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0975 PITCHER'S WAY - Health
975 Pitcher's Way Hyannis A = 272 145r 1 I l r n n w TOWN OF BARNSTABLE i LOCATION � P Q � PR S w (� `1 SEWAGE# 0 O 1'04 D VILLAGE \�` �/,/W S ASSESSOR'S MAP&PARCEL Q 12 ' 1-1 5 INSTALLERS NAME&PHONE NO. KG V1,A1 SZ2' S-6 Y o _ I SEPTIC TANK CAPACITY Q,d o 0 CA-k LEACHING FACILITY:(type) �'o®y 4A (a w`4J1A bekV(size) '�Q - 31YX 1 NO. OF BEDROOMS OWNER 1111219- C l�rel� PERMIT DATE: 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 1 ac ing facili ) Feet FURNISHED BY �.�• . ocs � k O ^se 6 Yl�� ;lr No. ' v ► Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplication for �Biopo$al 6pztem Con5trUCtion Permit Application for a Permit to Construct( ) Repair( ) Upgrade j?t) Abandon( ) ❑Complete System ❑Individual Components Lation ddress or Lot No. t / flrov 3 e q' Owner's Name,Address,and Tel.No. 2-Ixag oc ��-�C��et's wky Assessor's Map/Parcel Installer's Name,Address,and Tel.No. laVIA( S'°'O l fC� Designer's Name,Address and Tel.No. ry2 Reg1S Ku E 'Fojrh,vjl- I m4cs luI T., H41 -Squ-sx 5,0%— Y6 cl— Type of Building: Q' / Dwelling No.of Bedrooms u Lot Size 0�6, 0 y sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) q T6 gpd Design flow provided C/ gpd Plan Date pp 3 Number of sheets Revision Date Title Size of Septic Tank O d Type of S.A.S. fy 6 k, �(itr•►jo�rS Description of Soil Nature of Repairs or Alterations(Answer when applicable) ,y /1 6— S00 n 2! 16 W � sst Yll 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 Certificate of Compliance has been issued by this Board of Healt . �gned Date /— 16—o ^7 'Application Approve by Date Application Disapproved by: Date for the following reasons Permit No. Date Issued P 6 r No. Fee / THE COMMONWEALTH OF MASSACHUSETTS• Entered in computer: yY 1 PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZippYication for,0iPo5al *p5tem Construction Permit Application for a Permit to Construct O Repair O Upgraded Abandon(') ❑ Complete System ❑Individual Components ocatio .Address or Lot No. I ! f�OU 5 9 7 '� Owner's Name,Address,and Tel.No. /_/Xo 9 e14,11/ 4eji-er's WRy - Assessor's Map/Parcel e �� V i�� S'rh° ICE Installer's Name,Address,and Tel.No. Jj Designer's Name,Address and Tel.No. �t 9c9i.S IZU E. 1✓AtvheV7�' f mim lU/ '74wi•�. /t4I Uif l SS Tot- 560- t17Yb. �-/ 2 4- Type.of Building: Dwelling' No.of Bedrooms u Lot Size cAp)�+, o��`� sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures / Design Flow(min.required) U gpd Design flow provided gpd Plan Date 2 ou 3 Number of sheets 2- Revision Date Title Size of Septic Tank /TPC) d Type of S.A.S.4rtft Description of Soil Nature of Repairs or Alterations(Answer when applicable) H S /1/ i - -oa :F /GW rFj, py S Date last inspected: r Agreement: ' r 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 Certificate of Compliance has been;issued by this Board of Heal ) i igned Date Y Application Approve by Date �$ Application Disapproved by: Date ' t for the following reasons Permit No.QW-7 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 ` F f at ,C L.c2 S � has been constructed in accordance with the provisions of Title 5 and�tt e for Dispo System onstruction Permit No. � d dated t Installer p v/Al C�y (^1 Designer -FA Mavd/7 ,c(S IAIeP.C/�/�_ #bedrooms Approved design flow 671-�2 gpd The issuance of this permit shall of be crstrued as a guarantee that the system wiClYfu cf esign n a'designed. Date ' Inspector { —. —,- ------------------------------------------ No. r Fee QV THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS lwigogal *p.5tem Construction permit Permission is hereby granted to Construct ( ) Repair (6/) Upgrade ( ) Abandon ( ) System located at 96 ����fl//IS ��'►/ ����/✓/`"/ S /yes and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construlction must Pe completed within three years of the date of this ermit. Date ! g 1 I Approve�y°" -� Town of Barnstable Regulatory Services Thomas F. Geiler,Director M ABLK Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: Sewage Permit# U7"�D Assessor's Map\Parcel 1 P,/W� 7 Designer: YL . Installer: s/VCf7 Address: Address: On 07 was issued a permit to install a (date) (installer) septic system at 7 based on a design drawn by (address) dated ( � (desig r I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. 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 Re u ations. Plan revision or certified as-built by designer to follow. OF PA,QS1� p� MICHAEL J. BORSELLI vV,_a,' CIVIL H (Installer's Signature) No 35054 A9�ica►StE��� s1ONAL�4 (Design is Signature) (Affix Designer's Stamp Here) I 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:Health/Septic/Designer Certification Form 3-26-04.doc JA?!18-2007 15:09 Falmouth Eng. �� 508 495 3229 P.03 q Notice: This Form Is To Be Used-For the Repair Of Failed Septic Systems Only PERCOLATION TEST AND SOIL EVALUATION EXEMnON FORM •I, Mi ch a 21._-Bo r s e 11 i . ,hereby tor*that the ov&oersd plan signed by me dated 4/18/0 3 ,concerning the property located at Lot 0, Pitchers Way (#975) meets of the following criteria: . Two soil evaluations excavated for detailed Mamination(go hand augerlgg)and two percolation toots ohell be aonductod. • This Wed system is connected to a residential dwelling only. Where are no commercial or business uses associated with the dwelling. • The soil'is Classified as CLASS I and the percoladon rate is lose than or equal to 5 minutes per invh. ' • There is no increase in iow and/or Chop in use proposed • There are no varianves.mposted or needed. • The bottom of the proposed leaching f$oility ar Lbe located no leas than five feet above the maximum adjusted groundwater,table oevation. [Adjust the groundwater oble using the FdMtor method who applicable] please eomblete the Moving: - r on the round instrument survey A) Ito of Grgund Suftee Elevation( 60.0 B) G.W.Blevation 3 3* +aQ r high G.W.10 **=4 3.0 r z f DIFFERENCE BBTME N A ��tK OF e �p MICHAEU. . BORBFW SIGNED; ATE; 1/18/0 7 Based upon the above inforinatian, a rapWr permit will be issued&r-bedrocme maximum. No additional bedrooms are autha died in the Mae without engineered septic system Flow. * Estimate obtained from Town of Barnstable Engineering Department ** Conservatively estimated adjustment . q,1SepBalyecaaxemD.d�a HZIU3H Jo addOa 31HdiSWa E W00:6 L002'LT'Ndf TOTAL P.03 LOCATION ( z SEVAGE PERMIT NO. 11 �� ��� IN Ca / VII.LA'GE t L\11 �4/ .,V/y y �. INS.TA LL.ER'S NAME i, ADDRESS S U I'L DE R OR OW ER DATE: PERMIT ISSUED c Aa/Sl� D`A-T, E C0MPLIA-NCE ISSUED p//g,, f/ :���°1� ��ti� .d �� s s - . T 1 i ,� � _ s i No.