HomeMy WebLinkAbout0153 FAWCETT LANE - Health 153 FAWCETT LN. ,HYANNIS
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TOWN OF BARNSTABLE _
LocA 'ION�5 f 9w C �� �ti SEWAGE #
` +/ILLAGE ASSESSOR'S MAP & LOT0261-14
INSTALLER'S NAME&PHONE NO. ®O
SEPTIC TANK CP_PACITY / 'Oa
LEACI-BNG FACM=: (type) Den,i (size) 3,x�2
NO. OF BEDROOMS
BUILDER OR OWNER
PERMITDATE:69—A y" h ., COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist.
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility (If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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�Z-ek-M' W&-Xt��SEWAGE
WN OF B STABLE
LOCATION #
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-'✓II.LAGE S ASSESSOR'S MAP &Z,DTl
INSTALLER'S NAME&4NE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) (size)
NO. OF BEDROOMS
BUILDER OR OWNER
PERMTTDATE: COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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Wlj a
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TOWN OF BARNSTABLE
LOCATION 5�p .G`� 'C.�/� SEWAGE # Z ` IS 60
VILLAGE_ _. � rwd S ASSESSOR'S MAP & LOT ,:�61f- 14 6�
INSTALLER'S NAME & PHONE NO. did P-r,(/jg�y1 ��YL
SEPTIC TANK CAPACITYtj
C r
LEACHING FACILITY:(type) (size) /�� '®
NO. OF BEDROOMS 3 PRIVATE WELL OR 1'�C W—�It
I BUILDER OR OWNER
DATE PERMIT ISSUED: ( l Y LI - 21
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No .
Ur
TOWN OF BARNSTABLE
LOCATION 155 � T ZVI SEWAGE#. (Z3,3
VILLAGh " "' ASSESSOR'S MAP&PARCEL 7� 7
INSTALLER'S NAME&PHONE NO.I' (X_ —RLWJ
SEPTIC TANK CAPACITY -Ud
LEACHING FACILITY:(type) - Spa (size) 16 )<, XZ_
NO.OF BEDROOMS
OWNER " al.
PERMIT DATE: `� L \ COMPLIANCE DATE: &AI
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility(If any wells exist on
site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist within
300 feet of leaching facility) Feet
FURNISHED BY 'ID ��/
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TOWN OF BARNSTABLE C
zOCATION -F,0,14617' Z4A P, SEWAGE # 168 00
VILLAGE !lvrs�t~ ASSESSOR'S MAP & LOT 270 /77
INSTALLER'S NAME&PHONE NO. _975-oV fZ
SEPTIC TANK CAPACITY _ /000
LEACHING FACILITY: (type) 2-�SOa 6,al /fin...,cvi=l/s (size) _,U X /
NO.OF BEDROOMS s'
BUILDER OR'OWNER �s4ysSODl�I
PERMITDATE: 3-20- 00 COMPLIANCE DATE:
Separation Distance Between the: .
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply.Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland.and Leaching Facility(If any wetlands exist
within 300'feet of lea chin faciilii Feet
Furnished by
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No. pL Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN:OF BARNSTABLE, MASSACHUSETTS
appfication for isposaf 6pstem Construction i3ermit
Application for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.iS3 Owner's�ame,Address,and Tel.No._CNft4% Umb
i�3 r4,e ,c4-j, �^ Vv q^"%�
Assessor's Map/Parcel � p j`1°�
Jnstaller's ame,Address,and Te No.''U� �lj�--X6Zl Designer's Name,Address,and Tel.No. " L4AC. S14'fr_
C 3 a .:'...e-'•.�y,e�s ,� �:►�b �- � �✓E-s.r y�i�
It C "L 0'0
Type of Building:
Dwelling No.of Bedrooms Lot Size 3 OLD® � sq.ft. Garbage Grinder( )
r
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) 33 o gpd Design flow provided -331 gpd
Plan Date iLl�b3�Vi Number of sheets Revision Date
Title
Size of Septic Tank j6i�-0-: g �.p Type of S.A.S.(3��J,* 'tea 40,ALA^
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) ' P IL � r V �
s.
���>�-1 �..� ��,t a—[may" t rt �// 1„
Date last inspected:
Agreement:
The undersigned agrees to ensure the constructio/Codnd
f the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environme place the system in operation until a Certificate of
Compliance has been issued by this Board lth.
x Signed A Date
Application Approved by _ All A Date
Application Disapproved by Date
for the following reasons
Permit N0.
