HomeMy WebLinkAbout0022 ASA MEIGS ROAD - Health 22 Asa Meigs Road i—
Marstons Mills F/R
A = 031 000011
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TOWN OF BARNSTABLE
LOCATION ✓yl,�'['-/ SEWAGE # — S�
VLLAGE ✓�AJ9Lr7_ -"'ILL ASSESSOR'S MAP & LOT 4� l
INSTALLER'S NAME&PHONE NO..,,_ -
SEPTIC TANK CAPACITY LrS6)0_1__3 �t=34-ts—i I�C \
LEACHING FACILITY: (type t)" all
<L to
NO.OF BEDROOMS
BUILDER R OWNER l-- �
PERMTTDATE: •Q COMPLIANCE DATE: 2
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
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-
' ��� ' dv
No.c9� 3 — Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01ppYication for Migozar OpAem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade(/)Abandon( ) O Complete System RIIndividual Components
Location Address or Lot No. r Owner's Name,Addss and Tel
;7
Assessor's Map/Parcel ,0� , a'/e �� ,/��115
Installer's Name,Address,and Tel.No. Designer's Name,Addres and Tel.No.
7 -
Type of Building:
Dwelling No.of Bedrooms u3Lot Size 5V 04 sq.ft. Garbage Grinder( �
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow 330 gallons.
Plan Date 17V�(Z3 Number of sheets Revision Date
Title �1 Z�
Size of Septic Tank ,Le.,6z�w9 Type of S.A.S.
Description of Soil
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 issued by is Board He th.
Sig d Date -
Application Approved by Date
Application Disapproved for the following reasons
Permit No. —C �J Date Issued 0
3 _ S tY
No. �✓ Fee
THE COMMONWEALTH OF MASSACHUSETT9 Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
ApOication for Miopool 6petent Construction /Permit
Application for a Permit to Construct( )Repair( )Upgrade(�)Abandon( ) El Complete System C TIIndividual Components
Location Address or Lot No. /' .;,S Owner's Name,Add ss/and Tel.No.
Assessor'sMap/Pazcel Gocro�
r � Oil
Installer's Name,Address,and Tel.No. Designer's Name,Addres and Tel.No.
7 --03 *Y
Type of Building:
Dwelling No.of Bedrooms Lot Size J —sq.ft. Garbage Grinder( d
Other Type of Building R . e No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow J 3el gallons.
Plan Date 1117,1 /2 3 Number of sheets / Revision Date
Title
Size of Septic Tank /OGYI ,1�_,ri' fir. c7 Type of S.A.S. y� 1'rw'-111
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) w „g..
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this Board of Hepjth. { l
Sig ed Date 1
Application Approved by _ Date 6 O
Application Disapproved for the following reasons
i Permit No. rl9o�v —C35 Date Issued 0
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THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of (Compliance .
THIS IS TO CERTI Y, that the On-site Sewa a Disposal System Constructed( )Repaired( )Upgraded(W
Abandoned( )by 1 /7 S
at 7 Q A9POAP5 1 DIIS S has been constructedp'n ay cordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 2 CO3- 2.5/ dated 69/ o 0.3 —
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Installer Designer
The issuance oft s e t shall not be construed as a guarantee that the system f ti s d
Date �� �3 Inspector a
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No. 9-co -�) ( Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
Miqu a[ *pgtem Congtruction Permit
Permission is hereby granted to Construct( )Repair( )UU grade(Y)Abandon( )
System located at 2, 7 X_5q
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:Construct on must be completed within three years of the dat(by
f this pet
Date: U � io Approved
TOWN OF BARNSTABLE
LOCATION,�3
r,,� SEWAGE # � — �
�., ��i,,�L_`L✓> `t L-L S ASSESSOR'S MAP.& LOT
VILLAGE d�A_- _ ---T--
INSTALLER'S NAME&PHONE NO. JT,a2--, Qt.''I
SEPTIC TANK CAPACITY t u
Y CA. i /
LEACHING FACILITY: (type,
NO.OF BEDROOMS
BUILDER R OWNER
PERMIT DATE: COMPLIANCE DATE:
Separation Distance Between the:
Feet
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility x ---
wells exist
Private Water Supply Well and Leaching Facility (If any Feet
on site or within 200 feet of leaching facility),_
Edge of Wetland and Leaching Facility.(If any wetlands exist
i Feet
within 300 feet of leaching facility)
Furnished by
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�rf�»Ya'J
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: 3- 3s,6,
l9 j RECEIVE®
'"07-CTION
.... r.J �� �.� h1AY 0 6 2003
DATE: i4_/_2_8/03_____
TOWN OF BARNSTAL
PROPERTY ADDRESS: 22 Asa Meigs Road t HEALTH DEPT.
