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HomeMy WebLinkAbout0415 SAMPSONS MILL ROAD - Health 4115 Sampsons Mill Road - Cotuit A= 039-153 f TOWN OF BARNSTABLE LOCATION ' _Cqt1Q( I L SEWAGE# J014 —JI-q-3 of VILLAGE ( &t LL, ASSESSOR'S MAP&PARCEL 3 - (_ 3 45 0 INSTALLER'S NAME&PHONE NO. j��pr�:-t SEPTIC TANK CAPACITY LEACHING FACILITY..(type)`'a���c�t�i.� (size) 4{o W to',t NO.OF BEDROOMS OWNER PERMIT DATE: g (- per_ COMPLIANCE DATE: �- l Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 4- � Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) A- Feet FURNISHED BY J �,/t ��J *�•rrn� �yiT �axY �j �yo �3�4 b� .. � �,� O g✓� !�/�6� s's'�,. ' °O � ��„F y®' Town of Barnstable P Departzmerit of Regulatory Services • Ala Public Health Division DateMAM rev h1 200 Main Street,Hyannis MA 02601 Date Scheduled Time Fee Pd. Soil Suitability Assessment for Sewage lisp®sal Performed By: Witnessed By: Location Addres 5 s LOCATION& GIGt NERAL INFORMATION Owner's Namc �/s SA S ono Nt; l / , ' Ile a�t�. �'O��^! Address Assessor's Map/Parcel: 3�/�`�� '1 Engincer'sNamc G�n/� � e NEW CONSTRUCTION REPAIR Telephone# h o e J b a V Land Use: 'a WV-2 Slopes M G" Surface Stones //0l_7 e Distances from: Open Water Body tt Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SIMI TCH:(Street name,dimensions of lot,exact locations of test holes&Pero tests,locate wetlands 1ln proximity to holes) eK..e C.a ` 41n cT i'> i r 201 lj�l CV Parent material(geologic) G to, 0,I &C,4 VV Depth to Bedrock Depth to Groundwater. Standing Water in Hole: Weeping from Pit Pgoe Estimated Seasonal High Groundwater Method Used: DETERMINATION FOR SEASONAL HIGH WATER TABLE Depth Observed standing in obs.hole: In, Depth to s9II InoUles: Jtt, Dcpth to weeping from side of obs.hole: In, Clroundwater Adaustment f. V6 Index Well# Reading Date: Index Well loyal _ Adj,&ctor�,,,,,.`.__ Adj.Groundwater level Observation PERCOLATION T +'ST Date__�__,�, Tilde 1 Hole# I Tlme at 9" Depth of Pere Time at G" Start Pre-soak Time @ Time(9" G") ..End Presoak Rate Min./Iach C ' Site Suitability Assessment. Site Passed — Sitq Fallcd: Additional Testing Needed(Y/N) Original: Public Health Dlvisio❑ Observation Hole Data To Be Completed on Back---------- ***I£percolation test is to be conducted within 100' of wetland,you]must first notify the. ! Barnstable Conservation Division at Ieast one(1) week prior to beginning. Q:\S EPTIC\PERCFO RM.D O C • r DEEROBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Sdil Color Soil. Other Surface(in.) (USDA) (Munsell) Mottling (Structure, Stones;Boulders. �- LS 3- �o L S 2� • ��/ 20-1 y4 C DEEP OBSERVA�TION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) '(Munsell) Mottling - g (Structure,Stones,Boulders. - .� � � � � � ��/ •�S/� Consistency.96 O ave 3 710 L R DEEP OBSERVATION ROLE LOG Hole#. Depth from Soil Horizon Soil Texture Soil Color Soll Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stories,Boulders. Co i to c e DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders, Car sitn y Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within 100 year flood boundary No._ Yes.,.__y.. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? g ` Certification ti I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in�10 CNIR 15.017. Signature Date Q:1S.BPTIC\PERCPORM.DOC r No. d �- r Fee o0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for Disposal 6pstem Construction permit Application for a Permit to Construct( ) Repair(k� Upgrade( ) Abandon( ) ❑Complete System [Individual Components Location Address or Lot No. 4`5 5, a.rqeS0AS Will Owner's Name,Address,and Tel.No. mUid 4 dixrr t 4 Lod. y/S-SrXM PSot,S A41 it G'oi-u s+- Assessor'sMap/Parcel 3q r5-3 jW•Sl.;1p- y1g0 rIinstta9ller's Name,Address,and"Tel.No. 5ZA-711)6-93701 signer' Name,Address,and Tel.No. ixry-e�fo i �rS{72��c35�,?�c =n & t1Aelp-17j Q 1311 V110 tot%f O Type of Building: Dwelling No.of Bedrooms Lot Size oZ 7 °7y/ sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 330 gpd Design flow provided Y gpd Plan Date , IlJ, �Ol Number of sheets Revision Date Title j SSite- S ASMS Ville A Size of Septic Tank Type of S.A.S.3 %f/p ,�(/ jg�� x t Description of Soil Nature of Repairs or Alterations(Answer when applicable) - U 6Z6 c' X 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 Environm Code d not to place the system in operation until a Certificate of Compliance has been issued by this Board of He Signed Date Application Approved by Date �- Application Disapproved by Date for the following reasons Permit No. 2-o �- 02 Date Issued z- ` 'S , F yNo. d f C.a ` Fee d .