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Home My WebLink About0125 WOODSIDE ROAD - Health 125 Woodside Road Marstons Mills A 127.'r027,., ////UPC �cruso H No. H1163Y HASTINGS, MN �f ��?r�r� �—�v� _ �e,�-�� ;� ��r r: Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .'' 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is Marstons Mills Ma 02648 8/13/12 required for every page. Cityrrown 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 X General Information forms on the (- computer,use E/ 1. Inspector: only the tab key to move your Scott Campbell cursor-do not Name of Inspector use the return key. Cardinal Construction Company Name 32 Rid eto Rd: Company Address Cotuit Ma 02635 Citylrown State .=. R Zip Code 508420-1295 S1388 t.a Telephone Number License Number 'B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 16.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails WNeed Further Eva tion by the Local Approving Authority 8/13/12 ig Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the approp-iate regional'office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. ` t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 17 } Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 125 Woodside Rd. Property Address David Brito Owner Owners Name information is required for Marstons Mills Ma 02648 8/13/12 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B-) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank.is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 %,po 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills Ma 02648 8/13/12 every page. CityrFown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed.pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR' 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills Ma 02648 8/13/12 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: . ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or'No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged.SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills Ma 02648 8/13/12 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged.or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 16,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills Ma 02648 8/13/12 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the�ystem 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? ❑ II) ❑ Were as built plans of the system obtained and examined? (If they were not IVl available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ❑ ® Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided'with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x.#of bedrooms): 440 l5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills Ma 02648 8/13/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: between january 2012 to june 2012 gallons used 31,000 Sump pump? ❑ Yes ® No Last date of occupancy: Newe Home2012 Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based,on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-1 Ill 0 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills Ma 02648 8/13/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Home owner David Brito Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Site glass in pump truck Reason for pumping: Maintenance Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments :y 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required'for Marstons Mills Ma 02648 8/13/12 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Compliance date 9/3/02 sewage permit#2002-376 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑cast iron ❑40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): ' Depth below grade: 1 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: Sludge depth: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills Ma 02648 