HomeMy WebLinkAbout0039 SPUR LANE - Health 39 Spur Lane
Marstons Mills
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No. -U I Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplication for Misposal *pstrm Construction permit
Application for a Permit to Construct( ) Repair W Upgrade( ) Abandon( ) ❑Complete System individual Components
Location Address or Lot No. p wt Owner's Name,Address,and Tel. o.,98i-5�._ 9:9s_5"
Assessor's Map/Parcel-2°7/2-X A aeg- s ,A s 3 Q -
I staller's Name,``�dress,and T No. (5e-8- ��_$9� Designer's Name,Address,and Tel.No.
O!ilo�d r1l5" 241c
Type of Building: 2
Dwelling No.of Bedrooms 3 Lot Size U71 t�G� " sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures B I
Design Flow(min.required) ?J' 3o gpd Design flow provided 3 `f 9 gpd
Plan Date A4 ,JV 19 Number of sheets la —/ Revision Date
Title ! 1��C'��1 VD1a4-)a1 89 6,OUA � ✓ l'IY GC,C.�/9 j
Size of Septic Tank`e-;k 54t:. Type of S.A.S.c2-µlU
Description of Soil Is22.�Lt e�Q 1 co
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenanc f the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental C and n o place the system in operation until a Certificate of
Compliance has been issued by this Board of Health.
Si Date
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. Date Issued
T. .r.
No. 0 t K— _ Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:Yes
V
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
application for Misposal'*P�tem Construction vermit
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) ❑Complete System ®Individual Components
Location Address or Lot No. C Owner's Name,Address,and Tel.No. .. a�'J
31 S p tom. Cam!-)e. f-u� i �4Nur_ �! q G�,
Assessor's Map/Parcel�t7� �. ltle s� .,srt5 m d:s ILl/l r 5, .h ,, It l /?
Installer's Name,Address,.and T 1.No. S�$- 02�_ Designer's Name,Address,and Tel.No.
ryC��/r)/Or C �/Or�Se,T° Ur;'Tric 39
Type of Building:
f
Dwelling No.of Bedrooms''' 3 Lot Size a), 4(, - sq.ft. Garbage Grinder( )
Other Type of Building ti No.of Persons Showers( ) Cafeteria( )
Other Fixtures 1
Design Flow(min.required) ]30 gpd Design flow provided 3 t 9 gpd
Plan Date At 1AWA� IL I, o 19 Number of sheets / Revision
Date ,/
Title i'�i� �� ��n� �� 9�►S I,GI!) yam►LA di' i,11y A4 i 1
'e� � r
Size of Septic Tank'C IL! t. /�X9C74�.T Type of S.A.S.rx- !{•/t>SC ly v� xr�,a U IXS,�
Description of Soils
a
Nature of Repairs or Alterations(Answer when applicable)
iw.
Date list 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 d=�place the system in operation until a°Certificate of
Compliance has been issued by this Board of Health. ,. ~�•�.. „.
Signed) �A Date.. � /(Jl A
Application Approved by ( /.y (A,, � �� } Date
-Application Disapproved by Date
for the following reasons
Permit No. 2 d t P Date Issued I ( t/ A
-------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(2VI Upgraded( )
Abandoned( )by N,r�c,1,r 44- C��+��
at___'��' ()t,t /-�, . - tart^t't t. -»�n`-f/�'�t.k Ghas been constructed in accordar}
p ./ `
with the provisions '}ons of Title 5 and the for Disposal System Construction Permit No.,,! 0 t p dated C)f i t! /
Installer � ra�*r} ,� e 4 't�� � t" rn,T-Tr\ C Designer_--w, -,y f 410et i AJ t� +�e�.+r A_•a 0,0_4.t,W -T�e,r
#bedrooms Approved dgsign flow ci gpd
The issuance of this permit sh
all no be construed as a guarantee that the system will C t n asasdesigned.
