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Home My WebLink About0061 CEDAR TREE NECK ROAD - Health 61 Cedar Tree Neck Road Marstons Mills A= 075-015 I `� tide�� 1 �� -��7 �� Page 1 of 1 McKean, Thomas From: Steven Sheftel [stevensheftel@gmail.com] Sent: Thursday, July 09, 2015 10:38 AM To: Health Cc: 'John Abodeely' Subject: Attn: Tom Re: 61 Cedar Tree Neck Road, Marstons Mills -Conditional Pass Title V Inspection Report Dear Torn, Thank you for talking to John Abodeely with regard to our home. I have attached a copy of the inspection report for your use. And at your convenience, if necessary, I will meet with you to discuss. I am asking that, pending adding the missing tee and replacing the Dbox that my system be given.a Title V pass. See notes below. Thank,you for your consideration, Steve cell 508-364-3400 email stevensheftel 113 M�� ar Page'3 of the report (p.20 at top of g — )J Broken pipe= pipe is not broke . There is a missing tee in one of the pits. Tee needs to be �/ ad ed. I ag'reee) 2. Page 3 of the report (p.20 gat top of page) — D box needs to be replaced and if any of the related pipes are indeed broken replace them. agree. 3. Page 9 of the report (p.26 at top of page)- "Piping is 4" PVC SCH 40 and SCH-20. Need to replace SCH-20 lines." The schedule 20 lines are in good condition. No breaks, no cracks, no blockages (viewed with a camera). I ask that this be `grandfathered' allowing the schedule 20 lines be allowed to remain and not replaced with schedule 40 lines. Replacing will require removal of asphalt drive and a lot of excavation (lines are approximately 4' below grade). 4. Page 1 of the report (p.30 at top of page)- 'Pit 3, under paving is H-10. 1 ask that this be `grandfathered'. The pit is 45" below grade, is/was (empty with) "clean walls and bottom like new". It is located in a section of paving that is rarely driven or parked over and there are no signs of compaction in the drive. It is like new. 7/9/2015 Jun 23 15 08:18p p .18 Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 61 Cedar Tree Neck Road — Property Address Elaine Shefiel -�- Owner Owner's Name information is MarstonsMitts MA 02648 6-1?-15 required for eatery City/Taam State Zip Code Date of Inspection page, inspection results must be submitted on this torn.Inspection forms may not be altered in any way.please see completeness checklist at the end of the form. Important:When A. General Information �0%%11r'rt,i1111 filling out forms �``r�4f��\�OF t'4,q �i�� on the computer, use only the tab Inspector: •'yG 1. 4o;' key to move your JAMES_�: cursor-do not James D.Sears use the return Name of Inspector key. CapewideEnterprises,t.t.0 rrt..... -- . . - Company Name ,ff��i,��•s.•I N 5'PtGO```� rffi utrntn 153 Commercial Street npta�`�`� Company Address Mashpee MA � 02649 _ Citylrown Stale Zip Code 508-477-8877 S 1623 Telephone Number License Number B. Certification —� 318 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 15.0001.The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 6-22-15 peciaes Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection, If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. '"*This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system wtti perform In the future under the same or different conditions of use. t51ns.3113 Title s OFfical Inspection Form:Sub5Wuce Swaps Disposal system•Page t of 17 Jun 23 1508:19p p.19 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments kvi 61 Cedar Tree Neck Road Property Address Elaine Shefiel owner Owners Flame information is Mansions Mitts MA 02648 6-17-15 required for every page. Citylrown state Zip Code Date of Inspection B. Certification {cont.) inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: Con Pass D Box Lines H-10 Pit The system is a 1500 Gal.Tank D Box and three pits. B) System Conditionally Passes: ® One or more system components as described in the'Conditional Pass'section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Check the box for"yes',"no' or"not determined" (Y, N, ND)for the following statements, If"not determined," please explain. The septic tank is metal and over 20 years old"or the septic tank (whether metal or not)is struclurally unsound,exhibits substantial infiltration or eAltration 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. El Y C1 N ❑ NO(Explain below): t511is•3i13 TWA 6 WNW InspecUon Fomc&bout%ce so+ep►Dispowl Sy Mom•Pape 2 of 17 Jun 23-1508;19p p.20 " r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System FOrm-Not for Voluntary Assessments 61 Cedar Tree Neck Road Propeny Mdress Elaine Shefiel Owner Owner's Name information is Marstlons Mills MA 02648 6-17-15 required for every CityfTovrt► gee Zp Cade Date of Inspection page. B. Certification (cont.) ❑ Pump Chamber pumpstalarms not operational. System will pass with Board of Health approval If pumpslalarms are repaired. 8) Systern Conditionally Passes(cunt.): ® 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 ins -ap of Board of Health): ® broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): c /❑ removed ❑ Y 0N ❑ ND(Explain below). ® distribution box is leveled or replaced ❑ Y ❑ NRND(Explain below): Need to replace D Box-Need to replace lines. Need to repla H-10 it in drive way or remove that part of drive way, ❑ The system required pumping more than 4 limes a year due to broken or obstructed pipe(s).The system will pass Inspection if(with approval of the Board of Health): ❑ broken p1pe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(plain below): C) Further Evaluation Is Required by the Board of HeaRh: ❑ 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 xb)that the system is not functioning In a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 60 feet of a surface water ❑ Cesspoof or privy is within 50 feet of a bordering vegetated wadand or a salt marsh � 1s'rn•Y13 Title 5 OWN wapecuan Fam:Stb me 3"Age Oia I SAWR•Papa 3 CO 17 Jun 23 15 08:19p p.21 commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 61 Cedar Tree Neck Road -- Property Address Elaine Shefiel Owner Ovmer's Name information is MarstonS Mitts MA 02648 6-17-15 r required for every Marsto State Zip Code Date of Inspection page. B. Certification (cunt.) 2. System will fall 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 khan 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 or ondin of effluent to the surface of the round or surface waters Discharge p g g due town overloaded or clogged SAS or cesspool ❑ Static liquid level in the distribution box above outlet invert due town overloaded or clogged SAS or cesspool ❑ Liquid depth in ceeepeal is less than 6"below invert or available volume is less than Y2 day flow A T t5ine•31i� Tdle 6 Min%trispo6on Form:Subsurface Sewage Disposal Syctern•Page 4 of 1T Jun 231508:20p p.22 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name Infomatim is Wrstons Mills MA 02646 6.17-15 required for every Cgy/Town state Zip Code pate of Inspection page. B. Certification (cunt.) 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 i cf 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 anrrronte nitrogen and nitrate nitrogen is equal to or lean then 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 20009pd- 10,0009pd, Q The system ta,ails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fags.The system owner should contact the Hoard of Health to determine what VAl be necessary to correct the failure. E) Marge Systems: To be considered a large system the system must serve a facility with a design How of 1o,000 gpd to 15,000 gpd. For large systems,you must indicate either"yes"or'no'to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply 0 ❑ 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 11 of a public water supply well If you have answered'yes"to any question in Section E the system is considered a significant threat, or answered°yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department t5lns.3n3 Tithe s Ofiad Inspection Porte Owsudew Somw DiepaW SYd'P29e 5 or 17 Jun 23 15 08:20p p.23 Commonwealth of Massachusetttts Title 5 Official Inspection r n F p to Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road P►opedy Address --- Elaine Shefiel Owner Owners Nerve equire twn ad far every r Mafstuns Miffs MA 02648 6-17-15 require page. City/town Staha Zip Code Dale of Inspection C. Checklist Check if the following have been done.You must indicate"yes°or"no`as to each of the following: Yes No -® ❑ Pumping information was provided by the owner, occupant.or Board of Health ❑ ® Were any of the system components pumped out In the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(if they were not available note as N/A) Was the facitity.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 it different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and locatlon of the Soil Absorption System(SAS)on the site has been determined based on. ® ❑ Existing information. For example,a plan at the Board of Health. ❑ ® Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)) D. System Information Residential Flour Conditions: Number of bedrooms(design): NA Number of bedrooms(actual): 6 DESIGN flow based on 310 CMR 15.203(for example: 110 9pd x*of bedrooms): 660 Bin•313 TWO 6 0McM Mpsotlon FOM;Mourfem S Dii ewep� p vasl S yshm•Pepe 8 or 17 Jun 23 15 08:21 p p.24 Commonwealth of Massachusetts Title 5.4ffcial Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owners Name information is Marstons Mitts MA 02648 6-17-15 required for every page City('fown State Zip Code Date:of Inspection II D. System Information Description: s The system i a 1500 tank- D Box and three pits. 2 Number of current residents: Does residence have a garbage grinder? ❑ Yes No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes No information in this report.) Laundry system inspected? ❑ Yes 0 No Seasonal use? ® Yes ❑ No - Water meter readings, if available (last 2 years usage(gpd)): 2013-32,000GaI2014-32,000Gai's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Date Present CommerciallIndustrial Flow Conditions: Type of Establishment: — -� Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: M—W-3M 3 TNIe 5 Orficlel Inspeclion Forrm Subsurfram Sewage DisPosA Systom-Page 7 of 17 - Jun 23 15 08:21 p p,25 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 6-17-15 page. CityfTown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 08112 _-- Was system pumped as part of the inspection? ❑ Yes Z 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 0 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 l/A.system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5 na•3113 T-Wo 5 Of cid RMaWat Fwni:SdwAfara Sewage Oispwl System•-Page 8 of 17 Jun 23 15 08:22p p,26 Commonwealth of Massachusetts W Title 5 {official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments _ 61 Cedar Tree Neck Road property Address Elaine Shefiel Owner t"wn Name information is Marstons Wits MA 02648 6-17—f 5 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: 1980 and pit 1996 permit # 96-332 _,-- Were sewage odors detected when arriving at the site? ❑ Yes No Building Sewer(locate on site plan): Z Depth below grade: feet Material of construction: ❑cast iron Z 40 PVC other(explain): Distance from private water supply well or suction line: fly Comments(on condition of joints, venting, evidence of leakage, etc.): Pipein is A" PVC SCH 40 and SCH -20. Need to replace SCH -20 Lines. Septic Tank(locate on site plan): 150 Depth below grade; Material of construction: concrete ❑ metal ❑fiberglass ❑ polyethylr ne ©other(explain) If tank is metal, list age: -- years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Gal PrecastH-10 Sludge depth: 1" 15i is•3'S3 ,'tale 6 omcial imspociion Fours subs olaos Sewage NuposW sy"m rage 9 of 17 Jun 23 15 08:22p p•27 $� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road _ Property Address Elaine Shefiel Owner Owner's Name information is Marstans Miffs MA 02648 6-17-15 required for every page. CV Town State Zip Code Date of Inspection D. System Information (cunt.) Septic Tank(cost.) Distance from top of sludge to bottom of outlet tee or baffle NA Scum thickness 1" Distance from top of scum to top of outlet tee or baffle NA Distance from bottom of scum to bottom of outlet tee or baffle NA How were dimensions determined? Asbuflt-Tape Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage.etc.): Tank at working level.Tank and covers at 15" below grade_ Inlet tee, No outlet tee or baffle. No sign of leakage or over loading. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle - -- Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Data t5ft•Yt s TW*5 MW Mm ediwt Forth:Subarfma Smops D4pmd Sydem•Page 10 of 17 Jun 23 1508:23p p.28 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Forth -Not for Voluntary Assessments _ _61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner GwnePs Name information is Marstons Mitts MA 02648' 6-17-15 required for every state' Zip Code Date of inspection page. CityfTown 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: l Material of construction: concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons - —_ Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order ❑ Yes ❑ No Date of last pumping: oate� Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•W13 I MIS 0 omaei timpv i g"rw„',G.n.—r—w...e.07opo.N 0�.4—•t+.g.+i.4 4� Jun 2315:08:23p p•29 N Commonwealth of Massachusetts Title 5 Official Inspection Form MW Subsurface Sewage Disposal System Form -Not for Voluntary Assessments UV s 81 Cedar Tree Neck Road Property Address . Elaine Shefiel Owner Owner's Name informationis required for every Marstons MPfds MA 02648 6-17-15 Pam• Clrylrown State Zip Code Date of InspecHa► . D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box, etc.): D Box is Wx21"-2' below gradewltwo tines out Weirs are gone, Need to replace box. Pump Chamber(locate on site plan): Pumps in working order. ❑ Yes ❑ No' Alarms in working order. ❑ Yes ❑ Nor Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.): •If pumps or alarms are not In working order, system is a conditional pass. Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5-M•al l's re 5 Officid inWadian Form.&tmnram sewage Disposal SyAwn•Pop 12 d 17 Jun 231608:23p p.30 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owners Name information is Marstons Mitts MA 02848 6-17_-15 requirpage- for every CitylTown state Tap Code Date of Inspedion p�- D. System Information (cant.) Type: ® leaching pits number: 3 ❑ leaching chambers number. ❑ leaching galleries number. ❑ leaching trenches number,length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number ❑ innovativelalternative system Typetname of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding, damp soil,condition of vegetation,etc.).- Leaching is three H-10 Precast Pits.( Pit 01) 1000 Gal.pit at 38"below grade w/cover at 21"dry. (Pit*2) 1000 Gal. pit at 5'below grade w/cover at 101'dry w/clean bottom and wall's like new. (Pit*3) 4'pit at 45"below grade wlcover at 20".Dry clean walrs and bottom We new. Note:H-10 Pik in drive way. Note: Pit needs to be replaced w/H-20 leaching or that part of drive way must be removed. Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): / r 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 a No MW•3013 Title 5 Olfi W inW@=n Faun:5u6aurtaw:ewepe Di og,- l plem•Pape 19 of V i Jun 2315 06:23p p.31 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Pmperty Address Elaine Shefiel Owner Owner's Name require for is a Mammon Mills MA 02648 6-17-15 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.): Isles•3119 Zltle 5 OtTiasl Mynctfon Force SOsuAOu Sarpe Oiepd?41 System•Pepe 14 d T7 I Jun 23 15,08:24p p.32 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments i 61 Cedar Tree Neck Road Property Address Elaine Sheffel Owner Owners Name information is Marstons Milis MA 02648 6-17-15 required for every state Zip Code Date of inspection page CitylTown D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two pemtianent 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 i TNb 6 cffW6W Inapecd7p fam:Subaurow.wwaps DldvmM Systam•Pops 16 of 17 pins•3n3 Jun 2315 08`.24p p.34 Commonwealth of Massachusetts Title 5 Official Inspection Form b Subsurface Sewage Disposal System Form•Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is Marstans Mills MA 02648 _6-17-'15 ` required for every _..._ _._._ Page. CityrTown State Zip Code Date of Inspection D. System Information (cant.) Site Exam: ❑ Check.Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Na Estimated depth toFigh ground water. feet - --- Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date Observed site (abutting propertylobservation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Rear of lot drop's of 25+. Bottom of pit #2 at 11'. _ Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Turn 5 official hspodon Fonn:Sifturiace Sewage ntspcsal System-Page 16 d 17 Jun 231.5 08:25p p.35 CommonweaM of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Corner. Owners Name required Fo is Marston$Mills AAA 02648 6-17 15 required for every page. Cityrrown Slate Zip Code Date of lnspedan E. Report Completeness Checklist ® Inspection Summary.A, B, C, D, or E decked ® 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 Birm•W3 Tifla 5 Offldd h paWon farm Subwrfaca Sawepa Dspasal Sym m•Pape 17 of 17 Y �V _�. 14 ila r f ,lk _ 1 1 ' (57' U10 � _r 16 w ; 1 cn cal lzlr� go t' e7 it tr `% C:1 Q 6 ZI A ££'d dt Z:80 9 L £Z unf Message Page 1 of 2 McKean, Thomas From: McKean, Thomas on behalf of Health Sent: Wednesday, July 15, 2015 9:51 AM To: 'Steven Sheftel'; Health Cc: 'John Abodeely' Subject: RE: Attn: Tom Re: 61 Cedar Tree-Neck Road, Marstons Mills-Conditional Pass Title V Inspection Report Good Morning, 1 talked to Mr. Sears, the certified septic system inspector this morning. You are correct; the pipe was not cracked. Therefore the piping does not need to be replaced. However, the distribution box does need to be replaced as you stated in your e-mail. In regards to the existing leaching pit located underneath the driveway, the Board of Health adopted a policy in 2013 which requires the inspector to"conditionally pass" an inspection if an H10 component is discovered beneath a driveway or parking area (please see attachment). Mr. Sears indicated that he suggested to you that you could shorten or relocate the parking area or driveway in such a way(i.e. install barriers)that no vehicle will have access or the ability to drive over the existing H-10 septic system component. This is one of the options provided in the Board's policy. If you should have any additional questions or would like to discuss this further, please feel free to call me at 508 862-4644. Sincerely, Thomas McKean -----Original Message----- From: Steven Sheftel [mailto:stevensheftel@gmail.com] Sent: Thursday, July 09, 2015 10:38 AM To: Health Cc: 'John Abodeely' Subject: Attn: Tom Re: 61 Cedar Tree Neck Road, Marstons Mills - Conditional Pass Title V Inspection Report Dear Tom, Thank you for talking to John Abodeely with regard to our home. I have attached a copy of the inspection report for your use. And at your convenience, if necessary, I will meet with you to discuss. I am asking that, pending adding the missing tee and replacing the Dbox that my system be given a Title V pass. See notes below. Thank you for your consideration, Steve cell 508-364-3400 email stevensheftel@gmail.com 7/15/2015 Message Page 2 of 2 1. Page 3 of the report (p.20 at top of page) — Broken pipe — pipe is not broken. There is a missing tee in one of the pits. Tee needs to be added. I agree. 2. Page 3 of the report (p.20 at top of page) — D box needs to be replaced and if any of the related pipes are indeed broken replace them. I agree. 3. Page 9 of the report (p.26 at top of page)- "Piping is 4" PVC SCH 40 and SCH-20. Need to replace SCH-20 lines." The schedule 20 lines are in good condition. No breaks, no cracks, no blockages (viewed with a camera). I ask that this be `grandfathered' allowing the schedule 20 lines be allowed to remain and not replaced with schedule 40 lines. Replacing will require removal of asphalt drive and a lot of excavation (lines are approximately 4' below grade). 4. Page 1 of the report (p.30 at top of page)- Pit 3, under paving is H-10. 1 ask that this be `grandfathered'. The pit is 45" below grade, is/was (empty with) "clean walls and bottom like new". It is located in a section of paving that is rarely driven or parked over and there are no signs of compaction in the drive. It is like new. I . 7/15/2015 ._r No. k-�� Fee e 00 ` THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplitation for -MispoBal *pstpm Construction Permit Application for a Permit to Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address or Lot No. (p I CLz6Ak- kjX C4.1f,'RD Owner's Name,Address,and Tel.No. Assessor's Map/Parcel �i Installer's Name,Address,and Tel.Ao. Designer's Name,Address,and Tel.No. upew oa a 6"TMP&Sc- /A Type of Building: Dwelling No.of Bedrooms Lot Size sq.8. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) PAT Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of He Signed Date Q Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued No b t 1 ' _. Fee t o o t '_ Entered in computer: r / i" THE COMMONWEALTH OF MASSACHUSETTS Y� PUBLIC HEALTH DIVISION -"TOWN OF BARNSTABLE, MASSACHUSETTS 21ppliLation for Disposal 6pstem Construction Permit �. Application for a Permit to'Construct( ) Repair(X Upgrade( ) Abandon( ) ❑Complete System Individual Components r Location Address or Lot No. (p 1 Cr/��tR1'�,�N45cu.RD Owner's Name,Address,and Tel.No. C(,46 JG S)4CFTEc.TR. Assessor's M4p/Parcel Q-7 0 I C� M� (o t CeD IL TXG5 054k— RD (�'( Installer's Name,Address,and Tel.No. 508-q 7 T-$S 77 Designer's Name,Address,and Tel.No. C.4P�w1� ttp�s� z' tJ/A Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required), gpd .Design flow provided gpd Plan Date Number of sheets Revision Datey Title ~ Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) j i w Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system-in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of He Signed Date C1 ;Q 1 Application Approved by b Date Application Disapproved by Date for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( x) Upgraded( ) Abandoned( )by 52 — a C G pQt-5 at�/ ��' (.P..,�F �—Z_U_AD Mn has been constructed in accordance c� with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer O&p 6-W 106" G P"'T'6WA JS'6C L 4� Designer N #bedrooms Approved design flow gpd The issuance of this/pe it shl not be construed as a guarantee that the system will tic s design . Date �/ f (� Inspector ' Kr No. Fee � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction Permit Permission is hereby granted to Construct( ) Repair(X) Upgrade( ) Abandon( ) tt/' System located at C Et)xp- -T-� M e-G.6C k©.E1 M P-5 my S L"`l CGS 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:Construction /must be com leted within three years of the date of this permit.Date Ct Approved by 1�/\ ,YN,— �S -----Original Message----- From: McKean,Thomas On Behalf Of Health Sent: Wednesday,July 15, 2015 9:51 AM To: 'Steven Sheftel'; Health Cc: 'John Abodeely' Subject: RE: Attn: Tom Re:�61 Cedar Tree Neck Road, Marstons Mills-Conditional Pass Title V Inspection Report Good Morning, I talked to Mr. Sears, the certified septic system inspector this morning. You ar-e-correct;_the-pipe_was-not-cracked. Therefore the piping does not need to be replaced. However,the distribution box does need to be replaced as you stated in your e-mail. In regards to the existing leaching pit located underneath the driveway, the Board of Health adopted a policy in 2013 which requires the inspector to"conditionally pass"an inspection if an H10 component is discovered beneath a driveway or parking area(please see attachment). Mr. Sears indicated that he suggested to you thai you could shorten or relocate the parking area or driveway in such a way(i.e. install barriers)that no vehicle wi I I have access or the ability to drive over the existing H-10 septic system component. This is one of the options provided in the Board's policy. If you should have any additional questions or would like to discuss this further, please feel free to call me at 508 862-4644. Sincerely, Thomas McKean t '' Jun 23 15 08:18p p.18 Commonweatth of Massachusetts Title 5 Official Inspection Form 111 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road -.._....___ Property Address V Elaine Shefiel _._. _.._...____._....... . _.... ._.— _— Owner Owner's Name b s-t�-information os o2sY€a — -- required for evey Mamtns Mitt __. __._....._ —._..._— M SSats _ Zip Code Date of Inspection page, Citytrown inspection results must be Submitted on this form.inspection forms cnay not be altered in any way.Please see completeness checklist at the end of the form. —.................. �_ t: important:when A. General information filling out forms `�o•�``�j1 pF on the computer, va�Y QC use only the tab 1. ItmS Cior: o`:' key to move your a' JAMES cursor-do not ,lames D.Sears '�' � use the return -- - __....._ -_�_--_St=Aries —�� Name of inspector key, CapewldeEnterprises,LLC' o :'4 ___..._ ._......