HomeMy WebLinkAbout0075 MARSHVIEW LANE - Health _ 75 Marshview Lane
Marstons Mills
A= 076 - 064
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Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal.System Form-Not for Voluntary Assessments
°yt 75 MARSHVIEW LN I*1
Property Address
NELSON
Owner Owners Name ./
information is MARSTONS MILLS I/ MA 02648 6-6-17
required for
every page. City/Town State Zip Code Date of Inspection r;y
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 ���0
When filling out
forms on the
computer,use 1. Inspector:
only the tab key
to move your DOUGLAS A BROWN
cursor-do not Name of Inspector
use the return
key. D.A.BROWN INC
Company Name
VQ P.O. BOX 145
Company Address
( � CENTERVILLE MA 02632
I f� City/Town State Zip Code
508-420-4534 S14297
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of
Title 5(310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
fl ✓� 6-6-17
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 101000 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
�Opci Vs
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
AT TIME OF INSPECTION SYSTEM MET ALL PASSING REQUIREMENTS. THIS REPORT DOES
NOT PREDICT THE FUTURE PERFORMANCE UNDER THE SAME OR INCREASED USE. THIS
REPORT IS NOT TO BE USED FOR BEDROOM COUNT OR DESIGN FLOW.
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System
will pass inspection if the existing tank is replaced with a complying septic tank as approved by the
Board of Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if
pumps/alarms are repaired.
B) System Conditionally Passes(cont.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
y 75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every 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:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No
❑ ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than Y2 day flow
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
,. 75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303, therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"non to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,
or answered"yes"in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every 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): 2 Number of bedrooms(actual): 2
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 220
t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M yT 75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
ACCORDING TO AS-BUILT CARD SYSTEM CONSISTS OF A POLY TANK D-BOX AND 2 3050
INFILTRATORS
Number of current residents:
Does residence have a garbage grinder? ❑ Yes ❑ No
Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No
information in this report.)
Laundry system inspected? ❑ Yes ® No
Seasonal use? ® Yes ❑ No
Water meter readings, if available last 2 ears usage d NA
9 ( Y 9 (gP ))�
Detail:
WATER USAGE WAS NOT AVAILABLE AT TIME I TYPED INSPECTION REPORT. SYSTEM IS
NOT DESIGNED FOR USE WITH A GARBAGE DISPOSAL.
Sump pump? ❑ Yes ❑ No
Last date of occupancy: Date
Commercial/industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M , 75 MARSHVIEW LN
Property Address
NELSON
Owner Owners Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
Source of information: OWNER STATED SYSTEM PUMPED IN MAY 15
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping: MAINTENANCE
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins•3/13 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M 5 75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
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:
11-13-07 PER AS-BUILT
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.):
Septic Tank(locate on site plan):
1.5
Depth below race: feet
p g feet
Material of construction:
❑ concrete ❑ metal ❑fiberglass ® polyethylene ❑other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
Dimensions: 1500
Sludge depth: TRACE
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
M s•'y( 75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information its required for MARSTONS MILLS MA 02648 6-6-17
every page. Cityfrown 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 TRACE
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.):
TANK WAS PUMPED IN MAY OF THIS YR.
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
Commonwealth of Massachusetts
Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
GM09
` 75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert
0"
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
BOX WAS OPENED AND SHOWED NO SIGNS OF FAILURE OR SURCHARGE.
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:
NO OBSERVATION PORTS
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M , 75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: 2-3050S
❑ 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.):
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
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M 75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(note ccndition 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 Forth:Subsurface Sewage Disposal System-Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every page. Cityrrown 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17
1
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
every page. Cityfrown 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: 5+ FOR ADJUSTED
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: 6-2017
Date
❑ Observed site(abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health -explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
DESIGN PLAN
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17
Commonwealth of Massachusetts
N Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
s•`'` 75 MARSHVIEW LN
Property Address
NELSON
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 6-6-17
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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
Assessing As-Built Cards Page 1 of 2
TOWN OF BARNSTABLE
LOCATI6N �JS�/�gt�6/ �., i(iv SEWAGE#,900 L
VILLAGE/lir�Q�C,{}�.+.s itrr��r ASSESSOR'S MAP&PARCEL 7 L
INSTALLERS NAME&PHONE NO. G'L-,.l !22/-^l 5 Y
SEPTIC TANK CAPACITY l,J ov
LEACHING FACILITY:(type) (size) Y,Y,r'it zL.L iy 2.
NO.OF BEDROOMS
OWNER ,G A k c✓S
PERMIT DATE: COMPLIANCE DATE: till SlOrf
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 teaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
FURNISHED BY
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http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=076064&seq=1 6/13/2017
Barnstable
Town of Barnstable ��
SARNSTAIR4
9 M^ Board of Health
AiFoy A 200 Main Street, Hyannis MA 02601
Zoos
Office: 508-862-4644 Wayne Miller,M.D.
FAX: 508-790-6304 Paul Canniff,D.M.D.
Junichi Sawayanagi
September 14, 2007
Mr. David Flaherty
Down Cape Engineering
939 Main Street, Route 6A
Yarmouth Port, MA 02675
RE:... 75 Marshview Lane, Marstons Mills , A = 076-064
Dear Mr. Flaherty,
You are granted variances on behalf of your clients, Saul and Irma Gershkowitz,
to construct an onsite sewage disposal system at 75 Marshview Lane, Marstons
Mills. The variances granted are as follows:
310 CMR 15. 405 (1) (a): To install the soil absorption system five (5) feet away
from a property line, in lieu of the minimum ten (10) feet separation
distance required.
