HomeMy WebLinkAbout0255 SCUDDER ROAD - Health y #�. t ider Road
� rti ille
_ A, 1 9, - 014
i;
TOWN OF BARNSTABLE
LOCATION QA_. SEWAGE# 2004- zq,5'
VILLAGE ASSESSOR'S MAP&PARCEL — d I
INSTALLER'S NAME&PHONE NO. 0RV_ Sir ,DJ�
SEPTIC TANK CAPACITY ),Syp
LEACHING FACILITY:(type) J_gAA&% _ (size) 2 X 2 )t 3®
NO.OF BEDROOMS
OWNER
PERMIT DATE: g COMPLIANCE DATE: /� 0
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
}-� IV
R fOAT'
\ CI
1 ` �
3 Li
1 - 5-:-3Z
- 1 po=32
B9:2 7
72 A7�
�=w► z
TOWN OF BARNSTABLE
Ldl'ATION a`SS 15 W J 4 G l R 8 . SEWAGE#
VILLAGE ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) pL' CM P, rS (size)
NO. OF BEDROOMS
OWNER ZWer lni
PERMIT DATE: 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 BYTr1���0�1 757
a aq
sy crt^ A ProAT
aq a3
3�
No. s V ' Fee r
THE COMMONWEALTH OF MASSACHUSETTS . Entered in computer:
LS
Yes
PUBLIC HEALTH DIVISION -"TOWN`OF BARNSTAB'LE3 MASSACHUSETTS
ftpricatton for Bi5po5ar bp5tem Construction Kermit
Application for a Permit to Construct( . )Repair(grade( )Abandon.( ) Complete System . O Individual Components
Location Address or Lot No. Owner's Name,Address and Tel:No.
Assessor's Map/Parcel r'f ( _®�LL 4r'�'`R
Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.'
g
U11
Type of Building:
Dwelling No.of Bedrooms Lot Size_ 6 sq:ft. Garbage Grinder
Other _ Type of Building No.of Persons Showers( )`Cafeteria( )
Other Fixtures
Design Flow '1l® gallons per day. Calculated daily flow -gallons.
Plan Date 7 Number of sheets Revision Date
Title
Size of Septic Tank 41e,4.. '/J7 V,21/ />/- ZD Type of S.A.S. f vL 7 X T X2— /ACA4^�J
Description of Soil P Z�7
Nature of Repairs or Alterations(Answer when applicable) ✓ �� fff y/j 4/
-w-) rTQ62- art D/?-J- 19- v�c J z7 'L- X `w A z`.A
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system,
1 of the Environmental Code and not to lace the system in operation until a Certifi-
in accordance with the provisions of Title 5 p y p
P
n i s d this B d of Health.has been s. cate of Compliance
Signed Date ZS
Application Approved by Date
Application Disapproved for fe following reasons
Permit No. dJ2 Date Issued
No. 01
Fee
THE OMMONWEALTH-OF-MASSACHUSETTS Entered in computer: Yes
.' '' t `vPli � F`BARNSTABLE}.'MASSACHUSETTS PUBLIC�HEALTH'DLV,lS10:N., T'
'Application for Migpo dl *p5tem Construction Permit
Application fora Pernut to,Construct( )Repair( rade(�"')Abandon( ^ ) omplete System ❑Individual Components
Location Address or Lot No. ®J Owner's Name,Address and Tel.No. C0 j
Assessor's Map/Parcel
VV JJ
Instarlller's Name,Address,and Tel.No. Dessiigfner's Name,Address and Tel.No. ( t
1 tRrwn) �Jnf f1'4' !l�i.I lit f7� P t^1 V Utz
Type of Building:
Dwelling No.of Bedrooms Lot—0— Size bZ—sq.ft. Garbage Grinder
Other Type of Building No. of Persons Showers( ). Cafeteria( )
Other Fixtures
Design Flow !fd gallons per day. Calculated daily flow / !� __gallons.
Plan Date T —�S—D Number of sheets Revision Date C1101
Title f
Size of Septic Tank n 41", 11219 �°+/ /�O'' �� Type of S.A.S. T -2 7 X ?X Z
Description of Soil 52 Y
Nature of Repairs or Alterations(Answer when applicable) Vr 1#L" y a If rylj""
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with.the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued br,y this Bo of Health.
Signed �- t m r` i Date -7 2 5
Application Approved by A-f- ate
Application Disapproved for t following reasons
d
Permit No. J e 1'� Date Issued r U C)
IT THE COMMONWEALTH OF MASSACHUSETTS
!
air BARNSTABLE, MASSACHUSETTS
tT9-
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( ) Repaired ( graded( )
Abandoned( )by
at Z.1-r fe--r4- %L& V c2.l ?P-0 V has been constructed,]n coidance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 001-A ) ated /
Installer Designer
The issuance of histrti it shall not be construed as a guarantee that the system wi fuAction as es a �1
Date t) Inspector a
_ <No.
1 11 ri G1 Fee UC
_ • .-, THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC\1 EN.41 TIP fD"ION - BARNSTABLE;.MASSACHUSETTS
�-
M!6po.5ar *pitem Con5truction Permit
Permission is herebyarai t q-tfiConstruct( )Repair( ade( Abandon( )
System located at 5'ii Li of c, , Q
and as described in the above Application foi�is osal System Construsgn eNi�t.The applicant recognizes his/herrd*to
comply with Title 5 and the following local p �is
s or special conditions.
