HomeMy WebLinkAbout0029 OAK RIDGE ROAD - Health 29 OAICR- 16GE ROAD, OSTERVILLE
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M%311�SON
NEWINGTON,,CT BRLDGEPORT,CT LOWER HUDSON VALLEY CANTON,MA NORTHEAST
124 Costello Road 91sland Brook Ave. NEW YORK 2 Wbitman Road PLANT DIVISION
(860)666-5634 (203)384-9402 (914)217-3530 (781)828-1350 877 754-2107
WORCESTER,AM• NORTH HARWICH,MA CLIFION PARK,NY,
WATERTOWN,NY EAST S IRA CUSE,NY•
57 Southwest Cutoff 518 Depot Street 612 Pierce Road 800 Starbuck Ave. 6040 Drott Drive
(508)754-2027 (508)430-1696 (518)877-3066 (315) 782 3785 (315) 7413087 .
�f TOWN,OF BARNSTABLE
LOCATION C( F'C [ �SEWAGE#a[)1 S "L4
VILLAGE ASSESSOR'S MAP&PARCEL
INSTALLER'S NAME&PHONE NO. S`0V,X S 4 00b i
SEPTIC TANK CAPACITY a e i
LEACHING FACILITY:(type) \A i cc.e �A af9_ (size) �b
NO.OF BEDROOMS
OWNER �1 r��jCi,• t // 1
PERMIT DATE: COIt PLIANCE DATE: 1 a ( C) 1 I
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 j
FURNISHED BYC P`CAJ\
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iceJ Q �c,,�SQ-
SA
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t,No. 2;?D/5_ �//2- ;
Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered incom ter:
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes
2pplication for Disposal 6pstrm Construction Permit '
Application for a Permit to Construct Repair V Upgrade( Abandon "pp ( ) p ( pg ( ) ( ) ❑Complete System El Components
Location Address or Lot No. �A V,��� '��. Owner's Name Address,and Tel.No.
Assessor's Map/Parcel 5S
Installer's Nye,Address,and Tel.No. 1 Designer's Name,Addres and Tel.No.
kk3 Oka n d S.kcvp, k-�-4&,3 6 •U c36x 16
A of a�L O
Type of Building: V UL&11
Dwelling No.of Bedrooms 3 Lot Size 5 4j( sq.ft. Garbage Grinder(N)o
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) a 3 y gpd Design flow provided 3:3 G gpd
Plan Date O o� 1 ► Number of sheets Revision Date
Title
Size of Septic Tank 21C` A l S-6 U Q -1\L Type of S.A.S. 01 k-A i C* VA (�
Description of Soil % XA
Nature of Repairs or Alterations(Answer when applicable)
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 Health.
Si -- Date s
Application Approved by Date
Application Disapproved by Date
for the following reasons
Permit No. L Date Issued — f
ki
t l i�i
Fee .�
t ' THE COMMONWEALTH�;OF MASSACHUSETTS Entered in computer:
a« a Yes,
J" PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
application for bISp08ar 6pStemaCOnBtrUctlOn Permit �d .
Application for a Permit to Construct( ) Repair(\/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components
Location Address or Lot No. 9,1 0 Au, i0 _p_,C Owner's Name Address,and Tel.No. '
Assessor's Map/Parcel I (� t
-Installer's Na e,Address,and Tel.No. Designer's Name,Address and Tel No. !"
c o C rcav��c t�•3 0�d �,�,��fi^a - S keys.• ck�� 6�•D (3 o x 1 s 6'
U t a"G%A <0 X 'a ki 0'a 6 C!
Type of Bui ding: v CAC,Ili
Dwelling No.of Bedrooms Lot Size : ` rj sq.ft. Garbage Grinder(��}
Other Type of Building No.of Persons Showers( ) Cafeteria( )
.r
Other Fixtures
Design Flow(min.required) `� gpd Design flow provided 3?4 gpd
Plan Date � (� a ( � Number of sheets Revision Date
Title -
Size of Septic Tank S6 O . Q Type of S.A.S e,QG\krt,\-C Ck 01c) kA 1 C C�,c� �A- �✓
Description of Soil C `., nnto�Cr< 1 n� Z.'d %3 X3 X 3\� X ,
I�
Nature of Repairs or Alterations(Answer when applicable) �aT� �� �(��� �C,�`�Cct,,,, lj j LQ c��� ��CA
� w v
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 Health.