310 CMR 15. 405 (1) (a): To install the septic tank eight (8) feet away from a X
property line, in lieu of the minimum ten (10) feet separation distance
required.
310 CMR 15. 405 (1) (b): To install the soil absorption system ten (10) feet away V
from the foundation wall, in lieu of the minimum twenty (20) feet
separation distance required.
310 CMR 15. 405 (1) (b): To install the septic tank seven (7) feet away from a ( -
property line, in lieu of the minimum ten (10) feet separation distance
required.
Section 360-1, Town of Barnstable Code: To install the soil absorption system
seventy-five (75) feet away from a wetland, in lieu of the minimum
one-hundred (100) feet separation distance required.
Q:\WPFILES\FlahertyGershkowitz2OO7new.doc
Section 360-1, Town of Barnstable Code: To install the septic tank ninety-six
(96) feet away from a wetland, in lieu of the minimum one-hundred
(100) feet separation distance required.
These variances are granted with the following conditions:
(1) No more than two (2) bedrooms are authorized at this property. Dens,
study rooms, offices, finished attics, sleeping lofts, and similar-type rooms
are considered "bedrooms" according to the MA Department of
Environmental Protection.
(2) The applicant shall record a properly worded deed restriction, signed by
the property owner, at the Registry of Deeds restricting the number of
bedrooms at this property to two (2), before the applicant obtains a
disposal works construction permit.
(3) The septic system shall be installed in strict accordance with the
engineered plans dated August 24, 2007.
(4) The designing engineer shall supervise the construction of the onsite
sewage disposal system and shall certify in writing to the Board of Health
that the system was installed in _substantial compliance with the plans
dated August 24, 2007.
The existing septic system has failed. This variance is granted because the
proposed plan appears to meet the maximum feasible design standards
contained within the State Environmental Code, Title 5 and local Health
Regulations.
Sinc ely your ,
Wayne iller, M.D.
Chair mtr
Q:\WPFILES\FlahertyGershkowitz2OO7new.doc
i
�h � FEE:
� I$,i.�liT31!eA1CF 1& • 7
naasst. REC. HY
Town ofBarnstableSCFiED. DATE: V
Board of Health
200 Main Street,Hyannis MA 02601
Office: gqg- G2 644 Wayne A.Mille r,,V.D.
Paul Canniff.EI.M.'
FA`-:: 508-790-6304
VARIANCE REOUEST FORM
FropertyAddress: 1'_5 �{�_�t �1••J L� ..._._ — - .
Assessor's Map and Parcel Number: "l Size of Lot: [o
,VJrt[ar_ds Withut 300 Ft. Yes Business Name:
No Subdivision Name: ----
1. 1f'YY.i� '�Ift' PlA1dIE: '"JCL -Phone -
Did the owner of the property authorize you to represent him or her? Yes ---I, _
3t
P_qP "11PFitTY OWN 'S NAME
NL.me: s A,ut f t 2_ �` Name:
r ;dress: Kan rk�t-_ t LN: _ M-I-j-,.,.4�', Address:&Y-
).,1 �n Phone:
k)- Nd_C +ROiOT REGITLAT'I®N(List Reis.) REASON FOR VARIANCE(May attach if more space needed)
Ac
-� C c a
NA U,11,,,?OF WORK: House Addition 0001100 House Renovation ❑ Repair of Failed Septic Sys ern
r'; .d tss (to be completed by office slgfj-person receivingvariartce request application) ;r
please submit copies in 4 separate completed sets
_ your(4)copies of the compicicd variance request form t"
Four(4)copies of engineered plan submitted(e.g.septic system plans) ri)
_ Four(4)copies of labeled dimensional floor plans submitted(e-g-house plans or restaurant kitchen plans) C-
Signed letter stating that the property owner authorized you to represent him/her for this request
Applicant understands that the abutters must be notified by certified mail at least ton days prior t meeting da at pa plirant's expensi
I
i (for Title V and/or local sewage regulation variances only)
Full menu submitted(for grease trap variance requests only)
variance request application fee collected (no fcc for lifeguard modification renewals, grease trap variance fc ICvals [Sine
owner/leasee only], outside dining variance renewals (same owner/leasee only), and variances to repair railed sewage disposal systems
[only if no expansion to the building prnpmedl)
_ variance request submitted at lcact 15 days prior to meeting date — 1
\%Ai2IANCF APPROVED Paul
Miner,Chairmen
Paul J.Cannifi D.M.U.
NOT APPROVED
DISAPPROVAL____.-
tel.(508)362-4541
939 main street rt 6a fax(508)362-9880
yarmouth port
mass 02675
down cape engineering
structural design August 24, 2007 civil engineers &land surveyors Arne H.Ojala P.E.,P.L.S.
Daniel A.Ojala,P.E.,P.L.S.
Barnstable Board of Health Timothy H.Covell,RL.s.
land court 200 Main Street
surveys Hyannis, MA 02601
f
I
Re: 75 Marshview Lane, Marstons Mills
site planning
Dear Board Members:
sewage system
designs The enclosed represents a variance filing for the upgrading of a cesspool septic system
to a Title 5 septic system. No increase in habitable space or bedrooms is proposed.
The system is designed based on 2 bedrooms, with a deed restriction proposed.
inspections
The following variances are requested under Maximum Feasible Compliance 15.405:
permits
la: reduction in setback, SAS to lot line (10' to 5'); septic tank to lot line
(10' to 8')
lb: reduction in setback, SAS to foundation (20' to 10'); septic tank to
foundation(10' to 7')
Variances requested under Barnstable Board of Health Regulations:
Art I: Section 360-1: Septic tank to be 96' from edge of wetland (4' variance); SAS to
be 75' from edge of wetland (25' variance)
Due to severe site constrictions to include the presence of wetlands, severe
topography, small size of the lot and rock walls, setback variances are requested in
order to maintain the greatest distance possible to the wetlands.