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Marstons Mills,Mass. (j
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02648
----------------------FAU® INSPECTION
On the above date, I inspected the septic system at the above address.
This system consists of the following:
1 . 1 -1 500 septic tic tank. RECEIVED
g P
2. 2-1000 gallon precast leaching pits.
3 . 1 -Distribution box. APR 2 9 2003
Based on my inspection, I certify the following conditions: TOWN OF BARNSTABLE
HEALTH DEPT.
4 . This is a title five septic s stem C
P y ( 78 ode)
5. The septic system is in hydraulic failure.
6. A new leaching area needs to be installed. / \
7. Waste & waste water is over all the invert and outlet
inverts through out the system.
8 . System needs to be pumped. �Q
SIGNATURE:
Name:-J. P. Macomber Jr .______
Company: Josej)h_P. Macomber_& Son , Inc .
Address: Box 66
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Centerville , Ma .-02632-0066
Phone: 508-775-3338
THIS CERTIFICATION DOES NOT CONSTITUTES A GUARANTY OR WARRANTY
JOSEPH P. MACOMBER & SON, INC.
Tan ks-Cesspools-Leachfields
Pumped & Installed
Town Sewer Connections
P.O. Box 66 Centerville, MA 02632-0066
775-3338 775-6412
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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: 22 Asa Meigs Road
Mar tons Mills,Mass
Owner's Name: Joseph Loud
Owner's Address: Same
Date of Inspection: 4/2 8/0 3
Name of Inspector: (please print) Joseph P. Macomber Jr.
Company Name: Joseph P. Macomber & Son Inc
Mailing Address: Box 66
Centerville Ma 02632
Telephone Number: 508-775-3338
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
ap Roved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15,000). The system:
Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
Fails
Inspector's Signature: Date: -�
The system inspector shal ubmit a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner.shall submit the report to the appropriate regional office of the
DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving
authority.
Notes and Comments
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.
Title 5 Inspection Form 6/15/2000 page 1
Page 2 of 1 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 22 Asa Meigs Road
Marstons Mi11_s,Mass.
Owner:,TncPnh T.niid
Date of Inspection: 4 J?R /n-I
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 EM—R 15.304 exi�failure criteria not evaluated are indicated below.
Comments:
The septic system is in hydraulic failure. A new leaching
area needs to be installed
B. System Conditionally Passes:
A)d 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.
IV49 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.
ND explain:
lt)e) 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 spection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
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Page 3 of 1 1
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 22 Asa Meigs Road
Marstons Mills,Mass.
Owner: Joseph Loud
Date of Inspection: 4/2 8/0 3
C. Further Evaluation is Required by the Board of Health:
/16 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 envirotunent.
1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(l)(b) that the
system is not functioning in a manner which will protect public health,safety and the environment:
AJS Cesspool or privy is within 50 feet of a surface water
X)P Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health (and Public Water Supplier, if any)determines that the
system is functioning in a manner that protects the public health,safety and environment:
/1,0 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.
/M9 The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water suppl}'.
/LQ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well.
,00 The system has a septic tank and SAS and the SAS is less than 100 feet but 20feet or more from a
private water supply well". Method used to determine distance
"This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
failure criteria are triggered. A copy of the analysis must be attached to this form.
3. Other:
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Page 4 of 1 1
OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:22 Asa .Meigs Road
Marstons Mills,Mdss.
Owner: .Taseph laud
Date of Inspection: d f 2R f o i
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
�_ Backun of sewage into facility or syste o t due to overload clo ged 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 isnb1tion box above outlet invert due to an overloaded or clogged SAS or
cesspool
�_ Liquid depth in.ccrsPee}is less than 6"below invert or available volume is less than 'h day flow
;;;�/Requtred pumping�m��or�than
4 times in the last year NOT due to clogged or obstructed pipe(s). Number
of times pumped:-D
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 well.
_ y portion of a cesspool or privy is within 50 feet of a private water supply well.
