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HomeMy WebLinkAbout0071 CAPTAIN BAKER ROAD - Health 18 Captain Deyoung Terrace Marstons Mills F/R A = 125 025 TOWN OF BARNSTABLE l LOCATION EWAGE# VILLAGE ��s ,�,S /'h;J/J ASS SSOR'S MAP&PARCEL S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) bz,yS (size) NO. OF BEDROOMS ^� OWNER J4TT /"IOIrLt,SS PERMIT DATE: GODATE: �{�$r bIA4-1 Separation Distance Between the: . i 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 ;itl 300 feet of leaching facility) Feet FURNISHED BY 5 39 F F' f f f f f f�f ! f i f f f r f rowx \ \ \ \ \ \ t \'\ \ \ \ \ t t \ \ \ \ i.. f � s \ \ tttt \ \ ttt \ \ 42 ! f f f r f f f r F r r F f f ! r 49 F r r f r f r f r f ! \ \ t t \ \ \ t \ t \ \ t , ff / f f f fff / F 19 N Commonwealth of Massachusetts Title 5 Official Inspection Form =' Subsurface Sewage Dis osal System Form - Not for Voluntary Assessments ACapt. Deyoung Terrace -- --------- --- -- ------------ -- -- Property Address Jeff Morassi ------- -------- ------------ -- --- Owner Owner's Name information is Marstons Mills MA 02648 March 11, 2013 required for — --- --— every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the (� computer,use 1. Inspector: only the tab key to move your Patrick M. O'Connell --- cursor-do not Name of Inspector use the return key. Septic Inspection Services Co. -- Company Name rob 189 Cammett Road Company Address _Marstons Mills _ MA 02648 e City/Town State Zip Code 508-428-1779 S1 12855 ------— Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function ano .maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.30 of� Title 5 (310 CMR 15,000). The system: �=, C Ra.Mk ® Passes ❑ Conditionally Passes ❑ Fac41s p ❑ Needs Further Evaluation by the Local Approving Authority March 11, 2013 Job# 1 -15 o - �-------------------- ---- --._..._____------------------— �-�----cam-- I pector's ignature Date co The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or D'EP) within 30 days of completing this inspection. If the syster- 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. p ****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. I t5ms•11/10 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page'of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capt. Deyoung Terrace — --_-----__---- ---.------------- -- Property Address Jeff Morassi — Owner Owner's Name information is Marstons Mills MA 02648 Mar;h �1, 2013 — required for - -- —— ----------- every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/ always complete all of Section D A) System Passes: ® 1 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: Tank was not in need of pumping at time of inspection, Leaching system shv Ned no signs of saturation or surcharge. -- 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 cornpletion of the replacement )r repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following. statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not) is structurally 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. ❑ Y ❑ N ❑ ND (Explain below): Title 5 official Inspection Form Subsurface Sewage Disposal System•Page 2 of 17 15ins•11/10 Commonwealth of Massachusetts N Title 5 Official Inspection Form Subsurface ace Sewage Disposal I System Form Not for Voluntary Assessments 17 Capt. De�ounq Terrace ------ -- Property Address Jeff Morassi ___ _—_--_------_-__--- — -- — Owner Owner's Name information is Mar tons Mills MA 02648 M_ar_c_h_11, 2013 _ required for every page. City/Town State Zip Code Date of Inspection— — -- ----------....----...---- — B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ NJ (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public heallth, 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 Title 5 official Inspection Form Subsurface Sewage Disposal System•Page 3 of 17 t5ins•11/10 Commonwealth of Massachusetts Title 5 Official Inspection Form is - i. Subsurface Sewage Disposal System Form Not for Voluntary Assessments ,.w a 17 Capt. De young Terrace Property Address Jeff Morassi Owner Owner's Name information is Marstons Mills MA 02648 March 11, 2013 required for -------------- ------ - — — every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system 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 fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or "No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than_day flow t51ns•11/to Taie 5 Official Inspection Form Subsurfzce Sewage oisposat System•Page 4 of 17 Commonwealth. of Massachusetts Title 5 Official Inspection Form IA S, Subsurface Sewage Disposal System Form Not for Voluntary Assessments J _ 17 Capt. Deyoung Terrace Property Address Jeff Morassi _ Owner Owner's Name information is _ _ MA 02648 March 11, 2013 Marstons Mills required for ---- — 02 ----- ------------------- -- -- every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or "no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ - the system is within 400 feet of a surface drinking wa ! r supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply El ❑ 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. Tale 5 official Inspection Form Subsurf_ce Sewage Disposal System•page 5 of 17 t5ins•11110 Commonwealth ~. Massachusetts Title�����N�� �� �~���~�w~��N N������������~���� ����0°�l�) � �� ���� � ������N �nv�~��~����U��on Form ' Subsurface Sewage Disposal System Form ' Not for Voluntary Assessments � 17 Capt. Devounq T ---------________-__ Property Address JoffN1onaosi Owner Owner's Name information is KAom�onayNi||o MA 02848 KAaroh �13 ________ required for _-_ '- _-_-__'11�----____� -----------------'---------- State Zip Date every page. cvy�v~n C. Checklist Check if the following have been done. You must indicate ^yau" or^no" as to each of the following: � Yes No [K El Pumping information was provided by the owner, 000u/and. or Board.ofHealth El X Were any of the system components pumped out in the previous two weeks? [K F� Has the system received normal flows in the previous two week period? [�El Have large volumes of water been introduced to the system recently or as part of �� �� this inspection? [� [� VVareaabuilt plans of the system obtained and examined? (If they vvenenot �� �� available note asN/A) N El Was the facility or dwelling inspected for signs of oewaQ� back up? N El Was the site inspected for signs of break out? F� Were all system components, excluding the SAS, |oce i'adonsite? 