Date �G Inspector
No.�_ 0 Fee laC) r
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS
Misposal *pstem Construction 3permit
Permission is hereby granted to Construct( ) Repair(1;-5-JI, Upgrade( ) Abandon( )
System located at
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.
T, '
Provided:Construction must be completed within three years of the date of this permit. Q
Date G' // �� - `" Approved by �
-13-2018 01:01 From: To:15087906304 Paee:1/1
'own of Barnstable
ra Regulatory Services
Thomas F.Getler,Director
HAM Public Health Division
sbs
N►�" Thomas Mel Kean,Director
200 Main Street,Hyammis,MA 02601
Office: 508-862-4644 Fax: $08-790-6304
][taper&1[Desimer Certification lFoxm.
)IDate:. 1r-t'2--tA SewagePermait# 206 06E assessor's NEwparcel z � 2�
IIDesigmer: K"_Gcd , Installer: Fl./LqZU Cr-iv--r% .
Address: 3`l Address:
On 630/Lr - �r. was issued a permit to install a
( ) ( �)
septic system at ';� n� based on a design drawn by
(address)
dated
(designer)jV/J certify that the septic system referenced above was installed substantially according to
the design, which may include.minor approved changes such as lateral relpcation•of the
distribution box and/or septic tank.
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
Zcerfified - by designer to follow.
_t A OF1{4
Signature) °` DANIELA.
OJAIA '7
CIVIL N
No.46502 �
0/1 01STF-
(Designer's Siggature) (A#ix Desi�&t e)
n ASTf, FSUM, TO B&RNSTA.B U NMUC HEALTH �DIVISYON CICIMUCAM OIA
COMP7.][ANCE W" 'Nyr M ISSUM U?rM AQM TM FORM AND AS-IICr1]GT_CARD-MIE
A CEIVE]DBY T=AAAtN6TASLE P UBY.IC ISMALTU IDI MON. THANIK YOU:
Q:Hea1WSeptiG1DWgacr CuMcadoaFoim 3-26-04.doc
Town of Barnstable P#
ppTHE Tpk
Department of Regulatory Services
* Public Health Division Date a4, in
BARNSTABLE,
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�A 1639• 200 Main Street,Hyannis MA 02601
ren naafi
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Date Scheduled I Time Fee Pd. 100. 00 CM
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Soil Suitability Assessment for S e Disp®sal I1`0
Performed By: Witnessed By:
LOCATION& GENERAL INFORMATION
Location Address (` uY U—J Owner's Name
' �+ �S Address
Assessor's Map/Parcel: 02 7 d ck Engineer's Name 4)0 VjJ-. 0-
NEW CONSTRUCTION REPAIR JL= Telephone# CsOf �o/L
Land Use L cm sea Peo Slopes(%) — Surface Stones /yd�
Distances from: Open Water Body /C ft Possible Wet Area 0 ft Drinking Water Well 7�50 ft
Drainage Way 2 _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)
4 �
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7gTAI
x
Z
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Parent material(geologic) /ac a arc
PIA
Depth to Bedrock �2 /I
Depth to Groundwater: Standing Water in Hole: /y/A Weeping from Pit Face-ZO
Estimated Seasonal High Groundwater
DETEWA]CION FOR SEASONAL,WGII WATER TABLE
Method Used:' N G
Depth Observed standing in obs.hole: in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level..
Observation PERCOLATION TEST Date Time
Hole# Time at 9"
Sy"Depth of Pere ,.,., Time at 6"
Start Pre-soak Time @ Time(9"-6")
-- End Pre-soak / [�
Rate Min./Inch G V 7 �/Oh I
Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) /
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 100' of wetland,you must first notify the
Barnstable Conservation Division at least one(1)week prior to beginning.
Q:\SEPTIC\PERCFORM.DOC
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
11
Consistent %Gravel
0 -3 SL IOyk 15
34 P S L /0�/k 1Y
�g 3� c 2 5y 6/,V
30'/�(q cz
DEEP OBSERVATION HOLE LOG Hole# 2
Depth from Soil Horizon' Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
0 - �0Y�101
�-
zo
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,%Gravel)
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%Gravel)
Flood Insurance Rate Map:
Above 500 year flood boundary No_ Yes
Within 500 year boundary No vi Yes
/Within 100 year flood boundary No -v_ Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material?