The leaching facility is 5' above the full groundwater adjustment, which was over 3'
here. Due to the site's proximity to tidal waters, this adjustment is felt to be
conservative and realistically, the leaching facility will most likely be greater than 5'
to groundwater most of the time.
We reel that by granting these variances, the same degree of environmental protection
can be attained without the need for strict adherence to the Title 5 and Town of
Barnstable Regulations.
Very truly yours,
Arne H. Ojala, PE,PLS
Down Cape Engineering, Inc.
AbutterReport
. ":
Board of Health Abutter List for Map & Parcel(s): '076064'
Direct abutters(no set distance)and the properties located across the street.
Close
Total Count: 3
Mailing
Ma p &Parcel Ownerl Owner2 2Addressi Address 2 CityStateZip i
BARNSTABLE LAND P O BOX 224 COTUIT, MA
076008 TRUST, INC 02635
MARSTONS
NELSON, EDWARD& 61 MARSHVIEW MILLS, MA
076009 DIANNE P LANE 02648
MARSTONS
GERSHKOWITZ, 75 MARSHVIEW MILLS, MA
076064 SAUL&IRMA LANE 02648
This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a
certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is
from the Town of Barnstable Assessor's database as of 8/23/2007.
http://www.town.bamstable.ma.us/arcims/appgeoapp/AbutterReporLaspx?type=BOH 8/23/2007
- • .
tel.(508)362-4541
939 main street rt 6a fax(508)362-9880
yarmouth port
mass 02675
down cape engineering
structural design civil engineers& land surveyors Arne H.Ojala P.E.,P.L.S.
Daniel A.Ojala,P.E.,P.L.S.
Timothy H.Covell,P.LS.
land court
surveys August 24, 2007
Dear Abutter:
site planning
A public hearing has been scheduled for the Barnstable Board of Health to take action
on a request for variances from Title 5 Regulations under CMR 15.000 and Town of
sewage system Barnstable Regulations for the subsurface disposal of sewage for the proposed septic
designs p � p p p
system upgrade at 75 Marshview Lane, Marstons Mills. The variances requested are as
follows:
inspections
Variances requested under Maximum Feasible Compliance 15.405:
permits la: reduction in setback, SAS to lot line (10' to 5'), septic tank to lot line
(10' to 8')
lb: reduction in setback, SAS to foundation (20' to 10'); septic tank
to foundation(10' to 7')
Variances requested under Barnstable Board of Health Regulations:
Ari 1: Section 360-1: Septic tank to be 96' from edge of wetland (4' variance); SAS to
be 75' from edge of wetland (25' variance)
Said hearing will be held in the Selectman's Conference Room, South Street. Hyannis,
September 11, 2007 at 3:00 pm. Please check with the Health Department to confirm
date and time if you are interested in attendino,.
ti
incerely,
r Sa ah B. Ojaa
Down Cape Engineering, Inc.
cc: Abutters
_file
Barnstable Board of Health
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\ ENTIRE SECOND
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Town of Barnstable
��pETHE ipy'I�
o Regulatory Services
SrnB Thomas F. Geiler,Director
BAM9� '�l Public Health Division
ATBD Mp` A
Thomas McKean, Director
200 Main Street, Hyannis, MA 02601
Office: 508-862-4644 Fax: 508-790-6304
June 18, 2007
Mr Saul Gershkowitz
75 Marshview Lane
Marstons Mills, MA 02648
ORDER TO COMPLY WITH STATE ENVIROMENTAL CODE, TITLE 5
The septic system located at 75 Marshview Lane,Marstons Mills, MA was last inspected on
May 31", 2007 By Shawn McElroy, a certified septic inspector for the State of
Masshachusetts.
The inspection of the septic system showed that the system"Failed"under the guidelines
of 1995 TITLE 5 (310 CMR 15.00) due to the following:
Single cesspools automatically fail in the Town of Barnstable
You have 2 years from the date of the system failure to bring the system into compliance.
If there are any questions about this reminder,please feel free to contact the Barnstable
Health Department.
BARNSTABLE HEALT DEPARTMENT
T omas A.McKean, R.S., C.H.O.
Agent of the Board of Health
Commonwealth of Massachusetts
Title 5 OffidalIns-pie'd- tion Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owners flame
information is Marston Mills MA 02548 5-31707
required for City/Town State Zip Code Date of Inspection
every page.
Inspection results must be submitted on this fora.Inspection forms may not be altered in any
way.
A. General Information Y� .
1. Inspector.
Shawn Mceiroy
'Name of Inspector'
Shawn Mcelroy Enterprises t�
Company Name
29 Atwater Dr. l
Company Address
Ir. Falmouth MA �536 r �
Citylrown State Code
1-50$-4WO906 . -� -
Telephone Number License Number
iV r"
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.#00).The system:
❑ Passes ❑ Conditionally basses Fails
❑ Needs Further Evaluation by the Local Approving Authority
Axe 6-1-07
nspectora Signature elate
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 DER The original should be sent to the system owner
and copies seat to the buyer,if applicable,and the approving authority.
is 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 train perform in the future under
the same or dif€erent conditions of use.
