HomeMy WebLinkAbout0071 LITTLE NECK WAY - Health 71 LITTLE NECK WAY
Marstoris Mills
A 076 — '058
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TOWN OF BARNSTABLE
LocTiarr 71 L le
VII.I AGE �5 T'^� '" /"` ��` s L: ASSESSOWS'rvtQ;c' f.aT
SEP`, C TAfiIK C. .FACITX 1
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LEAC ENGACI€ S<
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NO {)PBl13QOMS
1)UMOSR OR OZNrIER
.PER%ITDATE COIVfPY::iAIdCE BATE.
Bets
Scpazstton Distance l the `
Maxittum Adiusfecl Groundwater Ta6ta to tie Bottom ofLeachtng Fac�tity Fit`
Pnvata Water Supply Well aad Tadung Filtty {�f aay wwells exist
at seta ar ithin 20D feet`of ie ag facs rcy) t
Edge;of WEt�and and Leaching>�aa�ity(If any wetlands exist '.
withliat 300 het teacfutig f ) /. Feet
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TOWN OF BARNSTABLE
LOCATION J I L-kit c SEWAGE# ON .�57 — 3 ,
VILLAGE M ASSESSOR'S MAP&PARCEL 0:7(d
INSTALLER'S NAME&PHONE NO. TA N C,€IZ CU Al 5 S-p f3 -27 44 -5-5
SEPTIC TANK CAPACITY &X 1 S T QV 6 /0 00
LEACHING FACILITY: (type) -T726N C (size) I2.6 X 2 S
7'-NO.OF BEDROOMS 3
OWNER KE �Vf 10 P A(,, }
PERMIT DATE: ZD/f J I COMPLIANCE DATE:
Separation Distance Between the: /O
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 20.0 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY ,� ; ,tM�✓
71 . L 1&--7 r, wA
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27 �1 I-7,q.
3.5
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No. ��/V— � Fee �J 6)0
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: r
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
application for MispoBAY 6pstem Construction Permit �
Application for a Permit to Construct( ) Repair( )T.Upgrade(y<Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. _7 I L) f. Pou Owner's Name,Address,and Tel.No. `
Assessor's Map/Parcel 7&— 056 U/)1;/1L1r �g -(t/�,Q
Installer's Name,Address,and Tel.No. ��8—2 7 —g 7�3 Designer's Name,Address,and Tel.No.
tAly N � G 2a 1 ,4� &/� '(flu2 �' so 7 7-
'type of Building: dz S 3 w
Dwelling No.of Bedrooms Lot Size �/sq.ft. Garbage Grinder(„,V
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3® gpd Design flow provided gpd
Plan Date f Z 7 l Number of sheets Z Revision Date
Title
Size of Septic Tank �X/ S r 1600 Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) 2 (J lk ( � X(C SSA S L✓
ct/ 2 X 257 NCA Z 0 4,70 o S
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance.has been issued by this Board of Health. /
Signed Date �2 !
Application Approved by Date j(:)4 /
Application Disapproved by Date
for the following reasons ,
Permit No. 64 61 a 3/`- Date Issued
;4
No. o NB- 3/ _ Fee �DO' L
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
�lpYication for 13I8t108aY pBtPltt Constructionerlttlt '
Application for a Permit to Construct( ) Repair( _};jLU grhde Abandon( ) ❑Complete System ❑Individual Components ' =
f:
Location Address or Lot No. -71 c 1 i.+C. lV (► J4'M Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel - /� �j" f J I G M��"
Installer's Name,Address,and Tel.No. wog_2 7 c'._9 75 3 Designer's Name,Address,and Tel.No.
N t G (lo I /�/ 1,(/u 2 K S So ? �-
Type of Building: .
Dwelling No.of Bedrooms Lot Size � ft. Garbage Grinder
r s
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 3�o gpd Design flow provided gpd
Plan Date 712 7 Z/e Number of sheets Revision Date
Title
Size of Septic Tank / T. M 0 Q Type of S.A.S. 2. 2 S
Description of Soil C, �I/_`AJ
Nature of Repairs or Alterations(Answer when applicable)e G ( t a/ �� S �✓ ( � tl
N-/- iz/ /2 , g x Z s N c 14- 16,4-(4 �7- 4 U T-o u
t 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 Health.
j
Signed Date
Application Approved by ' Date 15-/�(
Application Disapproved by Date
for the following reasons
Permit No. bj >� Date Issued (
= ------------- --------------- ------------ -------- - - - -----------------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(11. )
Abandoned( )by 2A A// f 6aAl�Tpv( T()/iI
at '� L, ��/ E Nf �(_ //� has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No.o2V/ (:�dated I� s
Installer /?-/4 AI RE y>~N6 � Designer - �� �'a e
a � �—
#bedrooms Approved design " gpd
The issuance of this permit shall not Pe construed as a guarantee that the system will function as, a ign
Date ( /� [� Inspector
- - - - - - - -- - - - - - -- - - -
-------------------------------------------------
n
No. 2019 -, /?- / Fee (2 OD
} THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
bisposal *pstem Construction i9ermit
s
Permission is hereby granted to Construct( ) Repair( ) Upgrade(t11( Abandon( )
System.located at t ff[-e �__ 6 (A/A I
and as described in the above Application for Disposal System Constructio'tl Permit. The applicant recognized 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 permit. �� )
C
Date �d � � Approved by
f
Town of Barnstable
oftwe ro
wo, Regulatory Services
1 r
f lJ BARNSTABLE, Richard 1 . Scali, Interim Director
•
a ! Public Realtb Ditlision
ATF°"'A ;Thomas N•IcKean,Director
200 i Jain Street, Wannis, MA 02601
O fiec: 508-562-4614 F,tv jtiti_790_(.;0
Installer- & Designer Certification Form
Date: It r' Sewage Permit# Assessor's Map\Parcel < Cn
�L.Lt �c� Edtr
Designer: Installer: 1 � ✓�S � } c.
