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Home My WebLink About0147 BRACKEN FERN ROAD - Health 147 Bracken Fern Road - -- -- Marstons Mills �T A= 042-031 r SEP-15-2011 15:38 From:BARNST HEALTH 15087906304 To:Fax P.2/10 Town of Barnstable Department of Regulatory Servilm q___ Public Health Division Date ._....200 Maid Sheri,Hyannis MA 02501 .Date Schedul Z I __ Tune lJ I Foa Pd. ' Soil Suitability Assessment,f'or Sewage Disposal t�rtataed.ay:,CN�t/sjoPN�'C eos�) P�s wlmneea np. ��t✓I'17 �/TdJC] • �7 LOCATION&G'ENMU .INFORMATION L—thm Adrh= (�T ?K y A,, gwutr's Name Aim J y_7 30AVK &/1 G4-Y V --' Aracsaw'a Map/!'atccL• ✓!1�0 L�z 0��03� 1�Y,InuY9 Name�•►n'/57a��s��QST.¢"� �/�/�G NNW C:ONSMUCMN___ !FAIR J11 Land try'..__ 3i�rjwr'is<t-'C_-sl a(�� o'3 s, a sue, I%byz- �, Digwc a$om: Opea W&WIlUdyU�� 11 &Mible WetAreuit Drinking Wata Wcll o 1� U12111 way �� R nwer[ytine t_R Doter tt Sail'1,011(Street nane..dm.axi.n,.or lm taus boraduns nr test balm a pert tease,butte wetlands to ptolwly, to hints) .`meat material(gealogle)� r --w, / Depth t0 Ek4w-k----._.� Depth to Groundwater StrtmbgW=InHole: AlN WeepiA¢florapitmiss�/Vd/V P,ethasttod 9eesoasl Hlg1t tDNmtdwate! N! /`� DF UMMMATION FOR SEASONAL HIGH WATER TABLE MnOtudUstaL• . DDecppth Observed standing in ubs.lmlo: In. Urpth io toil roculog Itetlth to woe&g ttvw lido orobs.hole,��In, Utnundwater AdJuetmest—ft. Lute,wall 4 Reading Ditto Index Well level..- .r Adj.ftow—Add,O 0urldwatu IAM.� PC,RCOLAnON TEST lisle 'stmn obaerntlon 71M Rt 9° .. Dnpsh of t4rc _ Time At 6" Start Prc enRk 71me 00 �^ 14n10(91.41) ' Sml No-soak Rate M311411)4h Site Saitab[Uty Awcm= c Site Passed Site NhA[:, _... AdMonai Testing Ncffdot(YIN) c O,tgtnxL Publa Newt?,131 w i Observation Hole S)ntA To 11e Cuutyluted ou Rank---—. , ***if paicelation teat Is to be conducted within 1001 of wetland,you moat first notify the. Barnstable Conservation Mylsiou at least one(1)week prior to beglindng. O,:�stlrr[c�l'attCttortM9oc SEP-15-2011 15:38 From:BARNST HEALTH 15087906304 To:Fax P.3/10 DLEP.OBSERVAU..ON ROLE LOG Hole#_,,,�,••_ rupth firm 8011 tlorlaau Sm'I Tnmm Still Color soil. now Surfs=0ai pJ30A) (Mansell) MotlllpS (StuuaRm,Stmer;Bottldcm O--G" �P Lort�✓l /4�t 3 _ lar �� y N ewe INK G H�=IZt�� Ga_ Cv. M� z��16 �_.hlrrt✓ �i�c i)MR, O?3SLk'VATION ROU LOG Hole#,_Z Depth6am SailHmimm MITsalum soilcolar soil Utlta Surface fnL/) (USDA) WM-11) Mnitllug y� (Sfruetwe,stuaq Oauldu:ua, - /`-C.f .Ld 14 -..,, .�..•_.� — 'y.989unYe1),,,w.,,..-. 10YK zy- 41_6 Ct DEEP OBSERVATION ROLE LOGY Hole# Dquhfwvo Saiulminn snilTalm sob Caw soil Other. Surface(iu.) (USDA) pmunedo Ma AS (ahrtalmm Stmm ttanitlm. f` mow.96 t7rxvnil D.FF.P OB,SMVATTON HOLE LOG Hole#_ Depth from $nll Rmimn Sail Texture $nil 61or sail UdIW sarfem(in.) (USUN (MumefU Mutttlaz (stru mna,8toam Atmidets. blood JostfroLum)late Mapg Ahcm500yexrflu brA,n" No.— Yes, Within SM year boundary No_`/ Yta,_ W]ffiiu 100 yar pond boundary Naz Yes n_enth of Naturapy nmmtine PwTinua Material Doc$at least four feet of natttrally occurring pervious matt:rlal exist in all dress observed thmughout Clio area prupuaui for the soil nbsorptiim syslwn? If not,what is the depth of hanrally occurring pervious matarial7.� t::ertiocado I certify that on N/ (date)I have passed due il evaluntnr examination approved by the Department of I'nv' n n P otccdn'and tha a ve ana)yala was:performed by me consistrrnt with the required a exist tY $t0 CMR 15,017. ° Si Q v ernL7PSliCPORM,DOC TOWN OF BARNSTABLE J LOCATION LI ? 3 eo k.. &,v VI) SEWAGE# 3// VILLAGE f/ /1.S�U InIIIf ASSESSOR'S MAP&PARCEL11 INSTALLER'S NAME&PHONE NO. l C,L f D 9' 5'6 e f -4-/71/0 SEPTIC TANK CAPACITY /,0 lv y �9- i LEACHING FACILITY.(type) SAS® Cd 9kw (Size) /D x j NO.OF BEDROOMS 3 OWNER PERMIT DATE: COMPLIANCE DATE: �I- o`j 0 -Z 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 etlands exist within 300 feet of leachmi f ility) Feet FURNISHED c �r o � 6 � P . No r• Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplitation for Disposal 6pstrm ConstCUCtion 3permit Application for a Permit to Construct( ) Repair(Vr_1U,"pgrade( ) Abandon( ) ❑Complete System ❑Individual Components 1' Location Address or Lot No. IA17 B R IlC kYM IV wner's N Addres and Te. 1o. Assessor's Map/Parcel �^� o �( 4 y frVI R S 40 fS ►,/I Installer's Name,Address and Tel.No. Yd Designer's Name,Address,and Tel.No. �rO 6�'pY€6y Z`f 1 R e r r-A) 1, Mg 4 Lt 6 1,d-1. 1 C Type of Building: &IV;A V Dwelling No.of Bedrooms 1.5 Lot Size t141C-7 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 53 O gpd Design flow provided zyw gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank 11006 4'A\ Type of S.A.S. eZ—S`dQ Q x�-- Description of Soil Nature of Repairs or Alterations(Answer when applicable) q S i^�L '> — S d-n k�I _wL4{p p4,0 y S Q ei TDw�� ,Gtlsae� 5'�Fl eS , G4 i� (3.e-4wee vJ : L/tt �� 16�✓4 1�N�S 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 issu(r6y is Board of Y e h. Date 61-- l Application Approved by Date 9011-2111 Application Disapproved by Date 11 for the following reasons Permit No. Date Issued No �+ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes fUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 1 . Rpplication for bisposal 6pstem ionstrurtion ermit Application for a Permit to Construct( ) Repair(t Upgrade( ) Abandon( ) [:]Complete System ❑Individual Components ! ' Location