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HomeMy WebLinkAbout0110 BLUEBERRY LANE - Health 110 Blueberry Lane L102Marstons Mills P 116001 { (� T WN OF BARNSTABLE L(K ATION t (d 1 JIUC took ^L SEWAGE # Of - 3 S VILLAGE_ /�• aMi S ASSESSOR'S MAP & LOT 0 `1 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 1560 �..EACHING FACILITY: (type) Cy� u- 3 301 (size) /a'x G NO.OF BEDROOMS C nn BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility -�� J Feet Furnished by -�^ �^s'pt v t bn J . ���G A k 61 A 13 3 3 �a a� TOWN OF BARNSTABLE � LOC"ATION f0 plueh�rt� Ivy SEWAGE # 3S 1 VZL.LAGE Mlra)n s h�\1ti ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. Sy' C. S)eveN -'SEPTIC TANK CAPACITY �LEACHING FACILITY: (type) c te:c_ 330-1 (size) 7),x XG NO. OF BEDROOMS oL BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: I 01 J00 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 1 within 300 feet of leaching facility) Feet Furnished by i Jch ehh =� 1 �dt�c dT No. Feed THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pprication for Mtopoot bpotem Conelruction Permit Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot No. l/6 (a'V c,6e ry I a A C Owner's Name,Address and Tel.NNo/.' Assessor's Map/Parcel 1 /�A9J,jQJ l fDh S rI/s /,1��VJ�A e - / C.IJ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. C01 Val Psi.�,i ��\� �4. az6s� 14l k)q , ��� �/o%t �iicn Type.of Building: Dwelling No.of Bedrooms Z Lot Size 0.11 0-0 sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank /S0C3 Type of S.A.S. 830 !2&rS 1Z z)e Description of Soil muk., 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 Environ ntal Code and not to place the system in operation until a Certifi- cate of Compliance has been issu d of He Signed Date ro 61 Application Approved by Date l Application Disapproved for the following reasons Permit No. Z;2 Date Issued No.� �r � Fee e' G'��'�q-_145�_ F THE COMMONWEALTH OF MASSACHUSETTS Entered.in computer: ' . PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS J 0[ppYtcatton for Mtsposal *pstem Construction Permit ;Application for a Permit to Construct()�)Re-3air( )Upgrade( )Abandon( ) El Complete System El Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. l 14 &)C"er►� �e�e Jog 4Kag $S6-i5 Assessor's Map/Parcel m d/gs tl'Dh 5 I Installer's Name,Address,and Tel.No.rneS�e��jt1S}. Designer's Name,Address and Tel.No. .'R\L .5ts caj- �• n �( �4ZkpQ Afi,/im cn 5 ; i h a Type.of Building: Dwelling No.of Bedrooms Z Lot Size /T_sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons .�-'—^-Sho`.wers(_ ) Cafeteria( ) Other Fixtures ' 6, 1f / 1 5 r. Design Flo `;�`2C gallons per day. Calculated daily flow rf,rr 694: gallons. -.Plan Date Number of sheets Revision Date J. . Title Size of Septic Tank /SO© Type of S.A.S. 230 likC �, "X -267 r r_.t R_r A,,,,,,,,Des:iption of Soil Nature of Repairs'or Alterations(Answer when applicable) 19 Date last inspected: - Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system ii in accordance with the provisions of Title 5 of the Environ ntal