Sid-- Date
Application Approved by Date
r
Application Disapproved by Date
for the following reasons
Permit No. 1 f^" Date Issued 1 d
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( 1Y Upgraded( )
Abandoned( )by
at ,. __ f�V, y t c (,p ( .V Q U �` _, has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. C9 0 IS- [/Q`dated
Installer 3 C C \ V v,,,kx Designer Ek t I-e—_ `\C,
#bedrooms Approved design flow�k 7.1 Cr, . v. gpd
The issuance of this permits all not be construed as a guarantee that the system will fu ctr do as designed.
r ,
Date � ).` Ca I Inspector y t& Q (�
----------------- ----- -------
No. G I � � Fee 1�)
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
;Disposal 6pettm Construction Permit
Permission is hereby granted to Construct( ) Repair(V")," Upgrade( ) Abandon( )
System located at 4, A)x QAp C Z d n j ,\
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 permi.
Date � �"- � 1� '� � � { : .,.i'` Approved by
Town o Barnstable
Regulatory Services
• ��FTHE Tp� � v
c Richard V:SMR, Interim Director
Public Health Division
* BARNSTABLE, ..
'cb MASS..
� Thomas McKean,Director
200 Main Street,Hyannis,MA 02601 ; ,a
Office: 508-862-4644 Fax: 508-790-6304 r
Homeowner Certification Form for Alternative Systems K:EP
Property Address:
Assessor's Map\Parcel:
Property Owners Name: E'At K`(- (� �
In accordance with Massachusetts DEP alternative system approval letters, the following certification
information is required by the Owner of record. The Owner of record must place an "x" in the
applicable box next to each line certifying the information.
Yes NSA
❑ I have been provided a copy of the Title 5 I/A technology Approval letters.
(16 page Standard Conditions letter and the specific.technology letter)
❑ [A I have been provided with the Owner's Manual
❑ ® I have been provided with the Operation and Maintenance Manual
❑ Y For Systems installed under a Remedial Use Approval, I agree to fulfill my
responsibilities to provide a Deed Notice as required by 310 CMR 15.287(l0)
and the Approval
❑ [)4 For Systems installed under a Remedial Use Approval, I agree to fulfill my responsibilities to
provide written notification of the Approval to any new Owner, as required by
310 CMR 15.287(5)
❑ If the design doe's not'provide for'the use'of garbage grinders,the restriction is understood
and accepted
❑ Whether or not covered by a warranty, I understand the requirement to repair, replace,modify
or take any other action as required by the Department or the LAA;if the Department or the
LAA determines the System to be failing to protect public health and safety and the
environment, as defined in310 CMR 15.303 a
T cwE(L, agree to comply with all terms and conditions above.
Property Owners printed name
liq
Property Owners Signature Datd
Note: This form must be submitted along with the septic system disposal works permit
application for all I\A systems including new construction, repairs\upgrades, with and
without aggregate (stone) and with conventional design criteria or credited design
criteria.
Q:\Septic\IA homeowner certification.doc
Town of Barnstable
.fTME' tia Regulatory Services
Richard V. Scali, Interim Director
• wmsrnat.a.
���' Public Health Division -
A'� �' Thomas McKean, Director
200 Main Street,Hyannis,MA 02601
Office: 508-8624644 Fax: 508-790-6304
Installer Designer Certification Form
Date: ka 1 (:k\ k Sewage Permit# a0\ —�j a Assessor's Map\Parcel �L
Designer: . 5Tz:',0--� A - f'-e'=_ Installer- Sc_t�
Address: g23 12-ow—,z= 6,4 Address: �\ 3
on C 1 k 0l 5 S Co�A M `�,.r�C was issued a permit to install a
(date) (installer)
septic system at D-Ff 00kV_F c) � QJ based on a design drawn by
(address)
5 , t.�r c,s dated
(designer)
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. Strip out (if required) was inspected and the soils
were found satisfactory.
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 Regulations. Plan revision or
certified as-built by designer to follow. Strip out (if required) was inspected and the soils
were found satisfactory.
I certify that the system referenced above was constructed in compliance with the terms_ of
the I\A approval letters (if applicable)
`NF
(Inst 's Signature) -
` vat ' `
(Designer's Signa ue) (Affix Designer`s Stamp Here)
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 BARNSTA 3LE PUBLIC HEALTH DIVISION.
THANK YOU.
QASeptic\Desiper Certification Form Rev 8=14-1J.doc
• Town of Barnstable P#
Department of Health,S^fety,and Environmental Services
o�T Public a flibivision Date
Q, 367 Main Street,Hyannis MA 02601
HARNSrABM
MA99.
039.
Date Scheduled U - Time Fee Pd.
