Loading...
HomeMy WebLinkAbout0082 TIMBER LANE - Health k Timber Lane Marstons Mills V A 149 058 - Commonwealth of Massachusetts Title 5 Official Inspection Form K Subsurface Sewage Disposal System Form -Not for Voluntary Assessments � 82 Timber Ln Property Address CID Maureen and Phil Whitney , Owner Owner's Name f; information is Marston Mills MA 02648 11-20-2018 required for every ` page. City/Town State Zip Code Date of Inspection PO h 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:When filling out forms A. Inspector Information 6/* /34/99 on the computer, use only the tab Darrell Stone key to move your Name of Inspector cursor-do not Cape Cod Septic Inspection use the return Company Name key. P.O. Box 1466 rv6 Company Address Harwich MA 02645 Cityfrown State Zip Code 508-240-2500 S14995 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs F rt er Evaluation by a Local Approving Authorit 4. ❑ Fails 11-26-2018 I is S ture 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 has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc-rev,726/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 usetts Commonwealth of IVlassach �m Title 5 official Inspection dorm IA Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. CitylTown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: 2) 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): f5inso.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 i • Commonwealth of Massachusetts T 1. Title 5 Official inspection Form �e Subsurface Sewage Disposal System Form Not for Voluntary Assessments �r 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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): 3) 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. a. 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: t5insp.doc•rev.7/26/2018 , Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form " Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. 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. c. Other: 4) 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 • Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments e % 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No Static liquid level in the distribution box above outlet invert due to an overloaded ❑ ® or clogged SAS or cesspool 99 P El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow ❑ ® 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 El ® tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply 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.] 4 ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. 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 0 El Area— IWPA) or a mapped Zone II of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 18 Commonwealth of Massachusetts - Title 5 official Inspection Foft i� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for a/!inspections: 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)] t5inso.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 16 I Commonwealth of Massachusetts �> Title 5 Official Inspection Fora wa Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w% 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Description: 3 bedroom residential dwelling Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Da eonths ago t5insp.doc-rev.7/26/2018 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts F �m Title 5 Official Inspection Form A Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 9 P Y rY 82 Timber Ln L Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. City/Town State Zip Code Date of Inspection D. System Information (coat.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 316 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons)'sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: 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 below): F 3. Pumping Records: Source of information: Unknown Was system pumped as part of the inspection'? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5inso.doc•rev.7126/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 c Commonwealth of Massachusetts �m i Title 5 Official Inspecition Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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): Approximate age of all components, date installed (if known) and source of information: 2003 per Board of Health Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): 4211+/- Depth below grade:P 9 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.): Apparent good condition t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 c Commonwealth of Massachusetts �m Title 5 Official Inspection Form �a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank (locate on site plan): 36" Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallon Sludge depth: 5" Distance from top of sludge to bottom of outlet tee or baffle 27" ff Scum thickness 0 6„ Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Sludge judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grade to inlet and outlet cover 4" Normal liquid level SCH 40 outlet tee Recommended next maintenance pumping within 1.5 years Recommended maintenance pumping every 2-3 years 15insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 I c � Commonwealth of Massachusetts r Title 5 official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 82 Timber Ln u Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): i 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Bolding 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 eS g 0 gallons per day i5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts r Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 82 Timber Ln L Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. City/Town State . Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank (cont.) 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 cop of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Y p 9 9. 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.):. Grade to box 46" Cover 34" 2 outlets with speed levelers OK condition Normal liquid level No sign of leakage No scum No sign of failure 5insp.doc-rev.712612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 I Commonwealth of Massachusetts �n Title 5 official Inspection Form is Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owners Name information is required for every Marston Mills MA 02648 11-20-2018 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. 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. 11. Soil Absorption on stem t Sy stem y (SAS) locate on site Ian excavation not required):( P q ) If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 5 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 13 of 18 Commonwealth of Massachusetts " - Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ems % 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 5 Infiltrators with stone (37.25'x10'x10") Inspected chambers with a sewer camera Clean and dry No sign of hydraulic failure 12. 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 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.).- t5inso.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts 1p Title 5 Official Inspection Form �= w Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 1 = % 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owners Name information is required for every Marston Mills MA 02648 11-20-2018 page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): I t5insp.doc•rev.7/2612018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts 11P Title 5 official Inspection Fora Subsurface Sewage Disposal System Form Not for Voluntary Assessments 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owner's Name information is Marston Mills MA 02648 11-20-2018 required for every State Zip Code Date of Inspection page. City/Town D. System Information (cont.) 14. 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 i i I C� 0 i;g--.—, I � i, vent A B G 2 )---- 2 13-- 0 3 ,� � 10 1 cl 4 5 6 d :5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 Commonwealth of Massachusetts s 1. p Title 5 official Inspection Form i. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 82 Timber Ln v Property Address Maureen and Phil Whitney Owner Owners Name information is required for every Marston Mills MA 02648 11-20-2018 page. Citylrown State Zip Code Date of inspection D. System Information (cont.) 15. Site Exam: ❑ Check Slope ❑ Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: >5feet 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: 2003 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Plan on file ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Elevations from the design plan Bottom of SAS ELV.92.17 Bottom of Test hole ELV. 86.0 NWE Separation >5' Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Pace 17 of 18 Commonwealth of Massachusetts - 1� Title 5 Official inspection Fora J;1' a . Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 82 Timber Ln Property Address Maureen and Phil Whitney Owner Owner's Name information is required for every Marston Mills MA 02648 11-20-2018 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank— Pumping contract attached ' For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 TOWN OF BARNSTABLE LOCATION ,�� \ "K SEWAGE # ,/� \ VILLAGE V� , _S ASS OR'S MAP& LOT 4� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITYoST —.1 LEACHING FACILITY: (type) (size) Z2K11 1k 161 f NO. OF BEDROOMS BUILDER OR OWNE PERMITDATE: 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 � ��� ���� �� . ., 6 f� . � � 6 �{�1�� �l a �/ �� � ^ ��� � i �� n }1 No. 64U J� I �U/ Fee f THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for Zi.5pont bpgtem Conotruction Permit Application for a Permit to Construct Repair Upgrade Abandon El Complete System dividual Components Location Address or Lot No.6_2 i 0Q.—L.