�� �." Entered in computer: TFfE COMMONWEALTH OF MASSACHUSETTS Yes PUBLIC HEALTH DIVISION-rOIVN OF BARNSTABLE, MASSACHUSETTS � I 21pplitatton for Disposal 6pBtem ConBtrUttibn 3permit t Application for a Permit to Construct( ) Repair*4 Upgrade( )•Abandon( ) ❑Complete System ['Individual Components Location Address or Lot No. T 15 (�qpSOh g J i1 j Ad Owner's Name,Address,and Tel.No. ZIL UI-d# Cl @ ] � , Assessor's Map/Parcel 3 S C_a4t .:J- VIY54n 'tpSGnS MIl Co Q, #- 74 9,2 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. U • 31F�-Sl55�� &401041 � E.I inear-�'�ryc c 3� jAj i r,Si Type of Building: t y Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures-- Design Flow(min.required) 330 gpd Design flow provided �� gpd Plan Date Number of sheets Revision Date / A Title %tl., 4���n��.r. t/jS S.,v,/nw< i Size of Septic Tank _ ,� , Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) l?fin KiZA ' �6� S VEj , r Date last inspected: Agreement: 4 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-Codaa and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health: Signed ,'�A Date Application Approved by '` ( Date G Application Disapproved by Date for the following reasons Permit No. 2 a Date Issued G ti THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired O Upgraded( ) Abandoned( )by at�/�/ T1�^�T,slc+-i =-�B j �- has been constructed in accordance f with the provisions of Title 55�and the for Disposal System Construction Permit No.2-ol� -�°13 dated -i Installed , ' ( �, ✓� % Designer ' #bedrooms Approved desi flow v ?/ d jjgpd 17 The issuance of this pe t all not a onstrued as a guarantee that the system wil tion as�,rll� 4&4d;, Date Inspector ;�', fi/ l No. ")O !a - 7 Fee- .l ov , THE COMMONWEALTH OF MASSACHUSETTS -PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Disposal i§pstrm Construction Permit Permission is hereby granted to Construct( ) Repair(,k-� Upgrade( ) Abandon( ) System located at U/S ✓,cam.., Ail // �_�. rrL..''� ,F I — and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. r Date °;J l /,Z. Approvedby Coo ''----� LOoff, r � / roo I a � OCT-01-2012 09:32 From:BORTOLOTTI CONST 50842B9399 To:15087906304 P.1/1 FROM :down came engineering inc FAX NO. :1508362SE380 Oct. 01 2012 09:30AM P1 Lo � e►,►nuaan�t, � w MAHN Pubilo Health LDivisiumt 100 MAIR tifr'rrf,,,tilyrFsami9,MA Moll f)ffrr.: 508 862-46+ } Dote- 12 y.t7 __ =✓ / AM i9mied a ponmul to isasun a (cli�tr)� f1 (xz�stellrx) �,/� / Elept�it.System EEL , �,� tJ A Yh�f�'+'� �(ill _U%ged art a design dr8WU by (lulrS7•e;;h) 1 ( n Q�yl r .t•! l'�`' r�`�'i,�4;� {J�•�l��,ted rnwt.il�dolt Tha septic syaltmu ro-fismem-rl Above,"m imiakd yrihatm.tia,lly awording to Me demri, wbirsh may ia�lc•iial]x.uiiilor oVKaunri -Jta19.F';e� luu�i a:; l�atcral rclncrztinn of tkic dl rrca hubon bU f3 rlrf/c>r aepdc(uul�. f- cerlit'y that the se-ptia: Yjstozu idkLea('cri al 0W VPd!4 ilAAe irrf WiTb..1D�jnT QhaPgO (i.e. gff FatcT lhtazr, 1C IFiTeXa:I-th 64)Tl0J t})4 SAS or ALiy vaLT mfl relo •tim at'ally co1 ipontut nf the scvfatr aptem)tat iu amoids lace�uitli data&T,oi,-E!Re2,iilat 0rR. I'll-ill rVv'is'ioLt 07 ur`rified e� �,r.j 1t by de,gilp-,er In lulluw M f}aM,q��`�'n PANIELA y OJAI-A CIVIL. No 4(9&)7 (Dr'91(y*f1c.r'a 5iptr� u1�+) •(A i 13L r.T`w 'stn.r1,11 T7ucn) ,11/1 914. P`i1,FtiK �'s'� .TiTV4Ta LJ L'i1 ��; T; ' I11.Y15.4tm. i,;,(.Y%'N` TC;AT� QgA17JANQ4, WXFT, T3i�'Y' L BOTH THIN 1!�Ir ,tip;-�C�I��t aJil dT�F xa,:Q,�? ,r, .' ,�n ar ' " ,�; Yr r����rr AT�T�r IDIVIS11A jZ.AIUC VOL., ASSESSOR'S MAP NO.3-1 PARCEL 1�,,L0. CA'T10N . SEWAGE PERMIT NO. ;�-vILE LOT SI 5wlsyS 021-L_ ca �INSTA LL R'S NAME i ADDRESS e U I L D E R OR OWN ER O DATE PERMIT ISSUED 2. DATE COMPLIANCE ISSUED l� � /ccv CA IOGO.4P f V. No�6 r .ram. Fmc............................ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH Appliration for Diopoiiai Works Tonotrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .........................................••------••---------•-...... ....... s�---- - - cation-,Address or Lot No. ..............••---= ... �: --------------....._........----... ---------.....-------------------......