Provided: Construction must a completed within three years of the date of th I p t,.
Dater t 'r i... Approved by '' �/ �7 n
I { _ s ,
Town of Barnstable
Regulatory Services
Thomas.F. Geiler,Director
Y ` JtNnMM
MAS
S. ' Public Health Division
9�z6g9• 1�� -
Fo 3-9. Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer&Designer Certification Form
Date: Sewage Permit# Zool-zRy Assessor's Map\Parcel / J y�y
Designer: G 16. e Installer: "I C 5fiiwe_,0 S
Address: L Address: r�_b. ►� 7
0-C648
On was issued a permit to install a
(date) (installers ')
septic system at Z S's` JC-4-0i&. kZ; �'r based on a design drawn by
(address) `.
G{�,,, �. l�a-v•-.� -S. dated ,J•�f y
(desi er)
✓ 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.
1 ,.
f�eHOFMYq�
(Install is Signature) HARM N.
Ift 1070
d',gfiv'1 S'tQ`��a
NIT
(Designer's Sig ature) (Affix tamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF
COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU.
Q:Health/Septic/Designer Certification Form 3-26-04.doc
Town of Barnstable P# 7
Department of Regulatory Services
twuverest.e. : Public Health Division Date
H
200 Main Street,Hyannis MA 02601
Date Scheduled �'7 O l Time ALI Fee Pd.
t:
Soil Suitability Assessment for Sewage isposal
Performed By` c.s� (r--• ` #ajwh9 6oi Si n
Witnessed By: hV_
LOCATION& GENERAL INFORMATION
Location Address Owner's Name 5-2 ven Ajan,,1
�SSC vdd��' �vr,� o
G5�rvl i I-e Address rO. ? 7J tJS�-Cf�►f
Assessor's Map/Parcel: �3q/ol[j Engineer's Name. e� �6 rnY1G.
NEW CONSTRUCTION REPAIR Telephone# 3 1
Land Use /�R,vr� Slopes(g'a) 0-1
Surface Stones
Distances from: Open Water Body l� ft Possible Wet Area 0V ft .Drinking Water Well vo� fr
Drainage Way ft Property Line. _-__� -0 ft Other- ft
SKETCH:(Street name,dimensions of lot,exact locations of —orimity to holes)
isr
\ 0
LAJ 4 z0
CL
0 • 3 U
~; Z
® " '` I
Parent material(geologic) r � Depth to Bedrock > elc`70 1
Depth to Groundwater. Standing Water in Hole: � Weeping from Pit Face
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL HIGH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: in. Depth to soil mottle:
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level, Adj,factor— Adj.groundwater Level,;
Observation 3YZ7 �'itn
PERCOLATION TEST Date eA�
Hole# Time at o
Depth of Pere Time at 6"
Start Pre-soak Time @ /� t)2
- - Time(9"-6"). _.__.�._..._.
End Pre-soak
Rate Min./Inch ` Z
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To;Be Completed on Back-----=-----
***If percolation test is to be conducted within 100' of wetland,you must first notify the.
Barnstable Conservation Division at least one (1) week.prior.to beginning,
Q:\SEPTIC\PERCFORM.DOC
DEEP.OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders.
Consistency,% avel
Fe
!�—If 44 tso- y �C1 yi2 3/i
I If &-6 L fed !v /r, 6/ ti v
�Y-/OZ C. 1 WMeof• fa-,,d 3 90 ram.-e
/o 7? G Z &-te d Ja-,►e1
DEEP OBSERVATION HOLE LOG Hole# y
M Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Muasell) Mottling (Structure,Stones,Boulders.
Consistency. rave
'To.- 100 Cj1q-dScu d ltafal4d 2-s-y(A 111"
-T% �' �ot.,.,r'
/004?Z /ItaC)Ja.y rY G%7 2 ,5- y 7/? Ivd ,
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency..%Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,
Flood Insurance Rate Man /
Above 500 year flood boundary No— Yes
Within 500 year boundary No= Yes
Within 100 year flood boundary No Yes .
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in,all areas observed throughout the
area proposed for the soil absorption system? --,&A
If not;what is the depth of naturally occurring pervious material?
Certification
I certify that on (date)I have passed the soil evaluator examination approved by the
Depar*ent of Environmental Protection and that the above analysis was performed by me consistent with .
the required traini expertise and peri a described in 310 CUR 15.017.
Signature Date 7 l7 ��
Q:\S•EMC�PERCFORM.DOC
±E 'l r,i_r03iup FA"YN4. 5011102 94E t 4 Y '
ib'Maket application to local Fire Department., U I
Fire Department retains original application and Issues duplicate er
�5 _aria:*riFrrl a;�C � r:tarc �t• -- � re�cGYec='+�f lsaC C ''t� C>�/rav �c
f I and PERMIT. , Fee,_�=�.94�
for storage tank removal and transportation to approved tank disposal,yard in accor-darice'v✓ith the provisions
of M.G.L. Chapter 148, Section 38A,527 DAR 9.00, application is hereby made by
Tank Owner Name ipleasy print) X
- :irgna g rocFcm+fti -
Sveer CRr - a b'na
Company Name 9 F,sr Cc.or individual
Address VYItV' i�Jr_, Addresb — --
44 +� F inf n+
i Si natGreY ao g �errn Signature(if applying-for)permit).: e ;
IFCI' "Ced Other ❑ IFCI', Other
:r n
Tank I r.+catian � „_ No
sr-e+admeas - Cty _
Tank Capacity(gallons) —_ Substance Last StoredSC1�.�t
Tank Dimensions(drart7e r '!en fh)
Remarks: 42 Firm transportingvvasta�L R?Dk7te L',c.