CA
Soil Suitability Assessment for-Sew e Disposal
Performed By: J Witnessed By, ^.:1
LOCATION.& GENERAL 1NFQRMATION
Location Address Owner's Name
Address 5141- !C
Assessor's Map/Parcel:. / /c��, Engineer's Name 6jZ—�1f Ev-�/E •fF-.4+�'�,.
NEW CONSTRUCTION REPAIR �� t Telephone# 36Z
Land Use � ,+r�e .ft . Slopes(%) ' Surface Stones •y
Distances from: ..Open Water Body ft Possible Wet Area ft Drinking Water Well ft
Drainage„Way ft Property Line ft Other ft
,
SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes)
Parent material(geologic) " N Depth to Bedrock 2exv
Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face
1:stimaieu Seasonal hig l Groundwater
DETE I ATION FOR SEASONAII Gl I .... 'ABLE:
Method Used.
Depth Observed standing in obs:hole: in. Depth to soil mottles: in.
Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft.
Index Well#_ �._ Reading Date:._,-.__ Index Well level..._-_T Adj.factor_ Adj.Groundwater Level_
PERCOLATION TEST pats I trBe rJv ;
_.._ ....... _....._................._._.._ _................... ........... ........ .....
Observation
Hole# / Time at 9"
Depth of Perc' — Time at 6"
Start Pre-soak Time @ D=�'" Time(9"-6")
End Pre-soak
Rate Min./Inch Z 2—
Site Suitability Assessment: Site Passed / Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back j
Copy: Applicant.
DEEP OBSERVATION OG
Depth from Soil Horizon Soil Texture Soil Color Soil ther
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistent .%Gravel)
/L
Ap
120
DEEP OBSERVATION HOLE LOG
Depth from Soil Horizon Soil Texture Soil Color Soil Other "
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.° ravel
15
la VIOL-
12,0
DEEP OBSERVATION HOLE LOG Hole
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.%Gravel
DEEP OBSERVAM HOLE LOG Hole#_
Depth from - Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes.
Consistency.%Gravel
I �
Flood Insurance Rate Maw ;
Above 500 year flood boundary No— Yes
Within 500 year boundary No Yes
Within 100 year flood boundary No Yes
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?
Certification
I certify that on /1' 11Y 51 (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, goertise and experience described in 310 CMR 15.017.
Signature _..__ _____ Date
f
CERTIFIED SEPTIC SYSTEM REPORT
LOCATION
29 OAK RIDGE RD.
OSTERVILLE, MA 02655
MAP 118 PARCEL 046
PREPARED FOR
SELLER o
MR. & MRS . DAVID TROTTO 29 OAK RIDGE RD. e RECEIVED
OSTERVILLE, MA 02655 °p OCT 1 9 1995
r
u
BUYER
MR. DAVID WELTON V
1103 LAGRANGE ST .
CHESTNUT HILL, MA 02167
PREPARED BY
HILLIARD HILLER, JR.
P .O. BOX 250
CENTERVILLE, MA 02632
508-778-1472
I
M
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
Address of property �9 oi9� Rio6 h'o
Owner's name
Date of Inspection igvGvs7 oZ /79
PART A
CHECKLIST
Check if the following have been done:
v Pumping information was requested of the owner, occupant, and Board of
Health.
' None of the system components have been pumped for at least two weeks
and the system has been receiving normal flow rates .during that
period. Large volumes of water have not been introduced into the
system recently or as part of this inspection.
!/ As built plans have been obtained and examined. Note if they are not
available with N/A.
The facility or dwelling was inspected for signs of sewage back-up.
v The site was inspected for signs of breakout.
All system components, eluding the SAS, have been located on the
site.
i, The septic tank manholes were uncovered, opened, and the interior of
the septic tank was inspected for condition of baffles or tees,
material of construction, dimensions, depth of liquid, depth of
sludge, depth of scum.
The size and location of the SAS on the site has been determined based
on existing information or approximated by non-intrusive methods.
