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HomeMy WebLinkAbout0471 FLINT STREET - Health 471 FLINT ST. M,;RSTONS MILLS A `= 101 ,052 --- --- -- - - - --� I FILE# FE 1514 CENSUS TRACT# 131 CLIENT:DUNNING,KIRRANE,MCNICHOLS&GARNER LLP DEED BOOK 14175 PAGE 82 OWNER: MATTHEW C. &RACHEL A.DIXON PLAN BOOK 263 PAGE 42 LOT 4 APPLICANT: MARGARET MARY DWYER ASSESSORS PLAN 101 PLOT.. 052 MORTGAGE INSPECTION PLAN OF LAND LOCATED AT 471 FLINT STREET BARNSTABLE, MASSACHUSETTS SCALE: 1"= 50' December 28, 2011 _ 130.00 LDT 4 2c�z5 S.F. LOT S LOT 5 - i *-4`71 IG `A - ;,aq FLIN 1 STREE CERTIFY TO DUNNING,.KIRRANE, MCNICHOLS & GARNER LLP, USDA RURAL DEVELOPMENT, ,AN ITS TITLE INSURANCE COMPANY, THAT THERE ARE NO VISIBLE ENCROACHMENTS OR EASEMENT EXCEPT AS SHOWN AND THAT THIS PLAN WAS PREPARED UNDER MY IMMEDIATE SUPERVISION. THE LOCATION OF THE DWELLING AS SHOWN HEREON IS IN COMPLIANCE WITH THE LOCAL APPLICABLE ZONING BY-LAWS WITH RESPECT TO HORIZONTAL t�r DIMENSIONAL REQUIREMENTS. ° Y ��C THE DWELLING SHOWN HERE DOES NOT FALL WITHINr A SPECIAL FLOOD HAZARD ZONE AS DELINEATED ON A ;= ;-,"F-TRA MAP OF COMMUNITY#250001-0015C DATED 8/19/85 BY THE F.I.A. - - . 4• :�-c � ,. - Kenneth R. Ferreira Engineering P.O. Box 1903 New Bedford,MA 02741-1903 Ph: 508-992-0020 Fax: 508 992-3374 email:kenferreira.eng.pro rENERAL NOTES:(1)The declarations made above are on the basis of my knowledge,information,and belief as the result of a mortgage plo pe survey inspection made to the normal standard of care ofregistered land surveyors practicing in Massachusetts. (2)Declarations are madabove named client only as of this date. (3)This plan was not made for recording purposes,for use in preparing deed descriptions or fouctions. (4)Verifications of property line dimensions,building offsets,fences,or lot configuration may be accomplished only by an accurat strument surve . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,.' 471 Flint Street Property Address Rachel Dixon Owner Owner's Name information is required for every Marstons Mills MA 02648 09/20/11 page. Citylrown State Zip Code Date of Inspection Inspection results must be submitted on this form.Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your V w cursor-do not Michael Kellett (l use the return Name of Inspector key. Aardvark Environmental Inspections ay Company Name P.O.Box 896 Company Address r East Dennis MA 02641 Cityfrown State Zip Code 508-385-7608 813742 LU 01; Teleehone Number License Number c ` - B. Certification a = LL_ 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 b sewagefdisposal systems. l.�am;a DEP approved system inspector pursuant to Section 15.340 of Title 513,1©CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 11 Inspectors 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. Title 5 Official inspection Form:Subsurface Sewage D' I System•Page 1 of t5ins•11J10 � 9 Commonwealth of Massachusetts Title 5 Official Inspection Fora s Subsurface Sewage Disposal System Form Not for Voluntary Assessments 471 Flint Street Property Address Rachel Dixon Owner Owner's Name information is Marstons Mills MA 02648 0920/11 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary:Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of'Health,will pass. Check the box for'"yes","no"or"not determined" (Y,N,ND)for the following statements.If"not determined,"please explain.. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally 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•11l10 Idle 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Fortin s Subsurface Sewage Disposal System Form Not for Voluntary Assessments 471 Flint Street Property Address Rachel Dixon Owner Owner's Name information is Marstons Mills MA 02648 092011'I required for every page CitylTo— state Zip Code Date of Inspection• B. Certification (cont.) 