_ � ..... � # Company Name '' ,� 1 N S � . 153 Commercial Street Corppany Address Mash Q2firi 9 MA -- _._ _..... i Clty(rown State Zip Code r } 508-477-8877 Te .._... S1623 — ___.....-----...._....... iephone Number — License Number Q. Certification i certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site j 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 23 Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 6-22-15 peclors Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority I Board of Health or DEP)within 30 days of completing this inspection, If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform fn the future under the same or different conditions of use. i tWIS 3113 'title 5 cffi�a,inspeoian S'fz e •POQp 1 e 17 Jun 231508:19p. p.19 Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name IM d frr every n is requireaired MamOns Mills AAA Q2648 6-17-15 pop. CRylfvwn State Zlp Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E f always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 16.304 exist.Any failure criteria not evaluated are Indicated below. Comments: Con Pass-D Box-Lines-H-10 Pit.The system is a 1500 Gal.Tank D Box and three pits. S) System Conditionally Passes: ® one or more system components as described in the'Conditional Pass"section need to be replaoed or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Check the box for"yes%"no-or'not determined' (Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old"or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent System will pass f Inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. "A metal septic tank wid pass Inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 2D years old is available. Q Y 0 H Q NO(Erkplairt below): t311aS•3n 3 TWa 6 OlGaid Inq*c ion Fa i Subwdaco Sewp6 Oisgosd System•Pape 2 al 17 Jun 2315 08;19p p.20 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Addnes Elaine Shefiel Owner Owners Name informadon is Mansions Mift MA 02648 6-17-15 required for every We Zip Code Date of Inspection page. Ckyrrown B. Certification (cant.) ❑ Pump Chamber pumpslalarms not operational. System will pass with Board of Health approval if pumpslalamns are repaired. B) System Conditionally Passes(cunt.): ® 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 wi11 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): (deed to replace D Box-Need to replace lines. Need to replace H-10 pit in drive way or remove that part of drive way. !: ❑ 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): t ❑ broken pipes)are replaced ❑ Y ❑ N ❑ ND(Exp)ain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): s 1 Y 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 f 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 ' 15.30XI)(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 ❑ Cesspoor or privy is within 5o Beet of a bordering vegetated watlend or a salt marsh IQlM•3r13 Tltla S 011Iad kwpedian Fam:SLbarnWA Serm9a aispoael"am-Pape 3 of 17 1 {r t f s Jun 23 1508:19p p.21 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road —...._............._............ _.._._. property Address ElaineShefiei .._....._ _ —..__.___ ._._.____—...__..._ _ ---._._..._._. .... Owner 6Wners Name information is Marstons Mills MA 02648 � n-4 7-15 ____._.�......_.__._......... required for every page. CilyrTown State Zip Code Date of Inspection B. Certification (cunt.) 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. Q 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 weir*. Method used to determine distance: ........_ ........._._....._._ _..— ................._.. "This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal cofiform 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 atteched 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 Q . 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 eawpsel is less than 6"below invert or available volume is less than Yz clay flow /°i T -- IS-%•3113 ?01e 6 ORioat ancpec5on FOm:SUtbUrfaca Sewapo piSFQSa!Sy%*r,n•Pap 4,11 If Jun 231508:20p p.22 °Commonwealth of Nfiassachusetbs Title 5 Official Inspection Form tSubsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Addrm Elaine Shefiel Owner OwnefsName information is MafstvnsMills MA Q2646 6-17-15 required for every ckylrown State Zip Code Oats of InweWon page. B. Certification (cunt.) Yes No ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipets). 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 cf a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. i ❑ ® 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 systan passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence 4 of anrr warm nitrogen and nitrate nitrwen is equal to or leas thfsn 5 PPS*, provided that no other fallure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] 3 The system is a cesspool serving a facility with a design flow of 2000gpd- � ® ,o,oaogpd. ❑ The system ails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fads. The ` system owner should contact the Board of Health to determine what will be necessary to correct the failure. i E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 apd to 15,000 gpd. For large systems,you must indicate either"yes"or"no'to each of the following, in addition to the questions In Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department t5ins.W raw s ofriciai ins Famr"suttee Saaage Deposal System-Page 6 of 17 Jun 231508:20p p.23 Commonwealth of Massachusetts F; Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not fur Voluntary Assessment& 61 Cedar Tree Neck Road Pmedy Address Elaine Shefiel Owner Owners Nsme Iftmw is required Marston Mills MA 02648 6-17-15 required for every page. City/rows stab: Zip Code Dade of Inspection C. Checklist Check If the following have been done.You must indicate'yes'or"no'as to each of the following: Yes No ® ❑ Pumping information was provided by the owner,occupant.or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(if they were not available note as N/A) ® ❑ Was the facility,or dwelling inspected for signs of sewage back up? ® ❑ Was the site Inspected for signs peel stg of break out? ® ❑ Were an 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 infoormation on the proper maintenance of subsurface sewage disposal systems? The size and locatlon of the Soil Absorption System(SAS)on the site has been determined based on. ® ❑ Existing information. For example,a plan at the Board of Health. ® Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distanoe is unacceptab)e)(310 CMR 15.302(5)) D. System Information Residential Flour Conditions: Number of bedrooms(design): NA Number of bedrooms(actual): 6 --- -— DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 660 G t5irlt•3l13 TWO 6 McIM VIAIMtlaa Fa M 56ftUrf**S Die �'ea� D Gael S 1^sbm•Pepe 5 0117 Jun 23 15 08:21 p p.24 Commonwealth of Massachusetts r Tine 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address ElaineShefiel _......................__............_. ....................._ ._................—........ Cromer Owner's Name information is MA 02648 8-17_45 required for every rVtaratoriS�1r4YNS _.........-.._.._...._... Page. CityfTown State Zip Code Date of Inspection D. System Information Description: The.systern is a 1500 tank-D Box and three pits_ - _.... _...__ --........._-- __....._—._..... 2 _ Number of current residents: - — Does residence have a garbage grinder? ❑ Yes No -; Is laundry on a separate sewage system?(include laundry system inspection ❑ Yes Qj No information in this report.) t Laundry system inspected? ❑ Yes I?C—j No '< Seasonaluse? Z Yes ❑ No DGal Water meter readings, if available (last 2 ears usage d 2013-3, 0 OGal' g Y 9 (gP ))� 2014-32,000GaPs t. Detail* .._.............. _ _ t K Sump pump? ❑ Yes ® No Last date of occupancy Present . ___... . Commercial/Industrial Flow Conditions: Type of EstabCtshment: _._.. .__._._...____ __ ___ _... ............ Design flow.(based on 310 CMR 15.203): ............................-_.._ ......._......__...................... Gallons per day(gpd) Basis of design flow(seatsipersons/sq.tt., etc.): __,—..____.............................................._..... __ _.. Grease trap present? ❑ Yes ❑ Nc Industrial waste holding tank present? ❑ Yes [] No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: — - ------ Giro-W13 Ti to 5 Olfioa;inssxNwxn form Sobs.lc j Sewopo Disposal Systorn,P vac ci, t Jun 23 1508:21p P. Commonwealth of Massachusetts T Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck road Property Address Elaine Shefiel Owner _....._ Owner's Nerve information is i+�arstnrts Millsrequired for every MA 02648 6-17--15 page. City/Town --- __ State Zip Code Date orinspection D. System Information (cons.) Last date of occupancy/use: Date ._............_..__—__.._... ----...... Other.(describe below): General Information Pumping Records: Source of information: 08112 Was system pumped as part of the inspection? ❑ Yes Z 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 11 Overflow cesspool ❑ Privy ❑ Shared system(yes or no) (if yes,attach previous inspection records, if any,, ❑ InnovativelAlternative 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): 15ift5-3N3 TAb 5 Offkc d krvaaico rx-:Su)&X-we Sewage(YicNl7tai systxm•Pa{;5 a of 17 - t i Jun 23 15 08:22p p.26 Commonwealth of Massachusetts - Title v Official Inspection Form - Subsurface Sewage Disposal System form -Not for Voluntary Assessments 61 Cedar Tree Neck:Road Property Address Elaine Shefie( - -- Owner Owner's Name. mquirdfo a Marstlons Wits MA 026�48 6-17-15_ _ requ'ned'forevery __, : � _....................._ _. —........._ ___....... _...—...__.__- page. C1tyfrown State Zip Code Date of Inspection D. System information (cont.) Approximate age of all components,date installed (if known)and source of information:. PP 9 1980 and pit 1996 permit # 96-332 —......._._._.__._. Were sewage odors detected when arriving at the site? ❑ `des No Building Sewer(locate on site plan): 2' Depth below grade: s.._.-. __._... ._.....___....__ ,eet Material:of construction: ❑cast iron ®40 PVC other(explain): _.._.............._...J_..................... _-..---_---- Distance from private water supply well or suction line: t -.........-_._......._.... —......... Comments(on condition of joints, venting,evidence of leakage, etc.): Pi eiN is Q"PVC SCH 40 and SCH -20.. Need to replace SCH -20 Lines. ,.................__............................__..... .........--.... 1 Septic Tank(locate on site plan): f ti 1 g Depth below grade: reet ...... _.____.....____._.........___.__.___..._.----__.._..... ( Material of construction: ®concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) ..................... _ __.............._..................................._...__.__.. If tank is metal, list age: _____........................ _ years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Gal Precas`H-10 Sludge depth: 1 - t$t�s.yt� Title 5 0 tG sl irtspmfirn Fomc 5ursw4am Sawapu lJ V—A rynem•Page 9 c!17 Jun 2315 08:22p p.27 $� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address, -- Elaine Shefiel Owner ownees Nam f information is t required for every MarstonsMitfs MA 02848 6-17--15 is page. CVTown state Zip Code Dale of Inspection D. System Information (cons) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle NA ffl Scum thickness Distance from top of scum to top of outlet tee or baffle NA Distance from bottom of scum to bottom of outlet tee or baffle NA How were dimensions determined? Asbufit-Tape Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integn-ty, liquid levels as related to outlet invert,evidence of leakage.etc.): Tank at working level.Tank and covers at 15" below grade. Inlet tee, No outlet tee or baffle. No sign of leakage or over loading. Grease Trap(locate on site plan): Depth below grade: feet — Material of construction: ❑concrete ❑metal ❑fiberglass ❑polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle _ -- Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t31rs ] TW*5 OftW Iropedion Form:S%&W.9f a Sexape D4pwd Sydom•Pape 10 of 17 Jun 231508:23p p,28 Commonwealth of Massachusetts ion Fora Title 5 Official Inspect _ ✓'.,,.' Subsurface Sewage Disposal System Form Not for Voluntary Assessments 61 Cedar Tree.Neck Road ........ 1. P ro perty Address ElaineShefiel —..............___.. ........ . ._....:............_- __ owner owner'sNar** infon-nation is fNarstx+rts Mitts MA 02648 6-17-15 required far every ... _ _ ....... _ 'Zip- page City/Town Slate Zip Code Date of Inspection D. System Information (cons.