Hazardous waste manifest.4
Approved tankdlsposal varrc! �( & � S '- Tank yard,
Type of inert gas Tank yarrJ address
2
Miff—
City or Town Ceiterville FDIG#E 07920 Perm;t#_ 00.1603—
Date of Issue December 16, 2008 Date of expiration December.30, 2008
Oki safe approval number =2008 4160 Safe li Free .Rlumber-800 3?2 8
Signature t Title of Officer granting pen-nit _ —
i.
After removal(s)(`Consumptive Use`fuel oil tams Exempted)send Form FP-29OR i;igned Local Fire Dupt.to UST RegulGtory 'e
Compliance Unit,Department of Fira_ervices,PA'Eox.1025,State-Road,Stow,MA Olt 775,
'International Firs Code Institute
PP-42(rev)sed 4t97) ;
i;i ut, 1 UMM r"IVE liiSfF'EIMEN!
Make application to local Fire Department.
Fire Department retains original application and issues duplicate as Permit.
C 1 r Uiii?fi?? ��f(�CC�il l Z f A;[u'll M:, 61
:?
'-��ic��re wd af,:��+ v er:u+c t, -- �',� e cy, 0lv 6'ta C?'i�/l�a�,�lei/
AP LI T14""' 1i and PE IT IFee::
for storage tank removal and transportation to approved tank disposal yard in accordance vrith the provisions
of M.G.L.Chapter 148, Section 38A, 527 CMR 9.00., application-is hereby made by:
Tank Owner Name{please print) s<'� Ss? �'�'Yi� �CrV X J4�� . — I
y 3N^� rrnalj_ 1
Sweet
Company Name C6 or Iridivicual
j Address Address
- 4 w�� �� ant -FrFnr i
Si nature ao I ;ng�r�2rma7 :signature(it a lyjly for rmit)
_. r �
C)
VCI'4wffed Other ❑Ill Certlf e'6_-In_CSP# Other—. _._;i,
• n
rank i ocation rvh
SPofl1A we89 Ciy v --- � + -
Tank Capacity(gallons) , Substance Last StoredC1__
Tenk Dimensions(diarye r 'Ien th)
x,.
A O a s •
Firm transporting waste �-- ate Lic.ax
Hazardous irvaste manife3 fk 1=,P.4�'# n I
I I -IT- +_40 , .
Approved tank disposal yard 'Cank yard ti
Type o=inert gas Tank yard address
- . d
(
City or Town Centerville _—_ FDID# 01920 __Perm;t#_._001.603
Date of Issue December 16, 2008 _ Date of ev:ration December :30. 2008
Dig safe approval number. _2008W 4160 Safa II Free w Riumber s3GG 322-48 4
151gna:ure i Title of Officer granting permit _
After rermval(s)("Consumptive Use"fuel&I tanlm exempted)send Form FP-230R signet 4 Lwal Fire Dopt,to UST Regulatory
Compliance Unit,Dcpartmerrt ot.Fir-_ervices,P,O.Box 1025,State-Road,Stow,MA_04,775.
*International Firs Code Institute
PP-24P(re-.)sed 4187}
l
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL-PROTECTION
TITLE 5
OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 255 Scudder-Road 5 z
Osterville. MA 02655_
Owner's Name: Abraham ZwerdlinQ
Owner's Address:
Date of Inspection: December 1, 2008
Name of Inspector: (Please Print)James M. Ford
Company Name: James M. Ford
Mailing Address: P.O.Box 49
Osterville,MA 02655-0049
Telephone Number: (508)862-9400
CERTIFICATION STATEMENT
I certify that I-have personally inspected.the sewage disposal-system at this address and that the information reported
below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP
approved system inspector pursuant to Section 15.340`of Title 5(M0 CMR 15.000):.The system:.
_Passes
Conditionally,Passes
Needs Further Evaluation by the Local Approving Authority
Fai
Inspector's Signature:: Date: December 2: 2008
The system inspector shall subm' a copy of this inspection report to the Approving Authority(Board of Health,or Y
DEP)within 30'days.of completing this inspection.,If the system is.a shared system or has a design flow of 10,000
gpd`or greater,the inspector and the system owner shall submit:the report to the appropriate regional,office of the
DEP. The original should.be sent to.the,system owner and copies sent to the buyer, if applicable,and the approving
authority.
Notes'and Cotmnents
**"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.
6/15/2000 page
Title 5 Inspection Form- 1
Page 2 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 255 Scudder Road
Osterville, MA
Owner: Abraham ZwerdlinQ
Date of Inspection: Deceinber 2, 2008
Inspection Summary: Check A,B,C,D or E./ALWAYS complete all of Section D
A. System Passes:
✓ I have not found any information which'indicates that any of the failure criteria described in 310 CMR
15.303 or in 310 CMR 15.304 exist: Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes:
One or more system components as described in the"Conditional Pass" section need to be replaced or
repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.
Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please
explain.
The septic tank is metal and over 20 years old* or the septic tank.(whether metal.or not)is structurally
unsound, exhibits substantial infiltration or exfiltration or tank failure is inuninent. 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.
ND explain:.
Observation of sewage backup or.break out or high static water level in the distribution box due to broken or.
obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with
approval of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain: .
The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will
pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
` obstruction is removed
ND explain:
2
Page 3 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 255 Scudder Road
Osterville:MA
Owner: Abraham Zwerdlin
Date of Inspection: December 2, M08
C. Further.Evaluation is Required"by the.Board;of Health
Conditions exist which require further evaluation by the Board of Health in order to;determine if the system
is failing to protect public healthy safety or the environment.
1. System will pass unless Board of Health determines in accordance.with 310 CMR 15.303(1)(b)that the
system is not functioning in a manner which will protect public health,safety and the environment:
_ Cesspool or privy is.within•50 feet of a surface water
Cesspool orprivy 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 any)determines that the
system is functioning in a manner that:protects the public health,safety.and environment:
The system has a septic tank and soil absorption system(SAS)and the SAS_is within 100 feet of a`
surface water supply or tributary to a surface water supply:
The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water,supply.
The systein 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:'feetbut 50 feet or more from a:
private water supply well** :Method used to determine distance
**This system passes if the well water analysis;performed at a DEP certified laboratory, for coliform"
bacteria and volatile organic coinpounds`'indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen'and nitrate nitrogen is equal to or less than 5 ppm,provided that no other.
failure criteria are triggered.i A copy of the analysis must be attached to this form.
3. Other:
r ..
s 3
,
Page 4 of I
OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued).
Property Address: 255 Scudder Road
Osterville, MA
Owner: Abrahmn Zwerdlinz
Date of Inspection: Deceniber Z 2008
D. System Failure Criteria applicable to all systems:
You must indicate either"yes"or"no"to each of the following for all inspections:
Yes No
✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than'/2 day flow
✓ 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 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.[This system passes if the well water analysis,
performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds
j indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered. A copy of the.analysis must be attached to this form.]
No (Yes/No):The system fails. I have determined that.one or more of the above failure criteria exist as
described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large System:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,600.
gpd
You must indicate either"yes"or"no".to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
Yes No
the system is within 400 feet of a surface drinking water supply,
the system is within 200 feet of a tributary to a surface drinking water supply
the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped
Zone II of a public water supply well.
If you have-answered"yes"to any question in Section E the system is considered a significant threat,or answered
"yes"in Section D above the large system has failed. The owner or operator of any large system considered a
significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR
15.304. The system owner should contact the appropriate regional office of the Department.
}
4
r - _
Page 5 of 11
OFFICIAL INSPECTION'FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST .
Property Address: 255 Scudder Road
Osterville: MA
Owner: Abraham ZwerdlinQ
Date of Inspection: December 2, 2008
Check if the following have been done: You must indicate"yes"or"no"as to each of the following:
Yes No
✓ Pumping information was provided by the owner,occupant,or Board of Health
✓ Were any of the system components pumped out in the previous two weeks?
✓ Has the system received normal flows in the previous two week period?
✓ Have large volumes of water been introduced to the system recently or as part of this inspection?
My 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? M
✓' - Were all system components,excluding the SAS, located on site?.
Were the septic tank manholes uncovered,opened,and the interior'of.theaank 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 detennined based on:
Yes No
_ ✓ 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(3)(b)].
' . 5
Page 6 of 11 d
a
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM.INFORMATION
Property Address: 255 Scudder Road r.
Osterville, MA '
Owner: Abraham ZwerdlinQ
2, 2008
Date of Inspection: Decembe.��
-FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): n/a Number of bedrooms(actual): 9
DESIGN flow based on 310 CMR:15.203(for.example: 110 gpd x#of bedrooms):
Number of current residents: 0
Does residence have:a garbage grinder(yes or no): ,n/a
Is laundry on a separate sewage system.(yes or no): n/a [if yes separate inspection required]
Laundry system inspected(yes or no): No °
Seasonal use(yes or no): No s
Water meter readings,if available(last 2 years usage(gpd)): Unavailable
Sump Pump(yes or no)- No
Last date of occupancy: Unknown
COMMERCIAL/INDUSTRIAL ,
Type of establishment:
Design flow(based on 310 CMR 15:203): gpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):
Industrial waste holding tank present(yes or no)
Non-sanitary waste discharged to the Title 5,system(yes or no):
Water meter readings, if available:
Last date of occupancy/use:
•
OTHER(describe):
GENERAL INFORMATION ' ~;
Pumping Records
Source of information: . Unavailable
Was system pumped as part of the inspection(yes or no): ' No
If yes,volume pumped: gallons--How was quantity pumped determined? i
Reason for pumping:
TYPE OF SYSTEM
Septic tank,distribution box,soil absorption system
Single cesspool
✓2 Overflow cess ool
Privy-
Shared system(yes or no) (if yes,attach previous inspection records,if any)
4 -Innovative/Alternative technology, Attach a copy of the current operation and maintenance contract,(to be
obtained from.systein owner).