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 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 ❑ M ❑ 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 Healthl 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 mannerwhich will protect public health, safety and the environment: EJ 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-11/10 Tille 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 471 Flint Street Property Address Rachel Dixon Owner Owners Name information is required for every Marstons Mills MA 02648 09)20/11 page. City/Town 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. ❑ The system has a septic tank and.SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well"". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to,overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® Liquid depth in cesspool is less than 6"below invert or available volume is less *fra %day floc: t5ins•11/10 Tile 5Official Inspection Form:Subsurface Sewage-Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 471 Flint Street Property Address Rachel,Dixon Owner Owners Name information is required for every Marstons Mills MA 02648 09)20/11 page. Citylrown state Zip Code Date of Inspection. B. Certification (font.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to dogged 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 searing 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 ebst 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 31'0 CMR 15.304.The system owner should contact the appropriate regional office of the Department. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 471 Flint Street. Property Address Rachel Dixon Owner Owner's Name information is required for every Marstons Mills MA 02648 09)20/11 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 systerni 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? ® Cl 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 (f any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) P10 CMR 15.302(5)1; D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•11/1 D Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 471 Flint Street Property Address Rachel Dixon Owner Owner's Name information is required for every Marstons Mills MA 02648 0920/1.1' page. Cityrrown state Zip Code Date of Inspection. D. System Information Description: Number of current residents: 2. Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[f yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings,if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current.care CommerciaMndustrial 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: i5irrs•7 t/�0 Title 5 Official Inspection Form:S+:Csunace Sewage.Dlspwa!System•Page 7 of 17 i Commonwealth of Massachusetts w _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments: 471 Flint Street Property Address Rachel Dixon Owner Ouanefs Name information is required for every Marstons Mills MA 02648 0920/11 page. Citylrown 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: 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) (f 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 VA system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments. 471 Flint Street Property Address Rachel Dixon Owner Owner's flame information is required for every Marstons Mills MA 02648 0920/11 page. CityrTown state Zip Code Date of Inspection D. System Information (cunt.) Approximate age of all components,date installed (f known)and source of information: 09/12/01 Were sewage odors detected when arriving at the site? ❑' Yes ® No Building Sewer(locate on site plan): Depth below grade: 1.8 feet Material of construction: ❑ cast iron Z 40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints,venting,,evidence of leakage,etc.):. Septic Tank(locate on site plan): Depth below grade: 2.4feet 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: 1000 gal Sludge depth: 3" t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 I Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 471 Flint Street Property Address Rachel:Dixon Owner Owner's Name information is Marstons Mills MA 02648 09/20/11 required for every page. Cityffown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(coat.) Distance from top of sludge to bottom of outlet tee or baffle 28" 3 Scum thickness Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? measured Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.) The tank was sound and tight with tees in place and liquid at outlet invert. 