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): . —............__ ............... Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: _ .. .._.__. __.__.M.._._.._......................... Material of construction: ❑.concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: —.-......... Capacity- gallor►s n Flow _......... Design gallons per day Alarm.present: ❑ Yes ❑ No Alarm level: --------....... Alarm in working order ❑ Yes [ ] No Date of last pumping: o8i�..._. ....._._ __..�_...__ ........... .... _ .._ , Comments(condition of alarm and float switches,etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes C Nu 1 t5inb 3111 "r,ttt D O(8t]Ef e,xmuan!'w rt,.A.A.au.fwa Cv..cpo Diayo.o±C�>�«...,•oflo s�{17 Jun 2315 08:23p p.29 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel _. Owner Owners Name information is requilred Marstons Wis MA 02648 8-17-15 for every CiWrown State Zip Code Date or Inspection D�System Information (cost.) Distribution Box(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.): D Box 1s lWx2't'-2'below grade wftwo tines out waits are gone, (deed to replace box. 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.): 'If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS)(locate on site plan,excavation not required): If SAS not located,explain why: LSB,3n3 rds S Olri W hwad'on Fam:sdbasoace sewage oisposal SyAlm•Pepe 12 d 17 xll �g7 id e� 1 Jun 231508:23p p.30 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel owner owners Name Wormationfo is Marstons Wis MA 02648 6-17-15 required for every — pae. City/rown State Zip Code Date of Inspedlon D. System Information (cunt.) Type: 9 ® leaching pits number. 3 ❑ leaching chambers number. ❑ leaching galleries number. ❑ leaching trenches number, length: p r ❑ leaching fields number, dimensions: '1 D Cl overflow cesspool number. r ❑ innovativelaiternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding, damp soil, condition of vegetation,etc.); Leaching is three H-10 Precast Pits.( Pit#1) 1000 Gal.pit at 38"below grade w/cover at 21"dry. (Pit#2) 1000 Gal. pit at 5'below grade w/cover at 10"dry wlclean bottom and wall's like new. (Pit#3) 4'pit at 45"below grade wlcover at 20".Dry clean wairs and bottom like ne�.v. Note:H-10 Pit in drive way. Note: Pit needs to be replaced w/H-20 leaching or that part of drive way must be removed, i Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): r. Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of consiruction Indication of groundwater inflow ❑ Yes ❑ No t5be-303 Tdo 5 OMW inapocbm Form:5ubsuderw-:awape Mvpwal System•Pape 13 of 17 ,• I I Jun 2315 06:23p p.31 Commonwealth of Massachusetts Title 5 Official Inspection Form %bsurfat:e sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property AWdress Bain Shefiel owner Owners flame required a Atarsibris Miffs MA 02648 6-17-15 required for every page. cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): Privy(locate on site plan: Materials of construction: Dimensions - d Depth of solids Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): Wns•W3 TM @ B 0WdW 1 Al,n Foam swa+rwe Ssage DipOLri Sytlem•Pppe 14 d 17 J Jun 2315 08:24p p.32 E i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage p � Disposal System Form-Not for Voluntary Assessments lug .61 Cedar Tree Neck Road t Property Address Elaine Shefiel Owner Owners Name irrfom+aWn is Marstons Hills MA 02648 6-17-15 required for every page. cityrrown State Zip Code Date of Inspection D. system Information (corio 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 UMS•3111 Ties 6 015"Unpicks"Fam:Suaffiud a+'rawm pe Dboo A SYMM•Papa 16 o1 17 C M i t c-6 = G/ y a N � aD O 0 • _ Jun 23 1508;24p p.34 Commonwealth of Massachusetts Title 5 Official Inspection Farm Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 0 61 Cedar Tree Neck Road P oparty Address Elaine Shefiel Owner Cwner's Name information i required for every, Marstons Mills MA 02648 6-17715 _..........._......_.. page City/Town State Zip Code Date of Inspection 4 D. System Information (cunt.) r Site Exam: ❑ Check Slope 3 ❑ Surface water ❑ Check cellar Irl s Q Shallow wells N� 25'+ Estimated depth tough ground water, feed. .._..._ Please indicate all methods used to determine the high ground water elevation: 0 Obtained from system design plans on record If checked, date of design plan reviewed: 1. ate_ ._...... _._.. —._..........._......_................... ® Observed site(abutting propertylobservation hole within 150 feet of SAS) ' ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Rear of lot drop's of 25'+.. Bottom of pit #2 at 11', Before filing this Inspection Report, please see Report Completeness Checklist on next page. tqm•M3 oispuai system•Pa po,6 d 1? Town of Barnstable Barnstable SHE Tp�� y Board of Health j�;�a�j * nArs�S-ranr:e, - O D s639. y MASS. �a 200 Main Street, Hyannis MA 02601 $ArfD MAt `� 2007 OFFICE: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi Steven & Elaine Sheftel, 61 Cedar Tree Neck Rd, POB 399 MM email:stevensheftel@gmail.com ACKNOWLEDGEMENT OF RECEIPT: July 24, 2015 We have received your submission to the Board of Jkleafth. Re: 61 Cedar Tree %eck_W d, 9Vlarstons Miffs — asking for an appeafon a Conditional Wass of a Titfe V inspection. Thankyou. Your item will be heard at the Board of Health Meeting on the: Date of: Tuesday, August 18, 2014 Meeting Location: Town Hall, 367 Main St, Hyannis Hearing Room, Second Floor Time: 3:00—6:00 P.M. Approximately three days prior to meeting, an agenda will be sent out to you— once it is available. It will also be available on line at the town website: www.town.barnstable.ma.us Go to ..."Boards & Committees > Board of Health - or- Go to Official Agendas Q:\AGENDAS BOH\let Receipt of BOH Submission 61 Cedar Tree Rd MM Aug 2015.doc L w PAGE 1 OF 2 Town of Barnstable aAxrisrnai.e. Board of Health ►' MASS. y z634 �Ar fD �A 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 November 30, 2015 Mr. Steven Sheftel 61 Cedar Tree Neck Road Marstons Mills, MA RE: 61 Cedar Tree Neck Road/ Hearing Regarding Conditional Pass, Septic System Inspection Report A=075=015 Dear Mr. Sheftel, This matter came before the Board of Health upon your request, in regards to your existing septic system located at 61 Cedar Tree Neck Road, Marstons Mills, Massachusetts. Specifically, the issue discussed was the leaching pit located beneath a portion of your driveway. This H-10 leaching pit was not constructed of heavy duty (H- 20) iloading. Therefore, a "conditional pass" inspection report was submitted by to the Health Division from Mr. James Sears on June 17, 2015, in accordance with Board of Health Policy#2012-005.. As is discussed more fully below, after holding a hearing on August 18, 2015 and reviewing the evidence, the Board voted to deny the request to approve the septic system in its existing state with an H-10 component beneath the driveway. Background Information This parcel is owned by Elaine Sheftel, Trustee. The parcel is 1.96 acres in size. This parcel is assessed at a value of $2,217,200. According to the engineering plan which-was attached to the original Disposal Works Construction Permit #80-616, one of the two leaching pits was designed to be installed beneath the driveway. The installation occurred on April 8, 1981. Board of Health Policy The Board of Health Policy# 2012-005, requires a DEP Certified Inspector to deem a septic system as "conditional pass" whenever an H-10 system component is discovered beneath a driveway. Q:\WPFILES\Shefte161 CedarTreeNeckRoad2015.doc f PAGE 2 OF 2 Various options are provided within the Policy including relocation or blocking off the affected portion of the driveway/parking area, replacement of the leaching pit with an H-20 leaching component, or relocation of leaching component outside of driveway area. Discussion The applicant stated that the affected portion of the driveway is not regularly used; it is used infrequently as a turn around area. However, the Board voiced concerns in regards to unknown future uses by heavy vehicles (i.e. a moving truck). After careful consideration, the Board voted to deny your request to maintain the existing H-10 leaching pit in place (as-is) beneath the driveway. Sincer y, GG� W ne Ma ler, M.D., Chairman BOARD OF HEALTH TOWN OF BARNSTABLE UPDATE: It is noted the driveway "turn-around" area was removed from the area of the 'affected leaching pit and the according to the septic system inspection report dated October 7, 2015 by'James Sears; the system now "passes" inspection. QAWPFILES\Shefte16I CedarTreeNeckRoad2015.doc s r 7 m Commonwealth of Massachusetts 6f v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments i`.mtl ,M 61 Cedar Tree Neck Road Property Address _711 Elaine Shefiel V_;, Owner Owner's Name ' information is required for every Marstons Mills MA 02648 10-7-15 page. City/Town State Zip Code Date of Inspection a' C,..7 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:When A. General Information 1111/44 on l the compng out uter, 51# 11 22, ��``\`��H CF rA44, use onlythe tab �`y� •'• .9 1. Inspector: key to move your a O;' '•�G cursor-do not James D Sears JAMES m use the return Name of Inspector =;5'. ;�„ key. Capewide Enterprises, LLC �'•.o o: Company Name 153 Commercial Street ��i� �/INSP��G`\\`p Company Address Mashpee MA 02649 City/Town State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 10-7-15 spector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. V5 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal Sys em•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The system is a 1500 Gal. Tank D Box and three pits. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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 ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 r Commonwealth of Massachusetts w - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 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 aniggAmM is less than 6" below invert or available volume is less than '/day flow #P17s— t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 r Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments '�M s 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® 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 water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 I I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): NA Number of bedrooms (actual): 6 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 660 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M !61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. City/Town State Zip Code Date of Inspection !D. System Information Description: The system is a 1500 tank- D Box and three pits. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonaluse? ® Yes ❑ No Water meter readings, if available last 2 ears usage d 2013-32,000Gal g ( y g (gp )) 2014-32,000Gal's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 08/12 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M s 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1980 and pit 1996 permit#96-332 2015 New D Box. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 2' 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.): Pipeing is 4" PVC SCH 40 and SCH -20. Septic Tank(locate on site plan): Depth below grade: 15" feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Gal. Precast H-10 Sludge depth: 1" t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) 29" Distance from top of sludge to bottom of outlet tee or baffle OilScum thickness 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 18" How were dimensions determined? Asbuilt-Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank at working level. Tank and covers at 15" below grade. Inlet tee, Outlet tee. No sign of leakage or over loading. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments GSM , 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 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 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D Box is 16"x21"-2' below grade w/two lines out. Box is new 2015/cover at 6". 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.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts w - Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments G1M ,5'r 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 3 ❑ 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.): Leaching is three H-10 Precast Pits. ( Pit#1) 1000 Gal. pit at 38" below grade w/cover at 21" dry (Pit#2) 1000 Gal. pit at 5' below grade w/cover at 10" dry w/clean bottom and wall's like new. (Pit #3)4' pit at 45" below grade w/cover at 20". Dry clean wall's and bottom like new. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 61 Cedar Tree Neck toad Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 111-1101 In 97 5� C sBAR ll?FE /N£ck- "Pzl r Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells N0 Estimated depth t high ground water: 25'+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Rear of lot drop's of 25'+. Bottom of pit#2 at 11'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 10-7-15 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 i t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 r 8/11/2015 Re: 9/18/2015, Sheftel, 61 Cedar Tree Neck Rd., Marstons Mills Dear Dr. Miller and members of the Board I am appealing the Conditional Pass of the Title V inspection done at our home, 61 Cedar Tree Neck Road, Marstons Mills. The inspection was done by James Sears of Capewide Enterprises and is dated 6/22/2015. I was present during the inspection. 1. On page 3 of the report(P. 20 at the top of page) - The report incorrectly indicates a broken pipe. There are no broken pipes, this was verified by Tom McKean. See copy of email attached . 2. Page 3 of the report(P. 20 at the top of the page) - D box needs to be replaced. Agreed, it will be replaced. 3. Page 9 of the report(P..26 at the top of the page) - Replace schedule 20 piping. The schedule 20 piping is in good condition, is quite deep. No breaks, no cracks, no blockages. I ask that this be Grandfathered allowing the schedule 20 lines to remain. 4. Page 12 of the report(p. 30 at the top of the page) - Pit under paving is H-10. This pit is approximately 45"below grade, is empty "with clean walls and bottom, like new". It is located in a section of driveway that is rarely driven or parked over and there are no signs of sagging in the area. Under the Commonwealth's 310 CMR Department of Environmental Protection regulations this would pass. Under the (new) Town of Barnstable's regulations passed in 2013 an inspector must give it a `Conditional Pass". I ask that this pit be Grandfathered allowing the pit to receive a Pass. The system has three pits. The pit and paving is part of the original system installed and approved in 1981, (I had the third pit installed when we purchased the house in 1989/1990). Per the inspection report, (page marked P.30 at the top)the pits are in `like new' condition, two have "dry w/clean bottoms . . . like new . . .". There is nothing wrong,the top of the pit is quite deep, has no depressions in the paving, is in like new condition, has compacted soil over it including 3 to 4" of compacted stone dust with 3 plus inches of asphalt. Removing the asphalt and replacing it with grass will decrease the strength. Please put yourselves in my place. "If it is not broken do not fix it." (And my grandchildren will be able to shoot baskets.) Thank you for your consideration, Elaine and Steven Sheftel 508-428-4113 cell 508-364-3400 ` Enclosures: Copy of Title V report; Copy of email from Tom re: pipe not broken; Photos t a' Town of Barnstable s Re ulatorY Services De artme URNST"M MAW 1639. Public Health Division �1� 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richa" FAX: 508-790-6}04 Thomas CERTIFIED MAIL# 7014 1200 0001 0358 4985 August 4, 2015 Elaine 1. Sheftel %Elaine I. Sheftel Family Trust 61 Cedar Tree Neck Road Marston Mills, MA 02601 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located at 61Cedar Tree Neck Road, Marstons Mills,MA was last • inspected on 6/17/2015,by James D. Sears, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system."Conditionally passes" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Need to replace Distribution-box • Need to replace SCH—20 lines. • Need to replace H-10 pit in driveway Also, due to the fact that the leaching area is located underneath the driveway,the new leaching pit must either be H-20 load bearing/or relocated to an area other than the driveway. The septic system must be repaired within one (1) year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. P ER OF T BO OF HEALT A • Thomas McKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Conditionally Passes Ltr\61 Cedar Tree Neck Rd MM aug 2015.doc IKE r, Town of Barnstable Barnstable ASA9LE. : Board of Health j 9. a 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 FAX: 508-790-6304 October 9,2012 Revised November 20,2013 Public and Environmental Health Program Policies,Procedures,and Guidelines H-10 Components Discovered Beneath Parking Areas and Driveways During Septic System, Inspections Conducted Under 310 CMR 15.301,State Environmental Code,Title 5 No.2012-005 When a DEP certified inspector discovers an H-10 septic system component located beneath a parking area or driveway during a septic system inspection, conducted under 310 CMR 15.301 State Environmental Code Title 5,the system shall be deemed as a "conditional pass." The :system owner will then be ordered, by the Board of Health,to correct this problem within two(2) years and will be provided several options to rectify the issue, including by: a.) replacing the septic system component with a new component relocated into another area of land which is not beneath any parking area or driveway, and properly abandoning the discovered H-10 component; or by b.) replacing the septic system component with an H-20 component beneath the parking area or driveway, and properly abandoning the discovered H-10 component, (or in the case of leaching pit, replacing the top of the leaching pit with an H-20 slab top); or by c.) relocating the parking area or driveway in such a way that no vehicle will have access or the ability to drive over the existing H-10 septic system component. If it is unknown whether or not a particular system component which is located beneath a parking area or driveway, is H-10 or H-20 (for example: a leaching pit is locatedbeneath a paved driveway without an accessible steel cover to grade and there are no records on file indicating whether the system component is H-10 or H-20),the system shall also be deemed as a "conditional pass". In this case,the seller must make the potential buyer(s)aware of the "conditional pass" status,the unknown construction of the septic system component(s), and it's safety concerns. Wayne Miller,M.D. Paul Canniff,D.M.D. Junichi Sawayanagi Q:\POLICIES\H 1 OComponentsBeneathDriveways&ParkingAreasRevised2O 13.doc IKE fps, Town of Barnstable i EARNS[A8LC Apr b 9 A,.� Regulatory Services Department fa nw'� Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO Feb 6, 2007 Rev. 7/6/15 DEADLINES TO REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x" marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA � Discharge or ponding of effluent to the surface of the ground ❑ Pumping more than 4 times during the last year not due to clogged or obstructed pipe. I- Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Any portion of the SAS, cesspool, or privy,below high groundwater elevation ❑Any portion of the cesspool within a Zone 1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool SAS An "conditionally assed systems" broken cover,re o n of a pipeCelocation S of a driveway due to H-10 components, e ❑ Leaching pit or cesspool with high liquid level, <12"below inlet(per Town Code §360-9.1) OTHER e ace. COW k6x R.-pair deadline:_ Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc r 802015 Parcel Detail MASS GG Logged Tit As: Parcel Detail Monday, Augusr:3 2015 Parcel Lookue Parcel Info Parcel ID 075-015 Developer Lot LOT 1 Location 61 CEDAR TREE NECK Pri Frontage 246 Sec Road Sec Frontage village MARSTONS MILLS Fire District C-O-MM Town sewer exists at this address NO Road Index 0264 r Asbuilt Septic Scan: ? Interactive Map 075015_l v Owner Info Owner SHEFTEL, ELAINE I TR CO 0 canerELAINE I SHEFTEL FAMI Streetl 61 CEDAR TREE NECK Street2 City MARSTONS MILLS State MA Zip 02648 'Country Land Info Acres 1.96 use Single Fam MDL-01 zoning RF Nghbd�0118 Topography Level Road Paved utilities Public Water,Gas,Septic( Location Waterfront,Excel View Construction Info Building 1 of 1 Year Roof Ext Built 1981 Struct Gable/Hip Wail Clapboard J Living Roof AC 4706 Asph/F GIs/Cmp Central Area Cover Type Style Modem/Conte mp Wall nt Plastered J RoomsBed 6 Bedrooms Model Residential Int Floor Carpet Bath Rooms 4 Full-1 Half Grade Luxury Total j Type 'Hot Air j Rooms 9 Rooms � Stories 2 1/2 StOrl@S _j Fuel Gas eat _„�F ation Poured Conc. Gross 10138 Area Permit History Issue Bate Purpose Permit# Amount Insp Bate Comments GAS 6/30/2006 Generator 20061587 GENERATOR 3/1/1990 Swimming Pool B33630 $20,000 11/M5/1992 12:00:00 MM SW.POO http://issq 12/intranet/propdata/ParcelDetai1.aspVID=4553 1/3 Jun 23 15 08:18p p.18 � P d767- d` Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage'Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address -0 Elaine Shefiel ` Owner Owner's Name information is Marston Mitts MA 02648 6-17-15 required for every State Zip Code Date of Inspection page. Cityfrown 4 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:When A. General tnformatior� filling out forms + `` ,, .. I'+1gs_ on the computer, �'' use only the tab 1. Inspector: key to move your JAMES = = cursor-do not James D Searsuse the return Name of Inspector key. , CapewideEnterprises,LLC —'��.. .. . . ' �, Company Name 1NSPEG�.�°r 153 Commercial Street Company Address ,ffi,a Mash ee MA 02649 .._ City/Town State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ❑ Passes ® Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 6-22-15 ,;170spedors Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-3113 Title 5 Ofriclal Inspection Form:Subaurram Sawape Disposal System•Page 1 of 17 r Jun 23 15 08:19p p.19 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments , yY 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 6-17-15 page. CityfTown State Zip Code Date of Inspection B. Certification (cunt.) Inspection Summary: Check A,B,C,D or E f always complete all of Section D A) System Passes: ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: Con Pass- D Box-Lines-H-10 Pit The system is a 1500 Gal.Tank D Box and three pits. 13) System Conditionally Passes: ® One or more system components as described in the'Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not)is structurally 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): t5irtS•3113 Title 6 Official Inspection Forth;Subsu$ace Sewage Disposal System•Page 2 of 17 Jun-2315 08:19p p.20 Commonwealth of Massachusetts MMQ� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name informationis required for every Marstons Mats MA 02648 6-17-15 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumpslalarms are repaired. 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): Need to replace D Box-Need to replace lines. Need to replace H-10 pit in drive way or remove that part of drive way. ❑ 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): ❑ broke, pipe(s)are repJaced ❑ Y ❑ N ❑ ND(Exp)ain beJow): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated watland or a salt marsh t5ins•3r13 Title 5 Olfidal Inspedion Form:subsurface sewage Oisposal system•Page 3 of 17 Jun 2315 08:19p p.21 Commonwealth of Massachusetts Title 5 Official Inspection Form - o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is Marston Milts MA 02648 6-17-15 required for every state Zip Code Date of Inspection page. CitylTown B. Certification (cunt.) 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 mospiml is less than 6°below invert or available volume is less than %day flow Xi T t5ins•3113 Title 5 official Inspection Fars Subsurface Sewage Discosal System•Page 4 of 17 r Jun 23 15 08:20p p,22 . <L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is MA 02648 6-17-15 l�arstnns Miltsrequired for every State Zip Code Date of Inspection page CRylTown 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 cf a public welt. ❑ ® 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 enrrnonia nitrogen and nitrate nitrogen is equal to or less then 5 pprn, 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 faits. 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"non to each of the foftowing, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department t5ins 3113 Title 5 Official Inspection Fond:Subsuifece Sewage Disposal System•Page 5 of 17 Jun-23 15 08:20p p.23 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Miffs MA 02646 6-17-15 page. Citylrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as NIA) ❑ Was the facility.or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on. ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)) D. System Information Residential Flow Conditions: Number of bedrooms (design): NA Number of bedrooms(actual): 6 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 660 t5ins-3113 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Jun 23 15 08:21 p p.24 -7 Commonwealth of Massachusetts Title 5 Official Inspection. Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel _ Owner Owner's Name information is required for every Marstons Mills MA 02648 6-17-15 page. CdYrTow^ State Zip Code Date of Inspection D. System Information Description: The system is a 1500 tank- D Box and three pits 2 Number of current residents: Does residence have a garbage grinder? El Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes 0 No Seasonal use? !� Yes ❑ No Water meter readings, if available (last 2 years usage(gpd)): 2013-32,000Gal 2014-32,000Gal's Detail: Sump pump? ❑ Yes ® No Last date of occupancy-. Present iDate Commerciallindustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Lins-3/13 Title 5 Official Inspection Form Subsurraoe Sewage Disposal System.Page 7 or 17 Jun 2315 08:21 p p.25 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owners Name require reqationuired e every Marstons Mills re wired for eve MA 02648 6-9 7-95 page. Cityrrown State Zip Code Date of Inspection D. System Information (cant.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 08112 r Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank,distribution box, soil absorption system ❑ Single cesspool Cl Overflow cesspool ❑ Privy j ❑ Shared system (yes or no) (if yes,attach previous inspection records, if any) ❑ InnovativelAlternative 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 ❑ 'Fight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•113 Tift 5 Official tnspedlon Form:Skdmdace Sewage oisposal System•Page 6 of 17 r Jun 23 15 08:22p p.26 Commonwealth of Massachusetts Title 5 Official Inspection Form — Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel — Owner Owner's Name information is required for every Marstorts Miffs MA 02648 66 17,15 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 1980 and pit 1996 permit # 96-332 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 2' 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.): Pipeing is 4" PVC SCH 40 and SCH -20 Need to replace SCH -20 Lines. Septic Tank(locate on site plan): Depth below grade: Material of construction: ®concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Gal Precast H-10 Sludge depth: V 15iis-3l13 Title 5 Cdlicial Inspection Form Subsurface Sewage Disposal System-Fago 9 of 17 Jury 2315 08:22p p.27 Commonwealth of Massachusetts. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road _ Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02646 6-17-15 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (oont.) Distance from top of sludge to bottom of outlet tee or baffle NA Scum thickness 1 Distance from top of scum to top of outlet tee or baffle NA Distance from bottom of scum to bottom of outlet tee or baffle NA How were dimensions determined? Asbuilt-Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tank at working level.Tank and covers at 15" below grade. Inlet tee, No outlet tee or baffle- No sign of leakage or over loading. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle -- Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t51n5.3/13 - Title 5 Official Inspection Form:Sub3urface Sewage Disposal System-Page 10 or 17 Jurr 23 15 08:23p p.28 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is Marstons Mills MA _ 02648 6-17-15 required for every state Zip Code Date of Inspection page. CitylTown 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.): i i p Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity_ gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No tsins•3113 i me 7 omciai mapawgri rani.0%,to rro 11 ogo oiap000l 07-•Poe*11 of 47 Jun-23 15 08:23p p.29 Commonwealth of Massachusetts M Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstons Mills MA 02648 6-17-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): j D Box% Wx2i"-2' below grade wltwo tines out.Walfs are gone, Need to replace box. i i 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.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: tSns•3113 Tide,5 Official t-spedion Form.Subwrface Sewage Disposal System•Page 12 of 17 Jun-23 15 08:23p p.30 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name requiredifo a Marstons Milts LIRA 02648 6-17-15 required for every _ page_ Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number. 3 ❑ leaching chambers number: ❑ leaching galleries number. i ❑ 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.): Leaching is three H-10 Precast Pits.( Pit#1) 1000 Gal.pit at 38"below-grade w/cover at 21"dry. (Pit#2) 1000 Gal. pit at 5' below grade w/cover at 10"dry w/clean bottom and wall's like new. (Pit#3) 4'pit at 45"below grade w/cover at 20".Dry clean wall's and bottom like new. Note: H-10 Pit in drive way. Note: Pit needs to be replaced w/H-20 leaching or that part of drive way must be removed. I Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction -- Indication of groundwater inflow ❑ Yes ❑ Na t5ins.3113 Titre S Official Inspecton Form;Subsurfac.;:swage Disposal System•Page 13 of 17 I. Jun-23 15 08:23p p.31 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner owner's Flame information required for every Marstons Mills MA 02648 6-17-15 page. City/rown 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.): i i i 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.): 15ins•3A 3 Title 5 Official Inspection Form:Subsurface Sew w Disposal Systern•Page 14 of 17 r Jun•23 15 08:24p p.32 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments LV- 61 Cedar Tree Neck Road Property Address Elaine Shefiel Owner Owner's Name information is required for every Marstnns Mitts MA 02648 6-17-45. page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately r i 151ns-3113 Tile 6 M(cial Inspection Form:Subsurra 9ewape 0icpasa1 System•Pepe 15 of W IN , (Y) 0 '7 3- If co O Lo IP D Ju n.23 15 08:24p p.34 Commonwealth of Massachusetts Title 5 Official Inspection Form .law �s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 61 Cedar Tree Neck Road Property Address Elaine Shef-iel Owner Owner's Name information is required for every Marstans Mills MA 02648 6-17-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar s ❑ Shallow wells NC 254 Estimated depth toGgh ground water: feet feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting propertylobservation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Rear of lot drop's of 25'+. Bottom of pit #2 at 11'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3M3 Title 5 Official Inspection Form:Subsurface Sewage Dispcsal System-Page 16 of 17 li Jun•23 15 08:25p p.35 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 61 Cedar Tree(deck Road Property Address Elaine Shefiel Owner Owners Name information is required for every Marstons lirfills MA 02648 6-17-15 page. C411rown 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 i t5ins-3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 17 of 17 elaine & steven sheftel 61 cedar tree neck rd. po box 399 marstons mills, ma 02648-0399 MR 075-015 y I , r c. 508-364-3400 stevensheftel(a.gmail.com July 24,2015 Dr. Wayne Miller Town of Barnstable Board of Health 200 Main St. Hyannis,MA 02601 .Via Email—Sharon.Crockergtown.barnstable.ma`:us D.-ar Dr. Miller, I hereby request that I be put on the August 18t' agenda to appeal a Conditional Pass of a Title V inspection done at our home. Sincerely, Steven Sheftel Y S Z" 3 M No......!!_/4(0....... .,. Fss. .............. THE C004ONWEAL7H OF MASSACHUSETTS BaOAR� �O. F HEALTH Appliration for Disp.aiial Marks Tomitrurtinn ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: . .... D. ...`T ...._ .. ......... .... 1.......P_ 1u�P-1-V.............. ati n- d ss o t No. er - ` Addres a W ..............••---•-•..........................-••-----••--.........._......_........•- Ins ler Address QType of Building ''7� Size Lot............................Sq. feet U Dwelling ZNo. of Bedrooms............... ... ----------------------Expansion Attic Garbage Grinder U '4 Other—Type e of Building No. of persons....................... ... Showers — Cafeteria t4 YP g P ( ) ( ) aOther_'iygrres -------------------------------------------------------------- W Design Flow...........................................gallons per person per day. Total daily flow----------- ...... _ ............gallons. WSeptic Tank—Liquid capacit)..%:5 allons Length................ Width................ Diameter---------------- Depth..............- Disposal Trench—No............... Width.._........_....... Total Length._................. Total leaching area....................sq. ft. ( ( ) � Seepage Pit' No........_.._____.... D' eter----�.�____._._. Depth below inlet.._..-.......... Total leaching area.�..3�.sq. ft. Z Other Distribution box �1 Dosingtank Percolation Test Results Performed by-------------------------------------------------------------------------- Date----------------------v -••---..... -.-- Test Pit No. 1----• -......minutes per inch Depth of Test Pit-------i.�_....... Depth to ground water___r�_____:b''.// fT Test Pit No. 2................minutes per inch Depth of Test Pit.....1J......... Depth to ground water...0 ✓'.l� ------------------------------••. •••••-----••....................-o -- j................................................. o Description of Soil------ :1.........L.O.- ---- -�1j ...-="---.9 .........140.1.Lew. ... cxj _ _� UNature of Repairs or AJr/ati:o�n —Answer when applica le------------------------------------------------------------------------------------------------ ----------------------------•-------------------------------------------------------•---•--------------•-------------------------------------------------------------------------------------._.....••-. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TT . g g p y of the State Sanitar Code The undersigned further agrees not to lace the system in operation until a Certificate of Compliance ha een iss / t and of alth. f j / l Sign .. -• -- -•-------------------•-•--------•------...-•---------- ---._.(.d��/.�.... Date PP PP y••. r- r Application Approved B -- - ----- -=--- ----- - •--- - - - ------------ -----1-�_",�.�`.------ ---=- Date Application Disapproved for the f ecrwefiS: .................................... ,Aw Date JY PermitNo-----------------••-•----•-..._ Y!� _ Issued....................................................... Date No........................ - FEs............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD— OF HEALTH Appliration for Uiiipooal Workfi Tonitrnrtion ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at _ .. =" ocatio Ad ress ,.� «g ,J` i or-Lot No, .......................`F" G k.........-!_r►"- ...... ................. Owner AddresAY W Installer_ " Address Q Type of Building '' - I Size Lot............................Sq. feet V Dwelling x ;of Bedrooms.............. ......................Expansion Attic (40,:0 Garbage Grinder Other,—Type of Building ............................ No. of persons....................... Showers ( ) — Cafeteria ( ) QOthers fixtures -----------------------------------•------------------•••----•-----•••---••••••••••-•------••--•-•-••••••••••••••••••••-•_._......-•--•••..........-- WDesign Flow..........:. .-..._..._._..__._._...._ _gallons per person per day. Total daily flow----------- �:.r ---- WSeptic Tank—Liquid*capacit} ':ZZ.gallons Length.............L. Width................ Diameter._______-__.._-- Depth.....__.._...._. x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No ........ D,iameter.._. .:'---------- Depth below inlet.....: ............ Total leaching area...:......_f; sq. ft. Z Other Distribution box (,_-) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I...�=n_.....-_minutes per inch Depth of Test Pit_...._.L._..____.. Depth to ground water._.......`....�. fY4 Test Pit No. 2................minutes per inch Depth of Test Pit_____Z_.............. Depth to ground water.._["_c.: O Description of Soil.....� e/-7 L.,,A-evl rr " = - .! , , r, t.. rl; n I_U."T " ,- x .... ---•••---- V ----•-•••••-•••••-••-••••••••---••---••----•--••-•--•-•-•••••-•-•••••••--•-....-••-•••--------••--••--•-•••••---•-----------•------•••-•----•-----•-•-•-•••---------•-•.................