Tight Tank Attach a copy of the D.EP approval°
Other(describe):
e
Approximate age of all components,date installed(if known)and source of information:'.
Date of installation unknown
Were sewage odors:detected when arriving at the.site(yes or no): No
r t -
z
i
Page 7 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 255 Scudder•Road
Osterville, MA
Owner: Abraham Zwerdling
Date of Inspection: December 2, 2008
BUILDING SEWER(locate on.site.plan)
Depth below grade:
Materials of construction: cast iron 40 PVC other(explain):
Distance from.private water supply well or suction line:
Commments(on condition of joints,venting,evidence of leakage,etc.):
SEPTIC TANK: ✓ (locate on site plan) (Cesspool acting as a septic.-tank)
Depth below*grade: _system A- 10" system B- I V below
Material of construction: concrete _metal fiberglass _polyethylene
✓. other(explain) cesspool block
If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of
certificate)
Dimensions: 5'W x 5'T x 8'6"bottom to rag de
Sludge depth: --
Distance from top of sludge to bottom of outlet tee or baffle: --
Scum thickness: A-0" B-1"
Distance from top of scum to top of outlet tee or baffle: --
Distance from bottom of scum to bottom of outlet tee or baffle:
How were dimensions detennined: ' Measuring stick
Cormnents(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert, evidence of leakage,etc.):
"System A"from kitchen was dry.An outlet tee was present. "System B"from bath had l'of water on the.bottoin..An outlet
tee was present:
GREASE TRAP: None (locate on site plan)
Depth below grade:
Material of construction: _concrete metal fiberglass _polyethylene _other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to bottom of outlet tee or baffle:
Date of last pumping:
Comments(on pumping recornmendations,>inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert, evidence of leakage;etc.):
7
Page 8 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 255 Scudder Road
Osterville, AM
Owner: Abr aharn ZwerdliLig
Date of Inspection: December 2, 2008
TIGHT or HOLDING TANK: None (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: eallons
Design Flow: gallons/day
Alarm present(yes or no):
Alarm level: Alann.in working order(yes.or no):
Date of last pumping:
Commnents(condition.of alarm and float switches,etc.):
DISTRIBUTION BOX: None (if present.must be opened)(locate on site plan)
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.): .
PUMP CHAMBER: None (locate on site plan),
Pumps in working order(yes or no):
Alarms in working order(yes or no)
Conunents(note condition of pump chamber,condition of pumps and appurtenances,.etc.):
8
y Page 9 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 255 Scudder Road
Osterville, MA
Owner: Abraham Zwerdling
Date of Inspection:. December 2, 2008
SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required)
If SAS not located explain why:
Type
✓ leaching pits,number: 2-1000 ag 1. one for each system
leaching-chambers,number:
leaching galleries,number:
leaching trenches,number, length:' f-
leaching fields,number,dimensions:
overflow cesspool,number:
Innovative/alternative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,
etc.):
Both 12its were dry and clean. There did not gppear to be any signs of failure in either pit. I used a camera for system B.
CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan)
Number and configuration:
Depth-top of liquid to inlet invert:
Depth of solids layer:
Depth of scum layer:
Dimensions of cesspool:
Materials of construction:
Indication of groundwater inflow(yes or.no):
Comments (note condition of soil,signs of hydraulic failure, level.of ponding,condition:of vegetation,etc.):
PRIVY: -None (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.):.
Page 10 of 1.1
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE:SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
t
Property Address: 255 Scudder Road
Osterville, MA
Owner: Abraham ZwerdlinQ
Date of Inspection: Dece»sber 2, 2008
SKETCH OF SEWAGE DISPOSAL SYSTEM E
Provide a sketch of the sewage disposal system including ties to of least two pennanent,reference landmarks or
benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building.
Sy t'f A . Pron"f
ai
10
aq a3
c
, t
f
Page 11 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued) .
Property Address: .255 Scudder Road
Osterville, MA
Owner: Abraham Zwerdling
Date of Inspection: December 2, 2008
SITE EXAM.
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water 20 +/ feet
Please indicate(check)all methods used to determine the high ground.water elevation:
Obtained from system design.plans on record-If checked,date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
✓ Checked with local Board of Health-explain: topographic and water contours maps
Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain-
You must describe how you established the high ground water elevation:
Using Barnstable topographic and water contours inaps the naps were showing approximately 20'+/&round water at this site.
This report has been prepared only for the septic system and components described herein. This septic system has been.
inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will
function properly in the future. There have been no warranties or guarantees, either expressed, written or implied,
relating to the septic systenz, the inspection, this report andlor any components of the septic system which have not
been located and inspected.
11 ,
f
EXCERPT FROM BOH MEETING AUGUST 4, 2009:
IV. Septic Variance (New):
Glenn Harrington representing Steven and Nancy Costello — 255
Scudder Road, Osterville, Map/Parcel 139-014, 045 acre parcel, two,
non-environmental variances.
Glenn Harrington presented the plan and noted he will be doing a
revised plan to fix a type error. The size of septic tank is 1,500 gallons,
not 1,000.
Upon a motion duly made by Mr. Sawayanagi, seconded by Dr. Miller,
the Board voted to approve the two variances: 1) a setback from
foundation to 14 feet in lieu of 20, and 2) depth to grade will be 3 feet 9
inches in lieu of 3 feet with the following condition: a revised plan
showing the septic tank as 1,500 gallon.- (Unanimously, voted in favor.)