Certification
I certify that on Z (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 and experience described in 310 CMR 15.017.
Signature
Q:\SEPTIC\PERCFORM.DOC
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
d
DEPARTMENT OF ENVIRONMENTAL PROTECTION.
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TITLE 5
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Property Address: 39 SPUR LANE
MARSTONS MILLS MA 02648
Owner's Name:KAREN BUCHANAN
Owner's Address:310 CENTRAL AVE
HUMAROCK MA 02047 7
Date of Inspection: JANUARY 112006
Name of Inspector: (please print)SEAN McGONAGLE
Company Name: M.S.S.
Mailing Address: 603 FERRY STREET
MARSHFIELD MA 02050
Telephone Number: 1-888-810-9104
CERTIFICATION STATEMENT
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:
X_Passes
Conditionally Passes i
Needs Further Evaluation by the Local Approving Authority L5
Fails
Inspector's Signature: �T Date:
v�
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board Healthy
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flo of 10,09A
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional o ce of th( t—
DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and th approving rn
authority.
Notes and Comments SYSTEM IN GOOD WORKING ORDER AT THE TIME OF INSPECTION
****This report only describes conditions at the time of inspection and under the conditions of use at that
time.This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 page 1
Page 2 of 11 V*
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 39 SPUR LANE
MARSTONS MILLS MA 02648
Owner:KAREN BUCHANAN
Date of Inspection:JANUARY 112006
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
PASSES I have not found any information which indicates that any of the failure criteria described in 310
CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes:
One or more system components as described in the"Conditional Pass" section need to be replaced or
repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass.
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 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.
ND explain:
Observation of sewage backup or break out or lugli 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
obstruction is removed
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:
Page 3 of 11
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A -
CERTIFICATION(continued)
Property Address: 39 SPUR LANE .
MARSTONS MILLS MA 02648
Owner:KAREN BUCHANAN
Date of Inspection: JANUARY 112006
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
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 detennine distance
**This`system passes if the well water analysis,performed at a DEP certified laboratory,for coliform
bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and
the presence of aimmonia 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:
. t
Page 4 of 11 v
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 39 SPUR LANE
MARSTONS MILLS MA 02648
Owner:KAREN BUCHANAN
Date of Inspection:JANUARY 112006
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
X_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
X_ Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow
X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
X_ Any portion of the SAS,cesspool or privy is below high ground water elevation.
X_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface
water supply.
X Any portion of a cesspool or privy is within a.Zone 1 of a public well.
X__ Any portion of a cesspool or privy is within 50 feet of a private water supply well.
X_ 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 coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility 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.]
PASSES (Yes/No)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.
You must indicate either"yes" or"no"to each of the following:
(The following criteria apply to large systems in addition to the criteria above)
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.
Page 5 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 39 SPUR LANE
MARSTONS MILLS MA 02648
Owner:KAREN BUCHANAN
Date of Inspection: JANUARY 112006
Check if the following have been done.You must indicate"yes"or"no"as to each of the following:
Yes No
X_ Pumping information was provided by the owner, occupant,or Board of Health
X_ Were any of the system components pumped out in the previous two weeks?
X Has the system received normal flows in the previous two week period?
X Have large volumes of water been introduced to the system recently or as part of this inspection?
X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
X_ _ Was the facility or dwelling inspected for signs of sewage back up?
X _ Was the site inspected for signs of break out?
X _ Were all system components,excluding the SAS,located on site?
X_ _ 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?