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 ofscum? VVauthe famUtyowner (and occupants ifdi�erent �om owner) pmvidedw�h �� �� 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 | � �h B rd rJHoa|th�� Existing information, For example, a pan an e Boa /� [� Determined in the field (if any of the failure criteria related to Part is at issue �� �� approximation of distance ia unacceptable) [31OCW1R 15382(5)] � D. System Information Residential Flow Conditions: 3 3 Number ofbedrooms (deoign) ---'---- Number ofbedrooms (m±ua|)� �--------- 330 DESIGN flow based on31OCMR15.2O3 (for examp|e� 110gpdx # ofbednuoms): ----------' /�ns'`mo Title s Official m=ecl=°Form Subsurface Sewage Disposal System-Page pm`, | ==`'""o''=~~'~' of '^`~~~~~'---'-- fT ��~��N�� �� m~���~��~��N N��������^��^���� ����0°�1�) Title �� �w�� � ���N�wN �nw������������vn Form ' Subsurface Sewage Disposal System Form Not for Voluntary Assessments 17 Capt. Deyoung Terrace ------- Property Address Je#Monusni Owner Owner's Name information is K8a/stons [�iUo ' MA 02648 March 2013 required for ------ ------ — -------- e,erypoue. City/Town State Zip Code Date of Inspection — — D, System Information Desohphon� 3________. Number ofcurrent pesidonto� Does residence have a garbage grinder? E] Yes [9 No Is laundry on a separate sewage system? [if yes separate inspection required] D Yes 0 No No��Yes � Laundry system inspectedY �� �� �� �o Seasono| uso? �� Yes �� Water meter readings, if available (last 2 years usage (gpd)):Detail: ——----------������������ ��Yes No� Sump pump? �� �~ Currently Last date ofoccupancy: OoouPied Commercial/Industrial Flow Conditions: Type ofEstablishment: — ---------------'--------------- Denignflmw (bnsedon 310CW1R 15203): | Basis ofdesign flow (seats/peraons/oq,ft.. etc): ---- Yes �] No--- Grease trap present? ���~ No��Yes|ndushia| vvastmholding tank present? ���� �� Non-sanitary waste discharged to the Title Yes �� No 5 system? �� �� Water meter readings, ifevai|ab|e� ----------' ---- Title s official inspection Form Subsurface Sewage Disposal System-Page,"/,/ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �. 17 Capt. Deyoung Terrace Property Address Jeff Morassi -- Owner Owner's Name information is Marstons Mills MA 02648 March 11, 2013 required for -- ------ -------------------- every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: pate Other(describe below): I General Information Pumping Records: Tank pumped March 2011 _ ____ Source of information: --- Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: 9aiions How was quantity pumped determined? Reason for pumping: ---_--..--------.__.____.----------------------- — Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): t5ins•11110 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form of Subsurface Sewage Disposal System Form Not for Voluntary Assessments 17 Capt. Deyoung Terrace Property Address Jeff Mo rassi ----------------------— ----- — — Owner Owner's Name information is Mar tons Mills _ __ MA 02648 March 11, 2013 required for every page. City/Town State Zip Code Date of Inspection — D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Leaching system installed --- Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer (locate on site plan): 4' Depth below grade: feet Material of construction: ❑ cast iron ® 40 PVC ❑ other (explain): -- --- -- Distance from private water supply well or suction line. feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): 3' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) I If tank is metal, list age: -..---------_---------------------..-..--- years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No 10.5' lortg x 5.8' wide - 15009a1_ Dimensions: Sludge depth: --- _-- t5ins•11110 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 9 of 17 f Commonwealth of Massachusetts Title 5 Oifficial Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capt. Deyoung Terrace Property Address Jeff Morassi Owner Owner's Name information is required for Marstons Mills MA 02648 March 11, 2013 ----------- -- ---- .... ..... --- ---- - - every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 30" Scum thickness 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 Measured How were dimensions determined? - --- ---- --- ----- -- Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Liquid level was at bottom of outlet invert and tees were intact. --- -- Grease Trap (locate on site plan): Depth below grade: reel - Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain): I 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: Date 15ins•11110 Title 5 ofhaai Inspection Form,Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts r� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 17 Capt. Deyoung Terrace -- Property Address Jeff Morassi Owner Owner's Name information is Marstons Mills _ MA 02648 March 11, 2013 required for --- __------._- ---- every page. Cityrrown State Zip Code Date f Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: _____------__...--------------------- -- Capacity: gallons ._...-- _____-------------------.....----------- --- Design Flow: g gallons per day Alarm present: ❑ Yes ❑ No Alarm level: ----- ---- Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date -- --- -----._...--------- Comments (condition of alarm and float switches, etc.): --------- Attach copy of current pumping contract (required). Is copy attached? ❑ Yes ❑ No Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 1'1 of 17 Sins•11/10 Commonwealth of Massachusetts 1 rib Title 5 official Inspection Form �= Subsurface Sewage Disposal System Form - Not for Voluntary Assessments \;,a 17 Capt. Deyoung Terrace ---- Property Address Jeff Morassi -- -------- ----- ---------- — Owner Owner's Name information is Marstons Mills MA 02648 March 11, 2013 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert fit--- — --- -- Comments (note if box is level and distribution to outlets equal, any evidence: of solids carryover, any evidence of leakage into or out of box, etc.). Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t51ns•11110 1 the 5 Official Inspection form Subsurface Sewage Disposal System•Page 12 of 17 f . � Commonwealth of Massac husetts rU� Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 17 Capt. Deyoung Terrace------------- ---- ---- --------------- — Property Address Jeff Morassi Owner Owner's Name information is , 2013 required for Marstons Mills MA 02648 March 11--------------------------- --- ------ -- -------...---- ------- --- ------- every page. City/Town State Zip Code Date c f Inspection D. System Information (cont.) Type: ❑ leaching pits number: -- Two 500 gal ® leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: — ❑ leaching fields number, dimensions: - ❑ overflow cesspool number: -- -- ❑ innovative/alternative system Type/name of technology: ----------- ------ -_--- -- Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Area of SAS was probed with no evidence of satruation found. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration ------ Depth -top of liquid to inlet invert --- Depth of solids layer Depth of scum layer -"" "----- Dimensions of cesspool --- - Materials of con struction --""---"--_--- ----- Indication of groundwater inflow ❑ Yes ❑ No l5ins•11110 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page 13 of 17 L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 17 Capt. Deyoung Terrace Property Address Jeff Morassi -- Owner Owner's Name information is Mar tons Mills __ MA 02648 March 11, 2013 required for ______________ _ _.-------....-___-- _-- - -- every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions ------------------------------- Depth of solids -- ...--------------_----------------------- Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•11/10 Title 5 Official Inspection Form Subsurface Sewage Disposal System•Page Id of 17 I Commonwealth of Massachusetts -- - -{ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments .t =_ 17 Capt_ Deyoung Terrace Property Address Jeff Morassi -- - Owner owner's Name Information is Marstons Mills MA 02648 March 11, 2013 required for Sate -----Code Dal of inspection every page city/Town D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet Locate! where public water supply enters the building Check one of the boxes below ® hand-sketch in the area below ❑ drawing attached separately 39 9 17 42 49 19 Capt. Deyoung Ter. I i Commonwealth of Massachusetts ; a Title 5 Official Inspection Form �m Subsurface Sewage Disposal System Form - Not for Voluntary Assessments A . 17 Capt. De young Terrace _— Property Address Jeff Morassi Owner Owner's Name information is required for Marstons Mills MA 02648 March 11, 2013 -- - --- ------ -------------- — ------- every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells 15+ _ Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record i If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 fe:t of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers - (attach documentation) ® Accessed USGS database - explain: USGS topo map and town GIS ..-._...._._._-.___-.------_.------_----.__-_- You must describe how you established the high ground water elevation. Town groundwater map shows water at el 40 and topo map shows property 3t el. 60. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•1 MO True 5 Official inspection Form Subsurface Sewage Disposal System•Page 1E of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form ISubsurface Sewage Disposal System Form - Not for Voluntary Assessments .V c' 17 Capt. Deyoun Terrace ---- Property Address Jeff Morassi -- Owner . Owner's Name information is Mar tons Mills MA 02648 March 11, 2013 — required for -- -- every page. City/Town State Zip Code Date of Inspection _ E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11110 Title 5 ofiiaai Inspection Form Subsurface Sewage Disposal System•Page I-,of 17 r • S- 1T117 Zo COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION RECEIVED APR 2 7 2003 TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNT VIV �;`� S SUBSURFACE SEWAGE DISPOSAL SYSTE O - PART A CERTIFICATION Property Address: 18 Captain DeYoung Terrace FAILED INSPECTION Marston Mills, MA 02648 Owner's Name: Ed King Owner's Address: 32 Mirick Road Princeton, MA 01541 Date of Inspection: March 29, 2003 .Name of Inspector: (Please Print) James M Ford Company Name: James M. Ford Mailing Address: P.O. Box 49 Map: 125 Osterville,MA 02655-0049 Parcel: 025 Telephone Number: (508) 862-9400 Lot: 19 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 \ Needs Further Evaluation by the Local Approving Authority ✓ Fail Inspector's Signature: Date: April 2, 2003 The system inspector shall sub copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 I Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 18 Captain DeYoung Terrace Marston Mills, MA Owner: Ed King Date of Inspection: March 29, 2003 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 CM 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 rewired 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: 18 Captain DeYoung Terrace Marston Mills, MA Owner: Ed King Date of Inspection: March 29, 2003 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: 18 Captain DeYoung Terrace Marstons Mills, MA Owner: Ed King Date of Inspection: March 29, 2003 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 %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 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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.] Yes (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 f Page 5 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 18 Captain DeYoung Terrace Marstons Mills, AM Owner: Ed King Date of Inspection: March 29, 2003 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 r Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 18 Captain DeYoung Terrace Marstons Mills, AM Owner: Ed King Date of Inspection: March 29, 2003 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 3 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage 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 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): ______gpd Basis of design flow(seats/persons/sqft,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: Pumped approx. 