Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0041 HIGH VIEW CIRCLE - Health
41 -�' N Marstons Mills A= 030 --09 i b 9 , No. ��l Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 9ppricatiou for Bisposal �6pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(Abandon( ) DeOlImplete System ❑Individual Components Location Address or Lot No. L� r ',✓r� V �� Owner's Name,Address and Tel.No. `70 �$-$ -7 Assessor's Map/Parcel i Installer's Name, Address,and tel.No. 7 ?��S Designer's Name,Address,and Tel.No. OY�.tn�G,v�, tti�J1�''''-' `=k�-+'�a C7�"�j,`�� �(~�� Ti•!—' �^ 's Type of Building: / Dwelling No.of Bedrooms [��! Lot Size SO, cP©C--) sq.ft. Garbage Grinder( ) Other Type of Building "(y��j , No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) `( L{® gpd Design flow provided G gpd Plan Date o� � -Number of sheets Revision Date Title Size of Septic Tank Ste® Type of S.A.S. CQ Ae�..r,T'� C�a,SSA,—X__� Description of Soil,— , S4 �, r 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 Certificate of Compliance has been issued by this Board of He lth. Si ne Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued Y ' � ..�,v,.CF a. v+Rt,e/'7i � '�'`#''fc ,�Yr.�"°"�''^�' Iv w ^o�. „�..' ,.Y { y :ar .r"'...;m.:.+.•-.r.^,::'Rs. r,..ti.r^�. .r:in.fT'"' a ..r��,'ir'i.��l�_t.�� No, I r Fee 4�"' " } _ THE COMMONWEALTH`.OF MASSACHUSETTS Entered in computer: Yes M ' PUBLIC.HEALTH DIVISION - TOWN OF BARNSTABLE MASSACHUSETTS k 1plicatlon for Mi8posal !pstem Construction 3permit co Application for a Permit to'Construct Repair Upgrade( Abandon � m lete System ❑Individual Components � y:. Location Address or Lot No,.41, ; V �, s Owner's Name,Address and Tel.No. Sa'a-_7 37 Assessor's Map/Parcel W` �""s� ^ �` -f ( C% Installer's Name,Address,and del.No. Designer's Name,Address,and Tel.No. S"a*7-,•3G a i$ o Type of Building: J, Dwelling No.of Bedrooms Lot Size �(7! ' Q�"'j sq.ft. Garbage Grinder( ) Other Type of Buildings , No.of Persons Showers( ) Cafeteria( ) s, Other Fixtures41 '' Design Flow(min.required) L( gpd Design flow provided (S gpd Plan Date, z�cs.!;� Number of sheets M1� �C Revision Date u Title Size of Septic Tank Type of S.A.S. Cc3,n C o-�e.tr Description of Soil 1 n. '' *! Nature of Repairs`or'Alterations(Answer when applicable) Date last inspected: Y Agreement: A ` y + The undersigned agrees to ensure the construction and maintenance o the afore described on sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system`n operation until a Certificate of _ Compliance has been issued by this Board of Health. r Signe sg �- Date Application Approved by # 1 Date Application Disapproved by i ' Date " r for the following reasons Permit No. .. o -I Date Issued. q � j _ s i_1 THE COMMONWEALTH OF MASSACHUSETTS f r BARNSTABLE,MASSACHUSETTS"' (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) ., Repa ed( ) Upgraded(V/ ' Abandoned( )by at �- t <"` ; _' has been constructed in acco dance r With the provision os f Title 5 and the for Disposal System Construction Permit No. 0� f' dated Installer •�� � �ac,C�� >�c�.a ��C",'`v�L Designer }t. < #bedrooms ` Approved design flowl VA q `h gpd " The issuance of this pe its all not be construed as a guarantee that the system ilf func n as designed. Date Z �` r 1` Inspector _. _. .. '.;. 141- 1.. e ` - THE.COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( .) Upgrade(� Abandon( ) System located at �. ` i �� : .h L "1 r and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. ,. Provided:Construction must be completed within three years of the.date of this permit. Date . Approved by �+ ✓J t TOWN OF BARNSTABLE LOCATION C(( SEWAGE# 000(— Q Y 7 VILLAGE 5ASSESSOR'S MAP&PARCEL 71 INSTALLER'S NAME&PHONE NO. �.A it V, SEPTIC.TANK CAPACITY �69 CC, �cawo r�� V..hv.,1�Ta•1� . LEACHING FACILITY.(type) (size) Z2'S" NO.OF BEDROOMS OWNER PERMIT DATE: 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) �^ a��� Feet FURNISHED BYZ-,c��—Q,..� of l�►�.�b�, 01 r c ) 133 Ara 3� ` a�� rys—ro, c Town of Barnstable Inspectional Services snatvsr Public Health Division asLs, M6 Thomas McKean,Director a " 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer& Designer Certification Form Date: °�3 Sewage Permit# nc7a 1-cgY7 Assessor's Map\Parcel 30 7 Designer: Installer: S "'� r� L ►~ Address: fo o �J Address: On ��� u t(�� -� c„aars issued a permit to install a (datd) —�-(installer) septic system at V 0 Kk)C-- based on a design drawn by (address) NA?j\,4C,;V"' JZ�dated � Z IA designer) J� I certi t at the septic s stem referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. r ed was installed with major char i.e. I certify that the septic system referenced above � changes greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed inco'pan : .,'th the to rms of the AA approval letters(if applicable) Nth D €E" �40(Installer's Signature) � a (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. WoAdeptslHEALTMSEWER connect\SEPTIC\Designer Certification Form Rev&14-13.DOC WOE _.,f �L`��t, F�: _ �:,c.. �•. a'' 1^� '� � �'i '�' ,t„s,� 3. �c + it 'f4�•t•e�r S x'- {;' � .. MIA all _ -. !.T.'t 1{ �/i �iwl�t��-�J� ..1 �. ♦ L t - p J � ! '' Y 'S r • ..... C-4a'��.:. _ }}j __, _ �_i._ Y + � 1.�1 t A�Y�`tt) 's�` rt�l.�r� � .J: ... >.t !• q ./AV1A��►'147�r{Rt.�. .. ,��a �, yq "� ;� s w x��..,,��' 1 �+ R t /1 AA 1 � 't �, •� s .�sd1o51� �a� � � { 4. t , t Ita Sv�1�' C.o''= , . � �' •�1 S sv il `,`f '-' 4r%'trJ}'L�'�* �T/'/� ;.'i:. i "'+A'`� r '' ° -iv i - f,i �-• 1 • y FL . l 1 7 5' fi t�i �1 $ j.` W R0J11i1•"Ogg 1"`�• - \' •: - fob Q, TWO SANTA its r ���� 7 r � • .r ' yk # k : Y ��a �:t 1 F '. � � -___ .;ry :`�,'' ,+,, •�'s` r �s•�.„•4 �f>.i(,3� l,?i to r1 9.. I�.-Ofi tt.t� G'• =) r.. ' µ � r c� r ��`�<f�t51 y^„ >, sTj s. •� Y 3 1 r 1..• : .� 1 "t( �. �` i' -' p.•\il 3»<k. 1 'gyp' �'�� .H;.- R � t r .- / � !fj' • Y c,uuQ. �'.,�.. �- •.r a c9}„ t �-,..}:. --.rae.,t-as=•rs�,r�.- :.r ._ �. ....-, -.-w'��a'tr ,a:+4p2f�Y'�.ro• •+�;��t n ,.s.; ( .,c r^i , } S , } w - i., �; r 9: yy�$&L.Sl.n ffit i u 1 7 l jj IF . �y� lf7Y. d4 �'Sii 4OJL.