LOCATION SEWAGE PERMIT NO.
�1�
VILLAGE
I N S T A LLER'S NAME i ADDRESS
21 Mp coluLib 3
B U I L D E R OR OWNER
DATE PERMIT ISSUED Lf
DATE COMPLIANCE ISSUED '
i'
��
� ��� �'�
v (�i
l
C.+
r Iq
1 '
THE COMMONWEALTH OF MASSACHUSETTS
Application is hereby made for a Permit to Construct or Repair
,)o--an Individual Sewage^Disposal
System at:
I.. .......640
�Z_164 a......... .. ..................................................................................................
cation-Address or Lot No.
0�JX-4....... ------------------------------------------- ......----------- ---------------------------------- --------------------------------------
Installer Address
Z Other Distribution box ( ) Dosing tank ( )
:3� Nature of Repairs or Alterations—Answer when applicable-d' ........ .*-.5-- ---------------
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TH771E 5 of the State Sanitary Code—The undersigned further agj:Ves not to place the system in
operation until a Certificate of Compliance has bD en issued b3te A
j:.7 ---- ------ Date
Date
Application Disapproved
for the following reasons:................................................................................................................
_____--'__-_—__--_-'_—___—'__-._____'-___._-___-_--_—'--_--.---___----'_---'--__--
Date
Permit
Date
---------------'---'---
No....: :.�� .... FEs., d......_
THE COMMONWEALTH OF MASSACHUSETTS
BOARD E HE A TH
.: __
'........oF.....::. . :. ................
Appliratiun for Disposal Nurks Toustrurtiun Famit
Application is hereby made for a Permit to Construct ( ) or Repair V,-,*)Oan Individual Sewage Disposal
System at:
Ate._ . . .. ..Ava....-- .7 . .....---- . ..................•-- ..-••---.
.. �°cation-Address or Lot No.
................................. .....••.-- -............
W Ow r Address
Installer Address
Type of BuildingJ Size Lot............................Sq. feet
�-1 Dwelling VNo. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )-
......... No. of persons............................ Showers
a Other—Type of Building ___________________ p ( ) — Cafeteria ( )
Otherfixtures -----------------•------------...-•----------------------......------------•-------------------------••--------....._....•-----
WDesign Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other,Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by............................................................................ Date-----------............................
Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
O Description of Soil ....., .._._
U --------------------------------••-•-•---•-----.._......................-•--------- -----------------.---••---------------.......................----._--• ••-_........--•-....--•--•-----•--
U Nature of Repairs or Alterations—Answer when applicable_'. ....... -------- ----- -------------------
---------•------------------•-------------.......--•-----•-•-•-•-------------------....-----•--...------•-•---------------------------------•----------•----------------------------------------•-------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE. 5 of the State Sanitary Code—The undersigned further a es not to place the system in
operation until a Certificate of Compliance has ben issued byhhe b rd Ith. `
Sign ...............
Date
Application Approved By.........................
-------------------------••---
Application Disapproved for the following redsons__________________________________________
.........................................•--------.Date..........._r
----------------------------•-----•-------------------------•------------••---•=----------•--•------...•------.......---•-----•-----•--------•-----....................................................
T
Date
PermitNo......................................................... " Issued--------------------------------.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
4... ...../... ......o F....Aow��# .............................
Trrtifirat a of' (fuutphaanrr
T. ,IW
S ,Try' CERTI Y, That the dividual S ge Disposal System constructed ( ) or Repaired
by....... . ...... - A ......._r�_� ....... -•--------•-.....-•-------•-•------..............------------.......---........._
Installer
/�,�.� �.t
has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No......................................... dated................................................
THE ISSUANC OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM Wi F C ION SATISFACTORY.
DATE....I.. .... ...................................... ...................... Inspector..--•- -- -•----•._.._....•-----•--....•----...---•------..............•.....•--
THE COMMONWEALTH OF MASSACHUSETTS
BOARD ,/O HEALTH
j .... . ...... .OF.........ey ! .. .........................
/�� j�
No._..1... ......... FEE..61 �
�iu��au �a ��aa� iu rrbti
Permission is hereby ranted.. .. _._. +! *..............
to Construct ( ) or-R��pair I ivi Sew e Dispo ten
at No... ...... ��.. i� Street ��'�� �� ..........................
as shown on the application for Disposal Works Construction Permit No.__._. �_......... Dated..........................................
� h to ,
lel,r�9 f�/ Board of Wealth
DATE....... --- ..........// ...................................
FORM 1255 A. M. SULKIN, INC., BOSTON
1
_
7
61
IM
I: :.-
77
FR
{
..
O
-S .S
GO c AtR'l fl
"S S.,
_.
O
"
77�
SI RlIvillUT -IMA '6�5<<,i
.. ��., - _.� .- __. _ - `_ _ .. _ '` yam„..-,....,°T'-• �- --'"[1q. .. s._ - ..
l.
L. SSA SC.
•
The scale -is 1
255 Scudder Rd. OstervIlle' MA Proposed basement remodel
r
LA V n {
NC
n
_
v
w
t
s
tt�'ti � •
Mx,M€3a
, a
,
_
. IZ6 }
e
WAD - + . ,. `' w o, t��'S . i r
�.
s
•
28.88'
Q.M. -- 29.00' APPROX. NGV� Bay St.