�y 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 collform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia -
nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria
are triggered. A copy of the analysis must be attached to this form.]
(Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303. therefore the system fails. The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000
gpd.
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
yes no
Xe system is within 400 feet of a surface drinking water supply
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— 1 WPA)or a mapped
Zone 11 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.
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Page 5ofII
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 22 Asa Meigs Road
Marstons Mi11s,Mass.
Owner: Joseph Loud
Date of Inspection: 4/2 8/0 3
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
2were 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?
y _ Were all system components,&luding 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 ?
4/ _ Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems ?
The/size and location of the Soil Absorption System(SAS)on the site has been determined based on:
Yes no /
vvv 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 CZAR 15.302(3)(b)j
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Page 6ofII
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 22 Asa Meias Road
Marstons Mills,Mass.
Owner:Joseph Loud
Date of Inspection: 4/2 8/0 3
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 5 Number of bedrooms(actual): ���
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):1ALI
Number of current residents:lzA
Does residence have a garbage grinder(yes or no):,LJL
Is laundry on a separate sewage system.(yes or no):�� [if yes separate inspection required]
Laundry system inspected(yes or no): Y.,S
Seasonal use: (yes or no): 4,P
Water meter readings, if available(last 2 years usage(gpd)): 2001 —6 1 , 000 gal Ions=1 67 . 13 G P D
Sump pump(yes or no):A)v = , gallons=1 8 6. 31 GPD
Last date of occupancy:
COMM ERCIAL/INDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): M gpd
Basis of design flow(seats/persons/sgft,etc.): 10
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: _�Gf/e,
Was system pumped as part of the inspection(yes or no):
If yes, volume pumped: 0 gallons-- How was quantity pumped determined?
Reason for pumping:
Tt7SOF SYSTEM
Septic tank,distribution box,soil absorption system
-jJ Single cesspool
,kb Overflow cesspool
/90 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 systeln owner)
Tight tank X///}Attach a copy of the DEP approval
/GNU Other(describe):
Approximate age of all components, date installed(if known)and source of information:
Were sewage odors detected when arriving at the site(yes or no):-166
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Page 7 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 22 Asa meigs Road
Mars tons Mills,Mass.
Owner: Joseph Loud
Date of Inspection: 4 28 03
BUILDING SEWER(locate on site plan)
Depth below grade: _
Materials of construction:we cast iron >,40 PVC 4 Y ther(explain): 1011
Distance from private water supply well or suction line: l0'r
Comments(on condition of joints, venting,evidence of leakage, etc.):
Joints appear tight-No Rvidenre of leakage T e system is
vented through the roof vents.
SEPTIC TANK: Zlocate on site plan)
u
Depth below grade: /9
Material of construction:_✓concrete4/o metal fiberglass olyethylene
' �Dother(explain) iUy
If tank is metal list age:We ]sage confirmed by a Certificate of Compliance(yes or no);(j�(attach a copy of
certificate)
Dimensions: /���,/pr,
Sludge depth: !�!'
Distance from top o 1t dge to bottom of outlet tee or baffle:_ A IV
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:
Distance from bottom of scum to botto of outlet tee or baffle:
How*were dimensions determined: G.�1Sll/k��
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert,evidence of.leakage, etc.):
One system is upgraded.Pump the tank every 2-3 years. Inlet
and outlet tees are in place The tank is c;t-rurturally sound and
shows no evidence of leakage.
GREASE TRA Olocate on site plan)
Depth below grade:,10
Material of construction:,W con crete-f/4 meta 11�LXfiberglass/1/�olyethylene��other
(explain): �
Dimensions:
Scum thickness: 109
Distance from top of scum to top of outlet tee or baffle: 1060
Distance from bottom of scum to bottom of outlet tee or baffle: 4110
Date of last pumping:_G,V
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels
as related to outlet invert, evidence of leakage,etc.):
Greasy trap is no present
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Page 8 of 1 1
OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 22 Asa Meigs Road
Mzrs ons i s,Mass.
Owner: Joseph Loud
Date of Inspection: 4/2 8/0 3
TIGHT or HOLDING TANK4,)we,(tank must be pumped at time of inspection)(locate on site plan)
Depth below grade: tt 4
Material of construction: V4 concrete WA metal�fiberglass 4/_polyethylene44 other(explain):
Dimensions: AM
Capacity: A44 -gallons
Design Flow: .4l gallons/day
Alarm present(yes or no): Alh
Alarm level: ,V,4 Alarm in working order(yes or no): AM
Date of last pumping: Wi4
Comments(condition of alarm and float switches, etc.):
Tight or holding tanks are not present.