Address or Lot No. J y 13'R t4C k-ra rv: Wner's Name Addres and Tel.No. 7 n�n c g�oNS „�'.715 , IA/ l70<ee l/ a s o ti3 Assessor's Map/Parcel I- O 1 a-t^t t 4 o n t Installer's Name,Address,and Te.No. Designer's Name,Address,and Tel.No. 5-ri 6'S- 16`/Z CP,le, A( 5'o-a 11 fr1- chats Aos k,4 t 4*6 tv11- 4es :T,tif. Type of Building: Dwelling No.of Bedrooms 3 Lot Size �3/`K-7 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) `3 j 0 gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank ., c{ \ Type of S.A.S. ;2- `i 06 Description of Soil r Nature of Repairs or Alterations(Answer when applicable) '/ S n - S- v v Q A-\ e w ��vvi V9,r9 S 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 issue is Board of ealth. t i e Application Approved by Date Ile Application Disapproved by �� Date } for the following reasons; w Permit No. "'r _ Date Issued 1 ,- THE COMMONWEALTH OF,MASSACHUSETTS 1 BARNSTABLE MASSACHUSETTS t , Certificate of•Compliance , THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) p Abandoned( )by z at r k ! } has been constr cte in ac r ce with the provisions of Title 5 and the for Dis osal System Construction Permit No. ated A Installer 71'1!�� Designer _ #bedrooms 7i Approved design flow �d' 4 'god The issuance of this permit shall not be const ed as a guarantee that the system wil ncti as de ' d. -------�� Y Date l - Inspector - ---------------------------------- ------------------------------------------------------------------------ ------ ---- No.-.20 jj!:7�3// 4-10, Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS Misposat 6pste (Construction Permit Permission is hereby granted to onst ct ) Re air( Upgra e( ) Abandon ) nA System located at � 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 provisions or special conditions. Provided:Constructio must a completed within three years of the date of this permit. c) Date Approved by \) r Town of Barnstable oF�E r. o Regulatary Services • Thomas F.Geiter,Director s Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 0260, Office: 508-862-4644 , Fax: 508-790-6304 Installer& Designer Cent Ocation Foritn Date: Designer: Installer: �rNoG! POL Address: P,�, e)x I Zca Address: --q IMP 9 6 On (date) V/ 3M a was issued a permit to install a (installer) septic system at 1117 based on a design drawn b (address) Y C�fizi sTO Pf/��Ca�?t4 Q 410 C4 Adate d (designer) I certify that,the septic system referenced above was the design, which may include minor installed substantially according to di.stnb ition box and/or approved changes soh as lateral relocation of the septic tank. - I certify that the septic system referenced above was installed with greater than 10' lateral relocation of the SAS of the septic system)but is accordan or any vertical cation o€anp co ges (i.e. ce _ with State:&Local Regulations. Plan revision or Certified as-built by designer to follow. ♦�d� 4. t�aHler's PpF RnASs Signature) �OPNE a CDGNR�G S 05 N d 0. N0.3�3 D env �� s esigner's Signature ) (Affix Desi -�',��t�p Here) PEEASE RETURN TO BARNSTABLE PUBLIC g AL OE COMFLIACE WILL NOT BE ISSUED 'T DIVISION, .CERTIFICATE BUI�,T CARII ARE RECEIVED BY T BS E p 3S FORM AND AS- THANK aYOU. LIC IIEAI,Tg D ISIO�I. 'Q:Health/septic/Designer Certification Form i r COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECT ' `3 ONE WINTER STREET, BOSTON MA 02108 (617)292-5500 D 0 19 UDY-C XE to 15 tary ARGEO PAUL CELLUCCI DAVID$ S UHS Governor ssioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FO E ti PART A CERTIFICATION Property Address: 147 Brackenfern Road, Marstons Mills, MA Name of Owner: Kevin Lamoureaux Address of Owner: Same Date of Inspection: May 6, 1999 Name of Inspector: (Please Print) Gordon E. Bumnus I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: Gordon E. Bumous Mailing Address: 215 Osterville-West Barnstable Road, Osterville MA 02655 Telephone Number: (508)428-5640 Map. 042 Parcel: 031 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: ✓ Passes Conditionally Passes Needs Further Evaluation By the.Local Approving Authority Fails �+ Inspector's Signature: C6 � i,t A� Date: May 13, 1999 The System Inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP) within thirty(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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer,if applicable, and the approving authority. NOTES AND COMMENTS . revised 9/2/98 Page 1 of I Printed on Recycled Paper L j _ 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 147 Brackenfern Road, Marstons Mills, MA Owner: Kevin Lamoureaux Date of Inspection: May 6, 1999 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: ✓ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 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. Indicate yes,no, or not determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined",explain why not. _ The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank, whether or not metal,is cracked, structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health) broken pipe(s)are replaced _ obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 revised 9,/2/98 Page 2of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 147 Brackenfern Road, Marston Mills, MA Owner: Kevin Lamoureaux Date of Inspection: May 6, 1999 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 the public health, safety Y and 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 THE PUBLIC HEALTH AND 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 AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis 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. Method used to determine distance (approximation not valid). 