[�....l............... w Fps... ................... h COMMONWEALTH OF MASSACHUSETTS OARD OF HEALTH _._.... O F.............................•-..........----.--------------.........--------------....... Appliration for Disposal Works Tonmtrn.rtion ramit Application is hereby made for a Permit to CQnstruct (�r Repair ( ) an Individual Sewage Disposal System at: n..1........` ---------------------------------------------------- /� Location-Address or Lot No. .......0.. . .........1s.1- ........................•-•--•----•--...-•--------•- ------------ -......_. ......_... .......-•---•--• Owner, res �.� ----._...��1 R ...........1_. vARfS.... �,S.ax... 3% ---- � G f. ....-•----------. Installer Address / �7 / Type of Building Size Lot...2.(j.�S--�-4:_-.Sq. feet U Dwelling—No. of Bedroo ......: . _..___.__.Expansion Attic ( ) Garbage Grinder a' Other—Type of Building ..._ . __ .... No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtu .......sell 14 Design Flow..............�.1....................._gallons per erso er/da . Total it flow-______.----�� ............._._ ns. Septic Tank—Liquid capacit?- _.gallons L ngth n....._.. Widtl ._e_____ Diameter................ Depth..-.... x Disposal Trench—N?o.................... Width...._............... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.../0.......... Depth below inlet.................... Total leaching area.�O...A.5....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water-._-_-_______-__--___-. (%, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------•------------------------------------------------••--•------------............--••••-•----......................................................... 0 Description of Soil......................................................................-•-----------------------------•-------------•-----------------................................. W V •-----------------------------------------------------------•---------•---- -------------------------------------- •----------- ------------------------------------ ----------------- --------------- w -•------•------ -----------------------•--------•-•••-•-------------------------•-----•-••---------------------.......---•-----------•.......---•---•••----------------•----•-----------•-•••------...-- U Nature 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 TITI..1 5 of the State Sanitary Code—The undersigned further agrees not to place the s stem in operation until a Certificate of Compliance has be is d by the b ealth. Signed ` ....-••---•------•---• Date ApplicationApproved By.............................................. -_----_---_----_-- -------------------•--------•----------- Date Application Disapproved for the following reasons:-------•-----•------------•--•---•-•--------•---•-•----•----•-•----•-•---••-----•-------•-•..................... ---------------------------------•-•----...--•--••-•-----------------------------............--------------•--•--•-••....--•••------------------------------------------•-----•---------------.......... Date PermitNo......................................................... Issued....................................................... Y Date J No -. F• f Fx$.. _............... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......................................OF........ Appliratiun for Disposal Workii Cfonstriartion ramit Application is hereby made for a Permit to Construct �or Repair ( ) an Individual Sewage Disposal System at t ' �9c t r......WA1 -------•---------------1--------------------------- ---------- ................................ Location-Address or Lot No. ..... '. _. _... t...................................................... .......................................................---......... _--------------- ____.......... W Owner dres. E. a ................................... ----- ........_ ..... ....••- Installer Address ,//' Type of Building Size Lot_;J, .. ra 1.4, 3q. feet Dwelling—No. of Bedroo ...... ................Expansion Attic ( ) Garbage Grinder Other—Type of Building No. of persons.................•.......... Showers O — Cafeteria P-1 Other fixtu _ -�-.. ----... ) d lam-- -•------------------•----------•--------------------------------....---•------------------------••--------------------- W Design Flow.............�"_k.._.........._....._..gallons per person, er day. Total dail flow____.___. r ..__ _.... ons. WSeptic Tank—Liquid capacityl.- ...gallons Length, .. ..... Width.._ ...__ Diameter :............. Depth ........... x Disposal Trench—No. "Diameter kith................... Total Length.................... Total leaching area-__--_ ------sq. ft. Seepage Pit No.. -"• ` .....--... Depth below inlet.................... Total leaching area.t .....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-.-..._______-__-_-_---. fz., Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... R+' •----------------------------------------------- -------- ................ .-----.... -----------•--.----..-....-------------------------------- ODescription of Soil------------------•------------------------------....--•--•---•--------•----•-------------------------------------------•---------------------........................ x W U Nature 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 TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the s stem in operation until a Certificate of Compliance has be is d by the ealth. Signed .. -> gig' "¢1 -•------------------- Date t Application Approved By............................................. -------•-----------------------•••••---• 3 Date Application Disapproved for the following reasons:--------•-----------------------•----------------------•--------------------•--•------------•-•-......•--••-••-- ..................•••---•--•-•-----------•--•--••-----•--•-•••-----•--•-.....••--------•••••-••-----•-•--------------••••-•-----•--••-•---•----------•-••••-•-------•--••----•••-------•-••--•--•...... Date fPermit No....................................................... Issued....................................................... fDate THE COMMONWEALTH OF MASSACHUSETTS 1 I BOARD OF HEALTH I ................................h........O F................................................................................ ..... Tntif iratr of TompliFanre THIS IS TO CERTIFX,,,That the Individual Sewage Disposal System constructed r Repaired ( ) by...._.... ................. ..e F1 . ". ....... ...- --•------------------------- --------------------- ------ +�. E I staller has been installed in accordance with the provisions of TITLE 5 f The ate Sanitary Code as described in the application for Disposal Works Construction Permit � _�� _ _f.................... dated--------------------------...................... THE ISSUANCE OF THIS CERTIFIC TE AfqALL NOT BE CONSTRUE® AS GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFA T .--- Inspector..-_-_-----' _-•- --•-•-•--------•---------------------------------------•-•••-- DATE......... THE COMMONWEALTH OF MASSACHUSETTS WF BOARD OF HEALTH Nof ..........................................OF....................._..`........... FED t orkii Tonb#rion rranit Permission is hereby granted__.__:! ............................................................... to Construct ) or-NRepair ( r^� an Individual Sewage DisposarSystem,._^— .' atNo....... ------1- ---------•-_-- • Street ����r q l as shown on the ap. ication r Disposal Works Construction Per t s�_ Dated................... .................... d, r � ................... .....--••--•-•---.................................. - .........._...._ Board of Health DATE.... FORM1255 A. M. SULKIN, INC., BOSTON - T t�tp� /� �+ DATE April 17 , 1984 ❑ URGENT OF BAIg�NSTABOE ❑ SOON AS POSSIBLE y BOARD of HEALTH FILE NO. ❑ NO REPLY NEEDED 367 Maim Street P. 0. Box 534 HYANNIS, MASSACHUSETTS 02601 ATTENTION TO SUBJECT Sewage Permits 84-231 and 232 Lots 17 and 18 Pitcher' s Way Mr. Edmund Flynn Hyannis C & F Builders, Inc, 949 Pitcher' s Wayt HYANNIS MA 02601 MESSAGE Dear Mr.Flynn: We have been informed by Mr. Lahteine, Town 'Treasurer, that the check for $100 you gave the Board of Health for Sewage Permits 84-231 and 232, was returned unpaid for insufficient funds. Please see Mir. Lahteine immediately to take care of this matter. Very truly yours, SIGNED tk/eff REPLY dth DATE OF REPLY SIGNED. SENDER. DETACH THIS YELLOW COPY FOR YOUR FILE. MAIL WHITE AND PINK COPIES WITH CARBONS ATTACHED. � s THIS CHECK IB DELIVERED FOR PAYMENT " -' "' •- . ON THE FOLLOWING ACCOUNTS. I DATE AMOUNT =R _- `'__ :_ - C & F BUILDERS, INC. .218162 .. � .. ...:>E'1i�%it1��t.1�.Sc�E:�+�SS."eS`O"'�y'T���,`��!?'•�'�3��Ffl,;��:4.i 53-144 l �� ✓'�� 19 113 ORDER O TO THE .1 l ORDER Oh' ' TOTAL OF INVOICES nt� ?* LESS %DISCOUNT - —DOLLARS LESS vo TOTAL DEDUCTIONS AN 1- 0.2801 p AMOUNT OF CHECK 11'00 286 2u''®i:0 1 1 30 144 21: 0806 0 59 211" l} 00001000011 ��_._..__ „__._�__._...�-___.._._____.. _•�__..____.______._._,_.._--____- .- RETURNED UNPAID FOR _.._._ O� BANKOFNEW ENGIAND'akRwrAauooLwn,.NA., Hyannis, Mass.April 12 19_4 REAON INDICATED WE CHARGED YOUR ACCOUNT ON ABOVE DATE FOR REASON MARKED 01) PLEASE SEE ,r SUFFICIENT THAT THE AMOUNT IS DEDUCTED ON YOUR BOOKS SO THAT OUR ACCOUNTS MAY AGREE e'FUNDS C & F Builders inc 100 . 00 El ENDORSEMENT AMT. S . ( FEES ElM.IS•3ING TOTAL S 100• 00 ❑❑ NOT AS DRAWN WRONG BANK REASON FOR RETURN OTHER ❑ SIGNATURE BY THAN LISTED ACCT. W FUNDS OTHER UNCOLI_ECTE,D AC ❑ � OTHER REASON . ❑ (SPECIFY) T. C. CHARGE TOWN OP RARNSTARTE TRF.ASTTRRR 60 ATTN* MR TIANTTi:TNR w.' N .---------�. ...... 'Es �(�................ THE COMMONWEALTH OF MASSACHUSETTS . ' 1,31 BOARD OF .�H/EAL/THWlekl&------------OF...... M�/�!/& ---...----.............---------- ppliration for Uiiipoii al Workii Tomitrurtion ramit Application is hereby made for a Permit to Construct X or Repair ( ) an Individual Sewage Disposal Systemat: � .... , T. .----/ --------- ............................. . .......................................... Loc n-Add No. or t No. Ow i dress n 1.4 � Installer Address U Type of Building Size Lot_.C�. 4;?y ---Sq. feet Dwelling—No. of Bedrooms........�.._--_-•-______-_-___-_-_-Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building ............................. No. of persons............................ Showers — Cafeteria WQ, Other fixtures -------------- ------------------------------------------------------------------------...------------------ Design Flow..................�, ....._...; gallons per person per �y. Total dai flow___............ ._0............ lons. WSeptic Tank—Liquid capacit ..____gallons Length____.__.... Width._.......