Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0034 BLACKBIRD ROAD - Health
34 Blackbird Road, Marstons Mills A=151-008..019 r it �, A �lb P - 1006 5•T, qo 7 -Z4 -- IZ A 1 � .6 -03 -74- cvz G , 4 9 �3 � 1 �v '2�• c - ,� IQ6��2 � � 0U TOWN OF BARNSTABLE LOCATIONj'y �j��G �( ��ir� �pl9G( SEWAGE# VILLAGE TUhS ! 111'f ASSESSOR'S MAP&PARCEL r� 9 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /O00 / LEACHING FACILITY:(type) 2—S O(J �i�lr�l(�/;f" (size) NO.OF BEDROOMS 3 PERMIT DATE: 7 —2 D — J 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 w;thin 300 feet of leaching facility) ," Feet FURNISHED BY No. y^)L©� O 1� t Fee 0 V / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:_: / PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes RpPliCation for Misposai *pstrm Construction Permit Application for a Permit to Construct(.%r Repair(4oY pgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or LQt No. 3 y 61*Ck—(1t; Igo Owner's Name,Address,and Tel.No. �ylnrStdy.4 �1'I,/� ✓as�py ✓. r2 144 i Assessor's Map/Pa el 0,03- ! �� Installer's Name Address,and Tel.No.;f'O$-y20^71709 Designer's Name,Address,and Tel.No.s-OB-888—3G/Q ✓of-d,J4 0.s 60rovs Ca T .�dr 1/j'y, it e��.of� ems. AP rpofs 04.M i� A G� Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 6 gpd Design flow provided 5 +� gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �,�0 lk A X,-_4eZ 9 S K 2 " O 6.49/ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Beard of Health. igne Date -7 Application Approved by Date-2/ / Application Disapproved by Date for the following reasons Permit No. "IQ f '01- Co)- �� Date Issued ad Fee No. r• ,_ ; ,. y r THE COMMONWEALTH'OF-MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ftpYication for Misposai 6pstem Construction Permit Application for a Permit to Construct Repair(.)`Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or LobNo. 3 hivc/ Owner's Name,Address,and Tel.No., / I' Y9/9!''jfva�j vl'li%/} /osCpG, ✓, 6Y/�YZ jLL. / Assessor's Map/P/ el 6)U,- Installer's Name,Address,and Tel.No. SC G y`� - �/�3 2 Designer's Name,Address,and Tel.No.sp,3- &E- Jos �y 0, (3�rvvs� l:Aa S J'Ur VIZ y, / A16 rya-1�✓ T Type of Building: i Dwelling No.of Bedrooms 31 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building. No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 3 rJ �'�'� gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil r Nature',of Repairs or Alterations(Answer when applicable) ri^// .AII=e4l - 1?6,X 2 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. tgne > 2 ri"I/ Date / o� Application Approved by Date Application`Disapproved by Date for the following reasons , Permit No. C�) J `01 P Ti Date Issued Y --------------------------------------,._.-----______,_",___,_.___.___.__.___________.__. THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( /4--- Repaired( c..)— Upgraded( ) Abandoned( )by -7 at 3Li /� �7-.5 4�11111 has been consttruuc�cted in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.(9-�� 0 2-dated -7 AFL a Installer , Z25 Designer #bedrooms ? Approved design flow 3 S o gpd The issuance of this permit shall of be co ssstr��ued as a guarantee that the systemf ill firnc e�}igned. Date ��,/O� Inspecto'�� Q No. C��1 c;;-O Fee o THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS -MIsposal 6pstem Construction 3permit Permission is hereby granted to Construct Repair( C)- Upgrade( ) / Abandon( ) System located at Ste/ /�?��4�� l�/t �`2��a�( and as described in the above Application for Disposal System Construction Permit. The applicant recognized'his/her duty to comply with Title 5 and the following local provisicns or special conditions. Provided:Construction mu t be co�,pleted within three years of the date of this bEy t. Date 7� / ' �` Approved Town of Barnstable , S �oFt"E'°wy Regulatory Services o� Thomas F. Geiler,Director Mom. Public Health Division Alto �� Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Dater Designer: �/� 5 SJ(L✓�Y T�� Installer: O�`� S �G��C Address: �pU l� ox 17 Z 0. 9 Address: �� CMw\EEIT-gO II On Zvc� f�o.CL�Os was issued a permit to install a (date) (installer) !