X _ 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:
Yes no
X _ 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(3)(b)]
Page 6 of 11 Q
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 39 SPUR LANE
MARSTONS MILLS MA 02648
Owner:KAREN BUCHANAN
Date of Inspection:JANUARY 112006
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design):_3_ Number of bedrooms(actual):_3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):_330
Number of current residents: 0
Does residence have a garbage grinder(yes or no):NO_
Is laundry on a separate sewage system(yes or no): NO_ [if yes separate inspection required]
Laundry system inspected(yes or no):N.A._
Seasonal use: (yes or no): VACANT_
Water meter readings,if available(last 2 years usage(gpd)): 2005 194 G.P.D,2004 339 G.P.D
Sump pump(yes or no):NO_
Last date of occupancy: AUGUST 2005
CO MMERCIAL/INDUS TRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sqft,etc.):
Grease trap present(yes or no):_
Industrial waste holding tank present(yes or no):
Non-sanitary waste discharged to the Title 5 system(yes or no): _
Water meter readings,if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of infonmation: UNKNOWN
Was system pumped as part of the inspection(yes or no): YES,
If yes,volume pumped: 1000 gallons--How was quantity pumped determined?CALCULATED,
CONFIRMED BY PUMPER
Reason for pumping:MAINTENANCE,TITLE 5 INSP:
TYPE OF SYSTEM
3_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)
Tight tank _Attach a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information: CERTIFICATE OF
COMPLIANCE DATED MARCH 1986
Were sewage odors detected when arriving at the site(yes or no): NO_
Page 7 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:39 SPUR LANE
MARSTONS MILLS MA 02648
Owner:KAREN BUCHANAN
Date of Inspection:JANUARY 112006
t
BUILDING SEWER(locate on site plan)
Depth below grade:_8"
Materials of construction:_cast iron X_40 PVC other(explain):
Distance from private water supply well or suction line:>100'FROM OLD WELL
Comments(on condition of joints,venting,evidence of leakage, etc.): JOINTS TIGHT,VENTING NORMAL,NO
LEAKS IN OR OUT
SEPTIC TANK:_X (locate on site plan)
Depth below grade:_7'
Material of construction:_X_concrete_metal_fiberglass_polyethylene
_other(explain)
If tank is metal list age:— Is age confinned by a Certificate of Compliance(yes or no):_(attach a copy of
certificate)
Dimensions: 8'6"LX4'10"WX5'4"DEEP
Sludge depth:4"
Distance from top of sludge to bottom of outlet tee or baffle: 10"
Scum thickness: 3'
Distance from top of scum to top of outlet tee or baffle:_6"
Distance from bottom of scum to bottom of outlet tee or baffle: 12"
How were dimensions determined:DIPPERSTICK,TAPE MEASURE
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 NOT PUMPED FOR A LONG TIME SCUM LAYER
3' THICK,BAFFLES IN PLACE,TANK SOUND,LIQUID LEVEL NORMAL,NO LEAKS.TANK PUMPED
CLEAN
GREASE TRAP:_(locate on site plan)
Depth below grade:
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:
Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
__ '7
Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 39 SPUR LANE
MARSTONS MILLS MA 02648
Owner: KAREN BUCHANAN
Date of Inspection:JANUARY 112006
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/day
Alarm present(yes or no):
Alann level: Alann in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX:_X (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: 0
Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of
leakage into or out of box,etc.):D-BOX LEVEL,DIST.EQUAL,NO SOLIDS CARRYOVER,NO LEAKS, 25"
BELOW GRADE
PUMP CHAMBER: (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
Page 9 of 11
Y
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM _
PART C
SYSTEM INFORMATION(continued)
Property Address: 39 SPUR LANE
MARSTONS MILLS MA 02648
Owner:KAREN BUCHANAN
Date of Inspection:JANUARY 112006
SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required)
If SAS not located explain why:
Type
X leaching pits,number: 1 PIT 6'X6'.36"OF FREE SPACE_
leaching chambers,number:
leaching galleries,number: u
leaclung 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.): SOIL DRY,NO.HYD. FAILURE,NO LUSH VEGETATION
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 or no):
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.): .
