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Home My WebLink About0151 FLUME AVENUE - Health 151 Flume Avenue Marstons Mills A = 061 01,0,009. i' I P i V Commonwealth of Massachusetts OW r 0/0- C)0 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r M 151 Flume Dr Property Address �� r� Walsh Owner Owner's Name information is required for Marstons Mills V MA 02648 8-19-18 every page. City/Town State Zip Code Date of Inspection a� Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information / [� When filling out s. # ��a U� forms on the computer,use 1. Inspector: only the tab key to move your DOUGLAS A BROWN cursor-do not Name of Inspector use the return key. D.A.BROWN INC Company Name r� P.O. BOX 145 Company Address CENTE Vi'i-tt MA 02632 Cityrrown State Zip Code 5084204534 S14297 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 41 l/` 8-19-18 Inspe 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 g,pd 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 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: At time of this inspection this system met all passing requirements. This report can not predict the future performance under the same or increased usage. This report is not to be used for bedroom count determination. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be ireplaced 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•W13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every page. CityrTown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins•3113 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 F 151 Flume ume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every 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_ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M < 151 Flume Dr Property Address I4 Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every page. Cityrrown 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? Z ❑ 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? 0 ❑ 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): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G M ' 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: According to as-built card this system consists of a 1500 gallon septic tank , d-box, and 4 rechargers in a 35xl2ft area Number of current residents: 1 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 Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: 2106-------336 2017------378 gpd property has an irrigation system. Sump pump? ❑ Yes ❑ No Last date of occupancy: currently occupied 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 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , ' 151 Flume Dr Property Address Walsh Owner Owner's Name information is IC required for Marstons Mills MA 02648 8-19-18 I every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: currently occupied Date Other(describe below): General Information Pumping Records: Source of information: E.F. Winslow pumped 1500 gal 8-30-17 Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: 1500 gallons How was quantity pumped determined? Reason for pumping: maintenance Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 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: 9-4-02 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3 feet Material of construction: ❑ cast iron ❑ 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 2 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 gallon Sludge depth: mostly light at inlet end of tank t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 l Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness light clumping Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? scour pole 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 was pumped one year ago. I recommend pumping at least every 3 years for maintenance. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from to of scum to to of I p p 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every page. Citylrown 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 M 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every page. Cityfrown 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.): Box was level and was functioning properly with no signs of solid carry over or staining above outlet pipe inverts. 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: There were no observation ports on the s.a.s. f t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GM 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 4 rechargers ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): There were no observation ports on the s.a.s so we were unable to determine the actual level of ponding or staining. 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 El Yes No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewa ge Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M s 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every page. CitylTown 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 4M 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every 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 t5ins-3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,M 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every page. CityTown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: greater than 5 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: 8-2018 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: design plan Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Forth: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 151 Flume Dr Property Address Walsh Owner Owner's Name information is required for Marstons Mills MA 02648 8-19-18 every 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 or attached in separate file t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 l Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE LoCATIONJYJ F4,umr- AVe-nue SEWAGEa OOP-028 VU-LAGEMhRST,0V',S Mi RS ASSESSOR'S MAP&LOTDfo�QQZ INSTALLER'S NAME&PHONE NO. loc/em tc s�i9�th83 G21:a)�_>t" SEPTIC TANK CAPACITY / DO QAI LEACHING FACB.rrY:(type) Yard T (size) 3s'X 12. NO.OF BEDROOMS MRse6 w BUILDER OR OWNER PERMUDATE: 1/5.A.,COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by .• I 3s i t ,t `1$ t 3z SS` http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=061010009&seq=1 8/19/2018 i TOWN OF BARNSTABLE E� LOCATION 1 J2 FLume— AVe hu e- SEWAGE # 00-�t-02 S VU-LAGE M&RSTons Mi 11� / ASSESSOR'S MAP& LOT 2k �.:) INSTALLER'S NAME&PHONE NO. &C bM SEPTIC TANK CAPACITY /SDo AGI� LEACHING FACILITY: (type) !VPVeL 1,dLt4tr (size) 3S"X42, NO.OF BEDROOMS 4VA6C6xW BUILDER OR OWNER PERMITDATE: I as U COMPLIANCE DATE: VYh.2 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by I g av-K i CL l i 3�1 i Rt 3z SSt - j TOWN OF BARNSTABLE E L:,,)CATION IYJ FLume- AVehut✓ SEWAGE # VILLAGE�T�1/�S ASSESSOR'S MAP & LOTDh( 04DUDJ, INSTALLER'S NAME&PHONE NO. 0,0C 60" (",ft er�r�,�fb8�3GZ�=3j,ft90,r SEPTIC TANK CAPACITY' /S00 'A&) LEACHING FACILITY: (type) (size) 3J'X-/2. NO. OF BEDROOMS -4 BUa,DER OR OWNER B61LDivq PERMITDATE: 4&htnr- 1 as a' COMPLIANCE DATE: �" Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by � A � j �� (7) 3 ap , �` t H� 3� � SS' Fee t Oo C/a- 1 -7 THECOMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYtcation for IN-4pont *pmemc Com5tructiou i3ermit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot NISI F 1 ume Ave Owner's Name,Address and Tel.No. g Q gg Bayside Building CO. Inc. Assessor'sMap/Pazce�apaltYCl 9 ) P.O. BOX 95 Centerville, MA 02632 Installer's Name Ad ess,and