DISTRIBUTION BOX: 2(if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert:A 1
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.):
Distribution box has two laterals.There is evidence of solids
carry over.No evidence of leakage into or out of the box.
PUMP CHAMBE&Lke,(locate on site plan)
Pumps in working order(yes or no): tO
Alarms in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
Pump chamber is not present.
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Page 9 of I 1
OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 22 Asa Meigs Road
Marstons Mills.Mass.
Owner: Joseph Loud
Date of Inspection: 4 2f3 03
SOIL ABSORPTION SYSTEM (SAS): ' (locate on site plan,excavation not required)
2-1000 gallon precast leaching pits. Pits are in hydraulic failure.
If SAS not located explain why:
Located: See page 10
yType //ff/G�'�b,y
eaching pits,number:��/"`
leaching chambers,number:
d JQ leaching galleries,number:0
leaching trenches,number, length: C)
All) leaching fields,number, dimensions: Q
overflow cesspool,number: O r �/— ?�do innovative/alternative system Type/name of technology:/..� 1� x
Comments(note condition of soil,signs of hydraulic failure, level of ponding, damp soil, condition of vegetation,
etc.):
Loamy sand to sandy loam to medium fine sand Both pits are in
hydraulic ails new leaching area needs to be installed
Soils are damp.Vegetation is normal. System should be pumped.
CESSPOOLS✓Zk&�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: Aq
Dimensions of cesspool: /
Materials of construction: /J
Indication of groundwater inflow(yes or no):
Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.):
Cesspools are not present
PRIVY!a4,r-(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.):
pri vy i c not nraSPnt-
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Page 10 of I I
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:22 Asa Meigs Road
Marstons Mills,Mass.
Owner:Joseph Loud
Date of inspection: 4/28/03
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks. Locate all wells within 100 feet. Locate where public.,eater supply enters the building.
ZZ f}Sa (V\c�c�S Road , MarSnS iN� ;1�5
very/ �
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Page I I of I 1
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:22 Asa Meias Road
Marstons Mills .Mass.
Owner: Joseph Loud
Date of Inspection: 4/2 8/0 3
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water I4O feet
Please indicate(check)all methods used to determine the high ground water elevation:
NO Obtained from system design plans on record-If checked,date of design plan reviewed: NA
YES Observed site(abutting property/observation hole within 150 feet of SAS)
ND_Checked with local Board of Health-explain: W A
YE&Checked with local excavators, installers-(attach documentation)
YES Accessed USGS database-explain: http_ / /town_harn-,table.ma. us.
You must describe how you established the high ground water elevation:
fsed: Gahrety & Miller Model. 12/16/94 Ground water elevation-, AhovP sea level.
ised: USGS: Observation well data. June 1992
tsed: USGS: Technical bulletin 92-000-1 Plata #2 Annual ranges of ground
water 1�T vat i on-,_�Tanuaryl,Qg2
I up U-7 u n
Leaching
Pit /1 beet
�y
Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per Frimpter Method
Therefore,the vertical separation distance between the bottom
Of the leaching pit and the adjusted groundwater table is
feet.
11
nr.Kr- .—nrr--�— �r,nr•nmrnnert renr.rmr.•s'+:+r'rt+nn�+nn ne*s�u ►rs+�er..ee+ �'
TOWN OF Barnstable BOARD OF HEALTH i
-..,,-T.•-,.`_T•11x-_S0IISU[IFACF 3EWA(;F DISPOSAL SY�3T�F,M INSi)FCTION FORM - PART D '- CERTIFICATION I
-TYPE OR PRINT CI.EARLY-
PROPERTY INSPECTED
STREET ADDRESS22 Asa Meigs Road Marstons Mills,Mass.
