HomeMy WebLinkAbout0088 HUCKLEBERRY LANE - Health 8 Huckleberry✓
MArstons Mills
102 138
I
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
i;
88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
every page. City/Town state Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way.
Important: A. General Information
When filling out
forms on the
computer,use 1. Inspector
only the tab key
to move your VANCE STEVE YOUNG
cursor-do not use the return Name of Inspector
key.
Company Name `f�
BOX 1592
Company Address
MANOMET MA 02345
n City/Town State Zip Code
508 759 5603 S1686 @-
Telephone Number License Number
4- rDe
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and th t 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
9/27/07
Ins ector's ature 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.
HUCKLEBERRY LN•08M Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 1 of 15
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
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.
Answer yes, no or not determined (Y, N, ND)in the❑for the following statements. If"not
determined,"please explain.
❑ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent.
System will pass inspection if the existing tank is replaced with a complying septic tank as
approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate
of Compliance indicating that the tank is less than 20 years old is available.
ND Explain:
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s) are replaced
❑ obstruction is removed
HUCKLEBERRY LN-08/W Hite 5 Official Inspechon Form.Subsurface Sewage Disposal System•Page 2 of 15
f
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
every page. Cityfrown State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes (cont.):
❑ distribution box is leveled or replaced
ND Explain:
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s) are replaced
❑ obstruction is removed
ND Explain:
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health,safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or,privy is within 50 feet of a bordering vegetated wetland or a salt marsh
2. System will fail unless the Board of Health(and Public Water Supplier,if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
HUCKLEBERRY LN•OWN Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
�y 88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9127/07
every page. City/Town state Zip Code Date of Inspection
B. Certification (cont.)
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 feet or
more from a private water supply well*".
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform
bacteria 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
❑ ® 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.
HUCKLEBERRY LN-06/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
every page. CityrFown state Zip Code Date of Inspection
B. Certification (font.)
D) System Failure Criteria Applicable to All Systems(cunt.):
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 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
El ® criteria e)ost 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 11 of a public water supply well
If you have answered "yes"to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed.The owner or operator of any large
system considered a 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.
HUCKLEBERRY LN•06/06 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M , 88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
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 system received normal flows in the previous two week period?
❑ ® Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined? (if they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid,depth of sludge and depth of scum?
❑ ® Was the facility owner(and occupants if different from owner) provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil'Absorption System (SAS) on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field(if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
HUCKLEBERRY LN•oaM Trde 5 Official tnspection Form:Subsurface Sewage Disposal System•Page 6 of 15
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
every page. Cityrrown state Zip Code Date of Inspection
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms(actual): 2
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330
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
Seasonal use? ❑ Yes ® No
Water meter readings, if available (last 2 years usage(gpd)):
N/A
Sump pump? ❑ Yes ® No
Last date of occupancy: APPX 2 WEEKSDate
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:
Last date of occupancy/use: Date
Other(describe):
HUCKLEBERRY LN•08106 Tine 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cunt.)
General Information
Pumping Records:
I
Source of information: y
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:
® Septic tank,distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (rf yes, attach previous inspection records, if any)
❑ Innovative/Altemative 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 (f known)and source of information:
3 YRS PER AS-BUILT DATED 8/13/04
Were sewage odors detected when arriving at the site? ❑ Yes ® No
HUCKLEBERRY LN•08106 Tittle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cunt.)
Building Sewer(locate on site plan):
Depth below grade: 1
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.):
ALL OK
Septic Tank(locate on site plan):
Depth below grade: 6"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: 10X5X5
Sludge depth:
4"
Distance from top of sludge to bottom of outlet tee or baffle
26"
Scum thickness 0
Distance from top of scum to top of outlet tee or baffle
8"
Distance from bottom of scum to bottom of outlet tee or baffle
30"
How were dimensions determined? MEASURED/ESTIMATED
HUCKLEBERRY LN•GVU6" Tifle 5 Omciai inspection Form:Subsurface Sewage DLsposai System•Page 9 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
every page. City/Town 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,):
INLET AND OUTLET TEES OK..STRUCTURAL INTEGRITY OK.LIQUID IS LEVEL WITH OUTLET
INVERT.NO SIGNS OF BACK-UP OR LOADING NO LAUNDRY SYSTEM ON PREMISES
Grease Trap(locate on site plan):
Depth below grade: feet
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank (tank must be pumped at time of inspection) gocate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
HUCKLEBERRY LN•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M , 88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Tight or Holding Tank(cont.)
