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0085 WAKEBY ROAD - Health
r. 85 WAKEBY ROAD MARSTONS MILLS A= 043 -024 Commonwealth of Massachusetts �v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 85 Wakeby Road Property Address Susan Bethel .owner Owner's Name information is Marstons Mills MA 02648 06/17/2020 required for every page. Citylrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information I L+(aDA on the computer, use only the tab Michael T Bisienere key to move your Name of Inspector cursor-do not Cape Septic Inspections use the return Company Name key. 52 Rivers End Road � Company Address Teaticket Ma. 02536 City/Town State Zip Code 508-280=3356 S13938 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 Further Evaluation by the Local Approving Authority 4. ❑ Fails 06M 7/2020 Inspector's Si nature 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 18 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 page. Cityrrown 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: This 3 bedroom home has an H-10 1000 gallon septic tank with an H-10 D-Box feeding 2 leaching chambers with stone. At the time of the inspection no visible failure criteria was found. I did a walkthrough of this home and found 3 bedroom on the first floor. The basement is a walk-out. The basement is finished but none of the rooms qualified as a bedroom. 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): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 I Commonwealth of Massachusetts �^ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 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 i Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 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) determiines 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 + I� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u� 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is Marstons Mills MA 02648 06/17/2020 required for every page. City/Town 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 ❑ ® 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 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.] ❑ ® 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 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 Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 page. City/Town 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 all 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)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form b Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r; u� 85 Wakeby Road Property Address Susan Bethel Owner ; Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 page. Cityrrown 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 plus GPD Description: Number of current residents: 3 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 Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d town water 9 ( Y 9 (gp ))� Detail: In 2019-25,000 gallons were used and in 2018-32,000 gallons were used. Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 85.Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No 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): 3. Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 Commonwealth of Massachusetts �u ,(�p Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments j; 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 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: 05/14/2002 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 12"feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance fro-n private water supply well or suction line. town water feet Comments (on condition of joints, venting, evidence of leakage, etc.): Water was flushed and it came freely t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u� 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 3"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: H-10 1000 gallon Sludge depth: 4„ Distance from top of sludge to bottom of outlet tee or baffle 32„ Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 13" 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.): I recommend the new owner put the septic tank on a maint. plan with a local septic pumping co. based on the future use of the home. At the time of inspection the liquid level was at working level and the tee's were in place. t5insp.doc-rev.7/2 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form 1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u- 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date 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 Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 Commonwealth of Massachusetts ,�.p Title 5 Official Inspection Form 11 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 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 Iasi.pumping: Date Comments,(condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 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.): At the time of the inspection the liquid level was at working level and there were no visible signs of leakage or solids carryover. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System. Form - Not for Voluntary Assessments u � 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 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 :)r alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not ocated, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ 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 �I; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ............. 85 Wakeby Road V Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 page. City/Town 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.): At the time of the inspection no visible failure criteria was found. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface •Sewage Disposal System Page 14 of 18 P Y 9 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ............. 85 Wakeby Road u- Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 page. CityTrown 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.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is MarStonS Mills required for every MA 02648 06/17/2020 page. City/Town State Zip Code Date of Inspection 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 C r'� �- ,C �l-9 t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 18 I Commonwealth of Massachusetts ,w Title 5 Official Inspection Form +_ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments u� 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 page. Cityrrown 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: 12 plus feet feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: I augered a hole at a lower elevation and shot it with a transit to show 4 plus feet of seperation. 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•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form lip Subsurface Sewage Disposal System Form -Not for Voluntary Assessments u- 85 Wakeby Road Property Address Susan Bethel Owner Owner's Name information is required for every Marstons Mills MA 02648 06/17/2020 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 4 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.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 l Town of Barnstable a snttxsr�ez.�, MASS Regulatory Services e2639. Thomas F. Geiler, Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 October 15, 2002 Ms. Gladys DePaul 706 Old Barnstable Rd. Mashpee, MA 02649 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.602, STATE SANITRARY CODE, ARTICLE II, AND TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIONS,NUISANCE CONTROL REGULATION NO. 1 The property owned by you located at 85 Wakeby Rd., Marstons Mills,was inspected on October 8, 2002 by Sam White, Health Inspector, because of a complaint. The following violations of the State Sanitary Code and Town of Barnstable Board of Health Regulations, Nuisance Control Regulation No. 1 were observed: 105 CMR 410.602 and PART VII, SECTION 1.00 (RUBBISH): Rubbish throughout property. Numerous amounts of rubbish were observed at the above address including but not limited to: broken doors, old insulation, (1) couch, (1) VCR, (1) microwave, (1) treadmill, kitchenware, cleaning solvents, (1) floor fan, (1) television antennae, boxes of various household items. 105 CMR 410.602 and PART VII, SECTION 1.00 (GARBAGE): Bags of garbage on property not stored in watertight receptacles with tight fitting covers. You are directed to correct the violations within twenty-four (24) hours of your receipt of this notice, by removing all of the garbage and rubbish from the property and by removing or properly storing the garbage on the property. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance could result in a fine of up to $500.00. Each day's failure to comply with an order shall constitute a separate violation. PER ORDER OF THE BOARD OF HEALTH mas A. McKean, R.S. Director of Public Health Town of Barnstable Q:Health/W/DePaul ` ' 2 ''3y��.• £ Town of Barnstable Regulatory Services i0jro � x Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 January 30, 2003 Ms. Susan Bethel 85 Wakeby Rd. Marstons Mills, MA 02648 RE: 85 Wakeby Rd., Marstons Mills, Rubbish Removal Ms. Bethel, Per my inspection of your property on January 28, 2003, the following items have been removed from the front yard: -Treadmill -Kitchenware -Cleaning solvents -VCR -Microwave -Broken doors -Old insulation -Clapboard -Fans -Television antennae -Boxes of various items Additional progress has been made in the clean up efforts for the rest of the property. Samuel H. White Health Inspector Q:Health/wPBetheU k , mums Ln k ru p ru ✓*.3° T e. p Postage $ o 37 Ln CoCertified Fee e 2. 