71R.c 1V5.=.d t..e..aseb...C CbA—w!r-C-arsrt-Memfed Pl¢ .Pans 1 of 15
Commonwealth of Massachusetts
Title 5 Official tnsDection Form
Subsurface Sewage Disposal System Foam-Not for Voluntary Assessments,
75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owner's Name
information is required for Marston Mills MA 02648 5-31-07
r - ' .
every page. City/Town State Zip Code Date of Inspection
B. Certification (cunt.)
Inspection Summary: Check A,B,C,D or E I always complete all of Section D
�I
A) system Passes:
❑ 1 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.
Answer yes, no or not determined (Y, N, ND)in the[]for the following statements. If"not
'determined,"please explain.
❑ The septic tank is metal and over 20 years eld*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.
ND Explain: .
❑ 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):
> _ s
❑ broken pipe(s)are replaced`
❑ obstruction is removed.
tsinsp•om T to 5 ofEfd*fnepecOort Form:Subsurface Sewep Disposal System•P-190 2 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Fotm 4 :
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
y 75 Marshview Ln -
Property'address•
Saul Gershkowitz
Owner Owner's Name
information is required for Marstons Mills MA 02648 5-31-07:
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes(cunt.): r
❑ distribution box is leveled or replaced
ND Explain:
❑ 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
❑ obstruction is removed
ND Explain:
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. ,
Al 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
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 aseptic 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.
t5insp-06f06 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 3 of 15
Commonwealth of Massachusetts .:
Title 5 Official Inspection . Fo'rm
Subsurface.Sewage Disposal System Form -Not for Voluntary,Assessments .
75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owner's Name
information is required for Marstons Mills MA 02648 5-31-07
"
every page. City/Town' State Zip Code Date of Inspection
B. Certification (cunt.)
C) Further Evaluation is Required by the Board of Health (cunt.):..
❑ The system has aseptic 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 otherlfailure 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'overioaded or clogged SAS or cesspool
Static liquid level in the distribution box above outlet invert due to an overloaded
El 0--or clogged SAS or cesspool "
Liquid'depth in cesspool is less than 6"below invert oir available volume is less
❑ ® than %day flow
' o❑ ® 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.
7. ❑ ® Any portion'of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
t5insp•Oaft Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of'15
Commonwealth of Massachusetts
Title 5 Official- Inspection, Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments.
75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owner's Name
information is required for Marstons Mills MA 02648 5-31-07
every page. Citylrown State Zip Code Date of Inspection
B. Certification (cost.)
D) System Failure Criteria Applicable to All Systems(cont.):
Yes No
.❑ ® 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
1 laboratory,for fecal coliform bacteria indicates absent and the presence
t of ammonia nitrogen'and nitrate nitrogen is equal to,or less than 5 ppm,
provided that no other failure criteria are triggered.A copy of the analysis
and chain of custody must be attached to this form.]
The system is a cesspool serving a facility with a design flow of 2000gpd-
❑ ® ' 10,000gpd.
The system fails. I have determined that one or more of the above failure
❑ criteria exist as described in 310 CMR 15.303,therefore the system fails.The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered'a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd. ,
For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet of a surface drinking water supply
❑ ❑ ` the system is within'200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,
or answered eyes" 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.
t5insp•011106 . Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15
Commonwealth of Massachusetts r.
Title 5 Official Inspection. Form ,
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments'
75 Marshview Ln
Property Address
Saul Gershkowitz _l
Owner Owner's Name
information is required for-
Marstons Mills MA 02648 5-31-07 ,
every 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
❑ ® - a 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
t this inspection? r
y ® ElWere 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 she 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(f any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
t5insp 08106 + Tine 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15
Commonwealth of Massachusetts 4.
u Title 5 ®ffici-al. lr spection,fdr'
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owner's Name
information is required for Marstons Mills MA 02648 5-31-07
.every page. City1rown State Zip Code Date of Inspection
D. System Information
Residential Flow Conditions:.
Number of bedrooms(design): 2 Number of.bedrooms (actual): 2
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220
Number of current residents: - 2
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)): —
Sump pump? ' w ® Yes ❑ No
Last date of occupancy: 5-31-06
Date
Commercial/industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310'CMR 15.203);
Gallons per day(gpd)
Basis of design flow'(seats/persons/sq.ft., etc.): {
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non:sanitary waste'discharged to the Title 5 system?, ;. .•, ❑ Yes ❑ No
Water meter readings, if available:
Last date of occupancy/use: " Date
Other(describe):
t5insp•08/06 Title 5 Official inspection Forth:Subsurface Sewage Disposal System•Page 7 of 15
Commonwealth of Massachusetts
a W Title 5 Official Inspection Four
Subsurface Sewage Disposal System Form -Not-for Voluntary Assessments
yVe,� 75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owner's Name
information is required for Marstons Mills MA 02648 5-31-07
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (coat.)
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? -
y . Reason for pumping:
Type of System:
❑ Septic tank,distribution box, soil absorption system
® Single cesspool
❑ Overflow cesspool
Privy
❑ Shared system (yes or no) (f yes,attach previous inspection records, if any)
.Innovative/Altemative technology.Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)
Tight tank.Attach a copy of the DEP approval.