�/�„ ,�` sZ 5 septic system at 54 -� P� V-V0 V ML l L-lfS� based on a design drawn by (address) a =, dated °Iu L-,l 1�1� tot 2 (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic syst,-m) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. �IH OF vN'`A qc� Rom' DAVI D e—A VIX D. 17 ( stal er's Signature) ° FLAHERT' , JR. Cn No. 1211 G/STS'k X S4NITARO" . esiper's Signa ) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC FIPALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTEL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTAB_LE PU14LIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Desiper Certification Form CO p Ir �. . . . CO Ln OFFIC AL USE rLn u ^. Postage $ q(w-1U/S+� Certified Fee }� Postmark O O Retum Receipt Fee J Here tV O (Endorsement Required) 7 5 ResMcted Delivery Fee (Endorsement Required) 0 Total Postage&Fees $ 1 r-R Mr. Joseph Marzille 34 Blackbird Road Marstons Mills, MA 02648 Certified Mail Provides: o A mailing receipt opm _ a A unique identifier for your mailpiece, . o A record of delivery kept by the Postal-6ervice for two years "- Important Reminders: )W r to Certified Mail may ONLY be combinik with First-Class Mail®or Priority Mail®. o Certified Mail is not available for any dass of international mail. • NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured•, r Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT.Save this receipt and present it when making an inquiry. PS Forth 3800,August 2006(Reverse)PSN 7530-02-000-9047 ' -"I n Complete items 1,2,and 3.Also complete A. Signatu item 4 if Restricted Delivery is desired. ❑Agent o Print your name and address on the reverse WtW�)X ❑Addressee so that we can return the card to you. B. Re t a by(P ted Name) C. Date of D livery n Attach this card to the back of the mailpiece, R , LCs� 6 l or on the front if space permits. pa D. Is delivery addre different from item 1? es 1. Article Addressed to: If YES,enter delivery address below: ❑ No Mr. Joseph Marzille 34 Blackbird Road Marstons Mills, MA 02648, 3. Service Type ❑certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7011 04701;0001 4525 6898( (transfer from service labeQ PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-IW UNITED STATE§-R2 T STV' , ea'Y•'s, — '""• a �^a p g� A�. q spR � y :testa 6 aid LT.d:fi...,....1F • Sender: Please print your name,address, and ZIP+4 in this box • Town of Barnstable Public Health Division 200 Main Streety Hyannis, MA 02601 tF � p • ,e Town of Barnstable Barnstable p THE TOh'L BOARD OF HEALTH Amwica�j Il 9 nA MSSBLE,�� 200 Main Street, Hyannis MA 02601 �j 039 p�� 2007 �r4F MA't Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M. Junichi Sawauanagi CERTIFIED MAIL# 7011 0470 0001 4525 6898 May 31, 2012 Mr. Joseph Marzilli 34 Blackbird Road Marstons Mills, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 • The septic system located at 34 Blackbird Road, Marstons Mills, MA was last inspected on 5/16/2012, by Patrick M. O'Connell, a certified septic inspector for the state of Massachusetts. The inspection of the septic system showed that the system "Fails"under the guidelines of the 1995 TITLE 5(310 CMR 15.00) DUE TO THE FOLLOWING: • The System is in hydraulic failure. You are ordered to repair or replace the septic system within sixty (60) days from the date you receive this notification. Failure to repair/replace the septic system with the deadline period will result in future enforcement action PER ORDER OF THE BO OF HEALTH It mas McKean, R.S. CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Eva]\Regulatory Authority.doc ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16 2012 required for Y every page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information I When filling out n /J forms the computer, �r,use 1. Inspector: only the tab key to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. Company Name r� 189 Cammett Road Company Address Marstons Mills MA 02648 fe1A1 Cityrrown State Zip Code 508-428-1779 S1 12855 Telephone Number License Number B. Certification 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 16.340 of Title 5(310 CMR 15.000). The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority May 16, 2012 Job# 12-78 I ector's Sign ure Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP) within 30 days of completing this inspection. If the system 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. ****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. LZW 512A ZGR) l5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is y required for Marstons Mills MA 02648 May 16, 2012 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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. Check the box for"yes", "no"or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally unso ind, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): !Sins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16, 2012 required for Y every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obs:ruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 health, 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 or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16, 2012 required for Y every page. City/Town State Zip Code Date of Inspection B. Certification (Cont.) 