= s l � y l9 coo , f +01:l1J/ND44'd=w...:f tUttlD�vp' lffi flLltfYAVtt3,dlfGtlE � tVdLt dF�dV�. v < i., I O'Connell, Timothy From: McKean, Thomas Sent: Thursday, February 18, 2021 1:59 PM To: O'Connell, Timothy Subject: RE:41 High View Circle Ok I see the four bedrooms on the latest plan sent to me. Thanks. From: O'Connell, Timothy Sent: Thursday, February 18, 2021 11:53 AM To: McKean,Thomas; Patrick Sullivan Subject: RE: 41 High View Circle I see 4 bedrooms tom. Let me know what you want me to do. Sent from my Verizon, Samsung Galaxy smartphone -------- Original message -------- From: "McKean, Thomas" <Thomas.McKean@town.barnstable.ma.us> Date: 2/18/21 11:21 AM (GMT-05:00) To: Patrick Sullivan <ptsreadyrooter cr,Pmail.com> Cc: "O'Connell, Timothy" <Timothy.O'Connell@town.barnstable.ma.us> Subject: Re: 41 High View Circle The floor plans you sent are cut off so I'm not able to see the bedrooms. Building department records show approval of three bedrooms. Were the real restate advertisements showing a fourth bedroom in the basement? If yes, when did the Biildinf l Deoartment approve a fourth bedroom? On Feb 18, 2021, at 11:11 AM, Patrick Sullivan <ptsreadyrooterggmail.com> wrote: Hi Tom & Tim, I was able to get the original engineered plans from 1972 that show the property at 41 High View Circle, Marstons Mills was built as a four(4) bedroom home. I have attached a letter confirming the property has always been four(4) bedrooms, the original floor plans from 1972, and a current floor plan of the dwelling. I have made full size copies of the original plans with the date of 03/13/1972. 1 will make them available to your office for the file if needed or requested. Thank you for your response to this information, as the existing cesspool system is in hydraulic failure. i Please feel free to call my cell phone below if additional information is needed. Best regards, Patrick Sullivan Ready Rooter Excavating Cell: 508-509-0802 [https:Hipmcdn.avast.com/images/icons/icon-envelope-tick-green-avg- v 1.png]<http://www.avg.com/email- si nature?utm medium=email&utm source=link&utm campai n=sig- email&utm content=webmail> Virus-free. www.avg.com<http://www.avg.com/email- signature?utm medium=email&utm source=link&utm campai n=si - email&utm content=webmail> CAUTION:This email originated from outside of the Town of Barnstable! Do not click links, open attachments or reply, unless you recognize the sender's email address and know the content is safe! Error! Filename not specified. 2 030 Commonwealth of Massachusetts A11 Title 5 Official Inspection Form - a a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments `a�Z�Ps✓ M 41 Highview Circle Property Address r Mike Silveira Owner Owner's Name information is required for every Mastons Mills ✓ MA 02648 4-13-16 page. City/Town State Zip Code Date of Inspection m Ga 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 A. General Information filling out forms 54 116-5 p2 on the computer, � "AN OF rMq��4i,,� use only the tab 1. Inspector: ;31: �`� " ' ''• key to move your ��:•• ;�'yG cursor-do notuse James D.Sears ?Z JAMES :m key.the return Name of Inspector =0; SEARS Jim The Inspector Man �*�. • *, �y Company NameFR- T IF •O ��` P.O.Box 784 i,,'��'F 5 INSPEG���``��` Company Address nmu 1111 few West Yarmouth MA 02673 City/Town State Zip Code 508-364-4398 S 1623 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 15.000). The system: Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority Q,6"17LeA-- 4-13-16 nspector'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. ****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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 R t Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 page. City/Town State Zip Code Date of Inspection B. Certification (cost.) 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: House vacant at time of inspection. The system is two precast pits piped in line. B) System Conditionally Passes: ❑ r 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 page. CitylTown 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 aasapwl is less than 6" below invert or available volume is less than 1/2 day flow R)T t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 41 Highview Circle i Property Address i Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No i ❑ ® 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 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 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 system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the manholes uncovered, opened, and the interiorAIZIMMMM inspected for the condition of the 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): NA Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): NA t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 41 Highview Circle Property Address Mike Silveira I Owner Owner's Name information is Mastons Mills MA 02648 4-13-16 required for every page. Cityrrown j State Zip Code Date of Inspection D. System Information Description: 1 The system is two pit's piped inline. I i i Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report) Laundry system inspected? ❑ Yes ® No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage d NA 9 ( Y 9 (gP ))� Detail: t Sump pump? I ❑ Yes ® No Last date of occupancy: Da eA i 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•3/13 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 ;M 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 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: NA Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® 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): Main Pit. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1. 