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0058 MOCKINGBIRD LANE - Health
j R� -8 Mockingbir_ d Lane Marstons Mills A= 013-040 S TOWN OF By�ARNSTABLE 1� LOCATION J�� A,70 a k: � �,Q fJ r L •t SEWAGE# 2 o-O� VILLAGE/;7ar6 ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. ieo n 5 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) K DO (size) Y Z K l'!� AZ NO.OF BEDROOMS OWNER'- A �P� D h PERMIT DATE: f(7 Z Z - C7 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 i on site or within 200 feet of leaching facility) yv��--!✓" Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leach' g,fa i•F• ) Feet H FURNIS ED BY ��� -7r, �c t E s 61 �•l 5fi l� ��- O DO s i 4 _Q 1 S r 6 k r` t 6 2 4 f Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 58 Mockingbird Lane Property Address Mahoney Owner's Name Samstabte— W,W` V)I f Nn l,l11S MA 02648 7/15/13 Cityrrown C)13- Oq b State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. A. General Information 1. Inspector: Frank Nunes III (� Name of Inspector saa Company Name Box 841 Company Address East Falmouth MA 02536 Cityrrown State Zip Code 508.272.6433 Telephone Number B. Certification 1 certify that I have personally inspected the sewage disposal system at this addle'; and that�he information reported below is true, accurate and complete as of the time of the it s ction. The ins tlon was performed based on my training and experience in the proper function andcWgintenancaf orhaite sewage disposal systems. l am a DEP approved system inspector pursuant,tooSection t6.34O`fff Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails w G ❑ Needs Further Evaluation by the Local Approving Authority 7/15/13 Inspecto lgnatur 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. Foft 6/1/ 12 58 Mockingbird Lane•03/08 Tide 5 Officialial Inspectionge Disposal System•Page 1 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form 5 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648. 7/15/13 Citylrown 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: Pumping suggested every 3 yrs to prolong the life of the system. Pumping suggested at this time 13) 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: n/a ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed 58 Mockingbird Lane•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 I 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648 7/15/13 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ distribution box is leveled or replaced ND Explain: n/a ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: n/a 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. 58 Mockingbird Lane•03108 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 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648 7/15/13 Cityrrown 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: n/a 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. 58 Mockingbird Lane•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15 r Commonwealth of Massachusetts Title 5 official Inspection Foam Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648 7/15/13 Citylrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (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 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. 58 Mockingbird Lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments yy. 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648 7/15/13 Cityrrown 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)] 58 Mockingbird Lane•03/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 6 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648 7/15/13 Cityrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms(design): 4 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 Number of current residents: 5 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: Occupied Date Commercial/Industrial Flow Conditions: Type of Establishment: n/a 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): n/a 58 Mockingbird Lane-03/08 Title 5 Official Inspection Forth: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 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648 7/15/13 Citylrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: No recent pumping 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) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: Original septic tank, new d-box and leaching 10/23/08 per BOH record Were sewage odors detected when arriving at the site? ❑ Yes ® No 58 Mockingbird Lane-CG/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments a 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648 7/15/13 City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 18"feet Material of construction: ❑cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: >10'feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 12"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: 1000g Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle >12" Scum thickness 1 _2, Distance from top of scum to top of outlet tee or baffle >2 Distance from bottom of scum to bottom of outlet tee or baffle >2 How were dimensions determined? measured 58 Mockingbird Lane•C3/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648 7/15/13 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping suggested every 3 yrs to prolong the life of the system. Pumping suggested at this time Grease Trap(locate on site plan): Depth below grade: feet � Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): n/a 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.): n/a 