Tell.N O /oid0f Designer's Name,Address and Tel.No. 7 71-10 4 0 .2on e 3065 Baxter & Nye Inc. 812 Main Street Type of Building: s e r v 1 e, —9131 Dwelling No.of Bedrooms Lot Size'/' ®a l sq.ft. Garbage Grinder Wo) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flowy gallons per day. Calculated daily flow 7 110 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank l 5,'YV Type of S.A.S. G Description of Soil i �Gtr Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions f Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been iss�y thi oard Health. Signed Date Application Approved by n Date Application Disapproved for thY following reasons r Permit No. Date Issued Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC.HEALTH DIVISION -TOWN';OFBARNSTABLE., MASSACHUSETTS Zippric =tv; cr ,iqogar *p6tent Congtructionerutft 7 Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot N/S/F 1 ume Ave Owner's Name,Address and Tel.No. Bayside Building CO. Inc. Assessor's Map/Pazcel_aMa $t$c M'M j� 11 11 1•��i) P.O. Box 95 Centerville, MA 02632 Installer's Name Ad ess,and Tel.N ()+ Q 7 Designer's Name,Address and Tel.No. 7 71-1040 T!3 L�vl✓s h� S Baxter & Nye Inc. 812 Main Street Type of Building: y s ery 1 e, m. o2655 428-9131 Dwelling No.of Bedrooms / Lot Size° 'V JI sq. ft. Garbage Grinder(rvd) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow d 01-' gallons per day. Calculated daily flow f gallons. Plan Date Number of sheets Revision Date Title Size of Septic'kTank Type of S.A.S. C C.f Description of Soil' Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions P,Title 5 of the Environmental Code and not to place the system in;operation until a Certifi- i Cate of Compliance has been issu d by thi Board of Health. Signed Date Application Approved by �..,... �. Date Application Disapproved for A ol�ng reasons Permit No. - Date Issued � e I Q THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage_Disposal System Constructed(✓)Repaired ( ) Upgraded( ) Abandoned( )by -,� - -+� - �.d (�L... 7On„ J n,1I-ed, at ,/V rl 0 yl? .71 V4ff {'Y1 - !�N I Lc has bp, truft cordance with the provisions of Title 5 and the for Disposal System Construction Permit No. t Installer Designer r The issuance o thi4 permit shall not be construed as a guarantee that the system will function as Oesigped. Date t �� Inspector Jv r No. �• -- �O� 5------------------Fee 1GC� Pool e THE,COMMONWEALTH OF MASSACHUSETTS PUBLf_&,HEALTH 0IVISION - BARNSTABLE} MASSACHUSETTS migp,ogai 6p$tem Congtruction permit Permission is hereby granted to Construct(Repair( )Upgrade( )Abandon( ) System located at 5 `) /,;1V M A4• and as described in the above Application for Disposal System Construction ermit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:ConstructionJmust be completed within three years of the date of th7-s Lit.Date: `/�4 Approved by �- 2d•-N sp.� 8'-O" 8•-O' h Divi 121 -Al 2•_a' 6'_6' IT-V - public liew Town of Barn itable PO Box534 HFyannis,Ms790sach-6 , 5-3344 ax , 65 (50Phone �0,26/0 1Z <T Y Ra H PCC 2 2S • %AT 25 a/ rsn 3r F D 2s+aa 21'-6' T•.{' tJ 13'-0• SPy 2 • yD a_�D ,_ y'154�,,A BEDROOM #2 BEDROOM #3 (CARPET) (CAPPIE7) GL05f 7MASTER a MASTER b b (u+ar j I LMETI BATH SUITE a (TILE) 26 (CARreT) " D 2gSq 2` 26 %' SEAT 2 2 2-3E `' n 25 3^�r25 3/ y'rb4 3/A M(OAK) 26 �� p 2f. 2b BOGK9 b 1. K .. Sw PTD 245a ^ m CLOSET 24 S/y'rea 5/ BATH u3 _ PONDON E - CTL(!�)��))OFFICE SEAT / /1 � PTD 2..Sa l.. 'v (l , SD d-fLD 7-4' 6-G' i `! a 24 3/Ao S9 3/d' (" (OAR) ON.p ! _ 26 p q SQ d-fLD 2A § BEDROOM #4 n O (CARPET) PTD 245n A q BATH ¢2 2-4 (TILE) 0 SEC ND FLOOR FLIAN SCALE, 1/4' . 1-- 6� IL 5 � L M i H IL a'-� a'-a• z-Id 7-IO' y-6' a•-6• g. �• y,�. 