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Home My WebLink About0194 WHISTLEBERRY DRIVE - Health 194 Whistleberry Drive Marstons Mills F A = 063 087 TOWN OF BARNSTABLE L0CAn0 / 9� Gi�f3f7*L��k.wz SEWAGE # VTR LAGE A A&.>fo,-) 474-Z5 ASSESSOR'S MAP & LOT JG IN'A3TALLER'S NAME& PHONE NO. tT;r SEPTIC TANK CAPACITY t d4 b LEACHING FACILITY: (type) 4+s (size) 3 x NO. OF BEDROOMS 3 BUILDER OR OWNER v G z 6s PERMITDATE: la COMPLIANCE DATE: S �' 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 1 E o - .�_ No. Fee } THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 0[pprtcation for Oigooal bpotem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(V/)Abandon( ) El Complete System Individual Components Location Address or Lot No. Owner's am ,Address d Tel.No. /f�oWJ1,511c�eI'V Or, ��e_115 Assessor's Map/Par l W/3/0/j 14W 1_5 Installer's Name,Address,and Tel.No. i/ Designer's Name;Address and Tel.No. Aerla1"�>C® CQye -7 7/_e Type of Building: ? Dwelling No.of Bedrooms J Lot Size��sq.ft. Garbage Grinder(Ala Type of Building J 7i/Zfi No.of Persons Showers( ) Cafeteria( ) Other Fixtures ,fit Design Flow ! gallons per day. Calculated daily flow YW gallons. Plan Date Number o sheets 4 Revision Date Title Size of Septic Tank % Type of S.A.S. �9 Description of Soil 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 Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by is f ealth. Signed — Date Application Approved by _ Date Application Disapproved for the following reasons Permit No. ( ��' ��L� Date Issued 14 aCo I Ur,�_ 0 ASO— No. a +k ;,:�_; Fee / Entered in computer: f THE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH'DIVISION -TOWN OF BARNSTABLE,. MASSACHUSETTS � 2pprication.for'0igpogar *pgtem, Congtruction Permit Application for a Permit to Construct( . )Repair( )Upgrade(V/)Abandon( ) ❑Complete System U'Ir►dividual Components Location Address or Lot No. Owner's a ,Address and,Tel.No. m�ubefi s Assessor's M8(.03 V --7 .. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. / Type of Building: f� j Dwelling No.of Bedrooms Lot Size 221 sq.ft. Garbage Grinder Other Type of Building S f L°�1ee No.of Persons Showers( ) Cafeteria( ) Other Fixtures - - Design Flow gallons per day. Calculated daily flow gallons. F Plan Date 17 7 Number off sheets 4 Revision Date Title 11* P 15 .g1 1C /Z fy Ado15 kd l Size of Septic Tank AD O' cp -Type of S.A.S. Description of Soil t Nature of Repairs or Alterations(Answer when applicable) Date last inspected: G Agreement: CThe undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system r in accordance with the provisions 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 Bo .d f ealth. / 5� Signed 1' t Date Application Approved by r a , � t Date y 9 ; 1 Application Disapproved for the following reasons I �4 Permit No. Date Issued ` Q c u-4- --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS f Certificate of Compliance THIS IS TO CERT ,that the On-site Sewage Disposal System Constructed( )Repaired ( ' )Upgraded(f/ Abandoned( )by at 9� wh�s�`/P h�r��/ s�. �'/�S��S �J�fS has been constructed in accordance with the provisions of Title 5 and the Kor Disposal System Construction Permit No. dated n/C i7�-. Installer Designer The issuance o s ermit shall not be construed as a guarantee that the sy to jAilunction s esignedDate� G, � Inspector �' �' _ _ __ ___ No.—✓�- '` Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH.DIVISION - BARNSTABLE} MASSACHUSETTS G &5pogar *pgtem Congtruction Permit Permission is hereby granted o Construct( . ) epair( )Upgrade(yf)Abandon( ) System located at �� ✓f115Jf t®�'/Qj� (/�R. /�z�'�51`D�-5✓l//.�/5 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 oft this permi. Date: Approved by `/` j e TOWN OF BARNSTABLE LOCATION 9q �iilf3J�L�� SEWAGE #��'17�1 VILLAGE ^ An.J for-; ASSESSOR'S MAP & LOT sU INSTALLER'S NAME&PHONE NO. ,®�r��oL� t!;� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 4!�4-6 l e+s (size) '30;Ar NO.OF BEDROOMS 3 ' BUILDER OR OWNER CaS HERMIT DATE: COMPLIANCE DATE: 5 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i 4- 3 y ®-i yo to 6-1 93 d-V .J 1' I 6:3i18/2002 11: 30 5085647270 IOHN GR.ACI SEPTIC �-® PAGE 0, ' i RECEIVED ,F.. COMMONWEALTH OF 1VMASSACHLTSE7TS MAR 2 5 2002 EXECUTIVE OFFICE OF ENviRONMENTAL AFFAIRS TOWN OF BARNSTABLE HEALTH DEPT. DEPARTMENT OF ENVII1;01�MENTAL PROTECTI r ' IECT10N TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSU'RFACF SEWAGE DISPOSAL, SYSTEM FORM PART A CERTIFICATION O •„ Property Address: 194 WHISTLEBERRY DRIVE MA.RSTONS MILLS,NIA 02649 PARCEL : " Owner's Name: JUDY ABUGELIS Owner's Address: PO BOX 612 MARSTONS MILLS MA.02649 LOT Date of Inspection:3113/02 Name of Inspector:(please print) JOHN GRACI Company Name: SEPTIC INSPECTIONS Mailing Address: P.O.BOX 2119 TEATICKET, MA.02536 Telephone Number- 508-564-6813 FAX 508-56d-7270 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the infomiation 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. 