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 system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system Ihas a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ® ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ 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 day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16, 2012 required for Y every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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. ❑ 19 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. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® ❑ The system fails. 1 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. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. 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. t5ins•11110 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16, 2012 required for Y every page. Cityrrown State Zip Code Date of Inspection C. Checklist 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? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ❑ ® Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16, 2012 required for y every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage d N/A Irrigation g ( y g (gp )) system. Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins.11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16 2012 required for Y every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Tank last pumped 7/11/05 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ 1 ight tank. Attach a copy of the DEP approval. ❑ Other(describe): l5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16, 2012 required for y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 24 years Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): ' Depth below grade: 1 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): ' Depth below grade: 1 feet Material of construction: ®concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 8.5' long x 5.2'wide- 1000 gal. Sludge depth: 3" t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16, 2012 required for Y every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 27 Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 10" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Liquid level was at bottom of outlet invert at time of inspection. Observed solids on top of outlet tee indicating surcharge and hydraulic failure. Grease Trap (lo--ate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bcttom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments w 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16, 2012 required for y every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No l5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is y required for Marstons Mills MA 02648 May 16, 2012 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" 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.): Previously full to top, staining and solids to top of box. System in hydraulic failure. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16, 2012 required for Y every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Type: ® !leaching pits number: One 6x6 pit. ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ 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.): Unable to locate pit, likely under driveway. Pit shows signs of surcharge and hydraulic failure. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is y required for Marstons Mills MA 02648 May 16, 2012 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts - r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 34 Blackbird Road Properly Address Joseph Marzilli -- Owner Owner's Name information is Marstons Mills MA 02648 May 16 2012 required for ----------- -.._.__.___.....---- --- every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawina attached spnaratal%/ "I"N' IN % IN/ N N N N/N/N/ `,`/`,`/ N,N,N, 33 ' '\ . \ \/\,\ \ \ , \ \ / ! ! i 12 110 74 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16, 2012 required for Y every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water Check cellar ® Shallow wells Estimated depth to high ground water: N/A feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 34 Blackbird Road Property Address Joseph Marzilli Owner Owner's Name information is Marstons Mills MA 02648 May 16, 2012 required for Y every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 /TOWN OF B fARNSTABLE LO CATION, � CC `�% n��Y SEWAGE# �',?T_:AGE >ASSESS 'S MAP&LOTUIS�: a�9 SEPTIC TANK CAPACITY LEACHING FACILITY: (type)�7`�'7C (size) NO.OF BEDROOMS BUILDER OWNER PERMUDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility / Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) I �Aa Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 3 of//eaching fa ' i ) /�/� Feet Furnished ti r�B 7C) C `>VC � ��� r �� of .