�� -' Date Issued
No. r} �'' r' Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
•{ PUBLIC HEALTH DIVISION-- TOWN, �OF BARNSTABLE;"-W-ASSACHUSETTS
fiplication for„ isposal Opstem Construction Permit
Application for a Permit to Construct(Y Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No.Is3 Ta%.lc¢At Doi.. -3, Owner's Name,Address,and Tel.No.7:&,�Nr, v{„6
Assessor's Map/Parcel "k D �-11
Installer's Name,Address,and Te.No.`fim�Jay Ct t;0.v"C 0 Designer's Name,Address,and Tel.No. Ikkk COT.41C FA'�,e- , l'c: y' �'+4 r,� ,s' LL. - cis lUL- 213 W'L I.r
per (Tb �F l-Lt-n SQ$ 7 •-4 100
Type of Building:
Dwelling No.of Bedrooms 3 Lot Size 0 060 0 � sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
I
Other Fixtures
Design Flow(min.required) gpd Design flow provided 331 gpd
Plan Date �Z ,� Number of sheets Revision Date
Title
I
Size of Septic Tank o,on_ Type of S.A.S. ( 3\ tt--1 a �>oo Cto-V n n Q�%4 6d r J
Description of Soil Se-e-
Nf't'ture of Repairs or Alterations(Answer when applicable) 4-n Ski.t\ NcW
"
�r
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and mainten ce of the afore described on-site sewage disposal system in,
accordance with the provisions of Title 5 of the Environmental Code d not to place the system in operation until a Certificate of y
Compliance has been issued by this Board , ee th.
tSigned _�f n -A / Date
/ t�,
Application Approved by ;, / , Date / �2 �21
i Application Disapproved by 0 J Date
i
for the following reasons
Permit No. a 0 J Date Issued -.2 2
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( W- Repaired( ) Upgraded( )
Abandoned( )by ^,, I
q \..c�A`,�.r C.•T
atr.�✓C _t ,� ,-.. ..n.,'..c has been constructed in accordance
with the provisions of Title 5 and the fo .'sposal System Construction Permit No. dated
AInstaller {/ Designer Mk tw ,-'c- 11L (' ,
#bedrooms Approved design flow gP
V d
The issuance of this permit shall not be construed as a guarantee that the system willas�daesid.
Date oZ ��( 1 j�� Inspector
i ---- ----------------------------------- -----
No. "�G' I C2
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
Disposal 6pstem Construction Permit
j Permission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( )
System located at. l /, ,t^ n7,
i
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction must be completed within three years of the date of this permit.
Date 2 2 Approved by
Town of Barnstable
Regulatory Services
*
Richard V. Scali, Interim Director
* enxxsrnsi.e. •
. Public Health Division
�F039. a Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date: Sewage Per �, Assessor's Map\Parcel V10 ��
'7
Designer: AV 7'T W�J Installer:
Address: q� •1Ay��t Address: 61? F1 S-t-rbte-
On ®` ��`�`� , C-C was issued a permit to install a m
(date) (installer)
septic system at 1,a rh-a/Ge7-f— Ott based on a design drawn by
(address)
�c u rr /V(e l°10'{`� dated
(designer)
V I certify that the septic stem referenced above was installed substantial) according to
ce fY s p y y g
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out (if required) was inspected and the soils
were found satisfactory.
1th of
I certify that the system referenced _v.Q,was--c0nst t with the terms
of the I\A approv 1 etters icable) 0
o�
F. SCOtt A. �
U McGann to
( stall ign a .p #1224
.`red S ar�ti�
(Desi is Signature) (Affix Design tamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:\Septic\Designer Certification Form Rev 8-14-13.doc
Town. of Barnstable P# C_
Department of Regulatory Services ,
.a. 6 Public Health Division Date
w re3y 200 Main Street,Hyannis MA 02601
S r prfU MKI
a.,
-`-' Date Scheduled � / t�
��� Time � Fee Pd._ •f 1�t� .t'j'J• .`
• o
Sa►zr Suitability Assessment for S �Dis�pposal
Performed-By.- /�oant'J Witnessed By:
LOCATION&.GENERAL INFORMAT ION
Location Address /S3 Owner's Namo ` d A r\/
y
w
ti Pt V1 / Address j5�/�? y 0.
Assessor's Map/Parcel: Z�� / 1-7 -7 ` �1
1! � Engineer's Name Jam•Lp'`' M G Gy y�-aJ/V. V
NEW CONSTRUCTION REPAIR V Telephone/P jQ
Land Use S Slopes(96) 1A4— Surface Stones /✓��4-
I
Distances from: Open Water Body 23 ft Possible Wet Area ft Drinking Water Well "",a ft `
Drulhagc Way 149 ft Property Linc /D,.S r�� ft Other {rqL
SIKETCHt(Street name,dimensions of lot,exact locations of test holes&pero tests,locate wetlands-In proximity to holes)
08$ trot '��. - —
Trsrre - -- '
'�'�
�Q06-1,WLC-.Ir
Parent material(gcologle) Depth to Bedrook-- aA-
Depth to Groundwater. Standing Water In Hole: Weeping 1Yoln Pit Fnoe
Estimated Seasonal High Groundwater
DETERMINATION FOR SEASONAL'HIGH WATER TABLE
Method Used: rAfiV
Depth Observed standing in obs.hole: l'jZ In. Depth to soil mottles: ` it,.- .
Depth to wecping from side of qbs.hole: 2Z 1 In, Groundwater A&atmant ft.