12m a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 19.000). The system: _ Passcs _ Conditionally Passes _ Needs Furth r Evaluation by the Local.Approving Authority X Fails Inspector's Signature: Date: 3/I3/02 The system inspector shall submi a copy of th..i,5 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 SYSTEM FAILS TITLE Y INSPECTION,LEACH PIT IS IN HYDRAULIC FAILURE. PIPE IN LEACH PIT COMES IN 2' LOWER THAN NORMAL AND THERE IS LIQUID UP IN PIPE. ""This report only describes conditions lit 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. Ti!IP 5 lncrantinn Fnrm fill 51'1000 1 03.,16/2002 11: 30 5085647270 JOHN GRACI SEPTIC PAGE 02 ti Y Page 2 of!I OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM I1VSPECTiCDN FORM PART A CERTIFICATICIN (continued) Propertv Address: 194 WHISTLEBERRY DRIVE MARSTONS MILLS,MA 02648 Owner: :JUDY ABUGELIS Date of Inspection: 3/13/02 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 3I0 CMR 15,303 or in 3:0 CMR 15,304 exist.Any failwe criteria not evaluated are indicated below. Comments: SYSTEM FAILS TITLE V INSPECTION, LEACH PIT IS IN HYDRAULIC FAILURE. PIPE IN LEACH.PIT COMES iN V LOWER THAN NORMAL AND THERE IS LIQUID UP IN PIPE, 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. n/a The septic tank is metal and over 20 years aid* or the septic tark(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.Systern 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:n/a n!a 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: n/a n/a 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: n/a i a 03/18/2002 11:30 5085647270 JOHN GRACI SEPTIC PAGE 03 page 3 of 11 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAU DISrOSAL SYSTXM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 194 WHISTLESERRY DRIVE MARSTON$MILLS,MA 0264R Owner: JUDY ABUCELIS Date of Inspection.: 3/13/02 C. Further Evaluation is Required by the Board of kiesith: 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 C'vIR 15.303(1)(b)that the system is not functioning in it 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,i( pp f any)determines that the system is functioning in a manner that protects the public health,safety and environment; The system has a septi.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 I of a public water supply. The system has a septic tank and SAS and the:SAS is within SO&et 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.n/a *4This system passes If cite well water analysis, perforated 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 S ppm, provided that no other failure criteria are triggered.A copy of the analy3i5.must be attached to this form. 3, Other: n/a 03/18/2002 11:30 5085667270 J01-IN GRACI SEPTIC PAGE 04 Page 4 of I I OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A. CERTIFICATION(continued) Property Address: 194 WHISTLERERRY DRIVE MARSTONS MILLS,MA 02648 Owner- J'UDY ABUGELIS Date of Inspectlon: 3,13102 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to.each ofthe following for alLinspectioos: Yes No X . Backup of sewage into facility or sy-,qtetn component due to overloaded or clogged SAS or cesspool X Discharge or ponding of affluent to the surface of the ground or surface waters due to art overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow X Required pumping more than 4 times in the last year hIQT.due to clogged or obstructed pipe(s).Number of times pumped nLa. X Any portion of the SAS, cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy-Is within 100 feet of a surface water supply or tributary to a surface water supple. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes If the well water analysis,performed at a DEF certified laboratory,f:)r co6form 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 leas than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this forma X _ (Ye&No)The system fall.i have determined that one or more of the above failure criteria exist as described in.310 C.MR 1.5.303,therefore the system fails.The system owner should contact die Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system most serve a facility with a design flow of 10,000 gpd to 19,000 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 X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nit-ogee sensitive area(Interim Wellhead Protection Area—I WPA)or a mapped Zone 11 of a public water supply well If you have answered"yes'°to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a signifcantt threat tinder 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 03/18/2002 11:30 5085647270 JOHN GRAM SEPTIC PAGE 05 Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY`ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 194 WHISTLEBERRY DRIVE MARSTONS MILLS,MA,02648 Owner: AI DY ABUGLLIS Date of Inspection: 3/13102 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out In the previous two weeks 7 X _ Has the system received normal flows in the previous two week period' X Have large volumes of:vater been introduced to the system recently ot as part of"this inspection? X _ Were as bulk plans of the system obtained and examined?