6 2 Postm Return Receipt Fee { n �6 He rrl (Endorsement Required) (• l,6 -1L, r9 Restricted Delivery Fee p p (Endorsement Required) � p r Total Postage&Fees $ I. Sent To ` SuSc-K ( __________________ --------------------------------------------------------------- Street,Apt.No.;or PO Box No. C3 ---1�s2� - - -------------------------------------------------- p City,State,ZIP+4 Certified Mail Provides: o A mailing receipt • A unique identifier for your mailpiece o A signature upon delivery o 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•eceive 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, 'lease 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. . PS Form 3800,May 2000(Reverse) 102595-99-M-2087 SENDER: • •N COMPLETE THIS SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sig at re item 4 if Restricted Delivery is desired. / - ' ❑Agent X ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. Received by(Printed Name) _ C. Date of Delive�y ■ Attach this card to the back of the mailpiece, _ �a �UZ 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 V6c Ma-�s-t�ns Mf`II s, 3. Service Type Certified Mail ElExpress Mail S ❑ Registered Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 171�Q� t`3 ��g Zs 4. Restricted Delivery?(Extra Fee) ❑Yes i 2. Article Number I (transfer}from service label)', 3 t i i i i P +i 4 l + i t i t i l t 1.PS Form 3811,August 2001 Domestic Return Receipt 102595-01-M-0381 UNITED STATES POSTAL SERVIG&-r,—�. " Postage&Pees Paid `? M Permit No G-:,I&� it • Sender: Please phfll yAuri name, address,-9hd,ZLP.+ „in this bax'.�. .this Public Health D 141on Town of B&nstal*► 200 Main St, Hyannis,Massachusetts 02601 SW �`�'� 9 ff Town of Barnstable Regulatory Services A � Thomas F. Geiler,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 December 11, 2002 Ms. Susan Bethel 85 Wakeby Rd. Marstons Mills, MA 02648 NOTICE TO ABATE VIOLATIONS OF TOWN OF BARNSTABLE BOARD OF HEALTH-REGULATIONS,NUISANCE CONTROL REGULATION NO. 1 The property owned by you located at 85 Wakeby Rd., Marstons Mills, was inspected on October 8, 2002 and on December 6, 2002 by Sam White, Health Inspector, because of a complaint. The following violations of the Town of Barnstable Board of Health Regulations, Nuisance Control Regulation No. 1 were observed: 105 CMR 410.602 and PART VII, SECTION 1.00 (RUBBISH): Rubbish throughout property. Numerous amounts of rubbish were observed at the above address including but not limited to: broken doors, old insulation, (1) couch, (1) VCR, (1) microwave, (1) treadmill, kitchenware, cleaning solvents, (1) floor fan, (1) television antennae, boxes of various household items. Per your conversation with Health Inspector, Sam White on October 21, 2002, you were granted an extended period in which to correct the violations. You are directed to correct the violations by January 31, 2003 by removing all rubbish from the property. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance could result in a fine of up to $500.00. Each day's failure to comply with an order sha constitute a separate violation. PER ORDER OF HE BOARD OF HEALTH Thomas A. McKean, R.S. Director of Public Health Town of Barnstable Q:Health/WPBethel ' . : Town of Barnstable Regulatory Services Thomas F. Geiler, Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 \ October 15, 2002 Ms. Gladys DePaul 706 Old Barnstable Rd. Mashpee, MA 02649 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.602, STATE SANITRARY CODE, ARTICLE II, AND TOWN OF BARNSTABLE BOARD OF HEALTH REGULATIONS, NUISANCE CONTROL REGULATION NO. 1 The property owned by you located at.85 Wakeby Rd., Marstons Mills, was inspected on October 8, 2002 by Sam White, Health Inspector, because of a complaint. The following violations of the State Sanitary Code and Town of Barnstable Board of Health Regulations,Nuisance Control Regulation No. 1 were observed: 105 CMR 410.602 and PART VII, SECTION 1.00 (RUBBISH): Rubbish throughout property. Numerous amounts of rubbish were observed at the above address including but not limited to: broken doors, old insulation, (1) couch, (1) VCR, (1) microwave, (1) treadmill, kitchenware, cleaning solvents, (1) floor fan, (1) television antennae, boxes of various household items. 105 CMR 410.602 and PART VII, SECTION 1.00 (GARBAGE): Bags of garbage on property not stored in watertight receptacles with tight fitting covers. You are directed to correct the violations within twenty-four (24) hours of your receipt of this notice, by removing all of the garbage and rubbish from the property and by removing or properly storing the garbage on the property. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance could result in a fine of up to $500.00. Each day's failure to comply a gMcKea!n, R.S. itute a separate violation. BOARD OF HEALTH ------------ Director of Public Health Town of Barnstable Q:HealdiAW/DePaul ` TOWN OF BARNSTABLE LOCA F1ON clu '=4) SEWAGE # ?Wa 'VILLAGE ASSESSOR'S MAP & LOT Ot 3—0.2 V INSTALLER'S NAME& PHONE NO. / l kE' Alt 6" SEPTIC TANK CAPACITY l00C) LEACHING FACILITY: (type) (0/ 1! (size) NO. OF BEDROOMS J BUILDER OR OWNER PERMITDATE: 3 a COMPLIANCE DATE: , y Separation Distance Between the: s Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist Y} 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 � - � �>s / �.