8/13/12 every page. Cityrrown State Zip Code Date of Inspection D.'System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 31 Scum thickness 0 Distance from top of scum to top of outlet tee or baffle n/a Distance from bottom of scum to bottom of outlet tee or.baffle n/a How were dimensions determined? sludge stick, tape measure Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Homeowner directed to pump system every two to three years. Inlet and outlet tees in place at time of inspection. Tank at proper working height at time of inspection. No evidence of leakage into or out of tank at time of inspection. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills Ma 02648 8/13/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,- liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title- 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills Ma 02648 8/13/12 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Box is set level. No evidence of solids carryover. Single line out of box. No evidence of solids carryover, no evidence of leakage into or out of box. 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.): Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: 6 infiltrators. 10'+41'+2' t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills Ma 02648 8/13/12 every page. Cityrrown State Zip Code_ Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 6 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Dry soil, no signs of hydraulic failure. No ponding or damp soil. Normal vegetation. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills Ma 02648 8/13/12 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•11110 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is Marstons Mills Ma 02648 8/13/12 required for . every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately ` o � ti o � 1 e t5ms•11110 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ya< 125 Woodside Rd. Property Address David Brito Owner Owner's Name informations required for Marstons Mills Ma 02648 8/13/12 every page. Cityrrown state Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 12+feetfeet 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: Excavation at time of inspection. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5� °y� 125 Woodside Rd. Property Address David Brito Owner Owner's Name information is required for Marstons Mills . Ma 02648 8/13/12 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 `- COMMONWEALTH OF MASSACHUSETTS = EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION t y� TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM. PART A /4 '/— CERTIFICATION Property Address: Owner's Name: DJ ' / Owner's Address: b o q"f��pf �/� ya"fa Ar�t9 / vs yh Date of Inspection: Name of Inspector: (please print) ,E,o C ee Company Name: Mailing Address: Fp a.sf' n e n n Ls Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported R' below is true,accurate and complete as of the time of the inspection.The inspection was performed b Ssed on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP- approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 i Page 2 of 11 OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL`SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: /a s 92)eg Owner: KfN--wilff Date of Inspection: i p Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have-not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments- B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following ements.If"not determined"please explain. The septic tank is metal and over 20 years old*or the se c tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as proved by the Board of Health. *A metal septic tank will pass inspection if it is struc lly sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is a Table. ND