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Home My WebLink About0008 GOAT FIELD LANE - Health 8 field Lane 'Wtst V ftisPort; MA 02672 A= 3 i i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION i r 4 J� TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 8 Goatfield Lane � (p West Hyannisport Owner's Name: Denise Vannelli iOwner's Address: Date of Inspection: 7/5/2005 Name of Inspector: (please print) Patrick T. Sullivan Company Name: Ready Rooter < N Mailing Address: P.O. Box 371 CD ! Sandwich,MA 02563 0 i Telephone Number: (508) 888-6055 - s CERTIFICATION STATEMENT w �' r I certify that I have personally inspected the sewage disposal system at this address and that the i formation reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The System: i fPasses Conditionally Passes jNeeds Further Evaluation by the Local Authority Fails Inspector's Signature: Date: 7 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 DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****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. I Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 8 Goatfield Lane West Hyannisport Owner: Denise Vannelli Date of Inspection: 7/5/2005 i Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D C. System Passes: �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. i Comments: I B. System Conditionally Passes: One or more system components as described in the"Condit* nal Pass"section need to be replaced or repaired.The system, upon completion of the replacement or rep ' ,as approved by the Board of Health,will pass. Answer yes,no or not determined (Y,N,ND)in the or the following statements. If"not determined"please explain. The septic tank is metal and over 20 years of or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltr ion or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying sepfi tank as approved by the Board of Health. *A metal septic tank will pass inspection if it ' structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years Id is available. ND explain: Observation of sewage backu or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a brok n,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system re uired pumping more-than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if ith approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND expla' Page 3 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 8 Goatfield Lane West Hyannisport Owner: Denise Vannelli Date of Inspection: 7/5/2005 C. Further Evaluation is Required bXsurface the Board of Health: Conditions exist which requiraluation by the Bo d of Health in order to determine if the system is failing to protect public health,safnvironment. .1. System will pass unless Boah deter nes in accordance with 310 CMR 15.303(1)(b)that the system is not functioning inwhic ill protect public health,safety and the environment: _Cesspool or privy is witha surface waterCesspool or privy is withf a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)-determines that the system is functioning in a manner that protects the public health,safety and envi nment: _The system has a septic tank and soil absorption system(SAS)and t 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 withips Zone I 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 SEAS 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 and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. f j / 3. Other: I ti i Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 8 Goatfield Lane West Hyannisport Owner: Denise Vannelli Date of Inspection: 7/5/2005 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No _ _%Z Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ _�Z' 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 and 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 ;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. _Z 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 I of a public well. Any portion of a cesspool or privy is 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] (� (Yes/No)The system fails. I have determined that one or more of the above 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 fac' ty with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the folio mg: (The following criteria apply to large systems in additio o the criteria above) yes no the system is within 400 feet of a surfac drinking water supply i the system is within 200 feet of a tr' utary to a surface drinking water supply the system is located in a nitro a n sensitive area(Interim Wellhead Protection Area-I WPA)or a mapped Zone II of a public water sup y well If you have answered"yes"to an question in Section E the system is considered a significant threat,or answered "yes" in Section D above the la a system has failed.The owner or operator of any large system considered a significant threat under Secti9 E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner ould contact the appropriate regional office of the Department. i Page 5 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 8 Goatfield Lane West Hyannisport Owner: Denise Vannelli Date of Inspection: 7/5/2005 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? i 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? 