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•i VIC Trite 5 Official Inspection Fong:S�sbsuftm Sewage D%posa4 S;st m•Page 10 of V Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments > 471 Flint Street Property Address Rachel Dixon Owner Owner's Name information is Marstons Mills MA 02648 09PL0i'11 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cant.) 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of V Commonwealth of Massachusetts Title 5 Official Inspection Form "s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 471 Flint Street Property Address Rachel Dixon Owner Owner's.Name information is Marstons Mills MA 02648 09/20/11 required for every page- Cityrrown state Zip Code Date of Inspection D. System Information (font.) Distribution Box(if present must be opened)(locate on site plan):. Depth of liquid level above outlet invert even Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box, etc.): the box was level and tight with.no sign of carryover. Pump Chamber(locate on site plan):. Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): Soil Absorption System(SAS) (locate on site plan,excavation not required): If SAS not located,explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 471 Flint Street Property Address Rachel.Dixon Owner Owner's flame information is required for every Marstons Mills MA 02648 0920111 page. Citylrown state Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 4 ❑ leaching galleries number: ❑ leaching trenches number,length: ❑ leaching fields number,dimensions: i ❑ 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.): This system has 4 infiltrators in a10x30'field of stone.There was 1"of liquid in the bottom of the infiltrators. 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•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal,System Form-Not for Voluntary Assessments, 471 Flint Street Property Address Rachel Dixon Owner Owner's Name information is required for every Marstons Mills MA 02648 0920/11 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.): Privy(locate on site plan):. Materials of construction: Dimensions Depth of solids Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection For Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 471 Flint Street Property Address Rachel Dixon Owner Ownees Mme information is Marstons Mills MA 02648 WWII requUed for every st Zip Code Date of Inspection Page. CitYlrovrn D. System Information (cons.) Sketch Of Sewage Disposal System:Provide a view of the sewage disposal system,including ties to at temitwo permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the budding.Check one of the boxes below. ® hand-sketch in the area below ❑ drawing attached separately 3 43 Tide 50#,ft,mspec*m Form:Subsudsm Sewage DbpwWSySWM•Page 15 of V t5ins•11110 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 471 Flint Street Property Address Rachel Dixon Owner Owner's Name information is required for every Marstons Mills MA 02648 09/20/11 page. City/rown State Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ® Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: 20.0 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: USGS maps show an elevation of over 20 feet. Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 471 Flint Street Property Address Rachel Dixon Owner owner's.Name information is required for every Marstons Mills MA 02648 0920/11 page. Cityrrown 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 Orrattached in separate file t5ins•11f10 Tale 5 Official Inspecton Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE LOCATION y171 14-11 S SEWAGE #,��/- 57,Z /� VILLAGE ,,��,�/s ASSESSOR'S MAP & LOT 101-ef INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) /DEC 3a2 NO. OF BEDROOMS 3 BUILDER O OWNER -NarG�l� PERMITDATE: COMPLIANCE DATE: C� Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist ;y' within 300 feet of leaching facility) Feet Furnished by V71 d�ter f '3b6 , • y3 ' l p�cAw �o� ' tL�n .Gw. '� •.