Other(describe):
Approximate age of all components, date installed(if known)and source of information:
1970's
Were sewage odors detected when arriving at the site? ❑ Yes ® No
t5insp-08/06 Title 5 Official Inspedon Form:Subsurface Sewage Disposal System-Page 8 of 15
Commonwealth of Massachusetts -
Am Title 5 Official- Inspection Form '
_ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments + -
y�� 75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owner's Name
information is required for Marston Mills MA 02648 5-31-07 '
every page. City/Town State Zip Code Date of Inspection
D. System Information (cunt.) -
Building Sewer(locate on site plan):
16"
Depth below grade: feet
Material of construction:
❑ cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction fine: " feet
Comments(on condition of joints,venting,evidence of leakage,.etc.):
Septic Tank(locate on site plan):
Depth below grade: - feet
Material of construction: . .f. ,
® concrete ❑ metal ❑fiberglass ❑ poiyethylene*i:, ❑ 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:
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle
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
How were dimensions determined?
t5insp•08= Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 9 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form-
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owner's Name
information is required for Marstons Mills MA 02648 5-31-07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cunt.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc):
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 scum of to to of outlet tee or baffle
P
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
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):
t5insp-0a(06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15
Commonwealth of Massachusetts _ . . ' • .
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments _
75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owner's Name
information is required for Marston Mills MA 02648 5-31-07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cunt.)
Tight or Holding Tank (cont.)
Dimensions:
Capacity: gallons
Design Flow: '
galfdrls 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
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.):
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order. ❑ Yes ❑ No
t5insp-08/W Title 5 official Irmpection Form:Subsurface Sewage Disposal System-Page 11 of 15
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary•Assessments
75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owner's Name
information is required for Marston Mills MA 02648 5-31-07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cunt.)
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:
r. >
Type: j
❑ leaching pits number:
❑ 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.):
t5insp•08/O6' Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page.12 of 15
f
• Commonwealth of Massachusetts , .r
s � .
Title 5 Official Inspection,F®rm
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
r 75 Marshview Ln
Property Address
Saul Gershkowitz ;s
Owner Owner's Name
information is required for Marstons Mills MA 02648 5-31-07'
o
every page. City/Town State Zip Code Date of Inspection
D. System -Information (cunt.) , w
Cesspools(cesspool must be pumped as part of inspection)(locate on site plan):
Number and configuration 1
Depth—top of liquid to inlet invert
58"
Depth of solids layer 0
Depth of scum layer 0
Dimensions of cesspool 6x8
Materials of construction Precast pit
Indication of groundwater inflow ❑ Yes' ® No
Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Leach pit empty at inspection.
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.):
t5insp•08M trite 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 13 of Is
Commonwealth of Massachusetts
lugTale 5 Official Inspection, Form
Subsurface Sewage Disposal System Form Not for Voluntary Assessments
75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owner's Name
information is Marstons Mills. MA 02648 5-31-07
required for
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cunt.)
Sketch Of Sewage Disposal System: Provide a sketch 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.
4eJ
liL A-
A
C
�G J e L,-j 4L y 1
Tile 5 Official Inscec6an Form:Subsurface Sewaae Disposal Svshem•Pace 14 of 15
f
• C'oinmonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
75 Marshview Ln
Property Address
Saul Gershkowitz
Owner Owner's Name
information is required for Marston Mills MA 02648 5-31-07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
❑ Check Slope
❑ Surface water
❑ Check cellar
❑ Shallow wells
8'
Estimated depth to ground water. feet
Please indicate all methods used to determine the high ground water elevation:
® Obtained from system design plans on record
If checked, date of design plan reviewed: Date
® Observed site(abutting property/observation hole within 150 feet of SAS)
® Checked with local Board of Neaith-explain:
® Checked with local excavators, installers-(attach documentation)
® Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Town maps show water at 8'.
t5insp•08106 We 5 EHriciat Inspection Forth:Subsurface Sewage Disposal System-Page 15 of 15
iFROM :down cape engineering inc FAX N0. :15083629880 Nov. 12 2007 09:18AM P1
Town of Barnstable
Regulator-y Services
Thomas F. Geller,Director
Public Health Drirlslon
•d3�
Thomas McKean. Director
200 Msin Street,Hyaaais, MA.02601
Office: 509•862-464.4 Fay;: 309-790-6304
Installer cC Desiaer-Cerdfication Form
Date: �"� p 7 Sm-stge Permit# c200 — sV�2 Assessor's MapTarcel
Designer. I owti t ,ry ,�L bistaller: Y✓ U /19 G
Address: q�/ a r l� .Address:
(7n /oTf. 6ewi) . -;xas issued a permit to install a
(date) (instal]er)
septic system at 'VI-t ✓j t14) based or) a design drawn by
J (address)
dazed
esigner)
I ceitin' that the septic system referenced above -,vas znSrat]ed substantially, accordiq'12 to
the design; which may include minor approved ch=ges such as lateral relocation of the
distribution boa andr'or septic tank.
I ce-tify that the septic system referenced above vTs i1Wa?led with major changes (i.e.
greater than 10' lateral relocation of:l:ne SAS ox Verrical relocation of any component
of;he septic system) but in accordance with State S Local Rezulations. Plan revisioz) or
certified as-built by designer to folio-'.
ARNEJALA
(l:istalJe:'s SignanrW) civil_ - 1
No. 3')7q2 fir.
designers S izna re) (affix Designer's Stamp Here)
` PLEASE RETURN TO DARNSTABLE PUBLIC HEALTH DWISION CERTIFICATE OF
COlt4PLIANCE 'AIL), NOT BE ISSUED UNTIL BATH -rH)S.FQ—RNI AND AS-RUILT—CARD ,ARE
RECEIVED BY T) F BARN5TABLE PUBLIC HEALTH X11\71$10N. TRANK YOU.
