® Voluntary ❑ Required by order, letter, etc. (attach copy) ❑ Required following inspection pursuant to 310 CMR 15.301: date of inspection 2. Describe the proposed upgrade to the system: Install 1,500 gallon septic tank, 3 hole d-box, and 401 x 10'W x 2'D leaching with Infiltrator units. 3. Local Upgrade Approval is requested for: ® Reduction in setback(s)—describe reductions: leaching V from dwelling vs. required 20', septic tank 5'from dwelling vs. required 10', septic tank 4' from property line vs. required 1W ❑ Percolation rate for 30 to 60 min./inch: min.Anch ❑ Reduction in SAS area of up to 25%: SAS size,sq.ft. %reduction ❑ Reduction in separation between the SAS and high groundwater: Separation reduction ft. Percolation rate minAnch Depth to groundwater ft. ❑ Relocation of water supply well (explain): 45oreolaneform9A.doc•rev,5/02 Application for Local Upgrade Approval* Page 2 of 2 Massachusetts Department of Environmental Protection. Bureau of Resource Protection -Wastewater Management Program r , Form 9A - Application for Local Upgrade Approval Required by 310 CMR 15.403(1) n Other requirements of 310 CMR 15.000 that cannot be met—describe and specify sections of the Code: If the proposed upgrade involves a reduction in the required separation between the bottom of the soil absorption system and the high groundwater elevation, an Approved Soil Evaluator must determine the high groundwater elevation pursuant to 310 CMR 15.405(1)(i)(1). The soil evaluator must be a member or agent of the local approving authority. High groundwater evaluation determined by: Evaluator's Name(type or print) Signature Date of evaluation C. Explanation Explain why full compliance, as defined in 310 CMR 15.404(1), is not feasible. (Each section must be completed) 1. An upgraded system in full compliance with 310 CMR 15.000 is not feasible: Limited Property Size 2. An alternative system approved pursuant to 310 CMR 15.283 to 15.288 is not feasible: 3. A shared system is not feasible: 4. Connection to a public sewer is not feasible: _ 45oreolaneform9A.doc+rev.5/02 Application for Local Upgrade Approval, Page 3 of 3 Massachusetts Department of Environmental Protection, Bureau of Resource Protection —Wastewater Management Program Form 9A - Application for Local Upgrade Approval Required by 310 CMR 15.403(1) 5. The Application for Local Upgrade Approval must be accompanied by all of the following (check the appropriate boxes); ® Application for Disposal System Construction Permit ® Complete plans and specifications ® Site evaluation forms ❑ A list of abutters affected by reduced setbacks'to private water supply wells or property lines. Provide proof that affected abutters have been notified pursuant to 310 CMR 15.405(2). ❑ Other(List): D. Certification .1,the facirity owner, certify under penalty of law that this document and all attachments,to the best of my knowledge and belief, are true,accurate, and complete. 1 am aware that there may be significant consequences for submitting false information, including,but not limited to, penalties or fine and/or imprisonment for deliberate violations." Facility Owner's Signature Date Helen &Finn McCarthy Pint Name Darren M. Meyer August 28, 2002 Name of Preparer Date 43 Vine Street Duxbury Preparer's address City/Town MA, 02332 781-585-0293 state2lP Telephone NOTE: 310 CMR 15.403(4) requires the system owner to provide a copy of the local upgrade approval to the appropriate Regional Office of the Department of Environmental Protection, Bureau of Resource Protection, Division of Watershed Management, upon issuance by the local approving authority and before commencement of construction. 