__.Diameter................ Depth.......... x Disposal Trench—No.>_.- Width..---`tt j,...----- Total Length........ f-__._. Total leaching area..................:.sq. ft. Seepage Pit No........../.._------- Diameter------/0-I----- Depth below inlet..... Total leaching area._ .,���...sq. ft. Z Other Distribution box ( � Dosing tank ; )� j�� �j �— n � `" Percolation Test Results r� Performed by.. �.�. /'r,,.,l......i� �% Date---- �CI(- %--. Test Pit No. I__�_�X__-minutes per inch Depth of Test Pit--------�.Q�r Depth to ground water _ _ fs, Test Pit No. 2___. .minutes per inch Depth of Test Pit._-____.��_.__. Depth to ground water________-_�.-_-_--. �-d��G'���d`d ----`----�`---'-�"---=---- -�-� ....... - c3 --•- .1 d D Description of Soil------ —.---_---_----------------- x __ �n _4- W ---------------------- -------- ------------ � ` � � VNature of Repairs or Alteratidns—Answer whe applicable_.._........................................................ ................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of 1- p of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued bi_y3the oard of h It gned •--•----... . . ........ . -- ---- ------ --------- �.... Date Application Approved By---- ---• �j ----/ I Date Application.Disapproved for the following reasons-------------------------------• -----••-------------•--------------------•--•-----------•----•---•----....... Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF(t' HEALTH .. n�c ........... .i2. ��%�...........OF................. ty. '0....-............................................. � Trrtifiratr of Tomph anrr THIS IS TO CERTIFY, T,h t th I •iv u Sewage Disposal System constructed ( ) or Repaired ( ) by °�" A ., .�.. --- ---------------------•--------•---•----------- Instal at ----- has been installed in accordance with the provisions of T i r of The State Sanitary Code as described in the application for Disposal Works Construction Permit No dated dated___.-f.__. � --__-_-____-_--- TFIE ISSUANCE OF THIS CERTIFICATE SMALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector----•-•-------------------------------------------------•----•----..........---_--. ......)J3....... FRad................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEAL r Appliration for Disposal Works Tontrnrtion Prrmit Application is hereby made for a Permit to Construct X) or Repair ( ) an Individual Sewage Disposal System at: /!�!'.................... ---... --•---•---------------= .. ...........................•••--•-•--•--•-----.-_... .......................................................... Loca��-Address � .-, � ;�T or t No. ; -111,11116-, T.. L .r-- - ................................. Owri z Address f" Installer AddressPQ � � d Ty pe of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms...._.._. ____________________________Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building ............. No. of ersons.....__..___......_........_ Showers — Cafeteria Pa YP g --------------- P ( ) ( ) Q, Other fixtures -------------------------------• ••- W Design Flow.................55............ gallons per person pe day. Total dai y, flow.....................'''�..�........._..`g;0,ons. WSeptic Tank—Liquid capaccit /A1��..gallons Length._.....�..... Width....................__ Diameter---------------- Depth..t..__..... x Disposal Trench—No. -AM.._.... 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............. ! rf.'. .__ _! _.__`._fir Date___./ . Test Pit No. 1_ _ minutes per inch Depth of Test Pit•_-___- _. Depth to ground waterer ......_.. gw Test Pit No. 2...._... ._minutes per inch Depth of Test Pit.................... Depth to ground water........................ •-----. .. -------------- O Description of Soil_.... `_L- -_„ p .►. -_." .,, .erg. /i _ x P d.1 d-............................. ...................•.•- . '-- .... ----------- -------- --•------------------------------------------------------------------------------------------- ------•----------------- W ---•••••-•-•---------- f'�t.�&_...�'.. .!^C�' 1'1E `--------------------------------------------------------------------------------------------------------------------------- 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 ..:.::..� p T_1 -7 5 of the State Sanitary.Code,:= The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued h board of 1 al '4 Date Application Approved BY•f••. Date Application Disapproved for the following reasons:.............................. ...................................... ---•----•-•...............................•--•----•-----------------------•------..•.........-------•--------------------------------------------------------------------=------....--•---......•------- Date PermitNo.......................................................... Issued...................................=................... Date THE COMMONWEALTH OF MASSACHUSETTS a BOARD OF HEALTH /'..dJ. /!! ............OF................ if l}'°. .........................................._ Trdif iratr of Tom# iFanrr THIS S TOAd. ER I Y That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) b ,�� . .: A. ..............y ------- -------- ........................... w.at . Insta a �. / j .......................... has been installed in accordance with the provisions of 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit N f� .../�5................... dated__�/_:_._..�:�.t�__�.................. THE ISSUANCE OF THIS' CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. Y�F DATE........ .....--•..............................•-•-------.....--....... Inspector.... ......--•-------------- ------ ------- ••-•----•- ,w. _.; THE COMMONWEALTH OF MASSACHUSETTS r' f�. BOARD OF HEALTH ' f,�. ....... Af OF........ 