Q: Hca%WSentic/Dcsigner Cenification Form 9-26-44.doc
11/02/2007 03:02 FAX" 617 244 2996 D.0 LAW [AD02/003
10/15/2007 21:08 FAX 617 244 2988 D.0 LAW �002/OD3
Bki'22445 P9210 063206
1 1-01-2007 8 11 s 09a
��9II
WHEMAS.Sant Gnbkowita and Inn U nhkowitz,of 75 hdiarshview Lane.Marston
Mills,Massachusetts,are to owners of 75 Mershvtew Lear,Marstntt9 Mina,
MaesaC111UN s,5 parcel of land with thobtddhtge thereon situated in Bsmstable,
(Marston Mills)B srmtabk Cowq,Mawachuartts,being triangular in shape,gad
bounded and described as follows;
NOR TR WNSTMy by lmsd am orJbmlob of Q WOW Jones Jr.,as shown an a
JM irerrt3r4)3er w 4doned,two hWubvd„0r0+,rtr(Nd)fee!more or foss;
NORTHEASTERLY by a right q f way es;chows on raid pAax tglity-sis(8Q,feet,mare
or less,
SOOTHEASTERLY by land of Edwand K,D94 as shown an semi pies,two hundred
for*-sdx(34ti)fist,awre or less;
Bedng the somther(y pares!o f the tWo parcrfs of land shown ar land of C.Wilbur Jones,
on a plan q f land M&W `Plan of land at Mmrtotts UP,BarwWk,Scale St)'M as
dash,Sept`ernberZs,l9Sl—T.M.SArsAsmar,t;Yv ixoginver,BtUddle woulha,Mesa"
said pima being rworded fir Barnstable Camnty$egltt y gfDesds In p1m Beok 100,
Plan 147.
WMEAS.SOW GmhkmvJ z and Irma Gushkowitz,as the owners of said lot have
agreed with the Town of Ilu stabto$card of Health to a restriction as to the number of
bedrooms which can be included in any home built on said lot as a pro-cotAdon to
abtsitting a disposal works coaettta dad permit in compliance with 310 CMR 15.000
State Env9rontnental Code.Title V,Mmimtun RegnirementF for the Subsurface Dlspl
of Sanitary Sevrage;
WIEA,S,the Town of Barnstable BDud of Health,as a pmcondidott to granting a
disposal wMb construction petrrt for a sgRie system in compliance with 310 CM
15.200,Scam Bnviro metttal one,'Hth V,f&niamm Requirmwts for the subsurface
Disposal of Sanitary Sav%c,and authod2ing the issuance of abultding permit for
COMIC110110n Of a singie family home on this property,is roguiring tit the agcramaat for
the restriction on the number of bedrooms in any house conMucted on the lot be put on
record with ttte Barnstable C owny Ropey cf Decda by recording this document;
NOW.TEMRMR$S aW Ocabkpwitz and Irma Gatshlwwitz do hereby place the
tollowing restriction on tbair above•reform;ed land bi sccoedame with the asmomont
with the Town of Bamstable Boar of Reallh,which restriction shall run with the land
and be binding upon all sacoessots in title:
75 Marshview Lane,Marston,Milts,MA may have octstructed upon the lot a bone
containing no move than two(2)bedmotm. UW Clersbkowltz and Imra Gerthkowitz
agree that this ahalt be mpenmamt deedmuiction affecting Lot as described above,
. I�
11/02/2007 03:03 FAX, 617 244 2996 D.0 LAW 0 003/003
10/16/2007 MOT FAX 017 244 2086 0.c LAN Bk 22445 Pg 211 #63206
For our title see deed marded at aald Deeds as Book 9221,Page 269.
Bxc=sd as s sealed instrarnem thi s l0-*-'day Gf October,W.
Saul(iershtoowitz
T ma Oetshko
Commonwealth of Massachusetts
Ss:Barnstable
(, 2007
On thi Day of October, 2M before roe, the aadersigned notary public,
Pm0naliy appealmd Ud Gnihkowitz and Irma Gerahkowitz,and proved to me through
tisfacOy mddom of idendPicahoss, wNch were
tv to the petaon whose name is signed on the
PravAnB or Mmkod dmwncrA, and acknowledged to me that hef6Wboy signed it
voluntarily its alatad pwposc,
(official signamm and seal of notary)
. _. my coutwasioa expires: (o//glag
AmE�.
MSMLE REGIE RY OF DEEDS
TOWN OF BARNSTABLE
LOCATION �JS� �� k,. .� SEWAGE#,ACV')-�Y?Z
VIi tAGE1hh�,t�S .vs ���ASSESSOR'S MAP&PARCEL 76 G
INSTALLERS NAME&PHONE NO. R •C- Jr- �07/ e 91 S 7
SEPTIC TANK CAPACITY /'.J d 0
LEACHING FACILITY:(type) ;.2 30J—V (size) SC;Kr x Z2-2-
NO.OF BEDROOMS -�
OWNER
PERMIT DATE: //—0--0 2 COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
FURNISHED BY
r -tip � - • ?
� .
SI o �
o.
900'7 _ sow '.J , }
jo 50 � 4 , - I
No. GG�
� � �1 � v � -Fee�
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: _t
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
pplication for Tigpogal *pgtem (Eowgtruction Vermit
Application for a Permit to Construct( ) Repair(,Upgrade( ) Abandon( ) U.Complete System ❑Individual Components
Location Address or Lot No. f
7 , if �� Owner's Name,Address;and Tel.No. �h,(�pli/j�'L
7f/�l..✓�i"ia/ L✓
Assessor's Map/Parcel `7&/&V 97V1
Installer's Name,Address,and Tel.No.17a14/07 1, �`� Designer's Name,Address and Tel.No.