45oreolaneform9A.doc-rev.5/02 Application for Local Upgrade Approval* Page 4 of 4 4 1 FROM :RIDGEMONT FAX NO. Jul. 29 2003 04:53PM P1 July 29, 2003 _ Teo(VI To: Wayne Archibald G{�r 22A Arch Construction PO BOX 914 Hyannis, MA. From: Finn McCarthy 88 Oreo Lane West Hyannis, MA Dear Wayne, The work you performed to install a new septic system on my property is unacceptable. Your faulty work is as follows: • The installed system is not constructed according to the approved engineering plan. The grades/elevations of piping, tanks, and system cover are different from approved plan. (Note: This is illegal and blatantly deceptive.) • The engineer has stated he approved no changes. (Note: If a change is required, the engineer must approve it.) • The fill/loam requirements to cover the system were never pre-formed per the plans. The tank never had more than 2" i3wWled over it. • Your letter to the Board of Health was meant to deceive and misdirect the blame to me personally. • The only area that has been disturbed was a small hole to check a pipe invert. No loam has been raked or removed since the day Arch completed their work. In conclusion, if you installed the system to the proper lines and grades, it can be proven very simply by comparing the approved plan with a field survey. The surrey can check pipe inverts as well as material final grades over the system. If anything is different,why was it not approved by the engineer of record? Finally, we shall require your insurance companies name and representative. This issue shall be followed thru to a satisfactory conclusion even if we need to begin a 93a claim against you personally as well as your business. Your prompt review and corrective action is required so that court proceedings are not required. Sincerely, Fi/n McCarthy 808-862-0162 CC: Barnstable Board of Health (Tom McKeen) Darren Myers, Engineer i I S ',%S Lf eK cc � wv #-AA El rn I �,1► OT Sall }.& Wed `-L'Y1`C c�J ol v n �y f►^ �r'� t rt CA IAA,- tom' Qls��� G c1�U� • -ZAN 1, 611t&OD i � Wig. ' x�fC �''°.. �_._(�-"� . �_ - ----• - -------___ _ G' I �`u�U� -•Y,r�!( q,�fC Dom' "�'�� I � 23� rj,y9� i i I i 6 - TOWN OF BARNSTABLE ' Ci LOCATION Odd,F p L t9 v.e /�,�[� SEWAGE #-�60b2 j YII,LAGE_G�* ASSESSOR'S MAP& LOTLI INSTALLER'S NAME&PHONE NO.AA,1 -J 6;�v57- Cd SEPTIC TANK CAPACITY S 0 o LEACHING FACILITY: (type 6)A1a�1 av F i�7�og r o2s (size) X!6 X NO: OF BEDROOMS / BUILDER OR OWNER ^ry:/ C- 9a 7T PERMITDA7: _COMPLIANCE DATE: Separation Distance Between the:, Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility + ®s Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet •� Furnished by I • A� = � 9 ` 3- Iih = c-r _ � 'D C, , ! C nFLlf3 I C�F,�„vuT BORTOLOTTI CONSTRUCTION, INC. .. d SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address Pro �s 19 Date of Inspec} �s Ma arcel OwneF CHECK IF THE FOLLOWING HAVE BEEN DONE: PART A — CHECKLIST tZ PUMPING INFORMATION WAS REQUESTED OF THE OWNER,OCCUPANT,AND 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 COLUMES 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. v'THE FACILITY OR DWELLING WAS INSPECTED FOR SIGNS OF SEWAGE BACK-UP. THE SITE WAS INSPECTED FOR SIGNS OF BREAKOUT. ALL SYSTEM COMPONENTS,EXCLUDING THE SAS,HAVE BEEN LOCATED ON THE SITE. 