!/ The facility owner (and occupants, if different from owner) were
provided with information on the proper maintenance of SSDS.
i
8
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION
FLOW CONDITIONS
If residential
number of,.bedrooms
number of current residents
M& garbage grinder, yes or no,
laundry connected to system, yes or no
seasonal use, yes or no
If nonresidential, calculated flow:
Water meter readings, if available: /q9y
PR�s/l LILY Last date of occupancy
GENERAL INFORMATION
Pumping records and source of information:
Axe iPee�es 10,E 1Z ao°w
AA2 System pumped as part of inspection, yes or no
if yes, volume pumped
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)
Other (explain)
Approximate age of all components. Date installed, if known. Source of
information:
Sewage odors detected when arriving at the site, yes or no
I
9
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION continued
SEPTIC TANK:
(locate on site plan)
depth below grade: 7��
material of construction: concrete metal F'RP other(explain)
dimensions:- /d�c " X 6-'.2 `' (oo)
sludge depth
distance from top of sludge to bottom of outlet tee or baffle
scum thickness
7%a " distance from top of scum to top of outlet tee or baffle
/3 L* distance from bottom of scum to bottom of outlet tee or baffle
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, recommendations for repairs, etc. )
TAW G cwt,[.o Cs—,O
DISTRIBUTION BOX:
(locate on site plan)
b= 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, recommendation for repairs, etc. )
lb Qox ter. ro is o �i£y.� wlrrl ��vo S,ti�A.e� T�•�
PUMP CHAMBER:
(locate on site plan)
pumps in working order, yes or no
Comments:
(note condition of pump chamber, condition of pumps and appurtenances,
recommendations for maintenance or repairs,etc. )
10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION continued
SOIL ABSORPTION _SYSTEM (SAS) :
(locate on site plan, if possible; excavation not required, but may be
approximated by non-intrusive methods)
If not determined to be present, explain:
Type
leaching pits and number
leaching. chambers and number
leaching galleries and number
leaching trenches, number, length
leaching fields, number, dimensions
overflow cesspool, number
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding,
condition of vegetation, recommendations for maintenance or repairs,etc. )
CESSPOOLS (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 groundwater
inflow (cesspool must be pumped as
part of inspection)
Comments:
(note condition of soil, signs of hydraulic failure, level' of ponding,
condition of vegetation, recommendations for maintenance or repairs,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, recommendations for maintenance or repairs,etc. )
. 11
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
SYSTEM INFORMATION continued
SKETCH OF SEWAGE DISPOSAL SYSTEM: a9 Off/, �PivG.0 IUD fSTC.C�/GGC '`��
include ties to at least two permanent references landmarks or benchmarks'
locate all wells., within 100 '
d3ul..�h't A�
PST/a I G/�.Ci9G,s'
I
A
S
I
5 .
DEPTH TO GROUNDWATER
a8, depth to groundwater
method of determination or approximation:
.vX,VsJ�1 1-t G' S
0r1b. 1�/1
C.eiA
TOWN OF BOARD OF HEALTH
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION
-TYPE OR PRINT CLEARLY-
PROPERTY INSPECTED
STREET ADDRESS d1 GSiPf �i £ asTt��/GL,E
ASSESSORS MAP, BLOCK AND PARCEL
OWNER' s NAME "ez<- ✓wz9 I' J e- -t- A-/h 0
PART D - CERTIFICATION
NAME OF INSPECTOR /*..o h//0-6ex '5e
COMPANY NAME —
COMPANY ADDRESS dSy
Street Town or City State ZIP
COMPANY TELEPHONE {50� ) 7) - /�j FAX
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 time 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 .
Check one :
__L1_`System 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.
Inspector Signature � Date
One copy of this certification must be provided to. the OWNER, the BUYER
( where applicable) and the BOARD OF HEALTH.
* If the inspection FAILED, the owner or operator shall upgrade the system
within one year of the date of the inspection, unless allowed or, required
otherwise as provided in 310 CMR 15 . 305 .
partd.doc
I
.. osrfQdi��F
Lo LOT No."No."i ADDRESS:2 j. D4,k Zia /Pal
vII OWNERS NAME: Tie,T70
IN. SEWAGE PERMIT NO. :9'D-/ 2 NEW.: REPAIR:
SE DATE ISSUED:_�ra6~9ODATE INSTALLED: $-/O-90
LE INSTALLERS NAME: �.4Ennis
��}A�livR �E�RS Sons
INSTALLATION OF: po 9p��t �8
NC pan
1� T �,—
Bt
WATER TABLE: FINAL INSPECTION BY:le4e
Di
DRAWING OF INSTALLATION ON REVERSE SIDE: .
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No
47
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Ill l?04,
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L
THE COMMONWEALTH OF MASSACHUSETTS
_ BOARD OF HEALTH
. .......OF......=....!j��l�. % L. .............................
Appliration for DioVoo€tl 3Vork,i Tonotrur#ion Vantit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at: __
Lees ion-,A dress or t Ko.
Owner Address
W
Installer Address
Type of Building Size Lot...toe .......Sq. feet
U Dwelling—No. of Bedrooms........... ..............................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
A4 Other fixtures .......................................................
