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HomeMy WebLinkAbout0042 NIGHTINGALE LANE - Health 42 Nightingale Lane Hyannis A= 311-098 r i Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 42 Nightingale Lane Property Address Walter J. Glowacki Owner Owner's Name information is required for every �H annis MA 02601 8/03/2010 page. City/Town State Zip Code Date of Inspection Inspoctlon results must be submitted on this form.`Inspection forms may not be altered in any way. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Brian K. Tilton use the return dame of Inspector key. The Building Inspector of Cape Cod r� C ornpany Name PO Box 307 Company Address I E_astham -- MA 02642 City/Town State Zip Code 508-255-9343 - S14392 Telephone Number License Number B. Cehtification 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 s was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5`310 CMR 15.000). The system: 0 0 ® Passes ❑ Conditionally Passes ❑ Fails zo c� o L� Needs Further.Evaluation by the Local Approving Authority -n 361, A X,,pect�orr's Signature Date i tv 3> C" The.system in shall submit a copy of this inspection report to the Approvin4utt_Rity (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the.same or different conditions of use. l/lJ U � o 42 Nightingale Ln l5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal j tem•Page 1 of 15 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form _ Not for Voluntary Assessments M 42 Mahtingale Lane Property Address Walter J. Glowacki Owner Owner's Name information is required for every �H annis MA 02601 8/03/2010 page. City/'Town State Zip Code Date of Inspection Bo Gartificafion (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: lL 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: All components are in place and functioning as designed. B) System Conditionally Passes: [� One or more system components as described in the"Conditional Pass" section need-to be replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answor yes, no or not determined (Y, N, ND) in the ❑for the following statements. If"not determined," please explain. The septic tank is metal'and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: Observation of sewage backup or breakout or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s) are replaced ,. ❑ obstruction is removed 42 Nightingale Ln t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Yoluntary Assessments 42 Nightingale Lane Property Address Walter J. Glowacki Owner Owner's Name information is required for every Hyannis MA 02601 8/03/2010 page. City/Town State Zip Code Date of Inspection Bo C—artifscaton (cont.) B) System Conditionally Passes (cont.): [] distribution box is leveled or replaced ND Explain: n The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): tiroken pipe(s) are replaced �] obstruction is removed ND Explain: C) Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. i. System will pass awnless Board of Health determines in accordance with 310 CIMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, sa-fety and environment: [j The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. 7. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water Supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 42 Nightingale Ln t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 i Commonwealth of Massachusetts u W Title 5 Official Inspecti®n Form _ Subsurface Sewage Disposal System Form v Not for Voluntary Assessments 42 Ni htin aale Lane Property Address Walter J._clowacki Owner Owner's Name information is H annis MA 02601 8/03/2010 required for every __ _ page. City/Town State Zip Code Date of Inspection Bo Certification (coot.) C) Furthor IEvaivation is Required by the Board of Health (cont.): TIFIEI System has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: *' This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and.the presence of ammonia nitrogen and nitrate nitrogen is equal to or less titan 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) Sysitem Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: 'Yes No El H Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge.or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded L] N or clogged SAS or cesspool Liquid depth in cesspool is less than 6" below invert or available volume is less C-� than 1h day flow n Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: Any portion of the SAS, cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or 72 tributary to a surface water supply. 