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HomeMy WebLinkAbout0050 MARSHVIEW LANE - Health 50 Marshview Lane Marstons Mills A = 076 - 007 J I i� s F TOWN OF BARNSTABLE LOCATION 'S ^C SEWAGE# �� e VILLAGE b'1 6'_ASSESSOR'S MAP&PARCEL Oa INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACI•TY LEACHING FACILITY:(Type) (size) NO.OF BEDROOMS OWNER sue, �. PERMIT DATE: - (O t CO LIANCE DATE: 1 I 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 1 "7 q os � .3 TOWN OF BARNSTABLE LOCATION ' tL SEWAGE # VILLAGE ASSESSOR'S MAP & LOT a• INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size} NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER ti. BUILDER OR OWNERe DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No low rw o E VtS4 L.G fic Tire 4 Ira) G a � No Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �-- Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETT Zipplitatlon for Disposal 6pstent Construction 3pPrttttt , qt-ey A Application for a Permit to Construct( ) Repair(ik<upgrade( ) Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. _5T W k-*'f k7eiJ L✓i/1K10'/ Owner's Name,Address,and Tel.No. Assessor's Map/Parcel o76 0 0 7 6r,C41-eV Installer's Name,Address,and Tel,;�le -Df�� Designer's Name,Address,and Tel.No. 8i 067 ,�, -� ` ,, ell. 77�i-Z3�-/� _T R&' Lx��. Type ofB 'ding: fs Dwelling No.of Bedrooms I/— Lot Size I Zy 3 sq.ft. Garbage Grinder(✓v Other Type of Building SF& No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) y 0 gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. 7 ,SaO FA/ /�{-ZD Description of Soil o Nature of Repairs or Alterations(Answer when applicable) (At-f ,ka A i C /pLYi 7 /'r ZU S Lrl- A-1 �i�•�w,l�-�i�J G✓ Y r ci�n�� ,Ct Y y `2 Sd / /7 X 71,TX Z L 6-e,-% 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 Application Disapproved by Date for the following reasons Permit No. , 0 �� Date Issued to iV 4 No. n I A l� F THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 0[pplitation for Misposaf 6pstem Construction Permit 11 I S Application for a Permit to Construct( ) Repair(01Upgrade( ) Abandon( ) ❑Complete System ©individual Components Location Address or Lot No. _5 a W ko,I h Vi P6v Lh l 1"t" Owner's Name,Address,and Tel.No. Assessor's Map/Parcel O76 —0 07 /,'vc k ley Installer's Name,Address,and Tel y � Designer's Name,Address,and Tel.No. o ?4. � � y�1� 1 Type of Building:' M eel S�or+S A4'1(1 +, Dwelling No.of Bedrooms `f Lot Size '3 9,Zy 3 sq.ft. Garbage Grinder(•v Other Type of Building S No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) I// L/D gpd-] Design flow provided L�60 gpd Plan Date 3 0444 // ZD/6 Number of sheets / Revision Date Title i Size of Septic Tank t►-_ ,f' / 0 Type of S.A.S. 70 Ak-✓ Description of Soil r Nature of Repairs or Alterations(Answer when applicable) /Rl i 1-0 i i 7 /i/10 Date last inspected: f 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 7// Date Application Approved by Date Application Disapproved by � Date � l , for the following reasons Permit No. �L. //6 Date Issued I;� ------------------------- THE COMMONWEALTH OF MASSACHUSETTS 0 7 6 —0 v --7 BARNSTABLE,MASSACHUSETTS Certificate of Compliance r THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ✓f� Upgraded( ) Abandoned( )by at Du/A {'94,, L I- , ,W, 417 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.o Olt,-O W dated L;z4/ Installer �f Designer t #bedrooms 7 Approved design flow, ��40 gpd The issuance of thi� permit shall not be construed as a guarantee that the system will(7n•tionas desig ed. Date f f IL Inspector ` 0 l�r� � Q� i ' W ----------------------------------------------------------------- No.