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. 6--THE SIZE AND LOCATION OF THE SAS ON THE SITE HAS BEEN DETERMINED BASED ON EXISTING INFORMATION OR APPROXIMATED BY NON-INTRUSIVE METHODS. t/fHE FACILITY OWNER(AND OCCUPANTS,IF DIFFERENT FROM OWNER)WERE PROVIDED WITH INFORMATION ON THE PROPER MAINTENANCE OF SSDS. PART B — SYSTEM INFORMATION RESIDENTIAL FLOW CONDITIONS No of Bedrooms No of Current Residents �Z__Garbage Grinder Laundry Connected to System Seasonal Use 'I NON RESIDENTIAL: Calculated flow WATER METER READINGS,IF AVAILABLE: Pumping Records and Source of Information: GALLONS SYSTEM PUMPED AS PART OF INSPECTION? IF YES,VOLUME PUMPED = GALS Reason for Pumping: TYPE OF SYSTEM: Septic tank/distribution box/soil absorption system Single Cesspool Overflow Cesspool Privy Shared system (if yes, attach previous inspection records, if any) Other(explain) Appr ximate age of all components. Date installed,if known. Source of information. T r � l� SEWAGE ODORS DETECTED WHEN ARRIVING AT THE SITE? . a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B — SYSTEM INFORMATION (Continued) SEPTIC TANK: Wo Depth below grade: Dimensions: Material of construction: Concrete Metal FRP Other} Sludge Depth Distance from top of sludge to bottom of outlet tee or baffle Scum Thlckness Distance from Top of Scum to top of outlet tee or baffle Distance from bottom of Scum to bottom of outlet tee or baffle Comments: DISTRIBUTION BOX: DEPTH OF LIQUID LEVEL ABOVE OUTLET INVERT Comments: PUMP CHAMBER: Pumps in workin order? Comments: SOIL ABSORPTION SYSTEM SAS IF NOT PRESENT,EXPLAIN: J TYPE: — / Comments: ir7 i�o t CESSPOOLS: Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimension of cesspool '(�j,r ',� Materials of construction Indication of groundwater inflow(cesspool must be pumped) r nts: LQ � Ct /'yJC i� Pr d�2 PRIVY: Materials of construction Dimensions Depth of solids Comments: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B — SYSTEM INFORMATION (Continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: INCLUDE TIES TO AT LEAST TWO PERMANENT REFERENCES,LANDMARKS OR BENCHMARKS. LOCATE ALL WELLS WITHIN 100' ZL� 1�1` Cry ow DEPTH TO GROUNDWATER: I Z DEPTH TO GROUNDWATER METHOD OF DETERMINATION OR APPROXIMATION: I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C - FAILURE CRITERIA (Indicate Y-yes N-no ND-not determined.Describe basis of determination.If"not determined",explain why not.) Backup of Sewage into Facility? i Discharge or ponding of effluent to the surface of the ground or surface waters? Static liquid level in the districution box above outlet invert? I Liquid depth in cesspool, 6"below invert or available volume, 1/2 day flow? I�/v Required pumping 4 times or more in the last year? Number of times pumped ✓/! Septic tank is metal?cracked?structurally unsound?substantial infiltrationi substantial exfiltration? i tank failure imminent? Is any portion of the SAS,cesspool or privy, below the high groundwater elevation? I�Al Within 50 feet of a surface water? /I/ Within. 