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 than 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: Yes No _ 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(3)(b)] i Page 6 of 11 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 8 Goatfield Lane West Hyannisport Owner: Denise Vannelli Date of Inspection: 7/5/2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): '-S_ Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: _ Does residence have a garbage grinder(yes or no):`�zS Is laundry on a separate sewage system(yes or no):%�[if yes separate inspection required] Laundry system inspected(yes or no): Seasonal use: (yes or no): t--Az�k Water meter readings, if available(last 2 years usage(gpd)): a,-�tf = 1,53 6.�P,So, Sump Pump(yes or no): Last date of occupancy: COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc . Grease trap present(yes or no): Industrial waste holding tank present( s or no): Non-sanitary waste discharged to the itle 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or 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 _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) _Tight tank _Attach a copy of the DEP approval Other(describe): Approximate age of all components/ to installed(if k own)and source of info ation: r detected when arriving at the site e r no Were sewage odors de d g s (yes o )41L� i Page 7 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C iSYSTEM INFORMATION (continued) Property Address: 8 Goatfield Lane West Hyannisport Owner: Denise Vannelli Date of Inspection: 7/5/2005 i BUILDING SEWER(locate on site plan) Depth below grade: -c—) J " ' Materials of construction:_cast iron V40 PVC_other(explain): Distance from private water supply well or suction line:�— Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: locate on site plan) Depth below grade: ko to Material of construction:_Zconcrete_metal_fiberglass_polyethylene _other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions: Q X t{.,5' k 41, Sludge depth: Q " Distance from the top of sludge to bottom of outlet tee or baffle: 3 Scum thickness: Q" Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: I a How were dimensions determined`— f, Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): --Z,ti5A "GVCs�f'� -44.r' vv.%a 'Y�J3 GCO ji Alx- '.h�`e� 4 v�� GsJv�i�.l�� 6 e� C4 GREASE TRAP:_(locate on site plan) Depth below grade: Material of construction:_concrete_metal fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of out t tee or baffle: Distance from bottom of scum to bott of outlet tee or baffle: Date of last pumping: Comments(on pumping recomm dations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evide ce of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 8 Goatfield Lane West Hyannisport Owner: Denise Vannelli Date of Inspection: 7/5/2005 TIGHT or HOLDING TANK: (t/Ifiberglass mped at time of inspection)(locate on site plan) Depth below grade: Material of construction:_concrete_ _polyethylene_other(explain): Dimensions: Capacity: gal ns Design Flow: Ilons/day Alarm present(yes or>no)::Alarm level: working order(yes or no): bate of last pumping: Comments(condition nd float switches,etc.): DISTRIBUTION BOX: V (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: CD Q Comments(not 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— —isn't Q` S .r' .ITT C PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump cha er,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ISUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 8 Goatfield Lane West Hyannisport Owner: Denise Vannelli Date of Inspection: 7/5/2005 SOIL ABSORPTION SYSTEM(SAS): locate on site plan,excavation not required) If SAS not located explain why: Type ✓leaching pits, number:-L 6 X6" leaching chambers,number: leaching galleries,number: leaching trenches, number, length: leaching fields, number,dimensions: 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.)