-2 0119—0 4 - Fee of . THE COMMONWEALTH OF MASSACHUSETTS 07 vo7` PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS 6 — '. Misposal 6pstem Construction permit Permission is hereby granted to Construct( ) Repair(�� Upgrade( ) Abandon( ) System located at 0 W AA S (,ol; .A11 /—.tl and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. j Provided:Construction must be completed within three years of the date of this permit. Date 31/D //119 Approved by I12�-�►'-� 50 k pro-iiI_& L —�l0+ ��� &Za`fv Town of Barnstable �+ Regulatory Services g rY Thomas F.Geiler,Director BAIUMABM MAWPublic Health Division 6A,� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: 11,066 Sewage Permit# 0/6 Assessor's Map/Parcel 076 —00 7 Installer&Designer Certification Form Designer: Ct(p,F. �tf ,��S: Installer: Address: 9' C'acx- fz-oj� Lam,0— Address: c A-"J 111,mi /lei wq8 On 3/1 0// ,'e ,�aC was issued a permit to install a (date) I (installer) septic system at A-# oia1'6,aJ,e wLcAvr���,� based on a design drawn by (address) 1;F 6o_,.��,5 dated 3 �/ #Z 7W 6 / (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. Stripout(if required)was inspected and the soils were found satisfactory. P�(N OF MAss9 GLEN ( staller's Signature) o: ERIC HAW IN v, No.1070, MT (Designer' ature) (A 1 . . I p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DMSION THANK YOU. gAoffice formAdesigrercertification fonn.doc Town of Barnstable P# Department of Regulatory Services wuvsreStE = Public Health Division Date a /a KASS. 200 Main Street,Hyannis MA 02601 r` () �uV Date Scheduled Time Fee Pd.,� Soil Suitability Assessment for Sew a Disposal Performed By: �IX yl � IT(�t t'Y%i hR U�-��i Witnessed By: i/� n LOCATION- Location Address // AA Owner's Name vG 4r��' Y Address _5,0 "I CW 4�@.4-//J?i Assessor's :Ma /ParcelfD p 076—0 0-7 Engineer's Name 6&., � <l NEW CONSTRUCTION REPAIR Telephone# Land Use kfi dte&�kP t f�rJ Slopes S— Surface Stones Distances from: Open Water Body '7 ZCO ft Possible Wet Area �fS`U ft Drinking Water Well —&-A—ft Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) N 1 Parent material(geologic) ®fJ Depth to Bedrock ?0 Q Depth to Groundwater: Standing Water in Hole: Weeping from Pit Trace __. .. '�P t 2 Estimated Seasonal High Groundwater DETERMINATION FOR SEAS-ONAL.HYCH WATTR TABLE Method Used: ..��' Depth Observed standing in obs.hole. in. Depth to soil mottles: _ in. Depth to weeping from side of obs.hole: N In. Groundwater Adjustment �' 'r ft• Index Well# Reading Date: Index Well level_ Adj factor-4 Ad.Groundwater Level_z PERCOLATION TEST j1� Observation Hole# jZ Time at 9" Depth of Pere " , Time at 6" Start Pre-soak Time @ p0290 Time(9"-6") End Pre-soak a•�710 Rate Min./Inch z Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back-------- ***If percolation 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. /C Q:\SEPTIC\PERCFORM.DOC V J DEEP OBSERVATION HOLE LOG Hole# J. .., Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel 0,-10 L s j0x1t 'YZs( A-V DEEP OBSERVATION ROLE LOG Hole# Z Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel ®� Z L s r�y - �o L S 0/4-96 . /w G X-/Zp C 1 Sa--tj /a DEEP OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent Gr I Flood Insurance Rate Mau: Above 500 year flood boundary No_ Yes Within 500 year boundary No— Yes m 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? ke/� If not,what is the depth of naturally occurring pervious material? Certification I certify that on /a , 9 f (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 training,expertise an experience described in 310 CMR 15.017. Signature 2 Date Z Q:\SEPTIC\PERCFORM.DOC I ' -7 �� `�� 6 