100 feet of a surface water supply or tributary to a surface water supply? i i /V Within a Zone I of a public well? Within 50 feet of a private water supply well? Within 50 feet of a bordering vegetated wetland or salt marsh (cesspools&privies only, not the SAS)? — 41 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, attach copy of well water analysis for col form bacteria,volatile organic compounds,amonia nitrogen and nitrate nitrogen. PART D — CERTIFICATION I;INSPECTOR: ROBERT J. BORTOLOTTI ADDRESS: 765 WAKEBY ROAD, MARSTONS MILLS COMPANY. BORTOLOTTI CONSTRUCTION INC. MA 02648 (508) 771-9399 Ii CERTIFICATION STATEMENT , II 1 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 'RECOMMENDATION REGARDING UPGRADE,MAINTENANCE AND REPAIR ARE CONSISTENT WITH MY TRAINING AND EXPERIENCE IN THE PROPER FUNCTION AND MAINTENANCE OF ON-SITE SEWAGE DISPOSAL SYSTEMS. i CHECK ONE: , �i I HAVE NOT FOUND ANY INFORMATION WHICH INDICATES THAT THE SYSTEM FAILS TO ADEQUATELY PROTECT PUBLIC HEALTH OR THE ENVIRONMENT AS DEFINED IN 310 CMF 15.303. ANY FAILURE CRITERIA NOT EVALUATED ARE AS STATED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. lI HAVE DETERMINED THAT THE SYSTEM FAILS TO PROTECT PUBLIC HEALTH AND THE ENVIRONMENT AS DEFINED IN ji 310 CMR 15.303. THE BASIS FOR THIS DETERMINATION IS PROVIDED IN THE"FAILURE CRITERIA"SECTION OF THIS FORM. II INSPECTOR'S SIGNATURE: (I DATE: f�� i ORIGINAL TO SYSTEM OWNER,COPIES:BUYER(t applicable),APPROVING AUTHORITY ASSESSORS PAP : T T '`'``°� - - ---. . NOTES: � t �` + � PARCEL : ()4-2S -7 3 1) THE INSTALLATION MUST BE ITNT SUBSTANTIAL COMPLIANCE WITH SCE I I.. rVA3U A T 0 R ! _)��p-�-_� ��I L �'� . THIS PLAN, 1995 MASSACHUSETTS TITLE V & TO'VVN OF FLOOD ZONE : I _ I - ` 1 9I r .� BOARD OF HEALTH REGULATIONS. its WITNESS : ���C��ry�r �. i�� ��3� (-��-�- �.-- _ � �` REFERENCE : BV-. q_7 O DATE: US7 L_V 2,002 2 THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, p PERCOLATION RATE: � SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO LA low, t INSTALLATION. LLE raw 11 t' Try I r j � ,1+., TH-2 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION + "I _ _ (� - rb 1 ONLY, AND SHALL NOT BE USED FOR PROPERTY LINE ��� s _` + �, �� G N` �G��� /�l DETERMINATION, ti off; 3 .5 32 { � .� tO'4r' 4) ALL PIPING TO BE 4" SCHEDULE 40 cr I/8 "/ FOOT. (UNLESS 5 ;w + / - = ��} " �, 2I•S I i SAt°JD / a ' " SPECIFIED OTHERWISE) LOCATION MAP(( 1 •P �� r �1&DI um � 5) THE, aESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A GARBAGE DISPOSAL. / 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) of Mgss9c / 2 �I MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON o DARREN ti ,e'� A BASE OF 6"OF CRUSHED STONE. M M.E 7) _?� h xt i iNG1.C��SP �, 7v _'E_ PVAPL- Wt 56 CXI'5 s a� /ar D�vSl� ;� t c�.�1 i- X�.✓1 gNITAR�P \ I J «t 1V�V... 't-'E,�. l7 Irk1 ,��/ZIC SEPT I C SYSTEM DES I G N _____m _ . ra r ��.�� �,/ t• � �trE _r`k lam-__l1N SU r11� __ SOd L .�-��vv/J� f.�tC..�¢-/ ( FLOW ESTIMATE �b_._�L,. 1�.�5" 0r 7vp.&r--e_ q( �,.-'-- D BEDROOMS AT 110 GAL/DAY/BEDROOM - 4 GAL/DAY _ SEPTIC TANK I �1 -10 GAL/DAY x 2 DAYS - e;60 GAL �� C ��v�72-r. oF:._._G�/}7��_�-rrye USE I`, GALLON SEPTIC TAI K SOIL ABSORPTION SYSTEM � �1�/;e !. �_` `.� hJ_ f 1yt GCE ��rr-�N,� w,9 i ►2.- ry hjTvsb r----- _--- W,..,,,�...��) l r� ter- n-� / � `-�-�-i �_._ � •3 _ — _ � ____.—__ 7 5 `u 1. n1E SN P/v'D5.. �7 z;.(pf 5tbAc'cw cS!✓�L S 'L-,X- o'w x z SIDE AREA : (� Z fL1U] x Z- X 0, � � M BOTTOM AREA: /�o k 1O x C�, 7�/ _ Zl_b t�1� �${ N SEPT I C S Y S T SECTION 40 Ow&�A,5ur�--,o �e Lp-v). s , /1,01Z 7� A -,F � �' �('- Grp- »,sl, 51Mev�v I 17Lu�tr� F FLr 5mc' o' D-BOX P 1� r G,L�,I bF GI �,A � �1 �` a 1 6r" � 1,1�� ' ' P�umR i:!F+ c� /�. 