Index Well-Ip ' RondingDate: h1iji Index Well '2 Adj,lketbr O,A AdJ_Clroundwawr•LeveI3_&0ettQ
PERCOLATION TEST Date/Z rr f8 Tim m"mot
Observation /
Hole ff r Tlmo at V
Sy Depth of Pero Time At 6" ' -
�r
Start Pro-soak Time @ �J•'I Z Time(9'141) Mir✓Y�
End Pro-soak •Z/
Rate Min./Inch &—OIL
Site Suitability Assessment: Slto Passed `• �SItF Palled: Additional Testing Needed(YIN)
Original: Public Health Division ' Observa Ilon Hole Data To Btu Completed on Back-----
***If percolation test is to be conducted within 100' of wetland,you must first notify the,
Barnstable Conselrvation Division at least one(1) week prior to beginning.
Q:ISEPTICIPERCPORM.DOC
DEEP.OBSERVATION HOLE LOG Hole#�_
Depth from Soil Horizon Soil Texture Shcl Color Soil. Other
Surface(in.) (USDA) (Munsell) Mottling (Stnueture,Stones;Boulders.
Consistency,WGravol)
0
/ '
mot, Mo .
DEEP OBSERVATION HOLE LOG Hole#
Depth from Sall Horizon Soil Texture Soil Color Soil Other
Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,
o sl e
4-
6 so [O W-r/ (p
A
DEEP OBSERVATION HOLE LOG Holo#
Depth from Soil Horizon Soil Texture Sall Color Sall Other
Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders..
Consistency,
DEEP OBSERVATION HOLE LOG Hole#
Depth from Sall Harizon Sall Texture Soil Color Sall Other
Surface(In.) (USDA) (Munsoll) Mottling (Structure,Siepes;Boulders,
a
Flood Insurance Rate Map:
Above Soil year Mood boundary No— Yes
Within 500 year boundary No_ Yes
Within I0o year flood boundary No.,z_ Yes
Depth of Naturally Occurring Pervious Materlal
Does at least four feet of naturally occurring pervious material exist in all areas observed thrpughout the
area proposed for the soil absorption system? 6
If not,What 19 the depth of naturally occurring vlous Malaflal'� .
Certi�on
I certify that on vvy? (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 tra ng,expertise and experience described in 10 CUR 15.017.
Signature Datb
Q;\9BPTILVB11CPORM.DOC
I
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No. Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes'
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
01ppitratton for ]h5pont *p.5tem Comarurtion Vermtt
Application for a Permit to Construct(y-Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No./y j Owner's Name,Address and Tel.No.
Assessor's Map/Parcel —r .'
Installer's Name,Address,and Tel.No. 71 U-`� F e Designer's Name,Address and Tel.No.
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank / Type of S.A.S.
Description of Soil: .Ss3hcl/
Nature of Repairs or Alterations(Answer when applicable) i�,z,Z
G/'.5:ear e_ /'=
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this Board of Health.
Signed _ Date
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued
44
o - b/G-
No. ��// Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
01pplication for Oi5po5ar bpotem Construction Permit
Application a Permit to Construct(!,)rRepair( )Upgrade( )Abandon( ) O Complete System O Individual Components
Location Address or Lot No./5'3 1_1�14w cldrlr 4411l _ Owner's Name,Address and Tel.No.
� p- G�rsSah
Assessor's Map/Parcel
Installer's Name,Address,and Tel.No. 1/-71 -09 q Designer's Name,Address and Tel.No.
0-e
Type of Balding:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Bidding No:'of Persons Showers( ) Cafeteria( )
Other Fixtures
Designif low gallons per day. Calculated daily flow _ gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank / Type of S.A.S.
f Description of Sol SA'h�i1
Nature of Repairs or Alterations(Answer/when applicable) Z 5T4/1 -- Sad i l&Z ,(�fdi G/i,-o-ZIc
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system
in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been issued by this oard f Health.
Signed /1 Date J'� O
Application Approved by Date
Application Disapproved for the following reasons
Permit No. Date Issued
--------------------------- — --------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( �-Repaired( )Upgraded( )
Abandoned( )by __.�r��t,h
at G ,'z iS h constructed in accordance
with the provisions of Title 5 and the for Disposal System Cons ction Permit No. '- dated
Installer %(,,a6& /�m,rc Designer ,,Y_ -
�. /IA
The issuance of this permi s 1 be construed as a guarantee that the system- ll function as designee , r'
Date Inspector %��%,
NO. gau*? 9 �17 Fee
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS
30igpoal 6potem Conotruction Permit
Permission is hereby granted to Construct(z_p epair( )Upgrade( )Abandon
System located at /S9 K+ -e/7
�-lc��sotii'S �
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construc 'on mus be corn leted within three years of the date of thi "e
Date: Approved by
77
1/61"
NOTICE: 'This Form Is To Be Used For the Repair Of Failed
;Septic Systems Only.
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLAN
hereby certify that the application for disposal works
construction permit signed by me dated 3— .90-a o concerning the
property located at /5 3ui�istT �s��-� �v'$i�%� meets all of the
following criteria:
1 1•he failed:gy;tem is connected to a residential dwelling only. There are no commercial or business
uses associated with the dwelling.