42 Nightingale Ln t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15. Coin anonwealth of Massachusetts N F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 42 Mahtin ale Lane _ Property Address Walter J. Glowacki Owner Owner's Name information is required for every Hyannis MA 02601 8/03/2010 page. City/Te wn State Zip Code Date of Inspection E. Certification (cunt.) D) Systenn Failure Criteria Applicable to All Systems (cont.): Yes No [] El Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ S Any portion of a cesspool or privy is within 50 feet of a private water supply well L_ Any portion of.a cesspool or privy is less than 100 feet but greater than 50.feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] D �I The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a-facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes NO El F1 the system is within 400 feet of a surface drinking water supply ❑ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone 11 of a public water supply well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 42 Nightingale Ln t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 ' Commonwealth of Massachusetts W Title 5 Official inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 42 Ni htin ale Lane Property Address Walter J. Glowacki Owner Owner's Name information is H annis MA 02601 8/03/2010 required for every � page. Cityrrmin State Zip Code Date of Inspection C. C',hockfis"t Check if the following have,been done. You must indicate"yes" or"no" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health Were any of the system components pumped out in the previous two weeks? Ej Has the system received normal.flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of r_.] Elthis inspection? �� Were as built plans of the system obtained and examined? (If they were not available note as N/A) [!I Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? Were all system components,excluding the SAS, located on site? U D 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 cletermined based on: Existing information. For example, a plan at the Board of Health. Determined in the field (if any of the failure criteria related to Part C is at issue ❑ approximation of distance is unacceptable) [310 CMR 15.302(5)] 42 Nightingale Ln t5insp•03/08 Title 5 Official Inspection Farm:Subsurface Sewage Disposal System•Page 6 of 15 f Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 42 Nightin ale Lane Property Address -- Walter J. Glowacki _ Owner Owner's Name information is required for every �H annis MA 02601 8/03/2010 page. City/Town State Zip Code Date of Inspection ®. S%ys t ern ►rifoirmation Residential Flow Conditions: Number of bedrooms (design): .2 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Nrxmber of current resident:: Vacant- kDces .-e_--Iidence have a garbage grinder? [] Yes ® No on a separate Sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry systern inspected? Z Yes ❑ No Sr asonrfl use? [] Yes ® No ",`"later meter readings, if available last 2 ears usage d '08= 68 GPD, 9• ( Y g, (gpd)): '08= 166 GPD SUMP picmp? ❑ Yes ® No I ast.date of occupancy: w „ 412010 Date Corn mercia!/Industrial Flow Conditions: Type of Establishment: N/A Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): — Grease trap present? [] Yes ❑ No cn&r..�trcal waste holding, tank present? ❑ Yes ❑ No Non-sanitary waste discharged•to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available:. ._asf date of occupancy/us': Date Other(describe): 42 Nightingale Ln l5insp•03I08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 ' Collnmonwealth of Massachusetts w Tkle,, 5 Official inspection Form Subsurface Sewage Disposal System Form - Not for Vol untary.Assessments °M 42 Nightinaale Lane Property Address Walter J. Glowacki Owner Owner's Name information is required for every y H annis MA 02601 8/03/2010 — ___— page. City/1rcwn State Zip Code Date of Inspection Do 3y,alm-n i lllol't'ft'ation (coat) General Information Pumping Records: :Source of information-. lA/as system pumped as part of the inspection? ❑ Yes ❑ No lf'yas, v-ciarr;e pulttped: gallons How was quantity pumped determined? Peeson for pumping: Typs of System: Septic tank, distribution box, soil absorption system Single cesspool ❑ Overflow cesspool Privy , n Shared system (yes or no) (if yes, attach previous inspection records, if any) �] Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract Tight tank. Attach a copy of the DEP approval. n Other(describe): Approximate age of all components, date installed (if known) and source of information: t! KE!sewage odors detected when arriving at the site? ❑ Yes ® No 42 Nightingale Ln t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15~ ' Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 42 Nightingale Lane Property Address Walter J. Glowacki Owner Owner's Name information is required for every Hyannis MA 02601 8/03/2010 � page. State Zip Code Date of Inspection D. System aralFor ation (coat.) Building Sewer(locate on site plan): _ Depth below grade: 1.5'feet Material of construction: east iron 40 1 ❑ other.(explain): L)i;;tarice •!rom private ,n'ia er supply well or suction line: feet Cc.m-Bents (cwi condition of joints, venting, evidence of leakage, etc.): No evidence of leaks or clogs. :,3eptic Tanis.