Address: I tQ, C';�,sl eta P-0 Address: l _ � ,�vk��
Ott �'�� � �� ,' ��°as issued a ermit t in>t� �- p • . all a
(date) (installer)
f Ai o
septic system at 71 (�'- L �w{�i L`1 r d'� (�' il� based on a deswn drawn by
bit e-.C,+(e tt (address)
VtL e-
t lrje.f-", LC) WCI—VL 1
: f,2 ` dated 9 � Z�
�
(_designer)
I. ccrtit)� that the septic system referenced above was installed substantialiv accordinv to
the desiun. which may include minor approved changes such as lateral relocation ci�tlte
distribution box and:or septic tank. Strip out (if required) was inspected and the soils
were found satisfactorv.
[ certift. that the septic system referenced above was installed «ith major changes (i.c.
greater than 10' lateral relocation of the SAS or and vertical relocation of any component:
of the septic system)-but in accordance with Statc & Local Regitlatious. Plan revis1011 or
certified as-built by designer to follow. Strip out(if required) Nkas inspected C-ind the soils
NVCTc found satisfactorv.
I certify that the system referenced above was constructecj --,nee with the term
of-the I`•,A approval letters ppiicable) , � ,
F ,
�iitalter's SiOnature) -
t Desi�-,ncr's Signature) (Affix Desigtie'Stamp Here)
PLEASE RETUR-N TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF CO-NIPLIANCE Ni-ILL NOT BE ISSUED UNTIL BOTH THIS FORNI AND AS-
BUILT CARD :ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:',Scptic•=.Designer Certification Norm t2e:
Town of Barnstable P# -3
' Department of Regulatory Services
I Public Health Division Date 1`
MA84
200 Main Street,Hyannis MA 02601
Date Scheduled �// ! G/ Time /® Fee Pd.- /�j
p!
Soil Suitability Assessment for Se-wage Disposal
Performed-By:_ t zvt_ ` R�¢Q -$ } -4 . Witnessed By:
LOCATION&.GENERAL INFORMATION
Iveedon Address r"jkL Owner's Name
p� ttc q _
�\v Address 7 1 �-�
Assessor's Map/Parcel.` 6-7 C .—(3-5'Y Engineer's Name 1
NEW CONSTRUCTION 1 (REPAIR _ ,Telephone ,
Lund Use ��5` wti 1 Slopes(96) Z' Surface Stones ' v brv"y
Distances from: Open Water Body _:> 30U >t Possible Wet•Area C7f3<TC) ft Drinking Water Well?r s Q ft
Drainage Way A)Ii A ft Property Line Other ft
SKETCH:(Street name,dimensions of lot,exact locations of test holes&pere tests,locate wetlands-In proximity, to holes)
• b
f '
TIO-Z
• Igo`'
Vct< cis y
Parent material(geologic) �`'t 4-WM5 I-N Depth to Bedrock
Depth to Groundwater. Standing Water In Hole: Weeping from Pit Foos vote
Estimated Seasonal High Groundwater ? `'F
DETERMINATION FOR SEASONALMIOH WATER TABLE
Method Used:
Depth Observed standing in obs.hole: In, Depth to soil mottles,
Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft.
Index Well-0 Reading Date: Index Well level „ Adj4hetbr— Adj.Groundwater-Level,,,_
PERCOLATION TEST Dula,,. „ Time_____.
Observation
Hole# � _ Tinto at 4"
Depth of Peru LL-zdf ._ = Time at 6"
Start Pro-soak Time @ G!� g ` 1 � Time(9"•6")
i
End Pro-soak 1.3 M -
Rate Miu./Inch ,
Site Suitability Assessment: Site Passeii_(�_ Sitp Failed: Addldonal Testing Needed(YIN)
Original: Public Health Division Observation Hole Data To Be Completed on Back---------
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one(1) week prior to beginning.
Q:\SEPTIC\PERCFORM.DOC
DEEP.OBSERVATION HOLE LOG Hole# I _
Depth from Soli Horizon Soil Texture Shcl Color Soil. Other
Surfacc(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders,
• - o st i,�[ancy.96't3ravoll •
L� S9I (a Z
DEEP OBSERVATION HOLE LOG Hole# Z
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(In.) (USDA) J
(Munsell) , Mottling (Structure,Stones,Boulders. .
ChnsIstency.
/�• l04►� S�� I a ` (Zy Z
'2 Cat -IJ t® 12
28-13� C- • dam'! ��.� 2�''Y �/� �" �o�e .'
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders._
Consistency.
i
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Sall Other
Surface(In.) (USDA) (Munsell) Mottling (Structure,S;ones;Boulders,
c
Flood Insurance Rate Map: �[
Above 500 year flood boundary No— Yes
Within 500 year boundary No //= Yea
Within 1,00 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 thrpughout the
area proposed for the soil absorption system? �S
If not,what is the depth of naturally occurring pervious material?
Certii"ication
I certify that on (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with .
the required tr ,expertise and experience described in�10 CMR 15.017.