W Design Flow................................�'- gallons per person per day. Total daily flow.....733!9..........................gallons.
WSeptic Tank—Liquid capacitv�9.4 W.galIons Length .... Width.. . "... Diameter... Depth.S.. .....
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No..........1........ Diameter.-_ ..`....... Depth below inlet......e_`........ Total leaching area.u ....sq. fI.
z Other Distribution box (� Dosing tank ( )
Percolation Test Results Performed r ..... . !..:�f�.............. Date....'.^.. -.`�G
Test Pit No. I......'-'.._.ininutes per inch. Depth of Test Pit.../-r-.'�*��.. Depth to ground water.--- ........
Gz, Test Pit No. 2........?r_....minutes per inch Depth of Test Pit....e:?-`...... Depth to ground water.......
...........
..............................
............
O Description of Soil.... l �v!..I... !. ...............................................
U •••••........................•••-•-•--.......-•-••.......••••-•--•-••-•--•-•-•---•-••----•-----........................................................••------•----••---•...............--•--•------•••
W •••-••--••-•......................••••••--•-•.............-•------...-•-•-._....._......-•'--••••....--•••••••••-......-•••••••••••••-•----••-•-•••-•••---...--•-•••-••-•-•••••......••-•-•--••--.--•••-
UNature of Repairs or Alterations—Answer when applicable..................................-_....................................___.._................_.
----------------------------------------------------•---...._...................._.....................---..........----------------------------............._........------. ----................-••••.
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage D . osal System in accordance with
r1 T�'1 •-•
the provisions of .l,1 Y� 5 of the State Sanitary Co — T undersi nedff-thagrees not to place the system in
operation until a Certificate of Compliance has bee. is b I b rd o Signed. .. /�� .........:... .............
Application Approved By....'.._. ._....2--�.`.'..'- -(...................••----Q�•=���--------------------- ' ...........
Date
Application Disapproved for the following reasons:.....................---------------------------------•---•--•••••••••.........•••......... ......-----.•-
..........................................•-..........._..........._..........__.................._...............-----.................---................---......................_.............._.....
Date
Permit No.•., / r` � Issued......._�...'�.��._.-- --,��.......
Di-e
....- ..�.,...,....r.�-r.y.,..r t+w aa..a..yw........•a>.:-�.-nsee►-.w•,....«.....•^M.,•w-.....,.._.......,,,. ...
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
.............OF....... ...................................
Trrfif iratr of Tomplianrr
THIS IS TO CERTIFi', That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by..................................•-------................................................._..._.......---......................--•-----•--------•-----...------..................::......-•........
/n'���, Installeerr ,�}
at...............1„�S� ' Ikr(
....... :.------SST .t.11!.� �,....1"1.f1........ ..........................
has been installed in ance with the provisions of TIXjIE 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No..f".e...:..,�..�...?..... dated......7.—.;F �-_r....
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WI FUNCTION SAP&F�ACTORY.
®ATE...... y :... ----. Inspector_.......-•--Y.../c_ it................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
........�.C1.0.:n...............OF....... ...................................... /
�i,��oo�tl orko �ono�r�tr#iun �rrmi�
Permissionis hereby granted..................................................................................................................•-_.........................
to Construct_(/,-�or Repai;, ( ) a Individual Sew1agec /Disposal S stem
......................................................
treet //
as shown on the application for Disposal Works Constriction Permit No.. _ �l--. 2Dated...
'�
........................................: :..�.. ... .............................................
oard o ealth
DATE...................................•---.........-----.......•••.................
FORM 1255 HOBBS & WARREN, INC., PUBLISHERS
41.2 �37.P9 41.4
W12 r one Lf 2
.Cat 8 � o f f
r coy 3 a. o : ',goad'rV
}
0 r
lot, 7 4 1
- i-
ra Z
4003 - -.- - -- ---
lot A�tea i X z z' -
I 000=,s 9
31.6 /G
/41.71 1 4 0.9 40.0 �.4:
N
A-tG Cape �iu�.i ne4?�t.<.� i
4q karbo t load ��hi L10.0Op
�a '2-!0�9.0 .{.
/4ya,sni4, Na. 02601,
tic / P N �ca-Le
No. bed cooma. 3 pro i,Le o i
bi4po,iat No
£.aX,ianate.d stow 330 gpd
.(each.ing raaea 267 -- N 1500 -13
lea etu e va ►°. n i• 1-6 r� 6
Capacity 7!' in
.4'
31.5 IiZ� � � I �•:'ll i i
1..