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
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 LEVEL AND DISTRIBUTION IS EQUAL-STRUCTURAL INTEGRITY OK.. .NO SIGNS OF
BACK-UP OR SOLIDS CARRY-OVER
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
HUCKLEBERRY LN•08/06 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 11 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM 88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cunt.)
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:
Type:
❑ leaching pits number.
❑ leaching chambers number:
® leaching galleries number: 5
❑ leaching trenches number, length:
❑ leaching fields number,dimensions:
❑ overflow cesspool number:
❑ innovative/aftemative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
ALL DRY IN AREA
HUCKLEBERRY LN•08= Title 5 Official Inspection Forth:Subsurface SLwage Disposal System•Page 12 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
every page. City/Town State Zip Code Date of Inspection
D. System Information (cunt.)
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
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.):
HUCKLEBERRY LN•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
88 HUCKLEBERRY LANE
Property Address
N.E.PROP.SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9127/07
every page. City/Town state Tip Code Date of Inspection
D. System Information (cunt.)
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.
� ° bf
HUCKLEBERRY LN-08= Tdle 5 Official Inspection Form Subsurrace Sewage Dspowl System•Page 14 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
�,M s 88 HUCKLEBERRY LANE
Property Address
N.E. PROP. SOLUTIONS
Owner Owner's Name
information is required for MARSTONS MILLS MA 02648 9/27/07
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cunt.)
Site Exam:
❑ Check Slope
❑ Surface water
® Check cellar
❑ Shallow wells
Estimated depth to ground water: 11+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 4
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:
AS PER AS-BUILT ON FILE
HUCKLEBERRY LN-08M6 7rtle 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 15 of 15
TO OF BARNSTABLE ` r
LOCATION- v '� '� SEWAGE #—
VILLAGE K`\\\ � �_ ASSESSOR'S MAP & LOT Gl-)—��
INSTALLER'S NAME&PHONE NO. �� �v
SEPTIC TANK CAPACITY a �� G
LEACHING FACILITY: (ty ) ILCt "L-7—���size)
NO.OF BEDROOMS
— %- 22-- . -
BUILDER OR OWNER b�L1l]E-
PERMTTDATE: (P 'O q COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and 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
13-1
060 /�
I
TOWV OF BARNSTABLE
qC
LOCATION SEWAGE #
VILLAGE
\� ASSESSOR'S MAP& LOT
INSTALLER'S NAME&PHONE I O,O
SEPTIC TANK CAPACITY Z ✓C� G_3' -
LEACHING FACUM: (ty )
Iu— size..)
NO.OF BEDROOMS
BUILDER OR OWNER
PERMI TDATE:
9�I(0 COMPLIANCE DATE:
Separation Distance Between the:
Feet
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility
i
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet i
i
Edge of Wetland and Leaching Facility(If any wetlands exist Feet
within 300 feet of leaching facility)
Furnished by
d j
a oa0 l
A 14(
A
p 14
.LLf
S .r7,3f
No. W�" 3 FEE V
It Board of Health, , MA.
APPLICATION FOR DISPOSAL SYSHM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repai Upgrade( ) Abandon( ) -)<omplete System Individual Components ,
rX ❑
Location el, Owner's Name
Map/Parcel# Address
Lot# ) Telephone#
Installer's Name Designer's Name
Address ,5 l� ddress
Telephone# Telephone# nLA9 s-W (o
Type of Building Lot Size 1T&-) sq.ft.
Dwelling-No.of Bedrooms S Garbage grinder
Other-Type of Building nine No.of persons_�Showers (�afeteria (U�
Other Fixtures
Design Flow (min.required) ae gpd Calculated design flow) Design flow provided �31 S gpd
Plan: Date Number of sheets Revision Date
Title 'C.
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluator Date of Evaluation 8
AA
DESCRIPTION OF REPAIRS OR ALTERATIONS 2_� py!r,�
The and rsigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further a eest o to place min op ration until a Certificate of Co pliance h been issued by the Board of Health.
Signed Date
Inspections
-sr.....--��,.v-.;-'-.,...a,.ti,,..ti,,.;,.,� ..*.,�,;;.•-.'R�-'tin,.'d"'?.....`"iY`t,.'��-d'•�.+M'rR./''`�.��`^ �`"^r`+ror'�..�.k,.y,,je-....r„i�"h.�.r;.�vCi'��.arr.^..:x�;u,�'..'��,.,+y�. ..
r
e l o. FEE l0
-CTOMMONWEALTILOF MASSACHUIPP1141-4
Board of Health, eR., MA.