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 page. CitylTown E State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Estimate 30 years f Were sewage odors detected when arriving at the site? ElYes ® No Building Sewer(locate on site plan): �Depth below grade: 4' -6° feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition iof joints, venting, evidence of leakage, etc.): 4" PVC SCH 40. i t i I I Septic Tank(locate on site plan): Depth below grade: # feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) i I 1 f i 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts j W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 page. City/Town 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 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 How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap (locate on iite plan): Depth below grade: feet I Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): j Dimensions: I 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ��M s 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 page. CitylTown 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•3/13 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 wM 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 page. City/Town 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 No Box 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 ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments note condition of soil signs of hydraulic failure level of ondin dam soil condition of ( 9 Y P 9, P , vegetation, etc.): Leaching is a 1000 Gal. precast pit. Pit at 4'-8" below grade w/cover at 20". Pit is clean and dry at time of inspection. No high stain line. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 1 Depth =top of liquid to inlet invert 0 Depth of solids layer 0 Depth of scum layer 0 Dimensions of cesspool 6'x6' Materials of construction Precast Indication of groundwater inflow ❑ Yes ® No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 page. Cityfrown 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.): Main is a 1000 Gal. Precast pit at 4' below grade. W/cover at 16". Inlet no tee.Outlet tee. Main pit drey at time of inspection. 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•3/13. Title 5 Official Inspection Form: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 °M 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 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 Y a ' /° -6 G,4eA ,L FF. 0 0 i f 1 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells c N Estimated depth to high ground water: 60' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Rear of property slopes off 60'+. Bottom of over flow pit at 11'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 41 Highview Circle Property Address Mike Silveira Owner Owner's Name information is required for every Mastons Mills MA 02648 4-13-16 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 4. Commonwealth'of Massachusetts ll Titla 5. ', � 7� : rorm N m. Subsurface Sewage Disposal.System Form ;Not.for Voluntary Assessments r- 41 Highview Circle Property-Address _ Ruth Zwirner: Owner Owner's Name information is Narstons Mllis '"# MA 02648 ; 09/16/2009: required for every page. City/Town State * Zip Code Date of Inspection Inspection,results.must.be submitted on this forrn,tlnspectiorl:forms-may not be altered in any Wayr - . Important: k Gend a9 n.fo mationi When:filling out 55 forms on the � computer ,:use 1. Inspector only the tab key 4 to move your James D.,Sears cursor-do nof_ Name of Inspector - - - — - use the return, - s key: $luewater Company Name 350,Maln Streetq. ,. r Company Address West Yarmouth MA 02673 . =« Clty/Town State Zip Code (508)775-2800 : ;;S 1623 Telephone.Number . . License Numbed x k n I certify thatThave personally inspected the sewage:disposal system at this address.and that the ' information reported btrlow is Prue;.accurate and•complete as of the time of the inspection. The inspection " n.; was performed;based on nii 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(31;0 CMR 15 000) The,sysk6m , ❑d—Passes Eondltionall�Passe , ❑ Needs Further Evaluation.by the Local Approving Authority o yc JAMES :m= W. 0: _ SEARS 09/16/2009 '.% CFR T I F�`��•o�`� spector s Signature -`. .'. Date i4 5 INS? The ystem inspector shali'submita copy of this.inspecfion report to the Approving Authority(Board of Healtli�orD:EP)within_30 days bf 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 DER 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^conditioriis of use. at that tiii me::This inspection does not.address how the system will perform in°the future under the'sa6- or'differe .'nt conditions of use t5insp.doc o3/08. , Title 5 Official Inspection Form:Subsurface.Sewage Disposal System•Page 1 of 15 Commonwealth',,Of Massachusetts.. Title 5 Off ibia' sctc Ff . Subsurface Sewage tispotal System Form Not for..Voluntary,Assessments zo .w 41 Highview Circle f Property Address Ruth Zwirner . Owner Owner's Name information is : Marstons,Mllls .* MA. 02648 09/16/2009 required for every page. City/Town :` State Zip Code Date of.Inspection B'. Certification (cont.j Inspection,Summary."Check A;B,C D or E`%always complete all,of Section D A)' System Passes _I:have not found in which intlicates that any-of#he_failure-cnteria-described in.310=CMR 15.303,or in.310 CMR`15.364 exist.Any-failure.criteria not evaluated are" indicated below. Comments: ` Systerri,meets.pass<crlteria ai A .r �8): System Cor;diitionally 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' El the following statements. If"not' determined,"pleaseexplain 'W i❑ 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-wi{I pass-inspection-if-the=existing-tank4s-rep[aced-with-a-compl-yin."eptic-tanl-as `approved byrthe Board of Health *A metal septic tank,will pass inspection if it is structurally sound, not leaking and.if a Certificate `- of Compliance indicating that the tank`is less than 20 years old is available.: ND Explain ❑ Observation&sewage.backup or.tireak out or,high static water level in the distribution box due ,w to.broken or obstructed pipes)or due to a broken, settled or uneven distribution box.