� �3--- � yam, � :' r � - � ��� o - f..... � .a r I. No. r Fee- THE •, COMM WEALTH OF MASSACHUSETTS Enterecfincom9uter: 1�� Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUkTTS 01ppYication for Mi!6pogaf *pgtem Construction Permit Application for a Permit to Construct ' )Repair( )Upgrade( )Abandon( ) []Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Add ss an el.No. �5 L � �t . .l�S SvsA-tir _ L Assessor's Map/Parcel 9f 6"1 1%K�%� U ;ems f��S a�C�C4 Installer's Name,Address and Tel.No. Designer's Name,Addres and Tel No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Pip Other Type of Building No.of Persons I Showers(,Y-) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title 40 Size of Septic Tank Type of S.A.S. Description of Soil CIA, (1- Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Titl 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been i ed by is B of Health. Signe , Date s� /U2 Application Approved by Date �� 1 Application Disapproved for the following reasons Permit No. � =���� Date Issued O W 3� ; r elf�IF• v' i°.r."No.• �.... , y ` ,� fig,.�,,, .0 Y Fee THE�C-0 M0 �EALYN le ASSA�CHUSETT$` - — Enteredd c uteri Z�0� ` .. PUBLIC HEALTH 'ir bN -TOWN O BA"RNSTABLE}MASSACHU TTS Yes 21 tication for Mioogal *raem Congtructidn Vermi't. Application for a Permit to Construct()(,4);Repair( )Upgrade( )Abandon(� ) ElComplete Sys m El Individual Components t Location Addressor Lot No. Owner's Nameddrress and_T el. _No. fz Assessor S Map/Pazcel Qb , �.s L(/•"`�k'C.;�J�� �/-) 0 4 3 c�24 n 7�7: s ,�,fL s &J Installer's Name,Address,and Tel.No. _ Designer's Name,Address and Tel.No. (_ Type of Building: Dwelling No.of Bedrooms Lot Size 00b sq.ft. Garbage Grinder Other Type of Building rl S No.of Persons ( Showers Cafeteria( ) _i_ Other Fixtures D sign Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date � C, Title ^1 VW Size of Septic Tank Type of S.A.S. (Z) �J Description of Soil ti �ST Q I PCS I,-i Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of TAII 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been i ed by is B of Health. J / Signer ^^ �_ Date /� U Application Approved by Date ! 19 72 Application Disapproved for the following reasons r Permit No. ��` Date Issued r-QC)-Z THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance 'THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed )Repaired( )Upgraded( ) Abandoned( )by at '714; QCA has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction PermityNo.a.,1__�__)- dated Installer Designer ¢ The issuance of this,permits shall not be construed as a guarantee that the sy-M, wild f j nction a di&signed.� p }_ Date7�f_t� Inspector n �l IFNo. `-�""`-'� -------------------------- 1-9 Z. FeeTHE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migpogal *pgtem (Congtruction permit Permission is hereby grante to Construct ReP,a,ir( )Up lade( )Abandon( ) System located at �C 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:Construction must be completed within three years of the date of this pe it. Date: Approved by TOWN OF BARNSTABLE LOCATION Q �G4 SEWAGE # )&;- 2 VILLAGE A 44 -S l 0,11, S 1,4t I& ASSESSOR'S MAP & LOT OY3—0-2 V INSTALLER'S NAME&PHONE NO. 1Y I kif-i SEPTIC TANK CAPACITY 000 LEACHING FACILITY: (type] 1 C>C)64 . r (size) NO. OF BEDROOMS J j BUILDER OR OWNER PERMITDATE: r COMPLIANCE DATE:L _ 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 43` �/ r e� 00• CAT,10N SEWAGE PERMIT NO. VILLAGE o� I N S T A LLER' NA LEt& ADDRESS BUILDER OR OWNER qVikAb-lim P DA T E PERMIT ISSUED �A 7Y DAT E COMPLIANCE ISSUED � . ��i .� 2 i/ "��, 19 � ' �6` . �; No.......4..._....... Fps...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....................................I.....O F.......................................... Appliration for Dhipaii al Workii Tonitrurtion Frrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ................_................................................................................ ........... ....;-...........-P.e/ ..............----- ----..�...., /... ion-A 4' � iri��/�•6i�/J__ ---. :............. ---���. ....... f. ..... ner ` Address ...-j��. '��. ....................................... ----•-•-•---------------...---- -••----•---•-•--•-•----•-•-- --.... Installer Address Type of Building Size .........Sq. feet Dwelling—No. of Bedrooms.•.._....�.............................Expansion Attic ( ) Garbage Grinder ( ) '14 Other—Type of Building .............. No. of ersons..........................._ Showers — Cafeteria Pa YP g -------------- P ( ) ( ) a Q Other fixtures •---,---r------------------------------------------.----------------------------------------------------------------------------------------------- Ile W Design Flow._._.._....___... `S.S_______gallons per person per day. Total daily flow........ .................................gallons. WSeptic Tank—Liquid capacity/AA..gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No._�--4----- Diameter.................... Depth below inlet.................... Total leaching area.....'...........sq. ft. Z Other Distribution box (tl) . Dosing tank ( ) "" Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water____---_----_•_----_____ R+' ----------------•••--•••-••••••••••-•--•--•-•-------•-•--•---•-••••...................------..---_--........................................................ 