���� . xT. 'r �_1'1e'`i�-����� �� ti x'" �-=r 's£e,.'�"°S�,2w`'s'°�T,'. cm'��.'�*-� �,� fg LOCAT14�1 �f may/ . ASFSSOR;'S - „& LOT, INSTALLERS NAME&PHONE NO � � f 51f-Sy�j L , ZZ SEPTIC TANK CAPACIZY j LEACHIIVG FACII ITY (type) .��� a�i (size) _NO. OF`BEDROOMS �— BUILDER Q OWNER /Dare PERMITDATE: YJ-al-. COMPLIANCE DATE: (� Separation Distance Between the Maximum adjusted Groundwater.Table to the Bottom of Leaching Fac�l�ty Feet Private Water Supply We11 and.Leach ing Facility (If any wells exist on site br w'thin.200 feet'of leaching fac.iLty) Fee;'. { , Edge'bf Wetland and Leactung Facility(If any wetlands existOn— ,k within.:300 feet of:leachung facility) Feet '. Furnished by fr. ; 7 1 - L►L - oL , oy ( b I iLh� - �-�-� 00/- o5-Z_ No. t t � Fee 1 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �✓ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yication for Mi aal Stem Construction Permit Application for a Permit to Construct( )Repair( ✓)Upgrade( )Abandon( ) El Complete System LMlndividual Components Location Address or Lot No. , + / Owner's+>Na/►me,Addres/and el.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. AW A7��) D0U111 Type of Building: �0�/� Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder Other Type of Building �2'1o. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow Ile gallons per day. Calculated daily flow ;J J�0 gallons. Plan Date r Number of sheets Revision Date Title ) �)7 ® 1i'11; S Size of Septic Tank ®�® .'�`'il"%5�`%�19 Type of S.A.S. Description of Soil A2 lw, 2. Answer when applicable) �� /Z% �/ ` a Nature of Repairs or Alterations( pp ) 7�/�`/tom. .� /�J 9 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Boar Hea . Signed 1 Date a Application Approved by ffK_ la Date 21 Ab Application Disapproved for the following reas s Permit No. cpm Date Issued -7 l 'No. UVI-s I� v ' t�lc- �� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS Application for Migpo.5al 6peum Con5truction Permit Application for a Permit to Construct( )Repair( ✓)Upgrade( )Abandon( ) ❑Complete System L✓individual Components Location Address or Lot No. Owner's Name,Address and el.No. Z/7/ �fihr S>` c,�Qr� Assessor's Map/Parcel /1/ 1S�1S ,/�/�/S Installer's Name,Address,and Tel.No. / Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms 3 Lot Size zq��3 sq. ft. Garbage Grinder( � Other Type of Building % �y�°No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow l . gallons per day. Calculated daily flow 3 3eJ gallons. Plan Date jr 7,0�t°i ✓ Number of sheets Rf vision Date Title / t S/7� /l4Y1 D Z/o/_51;76; Size of Septic Tank AOKI mil"/S�ir>9 Type of S.A.S. Description of Soil /D Nature of,Repairs or Alterations(Answer when applicable) r�--jZ-1� i r Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has-been issued by thiskoff,ar H HX&9�� , Signed Date Application Approved by Date 2 J I) Application Disapproved for the following reaso s as Permit No. _—X(J - 'Y2 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-sije,sewap Disposal System Constructed( )Repaired(1/)Upgraded ( ) Abandoned( )by !?G�� / l9S at l _/ /� i ��' Curls /t�� S has been constructed in acc rdance with the provis'ons�of1Title,5,and the for Disposal System Construction Permit No. ?N S dated ZJ 161 Installer ://1X / Designer The issuance of tht's permittt shall not be construed as a guarantee that the system will function as designed. rr Date ��I�• I C)I Inspector . & . `C W._,t_ _ kf L .. No. �/—�• ��Z.--------------------/t// 2. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Migooal 6potem Construction Permit Permission is hereby granted to Construct( )Repair(✓ )U rade( )Abandon(/ p) / System located at 9 7Z /C✓1/f r _51-, " ✓,'� S�wl /7%Z1 S and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this p rmit. Date: O/2/� Approved by FILE No.4h2 Oe,,21 "01 AI i 10 c 32 I D c KRTOLOT T COI STRUCT I Oh,l FA:�;508 428 9"399 PAGE 1 ' r SP5/Qt NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. ^� PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FOR'N1 [, reN� a•i• ���t—a hereby certify that the engineered plan signed by me dated concerning the property located at ► -11 ��r-t� �t t� meets all of the following criteria: This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. The soil is classified as CLASS I and the percolation rate is IeSs than or equal to 5 minutes per inch. The applicant may use historical duty to conclude this fact or may conduct preliminary tests at the site without a health agent present. There is no increase in flow and/or change in use proposed There are no variances requested or needed. The bottom of the proposed leaching facility will not be located less than fourteen (14) feet above the maximum adjusted grOUndwat.er table elevation. LAdjust the groundwater table using the Frimptor method when applicable] Please complete the following: A) Top of Ground Surl'tice Elevation (using GIS information) S B) G.W.Elevation 4'b /+ adjustment for high G.W. i DIFFERENCE BETWEEN A and B , 'S ; DATE: SIGNED sIti t� .' NOTICE Based upon the above information, u repair permit will he issued fcsr bedrooms Maximum. No additional bedrooms are authorized in the future without engineered Je tic system plans. q,hcalch Folder:pereexmp r -- &Flint Street, Marstons Mills ` SaniServices � TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS P NAMES ADDRESS VILLAGE ��✓ ' ��, 1 ' LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: OR CHEMICAL (Give same information for any additional tanks on reverse side of card) DATE OF PURCHASE OF EACH: 1. _If 706 2. 3. 4. DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS �FTHEt� TOWN OF BARNSTABLE y M ~�^ OFFICE OF .. _;.._� • C�O�; i 7 BAflMIL E, : .BOARD OF HEALTH MAD B. oOA A�0139 0 367 MAIN STREET HYANNIS, MASS. 02601 February 17, 1981 THIRD REQUEST Mr. Philip C. McCartin AAA Sani-Services, Inc. 872 Main St. Osterville, Ma. Re: Your underground fuel storage .tanks Located Lot C, Flint Street, Marstons Mills Dear Sir: On March 11, and September 30, 1980, you were sent a copy h B Health Re Regulation for Underground Fuel of the Board ofg g Storage and a card to fill out and return listing information concerning your underground tanks. You have not returned the card nor acknowledged our letter. Town records indicate that you have received' a permit to store fuel underground. Please be advised that if you do not return the enclosed card within five (5) - days, steps will be taken to revoke your permit. Appropriate action will then be taken to have your tanks neutralized or removed. You are also reminded that any tank fifteen years of age or older must be tested by the Kent-Moore Pressure Test. An empty tank may be tested by a 5PSI Air Pressure Test. This testing must be done immediately. The enclosed card must be filled out and returned immediately. Very truly yours, M./Kel•� Y irector of Pu �icHealth JMK/mm encl. 1 0 i ,.<�' •,+• •�:•- * ` '.y 'Y y`�s:r �.v 4'a+ u"� ♦•`f tf r a�^�' .k y .. � ( .. +T•.,.jy pa:. : < .,Ar, *Philip C •McCartin' , AAA Sani-Services 'Inc. °} , 872:.Main,St, r. .'bstervil3.e; Ma. 3 a 4t I � i of •, �� �, �"y° ~'�, q !#: .., c ,.. r i n'a " C 'T n'. } Lot C Flint�Street. ,Marstons Mills , ♦ .y u, NAME LOCATION AAA Sani Services} Inc Lod C', Flint St., Marstons r w cj ci Phi is ;C McCart n M 11s (nearest `cross st: 2 .Nlairi St., '0sterville, .'CIA Old Falmquth Road) �:,►4J .� 7 PAGF; yA`1 , GRANTED Amount of storage J�%6y NOV!, ;1 1977 ,OOU gals underground 6 July 20, ,1979- gro00 diesel' d gals fuel ,under 135/13 _ ga , . 