Signature 41:ADate
Q:\SEPTIC\PERCPORM.DOC
f -
Town of Barnstable Barnstable
A AmMca 1.Q v
Regulatory Services Department F
v BAxrasrABLE,
y MASS.
16*9. �s,� Public Health Division
aTFO MA'ta 200 Main Street, Hyannis MA 02601 2007
Office: 508-8624644 Richard V.Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO .
SECOND NOTICE
CERTIFIED MAIL#7015 1730 0001 4987 5332
August 2, 2018
CARINDA, CHARLES T & CYNTHIA L
71 LITTLE NECK WAY
MARSTONS MILLS, MA 02648
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 71 Little Neck Way, Marstons Mills, MA was inspected on
06/02/2017 by Shawn Mcelroy, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system "Fails" under the guidelines
of 1995 TITLE V (310 CMR 15.00) due to the following:
• Static liquid level in the distribution box above outlet invert due to an
overloaded or clogged SAS or cesspool.
r replace the septic stem within one 1 year from the date
You are ordered to repair o p p y ( )y
you receive this notification.
Failure to repair/replace the septic system within the deadline period will result in future
enforcement action.
PER ORDER E BOARD OF HEALTH
oma cKean, R.S., CHO
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\71 Little Neck Way Marstons Mills
-Second Notice.doc
� 1
�p1NE O�H Town of Barnstable "�'" V U.S.POSTAGE>)PITNEY e0WES
P
Public Health Division I` �• /�/�—,j ®
98""M�B`E.0• 200 Main Street �'�1�� o�
4'rEO MA�AO Hyannis,MA 02601 ZIP 02601
# 02 41N $ 006.67
�7015 1730 0001 4987 5332 00003.36455 AUG. 02. 2018
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CARINDA, CHARLES T& CYNTHIA L
71 LITTLE NECK WAY
rl
W BARNS'T'ABLE MA 02668-1.737
RETURN TO SENDER
: 7 � arA.1g10� l,�I"1'IIII�4I141t'��S`,J�i�"�'� II1 III
N, SENDER: COMPLETE THIS SECTION. COMPLETE THIS SECTION ON DELIVERY
+�; _
P p
■ Complete items 1,2,and 3. A. Signature
■ Print your name and address on the reverse X ❑Agent I
so that we can return the.card to you.
❑Addressee I
■ Attach this card:to the back�of the mailpiece, B. Received by(Printed Name) C. Date of Delivery i
I or on the front if space permits.
Is delivery address different from item 17 ❑Yes
If YES,enter delivery address below: ❑No
CARINDA, CHARLES T& CYNTHIA L
71 LITTLE NECK WAY
MARSTONS MILLS, MA 02648
—- ' 3-.-Service Type 0 Priority Mail Express®
II I il�ll Irll III II I II II II III II III I I II II II III ❑Adult Signature O Registered MallTM
I I ult Signature Restricted Delivery ❑Registered Mail Restrictedl
9590 9402 4116 8092 9364 01 Certified Mail® Delivery
rtified Mail Restricted Delivery Return Receipt for
❑Collect on Delivery Merchandise
2._ACticle_Numher_LTransfer_frnm carvita imi,an . -❑_CoMct.on Delivery Restricted Delivery ❑Signature ConfirmatiohTM
I it ❑.Signature Confirmation
7 015 1730 0001. 4987 5332 ul Restricted Delivery Restricted Delivery I
x t S PS Form 3811,July 2015 PSN 7530-02-000 9053 Domestic Return Receipt 1{
., 11 1 1 71, .
F THE Town of Barnstable Barnstable
T�ti
y . Regulatory Services Department MkWaicaC j
■ARNS'MBLE, I
MASS.39. Public Health Division ltj iG7q, `0 m
'DIED MAt" 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Richard V.Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
SECOND NOTICE
CERTIFIED MAIL#7015 1730 0001 4987 5332
August 2, 2018
CARINDA, CHARLES T & CYNTHIA L
71 LITTLE NECK WAY
MARSTONS MILLS, MA 02648
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 71 Little Neck Way, Marstons Mills, MA was inspected on
06/02/2017 by Shawn Mcelroy, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system"Fails" under the guidelines
of 1995 TITLE V (310 CMR 15.00) due to the following:
• Static liquid level in the distribution box above outlet invert due to an
overloaded or clogged SAS or cesspool.
You are ordered to repair or replace the septic system 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.
PER ORDER BOARD OF HEALTH
oma cKean,R.S., CHO
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\71 Little Neck Way Marstons Mills
-Second Notice.doc ti
214 Wen Jce�,
f ow B cr:> #ftr s''"t e-
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~0 «'`°yam
Town of Barnstable Barn
. Regulatory Services Department j�;� �i
BARNSfABLF-
M"s` Public Health Division
3635 �� m
200 Main Street, Hyannis MA 02601 2007D
' `PI
r
Office: 508-862-4644 Richard V.Scali,:Director
FAX: 508-790-6304 Thomas A.McKean,CHO
SECOND NOTICE
CERTIFIED MAIL#7015 1730 0001 4990 5657
August 7, 2018
CARINDA, CHARLES T & CYNTHIA L
264 WOODSIDE ROAD
WEST BARNSTABLE, MA 02668
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 71 Little Neck Way, Marstons Mills,MA was inspected on
06/02/2017 by Shawn Mcelroy, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the'system"Fails" under the guidelines
of 1995 TITLE V (310 CMR 15.00) due to the following:
• Static liquid level in the distribution box above outlet invert due to an
overloaded or clogged SAS or cesspool.