(locate on site plan): Depth grade: feet Material cif r-mstruction: 171 c or,crete ❑ metal'- ❑ fiberglass ❑ polyethylene ❑ other(explain) I tan!:is metal, list age: years IF,age confirmed by a Certificate of Compliance?,(attach a copy of certificate) ❑ Yes ❑ No ---------------------------------------------------------------------------------------------------------------------------- Dimensions: — 11„ Sludge depth: — — Oist�ance frorn top of sludge to bottom of outlet tee or baffle g Scum thickn e;s M 6„ Distance frorn top of scum to top of outlet tee or baffle 6" 12" Distance from bottom of scum to bottom of outlet tee or baffle — — Accu-Sludge, (Baffle Stick and o� were dimensions determined? Tape measure 42 Nightingale Ln t5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 ' Conrsmonweafth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 4 42 Ni/ghtinciale Lane Property Address Walter J._Glowacki _ Owner Owner's Name information is required for every �_H annis MA 02601 8/03/2010 page. Cityrl_cvau State Zip Code Date of Inspection lit`li"Oif11natiOn (cont.) �,`;r,nin-jents (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): All_Tees and baffles in place and functioning. System was pumped as regular maintenance. (.3i (Ireo-;te or r-ite plan): "Depth below grade: N/A — h4at :vial of ccristruction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): imensions — — `3uurn thickne.-,s Di^>tanc:e from top of scum to top of outlet tee or baffle Di Stan•^e f om bottom of scum to bottom of outlet tee or baffle — Date of last pumping: — — Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, iic4uld levels as related to outlet invert, evidence of leakage, etc.): `Fight.or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): N/A Dekzth bf-low grade — Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): 42 Nightingale Ln t5insp•03/08 Title 5 Official Inspection Form:subsurface Sewage Disposal System•Page 10 of 15 ' Commonwealth of Massachusetts Title S Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 42 Niahtin ag le Lane Property Address Walter J. Glowacki Owner Owner's Name information is required for every _y ann H is MA 02601 8/03/2010 — —_ page. Cityri.^wn State Zip Code Date of Inspection e i Tight or Holding Tank (cunt.) Dimensions: N/A Capacity: — gallons DE:sign How: gallons per day , „i pr:�e,7t: El Yes ❑ No r.-tb.rtrn level:e .v..L Alarm in working order: El Yes El No D:.:ite of last pumping: Date "annments (condition of alarm and float switches, etc.): tach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distrilwficrn Box (if present must be opened) (locate on site plan): 011 Death of liquid level above outlet invert — Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-Box level, single outlet to 2 chambers in series, no evidence of leaks or solids carryover. Flu, ,!p Chamber(locate on site plan): Pumps in working order: ❑. Yes ❑ No - Alarms in working order: ❑ Yes ❑ No 42 Nightingale Ln t5insp•03I08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 15 ' CooniVIIc,UmmealEth of Massachusetts W Titi( , Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 42 Niahtingale Lane Property;'address Walter-,). Glowacki _ Owner Owne;r's E'larne information is H required for every annis MA 02601 8/03/2010 _y_._ __—____—_ page. CitylE'ctJn State Zip Code Date of Inspection Y It forniatiun (coat.) Comments (note condition of pump chamber., condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): 11W IOrEl ivd, '2xpl sir:w hy: Type: leaching pits number: -- leaching c,��«r.tbers number: leaching galleries number: st 4'x4'x4'W/ stone ❑ leaching trenches number, length: leaching fields number, dimensions: overflow cesspool, number: --- -_, innovative/alternative system -dyne/name of technology. Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): , Lawn over top.rio evidence of break out or hydraulic failure, no pondiong._ 42 Nightingale Ln t5insp•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 ' CORTIMOnweafth of Massachusetts W1'"FUe 5 Official inspection Form - Subsurface Sewerage Disposal System Form Not for Voluntary Assessments 42 Niahtin ale Lane Property Address Walter J. Glowacki Owner Owner's Name information is required for every Hyannis MA 02601 8/03/2010 page. Cityffcwn State Zip Code Date of Inspection a i f 4 in i1rifarmatirean (coat.) — Carsspaols (cesspool must be pumped as part of inspection) (locate on site plan): NUMber and configuration N/A _ Depth —top of liquid to inlet invert — Depth of solids laver Of' .cL.ra'ay `:'imen, sions of cesspool I`i1saterials of c:,ctnstrl-irtion --- lndi;:;ation of groUndwator inflow ❑ Yes ❑ No Comments (note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate o,.i site Man): •Idaterials of constru N/Action: — Dimensions — Depth of solids -- Comments (note condition of soil, signs of hydraulic failure,level of ponding, condition of vegetation, etc.)'. - 42 Nightingale Ln t5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 ' Counnionwealth of Massachusetts W Title 5 Official inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments ,qM 42 N ghtingale Lane Prop•a ty Address Walter J. Glowacki _ Owner Owner's Blame information is N annis MA 02601 8/03/2010 _ required for every _yam —__ _ page. Cityfl slvn State Zip Code Date of Inspection o S .