3) OTHER I revised 9/2/98 Page 3of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 147 Brackenfern Road, Marston Mills, MA Owner: Kevin Lamoureaux Date of Inspection: May 6, 1999 D. SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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 Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: _ The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 147 Brackenfern Road, Marston Mills, MA Owner: Kevin Lamoureaux Date of Inspection: May 6, 1999 Check if the following have been done: You must indicate either"Yes" or"No" as to each of the following: Yes No ✓ _ Pumping information was provided by the owner, occupant, or Board of Health. ✓ _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. ✓ _ As built plans have been obtained and examined. Note if they are not available with NIA. ✓ _ The facility or dwelling was inspected for signs of sewage back-up. ✓ _ The system does not receive non-sanitary or industrial waste flow. ✓ _ The site was inspected for signs of breakout. ✓ _ All system components, excluding the Soil Absorption System,have been located on the site. ✓ _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for conditions of baffles or tees,material of construction, dimensions, depth of liquid,depth of sludge,depth of scum. The size and location of the Soil Absorption System on the site has been determined based on: ✓ _ Existing information. For example, Plan at B.O.H. ✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)]. ✓ _ The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. i revised 9/2/98 Page 5of11 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 147 Brackenfern Road, Marston Mills, MA Owner: Kevin Lamoureaux Date of Inspection: May 6, 1999 FLOW CONDITIONS RESIDENTIAL: Design flow: 110 g.p.d./bedroom. Number of bedrooms(design): 3 Number of bedrooms(actual): 3 Total DESIGN flow 330 Number of current residents: 3 Garbage grinder(yes or no): No Laundry(separate system)(yes or no): No ; If yes, separate inspection required Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings,if available(last two yearg;usage(gpd): 1998-133,000 gals.: 1997-132,000 gals. Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIALANDUSTRIAL: Type of establishment: Design flow: gpd(Based on 15.203) Basis of design flow 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: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Never pumped- per owner. System pumped as part of inspection(yes or no): Yes If yes, volume pumped: 1060 gallons Reason for pumping: Maintenance 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) = I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components, date installed(if known)and source of information: 1989- per as built card. Sewage odors detected when arriving at the site: (yes or no) No revised 9/2/98 Page 6of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 147 Brackenfern Road, Marston Mills, M,4 Owner: Kevin Lanwureaux Date of Inspection: May 6, 1999 BUILDING SEWER: _ (Locate on site plan) Depth below grade: Material of construction: _cast iron 40 PVC _other(explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints,venting, evidence of leakage, etc.) SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 27" Material of construction: ✓concrete metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age_ Is age confirmed by Certificate of Compliance_(Yes/No) Dimensions: 8'6" x 4'10" x 5'8" (1000gal.) Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 5" Distance from top of scum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How dimensions were determined: Measuring stick Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) The liquid level was even with the outlet invert. There were no 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: (recommendation for pumping,condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) revised 9/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 147Brackenfern Road, Marston Mills, MA Owner: Kevin Lmnoureaux Date of Inspection: May 6, 1999 TIGHT OR HOL)ING TANK: Nine (Tankmust berumed prior to or 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: Alarm level: Alarm in working order: Yes_ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches,etc.) DISTRIBUTION BOX: ✓ (locate on site plan) Depth of liquid level above outlet invert: W Comments: (note if level and distribution is equal, evidence of solids carryover,evidence of leakage into or out of box,etc.). The box was level and there were no signs of solids or leakage. The box was 30"below grade. 