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HomeMy WebLinkAbout0112 FIFTH AVENUE (HYANNIS) - Health 112 FIFTH AVE., HYANNISPORT ..4 A=245-108 I i n j TOWN OF BARNSTABLE LOCATION. j 1 SEWAGE # ' I VILLAGE`. + fe'.i ASSESSOR'S MAP & LOT ag4lr- id R INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:..(type) Y�:15�0-e 6,0 'S (size) -3S--1 NO.OF BEDROOMS BUILDER OR OWNER . 'V 4 PERMIT DATE: ? S•^d -COMPLIANCE'`DATE: °Z 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 _ o � e t w. �S� f ��� s/� ��� i�J I� ' �� � � i �� � � �� R � �_.__� -� � . �, No. ! 7— % J it. S Fee$50 . 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: L; Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Zie;pozal *p.4tem Construction Permit Application for a Permit to Construct( )Repair(x)q Upgrade( )Abandon( ) []Complete System ❑Individual Components Location Address or Lot No. 1 1 2 F i f t h Ave Owner's Name,Address and Tel.No. 7 9 9-4 9 9 3 Assessor's Map/ParcelW Hyannisport Ronald Zive 82 Newton Ave North 74/ - /OF- Worcester, MA 01 602 Installer's Name,Address,and Tel.No. 7 7 5-8 7 7 6, Designer's Name,Address and Tel.No. W E Robinson Septic Service PO Box 1089, Centerville, MA 0263 Type of Building: Dwelling No.of Bedrooms 3/4 Lot Size sq.ft. Garbage Grinder(nol 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 s n n d Nature of Repairs or Alterations(Answer when applicable) Title 5 Septic System consisting of 1500g tank, D-box, and three 500-gallon stonepacked concrete precast leaching chambers. 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 thi _i&Boped of Health. Signed Date Application Approved by Date 7—f Application Disapproved for the following reasons Permit No. Date Issued_ 7-1-5--192 No. 7 7' I� Fee$50 00 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: t/ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Yes 0[pprication for Mizpogaf *pgtem Construction Permit Application for aPermit to Construct( )Repair CA)q Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 112 Fifth Ave Owner's Name,Address and Tel.No. (7 9 0 4 9 9 3 Assessor's Map/Parcel W Hyannisport Ronu&d Zivee 82 Newton Ave North Worcester, MA 01602 Installer's Name,Address,and Tel.No. 775— 7 Designer's Name,Address and Tel.No. W E Robinson Septic Sere - PO' Bq 1089, Centervill '26 ' Type of Building: _ C% Dwelling No.of Bedrooms 3/4 Lot Size U sq. ft. Garbage Grinder(nd 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. F Description of Soil sand J, f Nature of Repairs or Alterations(Answer when applicable) Title 5 Septic System consisting of'1500g tank, D-box, and three 500-gallon stonepacked concrete precast • leaching chambers. Date last inspected: YI 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 thi o �ojfHealth. — . Q Signed �" Date T Application Approved by ._.. _ Date 7—/ --/ Application Disapproved for the following reasons 1 S 1# Permit No. Date Issued —f 9 ✓' 1 THE COMMONWEALTH OF MASSACHUSETTS Zive BARNSTABLE, MASSACHUSETTS 1 (Certif Irate - �Q fiance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired (x%)Upgraded( ) Abandoned( )by at 112 Fifth Ave, W Hyannis port has been constructed in accordant with the provisions of Title 5 and the for Disposal System Construction Permit No. 5Pr---/SZ dated 7—IS-- Installer W E Robinson Sept SrV Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector QX --� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ' Zive Mi5po$a[ *pgtem Con.5truction Permit Permission is hereby granted to Construct( )Repair(xx)Upgrade( )Abandon( ) Systemlocatedat 112 Fifth Ave, W Hyanngh$port Installer: B E Robinson Septic Service 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 followingtlo al provisions or special conditions. Provided`Construction triust be completed within three years of the date of this permit. �^ Date: �7 � _" 9 Approved by -,LC.f.P.