10 years ago-per owner 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: Apit was added on June 26195-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: 18 Captain DeYoung Terrace Marston Mills. MA Owner: Ed King Date of Inspection: March 29, 2003 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: 3' 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: 1000 gal. Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle: 28" Scum thickness: 12"+ 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: 6" 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. Recommend pumping and installing risers. 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 r Page 8 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 18 Captain DeYoung Terrace Marstons Mills, MA Owner: Ed King Date of Inspection: March 29, 2003 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: None (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): I 8 Page 9 of 1 I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 18 Captain DeYoung Terrace Marston Mills. MA Owner: Ed King Date of Inspection: March 29, 2003 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 2-6'x 6'(1000 gal.) leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.): One pit 02)was full and the liquid level was up to the outlet pipe. The bottom to grade was 11. The cover was T below grade. The other pit 03)was full and the liquid level was above the inlet pipe. The bottom to grade was 11'. The cover was T belox� grade. Both pits were in failure. 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 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 18 Captain DeYoung Terrace Marston Mills. MA Owner: Ed King Date of Inspection: March 29, 2003 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. PrOAT, gy i9 a A f3 y� X7 s9 ys 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: 18 Captain DeYoung Terrace Marston Mills, MA Owner: Ed King Date of Inspection: March 29, 2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 22 +/- 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 the Barnstable topographic map and the Cape Cod Commission water contours map,the maps were showing approximately 22'+/-to ground water at this site. i 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. Il ✓�� TOWN OF BARNSTABLE L0,CATION /� � � �� f'�h! /� �t SEWAGE # a?Oa,'' 3J.3 V'IT_LAGE 0,a47 , AS ASSESSOR'S MAP & LOT 25`02� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY "~} LEACHING FACILITY: (type) fao Cl l�ia��.� �.2) (size) NO.OF BEDROOMS BUILDER R _hih PERMITDATE: 7�3%63 COMPLIANCE DATE: 18103 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility T- 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 leachin facility) Feet Furnished by �-Z rj-- y a ❑ 0 ❑ f j Q1- ylr No. ?'Do 313 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZippYication for Miopozal &p5tem Construction Permit Application for a Permit to Construct( )Repair Upgrade( )Abandon( ) O Complete System LJIndividual Components Location Address or Lot No. r Owner's Name,Address and Tel.No. eey� X10 Assessor's Map/Parcel ��5 $ f S Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size J�"sq.ft. Garbage Grinder(� Other Type of Building G No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow / gallons per day. Calculated daily flow J�© gallons. Plan Date "3 Number of sh ets Revision Date Title S�'G�G�' �J.r it Size of Septic Tank /42 ill�:l`i a'9 Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by 's Boar f Health. Signed Date � � Application Approved by s Date �S Application Disapproved for the following reasons Permit No. 2,0 0 3 — 3 13 Date Issued 57 0 3 2-5 /No. 20 p 3f-'r313 Fee ��. THE COMA' ONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS application for Migogal *potem Congtructton Permit Application for a Permit to Construct( )Repair(V/)Upgrade( )Abandon( ) ❑Complete System TlIndividual Components Location Address or Lot No. Owner's Name,Address and Tel.No. p S C4j�7�7111 Oe yin Assessor's Map/Parcel �II�.S�Q�J! �/^ • Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. • l30/'td/obi COdls�'"; ,Da�/�e� �I• �1�y��r �- 5_ 77 Type of Building: Dwelling No.of Bedrooms 3 Lot Size ZG' sq.ft. Garbage Grinder(1-e0p Other Type of Building /PPS/Gi�N�l° No. of Persons Showers( ) Cafeteria( ) Other Fixtures � # Design Flow M1119 gallons per day. Calculated daily flow 3 J Q gallons. Plan Date T�S" ��l 3 Number of sheets J Revision Date Title 5 Sf'Gd0'9 /J �5i- �4 TO%A �P}�U•y Size of Septic Tank //7/f�y Type of S.A.S. —7/ Description of Soil 1'r l7/7wie;5 i Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: ! The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance,has been issued by this Board-of Health. . 'Signed Date //0 1z;0_3 Application Approved by S Date 15- G 7 A Application Disapproved for the following reasons Permit No. 2 0 3 - 3 ( 3 . - ., .~ y Date Issued -7 5- O 3 --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS k BARNSTABLE, MASSACHUSETTS Certificate of Compliance r THIS IS TO CERTIFY,that the On-site Sewage Di s osal System Constructed( )Repaired(✓)Upgraded( ' ) Abandoned( )by l ® . ;4, at 13 ,4' ,hd _ has been constructed in ac ordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 7-00 3-313 dated l S 61" Installer Designer The issuance of taus pe/$mit shall not be construed as a guarantee that the system 1 W' tLasMsg7. Date I /g!d 3 Inspector n , ----------- --- '�'} No.2OD3— 3'3 ----- — '��—D� Fee �v THE COMMONWEALTH OF MASSACHUSETTS f l PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS,, 30igogaf *pztem Con.5truction Vermit Permission is hereby granted to Construct )Repair(k<)Upgrade( )Abandon( ) System located at / Q 9//! and as described in the above Application for Disposal System Construction Permit.The applicarit recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. ` a Provided: Cons Clio ust be completed within three years of the date of this pe Date:_ Approved by E _ TOWN OF BAANSTABLE LOCATION !