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.) I 1 revised 9,/2/98 Page 8of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 147 Brackenfern Road, Marstons Mills, MA Owner: Kevin Lamoureaux Date of Inspection: May 6, 1999 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan, if possible; excavation not required, location may be approximated by non-intrusive methods) If not located, explain: Type: leaching pits,number: 1 -6'x 6' leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number, dimensions: overflow cesspool,number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.) The pit had 3'of water on the bottom. There were no signs of hydraulic failure. The bottom to grade was 10'6". CESSPOOLS: None (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(cesspool must be pumped as part of inspection) 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.) revised 9/2/98 Page 9of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 147 Brackenfern Road, Marston Mills, MA Owner: Kevin Lamoureaux Date of Inspection: May 6, 1999 Map: 042 Parcel. 031 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks } locate all wells within 100' (Locate where public water supply comes into house) a . O d, A 'p c� 38 y3' wa' s 6 ' revised 9/2/98 11age 10of 11 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 147Brackenfern Road, Marston Mills, MA Owner: Kevin Lamoureaux Date of Inspection: May 6, 1999 NRCS Report name Soil Type Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater 20+/- Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record T Observed Site(Abutting property, observation hole,basement sump etc.) Determined from local conditions ✓ Checked with local Board of Health Checked FEMA Maps Checked pumping records Check local excavators, installers ✓ Used USGS Data Describe how you established_the High Groundwater Elevation. (Must be completed) Usingthe Barnstable topographic and water contours maps, the maps were showing approximately 40' to groundwater. Using the Cape Cod Commission Technical Bulletin, the adjusted high groundwater level for this site (SDW 253, Zone A,' 411199)was 1.8'. 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. revised 9/2/98 Page 11of11 'e i .3 TROY WILLIAMS SEPTIC INSPECTIONS ' "� d b At— Certified by MA Department of Environmental Protection 1996 8) 760419 40 Old Bass River Road South Dennis,MA 02660 r SUBSURFACE SEWAGE DISPOSAL SYSTEM I ORM Address of property 7 5,,._C k e.o Fft e" P\ Qom( . to u s l h s /1-7 1/1 -S Owner's name& Mailing address Date of Inspection PART A CHECKLIST Check if the following have been done: V Pumping information was requested of the owner, occupant and Board of Health. None of the system components y p have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. VAs built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. t/ The site was inspected for signs of breakout. _ All system components, excluding the SAS, have been located on the site. ✓ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. t/ The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of SSDS. Page 1 of 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential 2 number of bedrooms 1 number of current residents ,Ap_garbage grinder, yes or no yr SS laundry connected to system, yes or no .-ALL seasonal use,yes or no If nonresidential, calculated flow: Water meter readings, if available: q y _ d y� o 7' / 93 = C' a v ro t Last date of occupancy GENERAL INFORMATION Pumping records and source of information: r n. ► o �ot In 4-- N6 System pumped as part of inspection, yes or no If yes, volume pumped Reason for pumping: I Type o system eptic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (If yes, attach previous inspection records, if any) I Other(explain) Approximate age of all components. Date installed, if known. Source of information: LL N Sewage odors detected when arriving at the site, yes or no Page 2 of 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: t/ (locate on site plan) depth below grade: I �/o " material of construction: concrete _ 1�metal FRP other(explain) dimensions: _ ,5 X ti ' >r 6 _ 2 sludge depth . ' distance from top of sludge to bottom of outlet tee or baffle .5" 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 Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,,structural integrity,evidence of leakage,recommendations for repairs,etc.) 14L) o� inL �. c. � 4t—d , c.. .✓ ✓ ��S � / ✓ �Cr DISTRIBUTION BOX: (locate on site plan) I e_J e-I depth of liquid level above outlet invert Continents: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box, recommendation for repairs,etc) tJ— do Y, / �O J ti I LJ.e� Gr.. r G�J C�✓ t K G I�✓'d-e✓ ,/�!o .L i S G S O J� c� c� vLt � 9 L PUMP CHAMBER: �/�n (locate on site plan) pumps in working order,yes or no Comments: (note condition of pump chamber,condition of pumps and appurtenances, recommendations for maintenance or repairs,etc.) Page 3 of 7 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,if poss.;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: Type: leaching pits and number G ie 4 I Y ,, a ,S.A--.