The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
ere are no wetlands within 100 feet of the proposed septic system
There are no private wells within 150 feet of the proposed septic system
ere is no increase,in flow and/or change in use proposed
T'hcre are no variances requested or needed
•e- The bottom of'the proposed leaching facility will nit be located less than five feet above the
mammum adilzted groundwater table elevation. [Adjust the groundwater table using the Frimptor
method when applicable]
• If the S.A.S. "ill be located with 250 feet of any vegetated wetlands, the bottom of the proposed
leaching facil;:,y will Mt be located less than fourteen(14)feet above the maximum adjusted
groundwater Mble elevation,
Pteam complete the following;
A) Top or Ground Surface EIevation(using GIS information)
E) G.W. Elcvation
+the MAX Hlgh G.W. Adjustment ,:'
D �
DDTERErICF BETWEEN A and B _
SIGNED
(Sketch pcoposec,plan of DATE:
a;�u folder en system on back].
s ..
A
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n � , , �
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TOWN OF BARNSTABLE
LOCATION- SEWAGE # 168 00 #
VILLAGE l rtu�:�.�is .
ASSESSOR'S MAP&LOT 17017
INSTALLER'S NAME&PHONE NO. el
1 -
SEPTIC,TANK CAPACITY. %oao
r.
LEACHING FACILITY: 2^:SOo G</ ��u cy/-//s
(type) (size) .Z,S'X l
NO.OF BEDROOMS
BUILDER OR OWNER L�rssooH
PERMrrDATE: 3—20 od COMPLIANCE DATE: iy—do
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or:within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
z wtthiin 300 feet of leaehun :faciL )` Feet
} 1~urtushed by atr.
i�)t
hi 1
t t
t `
LOCQTIOPl SEW-Qf;E PERMIT 1.10.
VILLAGE
IW574QLLER- 5 UWAE. ADDRESS
�Oidl-
BUILDER-',5-- bDDRF-
D Is,TE_P_E R"1T__1-S.SU ED
.DATE COMPLM acF- ISSUEC) ._
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No.-----•.............. F�a..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
_.. ........... . .................OF................................----- --------------------------........................
Appliration lar M-4pufittl Workii Cnuuitrurtiou Prrmit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
-- 1 --------� e� -�---`�-------------------- --------------------------------------'-'---"--'•------•-......'-----'-----------'----'-----....
�&ocati nnj�dd or Lot No.
Own Address
------------------------� !.�i----- t Crl ... ............----•-......................................................................
Installer Address
dType of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms------`3____ __________________________Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Q' Other fixtures ------------------------------- - -
W
Design Flow--------------------------------------------gallons per person per day. Total daily flow--------------------------------------------gallons.
WSeptic Tank—Liquid capacity------------gallons Length---------------- Width................ Diameter---------------- Depth-----.-___-----.
x 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 ( )
Percolation Test Results Performed by------- ----------------------------------------------------------------- Date--------------------------- -----------
,al Test Pit No. 1----------------minutes per inch Depth of "lest Pit-------------------- Depth to ground water-.._____-._____._-__...-
G= Test Pit No. 2......_---------minutes per inch Depth of Test Pit.................... Depth to ground water-----------.------------
a' �1...?-.R.t.°'��., !-------------------------------------- --•-•----•---------.----.
-------- ------------- --- --- - --- ----------------- ----
0 Description of Soil____________________________________�4A.
V ---------------------...................................................................................................................................................................----------------
W -------------- ------------------------------------------------------------------------------------------------------,-----------......-•--•----•--•-----j
UNature of Repairs or Alterations—Answer when applicable.--------f�?-STl/ pull
----------------------------•-------.-.--.---------•----------------------------------••-----•---..-.•-----------•---•---------•---------------•----• ---------•---------------------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions.of Article \I of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has beerNsue,4 by the board of health
/J�Signe --- -_ -------- at ��
Application Approved'By-- ------- ----------•------ -- I --�S-
ate
Application Disapproved for the following reasons----------------------- --------------------...._..----------------------------------------------------'--"
--------------------------------------------------------------------------------------•------
Date
PermitNo......................................................... Issued.............. -------------------------'--•----------•-
Date
fit%
cp
No. ...................... FEs..... � ..............
THE COMMONWEALTH OF MASSACHUSETTS
EOAIRD OF HEALTH
............. _....----..._.OF..............................------. ...................--------....._......--...----
Appliptiun -for Dhgpniittl Worko Tnn31rnrtton Prrntil
3
Application is hereby made fort�'a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
ocatt�n �dd } or Lot No.
Own Address
V'!y �rlt mil! s ......................... ....--•----•---•........................---
Installer' ?' Address
Q Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms.___--!3---------------------------------Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
Other fixtures =- ----- --
W Design Flow............................................ per persotr per day. Total daily flow--------------------------------------------
1x Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter----------.----- Depth----------------
r
Disposal Trench,,—`' No____________________• Width--------------- .. Total Length.................... Total leaching area-------------
-------sq. tt.
3 ' Seepage Pit NO'_,................. Diameter.................... Depth below inlet.................... Total leaching area------------------Sq. It.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by.......................................................................... Date-.--•-•------------------------•-•------
a Test Pit No./l______`-______-minutes per inch Depth of Test Pit.................... Depth to ground water------------------------
fT Test Pit No. 2----------------minutes per inch Depth of Test Pit____________________ Depth to ground water--.-.----__--_.--_------
---•--...-•-=-----------------------------•-•------------------ ---•--------------•--••---------•---.......................................................