••-•---------- W -------------------------------------------------------------------------------------•----------------------------------------------------------------------------------------•-••------------•---•--- V 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 T T �" p 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. -� �4ed ) . 6-. Application Approved By......................................... ate Date Application Disapproved for the following reasons:................................................................................................................ ..••••.......-•••--•----•-------------•----•-•-•--•--•••-----•••••-••••••....---•-----•--....-••---••••_.••••••••---•-•-•--•••••••--••••-••-••••...--------••••-••••-•••-•----•------•--•----•-••••••--- Date PermitNo................................-----------------........ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEH/, f .................................I........OF..........................................I...... .............................. %Trrtifiratr of TI-ImpliFanr G-- _ THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ) .:•- :.. by �= �` ;r .' = ` -) -------- -;7f' r ... //G -(s�i 7 ns •(er' _ 1!J 1 at. -----••--•-•-•-•-•-•---••••-••--••••-------------------•----------•-------•---•-----•- has been installed in accordance with the provisions of T I :F �'of Zrhe State Sa.nitary.bid-e.�s de'sc4il�_ d•in the application for Disposal Works Construction Permit No---------------.......................... dated-......... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM W14 FUNCTION SATISFACTORY. DATE ... F.- �........................................... Inspector.................................. .........................:a..... THE COMMONWEALTH OFMASSACHUSETTS ' BOARD �'F �HEALtTI1'—�.r �} /l i ......................................0 F..................................................................................... No......................... FEE........................ Disposal Worb To Eton ramit Permissionis hereby granted.................... .: . ............••---•••--• ••• •--••------•-----•-•••-••-••......•-•-----•-•..............._-•-•-•--•--•... to Construct { ) or Repair ( ) an Individual Sewage Dispo Systemlp 1 as shown on the application for Disposal Works Construction/—Permit No--------------------- Dated....f�_._._�.�:-� C....... � J l r oard of"Heal `y _,. . DATE ;... ---•••�D------•-•-------------------------•••-•-•-•-.._..... 61 FORA :I255 HOBBS & WARREN, INC.. PUBLISHERS C TOWN OF BARNSTABLE Ck LOCATION lzt-&ed SEWAGE # ?,?a VILLAGE ASSESSOR'S MAP LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY )Q LEACHING FACILITY:(type) (size) 4P A G 'f NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: 7-Z 3 �� VARIANCE GRANTED: Yes No t �� Qj FEB THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Disposal Works Tonstrnr#iun 1junfit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...... ---Jed .................................................................................................. Location-Address or Lot No. ......................__--...................................................................... ...•••------••--------•-•----------•---..............------......------.........._................ Imo{ Owner . �2 dress /J ........................... Installer Address dType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) PL44 Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures -----•--•---------------------------------•--- WDesign 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. 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. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................-" fZ4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... 9 ........................................................................................................................................................ .---- ODescription of Soil...............................................................................:------------------------------------------------....------------------•-•--•-•--•---••- x U .-•-------------•--•----------- 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 TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance s e issu y board of health. Signed ---------- \ ^ ----------------------------- Date q Application Approved By � �. --- ......�..Mte -.3.^-L-G Application Disapproved for the following reasons- ........................................-------------------------------------------------------------------------..................... ----------- . . . --- - ----- - - ----------------------------- qDate PermitNo. .... / G ^ ------------------------ - Issued -----------------------------------------...--------------------- Date Fzic THE COMMONWEALTH OP MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE V' iratinn for Disposal Works Tonstrurtiun rrMit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: a- -------------------------------------------------------------------------------------------------- Location-Address or Lot No. t Owner � 0 dress � � f .. �'�� Installer ress d Type of Building _ Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) �. Other fixtures --------------------------------------------------.................................................................................................... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid ca.pacity__. '`'_____gallons Length................ Width-----------_--- Diameter................ Depth................ Disposal Trench—No_____________________ Width__.................... Total Length.................... Total leaching area....................sq. ft. 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. 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........................ a --------------------•-----•-------•••••---•--•--•••-----•------------•--•-••••-.........----•------•......................................................... 0 Description of Soil........................................................................................................................................................................ x U W U Nature of Repairs or Alterations—Answer when applicable............................................................................................... f ---------------------------------------------------------------------------------------------•---------------------------------------------------•-•----------------------•--___________ 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 has been issued y thelboard of health. Signed ..........d�g Date Application Approved By ..-----2 ------ (�/. - - - �� ' �9 Date Application Disapproved for the following reasons• ----------------------------------------------------------------------------------- ---------------------- el ---------------- ---------------------------------------...---- ---- -----....---------.............---. ................................................................... --------------------------------------- Date Permit No. ------�'6-------3_�_2 Issued ------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ' TOWN OF BARNSTABLE Cler-#tftc�x#e of (ITeraylian.ce THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by.................... :-------- .O a ...---- -------------..............................................................*.,'*................ ---------------------------------------------------- • Installer ��" q at -------------1 } � + ._...1!j"{ ` 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. dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL'NOT' BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....... '" .... .+-------- ---------------------------- Inspector - . . THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE n.-)., FEE.. ........ Disposal Works C�nnstrnrtion Vprrmit Permission is hereby granted ._Cis.� r2e� -------------------------------------------------------------------•---- to Construct ( ) or Repair ( an lzvid'U'a'i S .gage Disposal System at No.............1_4.---r rr/`�.r 1_Q� _._.l�al--------- . Street as shown on the application for Disposal Works Construction Permit Dated.......................................... •------------------------- --T- Board rd --of----Health----------------•-------------•------•--------- DATE............... C .................................... FORM 38808 HOBBS Q WARREN.INC..PUBLISHERS n AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION SEWAGE VILLAGE �/��5 ,.`/S ASSESSOR'S MAP G LOT INSTALLER'S NAME & PHONE NO. f Gd�' Girl LEACHING FACILITY:(tgpe) (size) NO. OP BEDROOMS PRIV*TE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No y Phttp://issgl2/intranet/propdata/prebuilt.aspx?mappar=075015&seq=1 8/25/2014 w LONGFELLOW DESIGN • BUILD LONGFELLOW DESIGN/BUILD 367 Main Street,Falmouth - MA 02540 (774)255-1709 i 7 0_l 6 nr� C� _— 18'-912" 14'-93/4" 9'-21/2" DEMO SOLARIUM,KEEP 4'-7" EXISTING FOUNDATION WALLS II CL. 9._6. v _ CRAWL SPACE ✓,I�JIfJI�J�jJ/ ----- '�� ---- MECH.RM.1 - MECH.RM.2 _ ------------ m . 1i - ill ---------- i MECH.RM.3 i �II i I in I I 11 1 '®I I i III I I I III I I I III I HALL ' - JI1 I 1 I In I I r------- N i ENVELOPE 'IX. V 1 5'-7" 5'-11 12" 6'-11 1/4" JIf I I 1 CHANGE RM. — No. Description Date nl I :4 .314 II SAUNA II I� BATH CL. CL. GAME R'M. _ I III I BEDRM. .. 21'-3 1/4" I 'I i ---11 IIII I I IIII' I IY�Illlrll I - i 18'-11 12" � -- -- -- -- Ted Sheehan 61 Cedar Tree Neck Rd.Marstons Mills Existing Ground Floor Demo Plan Project number Project Number rl Ground Floor Date Issue Date 3/8"=1'-0" Drawn by Author checked by Checker a D001 Scale 3/8"=1'-0" 5 t I t �LONGFELLOW DESIGN • BUILD LONGFELLOW DESIGN/BUILD 367 Main Street,Falmouth MA 02-0 (774)255-1709 9'_6" 24•_0" 7'-4" 10' 6" 6'-2" I 0 L i Lo TMOF ......-,Um I � � I � I I 1 I C 2' 0" 5'-0" 2' 8" i i I PROPOSED PATIO PHASE 1 SCOPE No. Description Date I i O1 PROPOSED BAR AREA f - ---------------------------____ 01 I -- I 6'-5 5/16" Ted & Stacey Sheehan I t 61 Cedar Tree Neck Rd.Marstons Mills Proposed Addition I Ground Floor Plan I Project number Project Number -- Date Issue Date n Ground Floor Drawn by Author U 1/2 -1-0 Checked by Checker n A001 scale 1/2"=1'-0" A202 2 �LONGFELLOW DESIGN • BUILD 34'-0" 12'-11" 20'-0" LONGFELLOW DESIGN/BUILD 1 367 Main Street,Falmouth MA 02540 (774)255-1709 F---------------------------------------------------- 03 I' 04 - i m W.I.C. 110SF. i I ___________________1 1 I 1 I MASTER BED 1 370S1. O O AULTEGCELING v � I PHASE 1 \ SCOPE �\ MASTER BATH os I ® 125 SF. ------ ------------------------------------------------------------------------------------------- 1 1 HEATED FLOOR MAr 1 No. Description Date I ruL cra. 1 02 c _ O I A202 ; Ted & St I I acey Sheehan I y I I , -- 61 Cedar Tree Neck Rd.Marstons Mills rl Proposed Master Suite -- -- -- __ -- -- -- ProposedAddition „2 _,_o - - — - --- First Floor Plan I I I i __-_ - _ __. _ _..- .___-- __-_.�._ --- __-. -_. ._ ._ _._��_ Project number Project Number I I I I I I - - -- - - -- I � I I I I I--- - ------ - - ------ ---- -----._ ._- — Date Issue Date --i ---- I i ii i I ....._. .-...... - ___._. ... ._.- _._- _ --_........ .._.....— ......,.__ Drawn by Author ......_._._...-____--..__.-_-_.._—._.- Checked by Checker A101 Scale v2°=1'-0- �I_ 3 �LONGFELLOW DESIGN • BUILD nzo2 z I ! LONGFELLOW DESIGN/BUILD ! 367 Main Street,Falmouth MA 02540 (774)255-1709 1 I t I 11 E MATCH SUNROOM Azo1 1 ROOF PITCH I 4 No. Description Date I Ted & Stacey Sheehan 61 Cedar Tree Neck Rd.Marstons Mills Proposed Addition \ Roof Plan Project number Project Number ---- ----- — —= —'— ———— Date Issue Date Drawn by Author n Proposed Roof Plan Checked by Checker a 1/2"=1'0" A103 Scale 1/2"=1'0" n r �LONGFELLOW DESIGN • BUILD LONGFELLOW DESIGN/BUILD 367 Main Street,Falmouth MA 02-0 (774)255-1709 PH Ll Y / A = 1 No. Description Date LU viwf l' J t LI Jill fj 111 Ted & Stacey Sheehan Cc D 61 Cedar Tree Neck Rd.Marstons Mills --- -------------------- ----- -------------------- _ — Proposed Addition -- - Exterior Elevations Project number Project Number Date Issue Date -III—III—III—III—III—III—III—III—III—III—III—III—III—III—III—III—III—III—III—III—III—III—III—III—III— — — Drawn by Author Checked by Checker a r,1 SOUTH A201 30/6=1'-0" Scale 3/8"=T-0" �LONGFELLOW DESIGN • BUILD LONGFELLOW DESIGN/BUILD 367 Main Street,Falmouth MA 02540 (774)255-1709 =LL - ---------- —_- �I I—I��—I��_WE ---_ — —_-- II ICI III III I�� I III-11�-1�1 -III—ICI-III„ 1�1-1�1-1�1 III ICI �� 1��-��1„ICI n ILIA—=1-0" No. Description Date - — Ted & Stacey Sheehan ---------------- ----'--- '_ o - -. 