(If they were not available note as NIA) X Was the facility or dwelling Inspected for signs of sewage back up? X Was the site inspected for signs of break out X _ Were all system components,excluding the SAS,located on site':, X _ Were the septic tank manholes uncovered,opened,and the interior of the tans: inspected for the condition of the baffles or tees,material of censtmetbm, dimensions,depth of liquid,depth of sludge and depth of scum X _ Was the facility owner(and occupants.if different from owner)provided with information on the proper maintenance of subsurface sewage disposal.systetns 7 The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no X Existing information. For example,a pian at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Fart Cis at issue approximation of distance is unacceptable)[310 CM>R 15.302(3)(b)] 5 03/18/2002 11:30 5085647270 JOHN GRACI SEPTIC PAGE 06 • Page 6 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Properly Address: 194 WHIST1111ERRY DRIVE MARSTONS MILT-.S,MA 02648 Owner, JUDY ABUGELIS Date of Inspection. 3/13/02 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:2 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): iVO Water meter readings,if available(Iasi 2 years usage(gpd)); n/a Sump pump(yes or no):NO Last date of occupancy:We COMM ERCIAL NDUSTRI(AL Type of establishment: n/a Design flow(based on 310 CMR 15.203): a/agpd Basis of design flow(seats/persons,sgft,etc.): rt/a Grease trap present(yes or no):NO Industrial waste holding tank present(_yes or no): NO Non-sanitary waste discharged to the Title 5 systcm;yes or no) NO Water meter readings, if available: n/a Last date of occupancy/use: n/a OTHER(describe):Wa GENERAL INFORMATION Pumping Records Source of information:n/a Was system pumped as part of the inspection(yes or tic):NO If yes,volume pumped:n/agallons--How was quantity pumped determined?n/a Reason for pumping: n/s TYPE OF SYSTEM X Septic tank,distribution box,soi I absorption system _Single cesspool Overfow cesspool Privy Shared system(yes or no)(if yes,attach previous inspection record9,if sly) _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): n/a Approximate age ofall components,date installed(if known)and source of information: 14 YEA4tS BY OWNER Were sewage odors detected when arrN-ing at the site(yes ar no):NO R 03/18/2002 11:30 5085647270 JJHN GP•.4-CI SEPTIC PAGE 07 Page 7 of 11 OFFICIAL.INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIOlh FORM PART C SYSTEM INFORMATION(continued) Property Address: 194 WHISTLEBERRY DRIVE MARSTONS MILLS,1NIA 02646 Owner: JUDY ABUGELIS Date of Inspection: 3/13/02 BUILDING SEWER(locate on site plan) Depth below grade:22" Materials of construction: cast iron X40 PVC other(explain): n/a Distance from private water supply well or suction line:n/a Comments(on condition of joints,venting,evidence of leakage, etc.): TOWN WATER SEPTIC TANK:X(locate on site plan) Depth below glade: 16" Material of construction: (concrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance.(yes or no):NO(attach a copy of certificate) Dimensions: 1000G L 6'6"H 5''-"W 4' 10"" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or bafftc:32" Scum thickness:2" Distance from top of scum to top of outlet tee of baffle- 6" Distance from bottom of scum to bottom of outlet tee or baffle: 16" How were dimensions determined:MEASURED Comments(on purnping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): SEPTIC SYSTEM FAILS INSPECTION. LEACH PIT IS IN HYDRAULIC FAILURE. GREASE TRAP: _(locate on site plan) Depth below grade:n/a MatErial of construction:—concrete—metal_fiberglass_polyethylene other(explain):n/a Dimensions:n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: nla Distance from bottom of scum to bottom of outlet tee or baffle:Na Date of lest pumping: n/a Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage;etc.): n/a 7 f 03/18/2002 11:30 5085647270 JOHN GPACI SEPT-IC PAGE V-18 Page 8 of 11 OFFICIAL INSPECTION FORM—NO1")F'OR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 194 WHISTLEBERRV DRIVE MARSTONS MILLS,MA 02648 Owner: JUDY ABUGELIS Date of Inspection: 3/13i02 TIGHT or HOLDING TANK: (tank must be pumped at time of inspecdon)(locate on site plan) Depth below grade:nla Mater_lal of construction:_concrete_metal_.fiberglass _polyethylene_othet(explain): n/a Dimensions:n/a Capacity n/a gallons Design.Flow: a/a gallons/day Alarm present(yes or no): N/A Alarm level:N/A Alarm in working order(yes or no): No Date of last pumping.n/a Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOX:X(if present must he opened)(locate on site plan) Depth of liquid level above outlet invert:LEVEL WITH BOTTOM OF PIPE Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): D-BOX IS STRUCTURALLY SOUND. PUMP CHAMBER:.