ASSESSORS MAP, BLOCK AND PARCEL #
OWNER' s NAME Joseph Loud
PART D - CERTIFICATION r
NAME OF INSPECTOR Joseph P. Macomber Jr.,
COMPANY NAME Joseph P. ' Macomber & SOfi 'Inc
COMPANY ADDRESS Box 66 Centerville Mass 02632
street Sown or City
State LlP
COMPANY TELEPHONE (508 ) 775 - 3338 FAX ( 508 ) 790 _ 1578
CERTIFICATION STATEMENT'
I certify that I have personally inspected the sewage disposaj system nt
this address and that the information reported is true , accurate , and
omplete as of the time of -inspection . The inspection was
recommendations regarding performed and any
g g u pgrade , maintenance , and repair are consistent
with my training and experience in the proper function and maintenance of on-
site sewage disposal systems ,
Check one :
System PASSED
The inspection which I have conducted has not found any information
which indicates that the system fails to adequately protect public
he-alLh or Lhe. environment as defined in 310 CMR 15 . 303 , Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
this form.
_21L/System FAILEU*
The inspection which I have con acted has found that the system fails to
Protect the public health and the environment in accordance with Title
5 , 3.10 CMR 15 . 303, and as specifically noted on PART C - FAILURE
CRITERIA of this inspection form .
Inspector Signatur -
Date
copy of this ctification must be provided to the OWNER, the BUYER
a7de
where applicable ) and the BOARD OF HEAL'r'II.
• If the inspection FAILED, the owner or""oporator shall u d
aYete
within one ,year of the date of the inspection , unless allowedortha requiredm
otherwise as provided in' 3.10 ChIR 15 . 305 .
partd . doc
kjo
LO CATION ' SEWAGE PERMIT NO.
VI'tiIAGE
INSTA LLER'S NAME i ADDRESS
-"cam"-*` '' �i/��~�"-i-..P. -r•-j Y$^}++r-'-s ++:.a-„ - ' '+^ .,�.,.. -. —.
BUILDER OR OWNER
�ww�
DA T E PERMIT ISSUED
DAT E COMPLIANCE ISSUED
. s
W
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
................OF....... aPA) ......................
Appliration for Disposal Works Tonstrnrtion umit.
Application is hereby made for a Permit to Construct (,() or Repair ( ) an Individual Sewage Disposal
System at:
Location-Address pr Lot No.
J --- --- --- ------ .... ® ...;(iV,.... � vi'+ ..............
e>_�s ow Address
w A�u /Y� /¢es, or-- ?s �±%a t •e �� = ¢ !/ �9�► M-
Installer •7)E PA y Address
Type of Building Size Lot......6. 0_�� _Sq. feet
V Dwelling—No. of Bedrooms...............4-••-•-___. -_._---------Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
Other fixtures -------------------------------- -
w Design Flow................ .................gallons per person per day. Total daily flow............... . ............gallons.
WSeptic Tank—Liquid'capacity451D-0..gallons Length,/V_.6.�. Width:5."6..... Diameter................ Depth.... ._
x Disposal Trench—No. ................... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No......../.O.At Diameter.... .6;0.. Depth below inlet........6.*s....... Total leaching area/f Z 46.sq-Et'<-.b
Z Other Distribution box ( ) Dosing tank ( ) - _
''" Percolation Test Results Performed b .--.��''�-. .W 19 ... ��� Date... /.... �.........
Y a *------•----
`�a Test Pit No. 1.---.Ka..4.minutes per inch Depth of Test Pit./4. . Depth to ground waterAA.!'_•.-..-- J'
Test Pit No. 2_..«...minutes per inch Depth of Test Pit--- Depth to ground water.�?4VN.7 ...cf_V
a --•----------•••---------------------•---••••••••-••-•••••-••-••••••...........---------
° _
Description of Soil---------------- � T`77
x d 4,V C®7kw, a 5, lfy Svb_s&i'-
--- -------- ........ .
UNature of Repairs or Alterations—Anssw*-er when applicable............. ...............................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
-the provisions of TITY•i=. 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Signed .. w. (.__......... ...................
Date
Application Approved BY _---452- Z --- .
Date
Application Disapproved for the following reasons---------------------------------------------------------------•-------------•-.................................
` ........................................................•----------------••---------------•-----....-----•••-•------------------------------•--••------------------------------•--••••---•-.........---
Date
PermitNo......................................................... Issued.......................................................
Date
� 4-%`
No............_l-G 3 FEs..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
1 ..................OF....... i e`2 h1 s (,. .......................
Appliration for Diopoottl Workii Cnonitrurtion runfit
Application is hereby made for a Permit to Construct (,() or Repair ( ) an Individual Sewage Disposal
System at:
- s= -•N1 16 .................................................. .............................. -o._.....a............................................