APPLICATION FOP DISPOSAL,SysTIM CONSTRUCTION PERMIT
Application for a Permit to Construct( ) Repairs Upgrade( ) bandon( ) -XComplete System ❑Individual Components
Location. Owner's Name
Map/Parcel# D'a t Address
Lot# - 2_1 Telephone#
Installer's Name �� � ` Designer's Name " :�� ��� �� \Sic
Address
L a t cr-
Telephone# 4148 -�LIC) ' Telephone# —b_9 (.
Type of Building .5 l C� C� Lot Size 1T sq.ft.
r Dwelling No.of Bedrooms `_Town � S Garbage grinder (A f A
Other-Type of Buildin {Q n�— w No.of persons Showers Cafeteria
4�Other Fixtures
Design Flow(min.required) gpd Calculated design flow 3,230 Design flow provided gpd
Plan: Date [A ' Number of sheets Revision Date
Title , CCZ3 r 4 �C k
Description of Soil(s)
Soil Evaluator Form No. Name of Soil Evaluator ackA:Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS r zr
The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and
further a ees to
/dOot to place?e t4 m in operation until a Certificate of Compliance h been issued by the Board of Health.
Signed �/LV Date — & —to
` r
Inspections
C/u FEE
COMMONWEALTH
W MASSACHUSETTS
Board of Health,&`n,C)& / , MA.
CERTIFICATE OF COMPLIANCE
Description of Work: ❑Individual Component(s) Complete System
The undersiLyned he eby certify that the Sewage Disposal System; Constructed ( ),Repaired ( ),Upgraded)6Abandoned ( )
at
v
has been insta`lled in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to
application N8 _)W11-`I 13 dated Approved Design Flow b (gpd)
Installer
Designer: Inspector: ` Date: 0/0
The issuance of this permit shall
not be construed as a guarantee that the system will function as designed.
No. W` ^ v 3 FEE O O
®loll ®NT,, OF MASS 1LJSETTS
Board of Health,C/�iL��lilrb MA.
�.f DISPOSAL SYSTEM CONSTRUCTIONPERMIT
Permission is hereby granted to; Construct( ) Repair( ) Upgrade(XAbandon( ) ai,��iindividual sewage disposal system
at ,� / !3 fi?/44,kcribed in the application for
Disposal System Construction Permit 40. , dated
Provided: Construction shall be completed within three years (Etoal
ears of the dateconditions must be met.
Form 1255 Rev.S/96 A.M.Sulkin Co.Boston,MA Date ��1? G`Board of Health
Town of Barnstable
'E .� Regulatory Services
Thomas F. Geiler, Director
• ea$xsreaLE.
� ' Public Health Division
prFDN A Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer& Designer Certification Form
Date:
Designer: Installer: �� ( 4
Address: `\D x te ate' Address:
On B \ 19 nq was issued a permit to install a
(date) (installer)
septic system at Lcc-,v_ based on a design drawn by
(address) ..
FhUWDT���' dated 19 I l(0
(designer)
I certify that the septic system 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.
I certify that the septic system referenced above was installed with major changes (i.e.
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.
(Instal er's Signature) o? WR ENw;
u SH.
Wo 1181
(Designer's Signature) (Affix De � ,q ere)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVIS N. 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.
Q:Health/Septic/Designer Certification Form
9/16/03
Notice: This Form Is To Be Used For the Repair Of Failed
Septic Systems.Only
PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM
I, hereby certify that the engineered plan signed by me
dated I concerning the property located at
4gckao L-Fi •K, ik%meets. all of the.
following criteria:
• This failed system is.connected to a residential dwelling only. There.are.no.commercial or
business.uses associated with the.dwelling.
• The soil is classified as.CLASS I and the percolation rate is less than or equal to 5 minutes
per inch. The applicant may use historical data to conclude this fact or may conduct deep
test holes and percolation tests at the site without a health agent present.
• There is no.increase in flow and/or change in use proposed
• There are no variances requested or needed.
• The.bottom of the proposed leaching facility will be located no less than five feet above the
maximum adjusted groundwater table elevation. [Adjust the groundwater table using the.