..: -:1 CESSPOOLS: (cesspool must be pu ed as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwate inflow(yes or no): 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/oydraulic failure, level of ponding,condition of vegetation,etc.): Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 8 Goatfield Lane West Hyannisport Owner: Denise Vannelli Date of Inspection: 7/5/2005 i I SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 3 � Page 1 I of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) I Property Address: 8 Goatfield Lane West Hyannisport Owner: Denise Vannelli Date of Inspection: 7/5/2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water, feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record—If checked,date of design plan reviewed: \ Observed site(abutting property/observation hole within 150 feet of SAS) Checked with the local Board of Health-explain: Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: G��1r� vvo , c5c�.n1 Q ��c�._/-- ,.3Z' cz i i i f TOWN OF BARNSTABLE LOCATION SEWAGE # G ASSESSOR'S MAP & LOTQLJ INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS 3 " BUILDER OR OWNER PERMTTDATE:�s� g3 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by'�4,e" $ t a • 1 LO CAT ION -99f SEWAGE PERMIT NO. VELLAGE. Y'1�U aGvi�►w�S INSTALLER'S NAME ADDRESS `, pp R UILDE R OR OWNER C e In C 0 lit ,. DATE PERMIT ISSUED . � DATE COMPLIANCE ISSUED" S� : rj w N F - O Noi ....--_.. ... FEs..� Q.:_C� 0..... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...........:/:p -.:.oF.................I�.�� -........-.._._.....-...:............... Appliratiun for MiVasttl arks C�uuutrurtiun Permit Application is hereby made for a Permit to Construct �epair ( ) an Individual Sewage Disposal System�at: � �� / Tl. �/ .. . ................ �' Location-Address or Lot No..... _. .. ............ ..................� -..-•---.........-•-----........-:----.......----•-----.. •caner... / Address Installer Address Q Type of Building Size Lot_.. ......Sq. feet - U Dwelling—No. of Bedrooms............... ... Expansion Attic Garbage Grinder .-� -------------- Other—Type of Builditl a g .......L�J�J..-�. No. of persons..........-�9............ Showers (�}� Cafeteria ( ) Otherfixture .......... ------------------------------•------------------------------ ---------------- W Design Flow............... .. gallonsflow.............. -- W Septic Tank—Liquid capacityl '?.gallons Length....1C/..__. Width....... Diameter................ e t ....a....... x Disposal Trench—No. __AP34 ..fWidth....................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 ) aPercolation Test Results Performed ......... Date................ l Test Pit No. 1._. 4-minutes per inch Depth oftt Pit_._.__. L...___ Depth to gr -/.aound water........ Gz, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ PG ................••rr....... -•- .. ......__.. .......................... O escrptono Soil..... ... � ,�. �C . . U --------------zl `�_. �Z..f.----/Y -t. . <liA�-.-------.c_..._....._..--------------••-----•-•--•----------...........-------•------ .............................................................-.............................................................................................................:............................ 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 system in operation until a Certificate of Compliance has been issued'by the board of health. Signed.......-.r?L'_• -` ......... Date Application Approved By.............................-_'fi- e -•-•----•----•----•-----•-----=-•- ......... ljl Date Application Disapproved for the following reasons:..................................................._............................................................ •.....................•----------....-------------•--------------•------------._.............-------..._..._.................----....-----...----•-------------------------------------------------••---- Date PermitNo......................................................... Issued---•--•-••-•--------------------....--••-.......•.....: Date Q -r Nol... v: . .. FEs...`P.U:: 0..... THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH 1 ......0 F,...............,1��CG�iGz�!/.`. - ............----- Appliratiun for Bhipuual Works Tonutrnrtion Permit Application is hereby made for a Permit to Co truct (1 or Repair ( ) an Individual Sewage Disposal System at ..-- ---- Location ddress or Lot No. e ........T..................................... ..........__...__ ... ` �wner / Address VV Installer Address � Q Type of Building Size Lot....... ....�..... ...Sq. feet U Dwelling—No. of Bedrooms..................... Expansion Attic Garbage Grinders 6)1 a Other—Type g ------- �.......___.. Showers d Other fixture ............... ... n.��.............•-----•--•---...--------------......---•---•--•--•---•------•------- Design Flow................. . ..............gallons per person per day. Total daily flow...........__�3. .U..............gallons. Septic Tank—Liquid'capacity/(f7�gallons Length__-.Zfl-. -- Width......�!e... Diameter.................Dept .....K,.... x Disposal Trench—No. �/�P....Width.................... Total Length.................... Total leaching area.".