��pl �t ���'� �"` �� SEWAGE # ?40 3>3 VII LAGE � s ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. 6rr���7��• Cas�J�`/�cT,orJ y'��-�q?G SEPTIC TANK CAPACITY i LEACHING FACILITY: (type) Fef el" Q-? (size) /7 :9, S- a i NO. OF BEDROOMS BUILDER R h/ire j . PERMITDATE: -7I/s/63 COMPLIANCE DATE: g Separation Distance Between the: 1 Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility T-71— Feet Facility If an wells exist Private Water Supply Well and Leaching Fa ty ( Y " Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leachin facility) Furnished by '� ' �' i I 1 & �. O.7 1 � TOWN OF BARNSTABLE LOCATION > iy► SEWAGE # VIL LACE/WCJ'/pry S 1-71/if, ASSESSOR'S MAP & LOT�� INSTALLER'S NAME & PHONE NO.41 .3 C40cv 77S"=c�ffOQ SEPTIC TANK CAPACITY /, Ce /&y LEACHING FACILITY:(type)o2 Wp 9!9/ (size) 6X6 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER ,g,Er� DATE PERMIT ISSUED: "�'i � DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No I `y`V ASSESSORS MAP J EL NO: �� L No... ? ._.... 9 Fas............._............... T E COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Diripwial Wurkt5 C omitr7an nPrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( Individual Sewage Disposal Sysl ............ . ...1 . .__ �-. 1 � .....................•....-•.------........._..............•--- n � �ddrrssf or Lot No. ow nef Address • a ...•••. 6,;6 --------------------------------------------------- ------ --------•------------...----------------------•-------•----------.......----.......-••---......... Installer Address UType of Building Size Lot............................Sq. feet r. Dwelling— No. of Bedrooms.-----..----3-------------------- ----Expansion Attic ( ) Garbage Grinder ( ) ok Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ------------------------------- -- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W Septic Tank—Liquid capacity............gallons Length---------------- Width--............-- Diameter................ Depth................ x Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter---..---.-.-.------- Depth below inlet---................. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. l................minutes per Inch Depth of Test Pit...---.............. Depth to ground water..--.................... Gi, Test Pit No. 2................minutes per inch Depth of Test Pit--.----.......--.... Depth to ground water........................ a .....--•-•---•-•--------•----•••-------•--•••----...---•.....•-•-•••----•......-•-•-•--•----•-•-----••-•--•-----•-•-•--•-•-••-•--••-•...............•...--••- 0 Description of Soil......................................... --------•----------------•--------------------•---------------...----•----•---• .............................................. x U ..........•-•---••--•.......•••••-•--••••--•••...........-•---•----•-•----------•...-••--•----------••-•-••--•--•-----•-••••••-•••-•--•-....----•••-•----••••-•-••--•............................••...... x ••••-•-•-•-•---------------------•••-•-•••-•••••--••---•-•---------••...............--•-•-•-------••----••-••--•------------------- •--....-•-•--........... • , U f N% e of Repair or Alterations—Answer rhejXlicabl ,._ I_ ...............r.-...... ................ �� �21K C S T`c Vt. .._... ` ._._...-.. sS-1� ..................................................... m Agreent:e 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 o system pe o p in ration until a Certificate of Com fiance qas been sued b he board of health. i Signed ............. ..�.a. .. Dare Application Approved B �........_ ...:..._R-...... -----------------.. ......... . .........-�—... ............... Dale Application Disapproved for the following reasons: ... .......................................................................... .............. .......... ..................... ........................ ...................................................... ............... .................... . �J Dare -- G. --- Permit No. ...... . ------.. Issued ....��............... ............... . Dare No.- . .. , Fas......................-... THE COMMONWEALTH OF MASSACHUSETTS 4 BOARD bF HEALTH TOWN OFvBARNSTABLE Apphration for Di ipas l Workii C omitrnrtinn Urrmit Application is hereby made for a Permit'to Construct ( ) or Repair ( 4/an Individual Sewage Disposal System at: . L -:\ddn•ss ... or Lot No.}n Oar--- Address -•--------•----•---------------------------- Installer Address UType of Building Size Lot............................Sq. feet ►� Dwelling—No. of Bedrooms.--_____--_tea-------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a 1 Other fixtures .................. W Design Flow............................................gallons per person per day. Total daily flow..._........................................gallons. WSeptic Tank—Liquid capacity........._.gallons Length---------------- Width---------------- Diameter---------------- Depth................ x Disposal Trench-- No. .................... Width.................... 'Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter-__..._-.-.-.--_-.-- Depth below inlet..................... Total leaching area......_...........sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.__.......___..__.__. Depth to ground water........................ Lit Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ....................................•-----------------------------••----•-------------•---......._.....-•-----------------•----------•-•---------------•----- 0 Description of Soil....................................................................................................................................................................... UW .............................................................