Frimptor method when applicable]
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information)
B) G.W.Elevation DO +adjustment for high G.W.Q,qT= 02
DIFFERENCE BETWEEN A and B �P
SIGNED : DATE:
NOTICE
Based upon the above information,a repair permit will be issued for bedrooms
maximum.. No additional bedrooms are authorized in the future without engineered septic system
plans. <t
gASeptic\percexemp.doc
c �
OF11HE Tpk� Town of Barnstable
> xsznB Department of Health, Safety, and Environmental Services
'""SS.
s6Sq. Public Health Division
�j �0
A'E0N1A�A P.O. Box 534, Hyannis MA 02601
Office: 508-862-4644 Thomas A.McKean,RS,CHO
FAX: 508-790-6304 Director of Public Health
November 18, 1998
Martha V. White
24 Marine Ave.
Westport, CT 06880
NOTICE TO ABATE VIOLATIONS OF 105 CMR 410 00 STATE SANITARY
CODE II MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
AND THE TOWN OF BARNSTABLE RENTAL ORDINANCE ARTICLE 51
The property owned by you located at 83 Huckleberry Lane, Marstons Mills, was
inspected on November 13, 1998 by Edward Barry, Health Inspector for the Town of
Barnstable, because of a complaint. The following violations of 105 CMR 410.00, State
Sanitary Code II, Minimum Standards of Fitness for Human Habitation were
observed:
410.602A: Piles of old wood and brush on the ground. Multiple parts of lawn
mowers, multiple used tires, more than 20 old lawn mowers and other
debris on the ground.
You are directed to correct the remaining above listed violations within fourteen (14)
days of receipt of this notice.
You may request a hearing if written petition requesting same is received by the Board of
Health within seven (7) days after the date order is received. However, these violations
must be corrected regardless of any request for a hearing.
Please be advised that failure to comply with an order could result in a fine of not more
than $500. Each separate day's failure to comply with an order shall constitute a separate
violation.
PER ORDER OF TIJE BOARD OF HEALTH
a �cKean
Director of Public Health
white/wp/q/Is
C1F,
v
The Town of Barnstable
? Health Department
367 Main Street, Hyannis, MA 02601
Office 508-790-6265 t� �/i� �� Thomas A. McKean
Director of Public Health
FAX 50��115e344 `_ 41
NOTICE TO ABATE VIOLATIONS OF_105 CMR 410.00, STATE SANITARY
CODE II, MINIMUM STANDARDS OF FITNESS F R HUMAN.HABITATION
The property owned b you located a �` ����4�- was
P P Y Y Y ` > ;-,Yi,/
inspected on 4/ /` / , ' 199f' by,
Health Inspector for the Town of Barnstable, because of a
complaint. The following violations of 105 CHR 410.00,
State Sanitary Code II, Minimum Standards of Fitness for
Human Habitation were observed:
h t..,�hlit
Al 41117eeV,400
•
'►ear �.�► /t?v f/'.C�-�
You are ected to rrect v ati within
four hours recei of tse notice.
You are also directed to correct
within f/yVj days/hours of receipt of this
notice.
You may request a hearing if written petition requesting
same is received by the Board of Health within seven (7)
days after the date order is received. However, these
violations must be corrected regardless of any request for
a hearing.
Please be advised that failure to comply with an order could
result in a fine of not more than $500. Each separate day's
failure to comply with an order shall constitute a separate
violation.
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean
Director of Public Health
..._...... ... . .. .
ai SENDER: I also wish to receive the
o ■Complete items 1 and/or 2 for additional services.
5 ■Complete items 3,4a,and 4b. following services(for an
■Print your name and address on the reverse of this form so that we can return this extra fee):
card to you.
■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address
` permit.
y ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery y
.t. ■The Return Receipt will show to whom the article was delivered and the date a
C delivered. Consult postmaster for fee.
3.Article Addressed/to,: 4a.Article Number
cc
a 4b.Service Type
❑ Registered Certified Im
jL ❑,Express Mail ❑ Insured F
w +
p Return Receipt for Merchandise ❑ COD
oa J 7.Date f De'very
z L C
z 5.Received By:(Print Name) fj.Addressee's Address(Only if requested
W and fee is paid) t
g 6.Signature (Addressee orAg nt)
0'
PS'Form 31811, December 1994 ' °t t'`t` f 102595-97-B-0179 Domestic Return Receipt
now
�'cpo`yT first a� i'�I
UNITED STATES POSTAL SERVICE �C OS
rf) 31�E
® Print your n�ar> 9� , and ZIP�ode�fn- ishox�- -�--�.�
Public Health Divis#on
town of Barnstable 1
P0.Box 534
Hyannis,Massaebusetts 02601
- g
E
,
o ,N� The Town of Barnstable
I Iealth Department
l �u,n�ri i
nnis MA 02601
367 Main Street, Nya ,
�
Pn�4� �R (� hI'Z�;
Office 508-790-6265 A-7 Timmer A. McKean
Public
FAX SO �344 � Din�ctorof Public Health
���S
NOTICE TO ABATE VIOLATIONS OF_105 CHR 410.000, STATE SANITARY
CODE IIj MINIMUM STANDARDS OF FITNESS F R HUMAN HABITATION
The property owned by you located at$` . ��h'����'?"�`� was o, f l
inspected on ,0Z/ / , 199cnt by, �G�' �.