4'-O• K'-a' d'-0• T-2' 6'--0• T-Y ?y'-0 2d-O• 20'-O' 72•-a 24'-r 7'-4' I I I I I I I i I i I I I I I I i I I i --------------------------- I I COL I ———————————————--------------Ep I Ir------------------------� I I l L------------a — --------------- 3 1 I I I i �- ---- i I I I I DEPRE`S 10'Foie CWR 2n�� I` t I 2 L* � I 2no. � ' pia. a I I I I v wo.c v wo.� m y s'o I II III m I R L I c_ 3 'r36'x1 7 COC.PAD CUFU BASEMENT _ 3 r 5Tr CLN a ir2'ca II II L—, I I I y I I GARAGE I r-11' er-2' rz-7' A' CONCRETE sua I I I I I I I L i I I I I I 1 � DROr conc:w�u_ -f 1 �.--- a'.e' ccw_. &4 J I I I I W.W CONT. FCOTFW.. DEPRMS 10 FOR DDOR a ' _ I I I I I I a I 36'r94'r12' CONC.PAD I I t 3 I/Y srEEL col u-+N — I I I I I I I I I t o r 2Q iCcur F0071N4 I --------------------------- I I I I L a i IVoo I I I h FOUNDATION PLAN SCALE. 14' - 7-10' 2A•-O' C'-u' 17-d b•-O' 7._b. 70'-d 4 T-O' 4'-O' 8'-O' 3'-V• 9'-4' G'-G' 4'-G" 19'-G' 14'-O' :. 6 IL h h b b n m REAKFAST Pro -2 a n m SO A'r"31A" (O ) B8 3/^"3/A' b O x m L H l tt V M q F O Irf1 q R--V*121 STEEL WA1'1 SM KE DETECTORS O.K. r a n AEVVE ` o a LAUN RY ---- 1 l llJ/ G°( �I RNSTABLE BUILDING DEPT. � � � r4MILT ROOM I �� 2L 1 (OAK) KITCI-JEN (OAR) 0 •'-� 2'k y._2. 12'-10' G•-�' 3'�" 3•_4• p•_4+ G._�. b GARAGE Y UP A+CONC.St?.D (OAR) m VY ; FZY FIRE W ® a b v (OAK) �i n a Q � RAT m BAZ 1J ssi m (QAK) CTD 2g73 w< O (OAK) L 81- 29 3.'✓x73 3/A 34F b flew 12 7,; 1< x CTD 3 J 6 2 LIVING ROC 2°a d na 3ra — (�) _ S 10'-Q' I V 1G'-o" S ✓J yh� H PTO 2-6--2 J9 q R1 q m 66 VA' 3/d FOYER, ((��y oTD (OAR) fl ` 24 3 W e7a 3/A i 3p m FIRST FLOOR FLAN PORCH �+ o a SCALE. 11A' '_0' T p' q T-O' '0'-fY T-FO" 6'-2• - 2A'-O' 6'-O' 12'-O" 't,uwn 01, Barnsta Die I' ll DerArtrnent of Ilenith,Safety,And I;itVII,ollmenlal Services P9a I7 Lln'StrIc It11 JAVISIo uAte I IynnnisA 6 MAPS. Time Fee I'd. t6J9 1` Date Scheduled �4D rAl� Soil Suitability Assessaa'eid for Sewage D44.. scat `P3 Witne Performed By: ��d A ssed By: Owner'sName Indian Lakes Dev. r• Location Address Lot 15 Flume Ave nddressP.O. Box 95 AA, AA Centerville, Ma. 0263 Engineer's Name Assessor'sMnP/Parcel: Map 61 Pcl 10 (Part) Baxter & Nye Inc. X REPAIR Telephone N 428-9131 NEW CONSTRUCTION � Slopes(%) 0 J 3 Surface Stones Land Use 3"i 06$4 I L p y n Possible Wet Ares► �oo n Drinking Writer Well Sri n Distances from: Open Water Dod _ -- '3 0 n Other n Drainage Way __�5�_R Properly Line SKEW1I:(street name,dimensions of lot,exact locations of test moles&Pere jests,locate wetlands In proximity to pules) LOT 15 -77 r M n 24,084 sq.ft. 0) o #I O DRAINAGE EASEMENT 25.30' �o N88'49100"W 1 4- �S ��I� Parent material(geologic) Ucplh to Daarock-�_._._ --� 44'ccping from Pit I'nce Ucpllt to Groundwater. Standing Wntcr in I tole:_ -- Estimated Seasonal high Group walcr w—__. -----— UI�a'J`t ILI1'l.[N�1'a'1.U]V 'Olt S1 A5DNAL IIKA[ t,ICtllod Uscd: _ ----- — In, I?r.ptl b soil mottles: _.—irr Depth Ubscrved slan(ling in obs,bolt: ^._____..---- -ln. (itoundwntcr Adjustment.--- ---•_•-_- -n. Ucplh to weeping fionr side of obs.hole: —' --.-- --- indc.e Wcll n_.--•_-- •Reading Dalc:—�-- IIIdCx Well Icvcl..._—_-- Arij.f:�aor--- Adj.Gtoundwate;L,evc-I } I;it(.Ut..1.'t'la) ( }-'}.::5'>[ idie_i .t.. : Ilrn0 .toM� Ubscrvation �i� 'I ime at 9" _ -- mole n --- 2d-jr l 'Lime at 6" _ Dcpth of Perc fig...,r,.-e"wk V tAJ '��t•-� JTT'7 '1'Lne(fl"•C') - - - laud Pre-sunk ii w Itatc Min./Inch — _ ----'� — Site Suitability Assessment' Site Passed ' Silt I'aii(:d:—_—_—___ Additiomal Testhrg Ncedc(I(Y/N) Original: Public Iiealth Division observatiun hole Vata To Be Completed Oil Ilaelc j Copy: Applicant DEEP OBSGItVATCON ROLE LOGS: ,t Hole # 'I Depth from Soil I lorizon Soil Tcxture Soil Color Soil other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Iloulderes. % It 9 12o to '`"' C IQ fZ`7 o 102, � S - G � DEEP OBSERVATION iiOLE LOG H01e Depth from Soil I lorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Uoulderes. 