� �' ,,o r TOWN Ol; L;A1?IVS'T/1 LtL1 & Cloy SEWA.(;E #ffl -_&il ASSESSOR'S MALT & LOTJf� 14:STALLER'S NAME & PRONE NO./7((h,, C ry4 SEPTIC TANK CAPACITY /ODb GG ;I'ACHING FACILITY:(Cype) CC,- I40. OF BEDROOMS _ PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER_ZAk/_ SO/�Q�,�_�,�__ DATE PERMIT ISSUED:--.—,. DATE COMPLIANCE ISSUED_ V hRIANCE GRANTED: Ycs A., 0 /S I — DES' — G �91 ~�. No. ............_....... Fss.......................... ... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..._._..7-'�.w�-----.0F..,`D�-. .SX:�-- .- . .1 ......................... Appliration for RopmFai Works Tonstrnrtiun ramit Application is,hereby made for a Permit to_Construct (ki-lor Repair ( ) an Individual Sewage Disposal System at: ........ ,-_4 7........� .. =_� -- . . ....•----------.1 'r= =:.. Qs,l -. .................... 6 WF �jA Lot No. Owne V .... ... .. ..... 0 ............ ... .. .... . .................... ................ ...... ............................... � Instaler Address Type of Building Size Lot.._ J_..; q. feet Dwelling—No. of Bedrooms.______•__ Expansion Attic-f'�f� Garbage Grinder--�-� Other—Type of Building No. of persons.......4t................. Showers Cafeteria_-r P.4 Other fixture ..--- ----------------------------------------------------------------------•----------•---------•---•-•-----------------------• W Design Flow.................... __________gallons per person per day. Total daily flow........ ._.d__ ............gallons. WSeptic Tank—Liquid*capacity 1D0!gallons Length__...G._.. Width_4../.<&.. Diameter................ Depth__.__ __- x Disposal Trench—No..................... Width..... _ .._.._.... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No........I........... Diameter......I_.... ....... Depth below inlet....:3 .!5 .`.. Total leaching area...3.0 .sq. ft. Z Other Distribution box ( V� Dosing to .�Ifi r- _ '" Percolation Test Results Performed b -___... e.l"^. s..S ��� Lt Date.. � __�... W y 3•• ;Z�------------------ ,� Test Pit No. 1.__:!�..Z-minutes per inch Depth of Test Pit_________________ Depth to ground water.-_f.Z_.... . Test Pit No. 2---..-=_z-minutes per inch Depth of Test Pit...../_Z_1'..... Depth to ground water___...�.`.._ � P1 •-----.....f ------•----•-•----------•--------•-------•--- -------------- ••• �(T Description of Soil 1. � :'I..-• x U --------------------- •--------------------- ••--------------------------------------------------- -•----------------------------------•--•----•-•-------------------------------------•--------.------ W VNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individ Sewage Disposal System in accordance with the provisions of TITLL3✓ 5 of the State Sanitary Co The un er gned further agrees not to place the system in operat' til a Cerca of Compliance has bee s t b r health. Signed ----- --- • .................................... .... .....� -- •--•-- �j ate j7/ Application Approved BY Q T---.............. Date Application Disapproved for the f ollowin easons:.. .............................................•--•---------------------......-•----------------------••••.-------------------------------------------------------------------------•----------------..... Date PermitNo...................................................- _ Issued_....................................................... Date ' No. 6. J FEs....l....................... THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH ------------------------------------•---. Appliration for Dioposal Works Tomitrn.r#ion jitrutit Application is hereby made for a Permit to Construct (P`)or Repair ( ) an Individual Sewage Disposal System at: • -1 1 �._ci 1 ...� ..f - c,-P_ ��Z VLr: i3.cc..�_.� Location-Address or Lot No. ......................_.......................................................................... .....•-•-•............---•-•----•..............----.................................-----........_ Owner Address W Installer Address .-- Type of Building 3 Size Lot._�-... -4?3- ...Sq. feet Dwelling—No. of Bedrooms__..._.....................................Expansion Attic-(—) Garbage Grinder-(—) a'4 Other—T e of Building _!__ �.r No. of persons __________________ Showers YP ------------- P �--) — Cafeteria-(—) dOther fixtures-....--•---------="==----------•-•-•---------------•---------------•--•---•------------------------•-----.....-----.. W Design Flow................... ..` .._.._._.._gallons per person per day. Total daily flow.......___.._.3.._0 .............. WSeptic Tank—Liquid capacity 2Qb_gallons Length_ _..(!.__. WidthA.r!.� -__ Diameter................ Depth._S....'2.." x Disposal Trench—No. .................... Width................ Total Length.................... Total leaching area_____-----------sq. ft. Seepage Pit No.......I------------ Diameter.....f.__._?__._._. Depth below inlet_..�:..�?...._. Total leaching area...:_0$..sq. ft. Z Other Distribution box Dosing tank.(--)" _ Percolation Test Results Performed by__.....rf.. ^^ .. .. . _. Date. ..... . �KZ� s--.---. Test Pit No. 1___ ._7_...rminutes per inch Depth of Test Pit... __e-_--___--- Depth to ground water.. ._�-_____ Test Pit No. 2___'`__?----n_inutes per inch Depth of Test Pit----f.e_....... Depth to ground water-_---_---_.__----___- ---••- --•----•--•--_... ••--•-•-------•- ....-----•----- ---------------•--•-•------•---••-•-••----•-•-- ------ --------- ------- ---=- ------ D Description of Soil . = : ..p....- .. _ ---I tip x U -------------------------------------------- --------------------- •---------------- ------------------- --•---------------------------•--------------------------------------------------------------- W VNature 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 agrees not to place the system in operat' til a Cer of Compliance has been issued by the board of health. Signed-''`,. ....-------•---------------------------•-------------------------......--•- A ------- Application Approved B `� Q Date} L PPPP y----• 7 ••----...--••--•...............•------ ------. Cl I Date Application Disapproved for the f ollowinaeasons:--•-----•-------- ---------- ----•----•-•-------•------- •-----•---•--•--------•---•-••••••----.............-.................................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............ .`�..`'"' ...OF....... '..:..- ..:.~ �l_ r c")13.�...`_`............. .. .......................... (Infifirtar of Tong haure TH /IS T TIFY�hat tl�e i ual Sewage Disposal System constructed (�or Repaired ( ) / Installc � at--- / n Yf S crc ,�--� 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 ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �--v FEE........................ �- � � o #r�r#� rrint� Permission is hereby granted--:- -___I.. ..ff�ze� �r' ......------•---------------• .......................................... to Construct (I-"�_or Repair ( ) an Individual SeucTage Disposal System at No........�=�' T / i c�j� y ref x % e )< <Sr - vv" 1 -. .......................................-•---•----------------•--•••-•--•----------•------•--............. Street ass own on the application for Disposal Works Construction Perrt� No..................... � Da Dated.........................------------••-• 2 - .._ � .'J--- Board of Health DATE................. --------------------------•--•• " FORM 1255 A. M. SULKIN, INC., BOSTON �� IPW a r RECEIVED JUL �, 51986 �U Imes and rncgrath, inc. civili,kngineers and land surveyors 200 maw street, room 201 falmouth, ma. 02540 548-3564 July 3, 1986 Mr. Douglas Lebel Lebel-Sollows Corp. 131 Old Route 132 Hyannis, MA 02601 Dear Mr. Lebel: Re Fieldstone Estates Our Job No 85,310 Enclosed please find the following: 1. . Topographic Plan of Land; Dated July 30, 1985 2. . Subdivision Plan of Land (3 sheets) ; Revised June 26,1986 3. Subdivision Plan of Land . (Sheet 2 of 3) ; Revised May 12, 1986 i 4. Results of Percolation Tests witnessed by Barnstable Board of Health. The Subdivision Plan of Land; Revised_ June 26,. 1986 (enclosure 2) is the plan approved by the Barnstable Planning Board on June 30, 1986. The Planning Board .is in possession of the signed copy of the plans. I have enclosed the Subdivision Plan of Land (sheet 2 of 3) ; Revised May 12, 1986 (enclosure.3) , because the test holes were located according 'to this plan. (Lot 1 on this plan corresponds to Lot 1 on the test report and Lot 2 on this plan corresponds to Lot lA on the test report) . Due to the redesign. of the lots during the testing procedure, the test reports themselves do not accurately reflect the final lot numbering. Adjustments should 'be made according to the attached sheet. If you have any questions, please call or write. Yours truly, HOLMES AND McGRATH, INC. Hobert A.' /urgmanrl Vice Pre�4dent RAB/dcl cc: William Haney TEST REPORT FINAL SUBDIVISION PLAN. Lot 1 Lot IA Combined into Lot 1 Lot 2 Lot 2 Lot 3 Lot 3 Lot 4 Lot 4 Lot 5 Lot 5 Lot 6 Lot 6 Lot 7 Lot 7 Lot 8 Lot 8 Lot 9 Lot 9 Lot 10 Lot 10 Lot 12 Lot 11 Lot 13 Lot 12 Lot 14 Lot 13 Lot 15 Lot 14 Lot 16 Lot 15 Lot 17 Lot 16 Lot 18 Lot 17 Lot 19 Lot 18 Lot 20 Lot 19 Lot 21 Lot 20 Lot 22 Lot 21 Lot 23 Lot 22 DEEP.OBSERVATION HOLE LOG Hole# IDG. Depth from Soil Horizon Soil Texture .Sdil Color Soil• Other Surface(iff.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. 