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): n/a 58 Mockingbird Lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 10 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648 7/15/13 Citylrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cunt.) Dimensions: Capacity: gallons Design Flow: gallons per day i Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last um in p P g Date Comments(condition of alarm and float switches, etc.): n/a *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 Level w/the bottom of the pipe Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-Box is 2' below grade, cover raised to 6", very good condition Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 58 Mockingbird'Lane•03/08 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 58 Mockingbird Lane Property Address Mahoney Owners Name Barnstable MA 02648 7/15/13 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach chambers were video inspected and are dry at this time. No indication of past backup 58 Mockingbird Lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts _ - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648 7/15/13 City/Town State Zip Code Date of Inspection D. System Information (cont.) 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.): n/a 58 Mockingbird Lane•C3/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 ,s Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE LOCATION 6-$ �Jf fle�<<�N.Q J3t°cp� La+•s SEWAGE#7upg VILLAGE/J?ara f`ow S Al v(.t S ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. oewi S 50 2 f7 J-a 1 7� SEPTIC TANK CAPACrrY /O 1 v q a/- LEACHING FACILITY:(type) 3 >{ c7 O (size) .3 Z K 13 K 2 NO.OF BEDROOMS OWNER X-4�41- PERMIT DATE: /a -ZZ COMPLIANCE DATE: /D '-Z I Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 4'k Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) T•--d✓"�'"t Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of[each Feet FURNISHED BY t lscd l .5� 7 O to 2 1'9 yin 3p © http://www.town.barnstable.ma.us/assessing/HMdisplay.asp?mappaY=013040&seq=1 7/10/2013 ,: , ., ., , . 1 � _ \�� � . �� l _. � Q� a— �, . . . � . _ .. . . � .. . , . . . . . . . , f .,.��. � c., . .v , � �--- �� � . . . ,, � . ; ..:} Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 58 Mockingbird Lane Property Address Mahoney Owner's Name Barnstable MA 02648 7/15/13 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: >12 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: NGW 12' per elevation of home 58 Mockingbird Lane-33/08 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 i . j 'down of B •nsta.ble. P# Department of Regulatory Services • Public Health Division DateKAS& — rbJq Mee$ 200 Main Stiee4 Hyannis MA 02601 ', 1 Date Scheduled - !Time' Fee Pd. I D oil' �Srxitability Assessmeit for Sewage 's osar a Performed By: Witnessed By: )0 � . i LOCATION & GENERAL INFORMATION Location Address 58 M U CIIC4 NC Owncr's Namc Rd -P rfro N& �VtS dvS t LZSAIA I Address �� dVte eb�►t�lA t Z.Nv I ,/•Y4', A4iL.L.S ► ok Assessor's Map/Pocel: 0 IS Name Mtgov- NEW CONS1RU(',1710N REPAIR j Telephone# a 34 z4 Land Use � � Slopes(go) I Surface Stones ft.Distances from: Open Water Body�ft •Possible Wet Drinking g Water Well Z2 ft. Drainage Way ®� ft Property Line —ft Other ft ! SIMTCH:(Street name,dimensiod6f 104 exact locations of te,St holes&pere tests,locate wetlands in proximity to holes) I C yM t 'eti W i rd3 co CD t F I i Parent material(geologic) 0`�/r" -1 I Depth to Bedrock Depth to Groundwater. Standing Water in Hole: i Weeping from Pit FACe N Estimated Seasonal T-ligh Groundwater DtTERMINATION FOR SEASONAL HIDE WATER T'Ar3LE Method!Used: I Depth dbperved standing!' obs.hole: in. Depth to sell tnottlas: tk Depth toiweeping from side of obs.hole I in. Groundwater Adjustment ! _ Adj.factor.,..._ Adj.Crroundwaterievel.,,.,e, Index Well# Reading Date Index Well level — ! Date .Thue�._._-_. PERCOLATION TEST ' Observation I , I Time at 9" 'v Hole# t J Time at 6" ----- Depth of Perc Z+ I Time(9"-6") -- Start Pre-soak Time.0 End Pre-:oak L- r1n` I Rate MinJlnch ' Site Suitability Assessment: Site Passed___,��_— Site Failed: Additional Testing Needed(YIN) Original:,Public He'�lth Division Observation Hole Data To Be Completed on Back-- --- ***If P ercolalyiOn test is to be conducted within 100' of wetland,,you must first notify the Barnstable 6� servation Division at least one(1)wedk prior to beginning. DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other .Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. nsistenc ravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, Gravel b04 Si yl 6DS DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA). (Munsell) Mottling (Structure,Stones,Boulders. Cons istencv. o Gravel DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, 1 .t 77 Flood Insurance Rate May: Above 500 year flood boundary No_ Yes A Within 500 year boundary No Yes Within 100 year flood boundary No k Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pe us material exist,in all areas observed throughout the area proposed for the soil absorption system? �S , If not what is the depth of naturally occurring pervious material? Certification I certify that on 1%' r ii�t (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required ni ;expertisgJjanndd ex erience described in 3.10 CMR 15.017. Signature . Date P V b4l QASEPTIMERUORM.DOC No. 