explain: Observation of sewage backup o reak out-or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, ttled or uneven distribution box. System will pass inspection if(with. approval of Board of Health): broken pipes)artxeplaced obstruction is removed distribution box is leveled or replaced ND explain: The syste required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection f(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 1 1 OFFICIAL INSPEC L ION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: /a,f _ Q Owner: p ,� Date of inspection: It 016 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. I. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(l)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water — Cesspool or privy is witin 50 feet of a bordering vegetated w and or a salt marsh 2. System will fail unless the Board of Health(and ublic Water Supplier,if any)determines that the system :s functioning in a manner that protects t public health,safety and environment: _ The system has a septic tank and soil a orption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surf a water supply. _ The system has aseptic tank and AS and the SAS is within a Zone I of a public water supply. — The system has a septic tank nd SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic t and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well" ,.ethod used to determine distance "This system passes if e we:l water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile o ganic compounds indicates that the well is free from pollution from that facility and the presence of am nia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are iggered.A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of l l OFFICIAL INSPECTION FOR NOT-FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DiSPOSAL.SYSTEM INSPECTION FORM PART:A, f CERTIFICATION(continued) Property Address: /AS V4V6.1 was a�H Owner: Date ,,� Date of Inspection: �W#&. D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool -1r_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6"below invert or available volume is less than'/2 day flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped _jj 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. q' Any portion of a cesspool or privy is within a Zone i of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ q! 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 colifc�rm bacteria and volatile organic_compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is-equal,to or less than 5 ppm;provided that no other:.failure criteria are triggered.A copy of the analysis must be attached to.this form.] (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system most serve a facili gpd• tyWAhlldesign now of 10,000 gpd to 15,000 You must indicate either"yes"or"no"to each of the fo g: (The following criteria apply to large systems in ad ' on to the criteria above) yes no — _ the system is within 400 feet a surface drinking water supply — — the system is within 20 eet of a tributary to a surface drinking water supply — the system is loc d in a nitrogen sensitive area(Interim Wellhead Protection Area IWPA)or a mapped Zone II of a p is water supply well If you have answere yes"to any question in Section E the system is considered a significant threat,or answered "Yes"in Section D ove the large system has failed.The owner or operator of any large system considered a significant threat der Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The syst owner should contact the appropriate regional office of the Department. Page 5 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKI:,IST Property Address: t d SS A)C>CJ,SIO6 Owner: C0tM+,tL_ Date of Inspection: fj p e Check if the following have been done.You must indicate`yes"or"no"as