Health Inspector for the Town of Barnstable, because of a
complaint. The following violations of 105 CHR 410.00,
State Sanitary Code II, Minimum Standards of Fitness for
Human Habitation were observed:
h .s4
/yt 0'W',d6o-e Jr
You are ected to rrect se v ati within
four hours recei of t not ' e.
You are also directed to correct
within fl:4o—j Tl��� days/hours of receipt of this
notice.
You may request a hearing if written petition requesting
same is received by the Board of Health within seven (7)
days after the date order is received. However, these
violations must be corrected regardless of any request for
a hearing.
Please be advised that failure to comply with an order could
result in a fine of not more than $500. Each separate day's
failure to comply with an order shall constitute a separate
violation.
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean
Director of Public Health
The 'Town of Barnstable
Health Department
t A} 367 Main Street, Hyannis, MA 02601
Public
Office 508-790-6265 t� �g � �� Thomu A. n
FAX 50b.JW 344 ` Director of P Public Health
NOTICE TO ABATE VIOLATIONS OF 105. CHR 410.00, BTATL SANITARY
CODE II, MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION
The property owned by you located at was
inspected on , • 199 by,
Health Inspector for the Town of Barnstable, because of a
complaint. The following violations of 105 CHR 410.00,
State Sanitary Code II, Minimum Standards of Fitness for
Human Habitation were observed:
Pt
You are acted to rrect se v ati within t -
four hours recei of t not
You are also directed to correct
within f/%4e j days/hours of receipt of this
notice.
You may request a hearing if written petition requesting
same is received by the Board of Health within seven (7)
days after the date order is received. However, these
violations must be corrected regardless of any request for
a hearing.
Please be advised that failure to comply with an order could
result in a fine of not more than $500. Each separate day's
failure to comply with an order shall constitute a separate
violation.
PER ORDER OF THE BOARD OF HEALTH
Thomas A. McKean
Director of Public Health
PAR ] Real Estate System - General Property Inquiry] Help [ ]
Parcel Id: 102 138- - Account No: 5033 Parent :
Location: 88 HUCKLEBERRY LN M Neighborhood: 20AC Fire Dist : CO
Devel Lot : Lot Size : . 22 Acres
Current Own: WHITE, MARTHA V State Class : 101
24 MARINE AVE No. Bldgs: 1 Area: 624
Year Added:
WESTPORT CT 6880
Deed Date : Reference : 1650/242
January 1st : WHITE, MARTHA V Deed MMDD: 0000 Deed Ref : 1650/242
Comments :
Values : Land: 24400 Buildings : 31100 Extra Features :
Road System: 88 Index: 747 (HUCKLEBERRY LANE ) Frntg: 98
Index: ( ) Frntg:
Control Info: Last Auto Upd: 050695 Status : C Last TACS Update : 052086
Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date : 0000
Tax Title : Account : Taken: Account Status : Hold Status :
Cancel [ ]
Press XMT for more data
Next screen [PAR ] Action [ ]
Owners Name [ ]
Road Index [ ] Road Name [ ]
Parcel Number [102] 1[139] [ ] [ ] [ ]
PAR ] Real Estate System - General Property Inquiry] Help [ ]
Parcel Id: 102 138- - Account No: 5033 Parent :
Location: 88 HUCKLEBERRY LN M Neighborhood: 20AC Fire Dist : CO
Devel Lot : Lot Size : . 22 Acres
Current Own: WHITE, MARTHA V State Class : 101
24 MARINE AVE No. Bldgs : 1 Area: 624
Year Added:
WESTPORT CT 6880
Deed Date : Reference : 1650/242
January 1st : WHITE, MARTHA V Deed MMDD: 0000 Deed Ref : 1650/242
Comments :
Values : Land: 24400 Buildings : 31100 Extra Features :
Road System: 88 Index: 747 (HUCKLEBERRY LANE ) .Frntg: 98
Index: ( ) Frntg:
Control Info: Last Auto Upd: 050695 Status : C Last TACS Update : 052086
Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date : 0000
Tax Title : Account : Taken: Account Status : Hold Status :
Cancel [ ]
Press XMT for more data
Next screen [PAR ] Action [ ]
Owners Name [ l
Road Index [ ] Road Name [ ]
Parcel Number [102] (139] [ ] [ ] [ ]
PAR ] Real Estate System - General Property Inquiry] Help [ ]
Parcel Id: 102 138- - Account No: 5033 Parent :
Location: 88 HUCKLEBERRY LN M Neighborhood: 20AC Fire Dist : CO
Devel Lot : Lot Size : . 22 Acres
Current Own: WHITE, MARTHA V State Class : 101
24 MARINE AVE No. Bldgs : 1 Area: 624
Year Added:
WESTPORT CT 6880
Deed Date : Reference : 1650/242
January 1st : WHITE, MARTHA V Deed MMDD: 0000 Deed Ref : 1650/242
Comments :
Values : Land: 24400 Buildings : 31100 Extra Features :
Road System: 88 Index: 747 (HUCKLEBERRY LANE ) Frntg: 98
Index: ( ) Frntg:
Control Info: Last Auto Upd: 050695 Status : C Last TACS Update : 052086
Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date : 0000
Tax Title : Account : Taken: Account Status : Hold Status :
Cancel [ ]
Press XMT for more data
Next screen [PAR ] Action [ ]
Owners Name [ l
Road Index [ ] Road Name [ ]
Parcel Number [102] [139] [ l [ l [ ]
/w
i
>: :> `'"::' : :::::. ':: :::«:„:::::::::: < < > > >>:`:`>: `. :'''jr::`':::YY :2: >'Y :::2: <:> :::::.;:.;:.;:.: ;:.;:March 1998:•;;::;•;;:'
S M T W T F S
1 2 3 4 5 6 7 :'•?