,Sketch. P•t a4 of .Card in Oa t�.i,ttle Na,
90,t hau-i d 2to Lto j
6" a -Cat ad. alww►z on a tevi4 d p Lan• o
1190wet 14., C" dated 12-5I and 4,eco42,ed.
t .
f.teuatw" ate on an aaaumed datum.
� :----A --- ze l�o-atcZ-o -rdui7,th
Seat pit #P-7523
1 , 14
Made 2-9-90E-
wit.
No water eacounte-red
ete.2 min. p eat
,
41
P I 9P 2
r-tnn o.0 TO p 4p•3
TOWN OF BARNSTABLE
LOCATION 6?9 ,el,676X /fn SEWAGE # :1 -/32
LL.AGE �5��/1v/L�/" ASSESSOR'S MAP& LOT
INSTALLER'S NAME&PHONE NO. X,<r tU/C
SEPTIC TANK CAPACITY 6614
LEACHING FACILITY: (type) piT (size) /ate'
NO.OF BEDROOMS
FOR OWNER AIX a 61/6 .ni9ys.0 3iQo Tlo
PERMPTDATE: 3-c?C. - 9t;> COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility o`�Fs 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 Z
�.. ,�
Aq rio
i � V-,
F'•9.�,•�y.
�ti
i 6�
� � �c
r I �\ �
f
0
-- � �u
t
LOT NO. ADDRESS:2 f Q*k +eioog Wd
.014NERS NOTE: rfo TogoTTo
SEWAGE PERMIT NO. AO,/,09 NEW: REPAIR:
DATES` ISSUED: ;?r2,,(-pQDATE INSTALLED:. TJOD 90
g.9�nnis
INSTALLERS NAME: HERS Sony
®Ts,
INSTALLATION OF: ®o�"i Tr�r►�:'l0�9,.��°nQi' `y�a' ronE
WATER TABLE: FINAL INSPECTION
DRAWING OF INSTALLATION ON REVERSE SIDE :
A -F S3 C
P�.0 a7'
`�39�
i Q
..:. ..
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
�...........OF... '.!< .................................
Appliration for Disposal Works Toutitrurtion Fumit
Application is hereby made for a-Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
.......
......... ....... ........................... .... .......-- _ --- ._..
-__- •--•ion-A dress ` or t Go. y
....................................
Owner Address
W '
Installer Address
Type of Building
Size Lot___154!�E4'.......Sq.
feet
�-, Dwelling=No. of Bedrooms........... ...............................Expansion Attic ( ) Garbage Grinder ( )
Other—Type of Building No. of persons........................... Showers — Cafeteria
a Other fixtures ----------------------------•--• -
w Design Flow................................jg. gallons per person per day. Total daily flow------ =10.........•..............._gallons.
WSeptic Tank—Liquid capacity126701u.gallons Length_«:' '__. Width__!�!.R~.._ Diameter----—..... Depth.S;.,'4."...
x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No.•-_____--�-___- Diameter... . Depth below inlet.....<...`.... Total leaching area.?.--• s ft.
� - -- - - P ••-- g �----- q•
Z Other Distribution box (/ Dosing tank ( ) _
aPercolation Test Results Performed by._/I�...�� `. V. —__..._._. Date_. -_cr'':�� ______________
,.,a Test 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..__-_-- __..
---------------------------------------------------------- ---------
Description of Soil - '' Y .......
x
w
UNature of Repairs or Alterations—Answer when applicable...............................................................................................
....-•--------------•--•-••----•----••--•-•--••••••••-•--••--•-----•-•-••-•--•-•-••-••--•-•--•---•-•-••---•----------•-------------•••-•-•--••••-------•--•••-•-•-•--•-•---••••--•••-••-............-•--
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage D's osal System in accordance with
�'1T�•1'^
the provisions of TTI of the State Sanitary Co — T undersi tiedff"t.h agrees not to place the system in
operation until a Certificate of Compliance has bee is b b rd o
�1 C
Signed--..... _. ...... ._ -------------------- •----------.Application. Approved BY-----. .. � .... � � ,-
Date
Application Disapproved for the following reasons-------------------------------=-----------------------------•------------------•-----------------.....-•-.._...
.............................................•------------------•----------••----------......--------------••••--•-•--•--•-•-•••--•-•-•----••-----------------•••-•••--•-••••-••----•••-•-•---••--------
Date
Permit No.... � �~ Z_.r.7,2.7................. Issued......................... = .r-A .........
Dsze
THE FOLLOWING
IS/ARE THE BEST
IMAGES FROM POOR
QUALITY ORIGINALS)
� ti•
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..................... ....................O F.................................................