•------------------•--•-•••••----------------•--------------...----------••---------.._---------••- j ----•....._... Nature of Repairs or Alterations—JJ Answer when applicable._-.---7_0: _ A_-.I f__...._._�._...._._.�.N__._.1 113.___ wZ : Y�.._.... _.. �(.... 'r-/?.�._._-�'`-.--�--..---.•:�r-•.. =ter S c' ? l..................................................... 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 system in operation until a Certificate of Compliance as been issued b he board of health. Signed ................... _.....4 CAA A g �........ - ----------------- ....>.- -- l Due Application Approved B .....- ....... ---------------".- ,....---.---------------------------------------------------------- �-•.7 `;z Dace .Application Disapproved for the following reasons: ................................................. ................................................................ ......... ... .............................................................................. Dace �_ Permit No. ...G1� _...... �.......... Issued ..... `"...2 . -..... .... Uare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BAR�r1NSTABLE Certificate of IImpitia ere THIS IS TO CERTIF , That the Individual Sewage Disposal System constructed ( ) or Repaired ( . by ................................ j4/-��---�-------...-....-..--------------------------------...__--...---------__-----------.---------_-------------------------------------------------.---- h., 1Dl Cam/ {r . / C/rf - -�._�- ..-.. .. ........ .............-... ... ...............-- . .. ......... at ............X..................... cj �/ has been installed in accordance with the provisions of TITLE,5 of The St to Environmental Code as described in the application for Disposal Works Construction,Permit'Nc�i. �� dated � ._. • -- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTOR]G: l'` J DATE L✓�' f I p -r .......-- _.... _... _i. ............ ns e .to f, THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH M TOWN OF BARNSTABLE -� No........... ... FEE. ._:..__. Disposal Workii Ton,otrudion "amit Permission is hereby granted........e'................................ qa(--d---------•--•••-••------...-----------•------•---...•-•........---.... to Construct ( ) or Repai (�n Individual Sewage Disposal System atNo.--/ --••------- ..'.......... " -•y '�l' ��.r� !` •-•--•----- ' ......................................... as shown on the application for Disposal Works Construction Perms-fPF �� Dated �/ Board of Health - DATE....---- ----- ----•-----•-----•--•••- FORM 36508 HOBBS&WARREN.INC..PUBLISHERS t /1 160 0 LOT 16 /w. 33 ' LOT Hf Lo< 2O I 6G't V r-'I i pfo�sed Ex15t sq�;�.rp..X m y' �i�tevr' DW�GCIrJC/ o a N , g CAPT. Ey d. s6 o 14 Qp; ..,�` PREPARED ,FOR Fo n rE .t Tr �oa�E CERTIFIED PL 0 T P AN LOCAT/ON _MA RSroNS .Nie-cs A►A. SCALE /" =30' DATES REFERENCE: LOT /S� P. B. 274 P. _ 3¢ L. CP. FLOOD ZONE �- of / HEREBY CERTIFY THAT THE BUIL DING SHOWN ON THIS PLAN IS LOCATED ON THE GEOR °s GROUND AS- SHOWN HEREON AND THAT IT 1OW OoEs CONFORM TO TH£ZONING 7e07 �° 4 BY-LAWS OF THE TOWN OF 819R45TA81/E WHEN CONSTRUCTED. O suit LOW & WELLER, INC. �. 714 MAIN STREET ooVAJ /OL/y'g YARMOUTH, MASS. DATE 786-i44 TOWN OF BARNSTABLE L()(�ATION e _ 9 10sEWAGE # ` 9� VILLAGE Af5�w6 J"+`lid ASSESSOR'S MAP & LO -®-2G ` INSTALLER'S NAME 6z PHONE NO. _ SEPTIC TANK CAPACITY f,000 qctR. LEACHING FACILITY:(type) (size) 6 NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER fuM,C, BUILDER-OR OWNERc� �'� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANG Rfi IsHa d, otoN 0 cl- _ /�, vl- __e2 C--L-4C LOCATION : .5F-W&nE PERMIT U,O. Or t_ AL �C —U4_ J IPISTQLLER S U&NAE 6 ADDRESS R , O d i2 Cep= (UC — — — — — BUILDER 5 Q A-"F- ADDRESS DATE PERMIT ISSUED D ATE COKAPLI &&ICE ISSUED : — — .— w mac' r II No.. ---------- FiCc$..Z.��................ _ THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH G� . ....-- .0F........... . ... `�1% 1.. ............................................. Appliratiun -fur Bi,ivunttl Workii Tonntrurtiun Prrniit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal Systemm at: r Location? ddress or Lot No. 04 Owner Address ----------------------------------------- ------•---- ze ti.---------dam--,. -7----------------------------- Installer Address U Type of Building Size feet Dwelling—No. of Bedrooms.............. ........_-------------Expansion Attic (1b) 'Garbage Grinder Wl p-, Other—Type of Building .....�© __-__-_-_- No. of persons____________________________ Showers ( ) — Cafeteria ( ) Q' Other fixtures ---------------- w Design Flow-----:...mod_________________________gallons per person per day. Total daily flow................_4 _0.__..........gallons. WSeptic Tank—Liquid capacity/ gallons Length_ _. ..... Width..5�.-�._._ lliameter__._....__.____ Deptil---------------- x Disposal Trench—No..................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-----, ......._.. Diameter..........4...... Depth below inlet-------------------- Total 1 chiiig area_,,?'0-__----sq. ft. Z Other Distribution box ( ) Dosing tank ( )-- 2 _13- 76 . /'C -- aPercolation Test Results Performed bY.......................................................................... Date--------------------------------------- ,� Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water-..----._._-.__-__--.. 44 Test Pit No. 2___-.-.____•..__minutes per inch Depth of Test Pit.................... Depth to ground water................---.---. p u t. `f f T 7... Description of Soil ©.' Y ....'' .. .. �' . - �.....-(: �l-u = .�1._L- Y U ••----------------------------- Via.�.l - ., --------------------------------------------------.........-•----. ------ w ------------------------------------------------------------------------------------------------------------------------------------------------- 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 Article XI of the State Sanitary Code—The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has Abeenis by thej4oiird �.igned. ---- `�---�� -----_`--- a r_. . �..