"'- 3' 0" 6' 0" 3' 0" 6' 0" 3' 0" �.
N GENERAL NQTES
- - - - ``� sin St
ON GAS CURBSTOP, _ a Rd
1. ADDRESS: 255s SCUDDER ROAD, OSTERVILLE B
2, ASSESSOR' NUMBER: MAP 139 PARCEL 014 2» 1/8"-1/2' West
o goo-textile
3. DEVEL PER'S LOT: LOT 3
29.19' 4. TOROG INFORMA N WAS COMPILED FROM AN ON THE Double-Washed Stone
(� GROUND INSTRUMENT SURVEIL EXISTING GRADE ELEY,= 29'f "'; fabric o
�\ 5. TOWN WATER IS PROVIDED TO THE SITE e: SURROUNDING PROPERTIES. FLEV
�� 6. BORDER OF VEGETATED WETLANDS LOCATED BY GLEN E. HARRINGTON, R.S. 0
9 00' 7. REFERENCE PLAN: PLAN BOOK 46 PAGE 11
.... ... ........ ......... .......
9
Dravida end cops at 3/8'-5/8 dia. holes 0" 0: (� aa r�
avement 8.90' O downstream and (typ.) locoted(tYP5 $ 7 o'clock. 4 of �0��
O ) g
ed �r Zg4 y0 4" perforated SCH 40 P.V.C. pipe 4"-1%" Double-Washed St ne
03 EB 4'(
29.00, slope-0.005'/ft. / 2 0. 0
8.92' ven
9.0 X 29.09' 22
29.36'U ✓. 9' �
• 2s 2 -� LEACHING TRENCHES CROSS--SECTION
c� T.H. 1 2 33 s .-.
�Go� 3-24• I)IAM. ACCESS MANHOLES NOT TO SCALE "OSTER VI LLE/WI AN N 0"
o . P
29, �o �
I
to 4 .10 2 u,, r,veWa �'P ,► 10' 6• L U S
-' a`je -90 .�, _•.t. r ,. . .:;.., • ,-1 NO SCALE
o .• ! Design Calcljlations
X
ce T.H. #2 .74' 26.42 '' `i Number of Bedrooms: 4 Existing
e11a� THE ACCESS COVERS FOR THE SEPTIC TANK, Garbage Disposal: No
28. 0' c. • "" INLET -- OUTLET DISTRIBUTION BOX AND LEACHING COMPONENT Leaching Capacity Required: 440 Gal./Day
.P W " /i�Q Q �. SHALL BE WITHIN 6" OF FINISHED GRADE. Application Rate for <2 min./inch - 0.74 gal/sq. ft.
w \r► pro9�' t,T. :, L Proposed Leaching Structure: 3-27'x3'x2' Leaching Trenches
oloC� /�/ de ,r INSTALL TUF-TITE GAS BAFFLES OR EQUALS
gto is ON ALL OUTLET TEE ENDS Bottom teaching Area Provided 81 sq.ft./trench x 3= 243 sq.ft.
f'" F slob a �., A .• . Side Leaching Area Provided = 120 sq. ft./trench x 3=360 sq.ft.
o, 25 :"' :'. ,: s"- ' Total Leaching Area Provided 603 sq. ft. x 0.74 gpd s .ft=446 gpd.
,nv. p,, �.//� 9 . _ qq
CP STEEL REINFORCED PRECAST CONCRETE Leaching Capacity Provided =446 gpd, > 440 gpd. required.
PLAI.. YIEw CONSTR }' TICJN NOTES
3-24" REMOVABLE COVERS
1. Contractor is responsible for Digsafe notification
rip1 7.99 X 16.88' ,„ and protection of all underground utilities and pipes.
qc 2 ` :. " • :_: ' '; a ''" t"` ; , 2, The septic tank and distribution box shall be set
o k ro 3 m . clearance � T•r._ level On 6" of 3/4 -11/2 stone.
t ' t INLET 6 min. 2` min. inlet to outlet Ir lu�
24.33 t►oor d level ounET 3. Backfill should be clean sand or gravel with no
ec
id
a' 26 IS
i f ev,22.22 X 18.8 �o•mM. I w = - stones over 3" in size.
o c slab e� s' -�' ode Y ! g' 4. This system is subject to inspection during installation
v car B - 9.42 .E oa ugsi°d de to Glen E. Harrington, R.S.
LOT 3 g
AREA J :� • 5. The contractor shall install this system in accordance
6 with Title V of the Massachusetts Environmental Code.
X 19.43' / �.. . •-�z=. �.,..;;;:�:r• •,, 6. If, during installation the contractor encounters any
24.43 X ""'` - rt�•"' '^ s' -a" soil conditions or site conditions that are different
24 ; _rrr,Tlnr�i from those shown on the soil log or in our design
,f, CROSS' ' SECTION �iv ��.�,
. - - ,.-�'� •-�---,--�--e. , the ,;��tuipr shall bait in+saliaton and mmer++iately notify
- - /
X 18.5o ev 13 TYPICAL 1500 GALLON H-2Q SEPTIC TANK Harrington,_ . Glen E. i-iarrin ton R.S.