-a— Owner's Name,Address and Tel.No. Assessor's Map/Parcel v•"`�'\ S p$�t L.e- ���- Installe 's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. `wr L $r(�)-_�&,I,�, A (,�s 5—Y Type of Building: Dwelling No.of Bedrooms � Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures e Design Flow gallons per day. Calculated daily flow 3'1 gallons. Plan Date Number of sheets Revision Date Title L—'c-e- Size of Septic Tank ZrType of S.A.S. 0 C, w t LT'',r-,w!'1 Description of Soil L G-Via S ILc � Sl Nature of Repairs or Alterations(Answer when applicable) — 1(NT�0 Y" A j Date last inspected: .,ESIGNING ENGINEER MUST SUPE,;.'; Agreement: INSTALLATION AND CERTIFY IN WRI T I : THE SYSdTEM WAS INSTALLED IN STI,:�T The undersigned agrees to ensure the construction and maintenance of the,afore escribedbon-s,ne i ruuv.sewage disposal system �,,.. .� in accordance with the provisi6,ns of Tine 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been is u Board Signed Date Application Approved by d, Date i Application Disapproved for the following reasons Permit No. 20 0 3 --6,2 � Date Issued 0 ol 0Z-- _ t7 No n6 Fee �b � � ?� V01ftenGe li�w^�� I 02 f! �r 0 3 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pprication for Migozal bpztem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System �Itdividual Components Location Address or Lot No.� A Owner's Name,Address and Tel.No.Lam` -- _ _ Assessor's Map/Parcel �` `` S A U L-,_ L_�� 17 r Installers Name,Address,an Tel.No. Designer's Name,Address and Tel.No. b. � I ��ma y- r «�_(_. 5� 1 Type of Building: t Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building ` No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow C7 gallons per day. Calculated daily flow _3_,�LA, gallons. Plan Date Number of sheets Revision Date Title l-__-T°' Size of Septic Tank (FLU i 4Lr3e— Type of S.A.S. 0 C, _S"wiZc t�T�,No t1 Description of Soil L try w-a Ynv\l) IA e-Q_ S14 Nature of Repairs or Alterations(Answer when applicable) S­t:n- yny��Vic- L-Q Y 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 provisi6ns of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued-by, + 's Board o"'''Iea/1 Signed ft"A"L ! Date Application Approved by �J_ �1,j Date 1 7) r t r�2 Application Disapproved for the following reasons s � Permit No. 0 a Z - /_ Date Issued 12 L ! Z. ----------------------------L-- ——————— THE COMMONWEALTH OF MASSACHUSETTS BARNS TABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(. )Repaired ( )Upgraded(V Abandoned( )by b e_ *s st M C_ at k _c.t_o 0 A has been constructed in`accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.I nj- !a In dated 1 2 /y i ri Installer �k,�, A—, Designer Z f The issuance of this permit shall not be construed as a guarantee that the s� stemawifl)function as signed. r Date 1 _ a- y Inspector -) f-') 1 ( G , --------------------------------------- No. _3 - Fto 2 6 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migont *pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair( V�pgrade( )Abandon( ) System located at 6,�,-- 1� . 1/h.s1l � and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Cons ction must be completed within three years of the date of this en . Date: �� / (f Approved by a /?IS - . 1 r,,N-VfROTE(-H1-ABOR,4 TORTES,INC 31A CERT, NO.:M�AIA 063 8 j,an Se basthin I)rive-Unit# Sandivich .11,1/1 0 1 508(888-640) 1-800-339-64619 F/LY(.508)898-6446 CLIENT, Marie Souza Realty Team LOCATION: 82 Timber Lane ADDRESS: 1597 Falmouth Rd., Rte. 28 Marstons Mills, MA Centerville, MA 02632 COLLECTED BY: Lecky Tolchinsky SAMPLE DATE: 10/30/2003 SAMPLE TIME: 12:25 WATER SAMPLE TYPE: Existing Well DATE RECEIVED: 10/3012003 LAB I.D. #: 0310602 WELL SPECS.: FLOW: 10 GPM RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Analyzed Limits Coliform bacteria / 100ml 0 0 92226 10/30/2003 pH pH units 6.5-8.5 6.22 4500 H+ 10/30/2003 Conductance umhos/cm 500 154 120.1 10/30/2003 Nitrate-N mg/L 10.0 2.46 300.0 10/30/2003 Nitrite-N mg/L 1.00 < 0.004 300.0 10/30/2003 Sodium mg/L 20.0 15.4 200.7 11/3/2003 Iron mg/L 0.3 < 0.1 200.7 11/3/2003 Manganese mg/L 0.05 0.150 200.7 11/3/2003 COMMENTS: pH is below recommended limit and may have corrosive characteristics. Manganese is not a health hazard, but may cause staining and/or give water an odor or taste. WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. <=less than ..Date, i-Z >=greater than Vnald J. Sa TNTC=too numerous to count Laboratory frelctor 03/16/2014 06: 19 FAX 16 0011001 12/18/2003 TMJ 1S:40 FAX 508 888 6446 EAIVIROTECH LGS Q 002/003 FNWROTECHLA fO.Rrf'rOAMS,XNC MA U AT.NO.:MJvU 4G3 3 j n SebasdAn Drim-Unit#12 Sandwich M4 w6.9 508(88844*7) 1.800-.U9-6460, FA-X'(SO*) W-04r, CLIENT; Alice Lee LOCATION: 32 Timber Lane ADDRESS. Wo Shay Environmental Marstons Mills MA PO Box 827 E Falmouth MA 02536 COLLECTED BY: CE Shay SAMPLE DATE., 12/17/2003 SAMPLE TIME: N/A WATER SAMPLE TYPE: Existing Well DATE RECEIVED: 12/17/2003 LAB I.D. #: 0312267 WELL SPECS.: N/A RESULTS OF ANALYSIS: Parameters Units Recommended Rosutts Method Date Analyzed Limits Cvlifvrm bacteria J 100ml 0 0 92226 12/17/2003 ,pH pH units 6.5-5.5 6.33 4500 H+ 12/17/2003 Conductance umhos/cm 500 198 120.1 12/17/2003 Nitrate-N mg/L 10.0 4.29 300.0 12/17/2003 Nwilu-N mg/L 1.00 <0.004 300.0 12/1712003 Sodium mg/L 20.0 13.5 200.7 12/18/2003 Iron mg/L 0.3 a 0.1 200.7 12JI412003 Manganese mg(L 0.05 0.199 200.7 12/18/2003 COMMENTS: pH Is below recommended limit and may have corrosive characteristics. Manganese is not a health hazard, but may cause staining and/or give water an odor or taste. WATER MEETS EPA STANDARDS AND 1S SUIIMABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTER, <-less than D >-greeter than 40ldJ, Saar TNTC=too numerous to count Laboratory Di r DEC-18-2003 THU 06:01PM ID: PAGE:1 I 5 - __. 12;1 u--2003 a 03 0 34 g:b DEED RESTRICTION This Deed Restriction is entered into this December 17, 2003 by 1 ;►; t = _v & Alice W. Lee of 82 Timber Lane, Marstons Mills, MA 02648 and the TOWN OF BARNSTABLE, by and through its Board of Health. Whereas, ` lL_y-.&-,l & Alice Lee is the owner(s) of certain real estate located at 82 Timber Lane, Marstons Mills, Barnstable County, Commonwealth of Massachusetts, as described in a deed recorded at the Barnstable County Registry of Deeds in Book 7955 Page 165, herein after referred to as the "Property", and further described as follows: ASSESSORS MAP 149 , PARCEL 058 and filed at the Barnstable County Registry of Deeds in Plan Book 247, Page 82 WHEREAS, L�_,o, & Alice Lee as the owner of said lot has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.00 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage. WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to grating a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and/or authorizing the issuance of a building permit for the construction of a single family home on the property, is the requiring that the agreement for the restriction on the number of bedrooms in any house existing and/or constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, NOW, THERFORE, 8l D_& Alice Lee does hear-by place the following restriction on his above referenced land in accordance with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: 1. 82 Timber Lane, Marstons Mills may have constructed upon the lot a house_ containing no more than three (3) bedrooms. DEED RESTRICTION A.� Mr _, n„ng ; agrees that this shall be a permanent deed restriction affecting #82 Timber Lane located on Marstons Mills, MA and being shown on the plan recorded in Plan Book 247, Page 82. For Title of #82 Timber Lane, Marstons Mills, MA, see the following deed: Book 7955 Page 165. The consideration for this restriction is the approval of the sewage disposal system for the Property by the Town of Barnstable Board of Health at its meeting of April 15, 2003 Executed as a sealed Instrument and Witness our hands and seals this i e day of r GG 2003 l ers Signatk Owners Si tore �,�-----� Notary Public 12►GAIL7 My Commissio .• res °7/29105' C,P.tvi. 1 , 2003 B&-i��, SS. Then personally appeared the above named; 'R VLL�/r.& Alice Lee known to me to be the person who executed the foregoing instrument and acknowledged the same to bed l,..L°=.o,& Alice Lee and acknowledged the foregoing instrument to be his/her free act and deed, before me. { BARNSTABLE REGISTRY AE DEEDS TOWN OF BARNSTABLE • I LOCATION. � �E3 r SEWAGE VILLAGE__ ASS OR'S MAP& LOT INSTALLER'S NAME&PHONE N0. SEPTIC TANK CAPACITY �oSZ LEACHING FACILITY: (type) 6�1�,c�(V-'NKLs (size) if NO. OF BEDROOMS r BUILDER OR OWNS `-- PERMITDATE: o� Gt COMPLIANCE DATE: 02 V 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 II II a ,� 1a 31� CARMEN E. SHAY (508)-548-0796 ENVIRONMENTAL SERVICES,INC. P.O.Box 627,East Falmouth,MA 02536 December 22, 2003 RE: Certification of Title V Septic System Installation: Residential Property 82 Timber Lane, Marston Mills, MA Dear Sir or Madam: On December 22, 2003, Roger Roberts, Inc. was issued a permit to install a Title V Septic System at 82 Timber Lane, Marstons Mills, MA, based on a design drawn by Shay Environmental Services on December 3, 2003. I Certify That The Septic System Referenced Was Installed Substantially According to the Plan I Certify That the Referenced Above Septic System Was Installed With Changes but in Accordance With State and Local Regulations, Revisions or As-Built Plans/Sketch will Follow. The Septic System Was Not Installed Per State and Local Regulations and Corrective Action is Required. If you have any questions, please do not hesitate to call the undersigned at(508)-548-0796. Sincerely, CARMEN E .SHAY ENVIRONMENTAL SERVICES,INC. *,A O CARKNAEN E. S 1181 Carmen E. Shay, R.S., C.S. � a President Sq N1 TAR�P� l Town of Barnstable `SAS Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,RS. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. December 30, 2003 Mr. Carmen Shay, R.S. Box 627 East Falmouth, MA 02536 �RE����82�TiarnberLane,,IUlarstons�Mills��� � s � f f � � 1�49059 � Dear Mr. Shay, You are granted conditional variances on behalf of your clients, William and Alice Lee, to construct a replacement soil absorption system at 82 Timber Lane, Marstons Mills, Massachusetts. The variances granted are as follows: PART XIV, SECTIONS 2.00 & 3.00: The soil absorption system will be located 110 feet away from the onsite private well, in lieu of the 150 feet setback separation distance required. PART XIV, SECTIONS 2.00 & 3.00: The soil absorption system will be located 111 feet away from the neighbor's private well at 98 Timber Lane, in lieu of the 1.50 feet setback separation distance required. PART XIV, SECTIONS 2.00 & 3.00: The soil absorption system will be located 124 feet away from the neighbor's private well at 64 Timber Lane, in lieu of the 150 feet setback separation distance required. These variances are granted with the following conditions: (1) The onsite private well water shall be tested at a certified laboratory. If the well water does not meet the National Primary and Secondary Drinking Water Standards and the U.S. EPA Maximum Contaminant Levels, this variance will be voided and the dwelling shall connected to public water before the issuance of a disposal works construction permit and before the construction of a proposed replacement septic system. ShayLee (2) No more than three (3) bedrooms maximum 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. (3) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to three (3) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (4) The septic system shall be installed in strict accordance with the engineered plans dated December 3, 2003. (5) The designing sanitarian shall install stakes at the four corners of the proposed SAS location prior to installation. (6) The designing sanitarian 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 revised plans. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to the existing private well locations and due to the small size of the lot. The proposed soil absorption system appears to meet the maximum feasible compliance standards contained within the State Environmental Code, Title 5. Sincer ly yours, Wa ne Mo er, M.D. Ch irman ShayLee r OFIHE Tp� DATE: FEE: • BAMSrABLE, 9 MAC' REC. BY C A Town of Barnstable CHED. DATE: Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORM LOCATION Property Address: (tile � Nd�Rs j Iy,�S`i Assessor's Map and Parcel Number: M(rQ i 40 --�;j n— Size of Lot: Wetlands Within 300 Ft. Yes Business Name: ! No Subdivision Name: t,312 APPLICANT'S NAME: ('e- Lf' Phone to t + j;�a � Did the owner of the property authorize you to represent him or her? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON Name: LC)t toc-C, k�O2 Leg Name: {' •. Z- ? r- . ..cAy y C a Address: 8 Z 70-1 r C e4-W , i . H t J i S NA Address:�- j—Dy - �U Lq)''a ,31-+� Phone: `7 A Phone: f�- _ VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System Checklist(to be completed by office staff-person receiving variance request application) _ Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) 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 ten days prior to meeting date at applicant's expense (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 fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H, REASON FOR DISAPPROVAL Wayne A.Miller,M.D. C:\Documents and Settings\decollik\Local Set t ings\Temporary Internet Files\OLKFB\VARIREQ.DOC CARMEN E. SHAY (508)-548-0796 ENVIRONMENTAL SERVICES,INC. P.O. Box 627,East Falmouth,MA 02536 December 5, 2003 Town of Barnstable Board of Health 200 Main Street Hyannis,MA 02601 RE: REQUEST FOR VARIANCE HEARING FOR TITLE V SYSTEM: Residential Property 82 Timber Lane, Marstons Mills, MA Dear Sir or Madam: In accordance with MGL 310 CMR 15.00, CARMENE. SHAY- ENVIRONMENTAL SERVICES, INC.(CES) request a local variance for the proposed Title V septic system for the residential property located at 82 Timber Lane, Marstons Mills, MA. The following details the type of variance requested, technical justification of the variance and evidence that the granting of the variance will not pose a risk the environment as defined in 310 CMR 15.410 (1) (b). The following details the type of variance requested, technical justification of the variance and evidence that the granting of the variance will not pose a risk the environment as defined in 310 CMR 15.410 (1) (b) Type of Variance: 1. A variance is requested to reduce the setback from the onsite private well from 150 feet to 110' feet. 2. A variance is requested to reduce the setback from the private well located at #98 Timber Lane from 150 feet to 111.5 feet . 3. A variance is requested to reduce the setback from the private well located at#64 Timber Lane from 150 feet to 124 feet . If you have any questions, please do not hesitate to call the undersigned at (508)-548-0796. Sincerely, CARMENE. SHAY ENVIRONMENTAL SERVICES,INC. Carmen E. Shay, R.X., . . President 12/04/2003 19:59 16177870119 HI HO SEAFOOD PAGE 01 VJ/VL/4V44 4V.vr rnn CAR ► E E• SHAY (808)•348•a796 Environmental Services,Inc. P.O.Box 627,East]Falmouth,MA 02536 AUtho,ization Agreement DATE: December 5,2003 Adress: 82 Timber Lane,Marstons NBIIs,MA Authorized By: Ms. Alicc Lee--property Owner I Authorize Carmen E, Shay Environmental Services, Inc. to represent me before the Town of Barnstable Board of Health for the Variance request relative to repair of the Title V Septic System at property known as 82 Timber Lane, Marston Mills, MA. Agreed and Accepted By: Namo ' Date: #82 TIMBER LANE - FIRST FLOOR SCHEMATIC 1 " = 10' Sun Room Deck Kitchen/Dining Room Bath Master Room Bedroom Living Room Bedroom Bedroom #82 TIMBER LANE - BASEMENT SCHEMATIC 1 " = 10' Sun Room Deck Foundation (Walk—Under) Furnace/Storage Bath Room GARAGE Family Room CARMEN E. SHAY (508)-548-0796 ENVIRONMENTAL SERVICES, INC. P.O.Box 627,East Falmouth,MA 02536 December 5, 2003 RE: NOTICE FOR BOARD OF HEALTH HEARING FOR TITLE V SYSTEM: Residential Property 82 Timber Lane, Marstons Mills, MA Dear Abutter: In accordance with MGL 310 CMR 15.00, CARMEN E. SHAY- ENVIRONMENTAL SERVICES, INC.(CES) request a local variance for the proposed Title V septic system for the residential property located at 82 Timber Lane, Marstons Mills, MA. The following details the type of variance requested, technical justification of the variance and evidence that the granting of the variance will not pose a risk the environment as defined in 310 CMR 15.410 (1) (b). A Meeting will be held on December 16, 2003 in the evening (7:00 pm) at the Barnstable Town Hall (200 Main Street, Hyannis) relative to the following. The following details the type of variance requested, technical justification of the variance and evidence that the granting of the variance will not pose a risk the environment as defined in 310 CMR 15.410 (1) (b). Type of Variance: 1. A variance is requested to reduce the setback from the onsite private well from 150 feet to 110' feet. 2. A variance is requested to reduce the setback from the private well located at#98 Timber Lane from 15,0 feet to 111.5 feet . 3. A variance is requested to reduce the setback from the private well located at #64 Timber Lane from 150 feet to 124 feet . If you have any questions, please do not hesitate to call the undersigned at (508)-548-0796. Sincerely, CARMEN E. SHAY ENVIRONMENTAL SERVICES,INC. Carmen E. Shay, R.S., C.S.E. President RECEIVED COMMONWEALTH OF MASSACHUSETTS _ OCT 0 Z 2003 � EXECUTIVE OFFICE OF ENVIRONMENTAL A FAaIRS T IRS OF BARNSTABLE DEPARTMENT OF ENVIRONMENTAL PROT LTH DEPT. NOPECTION TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 82 Timber Lane MAP Marstons Mills. MA 02648 Owner's Name: Alice Lee PARCEL Owner's Address: �•f%T - � Date of Inspection: September 19, 2003 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford Map: 149 Mailing Address: P.O. Box 49 Parcel: 059 Osterville,MA 02655-0049 Lot: 35 Telephone Number: (508) 862-9400 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: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority ✓ Fa' Inspector's Signature: Date: September 24, 2003 The system inspector shall subm' a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****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 I r Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 82 Timber Lane Marstons Mills, MA Owner: Alice Lee Date of Inspection: September 19, 2003 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. 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 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 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: 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 32 Timber Lane Marston Mills. MA Owner: Alice Lee Date of Inspection: September 19, 2003 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 determine 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 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: 3 Page 4 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 82 Timber Lane Marstons Mills. MA Owner: 4lice Lee Date of Inspection: September 19, 2003 D. System Failure Criteria applicable to all systems: You must indicate either`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 '/2 day flow ✓ 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 I 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 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.] Yes (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 System: 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. 4 Page 5 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 82 Timber Lane Marston Mills, MA Owner: Alice Lee Date of Inspection: September 19, 2003 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: Yes No ✓ 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)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 82 Timber Lane Marston Mills. MA Owner: Alice Lee Date of Inspection: September 19, 2003 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: 4 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): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): pd Basis of design flow(seats/persons/sgft,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 information: Pumped 3 years azo-per owner Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system (yes or no) (if yes,attach previous inspection records, if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: May 5184-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 82 Timber Lane Marstons Mills, MA Owner: Alice Lee Date of Inspection: September 19, 2003 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints, venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 3' Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: S" Distance from top of sum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: Measuring stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was up to the top of the tee. Solids were above the top of the tee. The system was presently backing up. GREASE TRAP: None (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 I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 82 Timber Lane Marstons Mills, MA Owner: Alice Lee Date of Inspection: September 19, 2003 TIGHT or HOLDING TANK: None (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): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): 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.): The D-box was located, but not dug up. The system was under water. PUMP CHAMBER: None locate on site Ian ( 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.): 8 i Page 9 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 82 Timber Lane Marstons Mills, MA Owner: Alice Lee Date of Inspection: September 19, 2003 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 1 -6'x 6'- 1000 Qal. 