`'System wilt+ pass ihspection`if(with approval of Board of Health) broken pipe(s) are replacedl Obstruction is removed t5in5p:doc•03/08 Title 5 Official'Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Y Y i,µ K` k : Commonwealth of.Massachusetts , ���"._��""0I,,,, _ 1 , t�I-i1 to , - Subsurface Sewage IOisposal�SystehiT&m Notfor Voluntary Assessments 4 j , ,p (q - c 3 r Y � �' 'Y f 4.1 Highview Circlea r_ Property Address r �Ru'th,wirner - ,, Owner Owner's Name rnformatlon is :, :. required for Marts.0 Mills MA 02648' 09/16/2009 ", .eve a e, City/Town 3 State Zip Code Date of Inspection rI.p 9 t it a - `� .*M 48 4 Rq . a t 3 5 �, B. Ce i i�a �� l (:cunt )': ` ;, - a y,, ` h d B) System Conditionally Passes (conf.) , 2 y ., `. y ' „f f, ' 4 r 4 S '� .Y k distribution box is leveled or replaced s �h , r r%! i �. - - {. g 7u d + Y f S >vD Ex_plaln 4 ° x 99 Y C.. Y (It- t "� y �' R v € so�� ', ru 3 -w s t ''' .,b Z; , sE ' a t *.'t ❑ The system required pumping more than 4 times a year due to broken,or-obstructed'pipe(s) The , a t b� system will pass inspection if(with approval"of the,Board of Health) _ a = ;„ ,' ❑ broken pipes)9. 1are replaced" 4 ., obstruction is removed ,i, F ,_ ND Explain - `� t . rf, o� ro r s - , '� ' _'C) Further Evaluation Is,Requ red by~11 the Board of Heal h: " � � t Y �J . . ..Y.3 z [y'.. 11 vs ,.. I �onditier}s e is wkuch,rar}u�re#farther-evaluation iy tf e Board of klealth in order to determ►ne if ` the system is ailing to;protect public-health,sa ety or the environment.. I. F 10, System will:pasp"unless Board of Heai#h determines in accordance wi#h 310 CMR 15:3a3(1)(b)that ttae sys#em_os not.functioning in a manner which will protect public health, - safety and the environment: _k",11 ❑ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetlantl or_a salt marsh f � w � „ w. 2` System will;fail uniess the Board of Health(and Public Water'Supplier,"if any) - determines`that the system is functioning m a'manner that protects,the;publi,c health' safety"and environment The system has aseptic tank and soli absorption system(SAS);an1.d.the SAS is within 4h ,100"feet of a surface wafer.suppIy or tributary to a surface water supply. ,.:. . :; r.❑, system,has aseptic tank and SAS and the SAS is within a Zone 1 of a public water The s : supply N'4 + The s stem'has a se`tic 'tank and SAS„and"the SAS is within 50,feet'of a rivate water . ` r` Y, P. p supply well1. t5msp:ioc^03l08 Title 5 Official Inspection Form'Subsurface Sewage bisposal System Page 3`of 15 I .�.. L , Commonwealth ®f;M ssachus6tts r �. Subsurface Sewage Disposal System Form Not for.Voluntary Assessments: F4 41 Highview`Circle Property Address -W. ri Ruth.Zwirner Owner Owner's Name } information Is': required for Marstons.Mills MA' 02648 09/16/2009' every page. .'Y CRY70wn:. State , Zip Code Date of Inspection r C)'. Further Evaluation is Required by the:Board„of Health (cont.): ❑ The system has a septic tank and SAS and'the.SAS is less than 100 feet but 50 fe'et or r more�from a private water supply well"* n� Method:used:to determine tlistance:- "'This'system passes if.the well,water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the'presence of ammonia nitrogen and nitrate nitrogen is equal.to.or less.:than 5,pprh'provided`that no other failure criteria are triggered. A copy of the analysis must-be attached to-this form ..; Y' .. 3. Other. r - . c D) Sys#em l=ailuce CKiteria Applicable-t¢AII,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 podding of effluent to the surface of the ground or surface waters . due:to an overloaded or clogged SAS or cesspool . Static liquid 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 available volume Is less El than '/z'day flow` " Required pumping more.than 4 times in the asf 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;sopply_or s .tributary to a surface water supply: ry t5insp.doc•03/08' Title 5 Official Inspection'Form:Subsurface Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts i Subsurface Sewage Disposal Systern Forth-Not for Voluntary Assessments 41 Highview.Circle Property Address Ruth Zwirner Owner 'Owner's Name ' information Is Marstons Mills MA 02648 09/16/2009 required for every.page. City/Town ` .`' :State ' ' Zip Cade` Date of Inspection B Certification (cont.) D) System Failure C�°teria Applicable taAll Sys#erns.(cont.): Yes No - ^_ Any'_portion--of a-cesspool or privy-is within a-Zone 1.;of_a public well Any portion of a cesspool or privy ls.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 fro r m a private water supply well with no acceptable water qualityahalysis.[This system passes if the well water analysis; performed at a DEF certified a aratory,for,fecal coliforrn ba cteria.indicates absent and the.presence rnrnonia ni rogen and. nitrate nitrogen is equal to or I ess than 5 plpm,. ,provided that no other failure criteria.are triggered.A copy of the analysis t and:chaln of custody must be attached to this form.] , The system is a cesspool serving a facility with a design flow of 2000gpd 10,000g pd. d 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 itc,determine what'will be: LL necessaryto correct the failure.' E) Large.,Systems To be considered a large system the system must serve a facii�#y witha desigr-flovof0;,000 gpd toe5f000 gpd. 7 For.large systems-you must indicate either`yes or"no"to each of the following,'in,:addition to the .questions in Section D w Yes No ❑ ❑ ` the system is within400 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 ha4answered"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 asignificant threaf 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'diffice of the Department. t5insp.doc 03108 `Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 e. Commonwealth of Massachusetts,. w Title f � �� s I Subsurface Sewage DisposalSystem Form--:Nofifor-Voluntary Assessments 41 Highviiew Circle t Property Address : Ruth Zwirner. w 3 y Owner Owners Name information is Marstons:Mills = ' MA: 02648 09116/2009e required for _ every page. ~, City/Town'"M State Zip