to each of the following: Yes No — Pumping information was provided by the owner,occupant,or Board of Health b Were any of the system components pumped out in the previous two weeks? . -.gL _ Has the system received normal flows in the previous two week period? Ar 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? t _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition o &baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge and depth of scum? �� maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no — Existing information.For example,a plan at the Board of Health. _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] I Page 6 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: L140 r Date of Inspection: 6/l'Idg RESIDENTIAL FLOW CONDITIONS Number of bedrooms(design): j Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x# of bedrooms): 3.6 Number of current residents: 8 Does residence have a garbage grinder(yes or no): Na Is laundry on a separate sewage system(yes or no): /✓vf if yes separate inspection required] Laundry system inspected(yes or no). /47 Seasonal use: (yes or no): &V Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no):VO Last date of occupancy: 06 COMMERCIALIINDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sqft ): Grease trap present(yes or no): Industrial waste holding tank pr nt(yes or no):— Non-sanitary waste discharg to the Title 5 system(yes or no):— Water meter readings,if ilable: Last date of occupanc se: OTHER(descri ): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): Na If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system Single cesspool _Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank —Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): /jD 6 Page 7 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: c, 17pc Owner: Date of Inspection: BUILDING SEWER(locate on site plan) , Depth below grade: *20 `, Materials of construction:_cast iron 0(40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: Y (locate on site plan) Depth below grade: 6 Material of construction: Jr concrete metal fiberglass_polyethylene —other(explain) — —' If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no): certificate) _(attach a copy of Dimensions: t a pp 4 Sludge depth: ,?•' Distance from top of sludge to bottom of outlet tee or baffle: _ Scum thickness: Distance from top of scum to top of outlet tee or baffle: 7" Distance from bottom of scum to bottom of outlet tee or baffle: " How were dimensions m determined: Comments(on pumping recommendations,—4'64tnlet and outlet tee or baffle condition,structural integrity, liquid levels as related t outlet invert,evidence of leak tee,etcQdt .) �K• � f w, � >< -.,� a u � le D-k& 5 - if GREASE TRAP:____(locate on site plan) Depth below grade:_ Material of construction:_concrete metal fiberglass__polyethylene other (explain): — — — Dimensions: Scum thickness: Distance from top of sc to top of outlet tee or baffle: Distance from bottom f scum to bottom of outlet tee or baffle: Date of last pumpi Comments(on p ping recommendations inlet and outlet tee or baffle condition,structural integrity, li uid levels as related to ou et invert,evidence of leakage, etc.): q 7 Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYST EM,INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 04 �� •� RrN Owner: 0 e� Date of Inspection:_ &(t c oL TIGHT or HOLDING TANK: (tank must be purr at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete fiberglass_polyethylene other(explain): Dimensions: Capacity: ons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Al in working order(yes or no): Date of last pumping: Comments(condition o alarm and float switches,etc.): DISTRIBUTION BOX: 1K (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 6164 Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no) Alarms in working order(yes or no): Comments(note condition of pump amber,condition of pumps and appurtenances,etc.): R Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: / el Owner �V�q,TN,, t dIe Date of Inspection:L— I t L10 6 SOIL ABSORPTION SYSTEM(SAS): d (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number:_ leaching chambers,number: pc_leaching galleries,number: leaching trenches,number, length: leaching fields,number, dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): / n Q � Y�C��d�.vw st/d✓�riD.rX 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 laver: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater i ow(yes or no). Comments(note conditi of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note conditio of soil,signs of hydraulic failure, level of ponding,condition of vegetation, etc.): 9 I , Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: West ae 4s-� Owner: Ce�u'Ety fd..�� Date of Inspection: eIj j i jj1 _ 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. Pea V, r m Page I 1 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: J— ; J �j /r, Owner: Date of Inspection: SITE EXAM Slope ves. Surface water" Check cellar No C,dictr Shallow wells IVp Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators;installers-(attach documentation) Accessed USGS database-explain You must describe how you established the high ground water elevation: Il TOWN OF BARNSTABLE LOCATION /;Z d- ujoodlSlele VR. SEWAGE #100 2- 37vl VI.LAGS`iM i9ee STDA.S 441Z-1 S ASSESSOR'S MAP & LOT �68� � INSTALLER'S NAME& PHONE NO. J A Ad A C- -0 /0 9 CAA SEPTIC TANK CAPACITY Z, D/l O O L D LEACHING FACILITY: (type) 4/,.- /A/FJL IX 4rc f 9 (size) /O y/NO. OF BEDROOMS y BUILDER OR OWNS PERMITDATE: z— COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by ----------------- Co r4GVeAIT i No. �/`" y� y Fee$50. 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pphration for Migoml *pftem Congtruction Permit Application for a Permit to Construct( )RepaitXXX Upgrade( )Abandon( ) El Complete System ❑Individual Components Location Address or Lot Not 2 5 Woods i de Road Owner's Name,Address and Tel.No.Kaar to Manni Nlarstq S M' lls,Mass. 02648 125 Woodside Road ssessors ap/Parce lam Marstons Mllls,Mass. 02648 Installer's Name,Address,and Tel.No.5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. J.P.Macomber & Son Inc. 4.P.L.S. ne H. Ojala Box 66 Centerville,Mass. 02632 Type of Building: Dwellin&X No.of Bedrooms 4 Lot Size sq.ft. Garbage GrindeoO ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 443 gallons per day. Calculated daily flow4 X 1 1 0=4 4 0 gallons. Plan Date 8.12 0_.1 Q 2 Number of sheets Revision Date Title Size of Septic Tank E.x J S t i n Q 10 0 0 Type of S.A.S. 1 _f,D_1 8 n n Description of Soil 0"-4"= A layer, 4"-27"=b—Layer 27"-1 20"=c- T,ayPr fine medium sand, Nature of Repairs or Alterations(Answer when applicable)Add i ng 6 H 2 0 High c a an c i t y infiltrators. 3. 5 ' of 1 '-z" stone on sides and 1 . 5 ' on ends and 14" under. 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 is ed by thy Bftd Health._ Signe , Date 8/2 8/0 2 Application Approved by S Date 2 Application DisapprovedForthe following reasons Permit No. Date Issued 2� 11t «• Fce$50.00 ..� t, THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:, ► _ R 1� , . Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS Application for Mizpoml &p.5tem Conztruction Permit Application fora Permit to Construct( )Repait)(X)e)Upgrade.