Code and not to place the system in operation until a Certifi- cate of Compliance has been is d of He Signed Date (O 6 6 Application Approved by Date / Application Disapproved for the following reasons Permit No. Date Issued —'————' ———————————————————————————————— — THE.COMMONWEALTH OF MASSACHUSETTS y- BARNSTABLE, MASSACHUSETTS ' i Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed(X)Repaired( )Upgraded( ) Abandoned( )by s fr' c n at 11n Blu 6 ,-r Fo/)S /l�s • has been constructed in accordance,., with the provisions of Title 5 and the for Disposal System Construction Permit dated 16'— Installer Designer < The.-issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date t d �; I ,: ' Inspector ---------�� /------------------------------ No. / � ! S Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS ,{ Mtsposal *pstem Constructton Vernitt Permission is hereby granted to Construct()()Repair( )Upgrade( )Abandon( ) System located at Od/1-, r. 6 e n u, Lo.1 2 M44 5 1a,q , //S M - and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permm/it. Date: �� lU Approved by y S - 24--I 1/2- LA = C BLA n wKlt " E! HA © R vA cil GIRT LIPI I 0 -O O ry •.� 13'-O 1/2" LA . n f — , � �--H A L F C0 r d i WALL ,STUDY/DEN LIVING IL 1/2, c'-L 1/2 /2' 9'-II 1/2' V-L' $ �q g L FIRST" FLOOR PLANcr SCALE 3/h4'-I'-D' 120 SF (9165PEG) TSF 1200 - � ATTIC /� ATTIC ,. a c .A T H e ~ `a 64'-9' KNEEWALLO E$ ATT1G_'° ATTIC \ ACCESS D O •ate r r ! � L I PV 7 - .. m e! t 3 BEDROOMU GI LI E O ow � � I 1 �� � • �ctwa � 1 F ► - - - - - - - - - - - - t- lill- - - o w n A Io° L -- r --� AT7iC — � ►- - - -- - S - 4'-9' KNEEWALL ^ AT TIC ► � d 30,-0. ' CDs ► SECOND FLOOR PLAN cr •' SCALE 3/it'=I'—O 480 SR f4tUSPEC) �„ ► N N t' f4'r--0,9.-00 08 : 56A P . 02 Z DUNNING & KIRRANE; 5U8 aii tMUf) Mai 1'"-. i.=.Li 9_t I-�t 4_=i �_t -0�_1 DEED RL-STRIMON VIIHERF�1:.. John Joseph Murphy and Macy Margaret Murphy under Revocable Declaration of Trust dated June.25, 19W("Owner') of I:alolla, California, are the owners of real estate located at Blueberry Lane. Marstom Nfills(Barnstable), MA, and being more pncticularly described as Lot 99 in a DoteA at Book 7475, Page 084 at the Barnstable County Registry of Deeds; VIIHEREAS, Jvhn Joseph Murphy and Mary Margaret Murphy under Revocable Declaraliork of Trust daG,ed June 25, 1990, as Owners of said.parcel, have agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on acid parcel as a pre-condition to obtaining a variance frurn the 710 C-MR 15,214 S•.3te Eavirorm,ental Code, Title V,Minimum Requircownts for.the Subsurface Disposal of Sanitary Sewage a nd to obtaining a building permit for this parcel; NOW TI',ti:KCFORE, John Joseph Murphy and Mary Margaret Murphy under Revocable Declaration of Trust dated June 25, 1990 do hereby place the following restriction on said parcel in accorcl.R"with this agreement with the Town of Barnstable Board of Health,which restriction shall run with the land and be binding upon all successors in title: The land described as Blueberry Lane.Marstons Mips(Barnstable), as referenced