D Description-of Soil...__%__________________________419
t
�., ------------------ ,
W = --
�ii7-- /
V Nature of Repairs or Alterations—Answer when applicable.-.-__----AN. i L...�pvt�: 9------- e_]P�lt_C�i__< �--.
x, s
--'------------•-------.---••--------------------------•-------------------•-•----•-------------•---------------------------------------------•------._.------•--•-----_------•---•••----•---...
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article N-I of the State Sanitary Code—The undersigned further agrees not to place the system in
operation�hntil a Certificate of Compliance has bee ' su by the board of health
. / - 7
Ag�Siglne
/Date ...........
Application Approved By--"--- •. ---• - — --- - ---------------- +Fd�..... '
Application-Disapproved for the following reasons-..........................• ---...-----•-•----•-------........._.......--••-•••---..._----••......---•--
\',l,-
�.
Date
PermitNo........... ------•-------------................. Issued..............................--..........-----•----
3 Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......:.........:O F..........
;r..................
Trdifirab of Tomplianr
THI I TO CE F ,� hat thy,,�''��'idual Sew e�ffE�isposaI System constructed ( ) or Repaired
--------------------------
' er, --•-------•-•------•-------------
Instal ------
a,.
-• --
has been installed in accordance with,the provisions`'of A ' I 4,:T�h,,e State Sanity at—
Co e as escribed in the
application for Disposal Works Cor st�ruction Permit No._.- ��..__.�_x2t#l- --__- dated...... ..........
t THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL" FUNCTION SATISFACTORY.
DATE___ ... .__ ... Inspector
4 at
. . .i .. �•., xa. s '#J�. p � r t r'M �4 c GrN.. v
ca4•+y'.r.°'�+yat134 - a*',��. s*�'s?i�s�'rsY+V9i• �EnC��tY:914*`�3tif�3'"4�' �LC'.�'1'•t�3�11t'Sx'��.' �:�:fYS�'t":C�y�s�k+ :2'��". ?'}�'�rt�;e;�w;;+.r n•�'��ti4;?:.;'..•t`Y,.,i......�; .�r:. .t ,
.. ..n- w�.x.:a:,..Y.3��.':4.Y.k+:...a•Y.OkMah..rra'ov:hfs.,!&C�;;it� 'as✓.9��,h...a..r..-„�•t' _ .. .
.y:
THE•COMMONWEALTH OF MASSACHUSETTS
BOARD rQ
f HEA•LTH
> .... ...
t.........O .... .......................
No--------------1.72. FEE-Z,,,,.,,
��r� rk� nn r#ivat �rrmi� .
Permission is hereby ranted_^' � :�(
to.Cons ct ( orle
it a Individua/� Sew�a►ge sposal Sys j
at No.- (' _.. / +r„�. y �� ' � t -------••---------
1j- ;
' p
Street
as shown on the application for Disposal Works Constructio mit _. !!___.._ .... Dated_... " n ...... _. ..
-----
.:- . -
DATE. A? ��------------------------------- Board of Health. •
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS -
No......................... Fa$..............................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
_.. ...............OF..................................................
.......
Appliration -for Di-qVviial Workii Towitrurtion Vrrufil
Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal
System at:
---'------ --------
Location-Address or Lot No.
•--•-------•----------•---•-•.......................'----'----------•-------------------•---•---•- ----------------------------•-----------------•------.....-•--------•••-••••------------.....-----
Owner Address
W
Installer Address
Q Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms______________________________ __ _Expansion Attic ( ) Garbage Grinder ( )
pa, Other—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( )
G-I Other fixtures ----------------------------------------------------------------------------------------------
W Design Flow............................................gallons per person per day. Total daily flow........................................----gallons.
WSeptic Tank—Liquid capacity-----------.gallons Length---------------- Width.--_-..-..----.- Diameter---------------- Depth................
x Disposal Trench—No. .................... Width-------------------- Total Length------------------.- Total leaching area--------------------sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area.__--.-._-._.-__-_sq. it.
Z Other Distribution box ( ) Dosing tank ( )
~" Percolation Test Results Performed by-------------------------------------------------------------------------- Date-------------------------------.--------
�_l
Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water.-.__--..-_-_-_---------
4q Test Pit No. 2----------------minutes per inch Depth of Test Pit.................... Depth to ground water--.-.____-_--__-_-------
9 ----•-•-•- --------------................................................................................................-------------------................
0 Description of Soil------------------------------------------------------------------------------------------------------------------------------------------------------------------------
W
VNature of Repairs or Alterations—Answer when applicable--------------------------------------------__-_-_.-____---_-_----.-_.---_-.-..._----.-----.-...
------------------------------------------------------------------------------------------------_-.---------------------------------------------------..--_------....-----------------------------------
Agreement: ,
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
Signed................---------------------...--------------------------------------------- --------------------------------
Date-
ApplicationApproved By------------------------------------------------------------------------------------------------- ........................----------.-----
Date
Application Disapproved for the following reasons--------------•--....--•-•-•---•----•----•-------•-•--.....-•-•--•-------•--------.............------------...... ..