8 9 10 11 12 13 14
<' 15 16 17 18 19 20 21 ..
3 22 2 24 25 26 27 28
�y /{�{/y�I.}�y�: 29 30 31
..........:::::::::::......::::: ::i.:::::::::::::::::::::::::::::::::I."",":::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::......:::::::.........................................................:::
.........:..:::::::::::::............:.......... :::::::::::.::..::::.:::::::::::::::::::::::::::::::::::::::::::::::::::::::::.::::::::::::::::::::::::::::::::::::::•::::::::::::::::::::::•:::•::::.
..................................... ....................................
8:00 7:30AM OFFICE
8:30
9:00
9:30
:::::.::::::::.;.::.;..;.:.;.:::::::.:::...:.........;:.:..:.:............ ..........:..............:..:...;:...,:.:..,...,...:.:..:.::.:::.::.:::.::::.::::::
10.
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10:30
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11:30 -`
12.00 <::<:»....X X«:......>::>:««««<:»»»»::::::>:«««:>:>>::»;::>;;::::>::::>:::::>::::>::::>:::«««::::::::::::::««««««««:::::::::::::::::::::::::::::::: :::
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1:30
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2:30
REST IPIuF?. " I..... »::P EI 1: :«:E T:<'[: :«: ............l�' ....................
3:00 ..
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E:GNTRI�E `. .. .7 ... .
4:00 : >
P 1�I <N #1>E�f�.................................................# .. ....... .....1..........................
4:30
5:00
5:30
6:00
2:17PM Wednesday,March 04,1998
TOWN OF WIRNSTABLE
LOCATION O ajuc� L�Z2� SEWAGE# F
JILLAGE ��u;�;d�ri2�d ✓�i��` ASSESSOR'S MAP&PARCEL
INSTALLERS NAME&PHONE NO. '
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) (size)
NO.OF BEDROOMS �l(o
gatha�. �c.r�l, 3 3o F`oiJ
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) :�r
Feet
FURNISHED BY 0 t�L ''� 007
_ �
. �,
,�
� ° b { �- , .
. �'!, �y
1 _" � � I��9/I
,� 3 ��//�
k
� l 1� �
,8� �g' 6 "
SECTION A -A �
S ARE TO BE 4' SCHEDULE 40 P.V.C. h t ` r I G SYSTEM �TRI TION eax PIPES i
10 min from
NOTE- ALL PIPE VENT PIP THE
E(o Least 24 Inches oil PROFILE V.ER'. OF ADDITION TO LEACH N °
Foisting Foundation house to septic tordc Schedule 4 PVC w/Charooal Odor Filter SET LEVEL For+AT LEAST 2 FT. 12'
TOP OF FOUNDATION = ELEV. 100.00 (Assumes!) �c tonk eevss imst be 3' of 1/8" - 1/2" Washed Peaaton _
within 6 in. of fWshed grads * ,i-
- 3/4' to 1 1/2 washed crushed Stan `•- s a-aunET -'`"•.-
o
Gr ode over D-Bax- 96 00 over SAS- 9ft 00 - e,
• !rods over Septic Tank-99.00 KNOCKOUTS
.. • - -- S.S' OUILE:T 12' tNUT . �'�,`c '' �'�:,
+ 11
S t y ' NfC1dlfMTl 0.02 3 HOLE H-10 3' Nmdrtwm Cover Tap load -Elev. .93 25 i
�j
DISL BOX
IO NEW F S.0.01 or Greater, 1s 6• 4' - SCH. 40 7,
tiFv a� - h u) 1,500 GAL S- 0.01" per foot • 12
N S' 0'Effective Depth i-
FROM EXIST.FM*MATMN w SEPTIC TANK a sr
5 units e 6.25' 30' PLAN SECTION CROSS--SECTION
. - ,O O .