� leaching chambers and number ' leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,recommendations for maintenance or repairs,etc.) CESSPOOLS (locate on site plan) : A14,1 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 (cesspool must be pumped as part of inspection) Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,recommendations for maintenance or repairs,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, recommendations for maintenance or repairs,etc.) Page 4 of 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' 23 ' 30 a� ' 3 � 39 55 DEPTH TO GROUNDWATER depth to groundwater adjusted high groundwater level method of determination or approximation: N Page 5 of 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no or not determined(Y,N, or ND). Describe basis of determination in all instances. If"not determined", explain why not) _A Backup of sewage into facility? Discharge or ponding of effluent to the surface of the ground or surface waters? Al Static liquid level in the distribution box above outlet invert? W19 Liquid depth in cesspool<6"below invert or available volume< 1/2 day flow? I` Required pumping 4 times or more in the last year? Number of times pumped N Septic tank is metal?cracked? structurally unsound? substantial infiltration? substantial exfiltration?tank failure imminent? Is any portion of the SAS, cesspool or privy: below the high groundwater elevation? IV within 50 feet of a surface water? _V within 100 feet of a surface water supply or tributary to a surface water supply? IV within a Zone I of a public well? within 50 feet of a bordering vegetated wetland or salt marsh(cesspools and privies only, not the SAS)? within 50 feet of a private water supply well? /V less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. Page 6 of 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART D CERTIFICATION Name of Inspector: Troy Williams Company Name: TROY WILLIAMS SEPTIC INSPECTIONS Company Address: 40 Old Bass River Road, South Dennis, MA 02660 Certification Statement I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true, accurate and complete as of the time of inspection. the inspection was performed and any recommendations regarding upgrade, maintenance and repair are consistent with my training and experience in the proper function and maintenance of on-site sewage disposal systems. Check one: --Z-I have not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15.303. Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. I have determined that the system fails to protect public health and the environment as defined in 310 CMR 15.303. The basis for this determination is provided in the FAILURE CRITERIA section of this form. Inspector's Signature Date Original to system owner Copies to : Buyer(if applicable) Approving authority PROPERTY ADDRESS: lq ? Page 7 of 7 V.40WN OF BARNSTABLE LOCATION If.,/ � y9 f .�c4e,.0 � R� SEWAGE VILLAGE ASSESSOR'S ASSESSOR'S MAP & LOT INSTALLER'S NAME 6z PHONE'NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) t' � (sue) l a a o NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER ,1 S,. w_j DATE PERMIT ISSUED: ` DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No } r l�e 23 l 2� 13 Y 3 l y • I i TOWN OF BARNSTABLE L(CATION 7 6�a �Hh SEWAGE # VILLAGE 44 . / A; LL S ASSESSOR'S MAP & LOTQ% "p3 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I LEACHING'FACILITY: (type) (size) C x6 ;2 NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: 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) Feet Edge of Wetland and Leaching Facility-(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i � 3 ` y� . . SS V,OOTOWN OF BARNSTABLE LOCATION �'o!� �y rAc�e•.y �, � SEWAGE VILLAGE �i3rr�`,S /cJ// ASSESSOR'S MAP & LOT INSTALLER'S NAME Si PHONE NO. 07 t�'�eile��¢ YZr^ 13S SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) / = o NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: ` DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 4r f HO Jst d Ti' 3 2-7 Y 3 1 No.-'an-'�-t FEs..... ............. THE COMMONWEALTH OF MASSACHUSETTS 9 a _31 BOAR® OF HEALTH ..............OF.......0;{nq'.5 �/G....................................................... ApplirFation for Uhipo i al Workii Tontrnrtiun Prrafit Application is hereby made for a Permit to Construct (Y,) or Repair ( ) an Individual Sewage Disposal System at: Ale Location-Address or Lot No.v_. -------....•--•-------T``'r`� K.... �!�!�h------••--------------•------------- •-----------._e ra s�t�!s_._..�rrr...2 ..............----._..-.-..._..... Owner Address a >�•� . �-7'.l' s s>/c'=-------------------------- --- -------- /gr �s_.... c l/.s.... ........... Installer Address dType of Building Size Lot-----/�� 67......Sq. feet U Dwelling—No. of Bedrooms--- r__________________________Expansion Attic G) Garbage GrinderPL4 Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures ......................................................... W Design Flow_..................................SS_gallons per person per day. Total daily flow...........................3.'50......gallons. WSeptic Tank—Liquid"capacity_I.00?O._gallons Length Width__4'-io.". Diameter______ _______ Depth ff-'../.. x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.____.�ru. ------- Diameter......A.Q.._..._ Depth below inlet....4?f........... Total leaching area__Z-!E_7______sq. ft. Z Other Distribution box (-K) Dosing tank ( ) Percolation Test Results Performed by...... _________________________________________ Date___?O?sI�................. aTest Pit No. I.......Z.....minutes per inch Depth of Test Pit_____ ._._..__. Depth to ground water_.. ....o� (i, Test Pit. No. 2................minutes per inch Depth of Test Pit.................... Depth to ground wate p ai •-•---•••--------------•-•••--•-----------••--......__._............-----•----......._............._............................ - 3�PPMff�t O Description of Soil.....C-^Z'"mo-e....102•.n)..... �1k a i -------------------------------------------------------------------- ALLYN- x ----------------------------------- - YY11�si�a� W 5 .... k�_Cf.X. .....!