Loading...
HomeMy WebLinkAbout2019 Mar 29 - Notes, Emails, Vol. T5 Assessment, Misc. ti\• No. ,e;b1+DC-(S4Rte'! V-,0 V FEE1551 Ul? 1 (Clitv oldko3q3 r COMMONWEALTH or MASSACHUSETTS 1111 Board of Health, ymemo tfn.i ,MA. APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Aplication for a Permit to Construct() Repair$) Upgrade( ) Abandon( ) - 0 Complete System 0 Individual Components Clcation Q .Add?Li Owner's Name hos Map/Parcel# OZSt 24 S ,,•�- L Address Lot# Telephone# Installer's Name Na - ''fArcm Designer's Name Address /7 /f va ftee / Sk wa Address Telephone# 7/ Telephone# Type o Jrildin¢ Lot Size sq.ft. D 3 . 2 9 `9 Garbage grinder( ) C ,�' / No.of persons Showers( ),Cafeteria( ) r nM1 file-/'° '` /: ►; a Nalculate. .esign flow Design flow provided gpd �� � heJ. ��`/� j ` peets Revision Date T • ek Sc 42e6/0-071"1 erd 6 V, 'Soil E iator Date of Evaluation D /6/jital affhvif'it-,- ,,p 1 ,, ,I Rio /act_ is6,-,6,/pei, ZIC /'9F 7 ?/ 6-- l r - Win/ , -@ t-tc�5 .621. 1 _owe_ cext"_- MS /` y,ae 4 4ividual Sewage Disposal System in accordance with the provisions of TITLE 5 and . muci agners w nor u pi t - •. .4yn. o I.4ym . .ia,r ..S. •`. - . irate of Compliance has been�is✓sued by the Board of Health. Si• d ! . .4."1"--,54;1%.-P .4.L�% Date /0 ' .5"-----4J Inspections << No. t+DC-i5-4Liq 5 FEE 7`5c aD _ CON MON LTR OF MASSACHUSETTS Board of Health, )4312M01)714 ,M.A.` ,6/," CERTIFICATE OF COMPLIANCE 7'e e Description of Work: // Individual Component(s) 0 Complete System Carr' The undersigned hereby certify that the Sewage Disposal System; Constructed( ),Repaired f Upgraded ( ),Abandoned( by: a-e f t4,47As JIM— , C .�- �C4•PciC- at dvv `>v�.il- Gi0.�.e. lcl//......' .a/ 1e S .L ya..c-��- installe in It dant a wail'the ovisions of 310 CMR 15.00 Title 5) and the approved design plans/as-built plans relating to has been _ l application No./Sj =1 • 0 , dated /0--64'/.Approved Design Flow (gpd) Installer -1-6 PS Date: 111 i J���,a O/,c/ i Designer: —"" Inspector: fiet.kir i 1' rh.;....aonu .f th;a nor.14.hall not 1w ennctrlPti ac a m.arantee that the cvstem will function as designed. . . -,2 9 -/ 7 /4"- , o ('4j 7/, d� 7�O � 'oar/c/t� of idddr/ vonHone, Am QV 'i . ' e ° kap , /to • friar ,' IF From: Joe Phillips <joe@phillipsinsurance.com> Sent: Thursday, March 28, 2019 1:08 PM To: vonHone,Amy Cc: Murphy, Bruce Subject: RE:200 South Shore Dr/8 Lyndale Road I think I understand the discrepancy.Until 1985 there were 2 bedrooms downstairs and one open area upstairs with 8 beds.In 1985 they made the open area into 3 rooms. Joseph Phillips,AFSB, CRIS 413-896-9272 From:Joe Phillips [mailto:joe@phillipsinsurance.com] Sent:Thursday, March 28,2019 12:59 PM To: 'vonHone,Amy'<AVonHone@yarmouth.ma.us> Cc:'Murphy, Bruce'<BMurphy@yarmouth.ma.us> Subject: RE: 200 South Shore Dr/8 Lyndale Road Thanks,the house currently has 5 bedrooms. It had 6 bedrooms from 1985 until around 2005.Now it has 5.My family owned the house from 1960(I think)until June 2015 when I bought it from my mother we estate and my 6 siblings.I have a special needs daughter that has to sleep on first floor so that is reason for plan.The house is occupied 50 days in the summer each year Any direction appreciated. Joseph Phillips,AFSB, CRIS 413-896-9272 From:vonHone,Amy [mailto:AVonHone(a varmouth.ma.us] Sent:Thursday, March 28, 2019 12:37 PM To:'joe@phillipsinsurance.com'<ioePphillipsinsurance.com> Cc: Murphy, Bruce<BMurphv@varmouth.ma.us> Subject: FW: 200 South Shore Dr/8 Lyndale Road Hi Joe- In response to your request regarding the possible expansion of an existing bedroom and addition of a bathroom, I have researched our files and have the following comments. 1. 