Code. Date of Inspection •" A 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 y f the system components:pumped out in the previous two weeks?,❑ � Were an o _ ❑ Has tfie system received normal-flows in the previous two week period? Have large volumes of water been.introduced to the system recently or as,part of ® .this inspections 4} Were as built plans'of thesystem obtained and examined? (If they were not ❑ �� ❑ available-note as N/A) _%Was the facilit orrdwellin ms ected for signs sewage back u o �� � ❑y Y, 9 p 9 9 p� " Was the,site'inspecfed 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 K. .dimensions, depth of liquid, depth:of sludge and.depth of scum? Na s the facility-owner(and-ocdupant84f-different-different -provided with reformation on the proper maintenance o subsurface sewage disposal systems r: s Th e and location of the Soil Absorption_ System(SAS)on the site has been'determined based on:`` :f:Existing information -For example; a plan at the Board of Health Determined in the field (if any of the°failure criteria related to.Part C is at issue ,,"approximation of distance is unacceptable).[310 CMR,15.302,(5)] t5insp.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•.Page 6 of 15 Commonwealth of Nlassachusnts, Tit 'I Subsurface Sewage Disposal System F6rm Not for Voluntary Assessments -41.Highview Circle Property.Address Ruth Zwirner Owner Owner's Name information is`.. Marstons Mills MA. 02648 09/16/2009 required for every page. : City/Town State Zip,Code -Date of Inspection . D. SysteM In rma ion Residential Flow'Cor�dffl ns. .`,Number of bedrooms (design). N/A Number of bedrooms (actual): 4.. Unknown _ _DESIGN flow based-on.310 CMR-15.203,(f6r example:,_110-gpd x#-of bedrooms)—= =s , Number of current residents :Unknown Does residence have a garbage grinder? ® Yes No y. Is laundry on,a separate sewage system? [if yes separate inspection.required] ® Yes No 41 Laundry system Inspected? ® Yes ® No Seasonal.use? a Yes ® No ,. Water meter.readings,,if aveilable.(last years usage(gpd)):: N/A Surnp'pumb? 'Cl, Yes No Current Last date of occupancy Date Carnrnerciaillndustrial:Flow Conditions: Typ e-of-€stablishment: Design flow(based on 310J,CMR 15.203):, Gallons per day(gpd) Basis of.'design flow.(se6ts/persons/,scl t., etc. Grease trap;present? ® Yes ®. No Industrial waste holding tank present? " ® Yes [INo Non sanitary,waste discharged to the Title 5 system? ® Yes ® No Water;meter.readings, if available. Last date of,occupancy/use Date >. Other-(describe) t5insp.doc•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-.Page 7 of 15 Coii i 111 on /ea I Y�V � assa Y�LJeL� = r s ct b 0 P!k _t Subsurface Sevvage Disposal System•Form Not.#or Voluntary Assessments ..•41 Highview Circle L' Property Address Ruth Zwirner, Owner `Owner's Name information Is'. iVlarstons Mills MA 02648% 09/16%2009'~ required for , every page; _ City/Town:, ,. `: State 'Zip Code Date of Inspection 3 `D. System 1nfbr4hati0n,,.(cont ) s . General Information W Pura� ing F32cor�ls N/A ounce of information _ k=4 3 p; Was system pumped as.pait:of the inspection?, ® Yes No If'yes;.:volume pumped - gallons How was quantity pumped determined? r q Reason for pumping ' Type of SystSM ,< Septic tank distribution•box;.soil absorption system R , Single cesspool ti Ove ow cesspool a ? ❑ hared.ex tem4yes- r-no}-(Ef-yes,attach-previous-inspection-records, i�a. ❑._:: Inn"ovative/Alternative technology.'Attach a copy of the current operation and, maintenance contract(to''be obtained from s stem owner) and'a copy of,latest Y inspection-of the.1/A system by system operator under contract Ti ht.tank;.Attach a co of the DEP approval': 0 . 9 pY Other(describe): �q 'Approximate age ofall,coniponen#s,"date installed (if known)and source of information ti Actual age of�the'system is unknown.,Cesspool and pit are both precast.`Estimate 25 years... Mre:,sewage o lors'detected when arriving at the site? ® Yes' No t5insp.doc•03/O8. Mf Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonvvealth of Massachusetts Title 5° Off iciall nspectf on Fpr � Subsurface Sewage;Disposal System Fofm-Nof for.Voluntary Assessments; 41 Highview Circle Property Address Ruth Zwirner ' Owner Owners Name infor`ination is : - ' required for Marstons Mills MA 02648= 09/16/2009 f .every pages. City/Townn State Zip Code',, Date of Inspection ' D. SVst6m In ormatJoh (cont.) y Building Sewer(locate on'site plan) 41 6 Depth below`grade:' feet. `Material of-construction x ,• ❑cast Iron 40 PVC- ❑ other(explain): N/A Distance from private water supply well or suction Ilne feet Comments (on condition'of:joints, venting; evidence of leakage, etc.): Building sewer is Irrgood condition. Used sewer camera to check piping, clean and solid' N S Seitfc Tank(locate on site'plan) S : L - '°Depthbelow,grade feet. Material:of construction ❑ concreteP ❑ metal ❑ fiberglass. ❑ polyethylene ❑ other(explain) +y `�f-tank-Es--metal—IEs�age - years Is age.co' firmed by a Certificate of Compliance? (attach a copy'of certificate) O'Yes ® No Dimensions , w Distance from top,of,'sludge to bottom of outlet tee or baffle Scum thickn."ess Distance from top:of scum to top of outlet tee or baffle ° Distance•from.bottom of scum to+bottom of outlet tee or baffle } How were dimen"ions determined? t5hsp.doc•W/08`, '. Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 Commonwealth,o assachusetts'I -InntPec-fiom' orm : Title 5 Off 1C al,_ L. i w� Subsurface tbwage atsposal'System Form Not,for Voluntary Assessments �~ 41'Highview Circle "Property Address { Ruth Zwimer Owner Owner's Name information Is Marstons MIIIS 'MA 02648 09/16/2009 required for every.page.`. City/Town._ .' ..State Zip Cade Date of Inspection 2. �.. _ K'^ i D. .S s m nI ' Cont. a Y , Comments (on pumping recommendations Inlet.and outlet tee or baffle.condition, structural.integrity liquid levels:as related to'outlet'inVert,.evidence of leakage, etc.): f - . • �Ja. }h. L �µ, :< Grease Trap'(locate on site plan): Depth below grade feet Material of construction s ; . , ❑ concrete >.