'e Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes �* application for Misposal 6pstent Construction 3perntit Application for a Permit to Construct( ) Repair D) Upgr#de( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.. wner's Name,Address,and Tel.Noss( E B j 0 Assessor's Map/Parcel () 1,3 — Installer's Name,Address,and Tel.No. Design 'seName,Address,and Tel.No. q FI 41) 1 T M WAC ♦ �rC Type of Building: i 9 r � l Dwelling No.of Bedrooms `"� Lot Size r�t/y�=--sq.ft. Garbage Grinder( ) 0-,.her Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) `1 1 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) Date last inspected: Agreement: Tha 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 C and not to place the ystem in operation until a Certificate of Compliance has been issued by this Boar of dA Date vff Application Approved by Z Lee Date Application Disapproved by Date for the following reasons Permit No. djMx -0 Date Issued -'..a'.�..-..�^4wTY.f�yr+.._i�.ie'4'Wa.....v'4......++:n .. _.". .�"`�•i_+s•^Z'!'�•b�.fi' f... i .: .: ....:,�.._ .w a � R - No. /'A. .. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN'OF BARNSTABLE, MASSACHUSETTS Yes hration for -Mts osar t�� � ps etn Construction 3pernttt Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ` mm Owner's Name,Address,and Tel.No SD MW4 I fl�$ g i rc( Assessor's Map/Parcel d L �"1� C &All Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel No. U D t/ lrC1 Type of Building: t Dwelling No.of Bedrooms Lot Size /)Q sq.ft. Garbage Grinder( ) Other -Type of Building ,0!�; 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) D to 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 C�Dd not to%place the s stem in operation until a Certificate of Compliance has been issued by this Boaz• of Bait . I S`gn d Date Application Approved by _ , ` Date &2 � Application Disapproved by Date for the following reasons Permit No. / / -J Date IssuedV I- � SJFj ________________.__-__-------- --------.--------._--_----_--------------- — ---------- 1_� -.- --___--_---------------------------------------- ,f THE COMMONWEALTHOF MASSACHUSETTS Y- ,� BARNSTABLE,,", SACHUSETTS CertificatelAf Compliance THIS IS TO CERTIFY,that the On-site Sewage Dijsallsystem Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by ' (�V> s Cad V1 d l yl y .v at �� QC !'/id' �y`Pe y_Q ° has been constructed` accordance with the provisions of Title` 5 and the for Disposal System Construction Permit No. "ated Installer //�� i �(,{- �' Designer ? #bedrooms 44- Approved design flow % d $P� The issuance oft is permit shall not b co�trued a g tee that the system wiWyAlf as designed. Date /J / S Inspector r7 r `V - - - -- ---------------- -------- - -------------------- ---------------------=�-------------------- - - - No. � /(l � Fee -���"".,-"'" �L - HE COMMONWEALTH OF — " MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstent Construction 3oermit Permission is hereby granted to Construct( ) Repair(�� Upgade( )�/j Abandon( ) System located at�_��C U l'► 11 `, 1 fA O VI,Q 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 wi� ` tlue years of the date of this permit. % \ Date �J --A, Approved by a/ Town of Barnstable 9pWE � Regulatory Services ( Thomas F. Geiler, Director 1 Public MAS& i63� b 1 1'c Health Division Thomas McKean, Director 200 Main Street,Hyannis,M_4 02601 Office: 508-862-4644, Fax: 508-790-6304 Installer & Designer Certification Form i1//? v Date: b Setivage Permit � Assessor's Map\Parcel Designer: Installer: Address: Address: On was issued a permit to install a (date) (installer) septic system at,`SZ92MOM,4141x JI� 1-.47VP based on a design drawn by (address) 1 � f � st, '� � �``t " �,•� /t� dated iOl 2-0 O8 (dest-ner) l certify that the septic system referenced above was installed substantially according to the design, which may include minor approvedhas lateral .eo�atiun on.. changes such relocation F t = . distribution box and�'or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. ;renter than 10' lateral relocation of the SAS or anv 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. of MAss9 cy DAR a Installer's Si_nature o. 1140 'f) 51E�� S01 TAB\PO (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARN ABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COiNTLIANCE 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 3-264doc A i1P,PQOVED THE COMMONWEALTH OF MASSACHUSETTS Barnstable Conservation Department OA R D OF HEALTH l OWN OF BARNSTABLE fined Data., Ali ji iratioit for Dhrip ml Works Tomitrnrtion ramit Application is hereby made for a Permit to Construct �or Repair (r ) an Individual Sewage Disposal Y t ...../ .....� .... •-•-•••-•-•�----�-s--------------- ---••-.........••• ----------------- ----�-- ............................................................. L atio»-,\ddres or Lot No. ........................ . ............... ��1 ............................. . .................•.......... ��O n Address a �' •------ �=A�` -----•------------- . ,1 .� - ��. ..-....... --- l: - ----- -- - --- Installer Address UType of Building Size Lot............................Sq. feet N .-I 77 Dwelling—No. of Bedrooms......... --------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons........_..._._..._____.._:_ Showers ( ) — Cafeteria ( ) Other fixtures d -------------------- ---------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid'capacity------------gallons Length---------------- Width-------_-------- Diameter---------------- Depth................ W Disposal Trench—No. .................... Width-.--_-.---____-_---- Total Length.................... Total leaching area....................sq. ft. x 3 Seepage Pit No..................