( )Abandon( ) O Complete System ❑Individual Components "Location Address or Lot Not 2 5 Woodside Road Owner's Name,Address and Tel.NO.Kaarlo, Manni M�arstaris M 11s,Mass,02648 _ _ 125 Woodside Road `� ssessors ap/Parce Marstons IllS,Mass.026�48 t -� Installer's Name,Address,and Tel.No. Designer's Name, ddress and Tel:No. 508-775-3338 , J.P.Macomber & Son Inc` Arne / ;0jala t Box 66 Centerville,Mass.02632 .E.P(y •S• Type of Building: DwellingtX .No.of Bedrooms 4 Lot Size sq.ft. Garbage Grindert(0 ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures " Design Flow 4 4 3 gallons per day. Calculated daily flows 11 A=4 4 4 gallons. Plan Date $/2 n/n a Number of sheets € ' Revision Date _-. Title Size of Septic Tank Exj_stf.nq 1 nnn Type of S.A.S. 1!T:u— �(�A Description of Soil 0"-411= A layer, 4"-27"=b-haver 2711-120"=c Laver f' ne j medium sand, v i Nature of Repairs-or,4:4 r6tions�Answer when applicable). ddina 6H2O High capacity � infiltrators.3.5' of 1�1' stone on ,sides and 1 .5' on ends and 14 under. Y Date last inspected- ' t Agreement: R 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 iss ed by th "Bgrd Health. Signe Date 8/2 8/0 2 Application Approved by t ) } ` S Date�S V Application Disapproved for the following reasons e N" Permit No. ' ALP l '` Date Issued R- 2 1 LU? v` THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,,MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired�X )Upgraded( ) ;J Abandoned( )by J.,P_Macomber & Son Tnc. at 125 Woodside Road Marstons Mills Mass.. . has been construete-d.i�/�accordauce `wills the,ppvisions of Title 5 and the for Disposal System Construction Permit No?2 C�-3�dated F</2 g �U7 Insfaller` J.P.Macomber & Son Tnc_ DesignerArene H. Ojala 9.E. P.L.S. The issuance of rermit tall not be construed as a guarantee that the systemm will fulictiop as de�ig�ned. Date t`^S �c`�-- Inspe--------------------------------------- ctor ""7� R Jc ►c �. `.1•�1 �� 1 No. >� - � Fee $5 0.0 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS lwiopooar 6potem Construction Permit Permission is hereby granted to Construct( )Repair KX)Upgrade( )Abandon( ) SviernJocatedat 125 Woodside Road Marstons Mills.Mass. ' 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 ompleted within three years of tltiie date of t`h�iss ermit. Date:t' h' (, 2 A rov b 4 I' a i TOWN OF BARNSTABLE LOCATION ulOddS/eZe o0k SEWAGE #10D" - 76 VILLAGE ASSESSOR'S MAP & LOT 'INSTALLER'S NAME&P,HONE NO. 4.4 A C O VI 8 P-A 9 r !/ SEPTIC TANK CAPACITY 0,0 0 o L y LEACHING FACILITY: (type) /1/�lL �R�4ToR'S (size) �O NO.OF BEDROOMS y BUILDER OR OW;12� PERMITDATE: o� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r — — — 2 a 10 � b 4 1-5 i P 3 1 LOCATION SEWAGE PERMIT NO. /,:;t5 (.t> .6 rcle u 6 VILLAGE INSTA LLER'S NAME i ADDRESS BUILDER OR OWKtM DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 10•-9_Fl x0 i 10007A J —7(;4Ln �ol� ONO3 002 3 � US 12 12 qV 2957 2957 I 6 m O i2957 2957 LEFT SIDE ELEVATION W O ' SCALE: I/4" I'-O" 3 = co d --------------- 03 El 01 lill R W UU Z W FFFR ® ® _1 ® W3 Z o � � O 29291{ T Q w� 2957 2957 �p 2957 lC- 2941 2941 ,�0 O W w Cl � FRONT ELEVATION SCALE: 1/4" - I'-0" - Q 2957 pp LO SHEET JOB: BRITO DRAWN BY: KN ` LLn ' 6i_pu 12i_e° 20'-I0n q_e" 9'_6" 3,_4e B,_Oa m m r n N % J11 •g aid _ 000 o 4 C ET Mlr-�l WINDOW EAT LOS LAUNDRY q 2957 TILE J 3co I i KITCHEN 15' q 1/4" '�' m N p I O 2q 3/4"z57 3/4" I5'-7 I/2" OAK '24'-7 I/4" 1 1 o z O I- (2)2g57 WI O � PANTRY° DINING ROOM o o Mo'la " LIVING 6 RO 29 3/4'x57 3/4° 2 m OAK OAK LIL II Oco � STEP 6 I I � 1JJ I I PECK r h„� 1(1 'o oA 7202 OX 7282 XO CASED L � RO 72"z52° RO 72"xe2° - ` � �- —� ____ _CASED_ RO 292354°x57 3/4" t.--- -,p OPENING 1 --� - S - OPENING 3682 L FOYER RO 36 34"k52" OAK `9 v g 2-GAR GARAGE ---- -- 2& - - - — 3' b p STEEL BEAM ABOVE _ 4-1 3/4" 5'-II /� .• DN. x' _ _____— a B H _ CLOSET . ,� r a TILE � � , COURT YARDL yQ .= PLANTINGS EXTERIOR STONE PLAN ING5 O 2957 �__ ______ � �__________________ i �•v,. ' - - _ �- • - - 9 I. I I I N WALK-1N COO L.-]- 9 e RO 29 3/4°x57 3/4" I i .q I I 2 CLOSET �2 _ I I _ RR .F LINE ABOVE ice\ 22 24 I L _ �_ -1.. T t;+ :,.