in the deed at Hook 7475, Page 084 as Lot 99 may have constructed upon the parcel a house containing no more than two (2)bedrooms and OWNER agrres that th1%shall be a permanent deed restriction. This restriction, however, shall not prohibit the expansion of the septic system on the premises to accommodate more than 2 bedrooms if the system, as designed and/or upgraded, conforms with the provisions of the State Environmental Code, Tide V and the Town of Barnstable Board of ftcalth Regulations. For title�,zc Deed at Book 7475,Page 084. Executed&3 a scaled instrument this day of March,2000 1bc/ -G4- J hn P urphy, cc a Y. ec A i &8: 56A P _ 03 s ANNING & KIRRANE nun ail 00=1, COMMONWEALTH Of MASSACHUSETTS ` March , 2000 Barr►BtablC, 9S. Then p�rconally appeared the sbove-named)ohn Joseph Murphy and Mary Margarct str od the foregoing inuusent to be their free act and deed, Murphy, as afore-Laid, and acknowlcdg before me Notary Public My Commission Expires: r aE :tom: ` t! 102116001 -4p21�SQ01� MURPHY,JOHN JOSEPH& ,ff r ` 0140 „ 0300 0000 i 1 06 2/13101 NE " t 'Y�n W Y►�nnJ�NOLi CMWMEU10f PUBLIC �iI1JEERlt�i DMSE�I � SS)kWq SiREE! tJSr i:f@3�i,,. � rA '.- ::,;sy ',SjiS .r';'✓�? �,� •l ••• -F '�y'-•' ..xl'Y&v ... ',:,,,.' -.f'f+txt Sv � „p ,• �y s4 r^1t`�µi'z. ;,,r• �, ,x n` tom.rat ����{ _" `z �+� '^.c:u"', {x " C _'`^ Jr r a,tr'"a' '> If w 4 L LOCATION �.� i x } VII lrAr A,SSESSOIt'S LO INSTALLER'S:NAME&PHONE NO.,'Cri c_ S�evz:N' 77fv-90 S�/ SEPTIC TANK'CAPAcrrY• /,'yon . LEACHIN ' G FACILITY: (.type) ���' 33 o� {size) 7 a x = 4' OF BEDROOMS - -- - - - -=-- -- — — _ ' BUILDER OR OWNER PERMTTDATE o01 IANCE ATE COMPL D r Y ,l.. {, V, r _ Separation Distance Between the ` Max imum Adjusted Groundwater Table to tfie Bottom of Leaching Fatility I Feei' Pnvate Water Supply Well and Leaching Facility (if any we exist n :` ! od site or,within 200 feet of leaching faciLry _ J Edge of Wetland and:Leaching Facility(If any wetlands exist within 30,0eec,gfleaching��cility !!. 1 ' a F .. j eet. ts! Ftittiished � r , j I f r:} f a •1 �I f41i 5 f t o.t 4 5 f- f1�55 55 rs (� 1-t f`'I�.t 5 tF 1 ! Y.l e 4 ! I [ t } 5. 5 4.' ; I A I f Si t t �i• - Za d j ' 5f F } , ax ro 7}4 it: r r;xt -+i�I ��5r�.�`.Ph'1���-.�L�• . , n� 5 r ,Zz 1 t hh =� 4-: I ,} ��- IM- o� COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION >>AP �Z= RECEIVED OARcEL OT S E P 0 12004 TOWN OF BARNSTABLE TITLE 5 HEALTH DEPT. OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: I10 Blueberry Lane i Marston Mills, MA 02648 Owner's Name: Bill Walsh � r /0 "R Owner's Address: y' Date of Inspection: August 25, 2004 Name of Inspector: (Please Print) James M. Ford t Company Name: James M. Ford Mailing Address: P.O. Box 49 Z- Osterville,MA 02655-0049 ca M Telephone Number: (5081 862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Neelk Further Evaluation by the Local Approving Authority Fail Inspector's Signature: Date: August 28, 2004 The system inspector shall sub 't copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completin 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 