-- Date Application Approved B / Date Application Disapproved for the following reasons------------------=---------- - --•-------..........-----•------------------•-•-...........-------•-•-•--- ..••---••-•----•-•-•--•----------•------------------------------•----------------••----------•-•----....... -------------- Date PermitNo......................................................... Issued........................................................ Date ----------------- -------�--------------- —__.__-------------------------------------------------------------- J 5 G3- 04; - 3S � -- .. � 1 o D � F ,0(SA)D /O o o GA,C. �A t3ox !�'oP �V o . P _4X8 AE,96W sz�g sv8 M y v w WIAe47 r�5 r Q G f Y 0 9 3 you GERTI FIED PLOT PLAN L0CAT10N: r�_ M/4 SCALE: / 3 0- DATE - _ //- g.Lf_zG R E F E R E N C E: )9,F/ A,)ri 4 O T- /y fI.,5 6h10 WAI D•v OX o9X; 600X ? 7 f 3 -s! .v.S r g a A E 1i ,W-G 145 7W D A T E I HEREBY CERTIFY THAT THE SUI LDIPJG R E G L AND SIJRvE � A SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORM TO rH E Z ON 1 N G BY - LAWS OF THE TOWN OF ass n ,p r' :% _'1PNZ4 _ W H E N CON 5 .t. I� U C f D + .' dII�' GEORGE yG LONil?,JR. �j � j F3AAN5TAElLF S (JRVI* Y C r) Ij 1► 1 IAt W F r t Y A R m '1 10 T p •a / `: (JVVV I No.......... ............. Flea.../v............. _ MASSACHUSET THE BOARD FHEALTH TS ............OF............ ............................................... Appliratinu -fur Ui.ipniittl 10orkii Towitrurtinu Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: / 1 ..........`Uf/%-- i..................' E' vey9.. �'..P/C/9G:/� i'!J r_ ......................................... /J Location,- ddress !f or Lot No. / �� ...............................................�� GU G�JI/"1990s/ .'�7 ..........................................................._................................ .---res....._'--- '-_._•___•___..__._..._....._.... .Owner Address Installer Address PQ Q ..Type of Building Size Lot. -?. "' ----- Sq. feet U Dwelling—No. of Bedrooms----------------2-__--_.__ __ Expansion Attic (' 2-) Garbage Grinder (/V�l a4 Other—Type of Building ______ __ _ __ No. of persons . Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- --- w Design Flow........... ..O........................gallons per person per day. Total daily flgw................... ------------gy WSeptic Tank—Liquid capacity of� allons Length... G.... Width... ..s_._ Diameter................ Depth...------------- x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area----_-_-____...___.-sq. ft. Seepage Pit No...... ......... Diameter........... ..... Depth below inlet.................... Total 194ching area------ p.....sq. ft. z Other Distribution box ( ) Dosing tank ( ) - 2 - A3- 76 - 14WC . aPercolation Test Results Performed bY.......................................................................... Date--------------------------------------- Test Pit No. 1................minutes per inch Depth of "Pest Pit.................... Depth to ground water..--_--..-_-_--.---_---. r3:4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-_.-..-_-____-._---_---- Q+' ^ ! - ------------ Description of Soil d. y ° S '(rle. . x /..Q - •�. ,..4- � - ------------------ -------------------------------------------------- w UNature 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 Article XI of the State Sanitary Code— The undersigned further agrees'not to ace the system in operation until a Certificate of Compliance has been issued by the�rd o hF;il'-h . igned__ ... ... .•• f (mil ' `Date / Application Approved BY--------- '� Date = Application Disapproved for the following reasons_____________________________ 7 _______ -----•.................."......................... . —-"'-- ..----------•----------'•-----------•-------•-------------------------------------------------------------------•---------------------•-------.•--•-------------------------------------•---•--•-------- Date PermitNo......................................................... Issued................ --------------------------•-------•---- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH 1 �� l G� LY U(mil/ Qrrtif iratr of fXlamphaurr T S T CERT That the Individual Sewage Disposal System constructed (�) or Repaired ( ) by - r l,�'l Ln -_� --9 '--'•------•""---'•--' -- ' \ ! Installer ------------------------- has been installed in accor nce with the provis' s of Article X of The State Sanitary Code as describee,1 t the application for Disposal Works Construction Permit No.-PF7- dated-.-.-_---3-`-.- `-- ./....... ... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE__-____ � .. Inspector.... .... _ THE COMMONWEALTH OF MASSACHUSETTS 76 BOARD OF HEALTH �jej � No. ......--- FEE-;•-•------ iAomtrurtionVamit Permtsston hereby gran ed_•-•�ir �----'----- --- --- ------------ to Constr cp ( ) or/I�'�epai ( ) �ij Ind'vi tal Sewage Disposa/ stem at No y --- ---- -------- ---'.... - / Street / as shown on the application for Disposal 1Vorks Construction Pee tf ,d;__ .?:_......_. Dated_._. ._.; to_.-7.G..... Board ofealth DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ASSESSORS MAP : 125 - -- - TEST HOLE: LOGS ' NOTES: PARCEL : 2G ^A ' �" �- Ly 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH FLOOD ZONE : SO I L EVALUATOR : �, 1y eLk 12S. C56 HIS PLAN, 1995 MASSACHUSETTS TITLE V & TOWN OF 3 C WITNESS : Nam' �CZ �I��p BOARD OF HEALTH REGULATIONS. REFERENCE: 131L fj(3$ DATE: MEZL!J )3 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, ° or lz PERCOLATION RATE:: c Z yk,� SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO CLSs T sD►L ' L;tr2= O-) vP�Qy INSTALLATION. �1 cIEtr 0 TH- 1 EL.W-1 TH-2 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION ��µl`7/ ONLY, AND SHALL NOT BE USED FOR PROPERTY LINE DETERMINATION. .,; SA-0t) I� 2 $� 5 4) ALL PIPING TO BE 4 .<SCHEDULE 40 @ 1/8 / FOOT. (UNLESS Lowy l �� SPECIFIED OTHERWISE) LOCATION MAP I4-T-S.) Sf 00 1 ��' 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A i C 34 F0 1-q7 GARBAGE DISPOSAL. G M EDI UN� e. 