---------------------------------•------------=----------------------------------------------•-------•----•--------•--.•----•-- •---•-----••------------------------------------ .......................
Date
PermitNo......................................................... Issued........................................................
Date
.. .........................................- ...........................►.............................................................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF................................................I...................................
%untif iratr of f"omliti ttur
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by......................................................................_--...........................................................................................-•------••......-•-•-------•••.
Installer
at.............................................................................................----------------_---- -----------------------.......................................................
has been installed in accordance with the provisions of :Article XI of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No------------------------------------------ dated.................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE................................................................................. Inspector---------------------------------- .................... =........................
--.-.-.-IJV.............................."................................................................................
..........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.........OF....................................................................................
,No......................... FEE........................
Dinpoiitt1 Workii QIumitrurtion Prrutit
Permissionis hereby granted-------------------------------------------------•-•-----------------------•---------------•--.-----•---------------------•-----------.-----
to Construct (, ) or Repair ( ) an Individual Sewage Disposal System
atNo------------------..............................................................................................................................................................................
Street
as shown on the application for Disposal Works Construction Permit No--------------------- Dated._-._---------.____-.___.-_-___--_--------
---------•------•-•-----•--------------------•-------------------------_.---------------•-----•---------
Board of Health
DATE................................................................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
CONSTRUCTION NOTES TOP OF FOUNDATION HYANNIS, MA
EL = 32.0± MINIMUM 20' DIAMETER CONCRETE Le
MINIMUM 20" DIAMETER COVERS COVERS RAISED TO WITHIN 6" OF
1.) ALL WORK SHALL CONFORM TO THE STATE ENVIRONMENTAL CODE, TITLE 5 (310 CMR 15.000): RAISED TO WITHIN 6" OF FINISH FINISH GRADE (OR AS NOTED)GRADE OR AS NOTED [oCUS STANDARD REQUIREMENTS FOR THE SITING, CONSTRUCTION, INSPECTION, UPGRADE, AND 1a ( )EXPANSION OF ON-SITE SEWAGE TREATMENT AND DISPOSAL SYSTEMS AND FOR THE TRANSPORT EL=31.6± EL=30.8 *AND DISPOSAL OF SEPTAGE, AND THE LOCAL BOARD OF HEALTH REGULATIONS. , � �\ , / \/ \/ if
\\ \\/ � ett's
2.) ANY SEPTIC SYSTEM COMPONENT INSTALLED IN A LOCATION WHERE THERE IS POTENTIAL FORo �/, /, �/ /,��//VEHICLES OR HEAVY EQUIPMENT TO PASS OVER IT SHALL BE DESIGNED TO WITHSTAND AN H-20
LOADING. IF UNDER AN IMPERVIOUS SURFACE, SYSTEM SHALL BE VENTED TO THE ATMOSPHERE. +l 4 �GEOTEXTILE29.727.9 '`� FABRIC
3.) TO MINIMIZE UNEVEN SETTLING, SEPTIC TANKS AND D-BOX SHALL BE INSTALLED ON ASTABLEMECHANICALLY-COMPACTED BASE ON SIX INCHES OF CRUSHED STONE.4.) COVERS OVER THE INLET AND OUTLET TEES OF THE SEPTIC TANK, THE DISTRIBUTION BOX, AND J West Mois
THE SOIL ABSORPTION SYSTEM SHALL BE RAISED TO WITHIN 6" OF FINAL GRADE. LEACHING 29.2E 4 28 6 \28.3 27.8 27.63 3/ " to
4FIELDS, TRENCHES, AND OTHER SOIL ABSORPTION SYSTEMS WITHOUT ACCESS MANHOLES SHALLSITE LOCUS
f N 27.4 tv m ` 1-1/2' STONE
HAVE AT LEAST ONE (1) INSPECTION PORT CONSISTING OF PERFORATED 4" PVC PIPE PLACED � pB-3 (Double wash) NOT TO SCALE
VERTICALLY TO THE BOTTOM OF THE SOIL ABSORPTION SYSTEM WITH A CAP, TIED WITH MAGNETIC �' c
MARKING TAPE, ACCESSIBLE TO WITHIN 3" OF FINAL GRADE. GAS BAFFLE H-20 Rated
THREE (3) H-10 500 GALLON PRECAST
5.) PIPING SHALL CONSIST OF 4" SCHEDULE 40 PVC OR EQUIVALENT. PIPE SHALL BE LAID ON A D- BOX 25.4 CONCRETE LEACH CHAMBERS WITH 2' OF 1.) Assessor's Map 270 Parcel 177
MINIMUM CONTINUOUS GRADE OF NOT LESS THAN 2% FROM THE BUILDING TO THE SEPTIC TANK, STONE ON ENDS AND 2.5' ON SIDES 2.) C160964
Ic
AND NOT LESS THAN 1% OTHERWISE. 11'± 1,000 GALLON -25'+ LonS9est Run 5.4 3
± .) L.C. Plan 22825-P Sht 1
6.) DISTRIBUTION LINES FOR THE SOIL ABSORPTION SYSTEM SHALL BE 4" DIAMETER SCHEDULE 40 SEPTIC TANK LEACH CHAMBERS 4.) This property is in a Groundwater
PVC (OR EQUIVALENT) LAID AT 0.005 FT/FT. UNLESS OTHERWISE NOTED. LINES SHALL BE CAPPED (Existing) (END VIEW) Protection District
AT END OR AS NOTED. FLOW PROFILE 5.) This property is not in the Flood Zone
7.) LINES FROM THE DISTRIBUTION BOX TO BE LEVEL FOR THE FIRST TWO (2) FEET BEFORE EL=20.0 Adjusted Ground Water
PITCHING TO THE SOIL ABSORPTION SYSTEM. DISTRIBUTION BOX SHALL BE WATER TESTED TO NOT TO SCALE
EL=19.7 Observed Ground Water
ASSURE EVEN DISTRIBUTION. EL=19.7`'Bottom Test Hole
8.) GROUT TO BE USED AT ALL POINTS WHERE PIPES ENTER OR LEAVE ALL CONCRETE STRUCTURES
IN ORDER TO PROVIDE A WATERTIGHT SEAL. Map 270
Parcel 103 VARIANCE REQUESTED Estimated High Groundwater Calculation
9.) HEAVY EQUIPMENT SHALL NOT BE ALLOWED TO OPERATE OVER THE LIMITS OF THE SEWAGE Index Well AIW-230 Zone D
DISPOSAL FIELD DURING THE COURSE OF CONSTRUCTION OF THE SYSTEM.