Allp iration for Disposal Works Tattitratrtivat Prrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal
System at:
�.i 'moon-A dress , or t :io.
Owner Address
W
...........................•----'•-------...---------... •-----....------------------•-•-•----•-•-•--............__.......-------•-------.._.__...._--•--
Installer Address
dType of Building Size Lot___ : ' ..:=%...._..Sq. feet
U Dwelling—No. of Bedrooms.......... ...............................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building No. of persons............................ Showers — Cafeteria
Q' Other fixtures ----------••--• -•----------•-- ---
W Design Flow...............................`.. __gallons per person per day. Total daily flow......=L ..........................gallons.
G: Septic Tank—Liquid capacity�.�ry '.gallons Length._"?'�L'... Width.,:" `_ Diameter__-------- Depth_ ::..
Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No----------%---__-•- Diameter.._. %. ....... Depth below inlet..... .`........ Total leaching area.�:Z,Z....sq. ft.
z Other Distribution box (/) Dosing tank ( )
'-' Percolation Test Results Performed by..t`_`?-__e-_-__- ...........................C,1, ��'-'� % •''- ``--
a '--=•------------------------ Date. ......•-•�--------G-••-----•--•.
Test Pit No. ...... minutes per inch Depth of Test Pit... Depth to ground water.__...."-------------
Test Pit No. 2........7.._._minutes per inch Depth of Test Pit----- :........... Depth to ground water---------7:�:--____
W ------•---•--------------•••-•-••-•-•--•--••-•------••-------------••----•=-----------•....--.--.............................................................
0 Description Of Soil. 'c'a'._ his i'. l'-, ll. f' -.F '; .r r,. .? v ' /,7
x -• - --------------•....---------------••-
V ----••-•-•---•-••-----•---•--•----••--•-•--•-•-•----------------•-•-------------------•------•----•-----•••-•--•--••--------•------------•..._._
W
--------------------- ---------------------------------------------------------------------------------------------------------------•--------------------•-•--......................................
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:I .
p 5 of the State Sanitary CoWTundersi ned fu-ti vt agrees not to place the system in
operation until a Certificate of Compliance has been i � b rd o' 1 t
1/l�
Signede-^ . .-•........................... .........................._ -^ ..
01-1
Application Approved BY --..... --Date--'
Date
Application Disapproved for the following reasons: ............................................-•---•--••-------------------------•--•-----•--•-•-----•••--.-----
--------------------•-•------•-------••-...--•-•-------------.......•••------------.........•-----------.-------------------•----------------•-----------------••••----•----••----•--•-•-••-----........
_ Date
Permit No.---V&..-�- .. ���r--------------- Issued.......;7 '.--------
LSt
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......7o 1 n.............OF.......� rt�5. ... ...................................
vErdif iratr of Toutph attre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by...............••-••-••••------------------.._.......--•----------•-•--••---•---•--......._--------•--------...----•--•-•-•--••--------.....------•--..............--------........----•---------••-
' Installer
has been installed in ac rdance with the provisions of TI"'7.�r' 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No.��® �. .....2...._ dated._._ _.
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WI _ FUNCTION SATJWCTORY. /�
DATE----- `� ................... Ins ector-�:--_-�'_-..-- -------- --------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
...1.0� 1.! n...............OF......... ( /Z .f�......................................
Disposal Worko TwOnstrudioat umit
Permissionis hereby -granted...............................................................................................................................................
to Construct or Repair ( ) a Individual Sewage Disposal System
atNo.......ty ` r;3 -�i� -----------------•----.......-----------
tree,
as shown on the application for Disposal Works Construction Permit No..,A. � �Dated... ® ._._""'_��}
..........................•-•----•••--.. , .............................................
oard of Health
DATE................................................................................
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
_ --y
T,
4/ /37." 38:4 -{ - -
-6 hG 6 'pit
2O' —
if
W12 ' 4 tone -
2 Q 5 i_• i ' 1
.(ot 18
I
i
0 TP, -
4 4000 WA rE
.cap 17
-Pot Aaea - - -- -- , - +,_
} � ;
31.6
/4/.71 4 0.9 1.
N _.i_ t_i_1
i f
A.I,C Cc p e t nci�u:e�ri.►x�. -• - � � p N � ;'_�-�ea.�z +l "-"� � -
49 Ida at I`oad 10 9�
Id yarn i4, Ma. 02601 a . rl o.o .._
I �
3�
ep.t i c :lea uoz Ato •L& .No j
IL
Cat ima -Cow 3 30 d-Di,jpo,lr,t No
.aching, a4.ea 267
11 d N 1500 -
12",&we 267 7 a -!
i •,�
Capac.�.tr3 549 qpd "' ,� G S 944
part
�yd - �--� -
t.b ' �t.a a_ -
t.