Location-Address or Lot No.
.........gs........_i--...................o.. ..--------------------------------------•---.. ...................®
/�dUSs[aI ow r Address
W SAasct - /�ss,� . ("o>� nS A�XA0f .... W .. ,/ ... s ,..1..)..am
a ---------...... = f
Installer Address �� /
.S
� Type of Building Size Lot....-....-.j_:��_....-.. q. feet
U Dwelling—No. of Bedrooms...............�............_..........Expansion Attic ( ) Garbage Grinder ( )
pa,, Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
aOther fixtures ------------------------•--•••......-••••-•---••-•-•••.-- •••-•-----•••--•-------•--•----••---•-••--...••-•...•••...........-••.......-•-•-.:...••---
d -
W Design Flow............................................J� gallons per person per day. Total daily flow............... .-VP.........._... eallons.
WSeptic Tank—Liquid capacityt0a.gallons Length/U. ..... Widthr..4_..... Diameter................ Depth..- •_..
xDisposal Trench—No. .................... Width..................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No-------- _ . Diameter....�Ur:.a`�... Depth below inlet....._C4_._..._. Total leaching area,//6 ZAsq-feGe2>
Z Other Distribution box ( ) Dosing tank (
tam �JEG- C.Ey2. /Auc z 1
a Percolation Test Results Performed by.....................�/................................................. Date.. .:....._1__..`.�._..........
,-a Test Pit No. 1....K. ..minutes per inch Depth of Test Pit.�41'----__- Depth to ground water!U.!..... �'� '
Test Pit No. 2.._`�. .__minutes per Inch Depth of Test Pit...�. _.:... Depth to ground water_��v!.'.._�._...
t
....• ----•-••••-••••--•-•-•--••--...•••-••-•--••-•---•-•----••-•--•-•-•--•----•----•••.........--•-.....•-•--••---•••-•...............•----••----.....----
O Description of Soil---------------`S .%y-3 -f f.. .........�G .q-A�
-•••••-•.............•••••--•-•--•••••--•-•....._..---.-•-•-
x
x ••--•••-•••-----------------•----••• ------------------...--------P•--•----•••---•--••••-------•-----••-•-•--•-•••-•-••...-••-•-•-•-:•••----•--•--•-----•-•-•------•--••••-
U Nature of Re air . r lteratio� -A r when a 1• le... .._....-:___ .
-•------•--•----------------•---.....••-•••--•----•----•----•••... ... . ------------- ..............................................
Agreement:
The undersigned agrees to install the aforedescribed. Individual Sewage Disposal System in accordance with
the provisions of TIT r sr. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been iss by the b�oard,,gf lvalth11/34 t
. 1
Sid ............. (�•--.� .J... ........................................ -----
ApplicationApproved BY....................................................---------------•--•-•---•-••-•----•------... ..............
��---......_......
1/-�---
Date
Application Disapproved for the following reasons------------------•-----•-----------•-----------•-----------------------------------------------•••--......-•-•--
Date
PermitNo.......................••----------------........_.._... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
................................I—......OF.....................................................................................
Tnr#ifiratr of Toutpliatta
THIS IS TO CERTIFY, TlIat the Individual Sewage Disposal System constructed (�r Repaired.( )
by.... P..k� T... -•---------•--•-•-•-------•------------•--------------------•-•---•------.....---•----•----•------------.....--•••------•---..._......--
Installer
at................. .�1.............. 5 c{._S.._P _... - M '0547"5 5 ._....._...
has been.installed in accordance with.the pro-sions of TT�mrII�'�,,6*1The State Sanitary Code as described in the
application for Disposal Works Construction Permit No......................................... dated-----_-------------_............................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATIS A TORY.
,
DATE......:.............................••---•--.f. ...---- I l 1-i.............. Inspector Inspector....--••--....--•------.._ ........._......---•-....--
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
OF.......... - 3 . s -
BfrGG ........................................... ................._..... .•--.........................
No.............. FEE........................
Disposal York$ notrudion rruti#
Permission is hereby granted................
�Fl
�f � .!
to Construct 1(x ) or Repair ( ) an I�Jndividdujal Sewage Disposal System, //��j� C
at No.. L"rrT ' �f. ��7T.----rT/' r/�J� r�/'St-----_ �A7 1...., il���.a .. ....--
reet
as shown on the application for Di posal Forks Construction S N�.__._ Da ._..