You are ordered to repair or replace the septic system within one (1)year from the c_�
you receive this notification. vJ
Failure to repair/replace the septic system within the deadline period ill result in future C..Dy
enforcement action. (C P
S
PER ORDER OF THE BOARD OF HEALTH
Tho as McKean, R.S., CHO
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\71 Little Neck Way Marstons Mills
Second Notice x 2-Copy.doc
COMPLETETHIS SECTION • • ON DELIVER
■ Complete,itbms 1,2,and 3. sig re v
``.`'. '.
■ Pr1rit your me and address on the reverse _ Agent
so that%4 an return the card to you. Addressee
' - B. R i e�e) C. Date f De e
■ Attach thitard to the back of the mailpiece, + �
or on the front if space permits.
1 ._e+, �e_e++.e���_r,• --n-1s liv address different from item 1? ❑Yes
If YES,enter delivery address below: ❑No
iCARINDA, CHARLES T& CYNTHIA L
264 WOODSIDE ROAD
WEST BARNSTABLE, MA 02668
II"IIICl till l'I�II I II II II�I�I I�I II'II II�1�1 1❑Adult/Signat reice e 0 Priority Mail Restrlcted D 11 elivery 11 Registeredre MaipRest®Restricted
9590 9402 4116 8('�' ,r�. ehvery
u per.,..-_. _Delivery etum Receipt for
❑Collect on L Merchandise
2. Article Number, „,at+on_—_ Collect on Deli% 3stricted Delivery ❑Signature Confirmation'"
E "❑ Signature Confirmation
''L".r �7..77,, •rf z +. i f t p i li s '-i ilCt•, l i i 1.111 f"oted Delivery
i
PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt
First-Class Mail
Postage&Fees Paid
USPS
Permit No.G-10
9590 9402 4116 8092 9362 58
United States Sender:Please print your name,.address,and ZIP+4®in this box*
Postal Service F-
Tc. I T-larnstable
2 C N Street
/annis, 1 M 02601
and, ��
p o
,n
Ln
Er Certified Mail Fee N
117 $ �G �.
Extra Services&Fees(check box,add fee as appropriate)
❑Return Receipt(hardoopy) $ • M prq ' l
El Return Receipt(electronic) $ t r-a --:Postmark
O ❑CertifledMailRestdotedDelivery $
C3 ❑Adult Signature Required $
❑AduR Signature Restricted Delivery$
O Postage - -
m $
Total Pos
talPos CARINDA, CHARLES T& CYNTHIA L
Se"tr° 264 WOODSIDE ROAD
C3 SI'ieefan WEST BARNSTABLE, MA 02668
city"sia
FiCertifiedflail service provides the following benefits:
•A receipt(this portion of the Certified Mail labeq. for an electronic return receipt,see a retail
■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
■Electronic verification of delivery or attempted return receipt for no additional fee,present this
delivery. USPS®-postmarked Certified Mail receipt to the j
•A record of delivery(Including the recipient's retail associate. . 11
signature)that is retained by the Postal Service' Restricted delivery service,which provides ,jj
for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent
Important Reminders. Adult signature service,which requires the i
■You may purchase Certified Mail service with signee to be at least 21 years of age(not
First-Class Mail®,First-Class Package Service®, available at retail). T
or Priority Mails service. Adult signature restricted delivery service,which
•Certified Mail service is notavailable for requires the signee to be at least 21 years of age,
International mail. and provides delivery to the addressee specified 3
■Insurance coverage Is notavailable for purchase by name,or to the addressee's authorized ageW,
with Certified Mail service.However,the purchase (not available at retail). Li
of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is
Insurance coverage automatically included with accepted as legal proof of mailing,it should bear a.r
certain Priority Mail items: USPS postmark.If you would like a postmark on r r.
■For an additional fee,and with a proper this Certified Mail receipt,please present your r;
endorsement on the mailpiece,you may request Certified Mail item at a Post Office-for
the following services: postmarking.If you don't need a postmark on this
Return receipt service,which provides a record Certified Mail receipt,detach the barooded portion,
of delivery(including the recipient's signature), of this label,affix it to the mailpiece,apply F-
You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.
electronic version.For a hardeopy return receipt,
complete PS Form 3811,Domestic Return
Receipt,attach PS Form 3811 to your mailpiece; IMPORTANT.Save this receipt for your records.
Ps Form 3800,April 2015(Reverse)PSN 7530-02-000-9047
Town of Barnstable Barnstable
ANnoduC
~° Regulatory Services Department
UMA j
"'"%63 . Public Health Division
rFDNt�'�A 200 Main Street, Hyannis MA 02601 2007
Office: 508-862-4644 Richard V.Scali,Director
FAX: 50£.-790-6304 Thomas A.McKean,CHO
SECOND NOTICE
CERTIFIED MAIL#7015 1730 0001 4990 5657
August 7, 2018
CARINDA, CHARLES T & CYNTHIA L
264 WOODSIDE ROAD
WEST BARNSTABLE, MA 02668
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5
The septic system located at 71 Little Neck Way, Marstons Mills, MA was inspected on
06/02/2017 by Shawn Mcelroy, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system "Fails" under the guidelines
of 1995 TITLE V (310 CMR 15.00) due to the following:
• Static liquid level in the distribution box above outlet invert due to an
overloaded or clogged SAS or cesspool.
You are ordered to repair or replace the septic system 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.