=l►1k%QN__. No.30216 -----•-•-----•--•--------- -----------•---------------••-•-•--------•-------••--•-•-•••----•-•._...------••••••----•--•--•-.....------••-------•-------•••-•--•-•-•-------. UNature of Repairs or Alterations—Answer when applicable______________________________________________________________________ o GtEQ� -------------------------------------------------------------------------------------------•----------------•------------•-•--------------------------•--•-•••••---•------•-•----- f. ..... Agreement: ud� r•,• The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in acco dance with �a.31.Pt the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place,the system in operation until a Certificate of Compliance has been issued by the board of health. Signed Date` ------ ...... - / Date Application Approved By ........... � .. .. ----------------------------------------------------------------------------- .... Application Disapproved for the following reasons: ...... . .......... ............... ...... ............................ .... to -- -- -- -- -------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------- ----- -- ...................................... Date PermitNo. ......3-Q,>!1..16 y.......................... Issued ------------...---------------------------------------------------- Date FFH lJ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........................................O �r..... /C Appliration for 11isposal Works Tonsirnrfiun ramit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: s ±P�`* ✓l '? :.. " .2.ns...e 'd.Z.......f1i��:.:. .�..:.... .............. .......................................••. . L T4 Location-Address or Lot 9u;,ix � N/��K. e/re" �,-r2 -------------------- ............................................... ..........-.................................... ................... Owner / Addr ss ....................... ..... .✓/_..TY...........`�.�- ............................................... Installer Address Type of Building Size Lot----- -----Sq. feet Dwelling—No. of Bedrooms___.�....f`cc...........................Expansion Attic (�G6) Garbage Grinder (�) Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures .................................. W Design Flow...................................'.gallons per person $er day. Total daily flow............................J...:3d......gallons. WSeptic Tank—Liquid capacityAvdd.gallons LengthWeIrl .,.. Width.A."!®_.. Diameter................ x Disposal Trench—No..................... Width.....1.............. Total Length.........+......_... Total leaching area....................sq. ft. Seepage Pit No.....!!�------- Diameter------s.d-------- Depth below inlet.._�............. Total leaching area.. .�E.2.......sq. ft. Z Other Distribution box (4) Dosing tank S_ ) `" Percolation Test Results Performed by------!_. ..c�...-�!......................................... Date.._-�sA� Test Pit No. 1......Z....._minutes per inch Depth of Test Pit..... ........ Depth to ground water.. V,OF f=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water . . ............ PI' .................•-....,...---...................^......,.....,......................._......----•----.....--------•----••---. O O_2 1� ......1,oz � SJf�.a� X .. ALLYN w Description of Soil �' . -•-•---------•-•--•-•-•- x ...................••••----• ...........................l6Yl.cf._vt41---�aE�.�-----•-••-•........•-••-•-•-••••••----•-•---••---......----•-......------..... WILSON U � _�.:�No:3tf278-. ---------------------------------------------------------------------------------------•-•-•---------------•------------------------------------------.----------------••• U Nature of Repairs or Alterations—Answer when applicable...................................................................... . ----------------------------------------------------------------------------------------------------------------------------------•---•----------------------------------•--. _ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the ��• .,Health. system in operation until a Certificate of Compliance has been issued by the board o h Y P P Y Signed 4 "z ................. ........ /...' ..:c J� A llcation Approved B 7 .....................................�� PP PP Y ......... .................... .--. ----.....-a.. r Date Application Disapproved for th fol�g reasons- ------------------ ------------------------------------------------------------------------------------------- ------ - ------ ---------- -------------------- Dace PermitNo. .... - ..l.. ..�.- + t-------------------------- Issued .---........ --------.......------........------------.......----- Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH k6ertifira a of (Q.1'omplinu.ee THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed or Repaired ( ) � ----------------------------------------------------------------------------------------------------------------------- er has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .......c ..r..;.. .... .._f........... dated ------------------------------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BElCONVTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------------------------------------------------------------------------------- -------------- Inspector ................................................................................................. THE COMMONWEALTH OF MASSACHUSETTS �-�-� BOARD OF HEALTH ................O F.......