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.): The liquid level was above the leach pit and filling the hole. The system was in hydraulic failure. CESSPOOLS: None (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: None (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.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 82 Timber Lane Marstons Mills, MA Owner: A1ice Lee Date of Inspection: September 19, 2003 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. A Ca Q 3 ali a- a 7 3` 3 3a6 a i y3sy� 10 Page I I of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 82 Timber Lane Marston Mills. MA Owner: Alice Lee Date of Inspection: September 19, 2003 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 25 +1- feet Please indicate (check) all methods used to determine the high ground water elevation: Obtained from system design plans on record- If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topographic and water contours maps Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using the Barnstable topographic map and the Cape Cod Commission water contours map the maps were showing approximately 25'+/-to ground water at this site. This report has been prepared and the system inspected and failed of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. 11 { No.9.3:Yfl.. Fxs.. .................. THE COMMONWEALTH OF MASSACHUSETTS os� BOAR® OF HEALTH ..........................................O F...............-....--....--...._ Alip iration for Uigaaal Works Towitrurtiun frrutit Application is hereby made for a Permit to Construct (V� or Repair ( ) an Individual Sewage Disposal System at: f ASP ��� `f ns .°'/S .. .g2.. _i!.'" •fir P`Qn = Z --._ .. ................ . Location-Address r Lot No.... ......G�.. _. . m. r.-�mt.:���.......•.......•........ a /J w�� Owner Address . ®.�..... ..............Inst .---......................................... .._.......-------- ddre-•--•--------•...........................-•-- � Installer Address d Type of Building Size Lot_�_�'�_m. . ....Sq. feet Dwelling—No. of Bedrooms.._.._... .............................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g ------•--------------------- P ( ) — Cafeteria ( ) Other fixtures ----------------------------------- ---------------------- W Design Flow............................................gallons per person per day. Total daily flow____........._....._............_...........gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width.........._..... Diameter--------------_- Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No-_--_-------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 0-4Percolation Test Results Performed by.......................................................................... Date........................................ a 14 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --••-----•-----------------------------------------•----••--------.....--•-----------•••••••..••----........................................................ 0 Description of Soil........................................................................................................................................................................ x U .....-•-----•-•------•---•-•-----••••-••--•----•••--•••-•-•-•---....._..-•----------•.....•---••-----•••-----------•-•--••--••---•---•-•------•-....--•••--------•--•........................••----••.... w M. Nature of Repairs or Alterations—Answer when applicable.............................................................................____._........_.... -------------------------------------------•----------------------------•--•--•--•..............---------------•---••----•-------••-----•-••••-•-•--------•------•-••----•••-----••-•••••---._.....----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT 4: 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance as been issued by the board of health. f� g ign .--_.. ......... ... ... -- --L ./.... .... ApplicationApproved By-- ------ ---------• •.=--•-••------•-••--------•----•--................---------.....-•--- . ` Date Application Disapproved or t e following reasons--------------------------------•----•-----------------------------------------------....._......-----........... -•.............................•••-•-----••---•----•--------....-•-------••-.........--•---•-••--••----•--•-----•--•--••--•••-------------=-••-•-••-----••...-••-•----••--••••--•------•--•---•-•-•---- Date PermitNo...............................0........................... Issued....................................................... Date No. .. Fss.. _.............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... ......... --..............OF.........................................----------------------------..................... Allp iration for Biiposa1 Works Tonitrurtion Prrmit Application is hereby made for a Permit to Construct (fit"} or Repair ( ) an Individual Sewage Disposal System at: / , ij+G'�.'/" ..................�..._.:_........... ...... ........................... � ,a7- *I -..... :.. ... .......... . -7-'_......_ . ..t_ _+L cation-Address . �. or Lot No. ..��Q..1--`:----..... �.�rr.�' �.�.� ------------------------- ��.. �Xt.1CL. �� ---- .��Y�r Owner Address W a -•---- -•--•-•------------------•----•--•----.....----•--•-----------•--.............._.--- ---- Installer Address Type of Building A& Size Lot. 4_)!!.41---_5 q. feet Dwelling—No. of Bedrooms:_.______Iff ....................Expansion Attic ( ) Garbage Grinder ( ) 'k Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures ----------------------------•-•. . W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth. below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank 04 Percolation Test Results Performed by---------------------------- -------------------•-•------- -------•----•---• Date........................................ 1.4 ,.� Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ /4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a •-----•---------------------••---•-••-••------•---••-•••............--------•---•---•-•-••----............................................................... 0 Description of Soil..................................... x •° �., ---•----•-•••---•-•-----•--------•--•--------------------------------------•-------•--------------------•--•-••••-•••--•••-••-•-•-•-•------------,--•-......-•......................................... W -••---------•---------------•-----------------------------------------------••------------------•-•---••--•-••••--......•-------.........----•-.. ...._..... U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ------....-•----------------------------------------••--••-•-••-----•-•••••.....--•--------•..----------•---------•-•--•••••-----•--••---••-•-•--------------------------••-.......................---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance as been issued by the board of health / Application Approved B�or .-•Ifollowing .-•••--------------------------••...------•-----•-••-•....••----..---•-- -- 11 J-----�---........ Date Application Disapproved t reasons:............................................................................................................... -•------•----------------------------------------•------------------------•-----•----------•------------- Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF.................................................................................... Trrtif iratr of Tootpliatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ......,; Installe `- at 1 has been installed in accordance with the provisions of I'- F 5 of The State Sanitary Cod 1 ri ed in the application for Disposal Works Construction Permit No.__ .a.._"':��_t'.__._._.___. ' dated- .-.-._.. ... ................ THE ISSUANCI OF THIS CERTIFICATE SHALL NOT BE CONSTRUED A GBJARANTEE THAT THE SYSTEM W I ^ TION SATISFACTORY. DATE...: ............................. Inspector. ----... ....................................................................... rS I THE COMMONWEALTH OF MA SACHUSETTS BOARD OF HEALTH rOF.................................. ,,f No. ....... le- .... FEE.yop.........•.•-•-•- �io�o� 1 ork� �on��rtion anti# Permission is reby granted........ � ......... .. .......................... .... to Constru ( l or eT-I.?4�t? Indivi .Sewage Disposal System at No. ` .. rr�-t,ed---------------•.- tr - Street � as shown o/th icati for Disposal Works Construction Permit No..................... Dated.. .. . .._............... ---------•---•-•..............•--••--•-•-----•---------------......----...------._....._.......---...._ Board of Health DATE---••. ..... ...••--••--------•----------- FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS - • r tv10 P �11 OF MSS uJ N. Ny 29874 '('Y';' �,r�h� '. �,}� �'v` 'mod, o s u� 47 Ole �. . AAV <� �6 y Xj i ub y/Ely'ID p6p. 10, T 1�~- y��I ♦l. �p Q/ ^\f A IRbt ExtSn 1�.* 0? �rCC' �� y^ 1f'1't ExrS7,W6 WELL-D IM i�.I?Ma!E�( j ;:�t* /_�..,, • � � ,Y! �. CIE J�� d fit• .. , 01 y : 45.�� F - -— ---- - --- - - --- --- e Al N /` - -.- --- — 30' Fl2nt_tr :::�I P_t'C,4: - �Mnije co4Au�� t�A�E : y lent. 1q�4 LEGEND EXISTING SPOT ELEVATION. ' OsO CERTIFIED PLOT PLAN €XIBTINS CONTOUR --- Q DF,y, LOT T�/►+G�k �� � T FINISHED SPOT ELEVATION . 