1987 septic system upgrade for a maximum 3 bedroom capacity per as-built card submitted by septic system installer 2. Current assessors record indicates 4 bedrooms(past records range from 2 bedrooms to 5 bedrooms) 3. Voluntary Title 5 Inspection Report dated July 23, 2014 attached to your email stating septic design for 3 bedrooms with actual number of existing 5 bedrooms(page 6).Our office did not have a copy of this 2014 report because we are not required to receive Voluntary inspection reports. 1 vonHone, Amy From: vonHone,Amy Sent: Thursday, March 28, 2019 12:37 PM To: joe@phillipsinsurance.com' Cc: Murphy, Bruce Subject: FW:200 South Shore Dr/8 Lyndale Road Hi Joe- In response to your request regarding the possible expansion of an existing bedroom and addition of a bathroom, I have researched our files and have the following comments. 1. 1987 septic system upgrade for a maximum 3 bedroom capacity per as-built card submitted by septic system installer 2. Current assessors record indicates 4 bedrooms(past records range from 2 bedrooms to 5 bedrooms) 3. Voluntary Title 5 Inspection Report dated July 23,2014 attached to your email stating septic design for 3 bedrooms with actual number of existing 5 bedrooms(page 6).Our office did not have a copy of this 2014 report because we are not required to receive Voluntary inspection reports. 4. Voluntary inspection report states conditional pass because of a deteriorating dbox, broken tank inlet cover,and cracked outlet tee. Repairs of all those issues were completed under a Title 5 repair permit filed with the Health Department on October 6, 2015. 5. Voluntary inspection report states the existing 1987 leach facility is located 0.5' above adjusted groundwater as of July 23, 2014. Current Title 5 code requires minimum 5' separation; 1978 code required a minimum 4' separation under which the existing system was installed. Based on my preliminary review,there is a discrepancy with number of existing bedrooms currently in the home. Additionally,the existing septic system is grandfathered for a maximum 3 bedroom capacity. Could you provide additional documentation, i.e.floor plan,that can clarify the total number of bedrooms in the home and/or past permitting that addresses the possible change in number of bedrooms? Once we clarify the bedroom count,we will be better able to determine the possibility of renovations to the home with the current septic system. Thank you for your inquiry and I will wait to hear from you. Amy Amy L.von Hone, R.S.,C.H.O. Assistant Health Director Yarmouth Health Department From: Murphy, Bruce Sent:Wednesday, March 27, 2019 5:34 PM To:vonHone,Amy<AVonHone@yarmouth.ma.us> Subject: FW: 200 south shore dr Hi Can you review and respond to this request. Thanks Bruce 1 From:Joe Phillips [mailto:ioe@phillipsinsurance.com] Sent:Tuesday, March 26,2019 1:14 PM To: Murphy, Bruce<BMurphv@varmouth.ma.us> Subject: 200 south shore dr Hi Bruce, We are attempting to do a 15 x 17 addition starting 2 feet into left corner of our house,please see attached. It will be an addition to an existing bedroom and adding a bathroom. The highlighted line of the attached letter prompted me to reach out to you. We have 1000 gallon system and the house is used probably 50 days a year. Any insight appreciated.Thanks Joe Joseph M. Phillips,AFSB, CRIS Phillips Insurance Agency, Inc. 97 Center Street Chicopee, Mass 01013 www.phillipsinsurance.com cell:413-896-9272 2 4-4 C.6 oo r '' o or ce ON r" s it� .. y M to N Y � P o e.1 .� N LNL V o Oo c t' V)N ma ODMOON O S,...n.tib M it qva. N ti .� NM M O© OO wmso `4; ,c d,HOo Eo� UMNNSc" �OOQ 000rWN �OM�pg NQM O O ap —NN �A w c oc 79 'i4 Nw Q h 1 44 OOq°OOmS c'-*'I' • NZ Uo `°oDar .,1.•“...) a d o EO, o � OE v' U o o 5 a= > E 0 0 0c . c ti N �" 4 0 oiaM° Oo a8aac3 U naa �, � © C 00w e y 0 0 ..¢ z� Gx � owwUUo ¢ooUN Q • .�,y is o. p Co t� ei 'V i = y p 7 �'C Ol �+. 