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal.System Form-Nof for Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is required-for MARSTONS MILLS MA 02648 1/15/11 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out I forms on the n computer,use 1. Inspector: J� only the tab key to move your DOUGLAS A BROWN cursor-do not use the return Name of Inspector key. DOUGLAS A BROWN INC Company Name f� P.O. BOX 145 Company Address CENTERVILLE MA City/Town State 02632 Zip Code 508-420-4534 S14297 Telephone Number License Number B. Certification [ certify that I'have personally inspected the sewage disposafsystem at this address and thafthe 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 _ 1/15/11 Inspector ignature 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. r— Ya ****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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 f I Il Commonwealth of Massachusetts mum Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 every page. City/Town Date of Inspection 1/15/11 State Zip Code 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: PROPERTY HAS 2 SYSTEMS THAT HAVE SEEN VERY LITTLE USE, BOTH SYSTEMS HAVE ALOT OF TREES AND SHRUBS ON TOP OF THEM. INSTALLING RISERS AND REMOVAL OF VEGITATION IS RECOMMENDED TO STOP ROOT INFILTRATION AND POSSIBLE LINE BLOCKAGES 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is required for MARSTONS MILLS MA 02648 1/15/11 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(dont.): ❑ 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. I. 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 L— Commonwealth of-Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 1/15/11 every page. C ty/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory,for 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 Yz day flow t5ins-09M Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is required for MARSTONS MILLS MA 02648 /11 every page. City/Town State Zip Code Date of b at eof i 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 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes"in Section D above the large system has failed. The owner or operator of any large j 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•09A8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is required for MARSTONS MILLS MA 02648 1/15/11 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? ® ❑ 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): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 t5ins-09/08 Title 5 Official Insp ection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIEW LN Properly Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 /11 every page. Cdyrrown Code 1-bate of i State Zip of Inspection D. System Information Description: ACCORDING TO AS-BUILT CARD SYSTEM CONSISTS OF 2 1000 GALLON SEPTIC TANKS AND 2 1500 GALLON LEACH CHAMBERS Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ❑ No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: 2010---5.4 2009-=---10.9 2008------32.8` HOUSE HAS BEEN VACANT FOR AT LEAST 3 YRS AND ACCORDING TO OWNERS WAS ONLY USED AS SUMMER RESIDENCE SINCE IT WAS BUILT IN THE LATE 1970S Sump pump? ❑ Yes ® No Last date of occupancy: UNKNOWN Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft.,etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No j Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 every page. Cdylrown D at eof State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: UNKNOWN Date Other(describe below): HOUSE HAS BEEN VACANT FOR SEVERAL YRS General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no)(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•09I08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '<0 