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a -------------------------------------•--------------------••--------- --•-------------------•------•......................................................... xDescription of Soil........................................................................................................................................................................ W ---------------------------------------•-•-----------------....------------------------------------------------. ------------------------............................................................. x ---------------------------------------------------------------------------------------------------------------------- •- . .............. U Natur of Repairs or Al rations R Answer when applicable.-.-.---��V�-.��-1-��;----- -----------L �---... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is, ed?ble board of health.Signed ......_. � �i,� f ,fir , i ...... Application Approved BY 4......... .... / -- ..... ..—. . ..- -- ....................... ------ ......Dare — — ——---- -- -- - - Application Disapproved for the following rear ............................ ....... . .. --...... ...................... . ................... ............. - ----------------------- ------------------------------------------------------------------.......... Dare Permit No. Issued ------- / r --- —...-ace-----------—..................... ------------------------------------ ----------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Gertifi ate of Tomplianre b THIS IS TO CIF�'}�,That�tl e IndiviwagDis��s�al, Systemclonstructed ( ) or Repaired r+ n at / �.... .....--- 9� >�"t��✓�; ---'------------- `-- ` �l v / � has been installed in accordance with the provisions of TITLE 5 a e State nvironmental Code as described in the application for Disposal Works Construction Permit No. ..._.. j _..... dated--.... .... ........... ............------------- -- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT B ONSTR EA AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------------------------------------------------------------------_---------- Inspector ----._...-----------------------------------------------................................ 4 I L Q I 0 0 No.. _... Fins.............................. r THE COMMONWEALTH OF MASSACHUSETTS " BOARD OF HEALTH lie 3`9/T0WN OF BARNSTABLE . pphration for Diti-po!3ttl Works Tonitrur#inn rrrmit Application is hereby made for a Permit to Construct '' II )—, or Repair ( ) an Individual Sewage Disposal System a ' 5— M L cati�n-).\�ddf e s or Lot No. (� Address a ............. -=•----- o_ 3�Z--------•--. c 7�:- ?- �.4---------. ....... 4 Installer Address Type o Building Size Lot............................Sq. feet V ,., Dwelling— No. of Bedrooms--------- -------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ______________________---- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ----------------------------- ------------------------------------------------------- .............................................................. Design Flow............................................-gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity............gallons Length................ Width---------------- Diameter................ Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No...................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed by.................................... ..................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit-.____________--_.._ Depth to ground water........................ 0i Test Pit No. 2................minutes per inch Depth of Test Pit---_-_..___________- Depth to ground water........................ �+ •-•-•---••••-----------------•-•••••---••--•-----•••---••••••------••-•--•-•---•----'•-•-••-----•--•......................................................... 0 Description of Soil........................................................................................................................................................................ x V ---------------••--•••--•-•••-•••••----•--...--••••----•---•---•---•---••--••-••-••-----••----------••----•----•---•--•--••--------------••-------------•------•-•••-......•-•-••-•''-'................ -----•--------- ---------------------------------------- ---•--•---.......---------•••......•--•- ---------------- U Nature of Repairs or Al-erations—Answer when applicable._..____ ..1v_ __ __ _________________ ------1��-----2-------------1. �- ---------------------------------------------------------------------------------------------------------- Agreement. The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is Uued by Che board of health. Signed --------- � -.. /. ----------- - ..g' Application Approved B :..',.Jir ....., ............/ �: / /e i R /j Dare Application Disapproved for the following rea.rps- �v f -� a .................... ---------- ---------------------------------------------- Dare Permit No. �}....... Issued -------- ——X————————— (/ ........................ are- i------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARN-STABLE Certifirate of Compliance f THIS IS TO C RTIF That t.•e Individual Sewag Dis oral System constructed ( ) or Repaired ( X) �. 6_-- on- -�-�� by ..................................... �.. .. - - ....� _ - ............. ......_.....................- - ��.. ---------..... ... 1 .r ... - '" �....