(locate an site plan) Pumps in working order(yes or no):NO Alarms in working order(yes or ne):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a u 03/18/2002 11:30 5085647270 JOHPJ 6RACI SEPTIC PAGE 09 page 9 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 194 WHISTLFBERRY DRIVE MARSTONS MILLS,MA 02648 Owner. JUDY ABUGELIS Date of Inspection., 3/13102 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) IF SAS not located explain why: n/a Type 1000 GAL 6' X 6' leaching pits, number: 1 Ala leaching chambers, number: n/a o/a leaching galleries, number: n/a We leaching trenches,number, length: nla n/4 leaching fields, number, nla n/a overflow cesspool, number nla n/a innovativelafternative system Typelnarne of technology n/a Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): LEACH PIT IS IN HYDRAULIC FAILURE.PIPE COMES IN V LOWER THAN NORMAL AND THERE IS LIQUID UP IN PIPE. CESSPOOLS: (cesspool must be pumped as pact of inspection)(locate on site plan) Number and configuration:n/a Depth—top of liquid to inlet invert:.n/a Depth of solids layer: n/a Depths of scum layer: n/a Dimensions of cesspool:n/s Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of loll,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): n/a PRIVY, (locate on site plan) Materials of cons?ruction: n/a Dimensions:n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): n./a 9 03/1812002 11:30 5085647270 JOHN GPACI SEPTIC PAGE 10 Page 10 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 194 WHISTLEHERRY.DR,IVE MARSTON$MILLS,MA 02648 Owntr: JUDY ABUGELIS Date of Inspection: 3/13/02 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. g-gl 06 AA �OG!Aft II �6 1'7 cc �7 in 03/18!2002 11:30 5085647270 JOHN GPACI SEPTIC. PAGE 11 • Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 194 WHISTLEIYERRY DRIVE M.ARSTONS MILLS,MA 02648 Owner: JUDY ABUGELIS Date of Inspection: 3/13/02 SITE EXAM _Slope _Surfacc water _Check cellar Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property observation hole within 150 feet.of SAS) NO Checked with local Board of Health-explain. n/a NO Checked with local excavators, installers-(attach documentation) NO Accessed USGS database-explain, n/n You roust describe how you established the high ground water elevation: HAND AUGER- 12+FT. it 1�f ti �CE1VluI ' 6 � " ECO-TECH ENVIRONMENTAL �'• iV , „ � THIS FORM IS A FACSIMILE OF THE STANDARD SEPTIC INSPECTION FORM ISSUED BY AS1�HUSR T �® ,� DEPARTMENT OF ENVIRONMENTAL PROTECTION f" ". .11�i d ' 19,96 SUBSURFACE SEWAGE DISPOSAL ALSYSTEM INSPECTION FORM , -P CERTIFICATION Z Property Address: 194 Whistleberry Drive,Marstons Mills Address of Owner 8 CA Date of Inspection: July 14, 1996 (If different) Name of Inspector:David D.Coughanowr,R.S. Company Name,Address,and Telephone Number: Eco-Tech Environmental 43 Triangle Circle Sandwich,MA 02563 (508) 888-0185 CERTIFICATION STATEMENT: 1'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 fu ctio d aintenance of on-site sewage disposal systems.The system: X Passes OF �SS7 Condia7v as cy Nee O er� l�don 9f? Local Approving Authority _Fails GH'N V ;9 _ R9 Inspector's Signature P Date: PLEASE NOTE: This inspection d4tgils 2� tit'on of the septic system at the time of inspection.A system passes on the basis of whether it adequately prt a health and the environment.No estimate or guarantee of system longevity is expressed or implied in this repo The System Inspector shall submit a copy of this report to the local Approving Authority within thirty(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 Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer,if applicable, and the approving authority. INSPECTION SUMMARY: Check A,B,C,or D: A]SYSTEM PASSES: X I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B]SYSTEM CONDITIONALLY PASSES: _One or more system components need to be replaced or repaired.The system,on completion of the replacement or repair,passes inspection. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances. If"not determined", explain why not The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exfiltradon, or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced With a conforming septic tank as approved by the Board of Health. f „ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 194 Whistleberry Drive,Marstons Mills Owner: Alan Aronow Date of Inspection: July 14, 1996 B)SYSTEM CONDITIONALLY PASSES(continued) Sewage backup or breakout or high static water level observed in the distribution box is due to broken orobstructed pipe(s)or due to a broken,settled,or uneven distribution box.The system will pass inspection if(with approval of the Board of Health): broken pipe(s) is/are replaced _obstruction is removed _distribution box is leveled or replaced. The System required pumping more than four 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)is/are replaced obstruction is removed 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 the public health,safety,and environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 foot to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone 1 of a public water supply well The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and that the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D) SYSTEM FAILS: I have determined that the system violates on or more of the following failure criteria as defined in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should contact me to determine what will be necessary to correct the failure. Backup of sewage into facility or system component due to an 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. I ` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 194 Whistleberry Drive,Marstons Mills Owner: Alan Aronow Date of Inspection: July 14, 1996 D) SYSTEM FAILS(continued): Static liquid level in 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 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 SOIL ABSORPTION SYSTEM,cesspool,or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 foot 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.