�,, enn �.rlsanytaflun (cunt.) — Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate,where public water supply enters�the building. W DWELLING h A NOT TO SCALE SLOPE 3 A 1_38' 131= 14' A2=33' ,B2= 16.5' A3=28' .B3'= 1:9' A4='20' `N=26' 42 Nightingale Ln t5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 C;ononionwea6th of Massachusetts Title fficia.i Inspection Form _ Subsurface Sewage Disposal System Form Not for Voluntary Assessments 'wM 42' NigjhtineLane Property Address Walter J. Olowacki Owner Owner's Name -- -- information is n H anis MA 02601 8/03/2010 required for every y page. CityfT vie State Zip Code Date of Inspection "S"Ya-LIG,r1`d '64`ilf7oJ'aut3buti1i (coat.) a�'sle Exam: (X� Check Slope U Surface water Chet,*,C,'ll?Ir SI i el"ti`N V/ ilS k."stirn,<)tr�d depth to high ground water: 12'+ No water encountered feet Plea st indic Ott,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 j; 0h,3erved site (abutting property/observation hole within 150 feet of SAS) Che-eked with local Board of Health - explain: _. Checked with local excavators, installers-(attach documentation) !\ccessed USES database -explain: You mut t de scribe hOW YOU established the high ground water elevation: Hand augered test hole 12' .from surface within 50' of SAS, no water encountered. Bottom of SAS at ii' from sul'fai'sE 42 Nightingale Ln t5insp•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 i ff�r �� � ��, y�✓ „^ . y t �. 7� p•� ,�. / t is � '� w v, • F%:rL f fF ( i 1 •4 � _�Z 'fie :(� r r f -'� . Nighti'nga�leLn;H,ya1nnisM/�02601 _ s €t� � �� 'fit 3 =�. �� ' �}, ��� �♦ +•• s Y� Y A 'r'.�`I t •R0. u.�. 4 1 �''.'a�,���i/ _ �td 1` y '� '�r� Y � .4� ny� 'ki • i r a .Y fit! y x�u—upa�A W�Af ht'a ay f. .� 02 4 E �V �.f� so-.,. K. KR` -. -ImagetyDate?Ju129 2409, ,. 14 1?_3,9'56.89,H.NJ1 70 1T24.36"W elev� 49.ItK Eyealt Ay-_ .�%yP. Z; _'� 7 at w f � ��i.' r 1 nw�� w3°: '�'-•�.o� � ," �' �''`� `i�' r�`. ,.2:>w;�, �, n s� �a�z� '^y�'..�r,. ®e h 2 s� H,. 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Cape Cod Commission: USGS Well Data=July 2010 Page 1 of 2 United States Geological Survey Observation Wells As a service to Cape officials, engineers and other interested parties,the Cape Cod Commission publishes monthly groundwater data gathered by its Water Resources Office. The water level measurements shown below are taken monthly from United States Geological Survey - (USGS) observation wells and compiled during the last week of each month.They are published as soon as possible thereafter. Listed below are nine out of the 61 wells measured across Cape Cod by the Commission's Water Resources Office. These nine are employed as index wells to.be used with Technical Bulletin 92-001: Estimation of Nigh Groundwater Levels for Construction and Land use Planning to predict high groundwater levels. For your convenience,we've also provided a link to USGS national data. See the last column in the table and the footnote below. To see what's happening in real time at a separate well in Brewster,visit the USGS site: USGS 414630070014901 MA-BMW 22 BREWSTER,MA. For further information about any of the data or links on this.page, please contact Hydrologist Gabrielle Belfit at the Commission offices(508-362-3828). July 2010 _ USGS Site Y YY'Y Water Record Record Departure from Average"* Number Location Well No. (links to USGS Level" High" Low* Monthly Overall national water- level database) 21.8 (provisional adjusted value) Thanks to NOT NOT Al W Horsley 19.5 26.6 AVAILABLE AVAILABLE 41.3956070164301 Barnstable 230 Witten Inc. AT THIS AT THIS for assistance TIME TIME s in providing substitute data -until a new well. can be drilled. Barnstable 24w 21.9 20.6 28.6 2.1 _ 2.4 ]14' 141-54070165001- Brewster BMW 2l 8.3 6.9 13.6 1.4 - 1.8 IM451807002030111 Chatham CGW 138 23.5 20.9 26.6 O.l 0.311414100070011tol http://www.capecodcommission.org/wells.htm 8/11/2010 . ' y HIGH GROUND-WATER LEVEL COMPUTATION Date: 53 20�o Site Location: '�` 6. Permit: Owner: WCL N—e-r J C �pW�� k/ Phone: Contractor: Su,i'��i�tHt Phone: y Notes: STEP 1 Measure depth to water table to nearest 1/10 ft. f f (depth, is in feet below land surface) Date: v� � �I� I 0 m /dd/yy feet below Is STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: A) Appropriate index well Pt LJ 2 B) Water-level range zone STEP 3 Using monthly "Current Water Resources Conditions" determine current depth to water °� ' level for index well. /. e j m m/yy STEP 4 Using Table of Potential Water Level Rise for index well (STEP 2A), current depth to water, level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level �� adjustment. p STEP 5 Estimate depth to high water by subtracting the water-level adjustment (STEP4) from., ` p measured depth to water,level at site (STEP 1). NOTE* Tables 1-9 "Potential 1Mater-Level Rise" are attached as worksheets to this file. monthly index well data: www.capeco.dcommission.org/wells.html TOWN OF BARNSTABLE LOCATION � A e, �f c SEWAGE VILLAGE Z�Z ASSESSOR'S MAP & LOT-9C/— 0 INSTALLER'S NAME & PHONE NO. Ob SEPTIC TANK CAPACITY �0 6 LEACHING FACILITY:(type) ,�. /*-I NO. OF BEDROOMS _PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER �', ,�N G A ) DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: `'— VARIANCE GRANTED: Yes No l./ . o � � Iv_ I ,� `� � � , i b� �`"? �, J ASSEMRSMAP0. PARCEL f f THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliration for Uhnp !i al Works Towitrnrtiun Prrmit V P 9 t—cc of e-- Application is hereby made for a Permit to Construct ( ) or ,kephir ( ✓) an Individual Sewage Disposal System at: 2 ti .