I 1 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 110 Blueberry Lane Marstons Mills. MA Owner: Bill Walsh Date of Inspection: August 25, 2004 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND) in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is 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: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: I10 Blueberry Lane Marsto,ns Mills. MA Owner: Bill Walsh Date of Inspection: August 25, 2004 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 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 has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory, for 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 110 Blueberry Lane Marstons Mills. MA Owner: Bill Walsh Date of Inspection: Auzust 25, 2004 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/z day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone I of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 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 the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 110 Blueberry Lane Marstons Mills, MA Owner: Bill Walsh Date of Inspection: August 25, 2004 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: Yes No ✓ _ Existing information. For example,a plan at the Board of Health. ✓ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 110 Blueberry Lane Marstons Mills. MA Owner: Bill Walsh Date of Inspection: August 25, 2004 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 Number of current residents: n/a Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Never pumped(new system) Was system pumped as part of the inspection(yes or no): 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) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Installed 1119101 -per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: I10 Blueberry Lane Marston Mills. MA Owner: Bill Walsh Date of Inspection: August 25, 2004 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 20" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1500 Qal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" 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: 12" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert. There did not appear to be any signs of leakage GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 110 Blueberry Lane Marstons Mills, MA Owner: Bill Walsh Date of Inspection: August 25, 2004 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even 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.): The D-box was level. No solids were present. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 110 Blueberry Lane Marston Mills, MA Owner: Bill Walsh Date of Inspection: August 25, 2004 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: ✓ leaching chambers,number: Cultec 330s- 12'x 26'(per as built card) 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.): There did not appear to be any signs offailure or backup. The bottom to grade was approximately 4.5'. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: I10 Blueberry Lane Marstons Mills. MA Owner: Bill Walsh Date of Inspection: August 25, 2004 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 106 feet. Locate where public water supply enters the building. I � Q a- `fy 3 3 a-) 10 Page 11 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 110 Blueberry Lane Marston Mills. MA Owner: Bill Walsh Date of Inspection: August 25, 2004 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 30 +/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: Topographic and water contours maps Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic maps and water contours maps the maps were showing gpproximately 30'+/-to ground water at this site. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees,either expressed, written or implied,relating to the system, the inspection and/or this report. 11 J . f LEGEND PROPOSE-1) �.�1sT��� N Design Schedule ELEVATION Leaching Area Requirements RF & GP [4) LAKESIDE DR. TOP OF FOUNDATION 95.0' .„ Edge t*r E`�s� t MINIMUMS ? 2 BEDROOMS AT 110 GPD/BEDROOM = 220 GPD t' e FINISHED BASEMENT FLOOR 87.3 slf AREA = 43,560 S.F. _ CUS FINISHED GARAGE FLOOR N.A. Catch 1.aaYE FRONTAGE - 20' W ADDITIONAL 50% FOR GARBAGE DISPOSAL N.A. u U�►gt y P � = SHUBAEL . , _ m SEWER INVERT AT FOUNDATION 92.0 WIDTH = 125 w ;C,���;e��;�� --�204 J POND SEWER INVERT INTO SEPTIC TANK 91,8' PERC RATE = 2 /1 MIN. / INCH (CLASS ] ) Sp ra [oao� FRONT SETBACK = 30 m I ' SIDE SETBACKS - 15' SEWER INVERT OUT OF SEPTIC TANK 91.5' LIAR = 0.74 GPD/S.F. Test PIS - r 71 Leach EIeEd REAR SETBACK = 15' SEWER INVERT INTO DISTRIBUTION BOX 91.3' -@--� ROU SEWER INVERT OUT OF DISTRIBUTION BOX 91.1' ED 5 = MIN. LEACHING AREA OF S.A.S. BUILDING HEIGHT 30' ; Sepik Tank - <2A PON SEWER INVERT INTO LEACHING SYSTEM 91.9' 'Nstr!butlon Box BOTTOM OF LEACHING TRENCH 89.9 220 GPD1 0.74 GPD S.F. = 298 S.F. MIN. I A Stake WATER TABLE PROPOSED SYSTEM SIDEWALL 3 Ir _ge anhola� LOCUS MAP (]2+26)( )( ) = 152 S.F.2 2 ! BOTTOM 12' X 26' = 312 S.F. y SCALE 1 = 2,000' { ASSESSORS TOTAL = 464 S.F. MAP 102 PARCEL 116-1 �I c: LEACH[SYSTEM WPTH INFILTRATOR DESIGN GENERAL NOTES: .a ALL PIIPES TO BE SCHEDULE 40 PVC USE 1 - 4" ©ISTRIBUTION LINE IN 3 RECHARGER UNITS ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH TITLE V OF THE STATE SANITARY CODE DATED Q) 91.7 IN A 12'X 216' WASHED STONE TRENCH AS SHOWN MARCH 31, 1995 & ANY LOCAL RULES APPLICABLE. r F i 1-1.5" WASHED STONE W.,,' ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING ' 91.4 91 5 BY DESIGNING ENGINEER LOT 98 -f- 12 WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, ® 1 7 existing NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT house BENCHMARK 9 5,0 ��-26' - � FOR INSPECTION. Z toe or PLAN OF LEACH SYSTEM DR AI NAG E foUndation THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN MANHOLE 91 2 92.2 NO SCALE APPROVAL OF DESIGNING ENGINEER . 