� (2)2957 0 BEDROOM #k2 1 -'COVERED ENTRY o T_'.S TER BEDROOM OAK 'm -ZrE�TERIOR STONES _ O F r a y RO 29 3/4°x57 3/4" - Q _ I 9'z 7'OVERHEAD DOOR I,_,I 9'x 7'OVERHEAD DOOR I �"_�_.- r y OAK _ 1 v - L� �-CJ 12'-3 1/4' 15'-8 3/4° - T- f S L C`L "'1 L._�_ k° nLe MASTER 9 -r = r =rT . i z. 5AL n, 7r42 L1 1 - ® TILE 4 4 i o 'I �� :a crr,,i. ae, azna+lxre �'tru• � LL o SEAT LI N STEP I `0 CLOSEF ' zQ 1 m I m m DN m m v w _l L x 4r, x P Q Z 3 �- K K K IX 2,_6n q,_O" '_O 9'-O" 2,_6" 7-0° T-0" 3'-q° 6'-3" 5'-Ou B'-Bu 13'-2" vOa LU LL 24'_0" 1k-O° 20,_0" 2B'-0111 n J m 1,1 I W 1772 50 FT _ (p p LL FIRST FLOOR PLAN SCALE: 114" 1'-0" O LD l � , SHFF.T JOB: BRITO DRAWN BY: KW DATE: 6/10/11 L cli . O 12'-0° W q'_o" J ° LANDSCAPE x U W RETAINING n WALLS AS W 1 NEEDED N m f— 24 0 \ _ 3'-0" TV j �J (2)2957 U ("�� V RO 29 3/4°x57 3/4" UNFINISHED--_ O ' it - _ \CSEE FOUNDATION) � -O. - _ � 111nJJJLLL/ --I- Q BEDRm M # (2)2957 0 ---- -- ---- UP ( 5 R ET) _ RO 29 3/4°x57 3/4° OD p I"!i5 i (6) ql RO 29 3/4"x2"x29 3/4" m up _ - Lo co W L——— = W r 2957 BONUS WE A A E O�`� rTlO = � I r = RO 293/4"x673/4° ----_ —---- ----------_ t 3060 _ - 1r 1T co � iv L RO 29 2468 BED M #3 q m RP Q (2)2957 3'-0" BA H #3 (, - � RO 29 3/4°x57 3/4° _ Z r (TILE) b l!� S UTILITY a O a O w LL 355 SO FT i. v 2 68 2,-0 U (� �'3'� �- w BONUS FLOOR PLAN .:< ,r ..n;7 � : b Z 3 SCALE: 114" I'-O" LANDSCAPE Q IZ WALLSNEEDE I V AS :\ J O ,,^^ ♦ . / Q U O � O V/ J W lln� 306 Sq FT 10 V/ BASEMENT FLOOR PLAN (FINISHED ONLY 0 SCALE: 114" I'-O" O z ro . L(l SHEET A ,4 JOB: BRITO DRAWN BY: KW DATE: 6/10/I I cli B'-0° 51-0 LANDSCAPE A (� RETAINING WALLS AS W 1 NEEDED 8 x7 9 CONCRETE WALLS 16x20 CONTINUOUS FOOTING - —_---_ --- --- ——————— — a y� I = 0 l9 vD OP WALL I-- v--rPKT PKTI PKTI T 40° 1 v-F o B I I I N BELOW I ,s' FULL BASEMENT! UNFINISHED m ( I I O I 1 I O (V I r_7n ISi_Su 12'-10" T IOr_7" •\ 2xI0sICY I I _ ISM II t" I 2 10'a 2x10'a k F: C Q3p5 1JI ' STUD WALL ABOVE - zGIRDER 6x6 P.T. POST _ I (2I)/2q I/2°. Bx3'-9 CONCRETE WALLS 3 DIA STEEL COLUMN PK 0x1 CONTINUOUS FOOTING I GA V METAL POST HPI T WALL FLUSH WITH4° SLAB 12" 'BOTUBE° PIER W/36°x36'xl2°CONCRETE PAD 1 KT P 28^ uGF v PKTI CONCRETE WALLS I; I ——— _Ib`"x 2-0"------ 2 zIbI0"a 0x6 CONTINUOUS FOOTING °x7 O.CCONTINUOUS FOOTING14- II zO 3069 I is I I y,w I 2x10s WALK UT I I g o I I 2—GAR GARAGE I I I I FULL BASEMENT I I VAPOR RETARDER I I I I FINISHED I I o 14°CONCRETE SLAB PITC+1 TOWARDS DOOR — Id— N 5'x7'-q"CONCRETE WALLS 10x20"CONTINUOUS FOOTING I. I I I -+: L�,�COLLTtT—— — — q j NOTE: I " 5/6" ANCWOR BOLTS I I EMBEDDED 7" I I I COURTYARD ABOVE w o I I 1 {:I SPACED 32" O.G. I FULL BASEMENT BLUESTONE SET IN CONCRETE I 12" FROM CORNERS _ I I I I UNFINISHED I ONTOP OF COMPACTED FILL WASHERS 3"x3"xl/4" I I f I s I I 2x10's I I DROP DROPWALL , I6"O.C. NALL AT DOOR ———————— AT DOOR2x10'e I I 10"x0'-q"CONCRETE WALLS .1 I (2 0T w n� I6°O.C. 10�20'CONTINUOUS#5 BAR TOP d 13FOOTING ----------- —1 I 11 I I Q 14'_On I I I I Ln /n� ' `- __ 1�- a I I ? E®> ---- ---- tf� ------ ----- -�m� �_ ——— —— ————————J SII Q -'I ------------ '..✓r;' -.;:'�..K GALV. METAL POST A s �h t ars:.—_— —s_«.sw.zrs'..,i,. ————————————— 10" "SONO TUBE"'PIER / —— DROP W ALL _ Z w Z 25" °BIG FOOT" FOOTING TYP. �TO SLAB _ W LANDSCAPE FROST WALL O_ RETAINING BELOW 2x6 STUD'WALL ABOVE WALLS AS B"x3'-q"CONCRETE WALLS Z NEEDED 10"%1b"CONTINUOUS FOOTING ''^ SLOPE GRADE WALL FLUSH WITH 4'SLAB I- V/ Q Q .6 w ' O 24'-O° 1� O FOUNDATION PLAN SCALE: 1/4" - 0-0" '2 S"EET sl JOB: 1105 DRAWN BY: KW DATE: 6/10/II " X\l \X, 2-IN G\21 1v s 0 U n fi v 0 0 w 3 3 }p c c\ C I 0 b R � � N n o �9 o� III n -- o O� �o o _ n U a c n �g go 0 � o ro ry ro r N R 3� 3� u o 8° �n �9 I �n O� N lA S U n 0 v o � U ❑ D 3 \. U � 3 U C C �a I 3 I � � I 0 0 o � I � g I 0 00 I 00 