5 11 —e. O pp V y 0 Q v 4; Q W `e °' a s x ° `o d o°1n ° m?3 `" s oo, "4 4 d .4 W•L d �_ V1 d i L m d �_ �' t A 0 "1 ". (4 0^yJ > 3 p to m i 7 O R p d CQ > p O y y Z c.) OdN 3 C� dCU4 C7RUa d ` c i W cC V U 00 � h ��x porn °e C' • "o p R ,. M M in 'C C M 7 M 7 ,...,-.4 a O c-) — y d �g O c, ' O O O N — = =, = O O O O O O N r O O .4 U� u y E 1,1 on O N t '�' ©. h 0 0 - .. . D..% z'N V sem. N y _q F� W a 1. 0.1 i ,� L o 0.1 w -5..., Q' ti C q r 3 3 > 3 3 w w ° Y o V C4N o ° L. O °' y c. ? ° v� U o 0 o o w F W W x X C4 N`L' o a °' v b 'V. :; °' o o ani `v t v ° a ca ca m m ea a o f U V p V h o ;? o x K o o U o 0 0 0 0 R Udo" dv� 0.1 cn , C7cnOwcvx � $ Sax ¢ HFFHHW aw 0.1wtz� - , o o o a o = e. -, o o = ,71 o o o .....© „,..,:,' t ':'.. tin en i, ....., as - --, ,.6. ,0 - •.! en gal el. t". o o •-' ,-" r,l, . tee "..-. c 's 7 Z • sOw) s r--P) .. un '4.) m t., . . m rit .-- - e4 o Ta oc .4- MI L. ce ., . . . s es e.t ,• 4.) u ' '74 • 1C) ; 6 • ,- ...,.. 'T ,-I 0 0 *7"— - 0, 4141...‘ r....1.... A -T .- c- ,•=7. © 24 -- 1.,T4c, xciacia= "R-CsArTi 4.1 o 70 *.c .- z cron In _ ....M In cy -'' I 0.• ...z i 1'1 O V, ,.. s. ..'''. tt q t'1) t4 cl) .,: .., .. tt, z,. 8 .—.,:p., . • a., a ,-. -6 - t 44„ 1) 'rt -crs 2 a er tz.1 -4 - .F, › > -c; . z •• ._ I. 4.1 ' VI i-3- CO: IQ LI, CX "COgio4g,SP,„ coX0 -) 09 .•• E -; 4.1 7 Cras,-,v,ONN ,I -4 c '1) 71) 7) "Fli 3 <F''''•-2 E t e.,.,rs,.r...•p._ t CC,::. st.1;1 .,.f., •.'-' •- •Fi 7s" rel ,'7.-c.,z ce g; 'is"- E.. 4:N.,QS C.4 + 0 MI ct y. •5 7.i. = Co = .., ei .-.'- =',4c ''' (11 4. '0'.e.1 " t, '6, cl• u - 74. '-a" tt '41 .. c :=, 0 > < z ; ogu ---- .‹ .‹ .< .< r./) - oo 44 "s en m c4 C13 z ' C • . ..,. z. ,••• .<,... ii (-) ''' I-. =,.-.1 3....,.., , Is'wa —— g: =g ,...,, 0: 040 ••• =rx • u- •• 0 gt), :::, 0 Cr C0 -E„,„,.. [-• CA :4 e4N' gl zci, v 418 C 4; 4.„ ,- C4 c: Q 14.1 c' N ZO t. SZ_ 4+ ....... i' Cli.1 Cli 44 ^ tu 7 0 s Tr4 T.4-= 44 rol LC --.p •• 6 1) 1. s.4 1 o 1' 41 z ...1 TO ..., •er 0 7 W.a.' 0 .'.‘le,'-' q4 f111 .41. 1...E .,, _ 04 b 44 N. e.., _ •., 44 O y g4 4 ,z, C C 6 C. ,.„ 'T• ral r4 ml ..... c'...a`•- d 0,41 w'm G.T. t '' L. s ct 44 tn (-4 O 44 CO1 . . .*44 41+1 te. -111, 4T4 ... _ czzi ;..et © sl••••,== I ,,,I r 18 ,...-4- )..., •'z.. -.4 •E ei tz e4- *S .0 pr ,.. 0 ,-.. _,,,0 E k4 Cq & •cs g o. tn ,..0, *a, ? ..siel 4t et ,e; . -,i.,t..._ _ ,,,00 44 tel ft 0 74 e- 7 s = s - = 1. Z g..., .• w, i -- *„- . cd L, tr.). ,47•4rw - 7: d 44 ca te ,.., s 7) 'i E. P. ,<tEr.et 11,Ln 4'1 Z '' •=,--1=c4.4 .`` . c0 N C:, Cen:01:14NC• tte' st cn g te'l 04 44 Pel 'r-I 1 E-,Z ,.. o ,4 al LT.1 11 s g c ,-4 a4 rn tu'e)ce d 04 4::• _ co C.:4 LT,4 © t,.. nq r....4 17._-' t• 't . c., 4 . t,.,o o t ', W „ .._. -1 107 ••,t A N C.) 04 =Mal .. z ---0 ,,7, " 0 0 ce t• u o ,p r- ,d Z 0 01 0 0 q0 , z, '=' z.. t..) ,..,•0,ce. c .• . _ .,,t con tn cn *4 A (,4 Z W f.7 To o.,C.Lt• cL, OZ > X :(. N 7+ • ,-. I= ..0 ,11_,-1,,.4 =.: o .'4'. ,`•••x g., °12 0.1:ma+ I:, 6. . . .._,2 p.--( 5.‘,/ itef//716. A-71-(r /5(4/#4/4-- .)_./ _9....(cm--), .._, --•„,. � ...t Jyern corm - tic Voluntary Assessments 200 South Shore Drive Yarmouth MA Property Address Marr Phillips e/o Joe Phillips 72 Dartmouth Rd •—et, ' Cw ner's Nae m eery Longmeadow MA 01106 7/23 /2014 City/Town State Zip Cade Date of hspection Inspection results must be cube i ted on this form. Inspection forms may not be altered in an way. Please see completeness checklist at the end of the form. y ;en A. General Information er, To b kr1. Inspector. 