3�.P'' ss M�hSTONS M/ LLS FINISHED CONTOUR 0�---- moo? A N I APPROVED., BOARD - OF . HEA.LTH ' RSE ; y ,pNo.10951�0� ����� ��� ♦ � � ®ATE AGENT '`Fssr �`'� SCALE, / = 40 DATES ZDREDGE ENGiNEERIII�G CUIENT I, CERTIFY THAT THE PROPOSED Y, s E8IsTERE R:Et>flSTVtl� �Z`i3,6 BUILDING .,SHOWN ON.;THIS _PLAi� CIVIL LAND CON:FORM8 TO THE .3ZONING l#1 E ®I E DR.SY+ A ,A OF , IARNSTA Lf YA33.� s. MAI N .STREET Cbl. ST • g 3:.g2 .—H Y.A N N i 8' S ! < EG.HEET. 4F OO LAND ',SU*V , r t o r' ' �'�°�-1 1,,, kf, ,G !,n' ' •:�-d�o-"' 4 x * 4.+7t, �e.,, i� ='Y'"4i.*'1 ,-':. s tv !.5:. -e:,. •. P. ..., ..- '-,C :^ ...,. .:..z_....,:xr,_ .. -x.. . _re a.-..z.,�.w. _. c ..r,.ti....,. Lax i_i"P"„skwb.sr.., .. .,.e:_+.a+aT'-':.+aa9aou:�rr6a.a:.""�."�.-.�;r�- _':::�_ ...__.._ —:�-��•>J�cts��•:�-s___--."-p.-r�_^LweT.-.�✓.-9��rt'sa ..�Eti-Svr-.._�.`�"::, _ _ 2p FT. M/N. /Y07"E /F E/TNER THE SEPT/G'TANk'^ { !,EACHiwG 1/T A.lE MORE 7-NJ" /2"QEL016I /O -r M/^/• 3RAo�, A 24"O/AMETEK CoNCR.ET.C-'- .,&R ' q'PYC P/Pt SNALL' eE aW009S y7 To 4RAoE.��;N'EX71-. CONC�4�E M/N. PITCH h+ERVY CA ST bPO/Y Co y.--R SHAL L L3E:USED :�. EL= 102.v G•OYE/�s �B�oER'FT /F//V OR/VEJ•VA y x is , A _ a�CAGQ CO✓Eft xs CC EAN MSAM.D II' PZ OF w UQ►t//D�EYEL �': '' (0(30 GAL. o �' • !. • • •• . e i //8'-'j/B ._ %f'Pdlt TA/VK D/ST. ••• . `. . . . . e ' a jVASHFO ST27NE ' r :s . . BL1X O • . • • .�• �Lr ~' ' .t o • •EFFECT/✓L • •, '��'4 - L, �2~ i y t �. r • • • • . OEPT/d • • • • • WA5AeP STDNE L • i s. • • • . • • • • . d •�o PRECAST SE.64AGE I/Vf�C/C'r dLEY�IT/DNs Is8.5 x 2.5 4-r C./D t •� • •. • • • • o P/7 OR EfJI/�V F KYERT:AT O/I(LD/NG _.94.0 78.5 / x 1:0 78•G/ D s7: D/AM. • _'_` L���I g , � T. ;a q INLET. SEOTI�C. TANK T 8.8 F , L 10 FT. O/AM. I C.�SliE T�iBt/LAT/ON�y 007LET SEPTIC TANK 96•Ca FT, Pr cAPsi�rN 549 U/D r /INLET A0157RL01,7/ON,BOX 98.4 97 SECT'/O/V OF GROUND WATEK TALE T Ol/TLt'TD/STR/®Ill'/ON BQX `I 8.�- FT IMZd Cr LEACHIJVa PIT 98.o FT. SEWAGE O/SPOSAL. SYST.E/r� LEACH//VG P/T TiiBULAT/ON . DAW MV CRI TER/A SCALE : %s D/MEN.T10A' 1 A _FT V4/MO'ER OF®EDRa0MS 3 i D/MFNS/ON C 4 FT. (MI.") GAReA�.e-o/sPo .�L uw/r o►►� SOIL LOG TvTAt ESr!/r1.47-4iFL) FLGry 33o 0A1-1,0A'e' SOIL TEST,*/ .So/L. TES-r,*2 JW1 TEST NUMBER GtiF LfAGK/NG.p/TS_ I �^Et.-K I00.0 `-tYteY loo.o . pA-i GF' SOIL TEST 8 3 8z S/DR LrACH/IVG PPit PIT J 08 $CA 0-7 _. o _ 2- IgEsuLT5 N//TNdffSSEO dY J 607T0/W L,&qC'N/NCr PER P/r 79 sq. /tT. -OAM Re&C04A-r410N AgrE / LEss TOTAL LEACH/NG AREA 2� SQ. FT. T�r'S L SAME !�COL.4T/ON R.�4TE JfiE� T� �•y M/ /NGH.. .QESER{iEGEACHlN6 AREA �� $Q• FT. Z - Fs o 2,O n; M CV.Si4✓ 4 s A✓C--� OF T1a974Y I04cX5.0 1A sk (t►OF N,4sf 7- 3 S- T/Ma C-,P- ZA E 1 . � ��.�� �.' '�Y rn SA N.� :' �!7/\`"S TUN S �I•�GG-S ; 1 § .: o C. }� t �� OOSE'L.y . � tvFORSE /> ft2w4 No.10 v" 951 O ORICAS E ENG/IViseR/JVG W. /NG Cq y0 pM1 1ST ��� EL= SS-o EL-. 88.0 7/2 14A/N ST. , A'Y.9NN/S. MASS' ° su i FSS/dtJAa r ® IV®GR01'N0 t-Yi4reR ENCOUNTER�O CL/E/V " DRTE �- A GM0UNO kVATER AT 6L.EN. _ �4-. �:s�iy;a` '•, r" s ' + t c*r d +� x` `Y .aw'R '`, a '. .'�' t l .` 'R� w 'A a.r .�r'_ I , z ; •`},� •ry r� r = + :..'j c "8,, - , , , -- y f�` q.a I i er--/.R y t ",* `',.s a .w !S' _ v t � V4,Y n_,r !P��+.`• r , . t71 ,''a.` s ♦_ /•� ,,�Qs'..-'s. 1. .' .t`- ' '` r. 4 f4 x.L Y �,,, f •r! rrt !r 11, r l (.i' t I wf T:.,s�'F«' " f' s r• (ti/ ,rt-+•� '.,.tr 4"' �: ko Y a'e+ :a t r a rt i ,.7:I . i? r t a i F J(��, _/(//ir * /-_/�;t, /1 L �� t r _ . 11 tic r r < t. KT ra �.°S' ,_ t ,i3« � -C rif.^c ,_ V � GV,,,:�V- { _�E"'rrZ P-..f is s z_.,v> W: , t ''',r;:J 5 't9 - '�+ w T r• c }�,. �. ''2 f t. '. .. 4r -'} 'C'' D " fi i r 4 4 f - + ♦' .�, `� i."4 1 i � - « i+t'...r `Mr;r .f� x 4 C { o ,rr ,l'+. t 1. ,f.({r gt •F '+ �` e I- 4:; 'a 1 4r, yt F lr. a�`.. v r2,` t M &t .'S I a' J 4^�tI es 7•r =r r'rr� '�A' '`�' r �, i r .,t F .:r ,t; ,r- `'�A ! ; �` , -r �?',' A v t " r+t t.�: = Y' ;fic r "7 C .t' .. r 1., f +, i 2 vS / �''* s y - V., y ',. .7F.. ,'r°.. 9+a.+; "# to, •.G X J. w r rt 3 a ' t 4 3 w nL s :` ncaa M{ fr ` ! r a e'; >� t r a; +1 r - �' �a'� _ t » �. ! '} h, .�.' - t ,..'L"' ,Y t' _ Y4 �L+L! ,S'- , -..a,/ t..� h .I.. x r+ly r ? �. "'�a�'.' r.�h ,r t- `"4.' '+ ti�` ,� ,y �` »'« i'. ✓ : . t .•„i 'ae r + { J' _ R'�, r L` l t r • 1jF -,4 is ' r' s r,, , - tt.! M »" Ya *ate ; •9. f August 18, 1982 < ,, 1 r rs , 4 . L tr- ' •f r4 " `` j�''* . t r` .}Ir t e 4 et e, ,. .1 1 r v , + a ,,. G ylr ,'er r. tfr i S i.:-. r ,� �.aU�.� y� s y,c�r f '�, / ''G'X .+'. T i S a r4'r .4. a P s. t" "'r a ,�, r. 'ai t0 �t r:..r Ayd v t .'r;� �, L r ..f '`:_ w, -1 !' ' r f.s t t - + .,'S Z.,� r. •' �y `,Lj. 5 r'.. '1 F q y �,i .. , a. ?. i l Y F, t .a- / c I P a`-i., < '�.v< �e ,�[ `a,ti :Z :. Jt -r y.i:, y �' Y 4.I t r„y. e t � r.. <v 1 w.is ,x+ - < s � n? s j. rrt4, a 1 t ti't; b ? ,. `i. : ,� ...,[,,�,F f j 5 �„ ,•1; a: y�`# ,e M ,y r. r r *-t^i �S 4 .., , - 'h`':_ ,- a� • '1 'a9' vs:.f a ' ' ti ,_ tv S+s{''j' fi•,, er. Y �L t x. .. ,'`.,, '� .`rr J M s "f, , #k.,Ps c_.. .h-e n� - -4../',ew ,fir i t,, +4_ 7y>. ; ? to t 4 r 1p,7} tL ? a 'ti, LrL.,t r 1� r t 9 T t a "•titi'. t`5 r �Y J• r . ,,. r !.. * .r +it i{ "t,C ,.r 'r ,,- x 3. ,ty-• ''"'A1 . r.. •r t S ' ;,'' -Ni" ;. "r t +' r ',,;. 1 wl ''' y1r l- i.. i.na 1 y.,, }d !` .T r - .. fi a` e:;elrt rMY`i Johri`�R�. `T+"'llls Ra,.L .rI. X2 eta ,.�. a-r.,�• *¢'s r �+ • v s. R' '.r .s I. is 1 t v, , ? - t r;e t r > >lk " 6' t +.. �. ` . t�.24 „ v F '; Y 6,• ts I�,. �'+Eldredge.'EngineetY'ing,Co•;Znc'�- ' �, sj ' < } Sri.' • ' . - _!+,�... t` , .. R «- 3.. .1 't - R1�y712 Main,Street ;k,:;',».r: f',4 _ r a 14 , '!"I L't*! ^.Y' r a } 1 t +i [ I,- . p `.t'',g�tr� a, rr I. 3 , . _ f �.1'iiyannis %Nia. 026jb1�' ;, 3 ti} �. rn �Y : ,' .. y ,�, �Y o' ti 3 x ` ? tom. G ,,.+.-„TP '"... e` ;",. a o v 4 ,+r f'.A,, +r �'7 � `-f �1 : n, ♦ 7s• 4 r . ' a �f r. K', ..s.• ' ,,., { a 1 t tY X- r vt F .iT,Y.'_rIC- .?:Mr�-+�•i+ •^ . '' r•,` ee - r ` 'J M"' h 'h?, '.,_',J i. � A ,.''' .� 4 i ' ✓r h 3.. k' Y i -.e h 'r f 3 y U A A _ 4 ' R Rc:, ,Variance for�Mr~,John McLaughlin,;,Lot 35,RT tuber Lane Road, Marstons M�1 s "° , ' r '. - _i . r _ v.a S +A • �. .y,' F•T * . W f " A •.i; t •f �, .''t 14�t t ,."ft i. ;L s , " ,F�". t1k , ,y �1 r,frY T t� r7 r .� r,:. ';. was ',r•rl - Y -•R. a, "k: r-Deaf" Mr: Ellis a,�. "4,-t 1 `�' �'6 `" '�S rrr� +"'e,; `* 'i"'.° 3 hs r r"; •t• ~ , 4. E' , 'M " . % .@ " e1.,+ t r,,-iJ .� .•1;' { :s, {_rrr. * 't `'a r n ..T t sar' h'� `.. 1,.Ii s You}are ,grantedr a "variance 'on behalf:'of your' client, Mr. JoYlnw McLaughlin to ins ,. r . T L, ,. Y .„ i. { " ' <stall'a e11:::1�00feety from a,leaching?facility;in Mlieu of. the_xe_quirL.edi`150,'feet 4 Y , I. on Loty,35 �Timber!'Lane;`.Road,; Marstons�Mills; with the'i ollowing conditions`•:1 _:, � ' . { .. ." l ..4 ..�3 1. a',�.. ..i 3 I. tr V' _r ' r t ♦ •v'�j.;r' y Jid.7�� '.•y -.•-.r rr• Y' R 't }r- ^fin' -.'i j s +..• Y 1, VI _ * t R +.,.t n r'. Y :*.. ' f '_a r P t " • -I S I,, T`h A.r _F a ,I a � ',i ' ` ' -(°1) Fr or �to:,the :issuance of`a,building ,peimit, `the we'll must,�be.:%i -s lled. f ems. . i t �V !, i !' 1 f 1j, J`and "the Water'.tes td&brr"bacteria�and;,Chemzca�],s � r' �J''� - �S i "'� ,; rl�, 11 '` `r l • �. .e i t' ! f:' .,. + �'Si "< ) `.I F- t r"•' .. �'t+a,. 3 4� ',„ •y -- �• 1, , r. '} Tq.,y,.x . T� - iL. Y•.: +., r4n. 1 '. .f f { ,,S i ! < .. -.s _ (2) Alla`other State rand`Town, Healthy Regulations' must Fbe striic.. complied ' J � , s Gr' L" with .'� t, r y'cc1 . '°w S` 7�+3.•1 ' i TJ �- �rS'* `t rYYa fit: `� r r�. S t �L C s-i ; » `Y. T jr,,, t w' a 4 g. `f, J= .. r c ',a t p.a -.j t`` :• e �, a y L� w,� . t t .! tt,, r '�tr,•, ,'f� b.+ ar - e f4 r r°.,ri rt r�, t $ - ,�- 1 R s �' r _ry r L. ':' This variance expires September}1_ 1983 r �,, , .t�� y fir. . :.;�' ` r ,; .;t+'. {, a + .4 I '#�` `: ' t't 4. i{� a`t L. a 4 ; R �titt•,r }ir a'K ,, r.:r`• ^. I r a-.. I * r Y.r. .t,. t 1r "` ^,t. '« •z•, r. a a a[ r ..tip- r" �.' •K1 '� •C. VeryT�truly -Yours,arm `r I,xr,�,.a r'., t, 4 �"�- a f r., x ''t $•'ar # Es.r=: s I �y 5 `� „, ; { ` l 4' f' k, f t a, T';. r'4 Y.{ `�' ,r. 3�,:.t'. 4t tr•n •ci S " a t. + Y, r , L t �`� I d+.c. t 9. ' -:ti k•Z ;k'." rx t`�. t` l Y.-: .: c -r r` , z, Y. s , c•?:- ar a t .z, 1 -sa 4 ,h .L' t - c, F,a r r - g a ai , F , fs ,��i t i a.. - f a s Y k I c-' C, a j. ,F. '1' nr�..*,.r �, ,;.E y r± },r '+ ,...� r. y=i-R`„ -R ,.t l ., 2 ' •f >i'. t.t s ,j Wbert L.�ChiI'ds, <Chairman j , 4 ter'`,. ,. ;y y r ' f r *'' ,,1_i _'it ,_! 'rw R .s et :r fir` •, v <: u.,ram„ t !a*,,• k"` rt y _ rz r.. Y iy r we Y r k �C• n v} r < , , +, w ti.r.( , `� ,cam?Yt v;ir o'k."�C„ $ a. ,,+•�' �1�^ ",-r r ' +! z rt't' r� t` .4{is j`� t - t t..I 1. r ,, r 4, . _ .,. r i i .4 - Jr'' ia» r r`3' 'A« L ram"t k It f I ,.t ' c.. -C. . tr ."+.�' augh- rr. r,'�R., :, 1 1 ? �'i. y • A= , , .. •.. {E x r, w •,+. i, y a - �� t air 3 T 11 z 1 �$ ,,Y at v ,r t i , 9� e s .� i pt t �. t k 1 n,.. r i;..~, e _ .:�r7' ti f'�`�i,ti' y t T'f'y }, `g { '. n - s, 4 �r ,�t^•'x �' r i , r e, 4 } ,t �, F r i i...(•' �kr: b r :,f,,,tr ,� 1 .I+F1k n.�>;-r 'I'm� :. r �d Y a +t r r"r ' $ r+4r..j Y .4� H;'F Inge, tD t y { , 5,I A .r4w� �f�a'y *t.y 3 h,.Y�I4 � � .� ; 1 ,e BOARD OF,HE H � sr �." ,'r �. F - ff ,aa 4R f7r. t raj t, a ,s.�it ".i aI .s.= = re+ V �f F`Lj' .y £r a-_� =.s v :+r+.4, 'J'1.^ • L t ti 4 {I'nnWi3 OF BARNSTABLE r i �' T` r r.' 't , i r ;. T' Y a �.,. ytr, r* 7,f f y ,,-11 ,{,"t,?, 1.�., •r.-.,.t g'`'"f� , �. ', , L `' i 'v r R.: ,i e.F w .S {; I { ..e,'.'"3 Y r r w"Uu°' `A.. l,'}•„!'' Y. , '1+�" , .. JMK/tutu A •S v fh t ' 't J 'r':'c"'r.�t "C. �'R,-. i i rJ5 `. f"t.I R{";�h t , -' ir''y-� t J '.,ti,f k} f t S'�y ;, r - 3: a♦ `:!,4 :. •.` ' j t* .,!^s r ..' r " f 1 ?2' / r %rya,^ % - t 0. _ +� y A 'r a' `cc's Mr John�McLaughli"n, :a� R -.+&r ; . ,_ '" ,:: . r , a s 1 s r f •» f `• cR Y ,.J r } ' 47, J r 3+ ,,,, ^j r L• 1 +.L.. r _ i` { , '4 ` Fr,+k,�F y, S y z, i L r - r a .M1 w.. t•~ r `¢ ' 1 } 1.=�.,t :: �.Q t+ {.EE11 I;fie • r' t-1 .+r r±.-_ 4�„t S " rta i :zf K..,I:'+tir C c ryt t'. i�♦tf `40 t 4r# r er _ '? $ x`, va 7 b } s . S L y 1a r S +tir 'r �3a •"- ;"` i= i7�'"i'-'a v-* .w +{ ` t . '� :>W,t t , ,� -7.e ,,� ; -'' ` i"+'qI-I ' �,''+• `'' ,, '''r' •,< -�41 ,�"• 1=.+y"e-'� t t`. *_.- Y 'S } n{.fli w, 1 X a.. " ' r. .r(} f,.ti'2•, r LYE. �t<.e'`,• { ., ,f�;f. b. � ^�e ,r .i / • . R .A -,,.4 ..�a't}� "1a'`y ,t.y,r - `'� .'� yi ,t t• � 't`' 'w r h,i 't i'r�r?•-$ t rr's b .*` Bf ;:T�t t 4 Y:w� ` r ti r •.a �, e.