92. > 1 ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" PVC. 9 2 LOT 121 12' EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING 9 22 SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5', PER _ FINISHED GRADE \\j\j\j\\j\j\\j\\j\\j\\j\\j\\j\/\\j\\j COMPACTED FILL 310 CMR 15.255. k X 92,3 93,4 N87°00'00" X 90,9 36"MAX.- 12 IN. /� �/� / �/ z / z / / / / / / 100,00' 2 .. J . a PEASTONE -� 9 4,2 X X (�2 2 9 g f a.. - 3 4" TO 1 1 2 PRIMARY BENCHMARK ASSUMED Q. / / PROJECT BENCHMARK SEE PLAN � 92,5 91,6 30.5» . . :.d: ... `.... DOUBLE r j Z a .... WASHED STONE ' �. ._ 0 I 7 � 0- > Q w w r O `� PROP, DRIVE FUTURE SECTION h N (� r ..LOCATION OF UNDERGROUND 'UTILITIES ARE APPROXIMATE AND ' �' GARS:-GE �' N0 SCALE SHOULD BE VERIFIED IN THE FIELD BY THE APPROPRIATE Z7 C? ' � � � c�2,4 W UTILITY COMPANY PRIOR TO ANY CONSTRUCTION. y .--� X - 9 3 LOT 120 o o I CIO 1 PROPOSCD _ o 4 c Gl L �, 4.1 111 _ < 20 min H WARIANCE REQUESTED: 9 3.4 9 5, ❑usE I Q 24.0' Title V: 310 CMR Sectioln 15.214:(1) - To allow a two bedroom c LOT 9 �� ® house to be constructed on a lot less than 20,000 sq, ft. a)200 SO. FT. -� 25.0 92,4 +�AZE� urNE (This varience granted by the Board of Health on February 16, 2000) 0,23 AGES { �-- 100.00' - 9 5�-`�-" X 4.2 S 8 7 0 00 i r 1 CERTIFY TO THE BEST OF MW KNOWLEDGE THAT THE PROPOSED FOUNDATION SHOWN 1S 9 O E IN COMPLIANCE WITH LOCAL ZONIING BY-LAWS (WITH RESPECT TO SETBACK REQUIREMENTS � LOT 100 �:• _ a ONLY) AND DOES NOT FALL WITHIN A SPECIAL FLOOD HAZARD AREA. LOT 119 OF Mqs V o �STEPFi�N ti� r THIS PLAN IS NOT TO BE RECORDED OR USED TO ESTABLISH PROPERTY LINES. � �74 TITLE ` s1t 16 A Design- �F ST�a �� REGI ERED PR FESSIONAL LA/MD SURVEYOR DATE Septic 20 0 20 40 s �G �IONAI SCALE IN FEET �/7/0! At #211 BLUEBERRY LANE SCALE: 1 "= 20' Marstons Mills, Massachusetts i J.K. HOLMGREN & ASSOCIATES INC. PREPARED FOR x SOIL LOGS DATE: 11-19-99 MR. & MRS. JOHN J. MURPHY TYXCAL SYSTEMPROFILE ENGINEER: BOARD OFHEALTHAGENT Finished Grade = 94'± Stephen A. Willson,P.E. Donna Miorandi, Barns. Health Dept. CONSTRUCT ACCESS NOT T❑ SCALE TEST PIT 1 TEST PIT 2 BA=R, NYE & HOLMGREN INC. fProposedMANHOLE OVER In't.ET TO TANK ,ra AT LEAST G.S.E. = 94.0 P-9588 G.S.E. 93.5 Registered Professional Foundation = 95,7' 'WISHED GRADE_ OVER 7ANfVITH N 6, FINIS11 GRADE FINISHED p »0" 0 "O" Engineers and Land Surveyors ' I ISHED GRADE OVER D. BOX = 9q't =. ^1 FINISHED GRADE OVER LEACHING TRENCH = 93't 4" 5" 812 Main Street, Osterville,Ma. 02655 H =I.n,�nla=n rrt _... .• '.,. B",'SIN, - » » » Phone (508)428-9131 Fax - (508)428-3750 4' SCH. 40 Pvc FIRST z' <To BE LEVEu A SANDY LOAM Ap SANDY LOAM (TYPICAL) ___ 6• W I 4' SCH. 40 PVC 12' (min) Coverers 8" 10 YR. 3/2 10„ l OL2' <�„� 36' ( ax) Cov 10 YR. 312 a eo' CI tees 4' SCH .40 PVC Proposed AS BAFFLE_ : „ » » „ f ' Fin.sheu 2'Layer 1/8'to1/2' B SANDY LOAM B SANDY LOAM Basement Peastone LEACIHING CHAMBERS p Floor - 87,3 y: , Slope = 0.005' (chin ) 26 1 YR 6/6 24 1 YR 5/6 I . r 6' CRUSHED . •-,;. .