7. No vehicle or heavy machinery shall drive over the
NOT TO SCALE septic components.
stem unless noted as H-20 septic SOIL EVALUATION P y P
-----
2 7.5 Date of SOIL EVALUATION: MAY 27, 2009 8. install Tuf=rite gas baffles or equal on septic tank outlet tee.
Evaluation Performed By. Glen E. Harrington, R.S. 9, All piping shall be SCH 40 PVC.
16 Excavator: Eric Stevens, Stevens Construction 10. No wells are located within 150' of proposed SAS.
•68' Percolation Rote:< 2 mpi assumed, 24 gals applied during presoak 11. Install a 40 mil rubber membrane or equal 5 feet from
14 - Witness: David W. Stanton, R.S., BOH Agent the proposed SAS to provide 20 feet of protection.
-1 .8 ' 22 12. Manifold three trenches together and install a 4" dia. SCH 40 PVC
12 / \Q Test Hole Test Hole
(�`� No. 1 No. 2 vent with carbon filter, as shown.
10 BVW .26 4�
EPA SOILS ELEV. DEPTH SOILS` ELEV. 13. The Contractor shall notify the Board of Health and the Designer
BVW-1 �/ PERK TEST #125g74 at least 24 hours in advance to inspect and certify the system.
(`� 0 29.10 a 29.1 9' 14. Encase the line from the septic tank to the D-Box in 6" dia. SCH
DEPTH: 38 56
h� BEGIN SOAK. :14 am 40 PVC to provide protection at sewer water line crossing.
FILL• 28.18' END SOAK. 11:14 am P P � g•
.SITE PLAN 18 son
" Y TIME: 12 MIN.- UNABLE TO SOAK. Local U rad A royal
10YR3 1• Flu. USE C2 MPI FOR DESIGN PURPOSES
310 CMR 15.405 )(b - A variance s requested to allow the proposed SAS to be
SCALE: 1 " 20' oarr,yywsan constructed approximately IV from the existing cellar wall
34" 10YR6 6 6.27' 30" 26.6 in lieu of the required 20 feet, A 40 mil rubber membrane is proposed
CONTOUR INTERVAL=2 38' "' ci to mitigate horizontal migration of odors/effluent.
,w•PERK med sand oorse son
56 102" 2.5Y6/4 20.6' 100" 10YR 6/6 0,77' 310 CMR 15.405(1)(b) A variance,is requested to allow the proposed SAS to be
constructed approximately 4 feet from grade In lieu of the required three feet.
sd. sand odium San A 4" dia. vent with carbon filter has been specified.
2.5Y 7/3 1Ol 7sa
132" 18.1' 132" 810'
Na Observed Ground water PROPOSED SEPTIC SYSTEM REPAIR
Soil Evaluation G.ertificatn PREPARED FOR
certify that on October, 1995, 1 have passed the soil evaluator
examination approved by the DEP and that the analysis was performed by STEVENS CONSTRUCTION
me consistent with the requir ` r ng, ex Ise 0,nd e rience described AT
in 310 CMR 15.017.
SYS'EW E139FILE 255 SCUDDER ROAD
Existing Dwelling
Not to Scale •Y Provide 4" dia. SCH 40 PVC cl . HARRI TON.. R.I. �vent with carbon (OSTERVILLE) BARNSTA$LE
: filter
5 HOLE H-20
WEL11 LAR < oIST BOX .,OWNER: STEVEN M. & NANCY M. COSTELLO
WALL Existing Grade 29.1' Finished grade ovelollr s.11PystemII, =2% slope away Existing Grade - 29't
Se tic tank covers must be D-Box cover shall e
p Provide 4' dia. observation ports Min. 2"-1/8"-1/2' Double ached Stone LEGEND '
within 6" of finished rode within 6" of finished grade on each trench to 6" of grade or gee-tex le filter clothe K.
S = .02 S 01 -a Approximalle location r .,, PREPARED BY:
.,' Level for 2' S=0.01 ft/ft o Peas v.= gas ne �Q
Basement Fl. - line 1= 35' EXISTING �--=;--
1000 GAL. I Apprwo ect neocation �'
. � -�- � � � p� � glen E. Marrington, R.S.
line 1= 43 19 10 �+
SEPTIC TANK 24" 4 ft. t6-- Existing contour �'; r % `„' Leda Rose Lane
Inv, 1 elev.= 26.9T H-10 _ P 24.83 g Y.t .5
rlarstons Mills MA 02648
Inv. 2 elev.- 26.3 Install Gas Paf a Facility Elev.-22.60
o Laaah new 1,500 cl. H-20 loading • 3
Tel: 508-428-3862
P-25.4,V or a uo E ev=21, septic ton E�Jz ,,. 'C b .
3 4 -14 Double-Washed Stone Confirm 5•inld provided- existing to bepumped�& removed h^ Fax: 508-428-3862
6" OF 3/4"-11/2" STONE .x
6" OF 3/4"-tt/2" STONE LEACHING TRENCH ' o_e ev.= 8.1' �.a clean-out '_ SCALD:"1"=20' DRAWN BY: GEH DATE: July 15, 2009
40 mil rubber
membrane DATUM: Approx. NGVD FILE: Stevenscostello SHEET 1 OF 1