I � ° I c� I � I I s I I � g I I Q a n � I o �f 3 I ®® I uo I I ---- - - - - - - - - - - - - - - - - - -- WMMM n - - - — - - - - - - - - - - - - � u� on 0n 0 o� o� N 0 0 U n 0 0 0 U 3 U Q 0 0 � � o 0 0 v 3 � 1t V� c 0 A CIO Va 11 S � r 0 � 4 am ❑ 0 t l 2 n 0 V Q O � V � 0 0 3 N U r N � n 3� 3U un° 8� n o a on o O� v� SYSTEM PROFILE TEST HOLE LOGS ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) f ACCESS COVER (WATERTIGHT) TO ENGINEER: AH OJALA, PE 4� i MINIMUM .75' OF COVER OVER PRECAST /� WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM DAVID STANTON 124.0 WITNESS. I EL. 127.3' RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE,,., MIN 18" COVER DATE: 8/13/02 I' - '`�--�j FOR FIRST 2' H-20 HIGH CAPACITY INFILTRATORS 122.0' PERC. RATE = < 2 MIN/INCH Locus ==A EXISTING 1000if I i GALLON SEPTIC 1 - CLASS I SOILS P# 10,299 0 121 .5' - 3.5 ® SIDES TANK (H- 1O ) GAS v, RF-USEBA FLE 121.67' 121 5' - 1.5' ® ENDS o cN 6" CRUSHED STONE OR MECHANICAL 2' �, `1`Y ELEV. COMPACTION. (15.221 [2]) $ �gg 14 08 o¢ 119.5' „ ' DEPTH OF FLOW 4', 6 A SLOPE) TEE SIZES: ( 3/4" TO 1 1/2" DOUBLE WASHED STONE LS INLET DEPTH 10" 4" 10YR 6/1 OUTLET DEPTH 14' B LOCATION MAP NTS 2' LEACHIIIC LS ASSESSORS MAP 127 PARCEL 27 FOUNDATION--- EXIST SEPTIC TANK 74' D' BOX FACILIT 5'3 10YR 6/6 , 27 121,9 114.2' PERC ® C I �0 AD SAND 1,a26 _ vpG1✓ of P A.+mr2',9 2.5Y 6/6 c 137.76 12 0 114.2 NO WATER ENCOUNTERED 1 .NOTES: 11 U 134. ~ SEPTIC DESIGN: (GARBAGE DISPOSER Is NOT ALLOWED ) 1 . DATUM IS APPROXIMATED FROM QUAD T 1, 3 34.41 - �.. \\� DESIGN FLOW: 4_ BEDROOMS ( 110 GPD) 440 GPD 2. MUNICIPAL WATER IS EXISTING q 440 GPD DESIGN FLOW 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. �. _, `r7` 440 GPD ( Z ) 880 ` . UC,.Ji Vlv �Vh1I,J11`i 1.7 f�Vii lJ �'V/. G4 i`ll�.'7fi Lh1,`I-iV:1 i uvi- L_`�h.i v .J 1(L TANK. 1000 T� - TO BE .AASHO H-20 USE A ____ GALLON SEPTIC TANK (RE-USE EXISTING) 5. PIPE JOINTS TO BE MADE WATERTIGHT. ' C�\ LEACHING: 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. ' 1311° +132.61 40 ( = 149 ENVIRONMENTAL CODE TITLE V. SIDES:' 2 .5 + 9.83) 2 (.74) 7, THIS PLAN IS FOR PROPOSED SEPTIC SYSTEM ONLY AND IS NOT ` 3,.9s N pS�pvNp 40 5 x 9.83 74 - 294 BOTTOM: ( TO BE USED FOR ANY OTHER PURPOSE. �� vN EXISTING 4 FT WIDE TOTAL: 599 S.F. 443 GPD 8. PIPE FOR SEPTIC SYSTEM TO SCH, 40-4" PVC. DWELLING STONE WALL USE 6 H-20 HIGH CAPACITY INFILTRATORS WITH 3.5' 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT \ \_ MANY FLOOR EVELS INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED 29.60 +22.7 STONE AT SIDES, 1.5' AT ENDS AND 14" UNDER FROM BOARD OF HEALTH. 0.00 1E7.50 +127s COTTAGE 10. PUMP & REMOVE (OR FILL W/CLEAN SAND) EXISTING LEACH PIT \ , o. +, 127.4 +1 7. 9 Na 126.83 \ �f.A � + 7.30 � �'uW3S 1 2.93 l 127.94 133.8a w LEGEND +127.32 y 24.12 � a LEG N D 27.35 r=J .17 +127. 122.99 123 3 129.,° , TITLE 5 SITE PLAN t "17 1 + '3+ 100.0 PROPOSED SPOT ELEVATION OF GRAVEL .61 311 +1 A H +123,77 +12 .27 125 W O 0 D S I D E ROAD DRI ARKING 12s,9, 10OX0 EXISTING SPOT ELEVATION TOP OF > 2h--I I SEPTIC N A9 1278 +1 429 123.64 °s. IN THE TOWN OF: ELEV 12 .3 1 00 18 �k PROPOSED CONTOUR ( MARSTONS MILLS) BARNSTABLE +1 42 S 12417 GRAVEL IVE/PARKIN +. TH •� \�+124 100 EXISTING CONTOUR \2 KAARLO MANNI BENCHMARK tiF 1 , , 12,.28 NIk PREPARED FOR: TOP BOULDER ' \ ELEVr127.78' 23.66 30 0 30 60 90 •\ ,9 124.68 +126.37 BOARD OF HEALTH 23. �-�' 1 ,83 ' _ MA SCALE: 1" = 30' DATE: AUGUST 14, 2002 NAIL IN 24" WHITE PIN APPROVED DATE 122. ELEV=127.8' r +121.4 off 508-362-4541 fox 508 362-9880 PROP. VENT (FINAL PLACEMENT IN \e4 CONSULTATION NTH HOMEOWNER) � v +124.75 /��1N QF �qs r. N;� Of MAJ., \ \ down cape engineering, inc. s�� RNEARNE H.� OJALACIVIL ENGINEERS CIVIL 3079 2634 �qe +121.°1 LAND SURVEYORS 939 main st. yarmouth, ma 02675 02-255 OJALA. P. P.L.S. _ DATE