� C �fs G.. i c: ,e ` i 4 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 ENGINEERED PLANS) I, William E. Robinson, Sr. ,hereby certify that the application for disposal works construction permit signed by me dated �7-/S�' , concerning the property located at 112 Fifth Avenue,W Hyannisport, meets all of the following criteria: * There are no wetlands within 100 feet of the proposed leaching facility. * There are no private wells within 150 feet of the proposed septic system. * There is no increase in flow and/or change in use proposed. * There are no variances requested or needed. * If the proposed leaching facility will be located with 250 feet of any wetlands,the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) � B)Observed Groundwater Table Evaluation(according to Health Division well map) SIGNED: DATE-77—IU LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER 20-1998 (Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted). � i � � � ~�^ � _ s� . r �., ,. .. r. t i.� '#�c' .. 1. - �_. _. 4�kw. �lb COMMONWEALTH OF MASSACHUSETTS f EXECUTIVE OFFICE OF ENVIRONMME.N�A�=AFFAIRS s DEPARTMENT OF ENVIRONM�,N>,T°AL"I PR'O'� ION ONE WINTER STREET, BOSTON. MA .2,L08 617- 2-5500 WILLIAM F.WELD /V V AUGS TRUDY COaE Governor -- 1pwN OF BARNSiABLE Secretan ARGEO PAUL CELLUCCI _ ;N nrci Ki ��� DAVID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM7�;. N FORM Commissioner PART A 112 Fifth Avenue CERTIFICATION11onald Zive Property Address: iyannis Address of Owner: 82 Newton Ave North Date of Inspection: 7—2 3—9 8 (If different) Worcester, MA 01 602 Name of Inspector: WM E Robinson Sr I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: WM E Robinson Septic Servi .A Mailing Address: PO Box 10890 C -n Prvi 1 1 A r nrtn 02632 Telephone Numbers 50 8 77 5—R 7 7 6 CERTIFICATION STATEMENT 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 inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: (_ Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ FailsI� Inspector's Signature: Date: `01 The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: AI have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CM.R 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B YSTEM 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. Indicat yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of .Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is.imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/97) Page 1 of 10 DEP on the World Wide Web: http:t/www.magnet.state.ma.usldep g e'j Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1 1 2 Fifth Ave, W Hyannisport Owner: Zive fti Date of Inspection: 7-2 339 8� � B) SYSTEM CONDITIONALLY PASSES (continued) A Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipes) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four 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 CJ FUR HER 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 the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND 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) YSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT HE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE NVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) THER (revised 04/25/97) Page 2 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1 1 2 Fifth Ave, W Hyannisport Owner: Z ive Date of Inspection: 7—2 3—9 8 D] SYSTEM FAILS: Yo must indicate ei;?,er "Yes" or "No" as to each of the following- To have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is,identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes o Backup of sewage into facility or system component due to an 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 1/2 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe($). Number of times pumped _. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LAR E SYSTEM FAILS: You m t indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The o ner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR.5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page.3 of 10 a n SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 112 Fifth^: Ave W Hyannisport Owner: Zive Date of Inspection: 7—2 3—9 8 Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes, No Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or t / as part of this inspection. v As built plans have been obtained and examined. Note if they are not available with N/A. The facility or.dwelling was inspected for signs of sewage back-up. _ The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. _ All system components, excluding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. / The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub-Surface Disposal System. _LI/ _ Existing information. Ex. Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) [15.302(3)(b)] J) revised 04 25 97 ( / / ) Page of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1 1 2 Fifth Ave W Hyannisport Owner: Zive Date of Inspection: 7—2 3—9 8 FLOW CONDITIONS RESIDENTIAL: Design flow: 00 g.p.d./bedroom for S.A.S. Number of bedrooms:,Lj Number of current residents: Garbage grinder (yes or no): /1- 6 Laundry connected to system (yes or no):y 6 Seasonal use (yes or no):__e s Water meter readings, if avails le (last two (2) year usage (gpd): metered 8-8-96 Sump Pump (yes or no): only reading: 4,000 cu f:t 30, 000g Last date of occupancy: C MERCIAL/INDUSTRIAL: Type f establishment: Des igr flow: gallons/day Greas trap present: (yes or no)_ Industr al Waste Holding Tank present: (yes or no)_ Non-s nitary waste discharged to the Title 5 system: (yes or no)_ Water meter readings, if available: Last date of occupancy: OT R: (Describe) Last beteof occupancy: GENERAL INFORMATION PUMPING RECOR 5 and source of information: Systerrf,pumped as part of inspection: (yes or no)/b. !� If yes, volume pumped: gallons Reason for pumping: TYPE,0 YSTEM (/ 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) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: •��- — c�_ `jS� � iQ Sewage.odors detected when arriving at the site: (yes or no) l� r (revised 04/25/97) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 1 2 Fifth Ave, W Hyannisport Owner: Z ive Date of Inspection: 7_2 3_g 8 B LDING SEWER: (Loc to on site plan) Dept below grade: Mater al of construction: _cast iron _40 PVC_other (explain) Dista ce from private water supply well or suction line Dia eter Com ents: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK:_ (locate on bite plan) e Depth below grader Material of construction: concrete _metal Fiberglass _Polyethylene —other(explain) If tank is metal, list age — Is age confirmed by Certificate of Compliance _(Yes/No) e d t Dimensions: �, 10 G. Sludge depth: C l Distance from top of sludge to bottom of outlet tee or baffler Scum thickness: © , Distance from top of scum to top of outlet tee or baffler Distance from bottom of scum to bottom of outlet tee or baffle. How dimensions were determined: ifs whJ Comments: (recommendation for pumping, condition of Met and outlet tees or baffles, depth of liquid level in relation to o tlet invert, structural integrity, eviJe�ce of leakage, etc.) 'Ll/ > S •b f'^ d 4 �' S GRE SE TRAP:. (loca on site plan) Depth below grade: Materi I of construction: _concrete _metal _Fiberglass _Polyethylene —other(explain) Dime sions: Scum hickness: Dista ce from top of scum to top of outlet tee or baffle: Dist ce from bottom of scum to bottom of outlet tee or baffle: Dat of last pumping: Com nts: (recom endation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integri , evidence of leakage, etc.) (revised 04/25/97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 1 2 Fifth Ave W Hyannisport Owner: Zive Date of Inspection: 7_2 3—9 8 TI TOR HOLDING TANK: (Tank must be pumped prior to, or at time, of inspection) (Iota on site plan) Depth low grade: Materia of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain) Dimensi ns: Capacity gallons Design ow: gallons/day Alarm le el: Alarm in working order_Yes; _ No Date of p evious pumping: Comment (conditio of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: " (locate on site plan) p� Depth of liquid level above outlet invert: (� Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) .