❑ metal ❑fiberglass polyethylene , ❑ other(explain) M a Dimensions: ° Scum thickness Distance from top of;scum to top of outlet.tee'or baffle s <; Distance from7bottom-af_scum--to-bottom-of outlet-tee-or-baffle ;4 Dater:of last,`:pumping Date Comments(on pumping'recommendations, inlet and outlet tee or baffle condition, structural integrity :liquid levels as related,to outlet invert, evidence of leakage, etc.): , i Tigfit or Holding Tank(tank must be bumped at time of inspection)'(locate on site`plan): Depth below grade. Material of construction ❑ concrete ;, ;❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): v: t5insp.doc•03108, Title 5 Official Inspection.Form:Subsurface Sewage Disposal System.-Page 10 of 15 1 #� - �. #*: Ai •( rypy�, ,, . k'"j,] 9,'}yJ�� K.�j1 t,�`�� /�}A� ,�'' t V} 19�, 2 5,..M . • �LJ7)II t7� YY eLiii� "iVIr SSQt/ u�ei � ,+ ^ '- t� _ --. .r a. Subsurface Sewage Disposal System Form Not,for Voluntary Assessments°. r �r - .T a a x +. :rt °� 41 Nlghview Circle ' . I ` Property.Address , , xsal3uth'Zwlkier ,., ; ":3 A' - owner Owner s Name forma ion Is Martsons,Mllls. MAry 02648 09/16/2009 regwred for:A„ °' every page I City/Town % State `=Zip Code Date of Inspection k d Y x rvY } v t a•• r ` z ,g a. �` ..-4 ��. - j. rt ® Sys#e I aa�#i (cunt ) z i p 2 c} ?*, } 7 S R, �': W -7 '~3 a1 'fE Y 'K Tight:or Haldlng Tank (cont) _ � . A I' , ems: : r ' ..S { $fi 3i.'t V Dimensions' ,r r r ! t as i 5 z a a s a. p; #; Capacity _ - gallons f e s s f �, . De- sign Flow. u ,A �, gallons per'day y t - Alarm preserit f': `> Yes No m h ; : c =' " .� - Y ; :Alarm: el �, " Alarm In working order ® Yes ® No At f - fi r r Date of last,pumping a , ,, {� V� e , , , Date x k r " ` } x,6 omments (condition of aaarrn and float switches etc ).: z {.; : � , _ i` e ,. ,A; , ..gym ` ,y n r t . t 4 r ' ;'' .s } Y ~A h u y Z - *'Attach copy of current.pumping contract(required) IS.copyattached? ® `Yes 01,No k ':, Y' Y,, 1 0. 5 i S e G } C :Y D9str9butaon 8ox;(if present must be openie (locate on site plan): , ,I ",'r , Depth=of Ilquid4iavekabove outlet-l4veFt � x , Comments(note If box is level and distribution to butlets'equal, any evidencI.eI.I of solids carryover,any evidence of leakage'into-or out of,box,,etc) , r:o , $ '_� 5M - < ?:_1 11 f` Pump charnbei•(locate on site plan) Pumps'in wo�rking order ® Yes ®;Noy '' ' jt 4 F r 11 11 Alarms In working order Yes " No t ,¥ e .N, t5insp.doc•.03/08 t * Title;5 official Inspection Forth:Subsurface Sewage Disposal System•Page 11'of 15 Commonwealth of Massachusetts =� 1 Subsurfac>?Sewage�isposai Systern,Porrn-,Not for Voluntary Assessments 5 � 41 Hlghview Circle- Property-Address t Ruth.Zwilner _ '` Owliec Owner's Name information Is Martsons Mills MA^ J . 02648 09/16/2009 r required for every page. CI y/Town State ;..Zip Code Date of Inspection Do-:Syst.em on Infbrm.a#j "(cons ) �f _ s Comments (note conditlon'of pump chamber condltiorrof pumps and appurtenances etc.): ' r t fW U SoA. il Absorpt�ort Sysern (SAS) (locate on site plan; excavation.not requ red) f If SAS.not located;explain why F x Type , { leaching its number: 1 @ 6'x 6' 0 r } .❑ leaching chambers number:. % ❑ leaching gallenes x' number: : fi ;' ❑ .:, , ; leaching trenches number, length: leaching fields number,—dimensions:, ❑ overflow cesspool !� number ❑ Irinovative/alternative-system Type/name of technology: bd Comments(note conditioh`of soil, signs of.hydraullc failure, level of ponding, damp soil, condition, of vegetation etc) Soil is'dry.No signs of hydraulic failure Vegetation-is normal. No ponding. :Top of pit is 4'-8" BG.aa Pit cover has risor 20" below grade. Pit was dry at time of inspection. ;y t5insp doc•03/08` Title 5 Official Inspection Form:Subsurface Sewage Disposal System-.Page 12 of 15 S Commonwealth of Massachusetts = W title 51 Official aspect o Form "SubsurfacE.Sewage.Disposai.System Forfn Not for.Voluntary Assessments 41 High view Circle Property Address Ruth Zwilner Owner Owners Name information is i Martsons''Mi�lls required for MA 02648 09/1.6/2009-: every page City/Town State Zip Code Date of Inspection D. System fnfottmation (cont ) . r Cesspools (.cesspool must be pumped as}part:of inspection) (locate.on site plan):, Number and configuration 1 .Overflow 31 Depth=top-of liquid-to inlet inverty Depth of solids1a'yer - 3 k Depth of scum layer ~ 6' x 6' Dimensions of cesspool Materials of construction Precast Indication of grouridwater inflow,; Yes No Comm.eats(note' ,conditionof soil, signs.of hydraulic failure,Jevel of ponding, condition of vegetation, etc} A �l Soil is`;dry_Ao signs of hydraulic failure,6'x 61'pre.cast::4' below grade: Cover has a risor at 16" 1+ below.grade.' 30".'of`water in it 1 pipe 0eaving'it'with tee in place. a•st Priv =locate-on-site-plan`: Materials,of construction.'_. 1: Dimensions Depth bf solids s Comiients(note condition of soii,'signs`of hydraulic failure, level of ponding; condition of vegetation, - - .. i t5msp:doc 03/08,: Title 5 Official Inspection Form:Subsurface Sewage Disposal System;Page 13 of 15 n ' WAN stl 31 _ _ Subsur#acE Sevyage �tsposel System Form Not°for Voluntary.Assessments &M 41 -Highview Circle , ' oval, Property Address f Ruth Zwilrier OwnerMiner's Name 'e .� .a r �` -< Y` t - Tc .� } c� Information is r • c required for MarstonS Mills ' MA•' r 0548 09/16/2009." every page City/Town Yp State ZIp CadeYK Date of Inspection $ 4 4 t C M k F s a, S ram.,� , f .° %;r - ;x x•'e, poll, a _ •A r ±'s, ti D. ��tb fnf6rM6 (cont ) too fj x Sketch Of Sewage Disposal System. Pr`ovlde a sketch of the sewage disposal.system including ties ;to at least two permanent reference landinarks.or.benchmarks. Locate all wells within 100.feet ENO Locate where pubhcWater supw"Aply enters the building L `a' wash SON - C r} e ' ti a x ^`ti a 'z e`[ - +iF'--SAW x lot ;y3y ° .t � 4 - - A no - WNWF 4AAli our CSKSIR—it I PY WASny p f Bf:—soon .