Q
Page 10 of 11
OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 39 SPUR LANE
MARSTONS MILLS MA 02648
Owner:KAREN BUCHANAN
Date of Inspection:JANUARY 112006
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.
to
if
y
r Page 11 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 39 SPUR LANE
MARSTONS MILLS MA 02648
Owner:KAREN BUCHANAN
Date of Inspection:JANUARY 112006
SITE EXAM
Slope NONE
Surface water NONE
Check cellar DRY
Shallow wells>100' AWAY
Estimated depth to ground water_12' feet
Please indicate(check)all methods used to determine the high ground water elevation:
X Obtained from system design plans on record-If checked, date of design plan reviewed: JANUARY 1986
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:PERC TEST DATED JANUARY 1986
(B.O.H. RECORDS)NO GROUND WATER AT 12'.HOUSE VACANT BOTTOM OF PIT @ 88"BELOW
GRADE PIT BONE DRY
Customer Service Report
N YJ'R=0 N M. E N TA L Wok Z�I-de 1
Sy". - System I.00atlOfl. .
BU
39 S PPjj
sx }
q M L`
dulomer.Home €uslomer 1.&- t303187.
Household Sin
TrchmNan ,�a
2 3 4 5 6 7 8
Type * Tank S' i 22 20 18 16 14 12 12 12
previous 1Serwiee 1250 f> 22 20 18 18 16 14 12 12
Service 1500 24 22' . 20 20 18 16 14 14
Data of Service:
1 '1 3Q- 26 24 22 24 20 18 16 16
5erirker Code Deserlption Charge Score From Table
ro 4n } Subtract6 Vor 9
prtp9e disposal
?! ) 1.00 9, ': Subtract 5 f etfi^is' an'10 4ears
Add 8 for sjV69 use i
f� Add 5 if syst dditive is us I i
1 tiI 1 Net sc�re
CIJ�1 /Store FK9�y
Less than 5 Every 6 months
6 to 15 Every Year
Payment Type: C h e.K; Expires: Tax t. 16 to 23 Every 18 months
GtidR Card Ati- Total .. _ r greater than 24 Every 2 years
Fedudcion Conimelts: Tank*Observations:
Good Condition
Leochfield Runback
Riding High(liquid level).
'? `� ✓'� �f/i'y� .j� /� �— Excessive Solids (top/bottom)
�fl T`
Use W Powdered Soap
Heavy Grease
Roots
Outlets Baffle Missing
Inlet Baffle Missing
Ysfi'r_I River r i lr ,:r. ea. -
.. Vi ' s,7f.?
Term
If; Payment is returned ttSF�ii..w�f}; r4-pz eentsti isc3.l�irlc tl;a11d YOU will.be assisssea a)rt> e �n�f;�,i2rc 1*i��?ic7n allcwed.by l�r .
;. Cast Signature
Cult~-Coov
cft
w
Sb� �71
THE COMMONWEALTH. OF MASSACHUSETTS
DEPARTMENT OF. ENVIRONMENTAL PROTECTION
BE IT KNOWN THAT
Sean McGonagle
Has satisfied the Department's qualifications as required and is hereby
authorized to use the. title .
CERTIFIED TITLE 5 SYSTEM INSPECTOR
as provided :in 310 CMR 15.340 and Section 13 of Chapter 21A of the
General Laws. Issued by .The Department of Environmental Protection.i .
March 14, 2602,
ll tin C
� or 'fib
� i a►n of Wa �o u o. antral
v .
ASSESSOR'S PARCEL14
L0C AT'ION 3 SEWAGE PERMIT NO.
{.
�d 7!`� v� v BUSS $(;- zgo
VILLAGE
VVI
I N S T A LLER'S NAME i ADDRESS
7Y-T.