�.. s y r � d;.a �._ ,� a a:... f`r^ ft ! y. ,,{.ft a�,R .t its .«'� e? t -i tl. I r -< , 1 !, Tt$ '� .�C,, i - i1. aa' , �}(-S t 'k ;, •t ,i' w 'r4 4 e ,.` {:'a a ,/r• .7'. y+. r> $ +'` { .t _^ a `i e i y: z =s. C i`-7. z F 1 �; + r l3 * s v , '. t. `aa i� t + Yttr ie'X.tf 'td ..' Y "=N 1 � *' ae a` 1., a'. ?e '} s t `.G r` �'» M s �t 'v t-,.e.,. +` �'.'-Y dy z-. q.., { r a. tyi4 r,` },.�;a' ,`, { y ttt~'t}'°`�° "load,;k "4< -1~,j."r a - -_. t .a c C✓r. ,"�, `l;," ] ,/,,. yi.` ^. .r.-,+ +`rt.. ` , Ji- .'y..4I Y',� .'t a1.'iA t ,« 1:, r F !b. '' � 4 •r k . S t 'r?A �J, %jJ P + ,4,• - � yy r, ✓ t„r _ i ,I Y �7.4' ~. 'F1. .', I. A !yei 'a%, '''. ! r • 'er + �� '� 7�71 F • t .,/y t1 « ft,t. X r '.a Y.. r i 1a°F. s .M-:. F !.;, c _r ati} tl ti , y `r �:T .+. - o s, '.+ r 4-_.. R 6 Fx ; 7 [er ,= G 1;5� s1'.re.1. . a,, .1�, ., t '` .a.F ,11 } r�`t b I - _ .y.... i `,- _r �f.4.;vf� J ;Y� ,a er���r f t'N'Pi'!" xR,ell k f f 'X. � :.<`a`,-1 Ai$_ 'e" .ter. �"' ' e"L Y Rc y: { tL 1, ..R i 'i 'i,,.. v{ t 1`P t Ri.:..t�� 'r r ,� :cYt f� ia. tr, {4.a k11, �4 ,� Y `...� `e 4, fw e'. #' n P'i Fy P; ,, k a y ,t . Y,,sr L' { { _ + a` sk f ��p.,` r,�rWr7 �,+a '`..a*•g' �, l = z4` F ci. f , r "r t'.ti .,3� t{r ¢y,i`Rf•.tiyh ,A 'i l r* '` * r �d`t#`M,a„,ti!•`� '? r,r "4 <; *f s*rf+l a3,y •+ %` + r �.+. R. }. ' " iF ! ` *. .+., ?i' V A 'e r H 1 .�rj L }, ,( r '3 f- ; 11 r 4 k s N 'ii. i �s N, y t r .I ;.-} y``',�. I ,`� R ,�, r 1- _L% ,c'� t .R, �_y t 1R + 5! i k{t•:'_+rr. ,a i,.. 7,F .�'.I-'r` .q, v T ie w i y.. e,. r r t a A , �a. , rf ' ,.•'.i+p� -,r Ir%l - `,��u 5= f .Yr" htR � .r'$. r n Li^,�ih.flf'S '�c �>. 4 *.1 1�., ;°}+ *' .1 te11 t y ,. a.f. r( !}! t * t. ,A..y'!W Xw 1 .. i'4.: R 4 r++�.-«. '" .k-s. �. ... _f,y . . a +11 N-:,. P��aidani: •ROBEAT BRUCE ELDREDGE.R.L.S. CAPE COD SOCIETY OF PROFESSIONAL ENGIEERS AND LAND SURVEYORS Office Menirger: ELDREDGE ENGINEERING MASSNASSOC OF LAND SURVEYORS f JOHN A.ELLIS,R.L.S. f Associates: AND CIVIL ENGINEERS AB60CI81e .P.E.,R.L.S. COMPANY, INC. AMERICAN CONGRESS ON ALBERT A.MORSE, PHILIP V;EINBERG•P.E..R.L.S. SURVEYING AND MAPPING . / AMERICAN SOC;ETY FOR �8C�11EE2EG1 GJ\EI�LSt£ZE� TESTING AND MATERIALS (y r i.rand - Livl[ 712 MAIN STREET G�iz9ineers HYANNIS,MASS.02601 TEL.(617)775-2244 f B k i } z August 5, 1982 Board of Health ' Town of Barnstable ` 367 Main Street Hyannis, Massachusetts, 02601 SUBJECT: request for variance from minimum well to septic system distance of 150 feet, as outlined in Town of Barnstable Board of Health Regulations. REF: Certified Plot Plan, Lot 35, Timber Lane Road, Marstons Mills, Mass., dated 8/4/82, by Eldredge Engineering Company, Inc. , 3 sheets Dear Sir: On behalf of Mr. John McLaughlin of 19 Shoreham Street, Quincy, Mass., 02171 I request he be allowed the following variances from the minimum. distance fora well to leaching pit/ 100% reserve: LOT VARIANCE REQUESTED 34 existing well to proposed leach pit 251 + 34 existing well to proposed 100% reserve 15, + 35 proposed well to proposed leach pit 401 + 35 proposed well' to proposed 100% reserve 301 + 36 ' existing well to proposed leach pit 251 ± 36 existing well to proposed 100% reserve 351 + Please note the "Tall Pines" subdivision is dated February 1971 and re- corded in plan book 247 page 82 at the Barnstable County.Registry of Deeds; subject lot is therefore exempt from the Town of Barnstable statute requiring a minimum lot size of 40,000 square feet to support a well and septic system. I thank you for your consideration in this matter. Very truly yours, ELDREDGE ENGINEERING CO. , INC. JRE/jre J R. 1' R S ` Y/1 �-:7L r &e c . L— GQ f r �•� '� ' +cj �• .n19• M�. k 30 `C�` .��'✓ Q'�,J' / s` /fir. `` �V> s.• y r. . QP �`+i.1�Y� ,��^,i'� ., ,�?�G ''�yX ,• ,� : O.? ..,lqN�STE��yp� '( �Q� �r its _.v/. Q� v * • iW SUq� Oy y�i �� � P.`� � • ` aP�� .pP` yid O �1 �`a Q 4' .��+' ` �/ '• o ,T o +X�r! io vQ�P.LEKN P+r I2rot Exlsnub WEu ,° �y^Ill.'* EXFT+N6 WELL-mDloolk RE5e"- ,�+U n \ >K 0 J O l C C / * VAS Iftr YF QPAiIR�ib `p�• ,�. � �� br PT m,creh %• • •..\•/(/ `v Q 'I,LL, �,-�` ZnuE G�lAt %'.,i tom!-TE": f,jn\/. 19.79 r,x LEGEND EXISTING SPOT ELEVATION. 0)g® CERTIFIED PLOT PLAN r EXISTING CONTOUR OFMq LDT FINISHED SPOT ELEVATION 1vlA1zS7-OJ1S MJLLr FINISHED CONTOUR O— A IN APPROVED BOARD OF HEALTH A oRSE No,10951 O � GATE AGENT `FSS, ���� SCALEs / 40 � DATEI s,'DREDGE ENGNEERONG Co IN CLIE T I CERTIFY THAT ' THE PROPOSED'' EGlSTERE RE6lSTLgt �0�. . 8z � BUILDING SHOWN ON THIS PLAN , F CIVIL LAND CONFORMS TO THE ZONING LASS ®1 E R OF . BARNSTA LE l�ASS. cEPT `. J R' As N�E( 71'2 MAI N' STREET;, CH. tv �;�� . MYAQJNIS,• :MA3S.. . 3 ' S•382 - -- -�- SHEET— OF DATE 'ES. LAND SURVEY^' � /VOTE" /F E/TNAd"R THE IC'TAMA< OR +.. '740 FT . M//V.• iEAGs!/NG PIT ARE MORE "THAW/ /2''49,F40J4 / . - /D P7! M/w/.• ,' .. "_.—__ : .rRAOEj f;r 24'O/.4METER L'OyCR.ET� COtiER SNALL ®E.BROUGHT TO 6,#fAO.E. -;N EXTRA G CoNcotCTE t/E4VY CAST /ROJY COVER SNAL 1- 0 USFL7 4 M/N. P/TCN /F/N OR/VEN/e4 Y EL= (O1.o COVERS �B'PER FT a GJ�.+1 O E COVER A • �_ G'L EAN SANG • � BAC-Ae L �• - UQ[//O LEVEL -. • -•� : • , • •Imo/ LAYER 4"CAST GAL o �a o � o 4 MIN.P/TC/V " I • • • a • • • • > • WA 5HF0 57V,^Ye D/ST PE/� SEPTIC' TAN/C. . s • • . . . . . . • , . - 90X v • � e1 • I • • � .•• • 14 • i. • • • D�PTtI • • • • o o IVASllEO STONE :�.• o PRECAST SEEPAGE • d� • 1 . O I' • 1 • • P • P a �.• • • • • O • • • . a �o P/T OR EQU/V. lNY,-RT g4EVATf4N_ s 188.5 x 2 s 4--i .v/.D _ . s INVERT:AT AVILDING 99.0 FT. I.a - -7-S.�/ D 6FTD/AM. 8.$ ,, I O FT. 4PIAJ► . �C CSEE T.48ULAT10N, INLET' .SEPF'/C Ti4NK FT,:. .P� cA Pac rr-r' 549 G/D: . dtITLET SEPTIC TANK;' 96•CD FT INLET D/SPR/BI/T/oN BOX' `�8.4 FT. GRO[1N0 JITEK TABLE SEGT/O/V O.= 0t/7LE7-D1 STROBIlTYON BOX `i a FT. SELVAGE OlSPASA L .SYSTE•/�9 //y1.ET LEACHING. PIT 9S.o FT. TAQ/JLATIDN LEACHI/VG im/T SCALE DJMENSION A D,eSl6N CRITERIA oI•►f N5 FT. NUMBER Of®EDROOMS. " '� D/MEI1/S/ON C 4 FT. G,.ReAGZ D/SPO5AL ulr/r ua.,E SOIL. LOG. TOTAL EST/MAT'ED FLON/ 33o GAL.14AY SOIL- TEST At/_ SOIL 7LrS7-402 SG�L TE$T. NUMBER QF LEAC/I/NG P/TS_. f^ELEY. i40•0 �'ELEY, I�O•o .DATE OF SOIL TEST 8 /3�� Z 5/064EAGHING PER P/T I08 RESULTS i�//TNESSED dY�� /Ffo'�y I BOTTOM LZA CHINO PER P/T 79 SO. FT L�/+�t. ` PERCOL�4T/ON RATic / LEss 7-0/OP c cL � M/N•I/NCP! TOTAL LEACH/Na AREA 2� Sip. FT. AERC01AT/ON RATE - Fr .O RESERVE LE,•4G'/HlN6 AREA FT. `S TlG#f 7 Y v�rG / I �c,ee 0 ` P I �,A OF dl, �,N OF M4SS'� T 3S ti 1qt yG4 A EFM$RN H MOOSE y /oosEtY 4 - o.10951 O o ?.,A?.,A cK .�:N. . � EL-DREDGE El1/G/NF,..ER/IVG CO,/NC. A9Fis-rs C'�• � E 7/2 MA/N S T.I, flYANNIS. /i g SS- o . a G RGUN7 VATLP EN REO GL/EIV D,4 `� g �� a GROUND YvATER AT EL.Ef/.. �0. 3 r'r.x.,a-r;•M?s am!•ya^i•,r m-^..,,...,w...Tm.+n••.w..•. -,-, .>»..,.. .xma.n.wx • w .+r..m ,:.w...,n -3..�*_w. e. �.r+.„,..w o....A - • 7 777"e<— :7 :17 '77 .I'� ""`,r'".._.g.o 7r?'^,si-•..«, a i 85 •� - LOC 3p 'C a. ' C-U-5 20 co C t . - � E ' .�s3.as• A--tXs 3 a0' 97SJ m ao 37 ' n �o sL s✓n (` azi 5�/ice M1 S 7 I 9 So P 1� T.56��. . 7=8SJS" A=/740:00'-? 9- .� , T; .ZS': A•/ 0.3/ 73.5/' - A• 7-/ G.6S' A=3Se2.S0' A-30 SD �,t7.00' ,•. /.v-� 78' 7 ''-�=/7o.z.36' -T./S �• 9 - �3B•/a• 0o <<{D'P2�✓A e= aio 78 T,. /73.35' �7• .��s a' - -- ,c"°/ 54a•36" T.lS'B- a' '`� 3 ► 3/?3.66 As/SS.Oo - T-93.S6' A° /B70o' �. -T.y�� St$ NEi s,ra 9c�° - S• ^� T,77S'f 1� V YT`Qrs' Ae/6B 00,'. - 'riC",fjL L1 H '� A / �R M y /6.39' V p; ♦ o •S Al RIEW a ,�ems✓n o o ao, /3z� � \ � � ��ao o6s.5 � a `� . . 6a_ - - _ _ h \ ,5s s� ; 7s`/ "• /a3.io- h \, � , . ✓ ate/ -�"` ..� o � : _ /�o•,� �_ /1s00 i aSO a0 �6-E F L6�•00' 1l/�go // ��' (o•i� '7 `� C�—oT C C 7- '7) • CLOT 4 I41 - �VO F��4.VC/S 0 NE.clJ�Y `t/ q;0 fIeCN/8A[_a,✓2. Its H/ 1p fiU/�U�t/DGEB ;1 K. FB.9.VC/S X�' �9 C/9eOL.L o ��' G$EE.0 ET` lJX CAI�80LL +(� JO N ES 1 .oQ.68 . A• '... .- .q• /SB 3 ` �./ 'c I I . 00 e=ioos�73Bee. 30 B.ea. To z.po� .zidp -oT6G g0 _ �u p t ,y _ Log Number: 2237 Date: OF BA�JY BARNSTABLE COUNTY HEALTH DEPARTMENT a SUPERIOR COURT HOUSE V BARNSTABLE, MASSACHUSETTS 02630 o • A 8$ PHONE: 362-251 1 DRINKING WATER LABORATORY ANALYSIS EXr. 331 Client: Mco Coslotruation Collector: Mailing Address: B031 ci3 Affiliation: re�,»n T1n17 1 77t., Naghmo., VIA. 02649 Time & Date of ������ Collection: Telephone: 4'TT••251.�3 Type of Supply: tyol:l. uatcr Sample Location: T3mlxr Tenn Date of Analysis: 12/5)/82 cmtoxri.11 n Parameter Sample Result Recommended Limits A Coliform bacteria (organisms/100 ml) 0 0 pH 5.8 Conductivity 156. 500.0 Iron (ppm) .42 0.3 Nitrate-Nitrogen (ppm) .4.3 10.0 Sodium 13. 20. Water sample meets the recommended limits of all above tested parameters. Water sample is drinkable but has higher than average levels of nitrato This does not represent a health hazard but future monitoring is recommended (2-3 times per year). We will test for Sodium. r€xcz Water sample is drinkable but may present aesthetic problems to users (staining, odor or taste). due to hiZh ix° nw Water sample is of poor quality and is not recommended for human consumption. Resampling and retesting is suggested. Results only. REMARKS: cc: V�3rrzrk i:lo r'_oard of he,,lth cc: lyrL-O vrp-11 rn,;nirz Analyst: 11/18/81 COMPLETE • ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signat item 4 if Restricted Delivery is desired. y '/ G ❑Agent II ■ Print your name and address on the reverse r ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of D livery ! ■ Attach this card to the back of the mailpiece, 1 � J 2` or on the front if space permits. fv\ D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No Michael Cannistaro 67 Timber Lane rI Marstons Mills, MA 02648 i 3. Sepflbe Type XCertified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (transfer from service lab 7�0 3 ;0 5 �;;0 0 1 4 4 47 8 0 7 PS Form 3811�August 2001 i I i Domestic,Return Receipt 102595-02-M-1540 STAT POSTAL SERVICE First-Class Mail ✓ happy Postage&Fees Paid USPS Permit No. G-10 U.from; a S,pQ$ a1 S • Sender: Iea"S��iWi your name, address, and ZIP+4 in this box • W` 0 ni SP36 MarstoPsIlls, MA ",a SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. 