�.......... ----------------------------------- has been installed in accordance with the provisions of TITLE f T e S�jeEnvironmen talCode as described in the application,for Disposal Works Construction Permit No. ..._ ..... .....�'"_ dated _-----------------------------THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE ONSTA AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------------------------------------------------------------- ----------------------- Inspector ---......-------------------------------._.:...------------------------------------------- ---------------------------------------------- ------------------------- THE COMMONWEALTH OF MASSACHUSETTS J BOARD OF HEALTH /... FEE. ...... ............. Biogrosttl/ o,ryk yT,owitrnrtion Vrrmit G � Permission is hereby granted-----------C �-/ C-/---------------- _.. to Construct ( ) or Repair an I dividual Sewa e Disposal Syst. at No...... - -r� U /G/�t/ }� G-� �J Street ��/!/^ as shown on the application for Disposal Works Construction Permit No,_._ _---_._. _ Dated................................._...._.... .......................................... ................................-............................. Board of Health DATE................................................................................ FORM 36508 HOBBS 6 WARREN.INC.,PUBLISHERS �C'� rn D (3 - off ry O r 01 � Cr � CD CJ Page 1 of 2 Miorandi, Donna From: Dmeyer369@comcast.net Sent: Monday, September 22, 2008 2:57 PM To: Miorandi, Donna Subject: RE: 58 Mockingbird Lane, M. Mills Ok,them are FIVE legitimate bedrooms. FOUR are being used as bedrooms, the fifth is being used as a den. What do we do now?? -------------- Original message -------------- From: "Miorandi, Donna" <Donna.Miorandi@town.barnstable.ma.us> Great!! -----Original Message----- From: Dmeyer369@comcast.net [mailto:Dmeyer369@comcast.net] Sent: Monday, September 22, 2008 9:21 AM To: Miorandi, Donna Subject: RE: 58 Mockingbird Lane, M. Mills I am going to do a walkthrough at noon, I will let you know what I find and we can go from there. -------------- Original message -------------- From: "Miorandi, Donna" <Donna.Miorandi@town.bamstable.ma.us> Yes, it is. But have the homeowner draw up house plans and come in and see us. If we do a room count he might get 4 out of it but that's a big might. That's Tom McKean and he can put his name on this one if that's the case. Donna -----Original Message----- From: Dmeyer369@comcast.net [mailto:Dmeyer369@comcast.net] Sent: Friday, September 19, 2008 5:13 PM To: Miorandi, Donna Subject: Re: 58 Mockingbird Lane, M. Mills Hi Donna, That works for me on Vineyard. What I will do is, design for 3 bedrooms because that is all he is allowed, and if he has more,he can deal with you guys on modification/removal of any additional bedrooms. That ok?? 9/22/2008 Page 2 of 2 Thanks. Darren -------------- Original message -------------- From: "Miorandi, Donna" <Donna.Miorandi@town.barnstable.ma.us> Hi Darren, Everything in the file says 3 bedrooms and only a septic for 3 bedrooms. However, in 1979 the plans state two bedrooms and adds a bedroom in 2002 and in 1994 took out a permit to add a 1000g leach pit but never acted on it. In this town to have four bedrooms back in those days you needed a 1 K ST and two 1 K leach pits. That second leach pit never went in. The original plans state three bedrooms with a design flow of 550 gpd. Under the old title V that's approx. what you got out of a 1000 gal leach pit anyhow. Tom states we need a floor plan for starters. The building dept. has the file as active because it never had final inspections- just a frame and insulation. Keep in mind that we are only in the office Mon &Tues. next week. I'm scheduling you for Vineyard Road for Oct. 10th at 11AM. Please confirm that for me. Thanks. Donna I 9/22/2008 Barnstable Assessing Search Results Page 1 of 2 go;a JvF C F 1 if Home: Departments: Assessors Division: Property Assessment Search Results New Search ,�: _- New Interactive Maps ii >> Owner: 2008 Assessed Values: MAHONEY, RALPH M 58 MOCKINGBIRD LANE Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $289,200 $289,200 013 /040/ Extra Features: $2,600 $2,600 Outbuildings: $0 $0 Mailing Address Land Value: $ 152,100 $ 152,100 MAHONEY, RALPH M Totals $443,900 $443,900 58 MOCKINGBIRD LANE Residential Exemption Received=$105,082 MARSTONS MILLS, MA.02648 2008 REAL ESTATE Tax Information: Tax Rates: (per$1,000 of valuation) Community Preservation Act Tax $66.88 Fire District Rates Barnstable FD-All Classes $2.04 C.O.M.M.-All Classes $1.03 C.O.M.M. FD Tax(Residential) $457.22 Cotuit FD-All Classes $1.33 Hyannis-Residential $1.53 Town Tax(Residential) $2,229.42 Hyannis-Commercial $2.35 Hyannis-Personal $2.35 W Barnstable-Residential $1.86 W Barnstable-Commercial $1.86 W Barnstable- Personal $1.86 Total: $2,753.52 Construction Details Building � ��Y Proper fy„sf�N cg�t�hV'9AtCh & AS® Building value $289,200 Interior Floors Carpet Style Colonial Interior Walls Drywall Model Residential Heat Fuel Oil Grade Average Heat Type Hot Air http://www.town.bamstable.ma.us/assessing/assess/displayparcelO8map.asp?mappa... 9/19/2008 Barnstable Assessing Search Results Page 2 of 2 Stories AC Type Central Exterior Walls Wood Shingle Bedrooms 5 Bedrooms 9A Roof Structure Gable/Hip Bathrooms 3Full WDK i.i 19`z TO, Roof Cover Asph/F GIs/Cmp living area 2306 � 8 7UUS Replacement Cost $328683 Year Built 1979 16 'SFB 1;' Depreciation 12 Total Rooms 9 Rooms Land BAS, " As g H,Tt, �2. 