✓�a t 5 4cm vvr L(,
8 U�1I L D E R OR OWNER
\Y'Y.Aojil � ��•2U t to Lv � -�'
DATE PERMIT ISSUED 74
/1ZS6,
DATE COMPLIANCE ISSUED `�
- --�
,;; -
� 6�
t
1�N,� �
,3n �°
��
�o�
ALL STE
SHALL
SYSTEM PROFILE MARKED WITHCMAGNETICTTAPE OR BE NOTES
(NOT TO SCALE) COM?ARABLE MEANS FOR FUTURE LOCATION. Bock
PROVIDE MIN. 20" DIAM. WATERTIGHT 1. DATUM IS NAVD 88 s C+ Ib
ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE
'a / ab
TOP FOUND. EL. 88.7' FILTER FABRIC OVER STONE 2. MUNICIPAL WATER IS EXISTING Long
2% SLOPE REQUIRED OVER SYSTEM 85.0' 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
MINIMUM .75' OF COVER OVER PRECAST O 9
NOTE: 2" MIN. WALL 4. DESIGN LOADING FOR ALL PROPOSED PRECAST a o
PRECAST H-10 THICKNESS REQUIRED BLOCKS OR UNITS TO BE AASHO H-LQ
RISERS (TYP.) PRECAST RISERS
''JEE
_ 6" MIN. S NL DIM. PIPES LEVEL 1ST 2' 4' CONTAR ALL H-10
'• ' PONENTS 4, 5. PIPE JOINTS TO BE MADE WATERTIGHT.
• 2� 85.1 4 GSCH40 PVC MOP (TYP.) _ �
_.. NDS SIDES 82.83
DODO 6. CONSTRUCTION ETAILS TO BE IN ACCORDANCE Q
10" **EXISTING Po�o�ooWITHOTEE SEPTIC TANK T I
° ���� �001 ����- -�00� ;°g 1.*83.7 ° ° ° ° ° ° WATERTEST D'BOX o ����0�����I� ElM ����� >°°°°°°° 310 CMR 15.000 (TITLE 5.)° ° ° O ° ° ° ° ° ° °GAS BAFFLE ° ° ° ° ° ° FOR LEVELNESS ci ����0 0 ° o ° o > ° °° ° o^° °_^ °° QQ�����0�0�;� DODQQQ���QQ 0� ;°o 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND80.0 NOT TO BE USED FOR LOT LINE STAKING OR ANY82.58' 82.41' go °o°o°o° m
4' LIQ. LEVEL (ACME OR EQUAL) .' ° °
':;. . .:.,:.; i OTHER PURPOSE. Pond
Qe Q
° ° ° ° ° ° ° °�°0°�°�°�°�°�°�°�°�°�°0°�°O°O H-10 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL.LLocus
° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° 3/4"-1-1/2" DOUBLE WASHED STONE 4' MIN. 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. Q
n,o^o^o_00_n_n_n.n o 0 0 0 0 o_n_n_n_n_o.o o (2) UNITS REQUIRED '}
ALL AROUND PRECAST STRUCTURES-
6" COMPONENTS NOT TO BE BACKFILLED OR `
6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 25.00' X 12.83'
COMPACTION. (15.221 [2]) o CONCEALED WITHOUT INSPECTION BY BOARD OF
U-i HEALTH AND PERMISSION OBTAINED FROM BOARD
-( 7 % SLOPE) ( 3 % SLOPE) OF HEALTH.
10. CONTRACTOR SHALL BE RESPONSIBLE FOR LOCUS MAP
FOUNDATION EXIST. SEPTIC TANK 16' D' BOX 12' LEACHING 75.0' BOTTOM TH-1 CALLING DIGSAFE (1-888-344-7233) AND
FACILITY NO GROUNDWATER FOUND t VERIFYING THE LOCATION OF ALL UNDERGROUND &
OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF SCALE 1"=2000'f
**INSTALLER SHALL CONF15M MINIMUM SEPTIC TANK WORK.
*THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL SIZE AT 1000 GALLONS AND ITS SUITABILITY FOR 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL ASSESSORS MAP 27 PARCEL 22
UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS RE-USE. REPLACE WITH 1500 GALLON H-10 BE REMOVED BENEATH AND 5' AROUND THE
PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM SEPTIC TANK IF NOT SUITABLE (OR H-20 SEPTIC PROPOSED LEACHING FACILITY.