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flow of systems is 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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 within a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA) or a mapped Zone II of a public water supply well. i The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00.Please consult with the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 194 Whistleberry Drive,Marstons Mills Owner: Alan Aronow Date of Inspection: July 14, 1996 Check if the following have been done: X Pumping information was requested of the owner,occupant and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. As-Built plans have been obtained and examined. (Note if they are not available with N/A) _X__ The facility or dwelling has been inspected for signs of sewage backup. X The system does not receive non-sanitary or industrial waste flow. X The site was inspected for signs of breakout. X All system components,excluding the soil absorption system.have been located on the site. X the septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,depth of liquid,depth of sludge,depth of scum. X The size and location of the soil absorption system on the site has been determined based on existing information or approximated by non-intrusive methods. X The facility owner(and occupants,if different from owner) were provided with information on the proper maintenance of a Subsurface SEWAGE DISPOSAL SYSTEM. - 1 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 194 Whistleberry Drive,Marstons Mills Owner: Alan Aronow Date of Inspection: July 14, 1996 FLOW CONDITIONS RESIDENTIAL: Design flow: 330 gallons per day Number of bedrooms: 3 Number of current residents: 3 garbage grinder(yes or no):11Q ILaundry connected to system (yes or no): Seasonal use(yes or no): no Water meter readings,if available: 1994: 68,000 gallons 1995: 81.000 gallons 1996. 29,000 gallons(through 7/-1) Last date of occupancy:current COMMERCIAL/INDUSTRIAL Type of establishment- Design flow: gallons/day Grease trap present: (yes or no): Industrial Waste Holding Tank present: (yes or no): Non-sanitary waste discharged into the Title 5 system: (yes or no): Water meter readings,if available: OTHER: (describe): 1 Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS (and source of information): System pumped June, 1995 (owner) System pumped as part of this inspection (yes or no) no If yes,volume pumped: gallons 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) Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source of information. Age: 11 years + System installed 4/23/85 by Eric Breman (BOH records) Sewage odors detected when arriving at site: (yes or no) n SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 194 Whistleberry Drive,Marstons Mills Owner: Alan Aronow Date of Inspection: July 14, 1996 . SEPTIC TANK:—X (locate on site plan) Depth below grade: 1 foot Material of construction:X concrete metal FRP Other(explain) Dimensions: 8'x 5'x 4' Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: 30„ Scum thickness: trace Distance from top of scum to top of outlet tee or baffle: 10„ Distance from bottom of scum to bottom of outlet tee or baffle: 14„ Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,evidence of leakage,etc.) Pumping n_ of required at this time Outlet tee crumbling but structurally sound Liquid level at outlet invert Tank appears structurally sound with no evidence of significant leakage in or out. GREASE TRAP: none (locate on site plan) Depth below grade:_ Material of construction: concrete metal FRP 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: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,evidence of leakage,etc.) I I I� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) (Property Address: 194 Whistleberry Drive,Marstons Mills Owner: Alan Aronow Date of Inspection: July 14, 1996 TIGHT OR HOLDING TANK: none (locate on site plan) Depth below grade:_ Material of construction: concrete metal FRP Other(explain) Dimensions: Capacity: . gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX (locate on site plan) Depth of liquid level above outlet invert At outlet invert Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) Few gdttly solids in D-box D-box appears structurally