4 CODE 1010 4 + Lot Size(Acres) 0.46 Appraised Value $ 152,100 AsBuilt Card N/A Assessed Value $ 152,100 View Interactive M Sales History: Owner: Sale Date Book/Page: Sale Price: MAHONEY, RALPH M Dec 15 1993 12:OOAM 8953/094 $97,000 SHEA, KATHLEEN R Sep 15 1984 12:OOAM 4236/ 163 $62,000 DOWNAROWICZ, DAVID F Sep 15 1981 12:OOAM 3148/343 $47,000 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL2 Fireplace 1 $2,600 $2,600 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area (Unfinished) FTS Third Story Living Area UHS Half Story(Unfinished) (Finished) CAN Canopy FUS Second Story Living Area UST Utility Area(Unfinished) (Finished) FAT Attic Area (Finished) GAR Garage UTQ Three Quarters Story (Unfinished) . FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story (Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/assess/displayparcelO8map.asp?mappa... 9/19/2008 L.0 CA:T ION, $194 6 E PERMIT 90. YIllA6E IMSTA LtfI'$ NAME a AOOtEss BURDEN OR OWNER DATE PERMIT ISSUED DAT E COMPLIANCE ISSUED 1 { � � '' � � � _ ` ... .. ._`ni eo �_ ' r - - - y �, . 4 _ ;� �� vx � - y,,\ ��� �� v � /I�e��'/r���/�� 1-����f • a No......Jr F.R$...3�............... THE COMMONWEALTH 01� MASSACHUSETTS BOAR® OF HEALTH �. 6 ApplirFation for Dhipa ii al Works Tons$rnrtinn ramit Application is hereby made for a Permit to Construct ( 41"or Repair ( ) an Individual Sewage Disposal System at: ",,� •Location-Address or Lot N. .............. Owner Address ----------7,f'......................�----.. Y, / = - Installer Address U Type of Buildings Size Lot. �� .Sq. feet Dwelling 0—� No. of Bedrooms......... : .................Expansion Attic ( /f Garbage Grinder ( ) pa., Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ............................... .. W Design Flow....._....�-......_.........•.__gallons per person jay. Total daily flow......33.0.....................gallons. WSeptic Tank—Liquid'capacity/�- allons Length .._..... Width__�Y....Z`.._ Diameter................ Depth_L6_2't_.. x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. �. Seepage Pit No-------- ------------ Diameter./e74C..4 Depth below Total leaching area... z Other Distribution box ( 4� Dosin tank ( ) Percolation Test Results Performed by. ._�L.l!�C �f�/�fV. t .... Date.. Z� /40 f.......... a 14 Test Pit No. L._._._._Z-___minutes per inch Depth of Test Depth to ground water--,A • �. (3, Test Pit No. 2..-e.:;r.:Z-._minutes per Inch Depth of Test Pit../.. Depth to ground water.-- - ....._. -------------------------------------------------------------------------.........------...-----•----•.:----..........--•----•..........................---•- O Description of Soil----�I� = � . .. 19 � '�" � ..........� i�-y- � ' ......................... 1�L�'Y� ... ---lt ?,� �us� G� ,shy :._... U Nature of Repairs or Alterations—Answer when applicabl`e................................................................................................ •-------------------------------------------------------------------- -----------------------------•-•-•--•--•••-•-•-•-------•-•-----•-•............................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of i?TLS 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beer► sued bey the boa�d o 1 eal�h. T N u (...i- / e ea S• ned_ r W`� eorV fT•�Gte:Tic !4...t_TD �� " L �at Application Approved BY f lrt ( = Date Application Disapproved for the following reasons:----•--------- ..............................-...............•--------- ..----•-•---•-•--•-------••-----------••-----•••----•------••-••----•--••---------••--...-•--•-•---•--------•-•---------•---•-•------•••----•••--••---------•--•---•-••-•---•••-----•••••---•---•-•----- ' 7 �, Date ' PermitNo......................................................... Issued- . --------y////. ..................... Date a ' t No........... .. Fps... ............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH M - G { / .............OF..13, ic�.'�T, ........................... Applira#tin for lliapaoal Works Toustrurtion pamit Application is hereby made for a Permit to Construct (4-)"'or Repair ( ) an Individual Sewage Disposal System at: .BOG/r't-/.L)62Z"...4/.gAe)&.-•-•------------- ................... ..............................__............ ocation-Address or Lot No • fG , Tc�c r T lJ ... c� ft Owner n _ Ad ess a ,l(/G` T :Q/�!,f'7 i2 CST/ .c� Lp------ g--S! �(/�Gs01y�►!..f !� 1?/ I:T�rvJ .fvr�C CS Installer Address Q Type of Build1) Size Lot_ O.Sq. feet V Dwelling ll''�r No. of Bedrooms �:_ ._._.Ex ansion Attic �-+ g— •--••--• •--- -•------ p,_;; Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) A'' Other fixtures -----------•--------•--------- -• - --..--_... _ W Design°'Flow_._. ..................gallons per person ear day. Total daily flow......3, ....................gallons. 04 Septic Tank—Liquid capacity/.I 'allons Length.(9_..�:_. Width._��_ .'-�.__ Diameter________________ llepth..6.',"Z`:__. - Disposal Trench—No ,Dia / ....................� Depth below nlet___ ......./' .. Total leaching area__ -`�_�.. . WidthTotal Length.___..__ Total leachingarea � <�<,:Seepage Pit No........,/ Diameter ' �- s ft. Other Distribution box (= Dosingtank ( ) '-' Percolation Test Results Performed by- ,1V4_-V_.t�t14 i�'�`�al ��<.... Date.__�..1tr�1�'. ......... . Test Pit No. L."L___mmut'es^per inch Depth of Test Pit:_�'.�_'`�__�N_. Depth to ground water_._ _ f=, Test Pit No. 2.�.�►__hiinutes per, inch Depth of Test Pit__l-`� ____,_. Depth 'to ground water.__�_.f,�:__.