'v- �/ ` «'........................ . � ....... FFA6( .................. Disposal Worker-Tonstra Olt rr i# _ Permission is hereby granted ....................................................... •} - - -----An...... Cl��..---...... to Construct: ( ) or Re:ai (� ) a�nIndividual Sewage Disposal System atNo............................. =.............................................................., �--------------...................--•--•---...----------=...................... Street �''" as shown on the application for Disposal Works Construction Permit off............ ..:. a " �-.:`A'-�.--_------ Board of Health DATE---- -------------•--------- .,-. FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date 2 hiA0 Time: In /0,'l — Out 16, 'SO Owner �£A ti r. �Li��L< Tenant LU�G/," � //0 u S� Address S—A Ai , k141N Kir. Address 7, P 76-1Yf4-& Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities v 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service All 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing 01 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; �G M Removal of Occupants; Demolition Number of Bedrooms L®�4ti1.1 1'7/la./g ctCQ S Number of Vehicles Allowed (max Number of Persons Al owed Person(s) Interviewed Inspector If Public Building such as Store or Hotel/ el s cify here TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date 1 Z II 161 Time: In V % l Out 3U Owner V V , 6LA4,L,,4-. --T, 12, S-I Tenant Address 3 S a i� 0 . "A. �"T , Address { "C C-N sl ©Z Sy0 �..//� �11 Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities ��, Z • �� 6. Heating Facilities �,� �4- 7. Lighting and Electrical Facilities (/ , / 7 C� - Cj �.�,- \/A cn,-( 8. Ventilation V �, 1 — A/0 9. Installation and Maintenance of Facilities rt o' w 4 v X, v/0 10. Curtailment of Service t a 10 Lz— 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural G C-`'(7 a,..'( Elements Do o (l. L Lo s L (t.. 14. Insects and Rodents YO 15. Garbage and Rubbish Storage and Disposal J-71.v 16. Sewage Disposal �M 17.Temporary Housing 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; �� " �E�SU,vS Removal of Occupants; Demo6f n Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed ( c Person(s) Interviewed :' Inspector ac7zlz-4 , If Public Building such as Store or Hotel/Motel specify here Commonwealth of Massachusetts PD, 7� b �p -,, Title 5 Official Inspection Form0/ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments vl I l 6 �h M 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information � on the computer, L use only the tab 1. Inspector: key to move your cursor-do not Joseph R. Smith use the return key. Name of Inspector Stevens Construction, Company Name P.O.Box 71 Company Address Marstons Mills MA 02648 Citylrown State Zip Code (508)776-9054 S14994 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the inforr�nation reported below is true, accurate and complete as of the time of the inspection. The inspection UJI was performed based on my training and experience in the proper function and maintenance of on site r�a sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title' (310 CMR 15.000).The system: '! 01- Passes E] Conditionally Passes ❑ Fails µ ❑`,Needs Further Evaluation by the Local Approving Authority 4-5-2010 nspecto6 Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DER 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. t5ins-09/08 Tide 5 Official Inspection Form:Subsurface Sew4Dislem-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every H annis MA 02601 4-1-2010 Y page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section.D A) System Passes: X 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: At the time of inspection none of the failure criteria described in 310 CMR 15.303 through 15.304 existed. l 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. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain: The septic tank is metal.and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating-that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-09/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA ' 02601 4-1-2010 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box..System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced [I Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless.Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 � I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments t 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage.into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/Z day flow t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 975 Pitcher's Way - Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No , ❑ ® 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. Q ® Any portion of 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 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ The system is a cesspool serving a facility with a design flow of 2000gpd-. 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to`a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone it 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. t5ins 09/l18 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® E] Were as built plans of the system obtained and examined?(If they were not available note as N/A) ® ❑. Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components; excluding the SAS,located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees,'material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 8 Number of bedrooms(actual): 8 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 880 t5ins•09/08 Title 6 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r� 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. City/Town State Zip Code Date of Inspection, D. System Information Description: Septic system that is serving this property consists of a 2,000 gallon septic tank, (3)d-boxes, and 2 leaching fields(13'x 34')that contain of(3)-500 gallon flow chambers a piece. Number of current residents: 9 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d See Below 9 ( Y 9 (gp ))� Detail 2008-302,192 gallons(40,400 cubic feet) ; 2009-310,420 gallons(41,500 cubic feet) Sump pump? ❑ Yes ® No Last date of occupancy: - Currently in use Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-09/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts _ . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 975 Pitcher's Way Property Address Jean Clark Realty Trust " i Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: , Source of information: Town of Barnstable B.O.H. Was system pumped as part of the inspection? ❑ Yes ED No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System:_ ® Septic tank, distribution box, soil absorption system ❑ Single cesspool c ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 f ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. Citylrown State. Zip Code Date of Inspection D. System Information'(cont.) Approximate age of all components,date installed (if known) and source of information: 11-18-2007-Town of Barnstable B.O.H, septic permit on file Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2.5 feet Material of construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 100'+ feet Comments(on condition of joints, venting, evidence of leakage, etc.): Joints and venting appeared to be in working condition, no evidence of leakage found while inspecting the building sewer line. Septic Tank(locate on site plan): Depth below grade: 2.0 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) ' 2,000 gallon septic tank with risers installed to final grade. If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 12' L x 6'6"W x 6' H Sludge depth: 8„ t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments . 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA 02601 r 4-1-2010 page. Cityrrown State Zip Code' Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 29" 3„ Scum thickness Distance from top of scum to top of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle - 17" ' How were dimensions determined? Tape Measure, Sludge Judge,Probe Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping not recommended at time of inspection. Inlet and outlet tees are in working condition, the liquid level in the septic tank as related to the outlet invert are at a normal operating height. No evidence of leakage or backup encountered while inspecting septic tank. ., 1. Grease.Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete, ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 � r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 975 Pitcher's Way Property Address Jean Clark Realty Trust , Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0"( Normal operating height) Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-Box is level and distributing flow to both portions of the leaching field equally, no evidence of solids carryover encountered and no evidence of leakage into or out of d-box encountered while inspecting the d-box. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: (2) 13W x 34L ❑ overflow cesspool number: ❑ - innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching facility consists of 2 leaching fields(13'x 34')that contain of(3)-500 gallon flow chambers a piece. No signs of hydraulic failure present, no ponding present within the chambers, soil was found to be damp. normal vegetation surrounding leaching field area. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer I Depth of scum layer Dimensions of cesspool Materials of construction I Indication of groundwater inflow ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 975 Pitcher's Way Property Address ` Jean Clark Realty Trusf Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System:.Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 1.00 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below drawing attached separately 1 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 r � � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,•' 975 Pitcher's Way Property Address Jean Clark Realty Trust Owner Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. City/Town State Zip Code Date of Inspection De System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 10+ feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: Accessed USGS database and obtained mean sea level datum information You must describe how you established the high ground water elevation: Accessed USGS database and obtained mean sea level datum information and also referenced the Town of Barnstable GIS site and referenced the elevation of the property that the title V inspection was being conducted on and related it to the mean sea level datum information from the USGS site. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 L f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 975 Pitcher's Way Property Address Jean Clark Realty Trust _ Owner' Owner's Name information is required for every Hyannis MA 02601 4-1-2010 page. Citylrown State Zip Code Date of Inspection E. Report Completeness Checklist, ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 , / TOWN OF BARNS'YABLE LOCATION.�( �Sr P �� Mr uL P SEWAGE# 0 ( '01- i VILLAGE \`';j,46y/ S ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO._K �! /V rk,. s o2- 5-e.y_ C0 (n SEPTIC TANK CAPACITY CAA LEACHING FACILITY: (type) (size) .