-� 41 e L -•-----•-•••••......•............/ ................. -......................................................................... r 'Locati a-:\ddr•ss or Lot No. r Owner Address W Installer Address Q Type of Building No Size.,Lot--4,,._.2...2'..•__Sq. feet Dwelling— No. of Bedrooms--------------------------------------.-----Expansion Attic ( ) `; Garbage Grinder ( )�o P4 Other—Type,of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Oa Other fixtures ------------------------------ -- w Design Flow..................... per person per d fy. Total daily flow.._...__._........._Z-.... ._......_._gallons. R: Septic Tank—Liquid capacitv.l.� gallons Length--- Width-.�_._.!"2_ Diameter................ Depth_.____. _ Disposal Trench—No. ......j_____...... Width.....<O!.-.-.-.--. Total Length-----lam......... Total leaching area__ ft.. 3 Seepage Pit No-------- ------------ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. -, z Other Distribution box (✓) Dosing tank '~ Percolation Test Results Performed by,._C_ 4-�..9.... �` ............. Date........ a - Test Pit No. L___4_.?....minutes per mch Depth of Test Pit._1.:¢---------- Depth to ground water..Naa <-- L� Test Pit No. 2................minutes per inch Depth of Test Pit---------------------- Depth to ground water......................... • .........................................t-........................................................-----------------•----•-•-----•-•-••-----...........---- O Description of Soil....-- A=' ---- ------- w UNature of Repairs or Alterations—Answer when applicable..-,.-.--- e-.f4 C c --X l_-L-t .-_C c S ------------------------------------------.-------•--•-•----•••-•-•-•-•-•-•••------...--•-•••--•--•••.��oe'1 d-----------------------------•..........---. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with ` the provisions of TITLE'5-of'the State Environmental Code—The undersigned further agrees not to place the system in operation- ntil + Certificate o mpliance as been issued � ,boa f health. GIi;G G Slgned' . ..... ..... .. ------ _._.3-- ---- te Application.Approved BY .. ......... -------------- ---. . ...------------------------------------ �`"�. Date Application Disapproved for the following reasons- -- ----------------------------------- ----- ------------------------------------------------------------------------------ ....................--- ------,---------- ... ...................................:------------------------------------------------------------------------------- ........................................ Permit No. /L./.J4. r}._0-------- ----- Issued _..... �.�- .� ........... / .............. ..... - Date 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH'-# TOWN OF BARNSTABLE Certifi ate of Graylianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Rgxair-ed ( ✓) by .... CY7----.- - Insr,JIer at ...LI. .....�..... - ---�--- --�j---`` 1 �' �-.G---------------�---- --±''-h--� 5 --------- -----------------------....-----......-------------------------- has been installed in accordance with the provisions of TITL/ 5 of The State Environmental de as described in the application for Disposal Works Construction Permit No. .. i-w.....'� .�.- dated THE ISSUANCE OF THIS CERTIFICATE SHALL NO BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. 'e 1� �4 DATE .. . .. .. Inspect -------- v ^ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE =r- Bis;viral Workii Tnnotrudinn "unfit Permission is hereby ra�ed----�-1--r4;0--- ���`--= - q-- ..S.h-- r ---------------•--....--------------------•-------------------••--••--..... to Construct ( ) or .e-}�a r- an Individual Sewage Disposal System stem g P Y at No..." � 'r' c,. f n -e Strei � �/ as shown on the application for Disposal Works Construction Permii: '--' l -- --hDated--- �.��'.. j5 ............................ ..q-- --- .. -----..-.-.....---......-----.-.-.-..-------..--------- Board of Health DATE-----------------L- -�-.�-�.--=��----------------- FORM 36508 HOBBS h WARREN.INC.,PUBLISHERS r, ol Q� r r THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 84o q TOWN OF BARNSTABLE ppliratilan for Dhi-pogat Vorlw Tomitrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Aepwir ( ✓) an Individual Sewage Disposal System at • N ; Location:Address or Lot No. ��.�.r�..!.� � I�c: C ►_0,�. .......1__�+-•.��r'_•/-_L � •� C_..,,..�!�_�h�i_`._..�,or—....�Z t..38 Owner Address W Installer Address PQ d Type of Building do Size Lot.. ,�__.... 2.._..Sq. feet Dwelling— No. of Bedrooms-------------------2_-_------_-..-_.-..Expansion Attic ( ) Garbage Grinder aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------- - - W Design Flow................................:..3.-.gallons per person per day. Total daily flow..-.-.-•_-_--.-_..__�..?_0_....._....gallons. t 0; Septic Tank—Liquid capacity-�PPO-gallons Length... �-.�'t Width.-9_{-.!.-?.-(Diameter.-.__----.-.-. Depth... .._..8 Disposal Trench— No. .......!............ Width.....�O...----...... Total Length.....Vie......... Total leaching area..j.