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) SIf►v� Sy Sl 0-13 MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON A BASE OF 6"OF CRUSHED STONE. 7.�_�XIST�.!t1C�__.CE.f�rf_P_r•75-?�..r3E. �UMPE,p�C�VS�D�_f}N©_._.._ I SEPTIC SYSTEM DESIGN — 9' �o__w�,t�_ �?.S__w LN--lso °� PR-���ED (,F►�tl..._ •__ O(L FLOW Es*r I MATE1/ 001' 3 BEDROOMS AT IIU GAL/DAY/BEDROOM - 33Z) GAL/DAY Sa. 3D SEPTIC TANK _ 13 330GAl./DAY x 2 DAYS - (06a GAL I \ . 1\ USE t I(7p GALLON SEPT I C TANK -FYtOA)C- 'P6Pt;Ac� w/ 6400 44t ��- G T' IF EA-ILEO) DAM�Ci� dRL-- I SOIL ABSORPTION SYSTEM v�►Q1zE�. � _ �x►ST7�4 t�'I U% (2) Syy 6A-erw4 Pe&-*Si l.F" cH*M 9fk5 rye w Iq ewd ftu, 5t r,�,-.: 2� 2' l SIDE AREA: ZS z +-Ci3�Z�k2 k 0. 7y \ Sjo# bwv �� BOTTOM AREA: ZS Y /3 ?6 Poo �3 4P4) rey SEPTIC SYSTEM SECTION v brr s >> iM '-K� (Ass VAO.P � &' of F,h►S Il l raadP Z G APT 4� 5L Dseox ►° AL 1o8.Z7 kfirst � 1�7� �7� L=Z to S 30 ! Mess - SEPTIC T K � 73a � ,, j i EKtS7�ti1� � � � - ! 1lLdtit o� 7�si��L� -3o N OF&"SS'9G' moo= A REN �, SITE AND SEWAGE PLAN Y LOCAT ION : /8 C�Ii�/ �e �avN�i T ��• 140 M�- To�6 AI/L s A4+ �018Tf SgNiTAR�Pa PREPARED FOR Wl ° SCALE: _ail � R�� c V y DARREN M. MEYER, R.S. W J z �� � SII� 43 VINE STREET RAN of DATE : .� LAN , I D UXB U RY, MA 02332 J 3 DJ l3u" -� hf;u� t c.4 t2LS DATE HEALTH AGENT (781) 585-0293 W Z ASSESSORS MAP : I213 TEST HOLE LOGS NOTES: PARCEL : 240 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH SO I L EVALUATOR : I , �S. C36 PLAN, 1995 MASSACHUSETTS TITLE V & TOWN OF 3 3 FLOOD ZONE: C WITNESS :�NUi vI, BOARD OF HEALTH REGULATIONS. S, REFERENCE: QV- 1513$ DATE: A S Zo'3 _ 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, R PCB 2�y PERCOLATION RATE : c 2 �,�,1� SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO CLASS T SOt 1, LTt�►2.= ()•)y v�d 2- INSTALLATION. mot.Sry �t ckrr TH- ( (,,�72.3 TH-2 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION NLY, AND SHALL NOT BE USED FOR PROPERTY LINE Ai�p IcjQ3/Z TERMINATION. L 1'-r S 4) AL PIPING TO BE 4" SCHEDULE 40 @ 1/8 "/ FOOT. (UNLESS p Loamy oy�s S CIFIED OTHERWISE) LOCATION MAP r�I T S. r`� 5) T DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A C ) 34'� P!�� �7 GAR AGE DISPOSAL. M ED►UM e G 6) SEPTI TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) (eV3 MUST B PLACED ON A MECHANICALLY COMPACTED BASE OR ON !� A BASE F 6"OF CRUSHED STONE. 7. _r xlsr� CEAGN.P_LTS 70 3E pu10PE-D 61?usffEp, t3ND T,lueV. /•Io G� aCiSt��0 g, �� � perv�-7�,�Z.(_S w �►� DSO I o� l�za��� CE�ctr SEPTIC SYSTEM DESIGN 9' _�lo__w�11,k�. --_w�1 nl_�5� v� PR_oP�tO Lr►�Gf/1�. . la)_/U v4rz-lam ._ ��-u�t Tl Tz.� 1-70.33 o FLOW ESTIMATE � BEDROOMS AT 110 GAL/DAY/BEDROOM GAL/DAY D� . 1 SEPTIC TANK i3 330GAI_/DAY x 2 DAYS - 60 GAL USE WV GALLON SEPT I C TANK -EXtS71A1 - ZEPLA4E, w/ /5� 01- �K- 1( \ � • �F Fftill.rt�� Dll•M�c� O1Z e I SOIL ABSORPTION SYSTEM ��� -�StzE+�• oa V t) G.%.2) 500 Q-LL04 P2frU4-S7- LF" CH*I 6f'F-S ` ry, i d 1 \ S !DE AREA: [�ZS)2- 4 (19 "7k2 k 0, 7y = /1Z .yg BOTTOM AREA: 25 /3 O, 7�/ x k So Lf4,n SEPTIC SYSTEM SECTION y v 2oJS off. I I 7.- NI,NN�tY-•IC. -rOF=73° - — � _._.__. _ o a C Ec 7/- 72 (Ass vlv� k Kj' N. lo''of irodPX4 ..__------._-- a 68.3v 1/�►-it------ - 77 QCYJ GAL D-BOX fig,! CT F- cl / G -�-- IoB,Z� (r.�l°`PSS SEPTIC TANK 67. WoshA SfwiP �.p I<-- Z5'Lx Q'W k 2 ID OFA4gSs9 SITE AND SEWAGE PLAN D E M LOCATION : / C417�711,v De Tegf o. 40 M�25T0/JS "ILLS� 0 S4NITAP0 PREPARED FOR : eDWAPID K-W O V o C p SCALE DARREN M. MEYER, R.S. J DATE :�,3 RAN or L+�N�� D � SI,$I 43 VINE STREET u DUXBURY, MA 02332 DATE HEALTH AGENT (781) 585-0293 W Z ASSESSORS MAP : I2 TEST HOLE LOGS t NOTES: PARCEL : 2. 1) THE INSTALLATION MUST BE IN SUBSTANTIAL COMPLIANCE WITH `� 4I FLOOD ZONE : (! SO I L EVALUATOR : T), Wool' 1115. -THIS PLAN, 1995 MASSACHUSETTS TITLE V & TOWN OF --T WITNESS : Nam' BOARD OF HEALTH REGULATIONS. 3 R�av�IP.�fl REFERENCE : 131E DATE: 2) THE INSTALLER SHALL VERIFY THE LOCATION OF UTILITIES, PERCOLATION RATE : c 2 `^ y�,f� SEWER INVERTS AND SEPTIC COMPONENTS PRIOR TO x� CS�> z So�L L7J�►2- 0 �� �P ��y INSTALLATION. C ckilr 0 TH- I E-72.3 TH-2 3) THIS PLAN SHALL BE USED FOR SEPTIC SYSTEM INSTALLATION L.C)Aµ�r I ONLY, AND SHALL NOT BE USED FOR PROPERTY LINE 1��D / DETERMINATION. I y 4) ALL PIPING TO BE 4" SCHEDULE 40 @ 1/8 "/ FOOT. (UNLESS (�y�-s�(, SPECIFIED OTHERWISE) LOCATION MAP(�.T.S.) CI me: 1v M 2.SY r/ 5) THE DESIGN OF THIS SYSTEM DOES NOT ALLOW FOR THE USE OF A s �u SAWY �O��l3 GARBAGE DISPOSAL. e C (,qlj 6) SEPTIC TANKS AND DISTRIBUTION BOXES (WHEN INSTALLED) I21'' --�2 22 MUST BE PLACED ON A MECHANICALLY COMPACTED BASE OR ON M A BASE OF 6"OF CRUSHED STONE. C. 3 S�r1fl 2.Sy7/ ;( ,.b3 7. ..EXr�_ Ef (74 g ►u�D.. ���? 7'rz.a_v. 8. o xNo� Ppeiu-m S._w11A) t� orgy pkap�� �L_-__ _M. __... y��/ Q _w_�TL9�>7S w t��s� SEPTIC SYSTEM DESIGN _>� - - - - -- � I-7O'33r FLOW ESTIMATE o - �O,ram----F�'4�'T�---P�--�'1�?�s 3 BEDROOMS AT 00 GAL/DAY/BEDROOM - 330 GAL/DAY ��� REMDye AW UIvSytTk&Z S01L 5_+4R0vN0 c,E4-C4 Sa. ,fir -to EL, Z.2-z oje-icy° o p C3 L,� '[-�3 _ SEPTIC TANK 12 -- �2. zoP_To P 330GAL/DAY x 2 DAYS - (060 GAL 1 \ COF C3 Lt`YcL USE ( pfXp GALLON SEPT I C TANK -EX/VhAJq I�._PGAz-_E w/ ))!;00 GM- T4',JIL n L 0 7— IF- FPrILEO bAmA�co a2 SOIL ABSORPTION SYSTEM a _12jj(2) SUO ►��u>n/ Pepsi _ram Cti �vt a£�25 (1• \ � btJ�1..1.I Nl1 ,.� j �a U,�� ''�' S"t-(�n,1� c�nl n l.w SI��s �5'L%�t iy k ti'11 I IDE AREA: / �ZS� 2 +-�i3�Z�k2k p. 7q i BOTTOM AREA: 25 x /3 u O, 7t/ SEPTIC SYSTEM SECTION '33C> 4w red �iq. rtoF-73° -- -- _ (Ass ul* �__, �' ,�h+s+7 Ufa _7?.. _�``J 411 NCB T C 68, 77 �saox Ib L7 GAL loB.Z� ter i_sf �1 I� 1 q (o S. SEPT I C TANK ll�ress) g Ex/57.7/J ./i2 l isle ,8 Washed Sl w,e �-- 25 1L x s"OFMAS SITE AND SEWAGE PLAN EN LOCATION : / /} E R cn too. 1140 MA-(26TO1JS P/LL S A4+ t SA1VITA0'N PREPARED FOR : fj� 0 r (�� I` ��ir✓ CALE: / I= � �u y DARREN M. MEYER, R.S.RSN o1r G�N�� Da-�� 5��$Iss 43 VINE STREET DATE: S-�3 ul DUXBURY, MA 02332 Rev. lO-/7 03 /ew Sor j C / Qu,I,60 Kf_ i / C�4 12LS DATE HEALTH AGENT (781) 585-0293