___. Rr' .. .. ..................................... O Description of Soil ss G ,. ................................................. l•_••G:�' ____________________ :. x ' _ U Nature of Repairs or Alterations—Aner when applicablt.............................................................................................. -----------------•-----=-=---------...----------------------------; . ----...-----•--•---•------------..__.._..-------------------........---------....-----------------------._._.._._._.:_.......__. N Agreement: PThe undersigned agrees to install the aforedescribed-Individual Sewage Disposal System in accordance with rRt���' the provisions of TITLE, 5 of the State Sanitary Code— The undersigned further agrees not to place the system in ' operation until a Certificate of Comp fiance has bee_p issueb the board of-health. n / .....S ti •4 . Application Approved B � f= Pate Date Application.Disapproved for the following.reasons:....................................,_........................................................................... -----•--•-•---------------------------------•-----...-----------.........---------------.._..---......._..__....__...----•------------------------•--------------------------------------------------- Date �- r' Date Permit No................. :_%._... --------------- Issued....................................................... Date II THE COMMONWEALTH OF MASSACHUSETTS X BOARD OF HEALTH G?re. .............OF..,,.4 - ................................ Trdifira#r of Toutplianrr THIS IS TO CERTIFY,That the Individual Sewage Disposal System constructed ( LI-00or Repaired by....t�/�' '. _ '�Y.....c c?ll�.�f:�' u c.ri a� 17-!)-•--•-----------------------------------------•--------............_........----....-- --•-• --- er at.._..4_•.�✓••_��... 5 � has been installed in accordance with the provisions of T rov r R of The State Sanitary C�de as described in the r p s' � application for Disposal Works Construction Permit No____ _________1 `d' ............ dated---..__ 71, THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. __•.........................................•------••---- Inspector_::..........------------..__....••-------:. ' DATE......... = .............•-----------•-•••--- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No.. ......Wf.. rLti'P4! .........OF.... /. C/� aP i �,r�'.......................... .. FEE......... ............ Disposal Works Tnnstrudian ramit Permission is, hereby granted- J- (J Ir 4-2-c���L'i�7"" -..4'�.,..... to Construct "'7 or Re air ( ) an Individual Sev�ra a Disposal System at No.-----� � ,� __.., trL� !.!` t! ,1 '� .-�1L -,/ ' 7n�. ?`�/% !L'? G _.... Street as shown on the application for Disposal Works Construction Perm' o..... ._____ ftated.__:_��'_ ' � DATE...... D--v Board of Health vn N. FORM 1255 HOBBS & WARREN, INC., PUBLISHERS - r I, LEGEND �:•` ,•off, ',a: r , PROPOSED CONTOUR ' `' tr x ® PROPOSED SPOT GRADE —— 98 —— EXISTING CONTOUR + 96.52 EXISTING SPOT GRADE Existing Leoch Pit (See Note 10) W EXISTING WATER SERVICE 105 I - -- - o� ir �� TEST PIT 7 160.00 ft---------------------- :. LLJ I / \ 2 r` LOT 110 ! s` %1 zt 10 ft I t � r R\ t,. j AREA = 20000 sf _ T�1 v _. r'- - i� us _�tn i Q _ LOCUS MAP N.T.S. -105 _J GENERAL NOTES: � I \ 106 i Existing 1,000 ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL \ \ BOARD OF HEALTH AND THE DESIGN ENGINEER. go/� �� j \ \ Sep tic Tank \ 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS IV OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLE 1013 j \ \ I \ LOCAL RULES AND REGULATIONS. \1 \\ \\ I \ ! 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR 7 A 1 \ 1 0 \ ! TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE W y \ 1 \ 1 z ,p 1 w DESIGN ENGINEER. 1 1 1 \ \ Z_ — z Cd� ! 0 z 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING w �o 1 1 \ — I FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN >Q N ! 1 1 \ J L`-(D \ 0 j Ln ENGINEER BEFORE CONSTRUCTION CONTINUES. ^^ I cv 1 \ \ U) W LL \ i I 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. I' Ir ti I ! 1 \ \\ >> O I 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF L- I 102 j \ \ \ X > II j THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF O I �\� \\ \\\ \\ W 0 O J j HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. Ld i o j 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. �\ \\ �\ j 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED wl i \ _ _ — �` ! 5 TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. \\ \� \ — 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE OVA tln \ \ ,( THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING / CONSTRUCTION. 1 \ 10. EXISTING LEACH PIT TO BE PUMPED, CRUSHED AND REMOVED. j PAVE'O DRjVEWkiY \\\ U j j REPLACE W/ CLEAN MEDIUM SAND 1 \ i� 1 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 13. NO PRIVATE WELLS WITHIN 150' OF PROPOSED LEACHING. 14. NO WETLANDS WITHIN 100' OF PROPOSED LEACHING. 15. ALL PIPING TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPECIFIED) 1 \\ - '.------------ 1 1 L-------------- - - - - - - - - - - \ __ j\\ - -- - 160.00 ft— ---— — — — — — — ------ — — ----------------- - - - - 102 103 10.4 i E3 E ICJ C H MARK .�. of - - -- _ r� ,�oT ON �� PROPOSED SEPTIC SYSTEM UPGRADE PLAN BULKHEAD CORNER Y D R Gr 58 MOCKINGBIRD LANE, MARSTONS MILLS, MA ELEVATION = 106.43 o MEYER BARNSTABLE GIS DATUM " No. 1140 "' Prepared for: Ralph Mahoney SURVEY REFERENCE: Engineering by: Surveying by: SCALE DRAWN JOB. NO. MAP: 013 PLAN OF LAND BY CROWELL AND TAYLOR CORP IC/$lE � DARRENM.MEYER,R.S. Bco-Tech Environmental 1"_20' DMM LOT.