��..k_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.........__--....__.._ ................ `-1 Test Pit No. 1....<.a----minutes per inch Depth of Test Pit----!.'4.......... Depth to ground water..N (i Test Pit No. 2................minutes per inch Depth of Test Pit............-------- Depth to ground water..-.._... --._-:.------ a -----------------------------------------r................................................................................................................... Descri tion of Soil I"� `�( T- cam _cr'_.� �.SQ � ��.-cL✓e -p -----------------------•--••-- W x .......................... ----------------------------------------------------------------•---- •-------•---------------------....-------------•---------•-----••-•••-••--•-----------•--•••.._...... U Nature of Repairs or Alterations—Answer when applicable.--4.......1 -�° .14_.C.�..-_._..4 K f .t..l._ .............................................. Agreement: - The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in o eration •ntil Certificate of m liance has been issued b_ t board of health. Y P P Date Application,Approved BY 'y � .- Dace Application Disapproved for the following reasons- ------------------------------------------------------------------------------------------------------------------------------------ .......... .......................... .. --- ................. -------------- ------------------- Permit No. ... ._. ... ---�. Issued ...... Date File Ivo Sheet;./ f -- r Client /!,r Location:__ 42. .. dr .N P r o j : D e s c r i p. r X 1-5 &-)on ®® e- /cm—n- ........I .... i I I i. ..... I O O i i t ; O ' ..... .... ....... ....... ................................_.__....,.............___......_ ... . .... .. ... .... .. .... ................... ............................. -._............. ..................... ...... ..:... ..... L.............. _................................................ .. :.........!�... ...... .. ..... : ......._�_................ 5 ........ ... __. .... ..._`� .. _................. ....... : ....... .. .. ..... ... ..... .... _ ....... _ ...i _. ...................:. ......... ...._...... ........ :....................... N. T. . f .........._.......... ....... . ........ ... ...:. . Li.. , ............ .......... . — v � f ... .t�' ............./`.....!..................:................ ................. .. . . .f.........' . . ... ......... ... ..................................................... . ...._.....................; ..... ......_........T ......... .............__......... ......... D A 'N ..:.... ............ .................................................................... ............. ......................_..................... CL ...:.... .......... ..... ..................... ......... .. .. ....... ............ .... ... ..............._.. . :...... .... ... ..... .... ....... .. ...... ....... _.........._.......... .......... ..................: ...................................._ ................ . .......... 131 .D 12e�o _ /..........:..........: .. .".136,I�T .vw1. :. .. ...__..................... ................ .... ............... . _. ..... _..... ................ _.._...... ...... ...... ..._..� .... _...........................l .. ............. _.. ................... ........ ....... ................. ................. G L. a, { ............._............................................................................................_....-.................................................... Member ASCE I MALSCE CRAIG R. SHORT, P.E. + 1 I 14 TORY LANE 1) DENNIS, MA 026M OFF.(508)385-6530 Date Professional Civil Engineer Custom Designer cl m . � . N N I a m IP c v � CP 00 WN T 71 T i � . i� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .. .A4..................OF...... "-a.9f'.a'..$. - Appliration for Dispniia1 Works Tonstrudion frrmft Application is hereby made for a Permit to Construct ( ) or Repair (7Q an Individual Sewage Disposal Sy tem at =•`t --- 6 n uE ,aa. . :Y. F `-----•....... ............... .................................................... ....................... -Address or LotNo. "......................................... ... M 164T i u:��..................4 :........... ._..--•......... ....... Ow er die ............................Q -�=-DU 7 --� ��'•------------------ ------4a....�tZe:.1�GK�. u x........................................... Installer Address Type of Building Size Lot................ Sq. feet U Dwelling—No. of Bedrooms.............................................Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building .............. No. of ersons._..__...._......__...__.... Showers a YP g .............. P ( ) — Cafeteria ( ) Otherfixture .........• • - .... -----......----•---------------•--•---......_.._...........----------.............-----•••-•-........_. W Design Flow..........................:...............gallons per person per day. Total daily flow.._.........._._..I1_Q......___._.._....gallons. WSeptic Tank—Liquid capacity..__i_._.._gallons Length................ Width_..r_..___..._. Diameter..._............ Depth................ x Disposal Trench—No........