'gnature item 4 if Restricted Delivery is desired. ` ❑Agent ■ Print your name and address on the reverse C _ so that we can return the card to you. B. Received b (Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, L�_i ; ` �G�� \a or on the front if space permits. �\ D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No Jonathon Simmons �j 85 Timber Lane 1 Marston,Mills, MA 02648 3. S ce Type Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise (;? ❑ Insured Mail ❑C.O.D. a 3 3 a S-0 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Num �! 7003 0500 0 0-01 .4447 ..0,814 N ; (Transfer fro a-rvic el)n, Form 3811, t11;D i ; : Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • 82 Timber Lane Marstons Mills, MA 1 SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received b. rint Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, Rj MA 02L or on the front if space permits. Q 1. Article Addressed to: D. I address different from item 1? ❑Yes 4 enter delive ss below: ❑ No Ellen Dellavalle `® Dorothy Faris PO Box 427 [ 3. S Type 1�cj West Hyannisport, MA 02672 I erti%fie W. Express Mail i ❑ Registered ❑ Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. ' 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service label) _..7 0 0 3 0 5 0 0_.0 0 01 4 4 4 7-0-20-3-- ' PS Form 3811 August 2001 s 1 Domestic Return Receipt 102595,024-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No. G-10 • Sender: Please print your name, address, and ZIP+4 in this box • aatw Fniviron"a€a S'Gr , IMA 0253:7 82 Timber Lane (` Marstons Mills, MA COMPLETE •N COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. ) , ❑Agent ■ Print your name and address on the reverse Xt L C( ❑Addressee so that we can return the card to you. qk eceived by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits.- a r C o D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No Davis Wadleigh Marcia Woods I 64 Timber Lane I 3. iice Type I Marstons Mills, 'LT,ertified Mail El Express Mail MA �264$ ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes Article 1 2 (Transfer from eservice la' i .P.1.0 3 05.00 0001 4447 0487 , � it + is PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540� UNITED STATES POSTAL SERVICE �NGE First.Class Mail O P 1�^ Po th, Paid 1 f�i1�,^ ecn5 it[ Nx° • Sender: Please print yo�dAe "address, and`ZIP+/4 t0hi'sS- 3R-4a9.ervice! Hu2:.sE�G"'�:,Ec DAL?6r,Zl`�,aCCS•i�.'4.�i>�ae� +I 82 Timber Lane Marstons Mills, MA COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. S ure- ,,�j item 4 if Restricted Delivery is desired. Z' /" ❑Agent ■ Print your name and address on the reverse Xzleft Aodressee so that we can return the card to you. deceived by(Prin Name) C.'Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address dill nt from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No Francis Rvan 105 Timber Lane Marstons Mi11s, MA 02648 3. Service Type TCertified Mail ❑Express Mail �- ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7003 0500 0001 4447 0821 (Transfer from service labe, _ 1 PS Form 3811,August 2001 i i j i IIDomestic Return Receipt 102595-02-M-15401 (ilil i ! m i! t ili sit ( [i l !l;i [4 i! UNITED STATES POSTAL SETw�' ,—.CGE Fir i- lass Mail Fees Paid P M pm S "P o0. �Rn �� .ti, u • Sender: Please p Xi �4e, address, and 'ZIP 4 in'tf& E6,2,7 Ea II 82 Timber Lane Marstons Mills MA COMPLETE • ■ Complete items 1,2,and 3.Also complete A. Si ure item 4 if Restricted Delivery is desired. A Agent ■ Print your name and address on the reverse &��(qiO Addressee pd so that we can return the card to you. Ileceived by(Printed Name Ur K e of Deliyery ■ Attach this card to the back of the mailpiece, AK or on the front if space permits. e✓t l� CI D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No Kenneth Marshal 135 Walnut St. I Marstons Mills, MA 02648 3. ice Type ! S ertified Mail ❑Express Mail j ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7003 0500 0001 4447 0517 (Transfer from service label) PS Form 381 1,i Au ust 2601 g 1 1 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SE®W,,_GE'�f�, First-Class Mail f;dslPM 5 I UPS Fees Paid • Sender: Please pr�l �4-Wi �e, address,and ZlP 4'in�tHis°`6tiz' `hay Environmental n East Fv1k oath,k k oCmso 82 Timber Lane Marstons Mills, MA { DELIVERY { { ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X �q Agent ■ Print your name and address on the reverse v V� ❑Addressee so that we can return the card to you. B. Received by(Print d Name) ` Da of Delivery ■ Attach this card to the back of the mailpiece, { or on the front if space permits. `°A^ D. Is delivery address diff9rent froWitern 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No Peter Spong 98 "Timber Lane . Marstons Mills, MA 02648 i 3. S ice Type + .Certified Mail ❑ Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7003 0500 0001 4447 0500 (Transfer from service lat I PS Form 3811;1August 2001 1 1 i Domestic Return Receipt 102595-02-M-1540 —r UNITED STATES POSTAL S ,,E fe_, irst-01 SS Mail p M psiage Fe Paid P u P cn- rmit No.G=10 as DEC • Sender: Pleaselprint!;n`� name, address, and ZIP+4 in this box • Shay t.0. C-2-53S 82 Timber Lane SECTIONSENDER: COMPLETE THIS . ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. �' // r.._ ❑Agent ■ Print your name and address on the reverse X l 9%'f� ❑Addressee so that we can return the card to you. E-LReceived by(Printed Name) Date of Delivery ■ Attach this card to the back of the mailpiece, M or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No Billy& Alice Lee 82 Timber Lane Marstons Mills, MA 02648 i 3. SS ice Type {i �i-Certified Mail ❑Express Mail ❑ Registered ❑ Return Receipt for Merchandise ❑ Insured Mail ❑ C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service label)I 7 0 0 3 0 5 0 0 0001 4 4 4 7 049 4 PS Form 381 1,August 2001 1 Domestic:Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SkiP \ GE First-Class Mail �� ©stagq A Fees Paid jT �€ , c o /�✓ ,.31 G-10 • n e, address, nd 4 vn�tf f Pm s1nLsbd%&�'z z!se prrqssbd%&�'z z! Shay Environmental Sorw-ea,'I�d. P.O.H_:cx•0-7 I East Valmoul.l.,t:,A C c 66-3. I 'a' 82 Timber Lane Im 1�I ` U '3 � Y LMO o .. 82 Timber Lan 0e � Marstons Mills,MA � ,-r 0 � F I 4 Postage $ SdS/j rR I Certified Fee C Postmark O Retum:Reciept Fee !� 7 ere p (Endorsement Required) D t��Z JK'JjU Restricted Delivery Fee ~ C3 (Endorsement Required) o Ln p Total Postage&Fees $ Sent C3 Ellen Dellavalle 0 C3 sfreei,api. Dorothy Faris orFoeox pp Box 427 City state, West Hyannisport, MA 02672 Certified Mail Provides:a A mailing receipt (asiena tl)zooz aunt goose-oj Sd a A unique identifier for your mailpiece n A record of delivery kept by the Postal Service for two years Important Reminders: n Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail a For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. e For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an Inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. Q' �. • _. a 82 Timber Lane p Marstons Mills,MA Postage $ g6 Certified Fee p !.•�� Postmark p ReturnReciept Fee / „��/ Here p Uy (Endorsement Required) J ._ �S y p Restricted Delivery Fee r!y p (Endorsement Required) U1 ✓/ p Total Postage&Fees $ 42-• m Sent To Richard Greer C3 Sheet,AptNa 1 15 Walnut Street. r orFO Box No. Marstons Mills, MA 02648 City,State,Z/F Certified Mail Provides: A mailing receipt esianay)ZOOZ aunf'008f wood Sd o o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: e Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. e For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. D ,flr,U,1f11 -- LLL�:.1L`YTu) � • • 82 Timber Lane E3 ,� &� �� � ����I Marstons Mills, MA i ���� x �� ---- - � Postage $ 37 r-I Certified Fee 0 Postmark ZyN p RReturnReciept Fee /j Q ire 0 (Endorsement Required) / Restricted Delivery Fee C3 (Endorsement Required) 0 oTotal Postage&Fees s 4-4 Q 231 m Sent To 0 Kenneth Marshal or PO 135 Walnut St. or PO Booxx Marstons Mills, MA 02.648 _____ ciry,ware; I i Certified Mail Provides:o A mailing receipt (asiane a)zooz ounr loose w,od Sd o A unique identifier for your mailpiece e A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted-Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. D GYV.1171 82 Timber Lane Ip Marstons Mills, MA-� Postage $ Certified Fee CO— `rpm p N Postmark p Return Reclept Fee O L�Here p (Endorsement Required) Q S` Restricted Delivery Fee !y v p (Endorsement Required) yh Ln Total Postage&Fees $ 44 � �� y enrro Peter Spong rest,aPEN 98 Timber Lane or PoBoxNo, Marstons Mills, MA 02648 ------------- -- Crty State,ZIl Certified Mail Provides:e A mailing receipt (asranay)z0ozaunr'o0e6 wood Sd o A unique identifier for your mailpiece e A record of delivery kept by the Postal Service for two years Important Reminders: e Certified Mail may ONLY be combined with First-Class Maile or Priority Mail& o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. n For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. e For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece withjarti endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the cle at the post office for postmarking. If a postmark on the Certified receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inqui Internet access to delivery information Is not available on mall addressed to APOs and FPOs. Cr 82 Timber Lane O Marstons Mills,MA r`- 0 F , Postage $ r=I Certifled Fee a ` S� o MO ReturnReciept Fee Q Po C3 (Endorsement Required) HereP Restricted Delivery Fee O (Endorsement Required) C3Total Postage&Fees 4 ��^�� m Sent To Billy& Alice Lee 0 o SYreet,4jot IVo.; 82 Timber Lane M1 or PO Box No. Marstons Mills, MA 02648 city ware,z�w Certified Mail Provides: as�ana r sd e A mailing receipt ( Ll)moe aun ones wjo o A unique identifier for your mailpiece n A record of delivery kept by the Postal Service for two years Important Reminders: e Certified Mail may ONLY be combined with First-Class Maile or Priority Maile. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. a For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted-Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. CO • -82 Timber Lane o - Marstons Mills, MA OTFI _-- .