PER ORDER OF THE BOARD OF HEALTH
Tho as McKean, R.S., CHO
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\71 Little Neck Way Marstons Mills
-Second Notice x 2-Copy.doc
C13 ..
o
tr Certified Mail F
Q' $ 11 t
:I- %r ervlces&Fees(check box,add fee as appropriate) 1�4,
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Return Receipt(hardcopy) $ ,�'i
0 ❑Return Receipt(electronic) $ ostmark �Z
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Certified Mail service provides the following benefits:
■A receipt(this portion of the Certified Mail label), for an electronic return receipt,see a retail
Y A unique identifier for your mailpiece. associate for assistance.To receive a duplicate
■Electronic verification of delivery or attempted return receipt for no additional fee,present this.
delivery. USPS®-postmarked Certified Mail receipt to the
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for a specified period. delivery to the addressee specified by name,or
to the addressee's authorized agent
Important Reminders: Adult signature service,which requires the T
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Receipt;attach PS Form 3811 to your mailpiece; IMPORTAPII:Save this receipt for your records.
PS Form 3SOO,April 2015(Reverse)PSN 7530.02,000.9047
�a
F SHE T°�
Town of Barnstable Barnstable
Regulatory Services Department
8AM!-MABI E
"`" - m Public Health Division
p'fD MA�a 200 Main Street, Hyannis'MA 02601 2007
Office: 508-862-4644 Richard V.Scali,Director
FAX: 508-790-6304 Thomas A.McKean,CHO
CERTIFIED MAIL#7015 1730 0001 4990 6548
June 8, 2017
CARINDA, CHARLES T & CYNTHIA L
71 LITTLE NECK WAY
MARSTONS MILLS, MA 02648
ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5
The septic system located at 71 Little Neck Way, Marstons Mills,MA was inspected on
06/02/2017 by Shawn Mcelroy, certified Title V Septic Inspector for the State of
Massachusetts.
The inspection of the septic system showed that the system "Fails" under the guidelines
of 1995 TITLE V (310 CMR 15.00) due to the following.
0 Static liquid level in the distribution box above outlet invert due to an
overloaded or clogged SAS or cesspool.
You are ordered to repair or replace the septic system 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.
PER ORDER OF THE BOARD OF HEALTH
PasMcKean, R.S., CHO
Agent of the Board of Health
Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\71 Little Neck Way Marstons
` Mills.doc
r
Town of Barnstable
Regulatory Services Department
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. 5111116
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 ;F
❑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.
❑Backup of sewage into the house du an overloaded or clogged SAS or cesspool
NE ;qui
EAR DEADLINE
evel 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
q Single Cesspool-
❑Any"conditionally passed systems" (broken cover,relocation of a pipe,relocation
of a driveway due to H-10 components, etc)
❑Leaching pit or cesspool with high liquid level, <12"below inlet(per Town Code
§360-9.1)
❑Leaching facility with standing liquid level at or above the invert pipe (per Town
Code §360-20 h)
OTHER
Repair deadline:
WSEPTIMDEADLINES TO REPAIR FAILED SYSTEMS.doc
' Commonwealth of Massachusetts
:a=1 Title 5 Official Inspection Form
'f-4 Subsurface Sewage Disposal System Form Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name information is Marstons Mills V/ MA 02648 6-2-17
required for every
page. City/Town State Zip Code Date of Inspection..
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
A. General Information
1. Inspector:
Shawn Mcelroy
Name of Inspector
Upper Cape Septic Services
Company Name
P.O. Box 73
Company Address
E. Falmouth MA 02536
City/Town State Zip Code
1-508-495-0905 S13971
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
6-2-17
Inspector'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.
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17
,C b
a�
Commonwealth of Massachusetts
�,^+ fJ Title 5 Official Inspection Form
J- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-2-17
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:
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
II
_ Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-2-17
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
f
Title 5 official Inspection Form
' 1�;, Subsurface Sewage Disposal System Form Not for Voluntary Assessments
0
sf % 71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-2-17
page. Cityrrown 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:
• r
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 stem component due to overloaded or
® ❑ p g Y Y p
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 'h day flow
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposwl.System•Page 4 of 17
Commonwealth of Massachusetts
f Title 5 Official Inspection Form
ICI Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-2-17
page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
® ❑ The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to.the
questions lin 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
Commonwealth of Massachusetts
=1 Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-2-17
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): 3 Number of bedrooms (actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
f Title 5 Official Inspection Form
�. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-2-17
page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
Number of current residents: 0
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:
Sump pump? ❑ Yes ® No
Last date of occupancy: 2017Date
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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
l_
Commonwealth of Massachusetts
f Title 5 Official Inspection Form
I.,
., Subsurface Sewage Disposal System Form Not for Voluntary Assessments
l� aA
u rW.. 71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is
required for every Marstons'Mills MA 02648 6-2-17
page. City/Town 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: N/A
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
:a= Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�_;;!✓ 71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-2-17
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:
1979
Were sewage odors detected when arriving at the site? ❑ Yes ® No
Building Sewer(locate on site plan):
Depth below grade: 18"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.):
Good condition.
Septic Tank(locate on site plan):
Depth below grade: 12"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: 1000 gal
Sludge depth:
12"
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
�•Jf!r 71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is
required for every Marstons Mills MA 02648 6-2-17
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank (cont.) u,
Distance from top of sludge to bottom of outlet tee or baffle
20"
Scum thickness
6"
Distance from top of scum to top of outlet tee or baffle N/A Tee Broken
Distance from bottom of scum to bottom of outlet tee or baffle N/A
How were dimensions determined? 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 in good condition with no sign of leakage. Concrete outlet tee has broken off.