�/11ti✓�11�r� /t� 939
Type of Building: � . ' r
Dwelling No.of Bedrooms � r yY�ric�tyv Lot Size�Q Y / sq.ft. Garbage Grinder (ALO
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow min.required) a2a20 gpd Design flow provided 023C� gpd
Plan Date v� �00 Number of sheets Revision Date Av 3/ 'QQ'7
Title dl O �� l�� yi �•,J LkH-� /i •-1 dl/i �/f
Size of Septic Tank /rcO Ce !/ /6 Type of S.A.S.a Sava
Description of Soil J re
Nature of Repairs or Alterations(Answer when applicable) ���i` S f7't ti /� pl4 h
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 Wthisid;4H 000e
l /,!g
Signed Date L�[ Z �
Application Approved by r Date S v T7
Application Disapproved by: Date
for the following reasons
Permit No. y J c) Date Issued �t/ S —d.
� 1
No. is i ',Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplicatio'n for �Dtqaal 6p5tem Construction Permit
Application for a Permit to Construct( RepairG4 Upgrade( ) Abandon( Complete System ❑Individual Components
- -
Location Address or Lot No.
7J 4 Owner's Name,Address,and Tel.No.
Assessor's Map/Parcel -7& '77(11
Installer's Name,Address,and Tel.No Designer's Name,Address and Tel.No.DWA.� lelld-r Av
C-vS f
Type of Building:
Dwelling No.of Bedrooms Lot Size Ar,0'� sq.ft. Garbage Grinder
Other Type of Building No.of Persons Showers Cafeteria
Other Fixtures
Design Flow(min.required) e2p10 gpd Design flow provided 4-936 gpd
.Plan Date A, Number of sheets Revision DateAK 3-1 ,)06--7
�jo;�j //f �
Title 7-, -7 c -7S-
Size of Septic Tank /J�O 41 1 Aoll- 16 _Type of S.A.S. Jam J,
Description of Soil 5- 1 61A n
Nature of Repairs or Alterations(Answer when applicable) AXe
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal syste'm 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 odrd ohHeakh
Signed Date A /0 7
Application Approved by
Date
Application Disapproved by: Date
for the following reasons
Permit No. 0-4 5b I-
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
Abandoned( )by
at has been constructed in accordance
with the provisions of Title 5 and the fior Disposal System Construction Permit No. 2 00:7 - 5 dated /I- o
Installer Designer
#bedroomsa� - J)'IIJ 'Ili/lIn/10-1 Approved design flow d A; J gpd
The issuance of this permit shall not e cons bed as a guarantee that the system will-function as designe�.W. <:7
Date t t till �Ito ft Inspector V
1--f%W /
------------ I -------------------------------
-)00 -7 - SC);L— Fee
No. ,
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS
I
lwiqont 6y!Aem Co 5truction 'Permit
Permission is hereby granted to CoDstruct ( ��?
Repaii ) Upgrade Abandon
System located at —7r
and as described in the above Application for Disposal System Construction Permit.The applie6ain't recognizes his/her duty
to comply with Title 5 and the following local provisions or special conditions.
_
Provided: Construction must be completed within three years of the date of th.4,erzmit:
Date Approved by
ASSESSOR'S MAP NO. `7 G PARCEL
LO CAT IONS � gE1NA G PER ii NO.
VILLAGE
I N S T A LLER'S NAME A ADDRESS
'S U I L D E R OR OWNER`
DATE PERMIT ISSUED
DAT E COMPLIANCE . ISSUED
l
y �
SYSTEM PROFILE NOTES
LEGEND SYSTEM DESIGN. TOP FNDN. AT EL. 1-5,.3' (NOT TO SCAM
Route 28 S�ofb
f: ACCESS COVER TO WITHIN 3" OF FIN. GRADE 1. DATUM IS APPROX. NGVD
ACCESS COVERS AT FIN. GRADE ACCESS _COVER (WATERTIGHT) TO_ 'Q�od cwi�fy
100.0 PROPOSED SPOT ELEVATION GARBAGE DISPOSER IS NOT ALLOWED MINIMUM 1' OF COVER WITHIN 6" OF FlN. GRADE
2. MUNICIPAL WATER IS AVAILABLE
15.2 OVER POLY TANK MINIMUM .75' OF COVER 2X SLOPE REQUIRED OVER SYSTEM 14.5' - 15.0'
1OOx0 EXISTING SPOT ELEVATION DESIGN FLOW: 2 BEDROOMS 0110 GPD = 220 GPD
3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
USE A 220 GPD DESIGN FLOW * 16.1' RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE Marshv If
(1.34') FOR FIRST 2' OR GEOTEXTILE FABRIC
100 PROPOSED CONTOUR L13,1S PROPOSED 1,500 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO �a v°0eY
SEPTIC TANK: 220 GPD (2) = 440 GALLON POLYETHYLENE EL. 93' INFILTRATOR 3050
SEPTIC TANK GAS CHAMBERS , H- 10 0 ��� o oc Sm°ke
100 EXISTING CONTOUR (H-10)
USE A 1500 GAL. POLY SEPTIC TANK BAFFLE ' a '` � Form
" 12.90' �� 12.73 5. PIPE JOINTS TO BE MADE WATERTIGHT. a
LEACHING: 1.7 -CRUSHEDDIONO(OR MECHANICAL o 12.70' o /
0 0 0 0 o 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH
SIDES: 2 (22.2 + 8.85) 2 (.74) 91I GPD ( X SLOPE) ' 0 0 0 0 0
DEPTH OF FLOW = 4' �g o � . / 10.70' MASS. ENVIRONMENTAL CODE TITLE V.