96'(iravel) d X �- d Fk > Gtfd 7 -all DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. - Q o sis n. %0 ve rnyJ �Sy2 �� DEEP OBSERVATION HOLE LOG hole#.- .Depth from Soil Horizon Soil Texture Soil Color S1311 Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. //Mn Co i to c 0 e ZZ-1 'n 7 S,12 �� o log"--120) c z Z, y? D Zvi gV1 ✓ ' DEEP OBSERVATION HOLE LOG Hole# Depth from Sail Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency. !d 2 Slz Ot3 y 5- s� o i249 /,39 CZ / e,51 7' d Ala Flood Insurance Rate Man: Above 500 year flood boundary No— Yes Within 500 year'buundary No Yes ' Within 100 year flood boundary No.,__._ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perv�;Z'terial exist in all areas obstrved throughout the area proposed for tie soil absorption system?If not,not,what is the depth of naturally occurring pervious material? Certification I certify that on ✓l/ J (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required traini g, peruse 7nei eri ce described in�10 CMR 15.017. Signature Datb Q:\S.RPTlC\PERCF0RM.D0C t� Town of.Barnstable P ' Department of Regulatory Services nra, i Public Health Division Date 200 Main Street,Hyannis MA 02601 Date Scheduled ✓/ Time �-- ]Fee Pd. �Gy Soil ,suitability Assessment for S age .disposal Performed By: -- �76 Witnessed By: L ATIO &GE RAL INFORAIAT N fa Location Address Owner's Name ���'" SAddress Assessor's Map/Parcel: Engineer 's Name�j� NEW CONSTRUCTION REPAIR Telephone# Joe - 52? -,3 460 . Land Us C 47 e -- .Svvve 0 C9 ev. Cc.►"? . \/ Slopes(96) Z '—/a/ Surface Stoucs Distances from: Open Water Body //�/� ft Possible Wet Area �/dl ft Drinking Water Well �t Drainage Way_ m to ft Property Line Zv ft Other ft Cg—,?.a/MS/N SIMTCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) � ;�3 d. • � r Parent material(geologic) o1C/Z Lf Depth to hedrocl < . Depth to Groundwater. Standing Water in Hole: �C Weeping from Pit Faee � T Estimated Seasonal H /igh Groundwater 7- 2 D TER�ATION FOR SEASONAL HIGH WATER TABLE Method Used: 2 �'� Depth Observed standing in obs.hole: In, Depth to sQII mottles: N. In, Dcp'th t weeping from side of/o�b�.hole: Irl, Groundwater f usttrient f[. Index Well# /� Reading Date: 0%/4 index Well lc of AEU,&ctor AV.4C Adj.Groundwater l evea �f z Observation PERCOLATION TEST Date d zG Z 'Jt'lnre>/ N_ ' Hole# � Time at 9" l?'� /. /�i/ Depth of Pere C.� Time At G" 2 .ZZ Start Pre-soak Time @ �27�_ Time(9"-G") ��' End Presoak 12 • -15 i 6 Rate Min./Inch Site Suitability Assessment: Site Passed Sitr,Failed: Additional Testing Needed(Y/N) O Original: Public Health Division Observation Hole Data To Be Completed on Back---------- 'c ***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 begirwing. Q:\S EPTIC\PERCFORM.D OC D.T.H. #1 D.T.H. #2 RAISE COVERS TO WITHIN 6" OF FINISH GRADE DATE: 6-26-12 DATE: 6-26-12 GROUND ELEV. 106.4 GROUND ELEV. 100.4 TOP OF FOUNDATION REPLACE EXISTING D-BOX WITH NO GROUNDWATER NO GROUNDWATER ELEV. 108.0 FINISH GRADE FINISH GRADE 4" C.O. SWEEP TO GRADE WITH NO MOTTLES NO MOTTLES SCREW CAP. INV = 101.20 RAISE TO WITHIN 6' RAISE TO 107.5 ELEV. 107.7 ELEV. 107.1 FINISH GRADE OF FINISH GRADE /�\ . LEV. 104.0 104.2 /,C�� ELEV. 104.1 GROUND ELEVATIO 104.1 TOP _ ///�� �� �� �� �� ��o, /��/��////��2" MIN 1/8��_1/4�� LOAMY SAND N N DOUBLE WASHED 10YR 5/2 18' OF 4" PVC 70'C�S=0.05 TOP ELE 101.2 INV.= 4" PVC SCH 40 35'(�S=0.015 1.5 """" 6'Cs�5=0.01 O 00 00 0 o O 00 00 s FILTERTFABRIC FILL LOAMYONE ORB SAND 8 '..,. CH 40 S=0.02 2 MIN-3 MA INV.= EXISTING 104.8 10"TEE 14"TEE INV.= INV.= 00000 o c 00000 N 7.5YR 5 6 t Y INSTALL 6" O O o o O O 78�, 32 5'-7 GAS BAFFLE 3 OUTLET O O O O O 3/4" DOUBLE ELEV =99.9 ELEV =97.7 4'-6 1/2 D83 TWO 4'-10"x8'-6"x2'-9" CHAMBERS > WASHED STONE EXISITNG PVC PIPE INV.=100.67 \INV.=100.44 m w TO REMAIN INV.=1O0.50 S.A.S. (13' x 25') � 98.44 Cdt Cd1 /o o SILT LOAM SILT LOAM EXISTING 1,000 GAL. TANK TO REMAIN 10YR 6/6 10YR 6/6 TEST PIT #4 ELEV 93.4 CONSTRUCTION NOTES: NO G. WATER 150" NO G. WATER 138" ELEV =93.9 ELEV =88.9 JOB # 12-0109 1. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND c o 0 ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING ;� D.T.H. #3 0 D.T.H. #4 0 WORK ON THE SITE. "� 0 0 0 o El 00000 °� DATE: 6-26-12 DATE: 6-26-12 SITE �c SEWAGE2. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE O0000 0 0000N GROUND ELEV. 105.9 GROUND ELEV. 104.9 WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT O 00 00 0 0 0 NO GROUNDWATER REPAIR PLAN IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY, NO MOTTLES NO MOTTLES 3. VEHICULAR TRAFFIC, PARKING OF VEHICLES AND PLACING 14.0'- - 5.0' --+-- 4.0'--� A SR AREA S PROHIBITED MATERIALS OVER SEPTIC TANK, DISTRIBUTION BOX AND 34 BLACKBIRD ROAD S.A.S. 13 0' FILL FILL MARS TONS MIL L S GENERAL NOTES: SIDE VIEW A 18" A 120'1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. LOAMY SAND LOAMY SAND IN TITLE V AND THE TOWN OF BARNSTABLE RULES AND 10YR 5/2 10YR 5/2 REGULATIONS FOR SUBSURFACE DISPOSAL OF SEWERAGE. DATUM: B 22" B 16" BARNSTABLE, MASS 2. AT LEAST ONE ACCESS POINT OVER TANK TEES SHALL BE VERTICAL DATUM: LOAMY SAND LOAMY SAND ACCESSIBLE WITHIN 3 OF FINISH GRADE, WITH ANY REMAINING MSLt TOWN OF BARNSTABLE GIS DATUM 7Amy 5 6 DATE: JULY 19, 2012 ACCESS PORTS BROUGHT TO WITHIN 12 OF FINISH GRADE. BENCH MARK SET: 54" 7.5YR 5 6 36" 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE ELEV =101.4 ELEV =101.9 CAPABLE OF WITHSTANDING H-10 LOADING UNLESS HYDRANT TAG BOLT. ELEV. 113.51 C_1 C-1 • OTHERWISE SPECIFIED. FINE SAND FINE SAND OWNER/APPLICANT: 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION OF ALL UTILITIES PRIOR TO ANY EXCAVATION. �� Or 1�SS \ -. DTH #1 l INDICATES DEEP 2.5Y 7/4 2.5Y 7/4 64" JOSEPH J. MARZILLI 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE _� q�ti` TEST HOLE 108" 120" 34 BLACKBIRD ROAD ,o DAVID OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. :� � 93.4 INDICATES ADJ. GROUNDWATER C-2 C-2 6. FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER o MEDIUM SAND MEDIUM SAND FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. F H TY, OBSERVED GROUNDWATER 2.5Y 7/6 2.5Y 7/6 MARS TONS MILLS 7. SEPTIC TANK SANITARY TEE'S SHALL BE CONSTRUCTED OF IN 21 MA 02649 SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" F�/sT���� GROUNDWATER ADJUSTMENT NO G. WATER 120" NO G. WATER 138" ABOVE THE FLOW LINE AND SHALL BE ON THE CENTERLINE DEPTH TO BOTTOM OF HOLE #2 11.5 ELEV =95.9 ELEV =93.4 SHEET 3 OF 3 AND LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. SSN� AKA 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN P# 13676 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT PREPARED BY: ELEVATION OF THE OUTLET PIPE. B.O.H. E A S S U I���-'=�� 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES DON DESMARAIS 10. THE OUTLET\VE Y, INC. BAFFLE, 4 INCHES IN'RDI METER AND CONSY TEE SHALL BE TRUCTED ITRUCTED IPPED 1 OF 4"TH A GPVC AS SOIL EVALUATOR ED. STONE 141 R T. 6 A 11 SHALLIBES SHALL BE SLOPED 11/4SCHEDULE 40 PVC NCH PER FOOT MIN.NE CEPTEFORDTHE BACKHOE OPERATOR. FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL I CERTIFY THAT I AM CURRENTLY APPROVED BY THE ELLIS BROTHERS (BRUCE) DEPARTMENT OF ENVIRONMENTAL PROTECTION TO CONDUCT SOIL TYPE: 1 P. O. B 0 X 1729 BE LEVEL 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION SOIL EVALUATIONS AND THAT THE RESULTS OF MY SOIL PERC RATE: : 2 MIN. PER INCH EVASANDWICH , MA 02563 TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW CMRLU5T100N ARE ACCURATE ANDIN ACCORDANCE WITH 310 LOADING RATE: 0_74 GAL/SF/MIN AND APPROVAL. PH. (508) 888-3619 13. MAGNETIC TAPE ON ALL COMPONENTS. __ ___________ CELL (508) 527-3600 EDWARD . S ONE, CERTIFIED SOIL EVALUATOR t SYSTEM DESIGN LOCUS DATA ��NOFMgs��q- N OMp50N �2�' c D3. IGN FLOW EDWARI BEDROOMS AT 110 GPB/D 3-IQ- GPD ODE o 3'-=s. PLAN REFERENCE 426-68 'o A. N v STONE REQUIRED SEPTIC TANK DEED REFERENCE 22379-24 No•28 8 _ ��o o N � E � ---330 x_2 -----660 GAL. Q6� s� AN 5 SEPTIC TANK REQUIRED = 1�500--GAL. �p ZONING DISTRICT RF EXISTING S.T. TO REMAIN = 1.000__GAL. SIZE OF LEACHING FACILITY REQUIRED RACE LANE C DESIGN PERC RATE __«____MIN./INCH FLOOD ZONE "" " J LONG TERM APPL. RATE_2•Z4_GPD/S.F. 28 ASSESSORS MAP 151 SHED SIZE OF LEACHING SYSTEM PROVIDED: LOCUS MAP PARCEL 008-019 1� 330 _ 0.74 SF/GPD = 446 S.F. MIN. REQ. NOT TO SCALE: OVERLAY DISTRICT NOT A ZONE II -1 LOT 19 s�� USING 2 H-10 CONCRETE CHAMBERS r� 21 635E S.F. s2. 5' WIDE x 2.75' HIGH x S.s' LONG LOT AREA 21,635t S.F. � � ory �Sy SIDE (13+25)x2x2x0.74 G/SF = 112 GAL B ....... A C K B I R D a BOTTOM (13x25) x 0.74 G/SF = 240 GAL 0 SIDE & BOTTOM TOTAL = 352 GAL c 352 GPD PROV > 330 GPD REQ. = 22 GPD RES. R 0 A D DECK UEC NO (GARBAGE DISPOSAL / GRINDER ALLOWED) SITE & SEWAGE REPAIR PLAN D.T.H. #2 #34 GARAGE 34 BLACKBIRD ROAD GFCI E 6gg0' ly EXISTIN\ S 23 51 11 UEC M%RS TONS MIL L S N \ BITUMINOUS 0 N 9• DRIVEWAY r,+: .O O• —i y0, TO REMAIN CAS W r......:. ..;.;:�:%�ii: :':iG' GAS B A R N S TA B L E, MASS � D.T.H. #1 fklSlTNG T `uF►S•"".'' ,i '"' AS Q � DATE: JULY 19, 2012 REMglN / r3 DRAINAGE PLANTED D.T.H. #3 / EASEMENT . . AREA o d OWNER/APPLICANT: JOSEPH J. MARZILLI D.T.H. #4 34 BLACKBIRD ROAD XIS ING AL�K ZPEA 10.0' WALKWAY MARSTONS MILLS OPEN SPACE N 03'55'16" W 109.1 EASEMENT • MA 02649 ' G `O PROPOSED NEW LEACHING AREA. SHEET 1 OF 3 12.83' x 25.0', <3' BELOW GRADE PREPARED BY: 0 30 45 60_ EAS SURVEY, INC. " 141 R T. 6 A GRAPHIC SCALE: OLD 1 INCH = 30 FEET P. O. BOX 1729 s7` G� SANDWICH , MA 02563 �D PH. (508) 888-3619 D CELL (508) 527-3600 SHED LOT 19 21 , 6 3 5± S. F. BENCHMARK BAGCBOLTRK CORNER OF BOTTOM A I R D STEP. ELEV 107.66 ON HYDRANT K E3 ELEVATION 113.51 s NOTE: R 0 A DECK REMOVE EXISTING UEC D-BOX AND REPLACE ? WITH C.O. / SWEEP L 11.3' . :: °o• 0 GRADE BENCHMARK SPIKE SET AT EDGE OF DRIVEWAY. ELEV 110.50 #34 GARAGE • 11^ 66.80' UEC ly / EXISTING SITE & SEWAGE BITUMINOUS s I REPAIR PLAN DRIVEWAY ::.: S. s � '0 r �:. 