�,.e ........... No.... r�. .�.. FEE.... -J -� �i��r�a��l nrk� ��aa��#rnr�#irrn �rnti# Permission is hereby granted-----....... .. ......... P! to Construct (6,ror Repair ( ) an./ndivvid�ual Sewage Disposal Systenf atNo.. t1T r'y ,c++ rK..._.d..a�w '�.... sr?.._. . ............... ....................................... Street as shown on the application for Disposal Works Constructio ermit No... ......,!-{..._ Dated..__._. -----•--•••------ ... 6**.... vr'�,,' q� `� f ........ ar3 of DATE........ • -- ' -------------•--------- FORM 1255 H BBS ARREN. INC.. PUBLISHERS L 1- Al w ' iS/O e4P13A�� 21i✓bE�.2 D4%tom✓ r'Irp�s/ //O X 3 = 3 3D 6.P.O-: s2 � P12 of- 72 g50 : e84 x /.o Pic � - //•N Z Mir✓vim. . , -. 4 STEPHEN RICHARD J - G f . I .. ALLYN 1NILSON c No.30216 N.24648 sT NAL G -elx �� .TEST,��y,�a�•E /�ib5'� �-Z588 /.�.sr�[_c...l�G.G:;�/� LAP. Ir-If. O Suds go 55oiL ' /.V✓. GAt�, ; God,L /�YY BOX- MAD Mom, ' JUASUED ,"• /NY. /iVt/ ;: shwr '' �.Z �•�f GE.GT/F/EO f�GDT PL:Q�✓ ' Z�-: c•• �..._ LoG,�T/asp �I�STb.�✓S �/l-LS A/o&4nm .to,.usr--;C � GE.eri cy' .4 T�ET// T rra�/S /oW.t / �/F0AC ,vZE; wo.Slie�EyaP,s TOWX1 41, /34RVSUB4E T GAS ,GYfGGc a- �•�.�, - • .- --r�b•�0��_ ';�-.. 14.�.Gfce,t�r-• c./,q�+-1E'S �, Ste//� , 7 G .`� ✓y.ST,?Z— shd�.t/yF,2EaN s.�cvw,liar of To ES.?.�L/S,�,i.Car-G/NF� USEp SCHEDULE OF ELEVATIONS NOTE: SEWAGE SYSTEM PROFILE & DETAILS GENERAL NOTES 1. RISERS AND COVERS TO FINISH GRADE NOT TO SCALE �Z 1 FIRST FLOOR = 1 101.58 2. H-10 COMPONENTS AND = 2 100.5 SCHEDULE 40 PVC PIPE THROUGHOUT 1. ALL CONSTRUCTION AND MATERIALS SHALL CONFORM TO MASS ENVIRONMENTAL 2 TOP OF FOUNDATION �O - * 1 101.58 3, THE CONTRACTOR SHALL BE RESPONSIBLE FOR OBTAINING S=2�' MINIMUM CODE (310 CMR 15.00,TITLE 5), AND THE LOCAL BOARD OF HEALTH. � 3 PIPE INV. AT FOUNDATION - TO BE VERIFIED 3 96.22 A TRENCH PERMIT FROM THE LOCAL MUNICIPALITY OBSERVATION PORT 2. THERE SHALL BE NO CHANGES MADE IN THIS PLAN WITHOUT THE WRITTEN AD INV. OF PIPE AT SEPTIC TANK INLET = 4 96.04 2 100.5 IN WHICH THE WORK IS BEING PERFORMED. = WAKEBY ROAD 4 PERMISSION OF THE LOCAL BOARD OF HEAL 5 INV. OF PIPE AT SEPTIC TANK OUTLET = 5 95.79 11 98.5 3. ALL ERRORS, OMISSIONS, AND CHANGE OF CONDITIONS AT THE SITE SHALL 6 INV. OF PIPE AT D-BOX INLET = 6 95.10 13 99.3 VERIFY EXISTING TANK INVERT ELEVATIONS BE BROUGHT TO THE ATTENTION OF THE ENGINEER PRIOR TO PERFORMING THE j PRIOR TO INSTALLATION OF 1 5' RELATED WORK. 7 INV. OF PIPE AT D-BOX OUTLET = 7 94.93 MIN. BREAKOUT Q �2� 8 INV. OF PIPE AT START OF LEACHING FIELD = 8 94.80 14 99.4 4 96.04 PROPOSED SYSTEM COMPONENTS - 9 92 80 �•� : 5 95.79 12 98.5 4. THIS PLAN HAS BEEN PREPARED SPECIFICALLY AS A SEPTIC SYSTEM DESIGN AND p 9 BOTTOM OF LEACHING FIELD - 10 95.63 IS NOT TO BE USED TO ESTABLISH PROPERTY LINES OR BUILDING SETBACKS. LOCUS 9 TOP OF STONE C 10 95.631PROPERTY LINES AND BUILDING LOCATIONS ARE GRAPHIC ONLY PROPERTY LINES P I IN I , it - �.ti_ „ , ��- - NOT HAVING BEEN VERIFIED. NO REPRESENTATION OR CERTIFICATION AS TO THE I �- - �;.. ! r�„_. 11 FINISHED GRADE OVER LEACHING FACILITY = 11 98.5 .a �,. _ Y ,�_ , (t1c - r : i�; .:,.•.• �,1, �' i ;!: 6 OUTLET '..,;r_ 12 FINISHED GRADE OVER D-BOX 12 98.5 _ �, J1 _ -- � _ BACK FILL WITH DISTURBED AREAS ARE TO B AND MAINTAINED ACCURACY OF THOSE SHOWN I _ =u � • � 5 ALL E LOAMED SEEDED A :� m eox „ W / SPEED CLEAN MLL 13 FINISH GRADE OVER SEPTIC TANK = 13 99.3 MIN. r rI VENT EROSION. . LE vELERs _ r u t :: . TO PRE 14 FINISH GRADE AT FOUNDATION = 14 99.4 5=0.01 L=18' ! MIN. r MIN. LOCUS MAP NOT TO SCALE 15 BOTTOM OF SEPTIC TANK = 15 91.54 ' S=0.02 L=33' I _ = ES 1, 6 ONCE A YEAR AND NCE SEPTIC TANK SHOULD BE INSPECTED AT LEAST w = S 0.01 L VARI E L I E �� `� FOR PROPER PERFORMANCE, 3 96.22 WHEN THE TOTAL DEPTH OF SCUM AND SOLIDS EXCEEDS 16 TOP OF CELLAR FLOOR = VARIABLE 16 TBD ' ' O SCHD. 40 PVC TEES , o o C3 Io a a L I . - To BE INSTALLED 1c r, o 0 0 0 0O 1/3 THE LIQUID DEPTH OF THE TANK, THE TANK SHOULD BE PUMPED. �- Ln 7. THIS SYSTEM HAS BEEN DESIGNED FROM DATA REVIEWED AND ACKNOWLEDGED 1 U!III GAS BAFFLE N 6 95.10 7 94.93 LW �' BY THE MASS. D.E.P. AND THE LOCAL BOARD OF HEALTH; AND TO BE INSTALLED 1 S' OF NATURALLY OCCURRING • r - I PERVIOUS MATERIAL I CV CONFORMS WITH THE REQUIREMENTS OF TITLE 5 OF THE MASS. SANITARY CODE. 8 94.80 NO GUARANTEE OF PERFORMANCE IS EXPRESSED OR IMPLIED. ' s r y 16 TBD J. ,.1 ... ._ _ _ r iµ , a •- 9 92.80 _ _ _ �. q a 8. TEST HOLE INFORMATION SHOWN HEREON IS LIMITED TO SOIL CONDITIONS FOUND 1,000 GALLON SEPTIC TANK a 1 EXISTING TO REMAIN IN SERVICE USE 2 GALLEYS WITH: AT THAT PARTICULAR TEST HOLE LOCATIONS AND IS NOT CONSIDERED AN • ( IF AFTER PUMP OUT AND INSPECTION " IMPLIED OR EXPRESSED WARRANTY OF SOIL CONDITIONS BEYOND LIMITS OF ::•. '.'i�: ti i ^r 30 STONE ALONG SIDES; IS FOUND TO BE IN GOOD CONDITION SUCH TEST HOLES. 15 91.54 60" BETWEEN - =�- =-- 6" MIN. CRUSHED STONE BASE 48" ALONG ENDS. 9. ALL ORGANIC AND UNSUITABLE MATERIAL MUST BE REMOVED FROM THE AREA TOTAL LENGTH = 30.0' TOTAL WIDTH = 10.0' DIRECTLY UNDER AND 5 FEET BEYOND THE PROPOSED LEACHING FACILITY. THIS AREA MUST BE BACK FILLED TO THE ELEVATIONS INDICATED ON THESE PLANS WITH SELECT ON-SITE OR IMPORTED SOIL MATERIAL, CONSISTING OF CLEAN GRANULAR SAND OR OTHER GRANULAR MATERIAL, FREE FROM ORGANIC MATTER AND OTHER DELETERIOUS SUBSTANCES. MIXTURES AND LAYERS DESIGN DATA SHALL NOT BE USED. THE FILL MATERIAL SHALL CONFORM TO MA STATE HEALTH CODE TITLE 5 - 310 CMR SECTION 15.225(3) AND SHALL HAVE 9.91 1. BUILDING TYPE: EXISTING 3 BEDROOM HOUSE PERCOLATION RATE OF BETWEEN TWO AND FIVE MIN. PER INCH, BEFORE AN -�7 100.04 2. DESIGN FLOW: 110 GPD PER BEDROOM = 110 x 3 = 330 GPD AFTER PLACEMENT. 