-040 DATED: MARCH 15, 1974 MNITAR\a� PSTSAIN1 (508) 364-0894 DATE CHECKED SHEET NO. DEED BOOK 8953 Easrss�aow�cy naa ozs3� DEED PAGE,*094 500-3622922 10/20/08 DMM 1 Of 2 ELEV. TOP F FOUNDATION **NOTE: ALL COVERS TO BE MARKED WITH MAGNETIC TAPE (Existing) = 106.60 F.G.EL: 106.0 � F.G.EL: 106.0 F.G. EL: 105.5 FINISH GRADE=105.5 i MAINTAIN 2% MIN SLOPE OVER LEACHING AREA COVER OVER LEACHING = 3.0 FT. � n• COVERS TO WITHIN 6 OF GRADE :. 2" OF 3/8" DOUBLE WASHED STONE :. 3/4" - 1-1/2" DOUBLE . • OR APPROVED FILTER FABRIC WASHED STONE s" . „ 4.' SCH 40 PVC 4 4" SCH 40 PVC (MIN.) 10"I 14 S= 190 (MIN.) e ® S= 1% (MIN.) ®®®®®®®®®®® 4: TEE'S ARE TO BE ®®®®®®®E3®®® 4' SCH 40 PVC 2 EFF. DEPTH ®®®®g®®®®®® INV. INV.103.25 } ; INV.103.05 EXIST. OUTLET: GAS J PROPOSED DB-3 3.25 3 X 8.5 3.25 BAFFLE EFFECTIVE LENGTH = 32' '. H-10 DISTRIBUTION BOX INV. 104.01 EXISTING 1,000 GALLON SEPTIC TANK INV. ELEV.= 102.0 _�/ GAS BAFFLE TO BE INSTALLED ON BREAKOUT OUTLET TEE AS MANUFACTURED BY TOP CONC. ELEV.= 102.5 ELEV.= 102.5 TUF-TITE, ZABEL, OR EQUAL Eau INV. ELEV.= 102.0 ®® EM NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING 3) REPLACE EXISTING 1,000 GALLON SEPTIC ®®®®®®® PIPE INVERTS PRIOR TO CONSTRUCTION _ TANK WITH 1500 GALLON SEPTIC TANK BOTTOM E.L.= 95.10 ®®®®®®® ®®®®®®® 2) D-BOX SHALL BE SET LEVEL AND TRUE TO IF FAILED, DAMAGED, OR UNDERSIZED. 4' S FT. 4' GRADE ON A MECHANICALL COMPACTED SIX 4) INSTALL INLET & OUTLET TEES AS REQUIRED INCH CRUSHED STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2) SEPARATION 6.00 FT. EFFECTIVE WIDTH = 13 BOTTOM OF TESTHOLE EL: 94.25 SOIL ABSORPTION SYSTEM (SECTION) SEPTIC SYSTEM PROFILE (500 GALLON LEACH CHAMBER (H-10) LOADING) SOIL LOGS N.T.S. DESIGN CRITERIA P#. 123fol - NUMBER OF BEDROOMS: 4 BEDROOM DESIGN DATE: SEPTEMBER 19, 2008 SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: <2 MIN/IN SOIL EVALUATOR: DARREN MEYER, R.S., CSE DAILY FLOW: 110 G.P.D. DESIGN FLOW: 440 G.P.D. GARBAGE GRINDER: NO (not designed for garbage grinder) WITNESS: DONNA MIORANDI, BARNS. B.O.H. SEPTIC TANK (VOL. REQUIRED): 440 gpd x 2 = 880 gpd (USE EXIST. 1,000G SEPTIC TANK) Elev. TH- 1 Depth Elev. TH-2 Depth LEACHING AREA REQUIRED: (440) = 594.6 S.F. 105.45 0" 105.45 0" .74 1UYFt 3/2 1 A LOAMY SAND A LOAMY SAND USE THREE (3) 500 GALLON PRECAST LEACH CHAMBERS (H-10 LOADING) 104.70 104.70 10YR 3/2 9" WITH 3.25 FT. OF STONE ON ENDS & 4.0 FT. OF STONE ON SIDES: 9" B LOAMY SAND LOAMY SAND 32'L X 13'W X 2'D 10YR 6/4 10YR 6/4 BOTTOM AREA: 32' X 13' = 416 SF 102.03 41" 102.03 SIDE AREA: (32 + 13) X 2 X 2 = 180 SF C1 Cl TOTAL SQUARE FEET PROVIDED = 596 vs. 594.6 REQ'D TOTAL G.P.D. PROVIDED: 441 gpd vs. 440 gpd required +� �F MEDIUM PERC 0100.75 MEDIUM �� MAss9�y PROPOSED SEPTIC SYSTEM UPGRADE PLAN SAND SAND i' D ^R N M G ----- 2.5Y6/4 2.5Y6/4 E 58 MOCKINGBIRD LANE, MARSTONS MILLS, MA No. 1140 t") i Prepared for: Ral h Mahone 132" 94.45 132" C��EO Engineering by: Surveying by: SCALE DRAWN JOB. NO. 94.45 DARRENM.MEYER,R.S. Eco-TeeA Environmental N.T.S. DMM PERC RATE <2 MIN/IN. ("C" HORIZON) PERC RATE <2 MIN/IN. ("C" HORIZON) S4NIT0,0' ao BOX 981 (508) 364-0894 NO GROUNDWATER OBSERVED NO GROUNDWATER OBSERVED EAST SANDWICH,MA02537 DATE CHECKED SHEET NO. W '1� 508-W-2922 10/20/08 DMM 2 of 2 J I bed bed den* room room bath bath liv. din. bed fam rm rm kit room rm bath master suite gar * — door to be removed per BOH. 15T FLOOR 2ND FLOOR 58 MOCKINGBIRD LANE, MARSTONS MILLS, MA ` d i r _ s- / IDS � ,�,,.. ..._ /\•`� /'..J��,•✓ � . _.._ ter'(;:w ' } r• V l'•` f 1/ / I _q 7, /L19A//�oG �S Co!/C= S To ACSF �: : To•� o� " , > �� . O r /-/,v/S///E d �� pc, . . „ , E .. - y •°.:'• 'ovc.Sc,y Sao � r y% % ON �/ - o,.r E • o /vvE p P;,'' 3�St-40 /�Z oil. 7 a';, /�C/E�'r /FAG- `• F •p ! , p,o=.-Gv,J.SNE o ,s•To /E Aq --—��:. �G E v �3 o � Gre%A/O c.,e a ,o/ T' PROFI LE OF SANITARY DISPOSAL SYSTEM NOT TO SCALE DES I G N DATA - BEDROOMS CONSTRUCTION OF SANITARY DISPOSAL DESIGN FLOW - GAL ./DAY SYSTEM SHALL CONFORM TO MASS . LEACH RATE - -- MINJINCH ENVI RON MEKTAL CODE TITLEM PROPOSED LEACH CA PAC IT Y :_ A N D T H E T O W N O F .��' ..3"7-ice 64 ' -/, HEALTH REGULATI ONS. GAL./DAY • r SITE PLAN SHOWING PROPOSED CONSTRUCTION LOCAT1 ON : 7- FOR : �...J, �i .oc'),00/t�, '�77 APPROVED I9 �� BOARD OF HEALTH SCALE: �` �� D A T E - � /�. ��. ��� REFERENCE: eC::: f DATE AGENT va�it`Of t1lt E RUT +' J . M. MONAHAN, JR. �► ASSOCIATEStf��nfy �4,�� C%S TAP ''►. ` '�` REGISTERED. LAND SURVEYORS 8 ENGINEERS t 651 MAIN STR E ET DENNISPORT, MASS. 02639 a.. Ar r • I 1 X` '.c..'�- • Cis .' •/ \ �r,f� '� .^ " f'4.- r - r o ° Q ol 01 -Z V o-/oL �SQF c9v/G7- 7-10 Q ph /N!/EeT .?o G/�LCON /AA�IC- 7 O/sr Y :,I] (7��_ /(/!/EeY SE•oT/G T�•t/.� - Bow /'c/�/E p p 4 ��S!-��Z a" /N!/EAe7- � . bc, '''p r �V ,a Lv `75.��Eo ST�vE p Ip L� �q C. .q.2 �-- / ;40 ---L7�' ` EGE!/ ,BpTTO�c ti. PROFI LE OF /o SANITARY DISPOSAL SYSTEM NOT TO SCALE DESIGN DATA 3 BEDROOMS CONSTRUCTION OF SANITARY DISPOSAL DESIGN FLOW'' GAL ./DAY SYSTEM SHALL CONFORM TO MASS . LEACH RATE -'�- -Z— MINJIMJ.CH ENVIRONMEKTAL CODE TITLEM PROPOSED LEACH CA PAC IT Y :. A N D T H E T O W N O F ' /c�*✓. "'f f-% 4. �,�- .r--;%-"le!�;. HEALTH REGULATIONS. G A L./ &A Y SITE PLAN SHOWING PROPOSED CONSTRUCTION ] F O R . �, /' �/ 7C,- APPROVED 1 9 S C A L E� .� f� =,,�.� DATE= ���'/� �� �.�1.� BOARD OF HEALTH R E F E R E N C E :/ '' ,''.�' � . ,. DATE AGENT $ $YFRF'CT � o LAIN- y LEY N J . M. M O N A H A N, J R - & A S S O C I A T E S �`�clSTV-fk Q� �''►:"''P REGISTERED LAND SURVEYORS & ENGINEERS 6S1 MAfN STREET DENNISPORT, MASS. 02639 S;i� G.. T 7 -/6