�... ......sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (L-� Dosing tan,,k ) / ~' Percolation Test Results Performed by..... :.v-<�! n-��«._ :: �!�?-? __......... Date....................... �........ 3 aTest Pit No. 1..../-�-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........................ PG "... -------•;'+ ............ ........................ O Description of Soil.. { :..` <f77n.-..... .. ....._� , �� V ................................ � A--•-•/ •-•...... .....�..... �(.nn G4 .......................... .................... .........................••-•------------:.............._........-•--------••'•---••-•-•----•---•-----------•-•--•-------•--.....•-----.........-•-•-•---...--•-----------------_.. V 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 system in operation until a Certificate of Compliance has been issued by the board of Health. Signed------- _•�-11 - � + 2 %ate .Application Approved BY r'' .�'�_ o -- ----•----------------- ,� Date Application Disapproved for the following reasons:............................................................................................................... ---•-•--•...........................••--•-•-•-------.....------..............•'•--•------------............------•----•-•--•-•-••-----------•----•......--'•---•------.....------•------•--•----.....---- Date PermitNo.......................................................... Issued•..................................................--- Date THE COMMONWEALTH OF MASSACHUSETTS 'BOARD OF HEALTH l `' .........o F............. �-G� -�a (9rrtif irate:of Tompliatta THIS IS TO C TIFY, That he Individual Sewage Disposal-System constructed ( or Repaired ( ) �...r. �/ `l' ....... .......................... .. .....--•--....-------••-•-•-•-•---•--•--..........bY...^ - ....... Instal)er 12 Cl at -------------------••--•-•---`�. ...... has beeri installed in accordance with the provisions of TITLE 5 of The State , anitary Code as described in the application for Disposal Works Construction Permit No...... ::...':. . ....._... dated................................................ THE ISSUA E OF THIS CERTIFICATE SHALL NOT BEXCONSTRUD ASA GUARANTEE THAT THE SYSTEId�NCTION SATISFACTORY. DATE..+� .....................••---...................•-----.......--.. Inspecto ---....,...................-•------•-----•---------.......... THE -COMMONWEALTH -OF MASSACHUSETTS BOARD OF HEALTH �,)ys .......:...,/Cl"�U'`.......0F........ 't ............................ . No. ............•--_..... FEE....... 1........... llispoua1 pr Tuntr ion ;permit Permission is hereby granted - ......................'t , :,;�1- ......-----•......-----•---•------------•...................................... to Construct (f/�or pfiir )_an Inual ewa€�D's Syst atNo ------------------ Street as shown on the application for Disposal Works Construction Permit No..................... Dated......................................... oazd of Health DATE............................................................... ................ FORM 1255 A. M. SUL-KIN. INC., BOSTON r - w Rs �+ 100' w i toT1f �0r ,14 OF v •<1 ( L o T .'�.: ,'J'. . • Eats ti AL 2W4 ISTS per I00 i W `��'IV 'SA .�d sera•�l•k -`{• ' , 7PwA( [ , d, �d ' Ali LEGEND ' . ' �. E• Ja�� yN uJr��,• Nk • l EXISTING SPOT ELEVATION Ox0 ~ CERTIFIED. PLOT PLAN EXISTING CONTOUR --- O — H OF ' FINISHED SPOT ELEVATION aoA ' ' ' , R'' /� ' P14*4 eooi,f ./S' FINISHED CONTOUR --- 0 -�-�- '` w RLi.`i ^'g I N APPROVED , BOARD OF HEALTH Nc'96aAA h�4''�. .a;' , y, _` J + . _ NAL E DATE AGENT SCALES / �� S,J� DATE LDREDGE ENGINEERING Ca IN E 1 CERTIFY THAT THE PROPOSED EGISTERE REGISTERED JO_@ NO,F 6Z BUILDING SHOWN ON THIS PLAN CIVIL LAND CONFORMS TO THE ZONING .'LAWS ENOIN ER Y DR�BY,�. '�;� OF.BARN9TAB LE ASS. . 712 MAIN STREET CH. BYE,, '';' " c�.• q NYA NN I S, MA9$. ; -"'•. '' SHEET .: OF� Z DATE RE .- LAND SURVEYOR 20 FT. M/N. /Y07-F /F E/TNER THE SEPT/C 7-AN.4C OR LEACt,I/NG P/T ARE MORE 77HA,A/ /2"B,=j_ow GRAOE� A 24"VIA M ETER CONCRETE C•OYER -- S,"ALL eF B•PDUGNT TO 6RAL�E.�,�N EXTRA CONCRETE 4�PYC P/Pz H.6-4Vy CA ST /RON COVER Sh'A2,L QE !/SEO /N DR/VEJ•VA y .::. 2 �y��y, CG/VCRETE A G .4oE COVER CL EA/V .SAND { &AC-le/=/L L - - UQt//D LEYEL - •I,/ 2'LAYER ~� NP o• or ��8 -3/B /RON / !r DO O r • o • MIN.P/TGV �> GAL. • d 1• . . . . . • • > •4� %4 PE�t 17: SEPTIC TANK D/ST, o • • • • • • • • • * WA SNFO 57ONE BOX • � e . r • • • � .•• • is; • • •EFFECT/✓E ' •� 3�4 - �2 t�` • • • Of�TN • r • ' . v WASWED S740NE 7/ C;� y :�I . � • . •. • • • • � D�� PRECAIS T SEEPAGE lNYGT EL EY.�IT/O/V s � 7�S t`o - � ' ' • � • • ' ' � o P/7 OR EQU/v. R INVERT AT 4011/LD/N6 �9-S "FT r^•. IA/LET .SEPTitC .Ti+NK 99.3 FT � FT. O/A)!M. LC� E T%�//L-'�TJON� O4/TLET SEPTIC 7A' NM -1. Pr INLET DISTX1460 ION BOX `i8 `j P7. 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