" Local Upgrade Approvals Date of Reading 1118
10.) IN ACCORDANCE WITH 310 CMR 15.221, ALL SYSTEM COMPONENTS SHALL BE MARKED WITH Variances: 310 CMR 15.211 Minimum Setbacks Depth to Groundwater 20.78
MAGNETIC MARKING TAPE. Requirements for All System Components: 0.3
11. THERE ARE,, NO-KNOWN WELLS WITHIN 150' OF THE PROPOSED SOIL ABSORPTION SYSTEM. t Groundwater Adjustment
} S 7�e 1.) Septic system component to foundation setback 19.7
26 35" 15' Held 5' Variance Requested Actual Groundwater Level
12.} FROM THE DATE OF THE INSTALLATION OF THE SOIL ABSORPTION SYSTEM UNTIL RECEIPT OF � (31.4) E q
THE CERTIFICATE OF COMPLIANCE, THE PERIMETER SHALL BE STAKED AND FLAGGED TO PREVENT 100.40, Estimated High Groundwater 20.0
(32 8}
USE OF THE AREA THAT MAY CAUSE DAMAGE TO THE SYSTEM. /Shed/ /
13.) THE DESIGNER WILL NOT BE RESPONSIBLE FOR THE SYSTEM AS DESIGNED UNLESS TBM EL = 32.9 (31.3) G
CONSTRUCTED AS SHOWN ON PLAN. ANY CHANGES SHALL BE APPROVED IN WRITING BY THE Top of.Concrete <�r `i(J, /2 ) SYSTEM/
DESIGNER. (Asaurned Elev:) / / See Note = / EM DESIGN CALCULATIONS
Cone `
14.) THE BOARD OF HEALTH REQUIRES INSPECTION OF ALL CONSTRUCTION BY AN AGENT OF THE W 119 ' / SEWAGE DESIGN FLOW REQUIRED: 3 BEDROOM DWELLING @
BOARD OF HEALTH AND THE DESIGNER. THE DESIGNER SHALL'CERTIFY `tN WRITING THAT THE L -1 q r ST Lot 54 j f 110 GPD /'BEDROOM =330-GPD-REQUIRED
SEWAGE DISPOSAL SYSTEM WAS INSTALLED IN ACCORDANCE WITH THE TERMS OF THE PERMIT cv �� `-' ��`� House 153 1 C,dCC`f SF / SEWAGE DESIGN FLOW PROVIDED: THREE (3) 500 GALLON LEACH CHAMBERS
AND THE APPROVED PLANS. 48 HOURS ADVANCE NOTICE IS REQUESTED. MOO 269 ' r7 O /� f - _/ � J / WITH 2' STONE ON THE ENDS AND 2.5' STONE ON; THE SIDES
15. LOCATION OF UTILITIES IS APPROXIMATE AND CONTRACTOR SHALL BE RESPONSIBLE FOR ;� SAS 7 3 Bedroom J
Parcel 62 N o ,o�^ oeo« (31.4) TOF = 32.0 Vt = [(29.5 x 9.83) + 2(29.5 + 9.83) (2) x .74 = 331 GPD PROVIDED
DETERMINING THE LOCATION OF ALL UNDERGROUND AND OVERHEAD UTILITIES PRIOR TO �- le ts.o. /' \ I / 331 GPD PROVIDED > 330 GPD REQUIRED
COMMENCEMENT OF ANY WORK. THIS INCLUDES, BUT IS NOT LIMITED TO, REQUESTS TO DIGSAFE, Z /
ANY PRIVATE UTILITY COMPANIES, AND THE LOCAL WATER DEPARTMENT. 32 �, oo / l} / // SEPTIC TANK CAPACITY REQUIRED: 330 GPD X 200
o` SEPTIC TANK CAPACITY PROVIDED: EXISTING 1,000 GALLON SEPIC TANK TO REMAIN
16. CONTRACTOR SHALL VERIFY THAT ALL WASTELINES ARE CONNECTED BY WATER TESTING
�eo6 DB / t i W�I I N // A GARBAGE DISPOSAL IS NOT PERMITTED WITH THIS DESIGN FLOW
WITHIN THE DWELLING,PRIOR TO INSTALLATION OF ANY SEPTIC COMPONENTS. °
17.) CONTRACTOR SHALL VERIFY EXISTING INVERT ELEVATIONS PRIOR TO INSTALLATION OF ANY 10