� Ali 1 w Z 2yt U Qjw U lei e � -+ e• r � r ` � - f 4 r1 �t - t ar Q ff"VILOL 4 IS ITS u k J 4kj'lye f 4• yA'4, �R '�' 3k 3 a; _ry Ix a g y f 4 S -"� 4its y "•- ^ f twoSTS ffi t � " as .3 x §'• ' q <£ '� x a� a} IT SO y o� & a t5insp.doc 03/08'; , " Tdle 5 Offaal Inspection Form:Subsurface Sewage Disposal System^Page 14. 15 7. Comrnonti>> alth.o#'f,lassacfusetts' _ Subsurface Sewa e.Dis osal:S stem Form-Not:for;Voluntary Assessments M g p y 41 Highview Circle : Property Address Ruth Zwilner. . Owner Owner's.Name ,. information is Marstons MIIIs „' MA `02648 09/16/2009 required for every page. CityfTown State Zip Code Date of Inspection' r D: System 1nfprm-atJbh in ) k � Site Exaan "# 0 ,.Check Slope r � ' S.urfacewater "- - -- — — '— ❑✓ :Check cellar ✓❑ Shallow.wells :60'+ Estimated depth to high ground water feet - Please Indidate all Methods used4to determine.the high ground water elevation. ;a ❑ Obtained from'system design plans on record If checked date of design plan reviewed: : .pate C. 3 ❑ Observed site;¢(abutting property/observatiori hole within 150 feet of SAS) ❑ Checked with local Board of Health =explain: . ❑ fi ec a wi `o-c excava or-s—►nstal ers -a ac ocurnen.a,ion ❑ Accessed USES database-`explain: You must describe how you established the high ground water elevation: There,is a.significant slope to,the rear of the property.The slope goes to 55- 60'.below.The bottom ofthe deepest pit is'at no more than 11' This leaves an additional 444 of seperation .d t5insp doc 03/08 Title S Official Inspection Fonn:Subsurface Sewage Disposal System-Page 15 of 15 No. i Fee /tO THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIpplication for Di!6po.5ar *pgtem Construction Permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location A dress or Lot No. L4 / P%"r(A�� e`er ���f` `Q Owner's Name,Address,and Tel.No. YW102S-C-.j wl o t 15 Assessor's Map/Parcel ®30 ©? Installer's Name,Address,and Tel.No. " �2S Designer's Name,Address and Tel.No. 1.� St R4- f IVA- Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) QJ-L �t ✓L6_ Ce � � L ✓��1 Date last inspected: Agreement: The undersig4uedby sure the constr ction and maintenance of the afore described on-site sewage disposal system in accordance with thetle 5 of the ironmental Code and not to place the system in operation until a Certificate of Compliance has beeBoard DateApplication Approv DateApplication Disappr Date for the following re �--, yy�� Permit No. s-y� 'O� Date Issued No. t Fee - ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for Mi5po5af- A�pgtern CdCongtruction permit Application for a Permit to Construct( ) Repair( ( Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components o ation dress or Lo No ` t V e�` �2 Owner's Name,Address,and Tel.No. �l`A ZUJ i Z V,�� Y yua ' -mot I � t15 Assessor's Map/Parcel 030 O? _T�n taller's Name,A dream.-and,Tel.No.,.,, .h n 1 Designer's Name,Address and Tel.No. IIV�`,2A �.s�✓t 16 Type of Building: _ Dwelling No.of Bedrooms Lot Size sq: ft. Garbage Grinder ( ) Ck Other 0/-N t'Type oyyf.BuiIding i `ANo.of Persons Showers( ) Cafeteria( ) Other Fixtures XIS Design Flow(min.required) gpd .Design flow provided gpd Plan Date Number of sheets Revision Date Title, Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) E Q-Z g_ Q Q "t M1 �� lre�e k>C• Ai ©v� ti Q 'o.Q oqq ,e lc, Date last inspected: Agreement: The undersigned agrees to a sure the const etion and maintenance of the afore described on-site sewage disposal system in accordance with the provisions o, itle 5 of the •/ ironmental Code and not to place the system in operation until a Certificate of Compliance has been issued by s Board ..f 1fh. t r ned Date ( ) Application Approve' by Date n . -- i Application Disapproved by: Date for the following reasons 1 Permit No. y"r / J Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERT(I�.F +that the On-s�teDSew�age Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) Abandoned( )by 8J/t)at � j ( I 4�' has beeri constructed in accordance with the provisions.• Ti'kl 5 and th for Disposal System Construction Permit?No. ��r�r1'�-. ��`J ram} dated C Y�i�/" � Installer L_ /Iv Designer_ �'�"•v"r� #bedrooms Approved design flow - —z_ gF'-I The issuance of this permit shall of e con trued as a guarantee that the system will funcfio as finned. Date { Inspector ' -- " - No.,wq 0--451'o-)_ w Y< �".f_^ c "t''ee- _..THE COMMONWEALTR OF MASSACHUSETTS i PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETT. r , Digofsal �§p!5tem Con5truction Permit Permission is hereby granted to onstruc�t / ) R air ) Upgrade ) Abandon ( ) System located at r and as described in the above Application for Disposal System Construction Permit.The applicant recogn zeis/her duty to comply with Title 5 and the following local provisions or special conditi:©ns. i Provided: Construction must be c mpleted within three years of the d�tt f thus Date lri �jc ApproveZ by__ - ..-.• . viV L-rIJJ L% IN O. IVIU I 1 06/2010 20:48 15088888667 TOM PONTBRIAND PAGE 02/02 C r 72 - A ' DL' K L ProPv4��( I per k- O;CK �0. 4'f / � X\ IGAR, �00 I ` r-CSPHALT I : _ 71 I ' ,I I'J m i }>! -W C10r%j i i MORTGAGE LOAN INSPECTION AA!!3999 SAGAMORE SURVEY ASSOCIATES SCALE: 1 P.O. aox .2a 'N = 60 FT. SAGAMORE BEACH, a. 02562 OA C: MAY B, (508). 888 ' rN. , 1 CERTIFY TO PAUL R: ARDIF, ESv A' THAT THE LOCATION OF T E 8L'.LGING SHOWN HEREON C0K'F0RHS a�r.;!��4 1 10 ,THE ZONI!vG Or TH~ TOWN Or BARNISTAi;LE I CERTIFI' THAT LOCUS DOES NOT LIE vNIT!-l;N -I{E FLOOD ZONE AS DELKATED ON MAP "015C HAZARD Hp o PL4N RcrERENCEt A NSTA6LE COMMUNITY NO. 250001 sUR � BOGK ?AGE:' PL '� aoos< �ISTRY Or S R=G! WNro �' A, 222, PAGE 157 LOT NO.: 72A PLAN BY: CHARL.