`2 'NO.OF BEDROOMS OWNER PERMIT DATE: 1 (- 9 COMPLIANCE DATE: f 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 1 on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of 1 Tacing fa 'I , ) / Feet FURNISHED BY d'(, I 3° P144 OF t�vs .Y r vwal V. 2SG 6 r 66' C3- 1� 12= 673 ✓ iL R— F� 7� • _ C-- 7 i TOWN OF BARNSTABLE l ��[ BOARD OF HEALTH ARTICLE I1:MINIMUM STANDARDS FOR HUMAN HABITATION':�(�Q�-�!��� �. DateOwner All All L�4.ngz1:f' C1--'4-AtA- Tenant Address Address 7� �7� —�� Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities t,flww /v . 3. Bathroom Facilities 4. Water Supply 9 5. Hot Water Facilities b. Heating Facilities " 7. Lighting and Electrical Facilities 8. Ventilation V 9. Installation and Maintenance of Facilities G' 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural 1� Elements 6� 14. Insects and Rodents all, 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing PART II 37. Placarding of Condemned Dwelling; f i � Removal of Occupants; Demolition d Person(s) Interviewed Inspect If Public Building such as Store or Hotel/Motel specify here MoBBs&WARREN,INC. TOWN OF BARNSTABLE BOARD OF HEALTH 6p)ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date Owner �\�1 �' Tenant Address Address Complionce Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply Vol y� 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation ,. l d f/ 4-- 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents �Y 15. Garbage and Rubbish Storage and Disposal 0 16. Sewage Disposal 17. Temporary Housing PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Person(s)Interviewe Inspe If Public Building such as Store or Hotel/Motel specify here MAP JAN 2 8 2003 TOWN OF BARNSTABLE PARCEL TOV'VN OF EiA;,iv,TAQLE BOARD OF HEALTH LOT HEALTH DEPT. ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date V / t \ Owner 4 ��� �� Tenant Address ` e"x' se Address Compliance Remarks or Regulation# Yes No Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 51A IC 5. Hot Water Facilities IJ /3&a 6. Heating Facilities 7. Lighting and Electrical Facilities rLo� Ir 4 1 -y' 8. Ventilation t'JF'bz' � las 9. Installation and Maintenance of Facilities3_. n / /� ntC 10. Curtailment of Service t�Ga4 fc wc�l 11. Space and Use 4 �c5+� 12. Exits 13. Installation and Maintenance of Structural ` Elements 14. Insects and Rodents �Q S .av1' �l � . �,yI• �C-�^ 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing PART II 37. Placarding of Condemned Dwelling; �� Removal of Occupants; Demolition Person(s) Interviewe Inspector If Public Building such as Store or Hotel/Motel specify here HOBBS&WARREN,INC. F F, TYPICAL SYSTEM PROFILE A R E A PLAN FDN TOP ' FINiSH GRADE NOT TO SC-A�E FINISH SCALE I 40 FINISH GRADE OVER TANK- GRADE OVER PIT= LO TrP i 7 P/ T'G H J Vv 1-4 'y' VC OR p 0 0 C. I . TEES 77733 '�C- /5 7 Vv HL- 5 / 7 L4 BSMT F P -q!q, 5 Ck' GAL, 4' 0 , 9 REINFORCED DIST. BOX L-4 z 2 1 CONCRETE ONCRETE TO BE INSTALLED ON LA LEVEL STABLE BASE TANK A SErTIC 'NSTALLEI) ON A 0;:� -'ABLF BASE V 2"-1/8" 1/2 "WASHED PEASTONE ALL 610 6 L 0 t BRICK 81 MORTAR Cf)URSES �?S AROUND FREE OF IRONS, FINES L11 REQUIRED TO BRING COVER Tt)' GRADE AND DUST IN PLACE LEACHING PIT 44t',-7 I < 24 "C.1, M AANHOLE COVER a 3/4 " TO 1 -1/2 "WASHED CRUSHED N FRAME SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE LEVEL �9 IRONS, FINES AND DUST IN PLACE > FOR FIN. GRADE SEE SYSTEM PROFILE ILE tn 1'�� � " L.----, SOIL AND PERCOLATION 7 PST 2-9 DATA 261) 6 5, F _�4 PERC. RATE * F M INJIN. %;q If I Z- 4 FOR INV ELEV SEE 1 0 . . 011 V INLET TA : C. D. SPOHR SYSTEM I-ROFILE KEN BY LINE WITNESSE D BY: A"I, 711) 3B," - -f - NGS W/ 4-nC TAjO a LiI A, a - 4 DATE : 2 pf-eo Z>/1� VE kw _ ASIDE DIA --�5 7 i I I 1 0 TEST PIT-GND ELEV. I1uTA AREA 6- 3 —, RLj5r Now Nvmw •%Ew*w -rV 0 0 60 0 0 0 0 LoTVIII- 16 6 6" D IA. 14'to EFFECTIVE DIA. BOT. PERC. HOLE DOWN -4f,; II LEACHING PIT SECTION W SCALE DESIGN DATA : NOTE' DO NOT RUN HEAVY EQUIPMENT OVER SYSTEM NO. OF BEDROOMS /V2 DISPOSAL F-L F V14 7-/0,&/-5 0/4.5 jeV 01V PC,'VrA--I�Al 7- LEACHING PIT N0'1 ES ' EST. TOTAL DAILY EFFLUENT GALS . CF)V rERLf Aj C OF 1.0 7- Ca- A4 55 U A 4 U E i, -&�14kAIS I �ONC- 'TO BE 4000 P.S.1 a 28 DAYS . SEPTIC TANK 1 -502 GAL. 0 i O,p L)f" , 2 . REINF W 6 " X 6 " 6 GA- W. W. M. 27/ jr-;'�67Z:- .3. 2 'AND 4 ' SECTIONS ARE AVAILABLE FOR GENERAL NOTES GREATER DEPTH REQUIREMENTS I . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN NOTE : 3-,"-:t ACCORDANCE WITH TITLE 5 OF THE STATE SANITARY CODE EXCAVATE TO ELEV. OR LOWER AS DATED JULY 111977 & ANY LOCAL RULES APPLICABLE. REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2� ANY CHANGE TO THIS PLAN MUST BE APPRV IN MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL WRITING BY MR. CHARLES D. SPOHR. WITH CLEAN,CLAY FREE GRAVEL, MECHANICALLY 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, COMPACTED IN PLACE. NOTI FY THE ENG I NEER AND BOARD OF HEALTH FOR I NSPECT ION. SIDE AREA = 3 A S. F.0 S. F./GAL GALS 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED. BOTTOM AREA= (- 5 S.F.@ S. F./GALGALS 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT WRITTEN TOTAL AREA 22 S. F. TOTAL ' 02 GALS APPROVAL BY CHARLES D. SPOHR. LEGEND 6. FOUNDATION INSPECTION READ. WHEN EXCAVATED. OWNERS " EU I LDERS- �RE-A PLAN A + 50.0' EXIST. GROUND ELEV. .4 50.0' FINISH GROUND ELE V."UNDERLINED" 11"'N. I FEI:3'821 k.'7:. cl-1--)kK f--1 y'Al.;''1111i 1-IE7 ickoAl L�,,,r Pl-,QAI 1475 PIPE INVERT. ELEV. REV. DATE DESCRIPTION CC AI/7-1,- i-plvo /IV TEST PIT LOCATION SEWAGE DISPOSAL SYSTEM / 11= -40 ,10 1(vov, 29, 1916<0 � y FOR ISI-141VO5 5-vkvz--y1A1cr co, SEPTIC TANK CLAP\K F _YNI'\j EAU ( LDEF-�,'-� cl DISTRIBUTION BOX -17 p I "T / , I i E , - p 5 f"'S VV Ay 4 " C. I . PIPE r . Charles i H YA N I J 1 tvi Ai . S -ittttti 4"BIT. FIBER PIPE TIGHT JOI NTS SPIO N. 7468 DESIGNED. C D SPOHR DATE: ! ) Uf:�2� 5k, D R A W I N G N 0 �7 PROPERTY LINE MIN. CODE DISTANCE IS -DRAWN . SCALE.AS SHOWN o MA p I S E C P C,L LOT HOUSE CHECKED: C. D S x 60.6 j LOT 27 60.3 tt { { 0- EXISTING { a HOUSE 0 ca LOT 18 #989 I Z { °- { { 61.1 61.2 � N89'52'51"E 60.0 60.1 59.9 196.64' NOTE THE CONTRACTOR SHALL CONTACT THE TDlyIV OF BARNSTA&Z-AND OTHER UTILITY COMPAN/ES TO 1 EAGY/ fN11/ .