0 Description of Soil --------------------------------•---------...............-----•- ----.•--------------------------- k..........G--....- W ------------------------------------------- ----------------------------------- ...................---------------------------- ............................... ................................ UNature of Repairs or Alterations—Answer when applicable............................................................................................... /.t.. rC ,�GLo!ti GGl L/u .... ............A............................................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL L 5 of the State Sanitary Cod T e undersigne rther agrees not to place the system in operation until a Certificate of Compliance has been 's o ealth. . ................•-----......••.......... 7 Signed ........... 7 .................... .....••--- Date Application Approved By•••--. ... .�� :................... ........................................to Date Application Disapproved for the following reasons:..................•••. ......................................................................... --..•......--•-•-••••--•--......•---•--•�•�---••••--•••...-••-•....•-••-•---•..............•-------......••-•-••---••--•---•--••--••------•••-•--•---••-��--•••-•-••••••••---••--•...__.... -•-_Date Permit No J..:........ .... Issued.•..= ..... _........................................... No------ ----------- F>s..........::................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................................OF....................................... ........................................ Appliration for Uhiposal Works Tonstrurtion "amit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: .......... W................................................................................ ..........................................;P.......... ........................................ .A. WOO,6'r1#11-1':........................................# ............................................. ........................................... .;;; . 1*0A _;. ......,ram netW It Address ........................................ .................................................................................................. .......... Installer Address Type of Building Size Lot..... ---------------------Sq. feet Dwelling—No. of Bedrooms._...__._C...._____________________________Expansion Attic Garbage Grinder ( ) Other—Type of Building ............................ No. of persons........................... Showers Cafeteria ( ) OtherfiZlyres ........................................................................... 1-1 0 - -------------- W Design Flow____________P90T -gallons per person per day. Total daily flow_.____...............79 ....................................gallons. 1:4 Septic Tank—Liquid capacityAtOf....gallons Length................ Width-_:_____-_______ Diameter---------------- Depth_.____________.. Disposal Trench—No. Width_____.....__.__.__.. Total Length___._.__.___._______ Total leaching area....................sq. f t. Seepage Pit Diameter.................... Depth below inlet_.___._..........__. Total leaching area..................sq. f t. Z Other Distribution box Dosing tank Percolation Test Results Performed by.......................................................................... Date.....................*------------------- Test Pit No. I................minutes per inch Depth. of Test Pit__._._.______.______ Depth to ground water__.___._.___..___._..__. fT Test Pit No. 2..................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ....................................................................................................................................................... 0 Description of Soil_.__.__._ '....... ........................... ....... --------------------------------------------------------------- 'A -7 ............ ..................................... - ;,j Z; -e, U .. .. ... ....................................................................................................................................................... . ........................................... .................................4.1-11—--------------------------- -------------------------------------------------------------------------------------- U Nature of Repairs4, 6r'Alterations—Answer when applicable.-_._.___.-----------------------------------------------------------................... 4- ..................I......... ................................................... ......... ....................... ....................................................;....... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions.of TLITIE 5 of the State Sanitary Co T rther agrees not to place the system in �e under operation until a Certificate ofCQrnpl'iance has bee 6.'i ne ealth. Signe ..... ........ _-Z............. ........................................... ................................ Date Application Approved By.......en........ 'fL .... ........ .......................... ........................................ Date Application Disapproved for the following reasons:.............................................................................................................. .................................................................................................................................................................................................. Date Permit No.... - _- : 7� ................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ............................. .......OF....................................................................... ...... Trrtif iratr of Tontlillia"r, THIS IS TO CERTIFY, That tjie Individual Sewage Disposal System-constructed or Repaired It, Vr- A*04. by---•------- ...... .............'........................................................................................................................................... ... Installer at............. h"If. .................v.�............................t.................... ... ........................................................................................................... has been installed 7.ift accordance with the provisions of TITLP. 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No_-.6,9............................... , dated---.,.------2,2_- I$P77 ----------------------THE,.ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFAICTORY. po 06 Inspector......DATE.......F: .... .................... . .......................................... -------- ------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF- HEALTH ..............A�� -...............OF...... No..............�t........ FEE........................ Permissionis hereby granted...n...... ........................................................................................................................... to Construct or Repair an jndividu lSewage D' sat System at No........4.4-f ......... wo ------------------------------------------------------- ........................................................................ Street as shown on the application for Disposal Works Construction ction--.,,Permit No--41........ Dated_.__ .............. .................................. .. ...... Board of He DATE-- alt............................!P, ...... ..... FORM 1255 HOBBS & WARREN. INC...PUBLISHERS ~,tt•-'4 k`LO%� i1C7,�c or b G.p:t? # f r- 1 1 C `C•�t�l 10./ {�E� `'�"o II 4_�' '6 P L7. {�I 4y U 54- AL • „mil`=+F'tX AL PIT - C..)5t= 14�. C«y AL' -� •'-•^"-'-""' ��- r AA $I� $�:�.� `,ate >; yLcS � �7�_C�..F?L� . �; i' � •,.....�•--'' '; ' `r'cs-r':;�c: '�?�ESI�t.IL= 1t25 Gp`t� ._ r� ���-•s .�, �. ' I r �'�.9dGGI.L�TIC?�.1 C�'A`C'� lI�i�.s Ztit'I�.4f2 �Y; `' #` � �` +'� � , .3,2� �a � ,, • ' _ ``, fr ¢.`5 r. ��. � -yet t 'l, ti r I • 1 Sta'�tC f�t��� a.. .;,i t4r i �•,;' � -. •�•ri• ;; ..,•:� ,��.7� `�.✓"" y { A H•'+.eg� � ,�.�- � �}'' a � j f�7 r �r �'�. ' ` J ;{ I . ti,, A,, t. a'' Lz ell eel %:f�ft�'✓ T'wt. quv15 CL ���� .. •i� +itG :( T',c,nlK .c.-�`> �' sti 3 csC?: B r tNv y bA ► trC�t-! ,rl/If I E �±.'Y` - T1-t'Gr`!L� kJt" , lad( '�4aC :c/�..1.. "' r �t:h! '� `• �'.t±.�,I�'. 1 X �,��'���E�1 roc-��'l''t,�L.�l�; u1�tT1-�.'-�`t•��: . .�tp� L.{�.ri� - .• t .b�1 . ' {."i" .yl l . C t C,Sit 6.dZ" 4 7',►-i t(.•C.�j �! . C. l�d t•4>C �.'ar Ai�-I r K+F'�.�c; { ; .' .,. t ♦ t 'h (t j Y A .ode r ♦. ••� .Y; + i } ��'.� t•�yy /� ! t 7r' �. ol �a.r Z,Q 4 5 11 f y„r s '' U+'b.•.r+' A ( �, �..I'C�"I" ,r.,,;�,C�4. .to j C ho U 1�-► fJ:8.1 f Z i.. Q< 1n A�y R y.. k7MW BAD o �s� BARNSTABLk 06UNTY HEALTH ©EPARTMENIL" ' t a SUPERIOR COURT HOUSE j BARNSTABLE, MASSACHUSETPS 02630 a�1l�$$ • 111HON6i 362.231 t [XT. ass Date: December 6, 1977 To: Mr. Arthur DePaul 848 Newtown Road Marstons Mills, Mass. 02648 On the basis of a sanitary survey and a laboratory examination on the sample of water taken from a ...well located on the promises of ..Arthur DePaul...... ,. Wake by Road, Marstons Mills located at .. .... .Lit.5. .... .... . ... ....... . ...... . .. . . .. .............. . on .....LeoGmber.5, .1977. .. . . . . . . this supply is approved for domestic purposes at the time the examination was made. If you wish further information regarding this supply, please contact us at the County 'Court House, Barnstable, Massachusetts (Tel: 362-2511 Ext. 331) and we will be glad to assist you in any way possible. Signed ...... . . ... ....Is./.... .... .... ... Public Health Sanitarian ce.� Mr. John Kelly, Director Barnstable Board of Health Town Office Hyannis, Mass: -02601 ecs Hackett Well Drillers B-tty's Pond Road Hyannis, Mass. 02601 ' I 1 DT'►�Jrz w,4y BE Lo w DECK q' X 20 ! - CN 235 ' - J (, SL I PER- ��_�c���r...1�;f, 3Q Ci9 w� R (oa 2),I�l o_v✓ - 2-yX _... PS—S.'._R. _ O = C2y 5Z „ 30� 246 24 1231 AP bbt0 ,� ( O C2'f 5 - - T; ' - O 0 WORK JTATIb>J -rove 36 X y «r 0Sur2ooM . i Z S PP Rf 6 u 2 L7L4 HELF 7ECK -- gx18 w i ------- _ CATS �Et L, 3) %D AA + ° - — 13LT up, GRAM �cAr 9,A ClC BLT UP G'EANI OPEN I ! S�aRGs�yJA � _ .. . ... � co. r at :.1 2/6 N 19 3, 6-" D)W)NG km VI O - - - x1' I'ST1 �> �10 USE # 7 ; AA-STEP- BORNE — 7 X 10 N I , 1 G3 A1 S i 7�'� �v- r, - �I c2 S' c2gs -T _ I , R ADD)TlDIJ B 5 - i y - 9 ; N, L 1�151DE 9 + . AND. 2o0 SE'qIES LAND12y/02 c7 I C1?5 Fl C3gS oll 5, SE•TH C L 85 WA KE�� 2D. 20 '- g '' $ O /W A R s aJ 5 L.t_ ::'4 8 - -- • SH�� o aF® mot' Couf..APRoW ! _ o --- --. ' 28 '- i_ Oil 8-'- O" SLIDE-R PIZ! VF WA y p ' --- ------------------ RF1`/jOVE O.H, C)OofZ -- 8 XI4. 