3oa Martins 04 k Accu Sepcheck Namof hs f4 r `1 F pector S. Dennis, MA 02661 ' 10, Name Company Nacre Company Address CitylTownQ� 1 .,.k. �o O -3E36--: 8 g ( State �-^ I I d 7 Zip Code Telephone Number J License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the , information reported below is true, accurate and complete as of the time of the inspection. The inspection 'was performed based on my training and experience in the proper function and maintenance of on site sewagtdisposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of w Title 5 (310 CMR 15.000). The system: ❑ Passes L(d Conditionally Passes 0 Fails ❑ Needs Further Evaluation by the Local Approving Authority (2.:„ /Irt/ArAdi — eP)' "-- hsp ors Sgnatu e r •- £ � , Date •eCtoF 4� b ita •p ., • . t.,. _ � ,• pravin Authority a : . x •� 0 1,,;II ��...�`f , .i: � � n � 9 y(Board • e e'., a r, e i s�e tor and th h Agra or 'S 4411" ip a yl' o � `, ., !u :, � � ent to the system owner IL ****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. ..-----r-- r4 Op-J.- / (�r'G.•. 3 •P -; ...m•Pd�C lc(t7 Ld6 Lv'°4�-'g- 4,k, asuLD bU ldE:e ewage utsposat System Form -.—.. „_-Voluntary Assessments 200 South Shore Drive Yarmouth MA Ft.eperty Address Mary Phillips c/o Joe Phillips 72 Dartmouth Rd Qv re's Name Longmeadow MA 01106 7/ 23 /2014 CitytTown State Zip Code tate of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E I always complete all of Section D A) System Passes: 0 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 VO TARY ASSESSMEfT B) System Conditionally Passes: ad One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND) for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. "A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. 0 Y 0 N 0 ND(Explain below): dfs i•rt 64/1-2/A4 //--Lidex,,,c,„0/67 2 04 cern / /- T c a frei — t /s X 1-0,ke,-) oewage uisposai system Form -*' .r Voluntary Assessments 200 South Shore Drive Yarmouth MA Property Address Mary Phillips e/U Joe Phillips 72 Dar/mouth Rd cw War's Nanta eir, Longmeadow MA 01106 7/ 23 /2014 City/T 'n State Zip Code date of hs paction B. Certification (cont) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): 0 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) El broken pipe(s)are replaced ❑ Y ONO ND(Explain,bl3tow): ❑ obstruction is removed ❑ Y ONON -(Bxplain below): ❑ distribution box is leveled or replaced El Y V:011.1 ReYw )A-SSESSMENI ❑ The system required pumping rmore than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection ' with approval of the Board of Health): ❑ broken pipe(s) - replaced ❑ Y ONO ND(Explain below): ❑ obstructio s removed OYON Cl ND(Explain below): C) Further Evaluation is Required by the Board of Health: 0 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 El Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh -- • ..•Page 3o!17 I __0- -°-r....a. ...yz•csin rorm • _r Voluntary Assessments i. 200 South Shore Drive Yarmouth MA r:`aperty Address Male Phillips ciao Joe Phillips 72 Dartmouth Rd ONner`s Name Longmeadow MA 01 106 7/23 /2014 t]ty;Town State Zip Code Date of inspection B. Certification (cont.) i 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: 0 The system has a septic tank and soil absorption system AS)and the SAS is within 100 feet of a surface water supply or tributary to a surfare'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 SASy,arid the SAS is within 50 feet of a private orate r supply well. ❑ The system has a septic tank and SASS and the SAS is less than 100 feet but 50 feet or more from a private water supply ell** Method used to determine distance: ..