�..X�.... Width....._-_1•.......... Total Length.................... Total leaching area.__1�......sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z •Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by................................•......................................... Date......................................... Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 04 .....-•-••-----•--•-------•...........................•----•--------....-----------•--•-----.................................... •---------- -•••-•........ •.... O Description of Soil............................. --...------•------..._......-•---•------------._.....--------------------••-•-------•--------............------•----•--•-•--------_••---- W U ------------- •-------------- ------------- ...........----------------- .....-------- •-------- ------------- ------------------- •-------- -••----------------- •-------------------------- ••------ •------...... W U Nature of Repairs or Alterations—Answer when ap licable.A9I?...._ P._F� M6-..t-r..A--- ! ---tog b&k._GWA4 .M:T._...'0..__.4�....Z�w!:Ge'- 0`1ome- `aIV4 (- v .i -UrsO ..�?1.P! . Agreement: The undersigned agrees to install the afore cribed Individu Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary ode— The under g d further agrees not to place the system in operation until a Certificate of Compliance has b issued y the of 1 ISned .......... .. ' -----------•....-------•--_._.. ..-••-_. ......... it �p Application Approved By................ 1..7.:_•. Application Disapproved for the following reaso •./.______-•--••--------•--•-------------------------••.-_.-_---...--•----_-•-- PermitNo..................................._.................... Issued....----------....... r FEZ........:.:.._ ........... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH fov,) G i c,�'A It , ... .............. ...........OF.........:.................:...........-------------.........-.....................----.-. Appliration for Disposal Works Tonstrudion Frrmit Application'is hereby made for a Permit to Construct ( ) or Repair (;A) an Individual Sewage Disposal System at: •..............i __k.._........... .................._.u Yea w 4-AA-----..--•••- .................•............................••-•••----..........._..........----................ {� ovation-Address or Lot No. ......+ti L F <. _ ......f:. :A............................................ .._� �`1.l _.1 T i ItJ :fit(.. _ ( 41\ .............................-..... LOwner. 60 1t�f G f..................................... pq Installer Address VType of Building Size Lot.................... .....Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons............................ Showers ( ).— Cafeteria ( ) al Other fixer Design Flow..................W._.............._.....gallons per person per day. Total daily flow..................15..Q..................gallons. WSeptic Tank—Liquid capacity............gallons 4ength................ Width......_........ Diameter................ Depth................ x Disposal Trench—No........�.. . ._.. Width....... ......... Total Length....k...........Total leaching area---11.5......sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by•-•-•••-•--•--•........................•-••-••••••.............•--.--_._. Date........................................ Test Pit No. I...._..!..._..minutes per inch Depth of Test Pit.................... Depth to ground water....................... L� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...................................... 0 ai ---------------........................................................................................................................................ Description of Soil..................................................................................................-----------•-----•--------............ U --------------------- --•-------------------------------------------•--------------- ------------ ------------------------------------------------------ ----------- ••------------------- W VNature of Repairs or Alterations—Answer when ap licable_.A! !�.....�a.. `�. =.... '.�.._. ...�'�^�rM�"..`; _ ... G?..._ ....._ U S17) X,. CE- �) >y V I? la•....-ter.. :....••••••---•••....- •-•- -•-•-• . • •-•-.•. Agreement: The undersigned agrees to install the afored cribed IndividuglSewage.Disposal System in accordance with the provisions of TITIE, 5 of the State Sanitary ode—The underg d further agrees not to place the system in operation until a Certificate of Compliance has b issued/lby the b6rd of ✓ Application Approved By............................................ ... .......................... r ' Date Application Disapproved for the follounn reaso s° ----••--• ••••..-.-.•.- ^-•• ..................................................---•-r......................_.--------•------------------------•-•---•--•--........................... - ....--------- Date PermitNo......................•-...---•-.....------...--- Issued.......................................... .-------------- Date THE COMMONWEALTH OF MASSACHUSETTS - r � BOARD OF HEALTH ........?.. ..e.S:...............OF...................-aW',..44 i" �1 .. ...................---................ Trrtifiratr of Tomplianu THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (. ) by.........: ........ ........ -----------------------------------------------------------------------------------•--•-------------------- Installer at..........G........._ll 1 �.t: l1�t.C- � ._...1���:t�(F. y41 A has been installed in accordance with the provisions of T r The State Sanitary Co scribed in the application for Disposal Works Construction Permit No. _ _._'...._ ................. dated--. -_ - ...-__.__._._._........ THE ISS AN E OF THIS CERTIFICATE SHAL NOT BE CONSTR ® AS A 6UARANTEE THAT THE ;SY rEM W1 L F NCTIDN SATISFACTORY. DATE.-„L.. . ... - ... Inspector.. ... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH g, ........ I�?.(�?m................OF............... Z.k...e&.�'A.3.�........._.................... No......................... FEE......e .t.�Z. ..... Disposal Works Tonsirur#ion rrmit Permission is hereby "granted.....P-PAPP-T.- ....................................................................... to Construct ( ) or Repair ( ` an Individual Sewage Disposal. System at No...... ......L--.!.. ................1:�4 at�i►�Ltrs� t �` 1 .. .....----- -- ............. Street as shown on the application for Disposal Works Construction Permit Ng .. .......... ated.. ....... ...................... ------------------------ ------ --------------------------------------------•-•._............._......_ Board of Health DATE...........................•----•-------•---•--......-•--•......•••••........... FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS i BENCH M A R K � � . � =- .. �,r o�� ��,�.,. ��2paR s� ssur^ �� �.� �. ., , c�0. � ca TEST HOLE RESULTS � P 84 � � r at � � DATE WITNESSED BY rEf2R nrrGN e� ` �` �`'��' HIGH GROUND-WATER ADJUSTMENT : CZ12 lc) % �. �� .� �/ ©l2, 7,. a:., °gyp Tt-� OBSERVED WATER DEPTH I- oc,gT /ON nrIAP INDEX WELL TEST HOLEx I TEST HOLE '#2 WATER RANGE ZONE f T Cl P ; CURRENT WELL DEPTH 'Jf3 s ° WATER ADJUSTMENT ESTIMATED DEPTH TO WATER ESTIMATED MAX, WATER ELEV. w . o E A S T- � c :. 'L - $� IVo GROUND , WATER GROUND WATER ENCOUNTERED ENCOUNTERED -� (r . MANHOLES AND COVER TO BE BUILT TO `� El_ EV Tt)F' OF WITHIN 12" OF FINISHED GRADE G2.4we. q__L p0t.tC3rlf FOUNDATICNo FINISHED GRADE MIN. 2 /o SLOPE - -- -- /OS� ,5eP77) 4 DIA --- - --- 4" DiA. PIPE FIRS "_ - r+ -_ .ID t6 TANK PIPE - ;�^„�, -- 2" LEVE •MIN . 2LAYEROF 9q2 �_ ..,�,,,,, MIN . PITCH %` FT, PEASTONE MIN PITCH ;m'M,N �,"d 97..S"C7 1 F T, rY f ? `04�1O t� T�'ST H LC /4/ INVERT G,•swHv INVERT' j'�f2G., INVERT EL`? O GALt 0T K G7 DIST r ' ®Q Q m - �4 2 D I A 'AEG t Imo NVERT ^ EFT 1C - AN INVERT BOX . W --�� '' v © WASHED STONE ;� J.7S+ 1NVERT ALL AROUND-- x 1G x 3 CGEP /O Pl- A C E ON •� *� j1 'Q F I M A S E --- ""�t —� _ — , ' a P 3� �EuN R B ,w. ; 1,, I TT M AT Et_ V, L ERG H. SAC; --- GARBAGE• 1 i i _M I ' x I 1N. \ w l I G R i N © E Fi L a � ' `0 2 G4 AL L.1'�y.5 +�✓.ST'e�u E` FUL i_ CC LtAR � Ae- E d- , A�+vcas: . —z1, 0 CEI-Lli Q_ 2, CD 770M '0r TEST- NC7LE E LEV , 7-n-EE I _, cx P R 0 F 1 L E O F SANITARY DISPOSAL SYSTEM - =--- t►-s ►--• '� ( NOT TO S C A L E ) �' Et EC. morretE Y DESIGN DATA .� c 11 CONSTRUCTION OF SEPTIC TEM HALL CONFORM TO S SYSTEM s ' /00 RESEkVe- THE COMM, OF MASS. ENVIF40NMENTAL CODE, TITLE 5 BEDROOMS • F��N AR �� AND THE TOWN BOARD OF HEALTH REGULATIONS . 1� DESIGN FLOW GAL ./DAY 2) THE DESIGN IS TO BE STRICTLY FOLLOWED . CRAIG R . LEACH RATE MIN./INCH SHORT IS TO BE CONTACTED PRIOR TO ANY CHANGES, PROP'D. BOT AREA X /O' <00 iF .� ` �---'. q� 31 SEPTIC TANK, DISTRIBUTION BOX AND LEACH - PROP•Q SIDE AREA 32'X3 SF TOTAL AREA - l44 SF ING UNIT TO BE OF REINFORCED CONCRETE - MIN . CONCRETE STRENGTH = 31000PS. 1. PROPOSED LEACHING CAPACITY 3?- GPD MIN. STEEL STRENGTH 20 , 000 PS. I . REQUIRED LEA ( RING CAPACITY.__= " GPD MIN. DESIGN LOAD I N G � REQUIRED SEP7I C TAN4K GALLONS 4) DRIVEWAYS NOT TO BE LOCATED OVER SYSTEM UNLESS H2O DESIGN LOADING IS USED 5) ALL PIPES AND FITTINGS TO BE WATERTIGHT PLAN SCALE • I — AND TO BE OF CAST IRON OR APPROVED P.V.C. HEALTH AGENT APPROVAL DATE CAUTION CONTRACTOR TO CONTACT DIG — SAFE 72 HOURS PRIOR TO EXCAVATION I i P0 IN SITE PLAN SHOWING PROPOSED CONSTRUCTION '` I`ve' C� �-,` ' / 1�l F_ ! 1:' H?:�!'-�'l� ZONING DATA L E G E N D 34, L O C A T I O N ______ Q FOR _ ' �� T�2 � . ,=� o ,� DATE : _ - ZONE ,...._ IV A TEST HOLE LOCATION I. � REFERENCE LOT AS SHOWN ON REVISIONS : REQUIRED AREA _ _ EXISTING SPOT ELEVATION 17.6 �+AP31i rncz. 8 .''•/ 7,3 P<.Af ' y L �iv. Sy&v�-y Csv1- '-4Ar ] S REQUIRED FRONTAGE EXISTING CONTOUR - --- 16 --- CLIENT' AGGRESS i TC)J2 \/ LAlV DENNk! , �!9 REQUIRED FRONT SETBACK PROPOSED CONTOUR - 16 IF THIS PLAN DOES NOT BEAR A RED STAMP BY CRAIG R. SHORT, THEN IT IS NOT A VALI D COPY 81 I ASSUME NO RESPONSIBILITLY REQUIRED SIDE SETBACK WATER SERVICE LINE W_ n FOR ITS CONTENT OR USE . REQUIRED REAR SETBACK GAS SERVICE LINE ----G ' � � r ` E,.ECTRIC 8 TELEPHONE LINES e T CIVIL274 a �.o �. ; rv�a. 27�63 ` CRAIG R SHORT , P. E . �2� �� ,. � �f`j:" P R O F E S S I O N A L CIVIL E N G 1 N E E R 'j . � 14 TORY LANE , DENNIS , MASS. 02638 FILE W. BUILDING INSPECTOR APPROVAL DATE .R 508) 3 8 5- 6530 w. SHEET OF