171L CUT �Arufo�uc. `NAu 1° p o I 0PfZ , I is; — — 5: iSTFP ;!----- N GARAGE o !�- ? x 20 �� x 2$ I MbF • ELLAR tr M 15� 5`roRAG� ,. f — - - �X1 ST)1JG ST'L BEAM 7'-6 ` :;'\ ►3' 6'� Q - � c71 � SHERTROCK + N SaNdTVgES x lJ _ W/ Vzj LE'XrT_M s 8 '' �cyri4itJCy �on�C. 8,_O.. _ WALL IAV. 1 n I FtZoST wA11 -Lr----- '----- — —� if �2 FI RE Coof — --- 1 ('x per- o 5!f EFT)eocK, 8 •G110E X PULL HT. M / / Apornom C Fou�JDgTioN 1— cl3 — C13 W,g LL o t i 20 '- 8 ,, � '- p„ SCA 8 S. BET14FL 85 WAZ2By 1;W. ---emu � —1 R,o�E v��r - 6,,X ►2-- � 2#06E. VENT 2yc1O R)DGE BI(2D s mouTN To MATCH qc 1ST)NC PEAK 0 C,� 2x!o �LLAA �w 12 lb 2XG CO)-LAP- 1b,o0'o TIES I - ± DES F���' -ro nMTGH JEXIS'TIM6 MAKC 2 - AAS 8",C)NG N)C;<5 - �ENTS 38 INS, 2 x 8 C."EIL• JO)5T5 I& o,C ( I 1 x 3 ST12�4PP,)JG '�Z." SNEi;TROCIC R�3 CAT-H. CLIL. ExiST►NG � 12'- (o' I, IA) SwNRooM oNi)( CHiMNE MA 5T,^R L3El�RDoM 3 f � , )STING 2xq � RI.3 U 5� srvps MATCH -M AM STING VqM Pcywoo_v 31q PI W0 9 YJTCNFO FLOO)Z LEVEL C4 T-0 ExisTl UIJL' J , 2xio FlooQ TJo)ST5 1(."O,C Rom_ J; ;_,1 2-x 10 �015 5 " o, c . i LEVf`'1-- IX3 s►RApP,NG t fto R► 9 N5 ll� - '/2"FIRF-CoDE 'fig FIRE COPE (CoRNEJZ) I �� -ID v SNEETROCK �HETROC - EjC1571?J HOUSE Fui.i H?• (o� �' � 2x6 p.T, SILL 7� 1O, ( WALL $ fowC. w/S)1.1. SEAL CE;�LAR 1r<1A1-•L GARAGE AT�Ff TO I —�`_�` I lyin EX)ST)0 G ISSTEP ;I '' 3� �C 5� ' EX I ST)Mc FLDO(Z t.EVE1-, D�vjN 3 CoNc SLAB i - . � . � /��` - .- -_ ��� /���� /,'tip' /���`y�l�� '. �ii�ti • •`�'�3' 2 " 13 '- 8"CCn�C. 8 " _ FRo s'I' vj,4 FRONT FPAM I m C ETA I L /� '' 2 o - S -BETH� L 8S WAKESY R.D MARSTO1)S MILLS FRAMING DETA) L, 1 '- 4g, uoQj►1o2, _FRA.ME- ..Prz-TA 1 L SH EJE-T 5 OF O O PERCOLAT O N TEST 10 min, from-.-- p ad to septic tank, "NOTE: PIPES ARE 0 4 SCHEDULE P.V 'Ee ExistingFoundation [house' p ALL PIE E T BE EDULE 40 C. O( e5 R ..eptk tank covers must be P aatr aQ4, Dote of Percolation Test: JANUARY 14, 2002 T.O.F. eiay. - 100.00 rrlthrs 6 In, of finished grade ra Test Performed By. CARMEN E. SHAY, R.S., C.S.E. Gros.ova Septic Tank- 93.30 Grose over D-Bar- 09.50 i---code over SAS - 99,30 SECTION A -A 2-1a" DIAAI. ACCESS MANHOLES WAKF_BY RC?A o WgKEB ROAD Results Witnessed By. WAIVER Excavator. Shay Environmental Services, Inc. PROFILE' YIE1F OF LEACHING SYSTE1lI ,Y � a ` s . o.oz X Percolation Rate: Less Than 2 min,/inch 3 HOLE ACCESS COVERS OF SEPTIC TANK TO BE a 3 �xM.r RAISED WITH THE APPROPRIATE RISER TO WITHIN Q Z -3 SITE d•,...s. iW•r.iV.atJ!.j3it,il.�+.�.-..aLer1.� --rye•' 10• ----_ ^____S-C.A1 D!'� f I F' ." 6" OF THE EXISTING GRADE AS PER TITLE V. X' r 44�� of SAS-EIev.=96.50 c? EXIST. PIPE w EXIST. 1,00A GA ""^- 0.010" per foot �� ----s/v" to f 1/2 ' Poahad CruOum sta.,s " of IA- - f/z` Irns*sra P«urtoxw ter Q Kerry Drive FR A€ FDUNDATEaN �d ci SEPTIC TANK / l ;, THE ACCESS COVERS FOR THE SEPTIC TANK, Ch 3 3 3 m H-10 0 19 2' Effective Depth i DISTRIBUTION BOX AND LEACHING COMPONENT C �p Z *t Test Hole n - L ❑ J M -_ou SET DEEPER THAN 1 FOOT BELOW FINISHED 7ri� m C NCRE:TE FULL FOUN > n �'san" rn rn o c� :f-0 1 GRFINADE GRADE• RAISED TO WITHIN 12" OF - > q a� ¢5 r' i s DEPTH SOILS ELEV. S STEM R I > ' TE P SF�E o w n i i ��: Spur lane ,A 1 POOa +/ 1 R-•tw; •- - �^-*^•;r-�; M INSTALL TUF-TITE GAS BAFFLES S OR EQUALS Not to scale I x n C3 Cm 0 r3 �' `� GENERAL NOTES Loamy Effect#ve Vidth _, C) C= a O L7 C7 STEEL REINFORCED PRECAST CONCRETE 10 Sand 3/2 - - 5' STRIPOUT ALL AROUND ca a Q a i= PL.AN VIE`�1 - 6 h.of 3/4"-1 t/2" 1. Contractor is responsible for Di safe notification L TO ELEV. 87�00 c' Units S,S' = 17' A 92.75 oompoctsd stone d a, � �3-24'REMOVABLE cxovERS� p g m 11 and protection of all underground utilities and pipes. Sand 9aitlzm..42_h�tE7. �' - 2. The septic tank a diet ri .#ion box shall be set Y r; Loan, 2�' - ~ 3.mM�oleos,« 4' level on 6" of 3 f4 -1 1�2 stone, 10 YR 3/g - - --�- z,mh t 1 ,r ',LET . 3. Backfill should"be clean sand or gravel with no B, 91.50 Effective Length INLET e' • .attTLET stones over 3 in size. 6 24" Foie Silt Mote: All leach lines to be capped at eilde */PVC caps. A 1a'min.�- LCquTd'G.Mx1 ,< 4. This system is subject to inspection during installation Sandy Note: Remove soil down to el. 87.00 do replace with SOIL ABSORPTION SYSTEM <SAS) 3' -7' i§ 3' -7' by Carmen. E. Shay - Environmental Services, Inc. 2s r e/3 clean coarse sand w/pArc. rate less than or e$ 4'-a^ min. 5. The contractor shall install this system in accordance 12L4"- 72" C, 87.50 or equal to 2 min./in. before tie after placement 500 C LEACHING UNITS / WIGGINS PRECAST �� ei" _ �� °o°ei with Title V of the Massachusetts state code, the approved plan Nate: CeAlfirotion of Fiil Material Required. and Local Regulations. I Mee Not to Scale Lti •i 6. If, during installation the contractor encounters an Sand Before and After Placement by Solve Anofyses !.; .