--- ,. ** This system passes if.the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicfes absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 pprp, provided that no other failure criteria are triggered. A copy of the analysis.must be attached to thi form. 3. Othe ' UNThRY D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or "No" to each of the following for AA inspections: Yes No ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ fij,,'"f Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ Q-" 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 i. pagegafli ji subsurface Sewage Disposal System Form — Voluntary Assessments 200 South Shore Drive Yarmouth MA RopertyAddress Mary Phillips c/o Joe Phillips 72 Dartmouth Rd Qv ner's Name Longmeadow MA 01106 7/ 23 /201=1 City frown State Zip Code Date of inspection P. Cte toftc.atiror (r-pnt.) Yes No VOLUNTARY ❑ Required pumping more than 4 times iSStirEffr obstructed pipe(s). Number of times p i" ❑ C13r Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ �.7 Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ Q' Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ [13"% Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ 42Any 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 ata 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. ite The system ❑ The systefails. 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 of a surface drinking water supply O 0 the syste • within 200 feet of a tributary to a surface drinking water supply ❑ ❑ •- system is located in a nitrogen sensitive area(Interim Wellhead Protection Area— IWPA)or a mapped Zone Il of a public water supply well If you h answered "yes"to any question in Section E the system is considered a significant threat, or atz ered "yes" in Section D above the large system has failed. The owner or operator of any large s,stem 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. •Page 5oi17 Subsurface Sewage Disposal System Form - r Voluntary Assessments 200 South Shore Drive Yarmouth MA R`operty Address Mary Phillips c/o Joe Phillips 72 Dartmouth Rd ow nes tsar, Longmeadow MA�v 01106 7/ 23 /2014 City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You m it yT4"RaChayFA of the following: Yes No ASSESSMENT ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ Cir Were any of the system components pumped out in the previous two weeks? ❑ ET Has the system received normal flows in the previous two week period'? ❑ Exp` Have large volumes of water been introduced to the system recently or as part of this inspection? ,Ai`/Iz 0 El Were as built plans of the system obtained and examined?(If they were not /! available note as N/A) 1 ' ❑ Was the facility or dwelling inspected for signs of sewage back up? az 0 Was the site inspected for signs of break out? finc 0 Were all system components, ex ' g 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: 0 0 Existing information. For example, a plan at the Board of Health. t' ❑ 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)] C. System Information Residential Flow Conditions: Number of bedroomsdesi n ( g ) Number of bedrooms (actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): frtL ) p,p _ ...•Paye6oti7 Subsurface Sewage DisposalhVoluntary nta ry Assessments 200 SouthSore Drive Yarmouth MA Property Address Mary Phillips c/o Joe Phillips 72 Dartmouth Rd Cy.,nes Name Longmeadow MA 01106 7/ 23 0014 Cityl'rown State Zip Code Date of inspection D. Svcfpm irtfnrmatir n VOL UNTA pv Description: /tT { ;<aitc ASSES ‘" , -sr -447) 44.XStviEtvT Number of current residents: Does residence have a garbage grinder? 0 Yes 12Y No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes No information in this report.) Laundry system inspected? /,4 0 Yes ❑ No Seasonal use? Yes '❑ No Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? 0 Yes No Last date of occupancy: / f Date 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? 0 Yes 0 No Industrial waste holdi present? 