34 BLACKBIRD ROAD —T-a _REEMAI�L EX�S�TN GgS ' w �, � ' ::.p�:::::::::::: . . . .` `":. .'. . : � G MCI RS TONS MlL L S D.T.H. #1 ° 4 ::�:� ;::,::::: :.::, : �As�� GAS 09, G N _ _ _ �MA/N `l08 BARNSTABLE MASS — � — � 10 � ---`� '� �'� 20.0 105 a_ -- j .,..--.- —104 _ _ ,.._.� . 1os��� `� `� ` ` � DRAINAGE _ --P-LANTED_ --103— _ �_ — �.04 � EASEMENT °s DATE: JULY 19, 2012 _ —104— ` -" � ,AREA_ -- -- --102- _ _ D.T�H.113 OWNER/APPLICANT: `102_ o93s JOSEPH J. MARZILLI _ _ _ _ _ -F- '�4.39• ---�— D.IT.H.1 #41 1° 34 BLACKBIRD ROAD EXISTING PEA E ' 141 102- 1 '03 13.8' I 25' \ I / M A T wALK N 03' - I I 10.o' RS ONS MILLS 5516 w 1091a., I WALKWAY MA 02649 OPEN SPACE NOTE: �° EASEMENT EXISTING LEACHING PIT TO BE o SHEET 2 OF 3 PUMPED, CRUSHED, SAND FILLED AND ABANDONED IN ACCORDANCE 01 PREPARED BY: �IHOFm4,S9' NOTE: WITH TITI F 5. PRnPSFD NEW LEACHING AREA. o�°� EDWARD y�N� EXISTING 1000 GALLON 12.83' x 25.0', <3' BELOW GRADE E A S SURVEY, INC. A SST$N80 SEPTIC TANK TO REMAIN 141 RT. 6A P . O. BOX 1729 �°�� ��S � 0 20 30 40 s d�A L 10 M SANDWICH , MA 02563 GRAPHIC PH. (508) 888 3619 1 INCH - 20 FE T CELL (508) 527-3600 ' ' - f' BENCH MARK coJZN' arz Q = �rt� n' os r n„��-,� i . TEST HOLE RESULTS . P# , L � oi • o �- DATE : WITNESSED B Y T-�•'O/Vl M �/� EFL N L', O. M . �\ N p�0 T o P a �/'Z /�I Y JZ D M �GzJz !ty, z�/ c \ �` •-- 24,, 5uL3sO/L 1,L I© 7, 0 24 5v�3s �7J L ,FL /03 C L rAA,r \ O 30 TN lot ' •1, 0 � 1 .. l C L :q y � �'�' ,�"r✓��vns z-�1z,�n ,C/n/E' �=/�',�"' � r, - - o��~ r3 �. Q )a R�• J N �fir., d"'�.?- i 5' 1 10 v \ �`'� �'_ C Qom ' .: ////� 4" �L 9 0 " PL 9 3 MANHOLES AND COVER TO BE BUILT TO I T-. ELEV. TOP OF WITHIN 12 OF FINISHED GRADE ., m FOUNDATION FINISHED GRADE MIN. 2% SLOPE 1 t'c �' 3 4 DIA. -- - 4" DIA. PIPE 2"M • I-�2o FIRS __. MIN. 2� LAYER OF • • `PJ P E —�i- � �' M'rN.PITCH FT. LEVE f ( I PEASTONE o I y MIN. PITCH �riv+w 14f' sc o v c ;%•� /8{�2 i' 8 I . I o C.50 �av / .00 /02B coo L E4 C h/ TR E-NC N I o $ INVERT I/4 FT GALL ON�Mio INVERT s sw INVERT . 'Q N Jm ' 1•W /oS.25 E TIC TANK DIST, + I ' DIA. `� • • INVERT /02.5 ..® /.Q 63� p••,. ED STONE ' N J voc� CCAc. •_j INVERT 8 INVERT �'� u JZ ul�. W PLA C E ON I�sEPTIC v - 12' � . � Na q � ALL AROUND. j', ti0 FIRM BASE ��----- 81:3 . �-10 � . � .' BOTTOM AT ELEV. 10/,S j 0 b 14 �� �- ln 10 M I N. �ir�c ,L GARBAGE ( 2D' MIN �X �'-�•xe u+ tl Q ��R•. °� r. '\: � TA�n/. _. . Ua _ GRIN 0E R _ r nv_- eN 7. '4 .v PROF I• L E OF GROUND WATER TABLE 93 1 SANITARY DISPOSAL SYSTEM �117, y E- NOT �TO SCALE L E l-. a (wN� ( DESIGN DATA loE�ir v -� CONSTRUCTION OF SANITARY DISPOSAL ` BEDROOMS E SYSTEM ' SHALL CONFORM TO THE MASS. DESIGN FLOW 3 ' o GAL /DAY �! $r''7� ENVI RON M E N TA'L CODE TITLE 3z S < 2 y oG� EL �o�.o y (REVISED . 7- 1--77) AND TfIE T 0 W N OF LEACH RATE MIN.�INCH REQUIRED LEACHING CAPACITY : 330GP H E A L T H REGULATIONS. o rt, .4,>c► s t C 7-c wtiI Z EG1.) • SEPTIC TANK, DISTRIBUTION IBOX AND LEACH PROPOSED '; " �3O GA DAY. ING UNIT TO BE OF REINFORCED CONCRETE . )oX32'-+ 84•Al ` 00 MIN. CONCRETE STRENGTH = 3000PS.I. REQUIRED SEPTIC TANK � /oQQ MIN. STEEL STRENGTH 2O,000 P. S. I. MIN. DESIGN LOADING : H / o H2© PROPOSED SEPTIC TANK: • DRIVEWAYS NOT TO BE LOCATED OVER SYSTEM UNLESS H2O DESIGN LOADING IS USED 02 • ALL PIPES AND . FITTINGS TO BE WATERTIGN'T 7 � S '` - ' AND TO BE OF CAST IRON OR APPROVED P.V.C. HEALTH AGENT APPROVAL- DATE SITE PLAN S oaSHOWING PROPOSED CONSTRUCTION ZONING DATA LEG END LOCATION : s-raw . 7J �5s. FOR 1. BE'L- sd � Z.0 Vs I,f- CcaF DATE 29/e ZON E � �,�.�-'�,� s ����" /�°�' /2� TEST HOLE L E LOCATION C A T I 0 N — — — — EFEREN CE � 1= 07— t 9 egs' SHaV//y C� REVISIONS : 6112 REQUIRED AREA C � � � - SRO EXISTING SPOT ELEVATION 17.f E `j� OF .��9/2 n/. 2 .� Cam. REQUIRED FRONTAGE _�1�d-� 3��5 EXISTING CONTOUR 16 0� cR + 4 25 8 REQUIRED FRONT SETBACK : (�� 30 PROPOSED CONTOUR k2i16 SCALE : � - ' REQUIRED SIDE SETBACK �5) ,'� PROPOSED WATER SERVICE -W--- .. 1,� ` PROPOSED GAS SERVICE -G- �L �\� I REQUI RED � REAR SETBACK i 1� ©Tr4" Q� VJ4�,, e7 PROPOSED ELEC. & TELE E a T 4/2��s� CRA ' rG . R . SHORT , P. E . PRO FESSIONAL` C IV I L EN G I E E R BUILDING INSPECTOR APPROVAL DATE 131 OLD ROUTE 132 ', HYANN IS M�. 02601 FILE NO. i -s84 �T•�LE (Gi7) 3L2.- 94// . SHEET 1 OF 1 �T,ti v R^11 17-- 6 < - 1344 ------------------- _- ---- - - - __ - - ------ �m_