'DATE Paid 978 FEB MH TOP FNDN EL. 79.1' ACCESS COVER TO WITHIN 6' OF FIN. GRADE (NOT TO SCALE) ACCESS COVER (WATERTIGHT) TO �.tY MINIMUM .75' OF COVER OVER PRECAST /� WITHIN 6' OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM --- t\7( 2' DOUBLE WASHED PEAST NRUN PIPE LEVEL FOR FIRST 2'EXISTINGALLON SEPTIC4,TANK (H- 10 ) AS "15' BAFFLE 71.68' 71.51 6' CRUSHED STONE OR MECHANICAL 2' Q COMPACTION. (15.221 121) DEPTH OF FLOW = 4� ( 15 % SLOPE) < 1 % SLOPE) TEE SIZES 3/4" TO 1 1/2" DOUBLE WASHES ST INLET DEPTH = 10 OUTLET DEPTH = 14" FOUNDATION-- EXIST. SEPTIC TANK 18' D' BOX 3' LEACHINGFACILITY ES BENCH MARK - CTR. OF C.BASIN ELEV. = 75.65 (ASSMD QUAD) FLINT ST17?EET m t:. -r•- -- ---7.6-4 — — _ _ — _ �- — — — + � 78.6 79. L=90 02' R- 58 00 39 8� 7 .3 4o LOT 4 D 20,513f SQ. FT. �\ W o I 1 SE < D 7 p0 DE 70 J x 00 U._ 'J 72.P c + 00 r� R 73 3 �� c� 78.6 + 7 2�� J + 81.3 LE U� EXIST, DWELL. `��';, -� TOP FNDN 79.1' , 78. I, V' t f B I -�x TC Y +- � 6 x X 80,1 + \ x `1 DECK C7 0�0 + 7 .'7 N 6 E S� EXIST. S 0 n7 .� RE-USE _ 00 x cp 75. x I x - + B x I OAKS x 79.7 x+ 72.3 x + 3.9 F 7.6 �4 70.0 ' l� + 764 - I } � x 9 . x x X X ENCE x 9.7 E 69 00 + 6l-2) rl" l N J P cn rn � n t- � 802 i 130,00' 05 SYSTEM PROFILE TOP FNDN EL. 79.1' " ACCESS COVER TO WITHIN 6' OF FIN. GRADE (NOT TO SCALE ACCESS COVER :WATERTIGHT) TO MINIMUM .75' OF COVER OVER PRECAST WITHIN 6' Or FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM 75 0' _ I 2' DOUBLE WASHED PEAST N ` CONTRACTOR TO CONFIRM SUITABLE SOILS =y. RUN PIPE LEVEL AT (LEACHING FACILITY'S INVERT ELEVATION FOR FIRST 2' �� 72.0' EXISTING1000 I _ // AND, FOR 5 BENEATH LEACHING FACILITY GALLON SEPTIC < AT TIME OF INSTALLATION. ANY 74.4 TANK CH 10 ) GAS 0 71.5' 3.5' @ SIDES UNSUITABLE SOILS ENCOUNTERED ARE TO Focus BAFFLE 71 68' � 71,51 "` .5 BE (REMOVED FOR 5 AROUND LEACHING 2 FACILITY, DOWN TO SUITABLE SOIL LAYER. 6' CRUSHED STONE OR MECHANICAL ,�o Q REPLACE WITH CLEAN MED. SAND. a COMPACTION, (15.221 121) s c$`� 14 0�5� o 69,5' J _ � � w DEPTH OF FLOW = 4 ( 15 % SLOPE) C_ry % SLOPE) q Gac= TEE SIZES, 3/4' TO 1 1/2' DOUBLE WASHEz) STL NE Z: J INLET DEPTH = 10 OUTLET DEPTH = 14 LOCATION MAP NOT TO SCALE 3' LEACHING 26't ASSESSORS MAP 101 PARCEL 52 FOUNDATION- EXIST. SEPTIC TANK 16' --- D' i3[JX FACILITY ES'.`MATED GROUNDWATER EL. 43'f BENCH MARK - CTR. OF C.BASIN ELEV. = 75.65 (ASSMD QUAD) FLINT S'TREE T --- _ r co_ ca> 78.E �` 7P• 1 L=90 02' R- 58 00' 4 7 .3 0.0 N LTA LOTv 7,• �J G - j'20 5 SQ, FT. W SEPTIC DESIGN (GARBAGE bISPOSER IS NOT ALLOWED > 1. DATUM IS ASSUMED DE'>IGN FLOW 3 OEDROOMS c 110 GPD) = 330 GPD 2. MUNICIPAL WATER IS--a LSD --' \ ;r\ °o US A 330 GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1 8 PER -- -- J SCf �1C. TAKIte: y30 : ; >_F1, e2 Via_= wE60 4. DESIGN LC1ALlIIVG FOR ^+ .I_. R RECAST U�;I S TO DE AASH❑ ii-10 -"�� USL A 1000_ GALLON SEPTIC TANK (RE-USE EXISTING) b. CUNSiKUCTION DETAILS Tn, BE IN ACCORDANCE W-'Tr-I '1AS` . ,.- + et. LEACHING: ENVIRONMENTAL CODE TITLE V• 1 EXIST. DWELL. (L -� TOP F'NDN - 79.1' 78.( 2(30 + 9.83) 2 (.74) 118 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO i� I SDES' USED FOR LOT LINE STAKING. .� BOTTOM: 30 x 9.83_(.74) = 218 8. PIPE FOR SEPTIC SYSTEM TO SCH, 40-4' PVC, Q i -x - 7 ` TC(AL, 454 S.F. 336 GPD 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT .6 INSPECTION BY BOARD OF HEALTH AND PERMISSION ❑BTAINED 80,1 DECK 00 rn _U S; (4), HIGH CAPACITY INFILTRATORS WITH 3.5' FROM BOARD OF HEALTH. \ 67 XIST S STONE AT SIDES, 2.5' AT ENDS AND 14"' UNDER 10. PUMP & REMOVE (OR FILL W/CLEAN SAND) EXISTING LEACH PIT \ + 7 -,..1 1 a RE-USE O 00 x F- � � 75. ca X ND �T� A + IL , � L LP" 100.0 PROPOSED SPOT ELEVATION OAKS x 471 FLINT STREET 79.7 100x0 EXISTING SPOT ELEVATION x+ 72.3 IN THE TOWN OF: � + �8 100 PROPOSED coNTOUR ( MARSTONS MILLS ) , BARNSTABLE 4�70,0 1�y + 7E,4 j 7,6 1 -- 100 EXISTING CONTOUR PREPARED FOR: BORTOLOTTI CONSTRUCTION /PACKARD I 0 20 40 x a .� 20 60 BOARD OF HEALTH - x I ' X_ X \�9 ENC� K X �9.7 A��RUVED DATE MA SCALE: 1" = 20' DATE: AUGUST 20, 2001 O + N -► -] + . �; n 60.2 off 508-362-4541 cn (7) op (r Fox 508 362-9980 P r, r. t` t �fq�fq� 130,00' OF I0f down Cape engineering, lI"c, ARNE4JJq�: �� AR o F OJALA H. o CIVIL_ ENGINEERS oJALA " No.I30792 . No• 2fi34E1 04 LAND SURVEYORS �p�Fss�rc STtR �oF�� ► fE Z/ ? � Q 1 --205 939 chain st. yarrtouth, ma 02675 ARNE, H. OJALA, P.,E., F.L.S. 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