0 Yes 0 No Non-s-• -ry waste discharged to the Title 5 system? El Yes 0 No Water meter readings, if available: T' •Pao-7017 • .scram a uiSposai system Form • . Voluntary Assessments 200 South Shore Drive Yarmouth MA Property Address Mary Phillips elo Joe Phillips 72 Dartmouth Rd Owner's Marne feyLongmeadowMA 01 106 7/ 23 /2014 City/Town State Zi Code Pcote of inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): • s IA y General information Pumping Records: et, /2e evi— loti Source of information: f 'l r Was system pumped as part of the inspection? ❑ Yes No If yes, volume pumped: ////// ```iii gallons How was quantity pumped determined? Reason for pumping: Type of System: Septic tank, distribution box, soil absorption system 0 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 VA system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): -.- - - - •Page Bot t7 Subsurface Sewage Disposal _ -Voluntary 9 Form -:, .r VoluntaAssessments 200 South Shore Drive Yarmouth MA PopertyAddress Mary Pliilli ps c/o Joe Phillips 72 Dartmouth Rd ON ne&s ttarr Longmeadow MA 01106 7123 /2014 City/Town State Zip Code Date of Inspection D. System information (cont.) Approximate age of all components, date installed(if known)and source of information: "?-7 /eeis. X57-4f 2d /67P 7 ..)/11: h4 Were sewage odors detected when arriving at the site? tytt4e1AYNo tic) Building Sewer(locate on site plan): Depth below gra de: Material of construction: (cast iron 0 40 PVC 0 other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): 0/€ /l 0 "...pat kr V/s/b (ts°' o # G ' r\t- Septic Tank(locate on site plan): Depth below grade: feet Material of construction: concrete 0 metal 0 fiberglass 0 polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes 0 No Dimensions: ��X�S,�X �/Q rJ Sludge depth: __-., •Paye9of 17 -- v. t,e�{�c,saj aystem Form - r Voluntary Assessments 200 South Shore Drive Yarmouth MA Property Address Mary Phillips c'o Joe Phillips 72 Dartmouth Rd Orr re's Name Longmeadow MA 01 106 7/23 /2014 City town state ��Code Date of hspectbn D. System Information (cont.) Septic Tank(cont ) IARY 2 q" Distance from top of sludge to botto o Sim r e gtf 1 Scum thickness t Distance from top of scum to top of outlet tee or baffle / C' Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? t' ,>° t°',� Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): irk✓ ! 7` ty rack- Grease Trap (locate on site plan): Depth below grade: feet Material of construction: 0 concrete ❑ metal 0 fiberglass g ,,__ ❑polyethylene 0 other(explain): Dimensions: Scum thickness Distan rom top of scum to top of outlet tee or baffle !stance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date �--- - n•Page la or 17 oewaye uisposai system Form • ..,,, ,4,,, Voluntary Assessments 200 South Shore Drive Yarmouth MA Property Address Mary Phillips elo Joe Phillips 72 Dartmouth Rd Cw ner's Name ery cityrro�vn Lontnneadow MA (11106) 7,/ 23 /2014 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.): N TA_R y AS . ESSME NT Tight or Holding Tank(tank t be mped at time of inspection)(locate on site plan); Depth below grade: Material of constru on: 0 concrete 0 metal 0 fiberglass ❑ lene of eth P Y Y 0 other(explain): D' ensions: ✓' Capacity: gallons s Design Flow gallons per day Alarm present: � r r Yes 0 No Alarm level: Alarm in working order: 0 Yes 0 No Date of last pumping: Date Comments (condition of al. and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? 0 Yes 0 No ..•Page 11 or 17 I i;-- Subsurface Sewage Disposal System Form -I.-Li - r Voluntary Assessments 200 South Shore Drive Yarmouth MA Popeny Address Mar.,' Phillips elo Joe Phillips 72 Dartmouth Rd Cw nes Name Longmeadow MA 01106 7/ 23 0014 -,/ City/Town State Zip Code Date of Inspection I D. System information (cont.) 1 Distribution Box (if present must be opened)(locate on site plan): Depth of liquid level above outlet invert /27 /44"(972 TS mments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any tke, dence of leakage into or out of box, etc.). 