---•_.. --- Address a .................... . c ...... ......._...:. -----------------_-----------------------•••------- Installer Address U Type of Building 3 Size Lo4,74____,__�7a ........Sq. feet �-� Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther —Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures W Design Flow____________________S _.._.._____.__gallons per person r day. Total ail flow...._.-3.3........................._ gallons. WSeptic Tank—Liquid capacity4t2 gallons Length g_.__._ Widthl.l�__-_ Diameter________________ Dept �___.__- x Disposal Trench—No_____________________ Widt __.___.__._..__.___ Total Length...... ..________ Total leaching area....................sq. ft. Seepage Pit No_____________________ Diameter.__.. __.____._. Depth below inlet____.______._._. Total leaching area_!P�e!Vsq. ft. Z Other Distribution box ( ) Dosing t a Percolation Test Results Performed by.__._ Test Pit No. I...____ ___minutes per inch Depth of Test Pit__ _ __. _� Depth to ground water............:.%______. f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ •••••••--•- --•- -..:•-- Description of Soil + ..-•--- .....•• •-_..... _ ... x :WZ �------- c, ----------------------- --------..... x ••---•-----•-------------•--••••------•••-•----•-••--•-•••---•-----••-••••••--- .........••-- •-- ••--- ------------------------------------------------------------------------------------ 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 TIT E 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 by the oar Signed -•-- . ......-••-•-----•-•----•••••-•-••••-•••- Date Application Approved BY j..•--•--•-•-•-•-•...--•--•--••••••._...--••---••-•_-•--- =•--•- . / ��----- ------------- Date Application Disapproved for the following reasons--------------------------------------------------------------------------------•-------••-••••••--•-•...._-•-•-- .................•-•..........•••---•-••-•••-••---•....•-••..._---•••••••-••--••-----•••••-•-•----•••--••I---•--••-----_....•••••---••----------•-•••-•••-•---------------•---••••---••••••-•---•---_._.. Date PermitNo.............. �..�_.... Issued-....................................................... Date No FRic.......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 'c' OF....................511, 7x&_i 5 .................. .............................. ................................... 7- lipfiration for Disposal Works Tonstrurtion "Jarrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ................................................................................................. ...... ...... a t 1 o n.-,A Address''e,e.�­ or Lot No. FT .............. ....... . ......................................................................................... Address .......................... ?.......... ....................... Installer Address Type of Building Size Lof�241-/._17--------Sq. feet U Dwelling—No. of Bedrooms...._...._'"..............................Expansion Attic Garbage Grinder C14 Other—Type of Building ............................ No. of persons....._...................... Showers Cafeteria Other fixtures Degign Flow.................... ..__._._...._.gallons per person per day. Total daily flow 9-3 0........................gallons. WSeptic Tank,--, Liquid capacit/e22(2gallons LengthZ.'��...... Wi&0.::/,�---- Diameter e`te"r................. Dep4 ........ Disposal Trench—,No. Widtp................... Total,Length....___.._.._...... Total leaching area-----------_------sq. f t. Seepage Pit No........�:�'__c.'Diameter.....A........ ......KZ inlet................. sq. ft. ------------- Depth below inlet.................... Total leaching area!7 Z Other Distribution box Dosing ta�<,/ 7 Percolation Test Results Performed by....Z44�.6. Date-6411��Ile rj .................... :;;....... Test Pit No. I... .....minutes per inch Depth of'Test Pit.., ............... Depth to ground water./�/Vi:_- ....................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit_` ._......._.._.. Depth to ground water......_.._...__......._. 04 ............ .. .. ... .../ — , . ............................. .................... ------ -------------- 0 Description of Soil....................o. ............... .... ............................................... ...... ......*...... U ........................................................................................*­...�17/...­­/............................................................................................ �4W ............................................................. ................................. / . .; �Q...................................................................................... 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 T1T!Lj 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 by the board,of health., Signed....4 D ate ............. .... ............... .................................... ...... Application Approved By..... ZP4 Date Application Disapproved for the following reasons:.................................................. ........................................................... ......................................................................................................................................................................................................... Date Permit No-------------&157......S�6_0....... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......TONNN...............0 F..................................................................................... ToWrtifiratr of Toutplitturr THIS IS TO CERTIFY, That t e Individual Sewage Disposal System constructed or Repaired by--------------------_--�_),......... gu 4..........L.. - at......�,u 0 Installer ..................................... - -----------61;0 has been, installed in accordance with the provisions of TITLE. 5 of The State Sanitary Code as described in the applicatio' n for Disposal Works Construction Permit No----- ...... dated-.....60- ....... I THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM IL FUNCTION SATISFACTORY. DATE .�. _2� 9 ---j�ot A Z.................................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH JN).................OF......&Alci�Qs I No......................... .................. FEE...S.b.:,......... Elispo.oal Works Tomtrurtion ranfit ............ Permission is hereby granted........I . ........................................................... to Construct Sr Repair an Indivi(4ual Sewjae OS,y­stem atNo....... ...................M........L_.(...... Street as shown on the application for Disposal Works Construction Permit N'og�tF.'_E�_-IZKZ Dated...C>_ .............. ......... ........ Board o f Health DATE........ ............. ................................... FORM 1255 A. M. SULKIN, INC., BOS`r`0_N'_---, Commonwealth of Massachusetts Executive Office of Environmental Affairs Department of• Environmental Protection William F.Weld . "_ Trudy Cox* swwry Gov«row David B.Struhs Argeo Paul Cslluccl LL Gowmw e ee SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Prolerty Add'e+N: 415 Sampsons Mill Road Cotuit Address of owner. 'C 8 Date of Inspe 4ow 3/2 0/9 6 (If different) ��99 Nameoflaspeotor.Joseph P. Macomber Jr. )COACom Nam Ad d Tal hone ber. J.I�Nracome►ber c Son nc. N ox 66 Centervi�.le ,Mass . 02632 508-775-3338 V� CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below=is=true,acctrrrtte and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: asses _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority pails Inspector's Siguat >' Date: , The System Inspector shall submit a Copy of this inspection report to the Approving Authority within thirty(�system days co mpleting this shall submit the inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector report to the appropriate regional oface of the Department of Environmental Protection. authority' The original should be sent to the system owner and copies sent to the buyer,if applicable and the approving INSPECTION SUMMARY: Check A,B,C,or D: A) SYSTEM PASSES: have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. —Z. I Any failure criteria not evaluated are iudicatod below. Bl SYSTEM CONDITIONALLY PASSES: One or more system components need to bereplaced or repaired. The system,upon completion of the replacement or repair►passes inspection. Indicate yes ,or not determined(Y,N,'or ND). Describe basis of determination in all instances. If"not determined",explain why not) The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exflltration,.or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved J by the Board of Health. (revised 11/03/95) 1 One Winter Street • Boston,Massachusetts 02108 ! FAX(617)556-10,49 • Telephone(617)292-SM i'3►,pmtee on Recycled Papa SUBSURFACE SEWAGE;DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) ' PropertyAddre" 415 Sampsons Mill Road Cotuit,Mass . Owner. Paul L. Clark Date of I=P"40n: 3/20/9 6 B)SYSTEM CONDITIONALLY PASSES(contitMed) e Sewage backup or breakout or 0 static water level observed in the distribution boat is die to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health: broken pipes)are replaced obstruction is removed distribution box Is levelled or replaced The system required Pumper more than four tin a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Heal ): broken pipes)are replaced obstruction is removed CJ FURTHER EVALUATION 19 REQUIRED BY THE BOARD OF HEALTH: NO Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM I9 NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 60 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 APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is.within 60 feet of a private water supply well. The system has a septic tank and soil absorption system and is less than 100 feet but 60 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that fatuity and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. 3) OTHER (revised 11/03/95; g r, a • SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(oontinuod) P:vpertyAddresss 415 Sampsons Mill Road Cotuit,Mass . Owner. Paul L. Clark Date of Inspeotion:3/2 0/9 6 • DI SYSTEM FAILSs • • Vj I have determined that the system violates ons or more of the following failure criteria as defined in 310 CMR 16.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be nacessary to correct the failure. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesapooL Disd.arg•or ponding of effluent to the surface of the pound 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 coaspool. 1--44h Ar Liquid depth in oeaape"leas than 6"below invert or available volume is less than l/2 day flow. Required pumping more than 4 times in the last year NOT due-to clogged or obstructed pips(s). Number of times pumped-- Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. Ay Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well Ai Any portion of a cesspool or privy is within 60 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 60 feet&Om a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for ooliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: _Q The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment bebauae one or more of the following conditions exist: the system L within 400 feet of a surface drinking water supply A0 the system is within 200 feet of a tributary to a surface drinldag 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6,00. Please consult the local regional office of the Department for Auther information.• (revised 11/03/95) 3 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST PropertyAddress: 415 Sampsons Mill Road Cotuit,Mass. Owner: Paul L. Clark ' Date of Impeotion: 3/2 p/9 6 ' Check If the fo wing have been done: , Pumping information was requested of the owner,occupant,and Board of Health. ,,,Koue of the system components have been pumped for at least two weeks and the system has been receiving normal flow sates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. ZAx built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow ZThs site was inspected for signs of breakout. , Ail system compoaents,h-Juding the Soil Absorption System,have been located on the site. -4/Ths septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of bames or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum. 2Ths size and location of the Soil Absorption System on the site has been determined based on existing information or approzimated by non•iatrusive methods. ,AThe facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Sub. Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Paul L. Clark Owner. 415 Sampsons Mill ,Road Cotuit,Mass . Date of Inspection:3/2 0/9 6. FLOW CONDITIONS RESID MAU,, e Design flow-.AWD sOons e Number of bedrooms: ..wI� Number of current residents:lJAc� Garbage grinder(yes or no) AD Laundry conuecte to systeg(yes or no Seasonal use.(yes or no):ALb— 1 Water meter-readings,if available 4 1 D ,!2 6 Last data of occupancy: COMMERCIAL/INDUSTRIAL:- Type of establishment: AM Design flow: Wday Grease trap present:(yes or uo),a}A Industrial Waste Holding Tank present:(yes or no).