50 MARSHVI EW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 1/15/11 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: BOTH SYSTEM APPEAR TO BE ORIGINAL Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑cast iron ❑40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): LINES APPEAR TO BE UNDER THE BASEMENT SLAB Septic Tank(locate on site plan): Depth below grade: 2 feet Material of construction: ® concrete ❑metal ❑fiberglass ❑ polyethylene El 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: 2 1000 GALLON TANKS Sludge depth: VARYING BUT LIGHT t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 every page. City/Town 1/15/11 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 0 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? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): TANKS LOOK CLEAN AT THIS TIME, BAFFELS SHOW SOME CORROSION TYPICAL OF AGE THERE IS SOME ROOT INFILTRATION PROBABLY DUE TO ALL OF THE VEGITATION ON TOP OF THEM 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•09iD8 Title 5 Official Insp ection Form:Subsurface Sewage Disposal System•Page 10 of 17 i— GommonweaCth ofWassachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 1/15/11 every page. Clty/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 El 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•09i08 Title 5 Official Inspection Form:Subsurface Sewage Dis g posal System•Page 11 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r`0 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 1/15/11 every page. Cltylrown 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 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.): NO D-BOXES PRESENT Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: PITS WERE LOOKED AT WITH A CAMERA DUE TO ALL OF THE VEGITATION t5ins•09Po8 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 i-. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 1/15/11 every page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 2 ❑ 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.): PITS SHOWED NO SIGNS OF HYDRAULIC FAILURE AT TIME OF INSPECTION THE LINES GOING FROM THE TANKS TO THE PITS SHOWED SIGNS OF SOME ROOT INFILTRATION PITS SHOWED SOME SIGNS OF CORROSION TYPICAL OF AGE 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disp osal posal System•Page 13 of 17 f - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 1/15/11 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name inf ormation is MARSTONS MILLS required MA 02648 1/15/11 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts 05 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 50 MARSHVIIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 1/15/11 every page. CiR own 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: AT LEAST 5 FT 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: AUGERED TO 12 FT NO G.W. ENCOUNTERED AT TIME OF INSPECTION Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09N8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not f 9 p Y or Voluntary Assessments 50 MARSHVIEW LN Property Address NEE FAMILY TRUST Owner Owner's Name information is MARSTONS MILLS required for MA 02648 1/15/11 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ❑ Inspection Summary D(System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 New Page 1 Page 1 of 1 + r ,, ��TOWN OF BARNSTABLL LOCATION 1 8"Z vt5� �� SEWAGE # VILLAGE I i ac_. ASSESSOR'S MAP & LOT.� INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(gpej (s1ze} NO. OF BEDROOMS _pRIVATE WELL ORjPUBLiC WATER BUILDER OR OWNER S� DATE PERMIT ISSUED: DATE COUPLIANCE ISSUED: VARIANCE GRANTED: Yes No NO or,; _ �us�' RE'AR VtSfig VLG q �b 1 7 f i Q, i http://www.town.bamstable.ma.us/assessing/2011/HMdisplay.asp?mappai=076007&seq=1 1/21/2011 MAR 7'16 Pni2=36 ru 9 " I C. 7 SCALE: APPROVED BY: DRAWN BY DATE: REVISED �� _ DRAWING NUMBER 2>/ MAR 71116 P'H12:316all j 17 DO T _ 2 I jZ:optjrl r. l (31 - NE ET o -3'b 1 N c .. I i 1,3 C< o >LI Lo i - i I i I ` vll= �� fit_ v✓S � � % ..N: S� P.�-E y = ioi � d mil% j I_oo P_L �.M.rl ; j , { : I ] � 1 MARSTONS MILLS • RIVER (tidal ) N S ITE PLAN P an Bk 232 Pg 107 SCALE: 1 = 20 28 o TE CONTOUR INTERVAL 1 R� U S.B. fnd B.M.=21 .3' APPROX. GIS SITE ON C.B. FND _ orsh Pie. P<`rGe :.:............................................................... PRINCE COVE O 0 0 0 24 0 "MARSTONS MILLS" � © = I= 5, LOT GENERAL NOTES LOCUS 4 4 AREA= 34,243± Sq.ft. 1 . ADDRESS: #50 MARSHVIEW LANE, MARSTONS MILLS NO SCALE 2. ASSESSOR'S NUMBER: MAP 076 PARCEL 007 3. DEVELOPER'S i T: LOT SAS X - SECTION 4. TQPOGRAPH C INFORMATION WAS COMPILED FROM AN ON THE GROUND INSTRUMENT SURVEY. 5. TOWN WATER IS PROVIDED TO THE SITE & SURROUNDING PROPERTIES. 6. REFERENCE PLAN: PLAN BOOK 232 PAGE 107 ��� 7. UNDERGROUND UTILITIES LOCATED IN ACCORDANCE WITH DIGSAFE. � 8. NO WETLANDS OR POTABLE WELLS ARE LOCATED WITHIN 150 FEET OF SAS. deck = 9. THIS PLAN SHALL 'BE USED FOR THE SEPTIC INSTALLATION ONLY. 10. THE SEPTIC REPAIR IS EXEMPT FROM THE RIVERS PROTECTION ACT. SYSTEM2 EXISTING be pumped & backfilled /DWELLING TO = , per: 310 CMR 15.354 . Bsmt. FI elev. 23.89 jj 0 o � Design Calculations n o. 50 ?� Number of Bedrooms: 4 Existingx 110 Gala Da Bedroom 440 Gal. Da � Y/ /� Y SOIL EVALUATION 28.68' x Garbage Diposal: Not allowed with this design Date of SOIL EVALUATION: FEBRUARY 18, 2016 oti ? Septic Tank Required: 1 ,500 _ gallons Evaluation Performed By. Glen E. Harrington, R.S. Excavator: MIKE LEARY t' p5C53 6'O 24.01' is Septic Tank Provided: 1 ,500 gallons Witness: David W. Stanton, R.S., BOH Agent �� 600 �o,�ec o ::. :.. LeachingCapacity. Required: 440 Gal. Da Percolation Rate:< 2 mpi assumed, 24 gals applied during presoak O� ��` Q� 4.00' 24 O p y q / y ?? �� ::::• ::• •::;.: : 24.26 N Application 'Rate for <2 min./inch = 0.74 gal/sq. ft. for Class I soil Test Hale Test Hole ::•:: :;• ;• a 23 Proposed Leaching Structure. 1 33.5 x13 x2 LeachingTrench * �No. 1 No. 2 ._ . DEPTHSOILS ELEV. DEP SOILS ELEV. i ::::::::: 23.27' ?, C.B. fnd -1�.M. ..:;:a ,.. :;.: 2.5 dia. o k ^ ��, Bottom Leaching Area Provided - 435 Sq.Ft. 0 0.85' 0 0.80' „� Side Leaching Area Provided = 186 sq. ft. loamy son loamy son Q 22.38 22 �, Total Leaching Area Provided = 621 s ft. 1oYR4/2 �oYRa/2 PERK TEST #14963 4 vent S �° �� 9 q 10" 12" o ' DEPTH: . �' ��������`� .,,,,,.• o � o LeachingCapacity .Provided =621 s ft X 0.74 al s .ft.=460 d.> 440 d. Bw Bw BEGIN SOAK: 00:00 x 1.5 3 P Y q 9 / q 9P 9P loamy san X 22.47' / Q " Y oamy san END SOAK: 08:30 :::. ::. :.: 35 10YR5 6 17.93 36" 10YR5 6 17.8' O 21 TIME: 8 MIN. 30 SEC.= UNABLE TO SOAK, c ca 36" V O PURPOSES t '• O i€ +� USE <2 MPI & CLASS I SOIL FOR DESIGN P � .. PERK ci c1 :;:: : }:}'. .:' CONSTRUCTION NOTES 1 28 � 1. ine 54� O sand sand 22.37' 20.50' 1 . Contractor is responsible for Digsafe notification :::::T.H. 1 �:::: X .18 10YR6/s 1OYR6/6 " '::::::. :: :;::y°" 20 and protection of - all underground utilities and pipes. 