1 i b 0 VI4 i' D.d 6).y. ' c).Pg../ te Ze ikeitAPae' '' Pump Chamber(locate on site plan). Pumps in working order ID Yes_ 0 No* ----- 1 Alarms in working order . 0 Yes 0 No _- - - Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): ..-- . . .._ „-.- .--- . '.7 .. ...--- If pumps or alarms are not in working order, system is a conditional pass. --7 Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: ( Subsurface Sewage Disposal System Form - •Voluntary Assessments 200 South Shore Drive Yarmouth M Property Address Mary Phillips clo Joe Phillips 72 Dartmouth Rd owner's Name Longmeadow MA 01106 7/ 23 /2014 aty/Town State Zip Code Date of hspection D. System Information (cont.) TypeN4(1\‘Al PA9k ❑ leaching pits nuo••- leaching chambers SSVAI •er. ,*4/ L � kSSleachinggalleries number. >/it9e C ,r/ ❑ leaching trenches number, length: O leaching fields number, dimensions: ❑ overflow cesspool number. ❑ innovative/altematitie system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): S7-7 ,..? F197 Ali �a' `e k- e? 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 const • ion Indication : groundwater inflow 0 Yes 0 No rw•. _.,...,........_..._ .R...:y....:.. .Page 13 d 17 4 Subsurface Sewage Uisposai System Form "7: Voluntary Assessments 200 South Shore Drive Yarmouth MA Property Address Mary Phillips cfo Joe Phillips 72 Dartmouth Rd owner's Name ry Longmeadow MA 01106 7/ 23 /2014 City/Town State Zip Code Cate of Inspection D. System information (cant) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): VOLUNT l INSSES ,3t Privy(locate on site plan): 7 Materials of construction: j Dimensions Depth of solids Comments (note conditio of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): r .AVusta oewage utsposat system Form -" ,'oluntary Assessments 200 South Shore Brite Yarmouth MA Property Address Mary Phillips c/o Joe Phillips 72 Dartmouth Rd ON ner's Mame xy Longmeadow MA 01 106 7! 23 0014 city;7own State Zip Code tate of Inspection D. System information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate vrher� public water supply enters the buildi g F �k ri plartARlacrw. hand-sketch in the area below 0 drawing attached separately i,.. kf 1W..' .„, ....,n `° .' maw ik I#r,,..ma % Y1 O , PAt N7 •R 0 i7 23 k '' '''' ', /xj" - .:1 . • -33 ,' biz--- ; /4-2_,--:- 3 = i3 = 2555 a3 = 3 84- Z31' eq `"32 „- - - _ _• WWI -ivut K,r voluntary Assessments 200 South Shore Drive Yarmouth MA Property Address N4ari-- Phillips c/o Joe Phillips 72 Dartmouth Rd Ow net's Name fez,/ Longmeadow MA 01106 7/23 /2014 City:Town State Zip Code Date of Inspection D. System Information (cant.) Site Exam: E Check Slope VOLUNTARY lkiSurface water ASSESSMENT 1 `Check cellar Shallow wells Estimated depth to high ground water: 0 ' 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 Qt 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) [Th”. Accessed USGS database-explain: 124/1)Ptle J 1 , You must describe how you established the high ground water elevation: t 17 -rid` «' f4r S- f 1t� • / . /t 2 ,Q`I prop. me 7/.1(21 _ 2. 2. S-e/94v-abeli 4 4/4 a .2) 7- Before filing this Inspection Report, please see Report Completeness Ch^^klist on next page. • /issessments 200 South Shore Drive Yarmouth MA Property Address Mary Phillips c/o Joe Phillips 72 Dartmouth Rd Cwrier's Name iery Longmeadow MA 01106 7/ 73 /7014 Cflyfrown State Zip Code Date of Inspection E. Report Completeness Checklist 0-1/Inspection Summary' A, B, C, D, or E checked fQ1 Inspection Summary D(System Failure Criteria Applicable to All Systems)completed EZI System Information —Estimated depth to high groundwater LC Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file VOLUNTARY ASSESSMENT }1} ei Or }1} . , i SWEETSER ENGINEERING 203 SETUCKET ROAD-P.O. BOX 713—SOUTH DENNIS—MASSACHUSETTS 02660 