0 o � D HEEP OBSERVATION IIOLE LOO I-[o1e# ' Other - Depth from Soil I lorizon Soil Texture Soil Color Soil Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Doulderes. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Ilorizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Stricture,Stones,Boulderes. i. Flood Insurance Rate Map: Above 500 year flood boundary No_ Yes Within 500 year boundary No_/ Yes Within 100 year flood boundary No" Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not, what is the depth of naturally occurring pervious material? ('ertificatlon I certify that onlq2<' (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performe by e co istent th the required training, expertise and experience described in 310 CMR 15.017. �� ..y .- 4 TOTAL UNITS 1 STARTER.1 END. &2 INTERMEDIATES. '! ~ 1. THIS PARCEL IS NOT LOCATED IN THE FLOOD PLAIN. 330S TYP 3 O1 330E I 2. THERE ARE NO WETLANDS LOCATED WITHIN 100' OF THIS LOCUS. 4.j, 7.5 6.256.25'4.4, I \\ f 3. REMOVE UNSUITABLE SOILS BENEATH PROPOSED SYSTEM, BACKFILL 1-1.5' WASHED STONE `y WITH CLEAN GRANULAR MATERIAL FILL TO BE GRADED AS FOLLOWS: NOT MORE THAN 15% RETAINED ON No. 4 SIEVE, NOT MORE THAN 90% RETAINED ON No. 50 SIEVE, OF FRACTION PASSING No. 4, 10% OR LESS TO PASS No. 4.15 41 100 SIEVE AND 5% OR LESS TO PASS No. 200 SIEVE, SOIL TO BE APPROVED �• �� N + BY ENGINEER FOR COMPLIANCE PRIOR TO PLACING ON SITE. 4. LOCATION OF UTILITIES NOT SHOWN ON THIS PLAN, AT LEAST 72 HOURS PLAN OF TRAC$ � ZQ.O�� "� ~-- 15, PRIOR TO ANY EXCAVATION FOR THIS PROJECT CONTRACTOR SHALL MAKE NO SCALE 1 ` ` _ 4,-®B-2�""sq.ft. THE REQUIRED NOTIFICATION TO DIG SAFE (1-888-344-7233) AND APPROPRIATE \ �� WATER DISTRICT TO DETERMINE UTILITY LOCATIONS. N O 1 z' GAR. FINISHED GRADE, .. _I COMPACTED F 12"-6"MAX 3 . MIN. ILL SINGLE FAMILY- 4 BEDROOMS 1 NO GARBAGE GRINDER z PEASTONE DAILY FLOW = 110 X 4 = 440 G.P.D. 3os" 3/4" TO 1 1/2 " n a. O •.a DOUBLE '� ?3� 2 l i. SEPTIC TANK 440 X 200% = 880 'e WASHED STONE USE 1500 GAL. SEPTIC TANK y��■ � VLaW �I K $EON R�C�ARt�ER =I& OR ZQMVALEI�T NO SCALE �}� - 25.3 o ALL PIPES TO BE SCHEDULE 40 PVC PERFORATED o o s WITH CAPPED ENDS ; 0 174.42 r USE 1 - 4" DISTRIBUTION LINE IN 4 RECHARGER UNITS I CERTIFY THAT THE PROPOSED FOUNDATION I N N88.49'00"W IN A 12'X 35' WASHED STONE TRENCH AS SHOWN COMPLIES WITH THE TOWN OF BARNSTABLE SIDELINE 1 24.00' LEACHING AREA REQUIRED AND SETBACK REQUIREMENTS AND IS NOT LOCATED 440 G.P.D./.74 = 595 S.F. WITHIN THE FL❑ D PLA , DRAINAGE EASEMENT LO � 2(35 + 12) X 2 = 188 S.F. SIDEWALL AREA DATE:g.'r qg _ R.L.S. j/ (12 X 08 TO 4 S.F. BOTTOM AREA 608 THIS PLAN IS NOT BASED ON AN INSTRUMENT SURVEY AND S.F. TOTAL PROVIDED THE OFFSETS SHOULD NOT BE USED TO DETERMINE LOT LINES. PERCOLATION RATE 1"IN 2'OR LESS 8/14/98 SCALE; 1"= 40' SOIL CLASS , TEST HOLE oFA9gssgo CERTIFIED PIAT PLAN I BARTER & NYE INC. �O STEPHEN yG COVERS LOCATED TO WITHIN I WCAMON #P-9217 N^1 LOT 15 FLUME AVENUE s" of F.G. I y MARSTONS MILLS F.F. ELEV. = 58.0 PIT #1 PIT #2 No.30216 ELEV. 56.0' ELEV. = 56.0' G�tity F.c= 56'f { / F.G.-56't, 9�,0 9F�/STER�� LEVEL \ , ^G=5 B LOAMY SANDum B LOAMY SAND FrS� NG�� AUG.17,1998 INV. c - 1500 GAL ETER 2 I ry - - -6" -s" AL _ 55.0' INV. _ 4"01q�{ 54.8 SEPTIG rAIIK INV.54 = T scHEDULe LEACHING CHAMBERS - -- HERRING RUN AT INDIAN LAKES 4.6 DIST. 40 P.v.c. _2' PERK TEST =:--2' PERK TEST INV. �X -- SUBDIVISIONS #762 INV. =54.2 INv. =54.0 = 10.00 IN. - ��s" STONE BASE--- ASSESSORS MAP 61, PARCEL :.:.:: MIN. _ BOTTOM ELEV. EL =52.0' - C CSANDE C COARSE 1 oYR.7/s 1 oYR.1/s BAXTER v BAXTER & NYE INC. t ewe LAND SURVEYORS, CIVILENGINEERS PROD �I - OSTERVILLE,MASS. NO SCALE -10 NO WATER ''-10 NO WATER ELEV. 46.0' ELEV. = 46.0' BAYSIDE BUILDING CO. INC. B'z�C91 #97012TYP 4