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
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
; lf;�I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required`or every Marstons Mills MA 02648 6-2-17
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
G
Subsurface Sewage Disposal System Form Not for.Voluntary Assessments
F%
a
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-2-17
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 had stain lines above outlet invert.
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
� Title 5 Official Inspection Form
I '�If., Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-2-17
page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
® leaching pits number: 1-1000 gal
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leach pit was empty at inspection with stain lines above inlet invert and into d-box.
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
=1 Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-2-17
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
�a Title 5 Official Inspection Form
[,_211 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is required for every Marstons Mills MA 02648 6-2-17
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
6
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t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
Commonwealth of Massachusetts
�+ f Title 5 Official Inspection Form
6, y
Subsurtace Sewage Disposal System Form -Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name
information is
required for every Marstons Mills MA 02648 6-2-17
page. City/Town 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: 20
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 and town maps show groundwater at greater than 20'.
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
Commonwealth of Massachusetts
la= Title 5 Official Inspection Form
1
F�+
I Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
71 Little Neck Way
Property Address
Jeff Carinda
Owner Owner's Name w
information is required for every Marstons Mills MA 02648 6-2-17
page. City/Town State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary: A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
LOCATION f SEWAGE PERMIT NO.
.CdT * 39 Near 00
VILLAGE
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INSTA LLER'S NAME & ADDRESS
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c /t�2t 0*0 ax• A00 /�r.✓ll tyi//c
B U It D E R OR OWNER
Cww sraPw-f-
o�i?lGe Ale�,xD PlI72s �ti3 rri.,�S
DATE PERMIT ISS..U'ED _
DAT E COMPLIANCE ISSUED z/��
3
3
Aly�
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4
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No........: .�_..... F�s.............. �
THE COMMONWEALTH-OF MASSACHUSETTS
A BOAR® O,f HEALTH
.r4ol............ .....OF.......... ... . _. .....................................................
A Iiration for Dis ils ai Works Tonstrnrtiun Vamit
1 Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at
Locatio--- d ess /� or Lot No.
O e Address
F-1
alley , Address
Type «�
d Type of Buildi g rfSize Lot............................Sq. feet ,W
U Dwelling No. of Bedrooms......_..�.eJ............................Expansion Att '( Garbage Grinder
aOther—Type of Building ............................ No. of persons............... Jr ( l) afeteria�(Showers — C
Pa Oth fixtures •-•••••••-•--•-•-••-•-••.............•---•--•-•-•--•--•-•••-• ....//��' ...--••••............ .Design Flow.................................gallons per person per day. Tg61 daily flow...._ lam........... ' ..gallons ^
W ,F '
WSeptic Tank. Liquid capacity 000.gallons Lengtlf............... W;,�tho............ Diameter------------- D th._.._..._....__
x ; leaching Disposal Trench—No. .............. . Width............._..... Total Len tti '.............. Total
Seepage Pit No......./........... Diameter...... .......... Depth belo inief..'K_ .._.. Total leaching area( 1..::: q. ft.
Z Other Distribution box ( ) Dosing link .` i
'-' Percolation Test Results Performed by...` --...... l....�,f st.k,�•s_._. Date_3 �,�.._. ,e......__.
; '' -
,� Test Pit No. I--- L-._minutes per inch Depth of Test Pit.................... Depth to grouno'water........................
(� Test Pit No. 2................minutes per inch Depth,.of Test Pit.................... Depth to grouifd water........................
O ? r
Description of Soil...............�--•....v�•---------
U -•---•.......•------•-••--•-•----•-•------••••--•--....•--•-•--------------•---....••---•••....-•- 4: kl• -H Xf..........................•----... rt�a. ,
---------------------------------------------------------------------------------------------------------------------------------------•------•----------------•---••---------------.................-•'
{ J...,..
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 TI IT,iE 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. �.
Signe ••••• .-•-••--•--=-------............... .......................... .
Date
Application Approved B � •7
Date
Application Disapproved for'the following reasons: ----------------------------------------•••----•--•--•---••••----••------
.........-•-...--••••-•--••..................•••••........i ��. .............Date-----.........
Permit No...------. ........ •---------------•......--- l Issued-._ ':21.��...............--•--••---
Date
L t ay -
No.......... -_....._ ..............
THE COMMONWEALTH_OF MASSACHUSETTS
BOARD- OF HEALTH.
«..ot .� ....OF...... .., .:'�......w ........................................
Appliration for Disposal Works Tonstrurtion ramit
Application is hereby made for a Permit to Construct ( )' or Repair ( ) an Individual Sewage Disposal
System at:
40.
... . . - .
-
oca d ess.. L ot N
............... o
'ry ...
Owner Address
:. --•......................••--•-•--------•..........--••-------- -•--•................._.....------__...
Installer Address
UType of Building Size Lot................:...........Sq. feet
.� Dwelling f No. of Bedrooms.__.___._ ____________________________Expansion Attic ( ) Garbage Grinder ( �
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Othp fixtures ---------------------------------------•-------------......-----------------..--------------------•--•----•.-----
----------------
Design Flow_ .. ...............gallons per person per day. Total daily flow----- 0 ---
....... ........
WSeptic Tank�Liquid capacity.14-OV.gallons Length................ Width................ Diameter................ Depth................
x Disposal Trench—No..................... Width.................... Total Length..... ,......._. Total leaching area....................sq. ft.