�� 5ro cALLGYV ,� L OCATE ALL UNDERGROUND !/TTL/TIES PR/OR TO 0WORERS Of71/ -it'OrSTC�ME 13 26 >� INSTALLATION OF Th'E PROPOSED SEPTIC SYSTE�If. ALL AROUMO l3' o IF THE EXISTING #A' ITR SER19'CE IS LESS Tf1AN s1.4 96.1' w w 10'FROM Tt/E PROPOSED LEACHING SYSMAI,, THEN Q THE IyATER SERl90,F SHALL BE SZ CZ7V&O OR �¢ RE-ROUTED. a ' 0 I I W w CBBC LOT 28 EX/S77NG E.Y/SIM9 2000 OALLOtN t #9�5 SE MOW TANK TO REMAIN CATCH 1.9 BASIN / --- 0 76 , 1.6 D-BOX - 1 $ I 61. 59.6 4 ENCHMA K 60.6 60.0 SILL EL.6- 8 PUMP ORY AND FILL i O ENS17W LE14h'INO P/1S 61.8 w EXISTING DRIVEWAY GENERAL NOTES: x 69.2 61.7 w �'-_ R sF�w 60.6 LOT 17 `" 59.7 1. HOUSE NUMBER: 975 26,296't 2. ASSESSOR'S NUMBER: MAP 272, PARCEL 145 W �0 3. ZONING DISTRICT: RC1 60.9 60.7 4. FLOOD HAZARD ZONE: C 5. TOPOGRAPHIC INFORMATION COMPILED FROM AN ON THE GROUND SURVEY. _ S8922'15"E HYDRA NIT #191 224.12' 60.1 6. ELEVATIONS SHOWN ARE BASED ON NATIONAL GEODETIC 0.5 VERTICAL DATUM. PP #24 LOT 29 62.1 1� 62.5 cv PLOT PLAN -- LOT 17 PREPARED FOR .�. LINDA CLARK EX,SnNG (L IN ovsE HYANNISLOT 16 MA � ;«1 no #967 s `rb��, ,� CBBC PLAN DATE: april 18, 2003 PLAN SCALE: 1"=20' x 62.8 MlCI-IAEL J. (n chi ©ORSELLI � CIVIL "� 60.9 CIVIL ENGINEERING r^`T WETLANDS PERMITTING �<NO-35054� CBBC WASTEWATER DESIGN M O v � COASTAL ENGINEERING Or- sSoPJAL�Ca i •? TITLE 5 PLOT PLANS PIERS AND DOCKS INEE LAND USE PLANNING COMMERCIAL/RESIDENTIAL S&wl7q Cape Cod and Southa+asta» &OSSM llsetts 101 TOWN HALL SQUARE FALMOUTH, MA - 02540 - 508.495.1225 - 508.495.3229 fax PROJECT NUMBER: 03010 CAD FILE NAME: 03010L17 DRAWN BY: L.M.,D.H.M. SHEET 1 OF 2 TEST HOLE #1 on EL60.0 RNISW QPADE S7V4LL BE 2X M/N/�I/UM OPVR ALL SEPM SYS7LW 6GN/PM&?V7S 10" SANDY LOAM 10YR 3 2 USE-K 014. SQVEDULE A0 Ply' OR CAST/ROW P/PE Sail TEST -------------- :-:_:__-.:.-_.. EL59.2 32" ::::_LOAMY SAriP:::.:::: 20' Date of soil test: MAROYV 25, 200J •: Y:-�- '' EL57.3 M/N/MUM.SETBACK FROM ED6F O-STGWE 70 a7LAR OWL w' '•:' ., 10'M/N/MUM Test taken by. DAND A/ARAN _ -�•. . Results witnessed by.NA '''` SEIBACvr Percolation rate: <2M/N./IN. -=�_' °:j`w'• REMOVABLE COVERS SET TO WITHIN Ground water NOT ENOW ERED c 12" OF FINISH GRADE (TOTAL OF 5) .ti OARE SAND:. r^t 2.5 Y 7/4:_.s; 'r, .+ ' ,. •, tom. 3' MAX. 120" EXISTING ` 2000 GALLON ' /NW?rEZEY - 57.5> 2"LAYFR 6Fr 1/B" 727 1/2' EL50.0 �%. sErf7Rsr S = .01 . 2 LEtj£L SEPTIC TANK CSaoo 0amoa A- oa®®aaoaaoolao :• 4� ®0®0093C3®®®0®® EXIST. Our BOX ®®®®®®®®®®®®® EZEK = 55.51 • II h ^ SET ON 5- W W h LAYER OF h W a II II CRUSHED n k. `` STONE INSTALL .�/4' 7011/z 55, W IYAS�'/ED, A4J'JS7YED STOWE ALL (4 AROUND OWAMBERS AND 00MV t., 70 THE 9071A1/ 6F 711E OYVAMBER l SYSTEM. REFER /V LAM1r Or _ S), TEA/Fla'P MOPE DETAILS (BOT7laV OF TFST HGYE EL 50.0,) BASIS FOR DESIGN: PROFILE 2• NOT TO SCALE 2—OUILEIS 13 - rO7AL /JAIL Y ROY/S BASED ON 8 BEDROIa $ NO GARBAGE DISPOSAL OUnET of s �-' • IN r rdWALin rO,-AL DA/L Y R 00'- 110 G M/bEDR&W A B BEDR"S 880 aKV "' — `ET , s• 3• _: 90T7LW AREA PROPOSED = 87Q 4 SF. 2_ OUTLETS mar 519E AREA PRO00-9W = J7K 4 SF. _ �B SF — NOTES: 12 NO E 727TAL LEAGY!/NG AREA PrPO�O.SEO PLAN VIEW cRoss sEc�n�oN CONSTRUCTION AP1VCAT70W RATE- 0.7W GJ°D/SF. �B-5 DISTRIBUTION BOX CH—�O LOADINGS 1. INSTALLAAOW Or A/E7�'ROPGSED SrPAC SYSTEM-WALL BE/N.4615WDAWY W N 77AE 5 DE3Y6W LEAO VINO CAPAWY= 921 6RO > 880 CPO AND THE BOARD Or HEAL TN REl6%LAAOVS NOT TO SCALE rY of AI ASS,F 2. A OLiPY 6F INE PLANS S7VW hr AVAILABLE OW.9'1F FM RDrERDVOE AT ALL TIMES DVAYNG T7VE'INSTALLAAOV Or THE SEPTIC 57S7Z7W MICHAEL J. Gs QORSELLI ,1 NO ONANGFS 70 7NE D&-.76W SYVALL BE 119PFOPMED INAVAUT THE APPROVAL 6F SON CIVIL FALA0101Y7N ENpNEDWN42y INC AND A/E BOARD 6F HEAL 1N. No 35054 wQK THE SEPAL SYSTEM/S SISARCT 70/N_WE0)76W BY FALA01OV171 EN6WNEEWN12 I= 8' - 3 1 2" r ;�F�FGIsT1:�����`` AND NE BOARD Or HEAL TN. �S10NALG 6" 1 1 5 THE OLWT/PACMW SVALL NOAFY FALVCV711 FN6VNMWNk; /NG AND AVE BOARD Or/V AL ® ® ® ® O ® ® ® ® rO IN-WI-Cr AVESEPAL 576)ZW PR/GYP M A940V 7LL IN SOME/NSTANOES MOPE 7NA WE N O /N.S70ECAOV MAY BE NEEDED. A/E 6 W7RACT W SY/ALL OWL Y 940MLL AVE POPAOWS 6F THE ® ® ® ® ® ® ® ® ® ® ® ® ® SYSTEM AVAT HA w BEFN/Nsw0)z27 AND APPRO"BY FALM WOUAV DWYNED 4 /NO: AND 34" 24" 6. /F NE 6YN/71PAC764 ENGYXJNTDPS AND t�AR/AAGWS/N SYTE GL'WL7/AGW.S S7/GYV AS IYFfZrR/NC r6poLJQAP7/Y, Aw-&ANOS OQ OTHER OLWD/AO'VS THAT MAY RE(XARE RE-EYAL!/AAOW CF GENERAL NOTES: AE7A0&Q ,0 fA6M WffACTa?-WAU IMMED/AM Y C WTACT FALMOY/A/E7VGYNEZWINQ INC 8. - 6. 1. HOUSE NUMBER: 975 1/17/07 REVISE ELEVAl10NS CROSS-SECTION DATE REVISION 2. ASSESSOR'S NUMBER: MAP 272, PARCEL 145 6" SEPTIC DETAILS 3. ZONING DISTRICT: RC1 , _ _ a •. PREPARED FOR 4. FLOOD HAZARD ZONE: C M g" KNOCKOUT LI N D A CLAR K 5. TOPOGRAPHIC INFORMATION COMPILED FROM AN ON - 210 DIAMETER COVER IN THE GROUND SURVEY. HYANNIS MA 6. ELEVATIONS SHOWN ARE BASED ON NATIONAL GEODETIC a 5" KNOCKOUT 5" KNOCKOUT PLAN DATE: APRIL 18, 2003 PLAN SCALE: AS SHOWN � VERTICAL DATUM. CIVIL ENGINEERING lL ^- WETLANDS PERMITTING WASTEWATER DESIGN COASTAL ENGINEERING • 5" KNOCKOUT TITLE 5 PLOT PLANS �r` PIERS AND DOCKS • GI NEER PLAN VIEW EW LAND USE PLANNING COMMERCIAL/RESIDENTIAL `A Sermg Cove Cod and SoutAwstffm mdmachumtts 500 GALLON LEACHING CHAMBER CH-10 LOADINGS 101 TOWN HALL SQUARE — FALMOUTH, MA — 02540 — 508.495.1225 — 508.495.3229 fax SCALE: 1' = 2' PROJECT NUMBER: 03010 CAD FILE NAME: 0301OL17 DRAWN BY: L.M.,D.H.M. SHEET 2 OF 2 i