TEL(508) 385-6900 SweetserEng(a�aol.com FAX(508) 385-6991 LAND SURVEYING—ENGINEERING—TITLE 5 SEPTIC SYSTEMS March 26,2019 Joseph Phillips joe@phillipsinsurance.com 72 Dartmouth Road Longmeadow,MA 01106 RE: Surveying Services @ 8 Lyndale Road, South Yarmouth In response to your inquiry regarding our surveying services. Our fee to prepare a proposed plot plan is$550.00. This includes research,traverse,locate existing structures,breakdown field notes,computations,prepare plan,copies. We must know the size and location for the proposed addition prior to the survey in order to show it on the plan. I have the sketch you emailed,please advise which dimension is the 17'. The estimated timeframe is 10-15 business days(weather dependent). Our timeframe is an estimate and work may be done sooner and occasionally later than estimated(weather dependent) Please be aware,the above is our customary fee for the services requested,however your house appears to be entirely in the FEMA Flood Zone AE EL 11. This may require filing with Conservation Commission. If such a filing is required,additional survey and information will need to be shown on the plan at additional cost. You should contact the Conservation agent,Kelly Grant to discuss your project and so she may let you know what if any filing that might be required : W* _. . r._...N . „. , ,_ r .. _ �_ �.. r,. ..._. . *ma Terms for payment for a certified plot plan: $350.00 retainer with balance due upon completion of the plan prior to its release. For us to proceed,please sign the bottom of this proposal verifying the work to done,as well as giving us permission to be on the property and return it along with the requested retainer. Please make check payable to Sweetser Engineering. We also accept payment via cash or credit card. If you plan to pay with a credit card,you will need to call the office to provide the necessary information. All balances must be paid in full prior to the release of the plans. PLEASE NOTE: No work will be done until we receive this signed proposal and retainer. Offered by: Accepted by: Seide,erdeA &9ime,ewe9 SWEETSER ENGINEERING Authorized signature Date Our work is proprietary and copyrighted. We do not release electronic copies of our work,only hard copies. Any revisions made to this signed proposal may deem it null and void if not accepted by BOTH parties No warranty or guarantee is implied or given to favorable decisions of any local,county,state or federal,board, commission,committee,department,official,employee,consultant or any person so authorized. This proposal may be withdrawn or prices and time-frames may change if not accepted within 30 days. Invoices are payable upon receipt. Interest of 1.50%per month charged on outstanding balances after 30 days. Plan revisions are not included in this quote. Requested changes may result in additional costs to the requester. Minor changes will be charged at$150 per hour,$150.00 minimum. Only our Professional Land Surveyor or OUR associates may make changes to stamped and signed plans produced by this office. Changes made by others to our stamped and signed plans render them null and void. Major revisions will be charged based on the change requested,time,drafting time,printing costs,prints,etc. Ask for an estimate. Any requested changes/meetings in-office will be billed at the rate of$150 per hour,$150 minimum. Meetings outside our office will include travel time and meeting time,$200(min)for the first hour and$150 per hour thereafter. Design Plans,filings and certifications released upon payment of all outstanding balances. Checks returned unpaid shall be subject to a$25.00 returned check fee Checks returned unpaid shall be reimbursed via certified bank check or cash only and shall include the$25.00 returned check fee.