CONCRETE t111L FOUftLM 'o N 0 vi 0) d 0.83" (10 inches) 3L25
o a, - 37.25' 3 HOLE H-10 DISTRIBUTION BOX ,
ISO
SYSTEM PROFILE 6 fn.o*
> compacted stone a r rn i Effective Length NOT TO SCALE
Not to Scale 5 ° o • 1! SOIL ABSORPTION SYSTEM (SAS) tazoo4rwdhcarYsc«�o
c $ 42.5 4 m NF LTATRDR HIGH CAPACITY (H-20 LOADING)/ GEORGE ❑'BRIEN GENERAL NOTES
6 In.of 3/4'-I 1/2" t0 u I I
acted stone EFfective vldth ( T) 1. Contractor is responsible for Digsafe notification
� .% OR EQUIVALENT) Not to Scale
NOTE ALL COMPONENTS MUST HAVE RISERS TO WITHIN 6" BELOW GRADE o Bottom of Test Hole 1 Elev.-87.00 In NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18' /EFFECTIVE HEIGI4T IS 10' and protection of all underground utilities and pipes.
No Groundwater Observed O 132�
_ 2. The septic tank and distribution 'box shall be set
level on 6" of 3/4"-1 1/2" stone.
3. Backfill should be clean sand or gravel with no
stones over 3" in size.
4. This system is subject to inspection during installation
by Carmen E. Shay - Environmental Services, Inc.
5. The contractor shall install this system in accordance
with Title V of the Massachusetts state code, the approved plan
PERCOLATION TEST - and Local Regulations.
6. If, during installation the contractor encounters any
soil conditions or site conditions that are different
Dote of Percolation Test: AUGUST 12, 2004
Test Performed By. CARMEN E. SHAY, R.S., C.S.E. from those shown on the soil log or in our design
Results Witnessed By. WAIVER (per Barnstable B.O.H.) installation must halt & immediate notification be
SHAY ENVIRONMENTAL SERVICES, INC. made to Carmen E. Shay - Environmental Services, Inc.
Percolation Rate: Less Than 2 MPI 0 48" Assumed LOT #143 7. No vehicle or heavy machinery shall drive over the
LOT #145 LOT #144 septic system unless noted as H-20 septic components.
\ 8. Install Tuf-rite gas baffles or equals on all outlet tee ends.
9. All Distribution Lines shall be 4" diameter Schedule 40 NSF PVC pipes.
r-- 10. All solid piping, tees & fittings shall be 4" diameter
Test Hole
NO. 1 Schedule 40 NSF PVC pipes with water tight joints.
11. Municipal Water is Connected to ALL OF The Residence and Abutting
DEPTH SOILS ELEV.
0 98.00
O Properties Within 150 Feet.
sandy �o� p�j THE PROPERTY LINES ARE APPROXIMATE AND
Lin I ! f COMPILED FROM THE SURVEY PLAN GENERATED BY
10 Y 3/2 \ I 1 1
o"-s' A 97.25 �� I ti PL TEST HOLE j�1 I GERALD MERCER & CO. OF YARMOUTH, MA
98.00 I ENTITLED " PLAN OF SAND SHORES, MARSTONS MILLS, MA,
ELEV.= 98.00 DATED OCTOBER, 1957, PLAN BOOK 138 PAGE 25
LOOM �� i f 7.25' 23, & THE DEED DESCRIPTION ( BOOK 1650 PAGE 242)
10 YR 5/6 �� �`� IT SHOULD BE USED FOR NO PURPOSE OTHER THAN
Be 1 1 ,t>�; r �`<".�. = 4 THE SEPTIC SYSTEM INSTALLATION.
8" 36" Loamy "no95.00 1 • . \ " ��
Sand 1 1 yam- .�• -c : s.• -� •"`s EXISTING CESSPOOL TO BE PUMPED OUT AND
25 Y 6/6 94.00 1 i - \ �\ REMOVED TO FACILITATE NEW SEPTIC SYSTEM INSTALLATION
1 - ox �� ��� NOTE: ANY STRIPPED OUT SOIL CONTAINING LEACHATE
Med. ! Failed NEWN 1500 gal. FROM THE EXISTING CESSPOOL TO BE DISPOSED
Sand
1 Cesspool Septi�Tonk
2s r 7/4 � �\ 26. 0 O � � _ -OF AS PER BOARD OF HEALTH SPECIFICATIONS.