`5
eoa 0- oo // Deck / I� W oC�' M `/
SEPTIC SYSTEM COMPONENTS. 000000a000�o.o SAS / 4 (,25.2 __3 /
18.) TEST HOLES COMPLETED PER STATE ENVIRONMENTAL CODE, TITLE 5. SOILS CAN BE 983 (30.6) ` - / / / /� �' / a / 29 5'
VARIABLE AND TEST HOLE DATA IS NO GUARANTEE OF SOIL CONDITIONS IN OTHER AREAS. IF -r-t l
�J C"q�Pl
(2�'S)/]�
SOILS DIFFER FROM THOSE SHOWN IN THE SOILS LOGS, DESIGN ENGINEER IS TO INSPECT THE (30.7) -r
SOILS PRIOR TO PROCEEDING WITH INSTALLATION OF ANY SEPTIC COMPONENTS. ❑bs Icr ` _ �� l / W / /l 2' 8.5' 8.5' 8.5' 2'
Hole #1
19.) EXISTING SEPTIC COMPONENTS TO BE LOCATED, PUMPED DRY, FILLED WITH CLEAN SAND AND Test N
ABANDONED IN PLACE OR REMOVED AS REQUIRED. AREA TO BE COMPACTED TO MINIMIZE SETTLING. Pit #1 Oo e / Grq�Pta
#2 / ,/ _J /
�, ,
0
Bedroom t ��Q,OQ� 2�) ' o �23'+of{ / ' O (?
0
Test Hole #1 (EL=30.7±) TEST HOLE LOGS 30 N j;7--- ,� ~ ' _ , _ / '00"' g�W -- �-
Layer Soil Class Soil Color �
Depth Elev. y 28
Both /(25.0)
/ o N
Mop 269 �D�i�,. / Q
0"-14" 29.7 A Loom 3 2 Parcel 82 0 O
10YR /
/ ). / 19.5
14"-37" 27.5 B Loamy Sand 1OYR 5/6 Be#2 om / J
37"-136" 19.7 C Medium Sand 2.5Y 6/3 ( Pond D-Box
/
I CERTIFY THAT I AM CURRENTLY APPROVED BY THE DEPARTMENT OF / Note:
Test Hole #2 (EL=30.7±) ; ENVIRONMENTAL PROTECTION PURSUAMT TO 310 CMR 15.017 TO CONDUCT / This plan is only valid for current regulations and may
2n d Floor Plan not be suitable for future regulation changes that may occur.
SOIL EVALUATIONS AND THAT THE ABOVE ANALYSIS HAS BEEN PERFORMED / -
Layer Soil Class Soil Color
Depth Elev. N.T.S. BY ME CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND EXPERIENCE o �l$ss�
0"-12" 29.7 A Loam 10YR 3/2 DESCRIBED IN 310 CMR 15.017. 1 FURTHER CERTIFY THAT THE RESULTS OF MY
,,
12"-38" 27..5 B Loam Sand 10YR 5 6 Eft SOIL EVALUATION AS INDICATED ON THE ATTACHED SOIL EVALUATION FORM
Bedroom saattA. 0Proposed Sewage Disposal System
y / Fomi;y A ACC R E AND IN ACCORDANCE WITH 310 CMR 15.100 THROUGH 15.107. o McGann
38"-136" 19.7 C Medium Sand 2.5Y 6/3 Room 0 #1224
153 Fawcett Road Hyannis, MA
Both
DATE OF TESTING: 12/11/17 SCOTT MCGYNN, CERTIFIED SOIL EVALUATOR ��1st �{� Prepared by:
SOIL EVALUATOR: SCOTT MCGANN red a Pre Pared for: All Cape Septic LLC
BOARD OF HEALTH AGENT: DON DEMARIS Kitchen
PERCOLATION RATE: LESS THAN 2 MIN/INCH IN "C" LAYER AT 54" U,4ng PROPOSED GRAPHIC SCALE John Hardy 618 Route 28
Room i `° 153 Fawcett Lane
GROUNDWATER ENCOUNTERED = 19.7 FOUR (4') zo o 10 zo ao ao West Yarmouth, MA 02673
OPENING Hyannis, MA 02601
(508) 771-4200
alicapeseptic@gmail.com
1st . Floor Plan ( IN FEET )
N.T.S. 1 inch = 20 ft. Date: 12/18/18 Sheet 1 of 1 By. MA Check: SM Project No. AC-153