��,�. s.."'r:' y zt1 r 7/4 Per 310 CMR t5.a55(3) •. -4'-10• • soil conditions or site conditions that are different •72"-168' C= 7s 5o from those shown on the soil log or in our design I CROSS SEQ710N END-SE_CT�QN installation must halt & immediate notification be mode to Carmen E. Shay - Environmental Services, Inc. FOUNDATION - r `----'a ---- - SEPTIC TANK -- t�� -.. D-BOX .. ---�s'----."- LEACHING FACILITY USE EXISTING 1000 G. ALLON H- 10 ,.SEPTIC TANK 7. No vehicle Or heavy machinery shall drive over the - - --- ---- - septic system unless noted as H-20 septic components. NOTr TO SCALE 8. Install Tuf-rite gas baffles or equals on all outlet tee ends. 9. All Distribution Lines shall be 4" diameter Sch. 40 NSF PVC pipes, Perc fit - _ 10. All solid piping, tees & fittings shall be 4' diameter Depth to Perc: 72" to 90" Perc Rate=Q min./inch (Assumed) Schedule 40 NSF PVC pipes with water tight joints. Groundwater Not Observed 11. SITE and Surrounding Properties are NOT No Observed ESHWT ALL CONNECTED to Municipal Water. Municipal Water is Available. ADJUSTED H2O Elev. - None NOTE THE PROPERTY LINES ARE APPROXIMATE AND COMPILED FROM THE SURVEY PLAN GENERATED SY CHALES SAVORY of YARMOUTH, MA ENTITLED " SUBDIVISOIN OF LAND IN BARNSTABLE, MA" LC 35186 B CERT. # 53407, DATED JUNE 28, 1973 AND IS NOT INTENDED TO BE A SURVEY PLOT PLAN IT SHOULD BE USED FOR NO PURPOSE OTHER THAN - r'�• THE SEPTIC SYSTEM INSTALLATION. (50 FOOT RIGHT OF WAY) THERE ARE NO WETLANDS LOCATED WITHIN A 200' RADIUS . "._``_---�-�_�_ r�l _- OF THE PROPERTY 98.24 _-_�___..•---- �-"""- �� �� NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE _ x ~~�-�-~ FROMOF THE HER BOARD OF SEPTIC HEA SYSTEM TEM TOCA E DISPOSED R - 780.00' i _ - _------- r EXISTING LEACH PIT TO BE PUMPED DRY & j L -'�' t.25.OQ' t -� - FILLED WITH CL EAN FILL MATERIAL. � P1 f' • 100--__ _FJ�~ PROPERTY IS WiTHIN A ZONE It. THEREFORE DWELLING I NOT TO BE EXPANDED TO MORE THAN 2 BEDROOMS WITHOUT / ONSITE WELL TO BE ABANDONED AND AN APPROVED ENHANCED NITROGEN REMOVAL SYSTEM. 98:31 X ��, / NEW J�dlC.,l, ;+L WATER LINE" TO BE INSTALLED. ,JRS MAP - 43 LOT - 24 X CJUFBL DRlVBAdY 99.44 1 � U i I_vNING `- RESIDENTIAL LOT 5 ''�-� FLOOD ZONE C , 9 � c 8 o eE A J THERE ARE NO WETLANDS LOCATED WITHIN A 200 RADIUS 97.54 .. OF THE PROPERTY , • ___ -_ 11 _.Pi:OJECi BENCH MARK t 98.85 ( TOP OF FOUNDATION - �•,.� i x • ; EI.EV. 100 (assumed) t , LOT #6 ALL au1�T PipEs rricxa THE LEGEND 93.50 I , r.96 DMIMIi'JTM sax sr�BE X \°\ / SET LEVEL FOR AT LEAST 2 FT. 11" cariCRETE COVER ---- -------- LOT #4A � e° `� �/ (PROPERTY CONNECTED TO MUNICIPAL WATER SUPPLY) 3- 3•OUTLET x' I `t EXISTING 2 1 MOCKO'Ts L_____ 8X0 DENOTES PROPOSED (PROPERTY CONNECTED TO MUNICIPAL. WATER SUPPLY) � �`'�, BEDROOM >rg � 33 0uaET " 12' ra�r SPOT GRADE HOUSE r _..-_ �1__. _?._ --- _ _ TOF= ELEV, 100 �� DENOTES EXISTING 4�?__ `�1 �J -1s3• X 104.46 SPOT GRADE 4` - SCH. 4a,T _11.Ta' #144 i S - I N pL PROPERTY LINE i 3 HOLE DISTRIBUT12A BOX ----- PROPOSED CONTOUR ^� Exist. 1000 1 r NOT TO"SCALE wW Gal. Septic Tank r'! 97-- - _ - - -97 EXISTING CONTOUR 91 .43 k 10 __�a X X - I ' 91.7$ J% i `9!1S�L� latons DEEP TEST HOLE & o PERCOLATION TEST LOCATION 9r2 --- ----____ _ ---- i Number of Bedrooms: 2 Equivalent to 220 Gal./Day (330 Gal./Day Min. per Title V) FENCE __________ -- X I r Garbage Grinder. No 92.52 92.52 ) Leaching Capacity Proposed: 330 Gal./)ay Minimum (Min. Per Title V) r_________ Septic Tank 2 x 330 Gol./Day = 660 USE 1,500 GAL, Septic Tank. PRIVATE DRINKING WATER WELL SOIL ABSORPTION AREA: using percolcition rate of <2 min./inch 'c Bottom Area: 0.74 gal/sq. ft. x 300sq. ft. = 222.00 gallons REVISIONS t -'u LEACH)' i ,i I Sidewoll Area: 0.74 gol./sq. ft. x 148 sq, ft. = 109.50 gallons Providing:. = 331.50 gallons TEST HOLE i 1 ELEV.- 93. 0 ' -=--=`; -• I j /'� i Use: {2) PRECAST 500-C UNITS, HAV JG A 2" EFFECTIVE DEPTH, N0. DATE: DEFINITION �- ''" R�' ! I - TO BE USED WITH 3.5' OF WASHED STONE ON THE SIDES AND _ � 913.86- 9 .68 '��•--''- --- �-� l 98.5'�' � 3' OF WASHED STONE ON THE. ENDS AMD 2 FEET II`d BETWEEN 2 UNITS. X X x r 94f04 27.99' I Failed X � f I 94.92 Leach Pit CZ X I X '-----_ _ Bid2 4� 1 f " L I 95.70 i Remove soil down to el 87.00 & replace with PROPOSED CB D.H. clean coarse sand t�f per=r. rate less than or PREPARED FOR * FND or equal to 2 m1n./in. �efore & after placement ---- (5 FOOT STRIPOUT ALL AROUND AS SHOWN) SUBSURFACE SEWAGE DISPOSAL SYSTEM OF #85 WAKEBY ROAD LOT #,8 LOT #f 7 LOT #f 6 M S . �U�(a,q B ETH E L MARSTO N S MILL, MA Private Well Over 150 Feet From Property (-IROPERTY CONNECTED TO MUNICIPAL WATER SUPPLY 8 5 WArr E BY ROAD (PROPERTY CONNECTED TO MUNICIPAL WATER SUPPLY) ( P y Line) ) PREPARED BY: MARSTONS MILL, MA 0264.8 �NOF�f ss � CARME �, ` z ENVIRON�f.E'NTAL SERVICES, INC.0 RffEyV E. SffA Y oy CDO 0. 1181 34 THATCHERS LANE 0 20 40 50 � �F �a orsT1 R EAST FALMOUTH, MA 02536 SANITAR\P- TEL FAX 508-548-0796 I SCALE: 1 p=20' b *. SCALE: LE. L. 20 DRAWN BY C ES DATE: E. JANU ARY 28 0 20 2 PROJECT#SD- _288 FILENAME: SD288PP.DWG SHEET 1 F : 0 1