Seepage Pit No.......r�_.________ Diameter....a-••........... Depth belo inlet.... Total leaching area ......sq. ft.
Z Other Distribution box Dosing tank ,( ) 1W
'-' Percolation Test Results. Performed by, : .. ........1"-L..�1A..1*_ __.�____ Date_ °'_:�: :___�7'__�x_._____..
►a s
Test Pit No. 1... ....minutes per inch Deptli of Test Pit____________________ Depth to ground water........................
Test Pit No. 2.................minutes per inch .Depth of Test Pit____________________ Depth to ground water........................
D D 'escr ton o Soil............... ' J -
V ....................../
�' `7"`. 11 --�4---------------------------------------•------•------------
............... .,d." ._ ._........_....._............_.................._._..................................................._..........._.._._....
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 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.
Signziol
.............................
Date
Application Approved B :� ..
Date
Application Disapproved for the following reasons: -------------------------------------------••-------------.....--•--••-------
h
.......-•-•-------------------------•-------•---•-••-------........-------•-----•--............--------...------------------------------..•...---...---------------•-------------------------•-••------•-
Date
PermitNo......................................................... Issued......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
. A.1........OF....... ...:................................................
TrrtdirFate of Tomptittnrr
THISi S TO CERTIFY ; ► t the IAdi�idual Sewage Disposal System constructed ( ��or Repaired ( )
. .. .. ------...�` 1��-�` -------------------------------------------------------------------•--
Ins)ller
has been installed in accordance with the provisions of T of The Mate Sanitary Cede as described in the
application for.,Disposal Works Construction Permit No.. .Ir + "----------. dated----•Vw 1.Z;_ • .
THE ISSUANCE OF THIS xCERTIFICATE SHALT. NOT BE CONSTRUE A GUARANTEE THAT THE
SYSTEM WILL FUNCT . N SATISFACTO
DATE................... ` ..... = = Inspector........ - - ----•----•-•---------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OFF, HEALTH
......
�... trig" .. .....0 F...... , 2.� .*........ �
No...................:..... FEE._......................
Disposal Work s Tonatt � . n
Permission is hereby ranted...
Y g p - l l
to Construct + or Repair ( ) an Indivl uaFSewage.Disposal�'s em
a
Street
as shown on the application for Disposal Works Construction ermit No..................... Dated.....
...........
. .........
......................................
Board ofAdHealth
DATE.................••----...-----•-•-•--= ... -'-.
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— 97——EXISTING CONTOUR w Dory Cir N
x 1.00.98 EXISTING SPOT GRADE R'94n9 Way
102 PROPOSED CONTOUR n CD
NCI EXISTING WATER SERVICE a
CD
TEST PIT
p Neck
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BENCHMARK o-
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LEGEND
LOCUS
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• LOCUS MAP
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107.70
c�9 O
S 1$�
((� \ CATCH BASIN
RIM=107.31
107.57 ..107.7 107.03 t S
107.82
106.96
CBBROKEN \ 106.94`
1° GARAGE
/ 0
/ ..
106.94
10358^1 x 105.�1 106.79
\
x 102(45 102.45 _
08 1 (�) �! ,-� x 1o1sa ) 103.27 x h EXISTING 1°a-- x 10325,
(� 1 �102.74 / o HOUSE(#71) w
1 i' ` � IT.O.F.=107.9t DECK +102.81
100. CELLAR FLOOR, EL.100.7t
1 x 101.38 x
1 1 , .31 x 101.77
S �1 x _ ����co x 102,28 102.70 N
a 10 101.35 i� 102BEN Z
WHITECPA�I,NT/ T WALL \ARK ` \\ ��CZ�\ 100.46,# 100.9.3 TP-1 0 101.82
Q J!V
1
EL.=102.26 \ \\ �. + to ROP�SA.S
jr
100.74
TP-2 �x .66
101.40 +.
EXISI7NG SEPTIC TANK �\ 101.20
TOP OF TANA', EL.=100.28
INV.(OUT)=9E.95f
EX1S77N-"2 LEACH PIT
CONTRACTOR SHALL PUMP,
FILL W/SAND & ABANDON
x� LOT 39 \�\
35,134f SF \\ +
1
/
S
o PETER T.
McENTEE
v CIVIL
No. 35109
RFGIS(ER�� �
OWNER OF RECORD
PARCEL ID: 07V-0�C7 2AJILLBSODEWEALOPMENT CORPORATION
EAST SANDWICH, MA 02537
Engineering by: SCALE DRAWN JOB. NO PROPOSED SEPTIC SYSTEM UPGRADE PLAN
Engineering Works, Inc. 1"=3o' P.T.M. 230-18
12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. 71 LITTLE NECK WAY MARSTONS MILLS MA
(508) 477-5313 9/27/18 P.T.M. 1 of 2 Prepared for: Wakeby Development Corp. E. Sandwich MA 02537
rA
.l
•r
NOTE: TO PREVENT BREAKOUT, THE PROPOSED
FINISH GRADE SHALL NOT BE < EL:98.3
SEPTIC TANK FOR A DISTANCE OF 15' AROUND THE
INSTALL RISERS & COVERS OVER INLET PERIMETER OF THE S.A.S.
PROPOSED S.A.S.