61 Cedar Tree Neck Rd.Marstons Mills ------------- ----- -- -- -- -- — -- -------- Proposed Addition -1�— —_ __---- --- ---- --- Exterior Elevations III=III-III=--_--=- ------- -_—_ _-------_.__ --------------------- Project number Project Number Date Issue Date — —� - - - - - - - - - - - - -� —� �— —� - - -� —� —� �— Drawn by Author Checked by Checker a n Elevation 1-a Scale 1/4" Window Schedule Door Schedule Mark Level Description Width Height Sill Height Head Height Comments I Head Mark Level Description Width Height Height Comments 001 Ground Floor Casement 2'-7 1/2" 4'-11 7/8" V-8 1/8" 6'-8" UV Tinted a L 0 N G F E L L 0 W 002 Ground Floor Awning 5'-11 7/8" 1'-5" 4'-0" 5'-5" UV Tinted 01 Ground Floor French Door 5'-0" 6'-8" 6'-8" DESIGN - BUILD 003 Ground Floor Awning 5'-11 7/8" 1'-5" 4'-0" 5'-5" UV Tinted 02 First Floor Single French Door 3'-0 1/8" 6'-7 1/2" 6'-8" Blinds between glass,UV Tinted,Storm Door 101 First Floor Awning 4'-0" 1'-5" 5'-3" 6'-8" UV Tinted 03 First Floor Sliding Barn Door 3-0" 6'-8" 6'-8" 102 First Floor Awning 4'-0" V-Y 5-3" 6'-8" UV Tinted 04 First Floor Pocket Door 2'-8" 6'-8" 6'-8" 103 First Floor Casement 2'-7 1/2" 4'-11 7/8" 1'-8 1/81, 6'-8" Tempered,UV Tinted 05 First Floor Pocket Door 2'-8" 6'-8" 6'-8" 104 First Floor Picture Window 5'-11 7/8" 4'-11 7/8" 1'-8 1/8" 6'-8" Tempered,UV Tinted 105 First Floor Casement 2'-7 1/2" 4'-11 7/8" V-8 1/8"' 6'-8" Tempered,UV Tinted 106 First Floor Awning 5'-11 7/8" V-5" 5'-3" 6'-8" UV Tinted 107 First Floor Awning 5'-11 7/8" V-5" 5'-3" 6'-8" UV Tinted LONGFELLOW DESIGN/BUILD 108 First Floor Awning 5'-11 7/8" 1'-5" 5'-3" 6'-8" UV Tinted 367 Main Street,Falmouth MA 02540 109 First Floor Awning 5'-11 7/8" 1'-5" 5'-3" 6'-8" UV Tinted (774)255-1709 110 First Floor Awning 5'-11 7/8" 1'-5" 5'-3" 6'-8" UV Tinted No. Description Date Ted & Stacey Sheehan 61 Cedar Tree Neck Rd.Marstons Mills AdditionWindow and Door Schedule Project number Project Number Date Issue Date Drawn by Author checked by Checker a A301 Scale a t 4 �. i • A108 2 �LONGFELLOW DESIGN BUILD i i LONGFELLOW DESIGNBUILD i 367 Main Street,Falmouth MA 02540 CL, (774)255-1709 i STUDIO ' DEMO GLASS CORRIDOR WALLS BATH iORRIDOj z A107 DEMO CARPET FLOORING u ■ O A108 t - --- No. Desoiptimr Date i' i I i --- - Ted Sheehan 61 Cedar Tree Neck Rd.Marstons Mills Existing Corridor & Studio Demo Plan Project number Project Number Date Issue Date Oraw by Author Checked by Checker a Comdor/Studio D 1 03 1 3/16"=1'-0" A107 Scale 3/16"= Azoz z nELONGFELLOW DESIGN • BUILD LONGFELLOW DESIGN/BUILD 367 Maln Street,Falmouth MA 02540 CL. (774)255-1709 Q D ®O `NE4V CARPET FLOORMO GAME RM. 780 SF. r" BATH ® 48 SF. 0 A203 q ® CORRID z Azo1 - 114 SF. 2 A203 1® No. Description Dale 1 REV 1:_Closet and Windows 04.19.17 ®1 11 NAR c Fwanw Az�z 1 PROPOSED PHASE 2 ADDITION Ted & Stacey Sheehan 61 Cedar Tree Neck Rd.Marstons Mills Proposed Corridor & Studio Plan Project number Project Number Date Issue Date Drawn by Author Checked by Checker a. A103 r�artidor/Studio V 3l16"=1'-0" � Azo1 � i Scale 3/16"=1'-0" g AtDB � 2 B _ �LONGFELLOW DESIGN BUILD ea e 2Y B B r LONOFELLow DESlcweuiLo B e 367 Main Street,Fabnoah B MA 025e0 (7Ta)255-1709 ®a ' B P e GARAGE B s B a a� e ¢ CIL DEMO ENTRY TILE FLOOR. 2 A107 I o� ENTRY a P �9 Na DesclpUon Date Ted Sheehan 61 Cedar.Tree Neck Rd.Marstons Mills Existing Entry Level Demo Plan Grolect number Project Number Dale Issue Date Orawn by Author aecged by Checker a t D101 3/16'=1'-0' A10T Scale S nLOWELLOW DESIGN • BUILD LONOFELLOW DESIGNBUILD \\ 367 Miin Straei,Fdmouth MA 02540 lna>zss+Tos t i� I DEMO.POWDER ROOM, ? CLOSETS AP1:iWINDOW I t /+ F- ,.✓ � No. DesvlPUon Date DEMO ENTIRE SOLARIUM '' 1 a ".� �1 oEMo DEMO HALF �-m I WINDOW ANO CIRCLE WINDOW ----- �� ✓� N I RELOCATE / )( _ r f 7!L I A —CABINETS BE DEMOI Z DEMO ID ANDD REUSED ((f ztr I DEMO COLUMNS f AND SOFFIT FOR - 1 NEW BEAM r ----------=--=-- —� I` --------------------,rj " LNINGRM I '- - -- ------- II OEM ALL KITCHEN J I DEMO ALL J COUNTERS AND I TILE AND TALL CABINETS s ++f DEMO ALL . N I I FLOORINGH SUN ROOM HARDWOOD FLOORING REF.TO BE u I REPANELED { AND REUSED R6R - EM05YINDOYJ —DEMOWINDO' ! Ted Sheehan I i R8R RgR � t 61 Cedar.Tree Neck Rd Marstons Mills R&R -�- ...� � Existing First Floor Demo Plan FYoleam,mba, Project Number Due Issue Date DmvA by Author Cheekedby Checker n Fir3/16--st Floor + `` D 102 1'-0' A+m A108 C 2 rMLONGFELLOW DESIGN • BU ILD, LONGFELLOW DESiGNBUI D 3r7 M3in Street;Febnouth IAA 02540 CC. (774)255.17M STUDIO DEMO GLASS CORRIDOR WALLS BATH • FOFtMDOI 2 A107 DEMO CARPET FLOORING 1. r ■ A10th 1 No. —.—,—.Desarlptlan Date ED 4.L� 77 Ted Sheehan L/ __e 61 Cedar Tree Neck Rd.Marston Mills v if Existing Corridor & Studio Demo Plan Proje m,mher Project Number Date- Issue Date Drawn try Author Checked by Checker m Corridor/Studio D103 Ato7 Scale 3/16"=1'-0" � A,oe � z �LONGFELLOW DESIGN • BUILD LONGFELLOW DESIGWBUILD 367 Main Street,Fe—Ah MA 02540 (774)2551709 DEMO TRIANGULAR STUDIO WINDOW i t 1 DEMO GLASS �I CORRIDOR ROOF i i �7 I { I � 2 A107 1 � 1 f I I 1 1 1 y � 1 � I � i � I t I Ir-6 Vl(r 11T at? -23116" 1d'_71' T-6" 0•1010 0'-11 Vd"5'-813ltB" ' I No., DeseripDon ._ Date r-�—�- BATH CL BEDRIVL r-•r W.I.C. BATH L DEMO HALL 5'-53118`. MIRRORS 18' 1' II II I 30-11 114' C DEMO BATH W0lDOW AND DOOR ��—+ Q MASTER BEDRM. nn SEDRM. =RaR --- DEMO BEDROOM WINDOWS - Ted Sheehan CL. I- � b 61 Cedar Tree Neck Rd.Marstons Mills R8R �.B' ;,•.� 3,.r Existing Second Floor R&R Demo Plan DEMO SECOND Prolev number Project Number FLOOR DECK Date- Issue Date Dram tr! Author �LSecond Floar Cheekeeby Checker a A707 ^ 'I Scale 3/16"=r-Y. A108 A. 2 �LONGFELLOW DES I G N • B U I L D LONGFELLOW DESIGNBUILD 3W.Main Street!Falmouth MA 02540 r774l 255.1709 i I � � i 2 A107 I 1 i I I I 1 I I I 1 1 I I I 1 I � DEMO HALL WM)OW 1 I I 1 I 1 Na DeeCIpUOrI .Dare 1 I R&R d DEMO SKYLIGHT I"ml f III I La-UU KID'S RM. CL . DEMO SKYLIGHT r: n Ted Sheehan r________ 61 Cedar Tree Neck Rd.Marstons Mdts - Existing Kid's Room -- ---- Plan Wojea number Project Number Dare Issue Date Drawn by Author Checked by , Checker a IGd's Room ffi At07 scale 3/16"=1'-0" v � A202 2 �LOWELLOW ` DESIGN BUILD 'OS i ewmucr sae�.aorr= ri wrniun¢vamwr.can rl.� � nworE-sun RECEs-- r IIGN 5 — ---- i' L67 h ft I"OESI Cuth O \ MA 254 Stree4 FWrquth NA 02540 r 4774)2551709 f ' i i � r GARAGE _._.. 045$F. rm r i r' i� CL T� ] AZ01 T ar+k:avwsoErar pg 2 M- ENTRY � Na - DescrWon Date l 312 SF_ "- ..x.r PROPOSED PHASE 2 azoz ' ADDITION Ted & Stacey Sheehan 61 Cedar Tree Neck Rd.Marston Mills Proposed Entry Level Plan Projea m mba Project Number Date Issue Date ormm oy Author Checked by Checker a e Entry A101 3/16"=1'•0" A201 Scale 3/1 U'=1'-0" �LONGFELLOW DESIGN • BUILD A203 LONGFELLOW DESIGNSUItD 36r Mfin 0Sired,Famouth IAA 025A (774)2551709 2 A203 1v-D1511(r 3.8' ADDITION TO BE PART ®, rno Aw.IICVI1 OF PHASE 2 WORK ® a-13a n � Q t IS-0 y S'-015'37 I - I 17-11• 20-v' wr'a+RclomwTDG1 i 3; `C' BumerB 1 paoaaewrloav 12 z ------ i PANTRY - -------� 1 I .;hEU111 ,.------- _----------------- 13 I5-01sw t6. 5-a 15'3T i . Q to --------- I 10 FORMAL LIVING W.LC 8 dV U� 3-S' SM SF. 22-1 114' 1 1 -- _ .MASTER BED _____ ____ ___________________________ ___ ; KVi MV�YC'OD ROGrtXG �. 370 SF. k.- _ _ _ "'� @ FAMILY ROOM e o 516SF. �- 1 ea�a.nu a I MASTER BATH i__. --'E -- ---------------------------------------_ IIF_w OM 125 SF.- a KITCHEN C C ie U EG w, ww Fug+ 365 SF. SUN ROOM mu�rv.>:uE and 1925F. No. Desctpalon Date IMF. I.RV B45EB°.W e _ DINING ROOM I 1 - 1 Y-1" J,L 5.6' I 5.•0_ -� -. .. y �. 15 707 _.. --_ In '�1 \� C� f9 _ __ 15 21-.3114•. tA_ _.�..-._�_._ _- -;. .. �_ 5.111f2" 6.8• 6-3.11T -" anTwat:rrolw�a�GaaF EXISTING=DEC. E, 1 1 OIRfBWE If!°RTAYtiGff VI,F. 1 Ted & Stacey Sheehan n First Floor Lh�inp Area 114I=TO 61 Cedar Tree Neck Rd.Marstons Mills Proposed First Floor Plan Proted mtrnbw Project Number Date Issue Date Drawn try Author Caeekeebr Checker a Al02 a Scala uc=1.-o:. � z �LONGFELLOW DES I G N - B U I L D LONGFELLOW DESIGWBUILO 367 Lbin Street,Fatrnouth IAA 02540 (774)2551709 CL GAME RM. 7S0 SF. 0 ® \ BATH ^ 48 SR A203 ® 1� 1 v CORRID 2 A2o1 114 5F. a s. 2 A2IX, Zn1 , No. DesctpUon Date i Henavoue Azaz , \PROPOSED PHASE 2 ADDITION Ted & Stacey Sheehan 61 Cedar.Tree Neck Rd.Marstons Milts _ Proposed Corridor& Studio Plan Projea Rumba Project Number Date Issue Date oravm by Author Checked by Checker a A103 COITidodStut50 c 3/16^ 1'-0" a2n, scale 3/16^=T-0^ �LONGFELLOW DESIGN • BUILD LONGFELLOW DESIGNBUILD 887 Main Street,Falmouth IAA 02540 (774)255-1709- 16-11' d'-5 T-0' 6'-Y 7y [] oussw Shah 3 Ct LAUNDRY RM. MASTER BATH 145 5F. ,82 SF. - `xar nEnata -- W.I.C. -- -- 153 1185F. F 0 utaOt6,YiAlLg 72 SF. `raw xwmxam�e�� ansn+c,ue 1 PROPOSED PHASE 2 ADDITION CRAWL SPACE NN BATH 1 50 SF. xEw w�ccTrLoauu J 1 ra I&L Description Date !/ ® e•2tv,e MASTERBEDRM. f 420 SF. `} BEDRM. 245 SF. UVYwTEwmaw CBLwG C'rEN� CL. IXmAn&s*�mm mam ,• a-211/16' L•�EWtwiC�S[F Second Floor iV /�.p" Ted & Stacey Sheehan 61 Cedar.Tree Neck Rd.Marstons Mills Proposed Second Floor Plan Proles number Project Number Date Issue Date Drawn by Author Chewed by Checker < m Al04 Scale 1/4"=1'-0" A202 L 2 - DLONGFELLOW BUILD LONG-E W DESIOWBUILD 367 Main Stree4 iutmouth MA 025a0 (na)255-1709 i A203 \\\y i \ 2 A2D1 A203 9f1'-0" fffi' PHASE 2 WORK M L Desaiptial Date � KID'S RM. m A202 CL. 4 g m Ted & Stacey Sheehan 61 Cedar.Tree Neck Rd.Marstons Milts Proposed Kid's Room Plan Wojed number Project Number Date Issue Date DMMM by Author Cheded by Checker a Kid s Roam t n �, _,'�- Al 05 A201 Scale 3116-=V 0- L �LONGFELLOW DESIGN BUILD PHASE 2 WORK i `Y — — — — �� LO@GFELLOW 0MC MBUILD 24' 6 3W Mav Street FabrI / NA OSaO r777 — _ _ — (774)25&1?09 _ ® — — — — IGds Room .,—. Second Floor�l 15>44" V M=;��om F7 1 F .7 m EE] 1 17-3" E@ -- — — — — — First ® - — — —t —1 =1 —1 ii= i—i I = =1 11=1 11=1 I H I 1=1 I Ian, —I — i— —I =l =i — —I = 11-1 I I-1 I I=1 11=111=1 l i=1 11=1 I II i 1=1 I f_I I I-1 I I-1 11=1 11 -1TI=tl I-11 1172i— 11= - - _=i= ►= I--1 11=1 I I 11=1 I f 11=1 I I-1 I I�I II I I I I�I I-1 I I-1 I I-1 I I1 I I-1 I 111=1 11=1 11=1 11=1 11=1 11=1 I i=1 11=1 11=1 11=1{1=1 I I-1 11=1 11=!11=I 11=1 11=1 .III=1 I I-1 I II I I_I I I=1 I i= =1 I I-1 I I=1 I I=1 I I=1 I I=1 I I=1 I I-1 I I-1 I I.III=1 I I=1 I I=111=Ili=1 I I=1 I I=1 I f=1 I I=1 I I-1 I I-1 I I-1 I I=i l I=1 11-1 I I=1 I I=1 I I—III=1 11=111=1 i t=1 I I=1 i II I I=1 I I=1 I I=i I I=11 I-!I I=1 I I=1 I I=1 I I=1 I I.I 11=II I-1 I I_ :I I L�I I I—I 11=1 11=111=11 I—III-1 11:-1 I I—i 11=1 11.-1 I I—I I i..-1 11=1 I L-1 11=1 11=1 11=1 11=1 11=1 I I TI 11.=1 11=111=1 11=1 11.=1 11=111=1 11=1 11=1 11=1 11=1 11=1 11=1 11=111-=1!1.=I I E=-I 11.=1 11=-1!1=1 11.=1 11=1 11=1 11=1 11.=1 11=1 11=1 11=1 11=1 11=1 11=1 I I II I I-T-1 I II iT�I I-1TI-111�1 I�I I�TI-1 I I�I I-1 I IlTl-1 I I-1TI-1 I I-1T1-1 I I-�-1 I I�I I-1 I I�TI-1 I I-i I I�I I-i I I-1 I I�-1 I I— 11-1 I I-1 I�I I�-1 I I-1 I I-1 I I-1 I II I I-1 I I-1 I I-1 I I-�-1 11-1 I f-1 I T 1 I I 1 I I-1 I I-E I II I f-1 -1 I I—III-1 I I-1 i 1-111—I 1 1—I 1 1—I 1.I-1 I t-1 I I-1 I I-11 1-1 I I—III—i I I-1 1 1-1 I I-1 I I—III-1 1 1—i i i—I I t-1 I I—I i t-1 I I—I I f-1 I I-11 1—I 1 1—t I I—i I I-1 I I-1 I I-1 1 1—III—I 1 1-11 1-1 I i-1 11-11 t-11 I—III—I 1 I-11 1-11 I—i I I-1 I(—i I I-1 I I—I 11—i I I—I i i—I I I- M EAST ft DlSeyWon 13at0 d — — — _ Otfi4'-6" v _ _ �cid's2�oa_5m — .. — — — — Seconds too- -4-170 R — _ _9qr_riC!0_r/StUdi017 3 Ted Stacey Sheehan First Floor t� 61 Cedar Tree Neck Rd Marston Mills Proposed Exterior =I =11 : I I 111 1I I I—!11=1 11=1 I15111 —o — - — - - � Elevations — — = I 1=1 11=1 11=1 11=1 I I I II I I 1=1 11=1 I!=1 11=1 11-1 f 1=1 11=1 I I III I =1 11=1 11-1 11— aojea MMlbw Project Number —1 I I�f 1=1 I I�11=1 I I-1 11=1 I hI I I-1 I i�l 11=1 I E=1 I I_I I i=1 11=1 11=1 I I-1!I_I 11=1 I hI 11.=1 11=1 11=I I 1=1 I h!I hl I l=1 11=11 I"III=1 11=1 I I—I 11= 11= I = I I= I— .,. Ground Fraor- Hate Issue Date � prawn by Author aeake4by Checker a - o. 2 NORTH A201 e Seale 31,6"=1'-0" a 1 1 �- � w LONGFELLO DESIGN • BUILDf PHASE 2 WORK A= �\ _�¢ LONWELLOW DESIONBUILO f ; s,11 4 "MOMP, kill" MA ® ® ® ® [B L..L.] ® _ - 1000 � SOUTH No.. Description Date f PHASE 2 WORK M3H - Z i. Ted & Stacey Sheehan _ = - - = {„ --- — 61 t;edar Tree Neck Rd.Marstons Milts — Proposed Exterior I I-t Elevations— �1-1If- F 1 - 1 -E wclea numbe ; Number Date, Issue Date Dram by Author Clewed by Checker a 0 2 WEST A202 e Scats 3✓16"=1'0" tt a i / tN T?4 4 0 'Z-7Tn ell y 10 � l l l ► /1 � ► oo -�o �'-Z--7 AIN WPM K _�- LE ' \� r. T 91 zo c a •ro:. , 15.7 It- 7PI N ol IJ � r ZZ GU K Y E w' No 193J1 i