18,70 vkil� 1J.v*t Fl E D SEPTIC TANK ��✓ %G�'�nPs � �°�'-I< ('1,04.ie 1E=jr�r w (✓i- P- j / Or✓ r �u„ � o�_ ti� I 375- I T !1 --�?7Z 'z SITE AND SEWAGE PLAN SWTEVEfNj W. �4' �/a rl� ''pUv�lP LOCATION : RUM" VARIA11tG p-wocs-_E�_1 5,� 1\ �-'--- 3l C rS. v �j�'a) V��JA L r N1 3i M 15.E r 1 rb A-L�w S:-P77c- p f U /�l�. %� �U U � �'-. , PREPARED FOR : ,f� p �T- �aW a� 7�� �l �, !-I' rf-DAA P'Q ( fi►A/� 1/�7 /�l�Ulp�� ✓� `v �, ! 1�\fi1� CCal�1JI l ✓L1 !O C,�1, ' /� 2 r/ 7`�'1tt.r�,.� SEr�Tt�. �� j tC IC) I'3t -�!c�nt I vA)9.A 19 V� '► I SCALE : --. ,P gVil� � �� �___-.-_ 12b - - D,A,RREN M. MEYER, R.S. - DATE.8-27-07 43 VINE STREET (\ , 6L -- ('�ri ,t© Cti12 �s'�fus(i ?Chi VArz1AIJ� f-��✓11 31v CMZ- tS, It �� "T-Lc '-o Gf ACHIM� DUX BURY, MA 023 /2U(� � 32 _ U (� (� t r�.aM fi'Uvnl �l� US_ 1�v10 2ea7 --- K :, DATE HEALTH AGENT (781) 585-0253 t d3 a � P ASSESSORS MAP: TEST HOLE LOGS NOTES: PARCEL' b(�3 l) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH ,, THIS PLAN, 1995 MASSACHUSETTS TITLE V & TOWN . OF sw n SOIL EVALUATOR : V`/�c�26Z M. ft� FLOOD ZONE: Y� BOARD OF HEALTH REGULATIONS. WITNESS : L,4_:�e 61�t,(.on�►vLt_ r(3�+ Sc� �- "° R_ # h,. l ' REFERENCE: I7ju �-] DATE:�j UST 20 e�t�2': 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, PERCOLATION RATE: 2, �'�/NG SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO , �- �,,� INSTALLATION. cL�ss .� 'S of .� (tly�v = .7`/ / a �u� � 1 INSTALLATION " TH- I CL.((o,�G TH-2 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM ONLY, AND SHALL NOT BE USED FOR PROPERTY LINT A- � LOA-K (D�� ) p� DETERMINATION. "u' �(jACnn 4) ALL PIPING TO BE 4" SCHEDULE 40 @ 1/8 "/ FOOT. (UNLESS SRtJp IUyR-S� SPECIFIED OTHERWISE) LOCATION MAF�N '�' 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A ' ` ��I UJ GARBAGE DISPOSAL. is ( �p 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON A BASE OF 6"OF CRUSHED STONE. 7) xtu ._C55 'Cx�z S 7'c> 116 / & //V SEPT I C ;SYSTEM DESIGN r FLOW EST _ BEDR(°OMS AT 110 GAL/DAY/BEDROOM - 44tC GAL/DAY 10) SEPT I C T.' K ~� /14UGAL.4DAY x 2 DAYS - GAL I( �t11 _. �'�T .O trl� ktt .._.t-t 7D. 54€ �/ 1 ._ / USE GALLON SEPTIC TANK �t SOIL AuS ,PTION SYSTEM �3�_ _lvL�rLvl? _w1 /a>_aiG ,ep ?...L �r_.t, _ .._ S I 1,E AREA: f G6)2- +-y'1012,� x 2- )t C, 2 Y 4 �� m BO"'TOM AREA: LC7 k l p K 0, ?L — Z11-6 p0 s N 1140 2 .e�. S �_ P T I C SSYSTF::M SECT ! ON 1AVIZr 7j 5� VAIN fiv 1 �� uR1 o /8.is-' 2: �"lJcvrle mew skv w 6'' ne t'9: --__ �'�. 13.E 5 t��- a y► Fvu,4 . ril} c'b S �� Q as D-BOX 1 ' 1� , U�► i.� GAL /8,70fsf `3 ` / ! `�` Mo17t t=►�i> , SEPTIC TANKlerm/nPss� / sa 1 ► -T' 8c )z6yv,2 � t ttAl 6&255 57,p� 40' It e--37,5L IT ti f2 �_ - pvasA ed S*G AA ! of !a" S I TE AND SEWAGE PLAN �,> � I � / 3 b �, v41P LOCATION SS- �o L.4-�J STEVE W � / -f z 0 RU V A121 �-` ' ` , 1 5 -- ----- 'I' ��, ieAn� , ta4�' — �' 3/O CMR, rs.�{O$�/��i� �/�'J�e��'N(� �1�dM 3fv CM,C,,, lS•2t i 7v fl'"�t..O1.v S�TZG- � � +� 3�. �'L-- 7rr ►�'fi �,� r�m P►�-�p e� 0 nlr_ v5 l�evraa o t0'. „ PREPARED FOR : �+C ST- 0 t 1 } Al 3lo 0W, /.$",Z.t/ 7`u t..t �w fL' j c3� r� =�o`„t 1vNd US I2�'' I SCALE: " —� DARREN M. MEYER, R.S. W DATE: 2-7-02- p2y•_ — Fe;c._ aid cM2 l S'L(vs(d.xh) vAz-ta-jt �-,�o.M fro cM.�. rs,al� tv r•I-c,r..o� LE ►�� 43 VINE STREET �2U v �� ._.,.. __ DUXBURY, MA 02332 W fi f M r 'RU �� US- qvd U Zr f DATE HEALTH AGENT (7$1) 5$5-0293 W ;�, .• s Z