&,& Non-sanitary waste discharged to the Title 6 system: (yes or no)jo Water meter readings,if available: /U Last date of occupancy: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS rmation: 1 System pumped as part of inspection: (yes or no) If yes,volume pumped:- Reason for pumping tLi/�/ K'Iy �� �s /W,1°5 0S TYPE OF SYSTEM Septic taWdistrib on ba lsoil absorption'system ,V4 Singio spool VQ Overflow owspool ` _4.)Q Privy Shared system(yes or io) (if yes,attach previous inspection records,if any) AM Other(explain) 0 fiE of all components,date installed(if Imown)and source of information: Sewage odors detected when arriving at the site: (yes or no)_ (revised 11/03/95) 6 ASSE;SOR'S MAP NO.3 I PARCEL l � 0CA'TION _ :. �'; .. SEWAGE P E It M:.IT: ....Poo. LACE TA 11 R'S NAME i ADDRESS e V-11::DE R OR OWNER DATE PERMIT ISSUED b . c DATE COMPLIANCE ISSUED 0 y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) Property Address: 415 Sampsons Mill Road Cotuit,Mass. Owner. Pahl L. Clark Date of Inspeotlon:3/2 0/9 6 BEPTIC TANK:✓l-IOdD�N t4+t)dC• . (locate on site plan) Depth below grade: • Material of construction:Zcoucrets_metal FRP­other(explain) Dimenilons: 7 1 b V 41me 1/6 Distance from top of shulp to bottom of outlet tee or baffle: Scum thickness:_0 Distance'front top of scum to top of outlet tee or baffle:�_ Distance from bottom of scum to bottom of outlet tee or baffle:,,�_ 6 Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.)' Pump tank onAP AvAry 9-3 yearsTI—N- -et wata:et tees are i sound and shows no signs of r gP GREASE TRAP:! (locate on site plan) Depth below grade:, Material of construction: concrete metal_FRP_other(esplain) AM Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or be.Me ja Distance from bottom of scum to bottom of outlet tee or baflle:A* Comments: . p (recommendation for puming,condition of inlet and outlet toes or bales,depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage,etc.) NO y� - i (revised 11/03/95) 6 D SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) PropertyAddrem 415 Sampsons Mill Road Cotuit,Mass . Owner. Paul L. Clarg,.-. Date of Inspection: 3/2 p/9 6 TIGHT OR HOLDING TANK • . (locate on site plan) • Depth below grade:. Material of construction: concrete metal_FRP other(explain) ` AJA Dimensions: /A Capacity: & gallons b Design flow: ns/day Alarm level: Comments: T (condition of inlet tee,condition of alarm and float switches,etc.) k)we- DISTRIBUTION BOX:, (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) PUMP CHAMBER. kw R (locate on site plan) Pumps in working orden(yes or no)_d)jQ Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) (revised 11/03/95) 7 � _ e SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM BYSTr:'.: .. :...JN (oontinued) Propertymdrem 415 Sampsons Mill Road Cotuit owners Paul L. Clark " Date of Inspeotioxu 3/2 Q/9 6 SOIL ABSORPTION SYSTEM(SAS):Z e Cocate on site plant,if possmu;excavation not requ*but may be approximated by uon•intrusive methods)' If not determined to be proaent,explain: loarhiag Pits,number:, leaching chambers,number.0 _D_ leacbIn trenches,utimber,length. . Web ing gelds,number,dia�enaioas• _ overflow cesspool,number Co ts:(note conditio ot,�i1, h�uktau a Solis see page'0A,N"o`1signs of nycLrauli_c�.fMure f or pondin vegetation is norms i is ry.No repairs neede a mime. - . ---- , CESSPOOLS sAaVe - .. .... .. (locate on site plan) Number and configuration: AZA Depth-top of liquid W inlet invert: MA Depth of solids Dyer: WO Depth of scum lspr: FDA Dimensions of cesspool: 10 jq Materials of construction: lV A Indicatiosi of groundwater. 019A • inflow(oesspool must be pumped as part of inspect;-:0 Comments:(note condition of soil,signs of hydraulic failure, lw,] cr condition of voptatioN•tc.) PItIVYs/,l , Comte on site plan) ' Materials of A�� --- Dimensions: Depth of solids Comments:(note condition of Soil,signs of hydraulic Wur .,on of vegetation,etc.) (revised 11/03/.95)• 8 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I M A�C(, I DATA ter.' � 'r y. •_ 'i dS r .. �`+ 4 f '�,4 y r • _:��. ,,� .x}�,� '. '. r °'•:...::.:.1.;2�:`y,-i I Bel" {��• �..•, + � '�. .�, ♦ 1�t r`j ':R•1 .`.•. rs,• l�=Ix'� •1.1^ �' yf +qC, .. .�. t• 1 74 7410 L7 Ord•NF..�•C i t'► ,��' ,�� ;; 1d4"- � .} T if.�''t:�';, ,G/�-I. i r'7 w (T t y Nr , t�t, rZ « .1,•T�lf ":L. +�. �.. ,/ry .. J �r� •' � 'r '.'wi� r ,•y j-•q•� +Sf t4. � �.'.• w •• j t�''- 1 �. �` ��-'�'�'�rt:A � �ar�16117jVtyl�r�!",.• � ".•r�'��+ '•N .}4 �: .t.�,.: .�..• '` ,� j ,.•.•t. /ti��Ma 1 I f •%.i. il f. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontinued) Property Address: 415- Sampsons Mill Road Cotuit,Mass . Owner. Paul L. Clark Date of Inspeotion:3 2 0 9 6 J SKETCH OF SEWAGE DISPOSAL SYSTEM: e include ties to at least two permanent references landmarks or benchmarks locate all wells within 100, Centerville Osterville Marstons Mills Water Company 428-6691 .'tip V .... • DEPTH TO GROUND*, Tf?,t� GW/ Depth:to groundwater: .,'1::-F leet method2of detsnuination ar*p,dmation: . _...• .e ge 8A, N. w ter enco tered at 1217 See - (revtsd� 11/03j9511 _._....._....... . .._ 9 .v• .. .i rr. . 1 I . .. :�r �i•,':Sri: .. •. •rssnr•:.—n•rr�-rrrnrrr.•nTrrra-e+n rsrrrr.::•rra.zfr:�rrrcrr..nrz•es r.s�s¢r:r.T .. — rs�'crzr.-strr<:.rn-rr:�•r.-.•Tr-�errr.r—••� 'TOWN OF Barnstable BOARD OF HEALTH 4 ( SUBSURFACE SFWACF DISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION t1•••rrt-r••.-:' --.tr.^.r.rrtmrm•n:rvl•r•iirmr+rrrr:r+•.r-c•i-1.--s-•sr+xr'•-rrr.*.t�.:+r rsr:rrns:sr+�sra tsm n•mrr'niav�rrrr�r•rnrnrrr•r.•�r-••••.� -TYPE OR PRINT CI.EARLY- PROPERTY INSPECTED STREET ADDRESS 415 Sampsons Mill Road Cotuit,Mass. ASSESSORS MAP , BLOCK AND PARCEL # 39-153 OWNER' s NAME Paul L. Clark PAI?Y' D - CERTIFICATION I NAME OF INSPECTOR Joseph P. Macomber Jr.. COMPANY NAME J.P.Macomber & Son Inc. COMPANY ADDRESS Box 66 Centerville, ass . 02632 Street Town or City State LIP COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX ( 508 )790 -1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate, and complete as of the ti.rne of :inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . . I. ,Il;r �• Check one: XXXXXXXXSyste6 PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* The inspection which I have conducted has found that the system fails to Protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection. form • •� I Inspector Signature Date 3/20/96 One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the 130ARD OF 1HEAL7'1I. * If the inspection FAILED, the owner or"" 'Perator shall upgrade ' the aystem within one year of the date of the inspection, unless allowed or required otherwise ad -provided in 310 CMR 15 . 305 . - tiw Lin THE COMMONWEALTH OF A IASSACHUSETTS.. DEPARTMENT OF ENVIRONMENTAL PROTECTION BE IT KNOWN THAT Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE 5 SYSTEM INSPECTOR as provided in 310 CMR 15.340 and Section 13 of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. M June 8, 1995 Acting Director-of the ion of Water Pollution Control `u Vic.t Jt✓ Ilk l _ - _ /� Vic, •. 3v INLET KNOCKOUT !� , ray t r rA. aA . d 1 PI •`�'.��'l•�"{1" _ _y;.-•�� .. �i ... 1�'. .r�TN77[ i° tY_...,Y'_ "'_""Sw""`..r.°•..^ � a� � % {+;','� 9 .'k 4 30 00 cl 7"Few RRVA"IL OE rA M 5 10 O v C) 0 O jr 6 C) C) O C) , •�•-.� v x . 8 U✓ :.r�' L -7�"� 1 49xo �{-- - - /2 10 4 m C) :J 0 I Z r17-0A 4;� 0 37X.'Y' —;� 1 i_i:�.i,�• + :'. t �... .i �r '^wY' .' >: °L V �.i qs •tee # r \ if 0 t� '1 _ � ♦t SG //�r. /,. I . 1 4 /per - -' jY�� l , : i... R'wl w+i W C, 0 `�l t � � 4J o v f{ t*y -"ewe . r ■ ! t r� � ri.,wv mww 5 1 t',•;, ,.fit :: !► ►� 's` �.k X rs-f` ? '� i1/'�'��'t`3't��s� N �\� `.n� -� _ �f' 1 ��1J9!1: G,•-- '41(r�:' ''"` j I .cam'�t �t��/V t-� !'� f" L✓�C�z�c�.�r�, -_.!� .._ J �_K `tea 4 3,•S s^ ��AG Wl. 3 3+� 427 �'?�� ��fig', � �7��, ,-� )w' � �!.'..7T.'i•-t�,�-' y fir'."� �' ,� . ,, :c/2�, �� h/L o a ► \\# f�i r _ .l / rry : d.: -:w ' -:fir• ;r/M` AA' 7 - -C 2 AIIN,/ACAI R�44TIM,-5 9'i J/,tit C c G C_ �' �;�'". �q ` � �, • .__ � � .�? •• \l p� ' 5'� ''�r*�,t �� � v ,C ry,f� AZ-?.h� � `� • �,. /� , ALL GAPE sc.tRvE Y \ �., i-�cj �I�/1 1.. _,rk p A r. l"' •�j", I'�~J'1:'1.. REALY -POST 07-/KJ At�l/ ti. .. ,., �"~�T �:� � ^J� ,��` Z 07 r - 0,4 f C a 7- Ul / �,,./x� �lr.�. �,et..1f.. - —/M. .7o SfQ �.. j '•�,}'eY N:�iR. t w,J}I••✓�I. (. r ,V� x j AL r . SYSTEM PROFILE ALL SYSTEM COMPONENTS SHALL BE NOTES l MARKED WITH MAGNETIC TAPE OR i �- COMPARABLE MEANS FOR FUTURE LOCATION. 1.'DATUM IS (NOT TO SCALE) ASSUMED o PROVIDE MIN. 20" DIAM. WATERTIGHT �/E"�'j r ACCESS COVERS TO WITHIN 6" OF FIN. GRADE CONCRETE COVERS TO WITHIN 3" GRADE y o TOP FOUND. 2" PEASTONE OR GEOTEXTILE 2. MUNICIPAL WATER IS EXISTING EL. 37.74' FILTER FABRIC OVER STONE a 1\ 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 36.4 Locus PRECAST H-10 H-10 BLOCKS OR 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO RISERS (TYP.) MORTAR ALL PRECAST RISERS H- 20 0 2" 33.65' 4"OSCH40 PVC COMPONENTS H-20 INV'S EL. PIPES LEVEL 1ST 2' 2 5 31.62' 5. PIPE JOINTS TO BE MADE WATERTIGHT. ENDS BET Hsi6ES 45'10" EXISITNG t4 CCORDANCE WITH 32 6 CONSTRUC110N DETAILS TO BE IN A .y • p°OO.'