Board of Health
J'I DATE.------•----------•-•--......---•---•...........................................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
BOARD OF WATER COMMISSIONERS
CENTERVILLE-OSTERVILLE FIRE DISTRICT
OSTERVILLE, MASS. 02655
September 25, 1981
Mr. Joe Loud
Robinson Supply
C. I. T. Road.
Hyannis, Mass. 02601
Dear Mr. Loud:
At the present time,. the Centerville-Osterville
Water Department is preparing contract documents to install
town water on Asa Megs Road in the village of Marstons Mills.
Our schedule is to have water available in..your area by
the end of this year.
If you have any questions, please do not hesitate to
call.
Very ly Mrs
Supt.
Donald F. Rugg
V " y
.SOIL TEST LOG DESIGN CALCULATIONS
, K
DATE OF TEST: APRIL 19. 2003 DESIGN FLOW: 3 BEDROOMS X 110 GPD - 330 GPD
SOIL EVALUATOR: DAVID D. COUGHANOWR. RS SEPTIC TANK: 330 GPD X 2 DAYS 660 GALLONS
WITNESSED BY: WITNESS REOUIREMENT WAIVED - NO VARIANCES SOUGHT
USE EXISTING 1000 GALLON SEPTIC TANK IF IS SOUND STRUCTURAL
NO GROUNDWATER ENCOUNTERED CONDITION. IF NOT. INSTALL 1500 GALLON SEPTIC TANK (MINIMUM ALLOWED)
TEST PIT I PARENT MATERIAL: PROGLACIAL OUTWASH DISTRIBUTION BOX: USE 3 OUTLET D-BOX
ELEVATION - 106.5 ;- PERC AT 92 in : 2 MIN/INCH IN C2 SOILS
SOIL ABSORBTION SYSTEM: A 29 fi x 10 ft x 2 ft LEACHING GALLERY CAN LEACH
DEPTH SOIL USDA SOIL SOL COLOR SOIL OTHER A b o t - ( 29 x 10 ) - 290 s f
A
(INCHES) HORIZON TEXTURE (MUNSELL) MOTTLING At dw - ( 2 9 i' 2 9 10 I O ) x .2 - 15 6 s f
tot - 446 of
0-12 FILL Vt 0.74 x 446 - 330.04 GPD
12-16 Ap SANDY LOAM 10 YR 3/4 NONE FRIABLE USE GALLERY BELOW. Vt - 330.04 GPD > 330 GPD REOUIRED
16-44 B LOAMY SAND 10 YR 5/6 NONE FRIABLE
44-72 CI SANDY LOAM 10 YR 5/4 NONE FRIABLE
72-144 C2 MEDIUM SAND 10 YR 6/4 NONE LOOSE
GROUNDWATER LEACHING GALLERY
ADJUSTMENT CONSTRUCTION DETAIL
HIGH CAPACITY INFILTRATOR
EXISTING GROUNDWATER LEVEL INTERLOCKING CHAMBER SYSTEM
BASED ON BARNSTABLE GIS USE 14-20 UNITS
DEPARTMENT RECORDS 29 ft STONE
OBSERVED GW: 55.0
INDEX WELL: SDW-253 N
ZONE: C
READING: 3-27-2003 - -
LEVEL: 52.10 M _
ADJUSTMENT: 6.3 f t
ADJUSTED GW: 61.3 N
NOTES 2.5 ( 24 fT 11.2.5 ,
29 N
1) GARBAGE GRINDER NOT ALLOWED WITH THIS DESIGN
2) ALL LINES TO BE SCH 40 PVC AND PITCH AT 1/8 INCH PER FOOT MINIMUM.
3) ALL COMPONENTS INSTALLED SHALL MEET THE MINIMUM REQUIREMENTS
OF MASSACHUSETTS TITLE 5 SEPTIC CODE (310 CMR 15)
4) INSTALLER TO VERIFY LOCATIONS OF ALL UNDERGROUND UTILITIES
BEFORE EXCAVATING FOR SYSTEM.