3. DESIGN PERCOLATION RATE: <5 min/inch 10. ALL STONE MUST BE DOUBLE WASHED AND FREE FROM FINES AND ANY 4. GARBAGE DISPOSAL: NO ORGANIC MATERIAL AND MUST HAVE LESS THAN 0.2 PERCENT MATERIAL 99.91 FINER THAN A NUMBER 200 SIEVE. �\ 5. SEPTIC TANK DESIGN REQUIREMENT: 200% DESIGN FLOW 11. THE DESIGNER HAS NOT BEEN RETAINED BY THE CLIENT TO CONSTRUCT OR 330 X 2 = 660 GAL. (EXISTING 1,000 GAL TO BE KEPT IN SERVICE IF FOUND TO BE IN GOOD CONDITION, OTHERWISE NEW 1,500 GAL 14NK SUPERVISE THE CONSTRUCTION OF THE SYSTEM. THE CONTRACTOR IS 99 72__Z_ WILL BE INSTALLED). RESPONSIBLE FOR MAKING ARRANGEMENTS FOR INSPECTION OF INSTALLATION OF THE SYSTEM WITH THE LOCAL BOARD OF HEALTH. 99.87 6. TOTAL LEACH AREA REQUIRED: 12. THE GENERAL CONTRACTOR IS RESPONSIBLE FOR ALL HORIZONTAL AND 100.31 TITLE 5: 330 GPD / (0.74 GPD/SQ.FT.) = 446 SQ.FT. (CLASS I SOIL) VERTICAL CONTROL OF ALL SYSTEM COMPONENTS. 7. TOTAL AREA PROVIDED: 13. TIGHT JOINT PIPING TO CONSIST OF POLYVINYL CHLORIDE (P.V.C.) 00 99.82 11' X 30' LEACHING TRENCH (SEE DETAIL) SCHEDULE 40, UNLESS OTHERWISE NOTED. EFFECTIVE DEPTH = 2.0'; LENGTH = 30.0'; WIDTH = 11.0' 14. THE CONTRACTOR SHALL NOTIFY THE DESIGN ENGINEER FOR CONSTRUCTION INSPECTION AFTER EXCAVATION FOR THE LEACHING BED (PRIOR TO THE "' 100.19 PLACEMENT OF STONE) AND ALSO AFTER PLACEMENT OF PIPE & STONE v 00 0.11 BENCHMARK SIDE WALL AREA = (2x30)(2) = 120 SQ.FT. PRIOR TO BACKFILLING. TOP OF HYDRANT BOTTOM AREA = 1000 = 300 SQ.FT. ' 100.10 1402. EL.=102.47 15. DESIGN FNGINFFR SHAi'_ r_� P, , �0N�T:',::;TI-N Gr �`rjie=hr, Hivv MHItKIALS END WALL AREA = (2x10)(?.) = 40 SQ.FT. INSTALLED. THE CONTRACTOR SHALL PROVIDE A SIEVE ANALYSIS OF THE FILL 100.17 J '5. TOTAL AREA PROVIDED = 120 + 300 + 40 = 460 SQ.FT. MATERIAL REQUIRED. AN AS-BUILT PLAN SHALL BE SUBMITTED TO THE LOCAL 460 SQ.FT. x 0.74 SQ.FT./GPD = 340.4 GPD BOARD OF HEALTH UPON COMPLETION. 00 PROVIDED P 16 SEPTIC BBED EXCAVATION BER TIRE RDUR NG CONSTRUCTION. UCTION MACHINERY ALL DRIVE OVER THE PROPOSED TOTAL FLOW L LO 0 DED = 340 GPD �ro NOTE: SYSTEM IS NOT DESIGNED FOR A GARBAGE GRINDER. 17. DIG-SAFE AND ALL OTHER NECESSARY AUTHORITIES SHALL BE NOTIFIED FOR to �a L97- 48 THE PROPER LOCATION OF EXISTING UTILITIES PRIOR TO ANY EXCAVATION. 04%;o SOIL EVALUATORS LOG � a Ny � W� y�y LOT 49 V) > �� c3`. Depth from Soil Soil Soil Soil Other w a �o 1 3,46 7 S.F. �j ��\ Surface Hor. Texture Color Mott. Relative (Inches) (USDA) (Munsel) Factors 99.66 0� �'• v� ELEVATION DEEP OBSERVATION HOLE #1 EL. 98.8 9.00 - 98.3 0"-6' Ap LOAM 10YR 3/1 NOT WELL GRADED 1 97.5 6"-16" B LOAM/SAND 10YR 4/4 NOT WELL GRADED REVISION DATE DESCRIPTION BY APPR 1 I 94.8 16"-48" C1 LOAM/SAND 10YR 6/6 SOME SILT APPLICANT: EXIs�!N� 1 47 EMIL Y HA SKELL DwEL`IN 48"-120" C2 COARSE 2.SY 6/3 NOT WELL GRADED \ FL.LS 0.6/ ❑U - MED. SAND 147 BRACKEN FERN ROAD F' z DEEP OBSERVATION HOLE #2 EL. 98.0 MARSTONS MILLS, MA. 02648 / 9 99.48 I Lil / _�� _ 97.5 0"-6' Ap LOAM 1OYR 3/1 NOT WELL GRADED LOT SO °/ ®8.83 / I 9 •48 Z 96.0 6"-24" B LOAM/SAND 10YR 4/4 NOT WELL GRADED PROJECT. / I U~i 94.2 24"-46" C1 LOAM/SAND 10YR 6/6 SOME SILT "I/ w 88.0 46"-120" c2 COARSE 2.5Y 6/3 NOT WE1L GRADED SEWAGE DISPOSAL SYSTEM REPAIR DESIGN U) \ 99.3 `99' ❑ MED. SAND �o � 08.23 O ( 98.75 ( 147 BRACKEN FERN ROAD _o \ 93 PERCOLATION RATE _ <2 MIN./INCH N ° 18' 30 0• \ -� DEPTH TO GROUNDWATER = NONE ENCOUNTERED IN ` + '+ \ .� 09 EXISTING ' • ' • ' PAVED AREA ' OBSERVATIONS BY: DAVID W. STANTON MARSTONS MILLS, MASSACHUSETTS DATE TESTED: 05/12/11 o f--A r ❑ T / RESER _ �y SHEET NO.: 1 OF 1 DATE: 05/17 2011 . 9 �s � SCALE: As Noted PRC FILE: BRACKENFERN_147_HASxELL ° 8.62 -ga ❑ 9 .67 DESIGN BY. DAVID FRENCH CHECKED BY.• CHRISTOPHER COSTA, PLS 98.79 � � ❑ 97.42 • ❑ PREPARED BY.• 0 PUMPED DRY NOTES _ Christopher Costa & Associates, Inc. LEGEND / � XISTING SYSTEM IS TO BE , �p�9 �O ( DISCONNECTED AND FILLED 1. THIS LOT IS NOT IN A FLOOD HAZARD ZONE IN PROPOSED �� 1'1 GL WITH CLEAN FILL OR REMOVED AS SHOWN ON FIRM FLOOD INSURANCE RATE MAP. GIVIL E�INEERIN6 LAND SUZVEYIN6 • ENVIRONMENTAL GONSI,LTINC� EXISTING 5P P 2. WATER SERVICE LINE SHALL BE LOCATED AND MARKED CONTOUR ELEVATION ( PATH OF Mq �-��;,'�" PRIOR TO ANY EXCAVATING AND 10 MIN. SETBACK P.O. Box 128 / 465 East Falmouth Hwy. 508.548.6424 PHONE 50x 5 SPOT GRADE LAYOUT PLAN OPG �� _�� v DISTANCE FROM SAID SERVICE TO THE SEPTIC SYSTEM www.costaassociates.com ��C r� �� N. DOUGLAS yG, SHALL BE MAINTAINED. East Falmouth, MA 02536 508.548.0350 FAX TEST PIT (TP) GRAPHIC SCALE �'S9 v o ., �y o SCHNEIDER N 3. ALL WATER UNES SHALL BE SLEEVED WITHIN 4" PVC DRAWING TITLE: ❑ � CONCRETE BOUND (CB) so o �o zo 4o so �� fi AHER � No 381540 � SCH 40 PIPE FOR 10' ON EACH SIDE OF SOIL ABSORPTION SYSTEM. ao -+ '°� R 4 4. GROUND ELEVATIONS ARE BASED ON AN "ON THE GROUND" SEPTIC REPAIR DESIGN PLAN O O SPIKE (SPK) < � Sy 5 �: o�FSScisTER INSTRUMENT SURVEY AND AN ASSUMED DATUM. NO INCREASE IN EXISTING DESIGN FLOW GAS VALVE GV �� SP�P S �� ' WATER SERVICE (WS) 1 inch = 20 ft~ s f��S�;-�r�C '� S "Z°�/ ASSESSORS INFORMATION: MAP 42 PARCEL 031