.jO cpO cyO Jo oo a°. o eo 00 00 TEE SEPTIC TANK** TEE To--o'o 0 o p o 0 0 0 °o°��° o p o 0 0 MASS. ENVIRONMENTAL CODE TITLE V. 32.25f* ° ° �MM ooao ° °p ®tea®o �a000 ° ° ° ° ° 6" M!N SUMP o°o° MME1 ®�®®� oo°o�� ®a®a®®ao®a >°�°o°o°oo°o°o°o°o°o° o '°°°° 0 0 0 0 °°°°° ° ° ° ° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO GAS BAFFLE::' °o°o°o°o°o° 12" MIN. INT. DIM. o°o° aa�®®®ao�� 00000° ��®�®®®®0® o0000.o BE USED FOR LOT LINE STAKING OR ANY OTHER PURPOSE. o„o N i0000 �0®®®®0®®� oo°o°o ��®�®®��®00000000031.93' 31.76' )°o°o °°0000 o ° ° ° ° ° ° ° 29.62 ;..: .: :„•..} +•` v': : ;- : ° o 0 0 ° 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. LH-20 500 GAL. LEACHING CHAMBERS BY ACME PRECAST 9. COMPONENTS.NOT TO BE BACKFILLED OR CONCEALED Cotuit 3/4"-1-1/2" DOUBLE WASHED STONE (3) UNITS REQUIRED WITHOUT INSPECTION BY BOARD OF HEALTH AND PERMISSIO 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF'STONE: 40' X 10' OBTAINED FROM BOARD OF HEALTH. DQy COMPACTION. (15.221 (21) N 10. CONTRACTOR SHALL BE, RESPONSIBLE, FOR CALLING (6'$ X SLOPE) (-!-X SLOPE) 1" DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO LOCUS FOUNDATION EXIST. SEPTIC TANK 32' D' BOX 16' LEACHING COMMENCEMENT OF WORK. L A 24.4' BOTTOM TH-1 11. EXISTING LEACHING FACILITY SHALL BE PUMPED AND NOT TO SCALE *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL **INSTALLER SHALL CONFIRM MINIMUM SEPTIC TANK SIZE AT NO GROUNDWATER FOUND REMOVED OR PUMPED AND FILLED WITH CLEAN SAND. UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS 1000 GALLONS AND ITS SUITABILITY FOR RE-USE. REPLACE PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM WITH 1500 GALLON SEPTIC TANK APPROPRIATE TO SITE 12. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE ASSESSORS MAP 39 PARCEL 153 CONDITIONS IF NOT SUITABLE REMOVED 5' BENEATH AND AROUND THE PROPOSED LEGENDLEACHING FACILITY. P VARIANCE REQUESTED UNDER MAX. FEASIBLE COMPLIANCE 99- EXISTING CONTOUR / ■�4.53 k15.405 1 b: SAS TO BE >3' BUT < 6' BELOW FINISH X 99.1 j I GRADE (VENT AND H-20 PROVIDED) EXIST. SPOT ELEV. �O 34.58 -[991- PROPOSED CONTOUR 198,4 / ] PROPOSED SPOT EL. � V L 34.68 7.76 v TH1 SYSTEM DESIGN. / � � TEST HOLE j � �y6 t�3 asi s SHELL DRIVE o" SOa CATCH BASIN 1GARBAGE DISPOSER IS NOT ALLOWED®J y s UTILITY POLE `"o .17 Q 5.43 FIRE HYDRANT Q� .67 z�000 'DESIGN FLOW: 3 BEDROOMS ® 110 GPD = 330 GPD W WATER LINE 2.P6 537 6.03/ x3 '49 �°\° 35.11 USE A 330 GPD DESIGN FLOW G GAS LINE 1 OHE -OVERHEAD ELECTRIC ° .37 , MAR RN K- COMER OF SEPTIC TANK: 330 GPD (2) = 660 NOTE NOT ALL SYMBOLS MAY APPEAR IN DRAWING �° PAVED 86 BRICK PA710 EL 30.3 -�� �-DRIVEUSE iEXISTING 1000 GAL. SEPTIC TANK 4 .; ED 6 TEST HOLE LOGS \°\ EXISTING 39.3 LEACHING: 36.33 37.67 °�D6.36.48 HOUSE 1936.6 SIDES: 2 (40 + 10) 2 (.74) = 148 GPD 9 6.40 PIT y7.17 BOTTOM 40 X 10 (.74) = 296 GPD ENGINEER: DANIEL E. GONSALVES, SE #13587 •�'^ 36 � 60TE, •�' 3, e•OAK 6.95 TOTAL: 600 S.F. 444 GPD WITNESS: DON DESMARAIS, RS �, p \•\• / 36.29 OAK ,r PROP.VENT WITH CHARCOAL FlLTER DATE: 9/10/12 LOT 51 DECK 5 ANDCON RACTORWIT (HOM PLACEMENT By USE (3) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) CONTRACTOR WITH HOMEOWNER PERC. RATE _ < 2 MIN/INCH 27,747±SF r OAK b1D 3 87 CONSULTATION) WITH 2.25' STONE AT ENDS 5' BETWEEN UNITS AND 2.6' x36.43 •36.25 TM' AT SIDES CLASS I SOILS p# 13729 � -37.30 ■ .25 2 36.29 - 37.74 \ s ■3 ELEV. ELEV. 36 0" 36.4' 0" 36.4' ` 3s.9s G �I 36. q - q ■35.3C �'�• / °. s TITLE 5 SITE PLAN 3.5 LS LS x 35. x 4.90 OF 1OYR 5/3 1OYR 5/3 3" 36.15' 3" 36.15' x71 36.39 E E \N x3 x3 66 M`O 1 415 SAMPSONS N LS Ls .66 31.63- MILL ROAD 10 2.5Y 5/1 35.56' 10" 2.5Y 5/1 35.56'" 35.00 wa 32.3w COTUIT MA E E x LS LS x 32a)6 ° •, PREPARED FOR ��. MgS �^ y " DANIELA. 2.5Y 5/1 ' 2.5Y 5/1 20 34.73 I�I(:.EL 1'v'IL 20 34.73 �� ORTOLOTTI/RYAN �� GA G � C �� A. N '65 2 I LA41 ®E55"RC No. 0D �0SJ '� � �°� DATE: SEPTEMBER 10, 2012 M/CS M/CS off 508-362-4541 10YR 7/8 10YR 7/8 CfAPtiIFL A,\tiG� � fax 508 362-9880 Y � DANIEL OJAII, i A. 144" 24.4' 144" 24.4' OJALA a �v >>�6ho"' , � ,; down cope engineering, Inc. Scale: 1"= 30' CIVIL ENGINEERS NO GROUNDWATER ENCOUNTERED • LAND SURVEYORS DCE #12-214 DATE DANIEL A. OJALA, P.E., P.L.S. 0 15 30 45 60 75 FEET 939 Main Street - YARMOUTHPORT° MASS. 12-214 BORTOLOTTI-RYAN.DWG