=S N. SAYER" ;NC DATED: AUGUST 12, 1968 BUYER: TH15 INSPECTIONf�NOT OM AN INST RUN{= N I SURREY AN �s NOT TO 6E uS_p OR FENCES. HEDGES OR TO ESTABLISH LOT LINES. FQR USE Or BANK ONLY. c Q �� LEGEND ` MARSTONS MILLS ' r PROPOSED CONTOUR PROPOSED SPOT GRADE 'd �o&° o� f •,,. `,�� __, _ —98 -- EXISTING CONTOUR A GS / Rp, � C4 1ti - tx + 96.52 EXISTING SPOT GRADE SA oti-"-C�� , ` _____ �� __ W— EXISTING WATER SERVICE p o / ' oo �TEST PIT qkF pv o \� �TP-2 HOR OR \°R / I° \\ i+ LOCUS ' i+1 41 HIGH VIEW CIR. o i LOCUS MAP BENCH MARK ° O ,may' ' ,' LOCUS INFORMATION TOP OF CONCRETE BOUND 93.09 C �s'�" o� i no PLAN REF: 222/157 BARNSTABLE GIS DATU v � Q Q �� I TITLE REF: 29769/262 orO o \ K� PARCEL ID: MAP 030 PAR. 079 PROPERTY IS WITHIN ZONE II/ESTUARIES PROT. DISTRICT FLOOD ZONE: "X" PROP. 1,500G i �� COMMUNITY PANEL: 25001CO537J DATED:07/16/1.4 H-20 SEPTIC TANK SEPTIC SYSTEM !` REPAIR PLAN - I LOCATED AT: Cp- ' I' I 41 HIGH VIEW CIRCLE ,, , 0. LOT 72— A MARSTONS MILLS, . MA ' / PREPARED FOR ,�' ! AREA = 50800 sf+— ,' �' ,! PLAN Bool< 222 PAGE 157 KOFF/GILBERT/ ASSR MAP30 PGL 79 READY ROOTER EXC. FEBRUARY 2, 2021 , OF ,yAss9�y ' o D R E To ' / O $41NITAR�1`� o _ ' MEYER & SONS, INC. P.O. BOX 981 PLAN ,-''i/ EAST SANDWICH, MA. 02537 0�1 PH: (508)360-3311 M SCALE: 1 in = 30 ft 0 30 60 FAX: (774)413-9468 -�' meyerandsonstitle5@gmail.com 0 10 20 30 60 i SHEET 1 OF 2 J 2076 NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GENERAL NOTES: TOP OF FND SEPTIC TANK GRADE SHALL NOT BE < EL:90.10 FOR A DISTANCE INSTALL RISERS & COVERS OVER INLET & !r 15' AROUND THE PERIMETER OF THE SA.S. EL.=96.50f PROPOSED D-BOX 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL OUTLET TO FINISH GRADE INSTALL RISER & LOCKING PROPOSED S.A S It BOARD OF HEALTH AND THE DESIGN ENGINEER. INSTALL METAL RINGS AND LOCKING COVERS INSTALL A RISER OVER ONE CHAMBER (MIIN) 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS COVER TO FINISH GRADE AND SET TO 3" OF F.G. 1 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE F.G. EL.=95.80t F.G. EL.=95.40t F.G. EL: 95.30t LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: h� F.G. EL: 95.0(MAX.) vENT - 310 CMR 15.405 (1) (B): 1)A 1.90 Fr.VARIANCE FROM 3laaat1s.221(7) To ALLOW LEACIQPXs 9" MIN COVER/ TO BE 4.90 FT (MAX) BELOW GRADE VS REWD 3 FT. (H20/VENT PROVIDED) 36" MAX COVER L = 20' L = 25 11C'(MAX) 2) A 1.AO FT.VARIANCE FROM 310CMR15.221(7)TO ALLOW PROPOSED SEP TANK O Sm1X (MIN.) EL.=91.0 0 S=1X (MIN.) O S=lx (MIN.) " TO BE 4.40 FT (MAX) BELOW GRADE VS.REWD 3 FT. (H2O PROVIDED) 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC 2 OF 3/8 DOUBLE WASHED STONE OR FILTER FABRIC 3/4" - 1-1/2" 3.THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR l0' B DOUBLE WASHED STONE UESINGSNPEENGINNEEAND DAPPROVAL BY THE BOARD OF HEALTH AND THE U-jINV.=9O.00 14 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING �� ID INV.=89.75 ®®®®. O M FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN PROPOr ®®®®®®®®®®® ENGINEER BEFORE CONSTRUCTION CONTINUES. GAS BAFFLE T ®E3®®®®®®®®® 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. D-BO . 9.35 E11007®®®®®®® INV.=89.55 DB-5 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF ' ' ' HEALTH FOR PROPER INSSPEECTIWNER ONS DURING CONS�TRUCTITION. OF PROP, 1.500 GALLON H-20 SEPTIC TANK 4 3 X 8.5 4 7. DWELLING IS SERVICED BY TOWN WATER. EXIST. SEWER OUTLET EFFECTIVE LENGTH = 33.5' 8.ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. INV.=so.5o INV. ELEV.= 89.10 I 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE BREAKOUT LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO STARTING WORK. NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING EL. 90.10 10. EXISTING LEACHING TO BE PUMPED, CRUSHED AND FILLED PER TITLE 5. PIPE INVERTS PRIOR TO CONSTRUCTION TOP CONC. ELEV.= 90.10 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 2) TANK/D-BOX SHALL BE SET LEVEL AND TRUE TO INV. ELEV.= 89.10 B®B 12. THIS PLAN IS TO BE AND IS NOT T BE CONSIDERED A PR FOR SEPTIC SYSTEM UR ES ONLY mWEMPROPERTY LINE SURVEY GRADE ON A MECHANICALLY COMPACTED SIX 0,30 30aaa 13. NO KNOWN ABUTTING PRIVATE WELLS WITHIN 150 FT. OF PROPOSED LEACHING INCH CMR CRUSHED ONE BASE, AS SPECIFIED IN BOTTOM EL.= 87.10 IREFFEC ' a5 FT. 3 75' 14. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPEC. ) _ 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW 3) INSTALL INLET & OUTLET TEES W/ II TIVE WIDTH = 12.5' FOR THE USE OF A GARBAGE GRINDER. GAS BAFFLE AS REQUIRED SEPARATION 5.10 FT. 16. NO WETLANDS WITHIN 100 FT. OF PROPOSED LEACHING SOIL ABSORPTION SYSTEM (SECTION) 17. NO PROPOSED INCREASE IN FLOW. BOTTOM OF TESTHOLE EL: 82.0 SEPTIC SYSTEM PROFILE _ (500 GALLON H-20 LEACH CHAMBER) SOIL LOGS TPT: 20-293 N.T.S. DATE: JANUARY 8, 2021 OF? ,yqs� SOIL EVALUATOR: DARREN MEYER, CSE 1614 WITNESS: TIM O'CONNELL, BARNSTABLE HEALTH DA EN TP-1 Depth Elev. TP-2 Depth 140 "' 94.0 A 0" 94.3 A 0" DESIGN CRITERIA r>rST M 3D L0� �D NITAR�1`� 93.67 B 4" 93.88 B 5" NUMBER OF BEDROOMS: 4 BEDROOM DWELLING �� 1 OAMY s5A/NBD Low SAND 5/8 SOIL TEXTURAL CLASS: CLASS 1 (0.74 GPD/SF) 67 DESIGN PERCOLATION RATE: <2 MIN/IN 90. C 40" 90.88 C 41" DAILY FLOW: 110 G.P.D. X 4 BR DESIGN FLOW: 440 G.P.D. PERC TEST MEDIUM MEDIUM 88.33 GARBAGE GRINDER: NO (not designed for garbage grinder) O� 2.5YY 7/4 2.5YY 7/4 SEPTIC TANK: 440 gpd x 200% = 880 gpd USE PROP. 1,50OG H-20 SEPTIC TANK 82.0 144" 82.30 144" LEACHING AREA REQUIRED: (440)/0.74 = 594.59 S.F. PERC RATE <2 MIN/IN. (-Cl- HORIZON) NO GROUNDWATER OBSERVED USE THREE (3) 500 GALLON H-20 PRECAST LEACH CHAMBERS I PROPOSED SITE AND SEPTIC UPGRADE PLAN W/ 4' STONE ON ENDS AND 3.75' ON SIDES: 33.5' L x 12.5' W x 2' D a 41 HIGH VIEW CIRCLE, MARSTONS MILLS, MA BOTTOM AREA: 33.5 x 12.5 = 418.75 SF Prepared for: Koff/Gilbert/ eady Rooter Exc. $� SIDE AREA: (33.5 + 12.5) X 2 X 2 = 184 SF system Design and Topography Plan by: SCALE DRAWN DATE I, Darren M. Meyer, R.S., CSE, h TOTAL SQUARE FEET PROVIDED = 602 vs. 445.94 REQ'D hereby cer* that I am currently approved by MADEP Pursuant to 310 CMR 15.017 ME Box YER�&fSONS,INC. N.T.S. DMM 02/02/21 to conduct soil evaluations and that the above analysis has been performed by me consistent with the EAST SANDHRCH,AfA02537 REV DATE CHECKED SHEET NO. ve DESIGN FLOW PROVIDED: 0.74(602 S.F.) = 446 G.P.D. vs. 440 G.P.D. req d requirements of 310 CMR 15.017. 1 further certify that I ha passed the Son Eval. Exam in October, 1999. 508362-2922 DMM 2 of 2 J