sound with no evidence of significant leakage in or out PUMP CHAMBER:none (locate on site plan) Pumps in working order, (yes or no) Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) I ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 194 Whistieberry Drive,Marstons Mills Owner: Alan Aronow Date of Inspection: July 14, 1996 SOIL ABSORPTION SYSTEM (SAS):_X (locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods). If not determined to be present,explain: Type: leaching pits,number: one leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) Medium sand indicated on soil test log No signs of hydraulic failure Pit contained 37'of effluent.No significant difference in surrounding vegetation CESSPOOLS:none (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(cesspool must be pumped as part of inspection) 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.) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 194 Whistieberry Drive,Marstons Mills Owner: Alan Aronow Date of Inspection: July 14, 1996 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references,landmarks,or benchmarks. locate all wells within 100' I 4D-BOX PIT EPTIC TANK B LOCATIONS SYM A B 1 14.5' 30' 2 17.5' 33' 3 27.5' 42' WHISTLEBERRY DRIVE 4 24' 49' DEPTH TO GROUNDWATER Depth to groundwater: 20+ feet method of determination or approximation: Comparison of USGS Topography maps and groundwater elevation data. Realth Complaints 25-Mar-02 Time: Date: Complaint Number: 3330 Referred To: DAVID STANTON Taken By: DAVID STANTON Complaint Type: TITLE V SEWAGE Article X Detail: Business Name: Number: 194 Street: WHISTLEBERRY Village: MARSTONS MILLS Assessors Map Parcel: Complaint Description: CONCERNED SYSTEM WAS INSTALLED WRONG. THINKS.A 4'.PIT WAS INSTALLED, INSTEAD OF A 6' DEEP PIT. Actions Taken/Results: MET WITH HOMEOWNER, REAL ESTATE AGENT,AND BORTOLOTTI (MIKE, THE PUMPER) MIKE OPENED.THE PIT UP, AND STUCK HIS SPOON DOWN INTO THE PIT. THE SPOON HIT SEDIMENT JUST OVER 4' DOWN. I CHECKED WITH MIKE, AND IT COULD JUST BE FROM SOLIDS THAT HAVE PASSED THROUGH THE SYSTEM, THE SYSTEM WAS INSTALLED IN 1985, AND COULD ALLOW FOR THE ACCUMULATION OF SOLIDS. THE SEWAGE WAS AT THE LEVEL OF THE OUTLET,AND WAS IN FAILURE. EVEN IF IT WERE ONLY 4'.TO THE BOTTOM OF THE PIT, IT WOULD STILL BE SUFFICIENT FOR THE DESIGN FLOW MINIMUM OF 330 GAL/DAY. A 6' PIT WOULD BE AN OVER DESIGN FOR THE 3 BEDROOM HOUSE. Investigation Date: 3/22/2002 Investigation Time: 3:00:00 PM 1 s LMtAT10N 9Y SEWAGE PERMIT NO. YlLLAGE ! INST 'AYL'LER'S 4 NAME a ADDRESS 1 U I L. D E R OR OWNER a ZDATE PERMIT ISSUED DATE COMPLIANCE ISSUED -2-3 - . > � s �a � �� y . a 1 (�, �.. o i� �+ �1 i �� i No...�� ..�.��- � o r • Fps......Ste._©......... THE COMMONWEALTH OF MASSACHUSETTS BOAR® 9F HEALTH ......-� 4w. . L---_.....OF......... 1t S:77 .� ............................. Appliration for Dispaas al 18orkii Tons rurtinn 1hrmit Application is hereby made for a Permit to Construct (vv\) or Repair ( ) an Individual Sewage Disposal System at: •...............__ltJll�i z� .t'.. :------------------•---•--•-- .................................--------------------------------- ............................................. Location-Address i or Lot No. - _ ..._+ fiQ .o n c' I-��..c.�lh' -celoa -••---..._ caner e /J Address a ----•- P .............. .......---...-•----•--•-•-----.............._..__. Installer Address Type of Building Size Lot____.t3,_90_e__....Sq. feet U Dwelling—No. of Bedrooms___..._..____________................Expansion Attic ( ) Garbage Grinder ( ) 'k Other—T e of Building No, of persons____________________________ Showers — Cafeteria Q' Other fixtures ___________________________________ W Design Flow............� .......................gallons per person peer day. Total da- flow.._.._.___.� ...........................gallons. WSeptic Tank—Liquid capacity_1QTV_gallons Length---`9..._------- Width----- Diameter________________ Depth... ......... x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq.-ft. t Seepage Pit No.......I............ Diameter....1®?S__...... Depth below inlet....... Total leaching area__5jR.!..sq--*�.Pp Z Other Distribution box (K) Dosing tank ( . ) 0-4 Percolation Test Results Performed by..... ...`..._ �Z �_.__�d1('�_............ Date......�4_' �_'__8 __._ 1.4 Test Pit No. 1___�___minutes per inch Depth of Test Pit..../yY....... Depth to ground water____A.O______Lx f=, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..' Q+' ---------- ODescription 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 TIli LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed-----•--•- ...�.1. 4C4.� 3—Z Z-9'5- .......................... Date Application Approved By-------- --•• -----•--- .............. Date Application Disapproved for th following reasons---------------------------------•---•---------------------......................................... -•------------•- --....--•-••--•-•-------••--•••-----__ -------------- Date Permit No-------- ----- --------------..