•- Reinforced f_oncret STONE BASE" " " ' "• . :: :. sTn _ 4' Pvc O O • • O O • • • • O C 1 MEDIUM SAND C 1 SILTY FINE SAND DATE. 1 / -� O O O O • O O O • O O 2 21/99 10YR. 6/8 1 OYR. 7/1 O O O O co 40" 56" REV. DATE: REMARKS C2 STRATIFIED BOTTOM ELEV. = 89.9' 'C2" SILTY FINE SAND 1 1 24 00 NAME CHANGE MEDIUM SAND �e iOYR. 7/2 2 5 7 01 CHANGE HOUSE 1500 GALLON SEPTIC TANK DISTRIBUTION BOX 7.9' 70" 144 1OYR. 7 4 "C3" STRATIFIED NO WATER ENCOUNTERED IN TEST HOLES TO BE INSTALLED ON A LEVEL STABLE BASE TO BE INSTALLED ON A LEVEL STABLE BASE r DRAWING NUMBER SEPTIC TAW TO BE INSPECTED & CLEANED ANNUALLY No Water Observed Elevation = 82.0' MEDIUM SAND) PERC @ - 60 I. RATE= < 2 MIN IN LEACHING SYSTEM WITH INFILTRATORS 144" 1OYR. 7 4 / H. 1999�99120� 99120CSP2.DWG r LEGEND Z0 N Design Schedule x ELEVATION Leaching Area Requirements � EXSTM PROKM ----~ -- -��-� Edge Of Pavement RF & GP LAKESIDE DR. TOP OF FOUNDATION 95.0' 2 BEDROOMS AT 110 GPD/BEDROOM = 220 GPD Mate/' , MINIMUMS FINISHED BASEMENT FLOOR 87.3' Catch BasIn AREA = 43,560 S.F. a L CUS FINISHED GARAGE FLOOR N.A. ADDITIONAL 509� FOR GARBAGE DISPOSAL N.A. FRONTAGE = 20' W SHUBAEL SEWER INVERT AT FOUNDATION 92.0' C�ontototrsde goo W , WIDTH = 125' Co POND PERC RATE = 2 /1 MIN. / INCH (CLASS 1 ) �` ''`�`'•0 �� Spot Gf"dCle 200.0 FRONT SETBACK = 30' m SEWER INVERT INTO SEPTIC TANK 91.8 � i Test Pit SIDE SETBACKS 15' SEWER INVERT OUT OF SEPTIC; TANK 91.5' LIAR = 0.74 GPD/S.F. Leach FIe1d `J REAR SETBACK = 15' SEWER INVERT INTO DISTRIBUTION BOX 91.3' .c\ SEWER INVERT OUT OF DISTRIBUTION BOX 91.1' BUILDING HEIGHT = 30' �� ROU � MIN. LEACHING AREA OF S.A.S. Septic Tank 2�, ON SEWER INVERT INTO LEACHING SYSTEM 91.9 Box o �� BOTTOM OF LEACHING TRENCH 89.9' 220 GPD/ 0.74 GPD/S.F. = 298 S.F. MIN. Stake WATER TABLE NA i A Stake nar�hote PROPOSED SYSTEM SIDEWALL (12+26)(2)(2) = 152 S.F. � LOCUS " BOTTOM 12' X 26' = 312 S.F. SCALE 1 = 2,000' TOTAL = 464 S.F. ASSESSORS MAP 102 PARCEL 116-1 « _ LEACH SYSTEM WITH DMTRATOR DESIGN GENERAL NOTES: ALLL PIPES TO BE SCHEDULE 40 PVC: USE 1 4" DISTRIBUTION LINE IN 3 RECHAXEP UNITS ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH TITLE V OF THE STATE SANITARY CODE DATED - 917 IN A 12!'X 26' WASHED STONE TRENCH AS SHOWN MARCH 31, 1995 & ANY LOCAL RULES APPLICABLE. ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING 091.4 1 1.5" WASHED STONE BY DESIGNING ENGINEER 915 LOT 98 2 WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, existing "' "''�`' ` NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT ® 1.7 House 26' FOR INSPECTION. BENCHMARK - -� � 95.0 '. DRAINAGE 2 t�«+�«+Of PLAN OF LEACH SYSTEM - APPROVALFTHESE IONS MUST NOT BE DESIGNING ENGIN ER HANGED WITHOUT WRITTEN MANHOLE 92.2 No SCALE 91.2 ALL SANITARY DISPOSAL SYSTEM PIPING TO `BE 4•" PVC. L T 112I 12' EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING 92.2 SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5 , PER X 9 2.3 FINISHED GRADEw _ o X 9 0.9 " " COMPACTED FILL 310 CMR 15.255. r 3.4 N87 00'00" ./V" 36 MAx.- 12 IN. P 100.001, 2=: ....�........................................................ ................................:-\ � EASTONE PRIMARY BENCHMARK . ASSUMED -� 94.2 XX ti 4.... 