5) EXISTING LEACH PIT TO BE PUMPED. COLLAPSED. AND FILLED. OR REMOVED
6) ALL STONE TO BE DOUBLE WASHED AND FREE OF IRON. FINES AND DUST IN PLACE
7) LINES EXITING D-BOX TO RUN LEVEL FOR 2'-0- BEFORE PITCHING DOWN
8) ECO-TECH ENVIRONMENTAL RECOMMENDS THE INSTALLATION OF LOW FLOW FIXTURES. SEWAGE DISPOSAL SYSTEM PLAN
AND APPLIANCES. AND BIANNUAL PUMPING OF THE SEPTIC TANK
9) SYSTEM IS NOT DESIGNED TO WITHSTAND VEHICULAR LOADING. DO NOT `` -TO SERVE EXISTING DWELLING
PARK OR DRIVE VEHICLES OVER SEPTIC SYSTEM.
10) INSTALLER TO OBTAIN DISPOSAL WORKS PERMIT BEFORE STARTING WORK. J O S E P H H. L O U D
11) SEPTIC TANKS SHALL BE INSTALLED LEVEL AND TRUE TO GRADE ON A LEVEL 22 ASA MEIGS RD. MARSTONS MILLS. MA
STABLE BASE THAT HAS BEEN MECHANICALLY COMPACTED AND ON TO WHICH
SIX INCHES OF CRUSHED STONE HAS BEEN PLACED TO MINIMIZE UNEVEN SETTLING
12) SEPTIC TANK TO BE PUMPED DRY AT TIME OF SYSTEM REPAIR AND CHECKED ECO-TECH ENVIRONMENTAL
FOR STRUCTURAL INTEGRITY. INSTALL PVC OUTLET TEE FITTED WITH GAS BAFFLE. 43 TRIANGLE CIRCLE SANDWICH MA 02563
#i
(
ETE-1400 I APRIL 21. 200.3 2/2
I
MARSTONS MLLS, MA
PLAN REFERENCE CONTOURS
LL&! o= PLAN BOOK 339 PAGE 55 EXISTING - - - - - - 106
00 U139 ASSESSOR'S MAP: 30 MINIMAL GRADING PROPOSED LOCH—� -+ j N ,
+ _,,,Z„ LOT: 1-11
�Z mHH N �`'"� ASA MEIGS ROAD
so O
i 29ftXl0ftx2ft 106 L EGEND
LEACH/NCB GALLERY EX►STM o
107"USE H-2C; UNITS 1000 GALLON � o
\w I O T I , o SEPTIC TANG
0 o AREA - 50016 sr .- \ a-0 , , /�/ Es PfT ® LOCUS M A P
NOT TO SCALE
N
}N z ' ros ELET�H A PIT OO
\_
N = w = W PPE UTLITY POLE $
U o TREE
o �m \
LL /
z W \ w z \ N roao �rwe
109
0 CD
O
~ Q a \ 1 0 O�� 2r \ 8 \pro
\ g� o LOT I I p
O X l v AREA -Soon d
Q m pLA
` M
cx� z I o c; Lf;
>LL 2 p 1 7F/94.457ty
p O w
z w PLAN
LLI E0V) 1
c �-m r SCALE: I in - 200 ft
Q
' � � � ? FMAS
! \ � O
C.
� � = DAVID o�
J2� BENCH MARK COUGHANOWR y
L1J W / !/ TOP OF FOUNDATION 9 #1093�
ELEVATION - 108,65 G 1 sl a
I 3 USGS DATUM ASSURED Sq N I T AP�P n C
w w N O z 10s r sg� ,4J
H
3 \<< w J H g ! 4
_ 0
t
OZ LL cam U �— — -8 � p' SEWAGE DISPOSAL SYSTEM PLAN
o p l 00 j EDGE Cp pA -TO SERVE EXISTING DWELLING
L_>
o t° � Si9 JOSEPH H. LOUD
tn z
�i cU'o �/�S 22 ASA MEIGS RD. MARSTONS MILLS, MA
LL PLAN R0,9 p
4 F a _ ECO-TECH ENVIRONMENTAL
O O w 6 SCALE: 1 in 30 ft 43 TRIANGLE CIRCLE SANDWICH MA 0256
` 508 364-0894
ETE-1400 I APRIL 21. 2003 - I/2
THIS PLAN IS TO BE CONSIDERED A DRAFT PLAN UNLESS IT
BEARS THE STAMP AND SIGNATURE OF THE DESIGN ENGINEER
ORIGINAL PLANS INTENDED FOR SUBMITTAL.TO THE BOARD
OF HEALTH WILL BE SIGNED N BLUE AND STAMPED N RED.
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