0o Bortei Neck Rd �y
BOTTOM 22.2 x 8.85 (.74) 145 GPD 1 1
= WE SIZES: ( X SLOPE) (_X SLOPE) 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO
TOTAL: 318 S.F. 236 GPD 10"INLET DEPTH = � 3/4" TO 1 1/2" DOUBLE WASHED STONE BE USED FOR LOT LINE STAKING OR ANY OTHER PURPOSE.
OUTLET DEPTH = 14"
USE (2) IN IL TOR 3050 CHAMBERS) 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. K r
WITH 4' STONE AT ENDS AND 2.3' AT SIDES FOUNDATION 7: SEPTIC TANK 3' D' BOX 5' LEACHING 5' 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED
. *2 BEDROOM DEED RESTRICTION REQUIRED FACILITY. WITHOUT. INSPECTION BY BOARD OF HEALTH AND PERMISSION
MA OBTAINED FROM BOARD,OF HEALTH. LOCUS MAP
APPROVED DATE BOARD OF HEALTH 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING
DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCATION NOT TO SCALE
USE ADJ. WATER AT ELEV. 5.T OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO
COMMENCEMENT OF WORK. ASSESSORS MAP 76 PARCEL 64
11. EXISTING LEACHING FACILITY SHALL BE PUMPED AND
REMOVED
12. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE TEST HOLE LOGS
REMOVED 5' BENEATH AND AROUND THE PROPOSED
* INSTALLER SHALL VERIFY THE LEACHING FACILITY.
THE I ENGINEER: DAVID FLAHHERTY, RS
LOCATIONS OF ALL UTILITIES AND ALL
BUILDING SEWER OUTLETS AND ELEVATIONS BENCH MARK - TOP OF CONIC WITNESS: D. MIORANDI, RS
PRIOR TO INSTALLING ANY PORTION OF BOUND ELEVATION = 10.0 #1
DATE: AUG 14, 2007.
SEPTIC SYSTEM �4.62
04 GROUNDWATER ADJUSTMENT DATA: PERC. RATE < 2 MIN/INCH
_
lt.
' WELL: MIW 29 CLASS I SOILS P#
ZONE: A
ADJ: 3.3
' 4.80
ELEV. ELEV.
1 2
•� 0" 9.9' 0" 9.9'
0.42
_ 1y \5.06 FILL
r >_ 10.00 FILL
� ... s� B B
5.24 LS LS
10YR 5/6 10YR 5/6
11d2 r -` VARIANCES REQRUESTED UNDER MAX. FEASIBLE COMPLIANCE 15.405: 32" 7.2 27" 7.6'
-PI1RbC1116-':.: 8.79
la: REDUCTION IN SETBACK. SAS TO LOT LINE (10' TO 5');
3Trt1 :gib<' ST TO L01T LINE (10' TO 8')
SETS TIC TANK TO FNDN (10' TO 7')
5' REMOVAL OF UNSUITABLE SOIL ' ' 1 EDUCTION IN SETBACK, C C
b. R CK TA
REQUIRED AROUND PERIMETER OF \ `. .87 AND SAS TO FNDN (20' TO 10')
LEACHING FACILITY, DOWN TO 15,
13.47 ti, .5s :..:; " OF
SUITABLE SOIL LAYER. REPLACE 2 0 5 • :s- -:: . �.,� VARIANCES_RF-OUESTED UNDER..BARNSTABLE HOARD HEALTH.
.p z` 8.72 6
PERC
WITH CLAN MED. SAND. ENGINEER. 1 Cp r
TO,INSPECT AND CERTIFY O :.:: ,,: 3.34 REGULATIONS: MS MS
7 !� PROVIDE APPROX. 32.
REMOVAL +,>3.e�'l� :.. . ....„.. ---
.....:. •.. .- OF 40 MIL LINER AT ART I: SECITON 360-1: SEPTIC TANK TO B 96 FROM EDGE OF-
-PI3.71 .� . ...
5' OFF SAS, BETWEEN
WETLAND (4' VARIANCE); SAS TO BE 75' TO EDGE OF WETLAND
+ '3 "" "�- ' ' '�� FOUNDATION AND SAS. ' (25' VARIANCE)I
2.5Y 7/4 2.5Y 7/4
~ �12. 93
...-.
OP AT ELEV. 13.27
90" 90"
T ,
.. ;....
.2
/ .4 8.53
LANDSCAPE TIE -�H°p .
WALL 1 1 a >4 7 120" -0.1' 120"091
5.3
• CA \
_15.08 > 1
8.27
d 4.41 I
EXISTING / ,�� QP 9:
DWELLING y �(
3zc 14.73 EXISTING 21 1.8114 a
DWELLING 16- \
23.10 0 GF' \
� .59
o �e
TITLE 5 SITE PLANT
14.47'pj�� % �2
2.67 OF
14.45�� �y169. �• \
13,02 - -
75 MARSHVIli�[- LANE-
13.22
NO ACCESS SHED f
MARSTON.S MILLS -
-�os \ PREPARED- FOR
BORTOLOTTI CONSTJ
PARCEL 64
10,454t SF
S. GERSHKOWITZ
AUGUST 24, 2007
Scale: 1"= 20' `�
0 10 20 30 40 50 FEET
off 508-362-4541
fax 508 362-9880
0 M OF
ARNE '¢
A N , H. down Cape erg g in e erin g, ire c.
OJALA OJALA Cn
CIVIL N�Zs34s„ Cl VIL ENGINEERS
No, 307 2 /
SR
al VE °� LAND SUR VEYORS
DATE H. OJALA, Pl., P.L.S.
g39 Maim Street - YA RMOU THPOR T, MASS.
07- 170
07-170 SP (SBO)
I
i