__... Issued....... Date ------------------------------------- - - - -- J ---- --- ------- -------- -- --------- N6. .... Fimic .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............10f.o.A...............OF........ .................................. . ...... .... ..... ...... ........................ Works Tonstrurtion "rrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ............................................... ....................................... --- ............................. Location-Address or Lot No ----------7------------------ .......... .•............. ,7 60�w n er 4r Address 2.,C_ .................... ................. ..... .......................e.... ....... .................. 7........ ...................................................... Installer Address Z.- � to � z.r�.1...........Sq. feet Type of Building Size Lot.....L U Dwelling—No. of Bedrooms.........AO�...............................Expansion Attic Garbage Grinder 4 P4 Other—Type of Building ............................ No. of persons....._.__................... Showers Cafeteria Otherfixtures ..................................................................................................................................................... Design Flow.............. _-___..___.._._._________gallons per person per day. Total daily flow..........J...............................gallons. d 1:4 Septic Tank—Liquid capacity.'.--" ....gallons Length................ Width._........_.___. Diameter..._._....______ Depth._..._......._.. W Disposal Trench—No. ................... Width.............__...._ Total Length..........-_........ Total leaching area....................sq. ft. Seepage Pit No._ ___ -------------- Diameter._.L_-A........ Depth below inlet...... ............ Total leaching area.__:. _ Z Other Distribution box (( ) Dosing tank ( Percolation Test Results Performed by.... ..... ........................................................ Date...../.......:-A L .......... 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. .......rN/I . ........... ............................................................................................................................................................ 0 Description of Soil............ .......... ........................................................................................................................ /................ U .......................................................................................m................................................................................................................ ....................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable....................................Z............................................................ ....................................................................................................................................................................................................... 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 has been issued by the board of health. e. 04444�� 3- Signed.. ... ...................................................... ------------------------ --- --------"----------- Date woe* - ----- --------- .......... ............................... Application Approved By....... Date Application Disapproved for t following reasons:...............V pp ---------------------------------------------------------------------------------------------- ........................................................................................................................................................................................................ Date ---Qm� ....................... ... . ............ Permit ilo._ ss . .................. Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ..........................................OF..................................................................................... THIS IS T,01 CERTIFY, That the Individual ear Systen; co-n-struc e r I .,? Repaired t d < on 0 bp �n tall ..... ..... ..ka&t?........Al-l-)ZSAleier . .......................................... isions of TITLE 5 of The State Sanitary Cod -as de ribed in the has been instilled'in accordance with the.',prov, I applicationte for Disposal Works Construction Permit�dno.. .2��—).4------------ _d.... _1..... ...16---------- , THE ISSUANP OF TPIS CERTIFICATE SHALL NOTBE C NSTRUED A 4A I T THAT THE SYSTEM WILL PlCT10SATISFACTORY. DATE............... ... .... .............................. Inspector..... 7' .... . .......................... It THE COMMONWEALTH OF MASSACHUSETTS BOARD OFY HEALTH ................................._&............. .. .. .....OF.......... ....................................... NO.. ?. EE _5 te ......... .......... -I Disposal fAll-r— Works 00Mnstrurtion frrm Permission is hereby grant ed........ .......... ................... to Construct or\Repair an Individua Sewag Disposal System atNo................... ........... Ae.