92,5 92,2 90,8 • ° 3/4" to 1 1/2 " 91.6 3 �• PROJECT BENCHMARK SEE PLAN E� i'' ; "`.", DOUBLE RESE � 15" � :° . .. WASHED STONE > 9'' TP 2P/0' AREA v ' C1 #2 Z FUTUt c � P DRivE � 1 • tU SECTION Z In . LOCATION OF'UNDERGROUND UTILITIES ARE APPROXIMATE AND = pi 00 GAGE a . NO SCALE SHOULD BE VERIFIED IN THE FIELD BY THE APPROPRIATE -0 1 31 W ¢ °" a ' ` ` UTILITY COMPANY PRIOR TO•ANY CONSTRUCTION. v {{� C, J 2.4 w i I� 20 LOT 12O y���� b X co CD e 94 ti ' w ,SE 4 z vaRLANCE MUESMU 9 3.4 95,0 31.oR 24.01 Title V: 310 CMR Section 15.214: 1 To albw a Iwo bedroom ( } LOT 99 . -.� house to be constructed on a lot less thcn 20,000 sq. ft. 10,200 SQ. FT/ 924 N (This varience granted by the Board of Health on hbruary 16,2000) %N of vo �tN o a 0,23 ACRESjo 9 100.00' X 4 2 S 8 7 e , I CERTIFY TO THE BEST iOF MY KNOWLEDGE THAT THE PROP0;E0 FOUNDATION SHOWN IS ' zeuo �� 9 00 00 E fc�sita . " co2,s Q IN COMPLIANCE WITH LOCAL ZONING BY-LAWS WITH RESPECT TO SETBACK REQUIREMENTS { At l�Mti �'0 9FCISTER�� ONLY) AND DOES NOT FALL. WITHIN A. SPECIAL FLOOD HAZARD /REA. o_"� _o ' �FSS/ONAL E i� LOT 100 LOT I19 A� THIS PLAN IS NOT TO BE RECORDED OR USED TO ESTABLISH PROPERTY LINES. TIRE 20 0 20 40 REGI TERED JPOFESSIONAL LAND SURVEYOR DATE Septic Design SCALE IN FEET ,At #110 BLUEBERRY LANE SCALE: 1"= 20' Marstons Mills, Massachusetts k,. PREPARED FOR J.K. HOLMiGREN& ASSOCIATES T s so>L LOGS DATE: I1.19. MRs IN 9.� OHR Jn MURP Y TYPICAL SYSTEM P OFI�,E Exc BOARD ors EALTH AGENT: Finished tc^ade'= 94't Stephen A. Wilson,P.E. Donna NoIrJ, Bams. Health d�pl~ TEST PIT 2 NOT ro SCALE TEST MIT 1 BAXTER, NYE & HOLMGREN INC. Proposed n�a1NSE ovE ACCESS G.S.E. _ 94.0' P 9588 �; G.S.E. _ 93.5 Top of TO TANK TO AT LEAST gI WITHIN 6' FINISH GRADE Registered Professional 0 "O/, "0" Engineers and Land Surveyors Foundation = 95.0 WISHED GRADE OVER TANK = 94't 812 Main Street, Osterville, Ma. 02655 �. FINISHED 'GRADE OVER D. BOX - 94't FINISHED . GRADE OVER LEACHING TRENCH = 93't 4" 5" f 8'MIN. .. 4• scH. 40 PVC > : - : •• : (TO BE LEVEL) A SANDY LOAM Ap SANDY LOAM Phone - (508)428-9131 Fax - (508)428-3750 (TYPICAL) �-- =- 4' SCH. 40 PVC FIRST r .� .. 36' (Max) Cover 8, 10 YR., .'.3/2 10" 10 YR. 3/2 OLr aw 12 (min) Cover � .'s � •'. PVC ''. .'' 4' SCH .40 PVC o Proposed jr CI tees BAFFLE u p Finished 2'Layer 1/8'tol/2' Basement t~. " '`' Peastone "B" SANDY LOAM ` SANDY LOAM Q; Floor - 97.3 :•; Slope - 0.005 (Min 1 i_ ::• ,: - LEACHING CWAM ER 26" OYR 6/� 24" 10YR 5/6 0 6 CRUSHED o - Reinforced Concret STONE US 7 , • • 4' Pvc / "C 1" MEDIUM! SAND 'C 1" SILTY FINE SAND DATE: 12/21/99 , i OYR. 6/�8 10YR. 7/1 CD 40" 56" REV. DATE: REMARKS BOTTOM ELEV. = 89.9' 'C2" SILTY FINE SAND C2 STRATIFIED 1 1124100 NAME CHANGE Cn MEDIUM SAND Cal " 10YR. 7/2 2 5 7 01 CHANGE HOUSE 70 144" 10YR. 7 4 10 10 01 CHANGE HOUSE 7.9 3 1500 GALLON SEPTIC TANK T HOLES DRAWING NUMBER DISTRIBUTION BOX ro BE INSTALLED ON A LEVEL STABLE BASE ! C3 STRATIFIED NO WATER ENCOUNTERED IN TES „ TO BE INSTALLED ON A LEVEL STABLE BASE r No Water Observed Elevation 82.0' MEDIUM SAND PERC © - 60 i LEACHING SYSTEM WITH INFILTRATORS 144" 10YR. 7 4 RATE= < 2 MIN/IN H:\ 1999\99120\ N 99120CSP3.DWC CD