�- Postage $ a Certified Fee s k 3 O RetReturnReclept Fee O -'-Here p (Endorsement Required) � c; Restricted Delivery Fee N (1- O (Endorsement Required) Ln t/) O ►n i `J O Total Postage&Fees $ u. C3 Sent To Davis Wadle-," I N sireer,apin Marcia Woods or PO Box N 64 Timber Lane City State,2 Marstons Mills, MA 02648 i Certified Mail Provides: es�ana r'ooae-od Sd e A mailing receipt ( N)zooz eun o A unique identifier for your mailpiece e A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. e Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. o For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. e For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted-Delivery". e If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. I� I ru .. - . . - EU 82 Timber Lane C3 Marstons Mills,MA Postage $ -37 r-a Certified Fee �36 p Postmark, p Return Reciept Fee O,Here 0 (Endorsement Required) Restricted Delivery Fee S Z) O (Endorsement Required) p <% � Total Postage&Fees rs m Sent To Francis Ryan M Street,Apt. 105 Timber Lane or PO Box Marstons Mills, MA 02648 City State. Certified Mail Provides: e A mailing receipt (asianay)z00z aunr'008£wood Sd e A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: e Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. o Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. e For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain ReturnReceipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. e For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement "Restrictedelivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. Co 82 Timber Lane C3 Marstons Mills, MA F Postage $ � cr? Certified Fee0?3c) �• 07 0 Return Reciept Fee 5— O (Endorsement Required) c. Restricted Delivery Fee \ C3 (Endorsement Required) O 0 O Total Postage&FeesF$ 4 4,:7 m Sent To Jonathon Simmons 0 C3 jrre -apt'j 85 Timber Lane r- or PO Box W Marstons Mills, MA 02648 ._ Certified Mail Provides:e A mailing receipt (asianayl ZOOZaunf'ooes w)0=1 Sd o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: e Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail®. e Certified Mail is not available for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail o For an additional fee,a Return Receipt may be requested to provide,proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a LISPS®postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement "Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. p r L I o .. . ... -U 82 Timber Lane o N Marstons Mills,MA 10 . - -7 Postage $ OCertified Fee 2r1 0�536 p Return Reclept Fee fir—/ Postmark Q (Endorsement Required) ` �� Fle're G� Restricted Delivery Fee Ln n C3 (Endorsement Required) y C✓ J C3 Total Postage&Fees $ �Oy y C �1 m Sent To Michael Cannistaro 0 rti sireer,nF 67 Timber Lane orPoeo, Marstons Mills, MA 02648 cry,srar� i Certified Mail Provides: a�a�aa)aooa aunr'ooee wood Sd o A mailing receipt o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: a Certified Mail may ONLY be combined with First-Class Maile or Priority Maile. o Certified Mail is notavailable for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Ma/For valuables,please consider Insured or Registered Mail. e For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". n If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. 77 SECTION_A *NOTE:N T . A PIP RE T 4 C 0 E ALL S A 0 BE SCHEDULE 40 PVC.E in fro TtET FROM 0 m m ALL'OUTLET vnrEs rr1E VENT e ( e PIE ® Last 4 Inches tallSYSTEM , 2 to eAl� n,��, �E10X,StiALL BE Existing Foundation_ ROF OF ADDIT ON TO` LEAC LNG DIS house to septic � .P ICE VIEtY I H Schedule 46 P COVER VC w/Charcoal Odor Filter 6'CXJCRE7E SET LEVEL AT LEAST FT. c tank.covers e " " P' f must b TO 0 .FOUNDATION E 1 0 � ,.•ELEV. 0 .00 Assumed P n ( 3 of 1 S i 2 Washed easto e ,.. within 6' •:: finished r m of n shed ode 9 ` - . ».... . r .. ,. s ed S e 3 5 OUTtE•1' s �- 2 _ � 4 to 1 2 -1Na hed Crush ton ,. `Q'ade over.Septic'Tank 98.00 a .: -. 1. ;.' _.._ ..-� k ......,.,. ..Sep Grad over D-Bo>< B&00 de ova SAS 96.OD / � r �.w.... e ltac L._ i 5.5 as � .w tY MET ! ..t 3•ww.M X a r OUTLET ) .• :a'.'- v-- .3 t :- a+. ,. .: 7• y- r a - : 3 HOLE H 10 {' 6_ T '.Load Elev: =sa.00 � - ., .� 3 T . .. .. -.: DIST, BOX Maklmum Cover: � j't2 EXIST. 0.01 or Greater .. '�•,. ter - NEY mE p 1,000'GAL. , s- o.ol toot . 15s^ "_ , . .,, a, in O N 20 per " 4 SCR: 40 T t.75 „ a w.f r FROM EXTST. F00UNDATMN o, SEPTIC TANK r* o EHecthm Depth n soCROSS-SECTION H 10 Units e- _ 3o r -> u ,•, Un s 6 PLAN SECTION > ,n o }, CONCftEfE FULL,FOt1NDAT1()W--� O , t .... .,p.. �..: ;� t� 0.83 (10 inches), ON - rn- 31.25 ai 1 n - 6 b:df 3 a 1 1 e 3 HOLE H 10 DISTRIBUTION BO SYSTEM PROFILE I /2 n; 37,25 v S LE > compacted at o o, c > e u ) 0) n NOT TO SCALE a < Effective Length zm ,, Not to Scale t � - • > c n SYSTEM (SAS) 4 I" 4 SOIL ABSORPTION SYS E 6 in.or3/4'-1 1/2' to INFILiATRt7R 'HIGH CAPACITY (H-10 LOADING)/ GEQRGE O'BRIEN GENERAL NOTES compacted atone Effective vldth f {OR EQUIVALENT) Not to Scale NOTE: ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6' BELOW GRADE w o 1. Contractor is responsible for Digsafe notification 1 N Bottom of Test Hole 1 Elev.=86.00 tl0 No Groundwater observed n 144' NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18` EFFECTIVE HEIGHT IS 10' and protection of all underground utilities and pipes. ------------------ 2. The septic„tank an4 distribution box shall be set level on 6 of 3/4 -1 1/2" stone. 3. Backfill should be clean sand or gravel with no stones"over 3" in size. 4. This system is subject to inspection during installation by Carmen E. Shay - Environmental Services, Inc. LOT #5 OT #6 ,LOT #7 5. The contractor shall install this system in accordance ' with Title V of the Massachusetts state code, the approved plan PERCOLATION TEST Municipal Water Connected Municipal WaterConnected Municipal Water Connected and Local Regulations. Date of Percolation Test: DECEMBER 1, 2003 6. If, during installation the contractor encounters any TEST HOLE #1 135.QQ 4 PVC 2 soil conditions or site conditions that are different Test Performed By. CARMEN E. SHAY, R.S, C.S.E. 19.62 Vent Pipe 4^`�9 from those shown on the soil log or in our design Results Witnessed By. ,WAIVER ( per Barnstable BA.H.) ELEV.= 98.00 f0.5' SHAY ENVIRONMENTAL`SERVICES, INC. - -----80.5' iP7.25 installation must halt & immediate notification be Percolation Rate: Less Than 2 MPI @ 48" made to Carmen E. Shay - Environmental Services, Inc. "`•'• Failed 0' 7, No vehicle or heavy machinery shall drive over the LOT #35 f ; ' �, Leach Plt SHED septic system unless noted as H-20 septic components. ';: 8. Install Tuf-rite as baffles or a uals.on all outlet tee ends. 20,093 Sgw,fsre...Feet +/- 9 "q 9. All Distribution Lines shall be 4 diameter Schedule 40 NSF PVC pipes. ! Test Hole i D-max 10. All solid piping, tees & fittings shall be 4" diameter ! No. 1 Schedule 40 NSF PVC pipes with water tight joints. DEPTH SOILS ELEV. PROJECT BENCH MARK 11 Municipal Water is AVAILABLE to ALL OF The Residence and Abutting 0 ss:oo TOP_ OF FOUNDATION z Properties Within 150 Feet. PRIVATE WELLS w/in 150' ARE AS SHOWN. dy ' -REV, = 100.Oa (Assumed) { O EXIST, 1000 gal- o THE PROPERTY LINES ARE APPROXIMATE AND Loam Septic Tank 10 Y 3/2 ` Co COMPILED FROM°THE SURVEY PLAN GENERATED BY 0*-•10' A 97.12 � I � � CENTURY CIVIL ENGINEERING., OF S. NEWTONVILLE. MA Sand ENTITLED " CERTIFIED PLOT PLAN OF #82 TIMBER LANE, MARSTON MILLS, MA", DATED MARCH 12, 1992 Loam DECK r/ \�\� LOT #36 AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN 10 YR 5/6 ��:\ ~ 10'- 3a` B" s5-so �\ 8 IT SHOULD BE USED FOR NO `PURPOSE OTHER THAN LOT #34 - ------ Ftne Silty THE SEPTIC SYSTEM INSTALLATION. Sand �:\ 1 4' 1 0' EXISTING 2.5 Y 7/4 3 BEDROOM EXISTING LEACH PIT TO BE PUMPED OUT AND 3o`-4s' C, 94.00 REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION '' i� \\ ECK HOUSE GRAVEL 1`t ` �. Med.-Fine r \\ ��v v #82 DRIVEWAY ti ` NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE M 7.5 Y 6/6 ��\ �� 3" FROM THE EXISTING LEACH PIT TO BE DISPOSED OF AS PER BOARD OF HEALTH SPECIFICATIONS. 1 48 144 � . ss.00 �\ e- � --------, I �� � \. : ,. -__-.. _ �._.:.. _.`.._,_..___._. .. _ .... ._ .:.: .. 'Y'R'C'f_'C�C'frT AT1r-,if•�-'3cvv' \ 1 ASSESSORS MAP 149, PARCEL 059 E LEGEND 115 - I Perc ##1 I I DENOTES PROPOSED Depth to Perc: 48" to 66" i 104X 1 Perc Rate= Less Tha 2 MPI 1 � SPOT GRADE Groundwater Not Observed a PRIVATE WELL 1 1 PRIVATE WELL 20.00' it i X"104.46 DENOTES EXISTING No Observed ESHWT L = 148.77 ADJUSTED H2O Elev. = None l 1 PRIVATE WELL SPOT GRADE PL PROPERTY LINE -296 _ PROPOSED CONTOUR - - - - - -97 EXISTING CONTOUR (40 FOOT RIGHT OF WAY) TYPICAL -1000 GALLON SEPTIC TANK DEEP TEST HOLE & ,NOT TO SCALE PERCOLATION TEST .LOCATION 2-18' DIAM. ACCESS MANHOLES 6 FOOT STOCKADE FENCE s' P LOT P LAN INLET ) ` .. PRIVATE PRIVATE WELL OUT ET WELL THE ACCESS COVERS FOR THE s£p11C TANK, O F PROPOSED SEPTIC SYSTEM UPGRADE MSTRI13UTM BOX AND LEACHINGCOMPONENT LOT #28 PREPARED FOR jyr-,.`:� SET DEEPER THAN 6 INCHES BELOW nNISHED -'� - �- GRADE SHALL BE RAISED TO WITHIN 6' CC ` STEEL REINFORCED PRECAST CONCRETE FINISHED GRADE. BILLY CSC A L I C E L E E f_LAN VIEW INSTALL TUF-TITS GAS BAFFLES OR EQUALS LOT #Z9 AT 3-2e REMOVABLE COBS VARIANCES REQUESTED: #82 TIMBER LANE is- Use:1. Request a variance to reduce the separation from an SAS to a Private well from 450' to _3 min clearance . t 124 feet from Well on Lot 34, 111.5 feet from Well on Lot 136 anINLETd 11C feet from the Onste Well. MARSTON MILLS , MA am,. i2_Rangt tlatmET Design Calculations rnfn.Ual _ PREPARED BY: 5 -T L5 -7Number of Bedrooms: 3 Equivalent to 330 Gal./Day (330 Gal./Day Min. per TitleV) E g 4-o• min. Garbage Grinder: No //�'' A TK) NT 7�/T fT{7. �q'Y THT/// �yT9..e.ai. Liquid depth _ l 4L/1 ► l.r AJ l l 11 l Leaching Capacity-Proposed: 330 Gal./Day Minimum (Min. Per Title V)S tic Tank 2 x 330 Gai. Day 660 USE EXIST. 1,000 GAL. Septic Tank. ENVIRONMENTAL SERVICES, INC. SOIL ABSORPTION AREAr Using percolation rate of <2 min./inch0 20 40 50' - " Bottom Area- 0.74 gal/sq. ft. x 370 sq. ft. = 273.8 gallonse._D, 4' -io' \ ' P.O. BOX 627 Sidewatl Area 0.74 gal./sq. ft. x 78 sq. ft. 58 gallons A• EAST FALMOUTH, MA 02536 CROSS "`SECTION END-SECTIONProviding: 331.s0,gallonsTEL/FAX 508-548-0796 F rl PTH SCALE: 1 =20 ., >5 INFILTRATOR HIGH CAPACITY H 10 UNITS, HAVING A 0.83 (10 INCHES) EFFECTIVE DEPTH, - Y: CES ATE: DECEMBER 3 2003 O SCALE. 1 =20 DRAWN B , TO BE USED WITH 4.0' OF WASHED STONEON THE SIDES AND 3.5' OF'WASHED STONE ON THE ENDS: NO STONE UNDER, PROJECT 5D501 FILENAME:• SD501 PP.DWG SHEET '1 OF 1