--- tree as shown on the application,for Disposal Works.Construction Permit, No5:7&-M_ Dated... .. ................... .............................. ......rT----------7--------------- ........... and e DATE----- ........................................ FORM 1255 A. M. SULKIN, INC.. BOSTON AF E LIC:A`1'IUt. F JF rL!-,LjL.Ai IjU, s L.i t At::i utiSL WATION Pii'S 0CATI0N L.o•T 8 10 H i_5 Tl-,S oeLC " -DP NO. 72 ✓ ILLAGE /"l iq o25Ta�� /mot e L LS DATE PPLICAN FEE DDRESS TELEPHONE NO. (Non-refundable .NGINEER C-aw TELEPHONE .NO3rZ C �� )ATE SCHEDULEDOG T' 01 (Ap icant' s signatu ) : : . : . :. e o . . a . . e e e e . . . : . . . . e e • e . . : . . . . . . . . . : . . . a . : . . : . . . . . . . . . :. : . . . . . : . . . . . . . SOIL LOG UB-DIVISION NAME w/-fi57ZE$�iE'.� Y` DATE TIME !d 3 a XPANSION AREA: YES .X NO _ LD�.J LJEL[r L-'7e /Nc-ENGINEER OWN WATER�_PRIVATE WELL R, 6 ,2D BOARD OF HEALT r_1 O'LO U G1_fL/A lAic- EXCAVATOR KETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) NOTES: 4< Yv_ Go, o 0 ERCOLATION RATE: C Z EST HOLE NO: ELEVATION: TEST HOLE NO ELEVATION.: 1 Go4 r► 1 2 - >. 3 3 4 5vg50lL - 4 ` 5 5 6 6 MeD . 7 7 8 8 9 9 10 .5AtiJb 10 j 11 12 12 1 13 13 14 ,v o ttZo 14 15 -15 F '16 16 UITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS LEACHING TRENCHES . NSUITABLE FOR SUB-SURFACE SEWAGE. REASONS! OTE : ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TE PLICATION RIGINAL: COMPLETED IN ENTIRETY BY P . E . AND RETURNED TO BOARD OF HEALTH COPY: RETAINED BY APPLICANT ! 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GRADE (NOT TO SCALE) ACCESS COVER (WATERTIGHT) TO ENGINEER: LOW AND WELLER WITHIN 6' OF FIN. GRADE MINIMUM .75 OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 51 p� WITNESS: R. GIFFORD �R e 2' DOUBLE WASHED PEASTONC� DATE: 10/31/84 RUN PIPE LEVEL I Q° EXISTING FOR FIRST 2' 3' MAX. PERC. RATE _ < 2 MIN/INCH ON SEPTIC * 48.0' I 3799 CLASS SOILS P# <H- 10o0 47.50'E-US BAFFLE 47 7 o 13 0 o ram" 0 C, o 47.174 O C1 C.D m C� CI � ,C C7 6' CRUSHED STONE OR MECHANICAL © [] [] (_ [] (_1 ,C 0 ELEV. COMPACTION. U5.221 E23) © ED 0,C 0� Q 52.o't 2 G7 CJ C] Q 45.17' 10C1S"' DEPTH OF FLOW = 4 ( M� SLOPE) (IN SIN % SLOPE) LOAM TEE SIZES 3/4' TO 1 1/2' DOUBLE WASHE ) S- ONE & INLET DEPTH 10' PROVIDE TEE IN D'BOX IF PIPING FROM SEPTIC TANK TO SUBSOIL OUTLET DEPTH = 14 D'BOX IS GREATER THAN 8% 4$„ 48,0' LOCATION MAP NOT TO SCALE SLOPE LEV.'HING FOUNDATION--- EXIST. SEPTIC TANK 21' D' BOX 16' -FACILITY- ASSESSORS MAP 63 PARCEL 87 L 5.17' * UNKNOWN INVERT OUT, CONTRACTOR TO CONFIRM MED SAND INVERT PRIOR TO INSTALLATION- OF k:°JY PORTION OF j. SEPTIC SYSTEM AND PROVIDE GRAVIT FLOW TO f D'BOX. IF UNABLE, CONTACT ENGINEE.-Z. Y 4 0.0' BENCH MARK - HYDRANT, ON TAG ' BOLT #1339. EL. 52.0' 't y 2.0 144" 40.0' \ Y CONTRACTOR TO CONFIRM SUITABE SOILS AND NO INO WATER ENCOUNTERED \ TEST HOLE LOT 8 WATER IN AREA,OF SAS, FOR 5' E:ENEATH SAS, PRIOR APPROX. LOCATION OF TO INSTALLATION OF ANY PORTION OF SYSTEM. N a ORRIGINAL. � \ 13� \ 43,907f SO. FT. NOT ALLOWED I. DATUM IS ASSUMED \ 1.01t ACRES `` SEPTIC _DESIGN: (GARBAGE DISPOSER IS > 3 110 330 2. MUNICIPAL WATER I, EXISTING \ 52 2 DESIGN FLOW: BEDROOMS ( _GPD) - GPD USE A 330 GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1/8 PER F'DOT, d� \ � 7 6 81�+ 6_1,7 + 61.8 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10 .. SEPTIC TANK: 330 GPD ( 2 > = 660 5. PIPE JOINTS TO BE MADE WATERTIGHT. 50.90' -60 5�1 2.3 3 528 5 59 60 9 USE A 1000 GALLON SEPTIC TANK (EXIST) 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. \ 8 8 LEACHING: ENVIRONMENTAL CODE TITLE V. 6 'd STONE pR1VE g3'1 57 AC 7 THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE \ 8 55 g SIDES: 2(30 + 9.83) 2 (.74) = 11'8 USED FOR LOT LINE STAKING. 5 � \ DWELL DECK 4 �a.7 BOTTOM: 30 x 9.83 (.74) - 218 S. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4' PVC. \ 50.7 5 '" 53 4 _' 9. COMPONENTS NOT TO BE BACK'FILLED OR CONCEALED WITHOUT TF 53.8' + 52 7 52 �_ _53 g TOTAL: 454 S.F. 336 GPD INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED 50.6 1. + 2 USE (2) 500 GAL. LEACHING CHAMBERS (ACME OR FROM BOARD OF HEALTH, \ W+�'� --�i EQUAL) WITH 2.5' AT SIDES, 4' AT ENDS, AND 5' 10. PUMP & REMOVE (OR FILL W/CLEAN SAND) EXISTING LEACH PIT 1 3a yo 0 BETWEEN UNITS - -> 9 50.2 \O (�3` 5 8 00 - - LEGEND 1 0. 0. g 5 + .1 TI TL E 5 SITE PLAN 1 + 50.6 V 5 I00.0 PROPOSED SPOT ELEVATION OF + 44.2 194 WHISTLEBERRY DRIVE 1 �1 + 48.7 100x0 EXISTING SPOT ELEVATION IN THE TOWN OF; 48.9 100 PROPOSED CONTOUR ( MARSTONS MILLS) BARNSTABLE 46.0 100 EXISTING CONTOUR A PREPARED FOR: BORTOLOTTI w _ A CONSTRUCTIONBUGEL S + 49.5 2 .910 h 30 0 30 60 90 # 47,61 BOARD OF HEALTH *WATERLINE PRESUMED TO ENTER FRONT OF DWELLING. ` - CONFIRM VIA MARKOUT PRIOR TO EXCAVATION _ M APPROVED DATE MA SCALE: 1>' = 30' DATE: APRIL 22, 2002 w + 45.6 DIRT DRIVE + 45.2 + 45.6 off � 362-4541 down cape engineering, Inc. � RNE H. �c� �`� ARNE o OJALA E sp CIVIL CIVIL ENGINEERS 0.30792 "a'.. / 348 Z�"• ! {` (;!LAND SURVEYORS ��- �R�� , �`' ''-E z.��: • SSA` 'Ai. L�,G � t I.RtSC�� 5 939 male st, yarmouth, ma 02675 _ _ A n r r. _ , _ _.__ ._ .�._. - _� _.• 02-- 101 __ - � tr nr.� r � I