LOT 126 \�� \�� NO WETLANDS ARE PRESENT WITHIN 200' OF THE PROPERTY
#
ASSESSORS MAP 102, PARCEL 138
1
LOT #1,28 LEGEND
1
PROJECT BENCH MARK II o o DENOTES PROPOSED
Perc #1 TOP OF FOUNDATION i EXISTING o
Depth to Perc: 48" to 66" ELEV. = 100.00 (Assumed) 0 1 2 EEDR00� a i I 104X1 SPOT GRADE
Perc Rate= Less Tho 2 MPI i I 1
Groundwater Not Observed I HOUSE N I
No Observed ESHWT ' ^\� i` o ' �`"'� DENOTES EXISTING
,/ o � � J 1 ! ! x 104.46
i ! if 88 U 1 1 1 I
ADJUSTED H2O Elev. = None SPOT GRADE
PL PROPERTY LINE
� r��
� � w ��r PROPOSED CONTOUR
LOT'#127 , ► � � 1 ��
is g Z 1 - -- - - -9, EXISTING CONTOUR
0 9,800 Squar Feet +/-
a
i "� ® DEEP TEST HOLE &
3-24" DIAM. ACCESS MANHOLES / Q I 98.00 1 1 ! /i��
PERCOLATION TEST LOCATION
! 6, _
Cb ; i 9 6 FOOT STOCKADE FENCE
• THE ACCESS COVERS FOR THE SEPTIC TANK, +�
'i DISTRIBUTION BOX AND LEACHING COMPONENT
±1 w SHALL 13E RAISED TO WITHIN 6' OF ---J
INLET FINISHED GRADE. ------- / ----------- ------------- �i �------------------------------
NLET / \`/ ``/ INSTALL TUT-TITS GAS BAFFLES OR EQUALS LOT
LAN
ON ALL OUTLET TEE ENDS
LEBE'R Y LANE
° �Ts.-rR `�....-, .r•. OF PROPOSED SEPTIC SYSTEM UPGRADE
STEEL REINFORCED PRECAST CONCREM (40 FOOT RIGF OF WAY)
PLAN VIEW PREPARED FOR
PLAN MS . MARTHA WHITE
r: I AT
`- 3-min. denruncs r .� #88 HUCKLEBERRY LANE
RUST -in, min. Net to outlet s.
T 1 OUILET
to-mh. ' I °'-K MARSTONS MILLS, MA
E$ e.am. ' LkW depth
<. . Design Calculations II
1� : OF MAs PREPARED BY:
�j u/� Y
.,-.�,. .. - .. . -I Number of Bedrooms: 2 Equivalent to 220 Gal./Day (330 Gal./Day Min. per Title V) AR cy REN l� a S11�1 l
` ` e. Leaching Capacity Proposed: 330 Gal./Day Minimum (Min. Per Title V)
ld-o- s' -Ir GarbageGrinder:
CROSS SECTION END-SECT'ON Septic Tank : - 2 x 330 Gal./Day = 660 USE NEW 1,500 GAL Septic; Tank. 0 20 40 50 " AY NVIRONMENTAL SERVICES, INC.
SOIL ABSORPTION AREA: Using percolation rate of <2 min./inch
00 GALLON SEPTIC TANK ` '. Bottom Area: 0.74 gal/sq. ft. x 370 sq. ft. 273.8 gallons - .{�: �a P.O.. BOX 627
TYPICAL 15 Sidewall Area: 0.74 gat./sq. ft. x 78 sq. ft. = 58 gallons 0 .�GISTEe BEAST FALMOUTH, MA OZ536
Providing: = 331.80 gallons S�NITRP
NOT TO SCALE :y.
SCALE: 1"-20' ,. � T�l./EAX 508-548•-0796 -
(H 1 0 LOADING) Use: (5) INFILTRATOR HIGH CAPACITY H-20 UNITS. HAVING A 0. 3' (10 INCHES) EFFECTIVE DEPTH, SCALE: 1"=20' DRAWN BY: CES DATE: "AUGUST 13, 2004
TO BE USED WITH 4.0' OF WASHED STONE ON THE SIDES, AND 3.5' OF WASHED STONE PROJECT#SD614 FILENAME: SD614PP.DWG SHEET 1 OF 1
ON THE ENDS. NO STONE UNDER.