TANK IF IT WILL BE SUBJECT TO VEHICLE LOADING). 12. EXISTING LEACHING FACILITY SHALL BE PUMPED
LAND D AND REMOVED OR PUMPED AND FILLED WITH CLEAN
(vim Iy SAND.
99- EXISTING CONTOUR
s P\tJR ; LA E �
X 99 1 EXIST. SPOT ELEV. SYSTEM DESIGN:
-[99]- PROPOSED CONTOUR 84 I I \ 85
19e 4] PROPOSED SPOT EL. 130.00, GARBAGE DISPOSER IS NOT ALLOWED
�,
.
TH1 EXISTING 3 BEDROOM DWELLING
TESTaHOLE \ QDDESIGN FLOW: 3 BEDROOMS @ 110 GPI = 330 GPD
2� SLOPE OF GROUND I �A ED \ USE A 330 GPD DESIGN FLOW
POLE
\ ERIVE
�Q� - UTILITY
750'
F M � I\ \ ��oG�� SEPTIC TANK: 330 GPD (2) = 660
FIRE HYDRANT STING WEL G �� _f
\
NOTE: NOT ALL SYMBOLS MAY APPEAR IN DRAWING _\ g6 �'�- 8j USE A 1500 GAL. SE T iC TANK
LEACHING:
SIDES: 2 25 + 12.83) 2 (.74) = 112 GPD
TEST HOLE LOGS 1 BOTTOM 25 x 12.83 (J4) = 237 GPD
ENGINEER: DANIEL E. GONSALVES, SE #13587 \ \ TOTAL: 472 S.F. 349 GPD
A
USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL)
WITNESS: DON DESMARAIS, RS WITH 4' STONE ALL AROUND
DATE: 8/20/18
/ EXISTING
DWELLING 5 G
PERC. RATE _ < 2 MIN/INCH / TOF = 88.7 IJ
1
DECK \
CLASS I SOILS P# 15756 o APPROVED DATE BOARD OF HEALTH MA
ELEV. ELEV. '9 BH a \
86 \
0» �' 85.5' 0" 85.5' ? '
A - A � \
�S L /S L
g6 .
3„ 3"
4/3 3» 10YR 4/3 ��- ,�� � ( TITLE 5 SITE PLAN
FIRE PIT \ OF
B B
/s� /sL 39 SPUR LANE
10YR 5/8 1OYR 5/8 LOT AREA \
18 84.0 20 83.8 21 ,566 S.F.f 40.11 MARSTONS MILLS, MA
84 O
C) / C1 / �� PREPARED FOR
BENCHMARK: \" r
/SiL /SQL MAG NAIL SET BORTOLOTTI CONSTRUCTION/
2.5Y 6/4 2.5Y 6/4 IN 16 OAK
30" 83.0 34 82.7 =86.6' NAVD88 TH2 { COURTNEY & JOSHUA HOPE
COOP
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C2 C2 UNSUITABLE
TH 1 DATE: AUGUST, 22 2018
PERC
M/CS M/CS SOIL ��oFn; s r��N OFMq� t � off 508-362-4541
�� gcti ' � DANIEL cyG fax 508-362-9880
2.5Y 7/3 2.5Y 7/3 130 D NIE! A downcape.com
LINE Y �� 10 OJIALA
MI CIV,t down cape eng1neer/ng, Inc.
�I 2 a ,� No �7i)980
126" 75.0' 126" 75.0' or
o��F�,s <;�\�� ,� F o;o civil engineers
Scale:1"= 20' ZZ _t .,, sr G U,R, land surveyors
NO GROUNDWATER ENCOUNTERED
939 Main Street ( Rte 6A)
® 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675
DCE # ' 8-2U 18-289 BORTO-HOPE.DWG
l II T
Large Format
Box #
Doc # AA
Image #
JMIA-�CGE
DATA