132" 9.85' 120" 10.8 2. The septic„tank and distribution box shall be set No Observed Ground Water '•" T. #2 � c� level on 6 of '3/4 -1 1/2 stone. ' p 3. Backfill should be clean sand or gravel with no Soil Evaluation Certification ep /� 19 stones over 3" in size. o set c certify that on October, 1995, - I have passed the soil evaluctor , ...;;;.;..;;:. .;.:.;.. k 4. This system is subject to inspection during installation examination approved by the DEP and that the analysis was performed by A=190.4 :.: . { 68' to Glen E. Harrington; R.S. me consistent with the required training, expertise and experience described R-230.00' elec nic 18•83' 5. The contractor ,shall install this system in accordance Y In 310 CMR 15.017. pas W eqr� / 18 with Title V of the Massachusetts os�f ett Environmental Code. GLEN E. HARRINGTON, R.S. 2 P 17.96' 17 and local Board of Health Rules and Regulations. ' 6. If, duringinstallation the contractor encounters an oY oy soil conditions or site conditions that are different 20.87' trope\\ea `v e 01 ?� from those shown on the soil log or in our design 20.60' eag Proposed SAS 1� ^16.1 the installer shall halt installation and immediately notify Provide 3-500 gal H-20 chambers Glen E. Harrrngton, R.S. with 4" of stone all around. 7. No vehicle or heavy machinery shall drive over the septic system unless noted as H-20 septic components. 8. Install TuI-Tite gas baffle or equal on septic tank outlet tee. g 9. All piping shall be SCH ' 40 PVC. PP 9 C P \v �` 10. Pump and backfill existing System 2 and leach It of front system. Remove If within 5 ofproposed P - 9 Y # P Y SAS. 11 . The "Contractor shall notify the Board of Health and the Designer at least` 24 hours in advance to inspect and certify the e P Y system. 0 _� 12. Provide 3 WI in Precast : 500 al. H 20 chambers and one WI in Precast H-20 DB-3 D-Box o . S 99 9 99 r equal. 13. Connect dischar e plumbing from System 2 internal) i .,,9 P 9 Y # y to main sewer line at -front septic .system. 4 diameter SCH 40 ' PV -14. Provide C vent with carbon filter. Locate vent per owners discretion. Q. P ,6 QO R Provide 4 dia. vent with carbon filter I SYST EM PROFILE REVISED: 10 MAR 2016 BOH COMMENTS ExistingDwelling g Not to Scale First floor 3 -HOLE H-20 PROPOSED SEPTIC SYSTEM REPAIR/UPGRADE - DIST. BOX Provide 4„ dia. observation port PREPARED FOR . 23.5'f Finished grade over s stem=2% slope away to 3" of rade Plumbing Change .,• Existing Grade 9 Y P Y Existing .Grade 21 t g -LEGEND MIKE LEARY See Construction -1/2" 8 A roxima a location AT ox cover shall be - PP I �. Septic : tank covers must be D B Min. 2 1 /8 Double Washed Stone One chamber cover shall beas Ilne Note #13. within 6" of finished grade within 6" of finished grade 50 MARSHVIEW LANE 9 9 within 67 of finished rade or geo-textile filter cloth 9 CELLAR S 0.02 FT. 9 � ,�� Approximate location S_0 To of Peastone Elev.=18.3 f water line BARNSTABLE (MARSTONS MILLS), MA WALL _ 01' FT. = ................................................. ..................:..................... Level for 2 S-0.01 ft ft :::::::.:::::::::::.:.::......:•::.:::::::::::::::.:::::.: :::::::::::::::::::.:::: ::.,............................... EXISTING '-�sP� Pro osed contour OWNER: SCOTT W. BUCKLEY ET UX 'i Bsmt FI. elev.=23.89 .:. 27' 36' Invert Elev.-17.80 P 1 ,000 GAL. ... 20' 24» -18- Existing contour ` �L•��OF1�Ss9 PREPARED BY: SEPTIC TANK 500 al. �° L ' :�, 0 0 ® Existing 1 g Glen E. Harrington, R.S. P=20.04 . ExistingInvert H-10 Ex.-2 7' Bottom of Leach septic tank �; 9 Leda Rose Lane Install Gas Baffle 33.5 Facility Elev.=15.80 A �Ir Marstons Mills, MA 02648 Inv. elev.=20.82' or equal P=20.21 E 7 Tel: 508-428-38s2 . 1 „ Existing Leach Pit 3 4 -1 4i Double-Washed Stone 0 9 / 6 t PROVIDED, 5 Min. REQUIRED to be pumped and filled rTA. 6 OF 3/4 -11/2 STONE LEACHING CHAMBERS Bottom of Test SCA =20' DRAWN BY: GEH DATE: 3 MAR 2016 i 6" OF 3/4"-11 /2" STONE Hole 1 Elev.=9.85' DATUM: APPROX. GIs FILE: LEARYMARSHVIEW SHEET 1 OF 1 _ • 3