�41' 'J, PU CHAMBER:_ (loca on site plan) Pum s in working order: (Yes or No) Alar s in working order (Yes or No) Co ments: (n condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/97), Page 7 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 1 2 Fifth Ave, W Hyannisport Owner: Zive Date of Inspection: 7—2 3—9 8 SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number: leaching chambers, number. leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil signs of hydraul failure, level of ponding, condition of vegetation, etc.) + D CESSPOOLS: _ (locate on site plan) Number and configuration: I/�1• Depth-top of liquid to inlet invert: Depth of solids layer. Z- Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow (cesspool must be pumped as part of inspection) Com nts: (note ndition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRI (Io a on site plan) Mater Is of construction: Dimensions: Depth f solids: Comme its: (note c dition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) (revised 04/25/97) Page 8 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 1 2 Fifth .Ave, W Hyannisport Owner: Zive Date of Inspection: 7—2 3—9 8 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) 9 f 4,, A �1�'IL�L,.rt/✓�/ (revised 04/25/97) Page 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1 1 2 Fifth Ave, W .Hyannisport Owner: Zive Date of Inspection: 7—2 3—9 8 Depth to Groundwater L Feet Please indicate all the methods used to determine High Groundwater Elevation: /Obtained from Design Plans on record t/ Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. (Must be completed) -s l (revised 04/25/97) Page 10 of 10 TOWN OF BARNSTABLE LOCATION _1 i i t 1 r 1 4 Z { SEWAGE # 7�� I Se� VILLAGE i+ ASSESSOR'S MAP & LOTS y.y- 1 d R INSTALLER'S NAME&PHONE NO. 66 4 7 7 L, SEPTIC TANK CAPACITY !r0__0 i LEACHING FACILITY: (type) (size) / ' •-'S s i NO. OF BEDROOMS BUILDER OR OWNER _Z 1 V L PERMIT DATE: "7 -i J'^q t 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 5 I i a j l.7ar. o \ '75 %% 1 1 REVISIONS: LOCUS INFORMATION NO. DATE DESC. N — O Q w I a CURRENT OWNER: DANIEL SERPICO OVERLAY DISTRICT: AP — _ KATHLEEN WALSH NITROGEN SENSITIVE cu FpVRTy �� TITLE REFERENCE: DEED BOOK 12152, PAGE 287 ZONE: NOT A ZONE II — PLAN REFERENCE: PLAN BOOK 34, PAGE 23 FEMA FLOOD J FIFTy ZONE DISTRICT: "CPO — � ASSESSORS MAP: 245 MINIMUM LOT SIZE: 43,560t S.F. — '�VF PARCEL: 108 �Q EXISTING LOT SIZE: 8,000 S.F. V ZONING DISTRICT: RB SETBACKS: FRONT 20' EXISTING LOT COVERAGE: 1,183f S.F. (14.87) LOCUS SIDE 10' REAR 10' PROPOSED LOT COVERAGE: 1,350f S.F. (16.97) CRAIGVILLE BEACH I CERTIFY TO THE BEST OF MY ' PROFESSIONAL KNOWLEDGE, INFORMATION LOCUS MAP AND BELIEF THAT THE LOT CORNERS, NOT TO SCALE DIMENSIONS AND SETBACKS TO THE I STRUCTURE AS DETERMINED BY INSTRUMENT SURVEY AND AS SHOWN ON THIS PLAN ARE CORRECT. ' aR`'�SN of MAss, 109-59—F1 I ?o� Z �~ ca I No.38= IRON PIPE La FND S02'38'24"E 80.00' 4.1' STAKE AND NAIL FOUND - I o/23113 SHED O 'PROFESSIONAL LAND SURVEYOR DATE BUILDING SETBACK LINE T I -- O I \ I PROPOSED a? I I ADDITION SET ON M PROTECT SEPTIC SONO TUBES COMPONENTS CERTIFIEDDURING I I CONSTRUCTION I SEPTIC PLOT PLAN ITANK I s 17.8' WITH FPATIO 7.4� PROPOSED 12.7' r — RAISED GARDEN ADDITION 8 i o AT iW I O o BULKHEAD _ - - #112 Y I GAS METER #112 1-1/2 STORY I FIFTiy AVENUE z CAPE STYLE I I ij CL DWELLING L_ n r --I 51 I N i WEST HYANNISPORT M MAS SAC H U S ETTS I 23.8' 8.0' (BARNSTABLE COUNTY) O I I Cn OCTOBER 23, 2013 Pli Q ►7 =54 I I M GRAVEL a DRIVEWAY Q N I PREPARED FOR: j KATHLEEN WALSH I N I , IRON PIPE 112 FIFTH AVENUE N FND WEST HYANNISPORT NO2'38 24 W 0.00 MASSACHUSETTS c ..._. � go BASCN 0 FIFTH °- A VENUE BSC UP (40' WIDE- 1953 LAYOUT) GRIIIJI 349 Route 28, Unit D West Yarmouth, Massachusetts 02673 CATCH ® 508 778 8919 BASIN gj © 2012 The BSC Group, Inc. 00 so SCALE: 1" = 10' 0 a 0 1.25 2.5 5 MEtExs m m 0 5 10 20 nmr d NOTES: PROJ. MGR.: CRAIG FIELD g 1.) SEPTIC SYSTEM LOCATION IS APPROXIMATE AND IS FIELD: P. HAGIST _ p a$ BASED ON A TIE CARD ON FILE AT THE BARNSTABLE T a�- CALC./DESIGN: K. HEALY a BOARD OF HEALTH. CONTRACTOR TO CONFIRM LOCATION PRIOR TO CONSTRUCTION. DRAWN: K. HEALY ' L, CHECK: CRAIG FIELD a 2.) THIS PLAN IS BASED ON A FIELD SURVEY E PERFORMED BY THE BSC GROUP IN AUGUST OF 2012. FILE: 9686-CPP.DWG E DWG. NO: 6135-01 SHEET 1 OF 1 ' JOB. NO: 4-9686.00 i