AND SET TO 6" OF FINISH GRADE. PROPOSED D-BOX
PROVIDE TWO ACCESS MANHOLES TO WITHIN 3"
CELLAR FLOOR=100.7t INSTALL WATERTIGHT RISER & OF FINISH GRADE FOR INSPECTION PURPOSES
T.O.F.=104t COVER SET TO 6" OF GRADE
F.G. EL.=102.0t F.G. EL.=101.35t F.G. EL.=101.5t F.G. EL.=101.5t
MAINTAIN 2% GRADE (MIN.) OVER SA.S.
L = 17 L = 5,
® S=1% (MIN.) ® S=1% (MIN.)
4"SCH40 PVC 4"SCH40 PVC
6" oo
10 6 BBaaaBB
14" �aaB6aa
EXISTING 48" LIQUID aaaaaB
LEVEL ADD 4' 4.8' 4'
GAS BAFFLE INV.=98.17 PROPOSED INV.=98.00
INV.=98.95t D-BOX EFFECTIV
(FIELD VERIFY) E WIDTH = 12.8'
INV.=97.80
EXISTING SEPTIC TANK 2-500 GALLON LEACHING CHAMBERS
SURROUNDED WITH STONE AS SHOWN
H-10 RATED
NOTES: TOP CONC. ELEV.= 98.6f
BREAKOUT ELEV.=98.30
1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.=97.80 ease
INVERTS, PRIOR TO INSTALLATION. aaaaa 00E313
ease eases
2) D-BOX SHALL BE SET LEVEL AND TRUE TO GRADE BOTTOM ELEV.=95.80
ON A MECHANICALLY COMPACTED SIX INCH CRUSHED 4' 2 x 8.5'=17.0' 4'
( ) PERVIOUS MATERIAL EFFECTIVE
2 .STONE BASE, AS SPECIFIED IN 310 CMR 15.221 4' MIN. OF NATURALLY OCCURRING EFCTIVE LENGTH = 25.0'
3) INSTALL INLET & OUTLET TEES AS REQUIRED. 5' MIN. ABOVE GROUNDWATER
LEACHING SYSTEM SECTION
4) CONTRACTOR SHALL INSTALL A GAS BAFFLE ON THE
OUTLET TEE. BOTT. OF TP-1, EL.=88.8 -
3/4" TO 1-1/2" DOUBLE
WASHED STONE
3" LAYER OF 1/8" TO 1/2"
SEPTIC SYSTEM PROFILE DOUBLE WASHED STONE
(OR APPROVED FILTER FABRIC)
SOIL LOG
DATE: AUGUST 14, 2018 (REF#15,735)
SOIL EVALUATOR: PETER McENTEE PE(SE#1542)
WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT
ELEV. TP-1 DEPTH ELEv. TP-2 DEPTH
100.8 A o„ 100.3 A 0" EXISTING DECK
--
LOAMY SAND LOAMY SAND p HOUSE#71)
10YR 4/2 10YR'4/2
100.3 6" 100.0 4" Q
B B
LOAMY SAND LOAMY SAND �.
97.8 OYR 5/6 36„ 10YR 5/6
C1 98.0 C1 28" 4)3 �J----�7
PERC I N I N
42'/60" PROP. S.A.S.1
MED. SAND MED. SAND
2.5Y 6/6 2.5Y 6/6
SEPTIC LAYOUT
88.8 1 144" 89.0 138"
NO GROUNDWATER, PERC RATE: <2 MIN./IN. GENERAL NOTES:
1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL
BOARD OF HEALTH AND THE DESIGN ENGINEER.
2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS
OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE
LOCAL RULES AND REGULATIONS.
3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR
DESIGN CRITERIA DOSIGN NSPE TIONER D APPROVAL BY THE BOARD OF HEALTH AND THE
4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING
NUMBER OF BEDROOMS: 3 FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN
SOIL TEXTURAL CLASS: CLASS I ENGINEER BEFORE CONSTRUCTION CONTINUES.
DESIGN PERCOLATION RATE: <2 MIN/IN 5. ALL ELEVATIONS BASED ON AN ASSUMED DATUM.
(0.74 GPD/SF LOADING RATE) 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF
DAILY FLOW: 330 GPD THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF
HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION.
DESIGN FLOW: 330 GPD 7. WATER SUPPLIED BY TOWN WATER SERVICE.
GARBAGE GRINDER: NO
LEACHING AREA REQUIRED: (330 GPD) = 445.9 SF 8• THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S.
9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS
74 GPD/SF AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE
EXISTING SEPTIC TANK: 1250 GALLON CAPACITY DIRECTED BY THE APPROVING AUTHORITIES.
PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY
USE 2-500 GALLON LEACHING CHAMBERS IN SERIES THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING
SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES CONSTRUCTION.
11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS
SIDEWALL AREA: 2(12.8' + 25.0') X 2 = 151.2 S.F. IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND.
BOTTOM AREA: 12.8' x 25.0' = 320.0 S.F. REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3).
12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE
TOTAL AREA:..............................................................471.2 S.F. INSPECTED BY A LICENSED SOIL EVALUATOR PRIOR TO BACKFILL.
13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND
DESIGN FLOW PROVIDED: 0.74 GPD/SF(471.2 SF) = 348.7 GPD Engineering by: SCALE DRAWN JOB. Na IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY.
Engineering Works, Inc. N.T.S. P.T.M. 230-18. PROPOSED SEPTIC SYSTEM UPGRADE PLAN
12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. 1 LITTLE NECK WAY MARSTONS MILLS, MA
(508) 477-5313 9/27/18 P.T.M. 2 of 2 Prepared for: Wakeby Development Corp. E. Sandwich MA 02537