-4 -?
Slaet.ch .Pta.z olf 1'and •ui C��:texu,%LCe, Mai, �_1 ,�
13ea oug. a tot l a4 ahow!g ors 'a &"v.1 d.p Can o� ;_ -
44
gowe t Id i,LZ dated `/2-5I aril .corded. _
I��watiopm a-te on ate` aaavmed'datum. } ; - t } '
l
Seat Pit #P-7523 ":
Made 2-9-90No wate�t ev>cow1te�ced tt fi t-; L
Peitc.2 min. peit
J v ,
! 2
7 t
coa�vs.e
COL /SP
37 r
to to
PtPcct lull �P�ZH } '" S . � �0 f
o E �� '•'
�N o.'32490
21.S ZyL
44 1-i
It i
4
APPLICATION FOR PER(':OLATION TEST AND OBSERVATION PITS
LOCTION ,��= ,�; NO.
��'r� t��•
DATE b
--_ .✓ __ FEE�lf
APPLICANTS✓i �� �. } � � (Non-refundable) .
1
ADDRESS � � G °°`� • f s�.✓,�/i TELEPHONE NO. 7f
ENGINEER•: ' ZCr_TELEPHONE NO.
DATE SCHEDULED Z,-Z-/!O- Cll ✓!'�
• (Applicant's Signature)
............... .....................................................
........................................................................ .
ASSESSOR"S MAP & LOT NO:
SOIL LOG ,
SUB-DIVISION NAME - 1,0 vJtEe, /^s'4,(__ DATE - ��'- �-'� TIME
`EXPANSION AREA:.YES V NO �� /� i��J� ENGINEER
.TOWN•WATER ZPRIVATE WELL BOARD OF HEALTH
°S. EXCAVATOR
SKETCH:...(Street name, etc., dimensions of lot,.exact location of test holes np.d percolation tests,
locate wetlands In proximity to test holes)
NOTES: I
I
i a:7
T
70-
77'
:OLATION RATE: ' �"� a ••
ELEVATION: TEST HOLE NO: ELEVATION:
HOLE NO. 1 P �411
• � 1 ;o� �' S��
2 2
__ s. _ —. . . . _
3
4
9 '��D 9
10 10 .
11
12 12 r '
13 � 13
14 14
15 15
16 ( 16 /
ACHING FIELD LE CHING PITS ✓'
TABLE FOR SUB—SURFACE SEWAGE: LE
LEACHING TRENCHES_
UITABLE FOR SOB-:SURFACE •SEWAGE. REASONS:
E: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION
3INAL:- COMPLBTED IN ENTIRETY BY R, E. AND BETU.NED TO BOARD OF HEALTH
y: RETAINED BY APPLICANT •
ACCESS COVERS MUST BE WITHIN INSPECTION 9" MINIMUM. INVERT ELEVATIONS : DESIGN CR I TER I A : GENERAL, NO TES :
6- OF FINISH GRADE PORT /3' MAXIMUM COVER
FIRST 2• TO INVERT OUT SEPTIC TANK: 96.2 DESIGN FLOW:
BE LEVEL INVERT IN DI ST. BOX: 9T,5•87 3 BEDROOMS AT 1 I0 G.P.D. PER I. THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION
9.0 INVERT OUT D I ST. BOX: 95.7 BEDROOM EQUALS 330 G.P.D. OF THE SEWAGE DISPOSAL SYSTEM ONLY.
4" DIAM PIPE 9 . CLEAN SAND BACKF l L L INVERT IN LEACH CHAMBER: 95,62
AROUND AND 2" OVER CHAMBERS BOTTOM OF LEACH CHAMBER: 94.7 NO GARBAGE GRINDER 2. VERTICAL DATUM IS ASSUMED. FOR BENCH MARKS
96. 95.7 // ' 11F SET. SEE SITE PLAN.
OAS / � 94.7 ADJUSTED GROUND WATER: N/A
BAFFLE 95.87 95.62 SEPTIC TANK REQUIRED:
6 OUTLET 20 HIGH CAPACITY OBSERVED GROUND WATER: N/A 330 G.P.D. X 200% - 660 GAL. J. ALL CONSTRUCTION METHODS AND MATERIALS AND
EXISTING D-BOX INFILTRATOR CHAMBERS BOTTOM OF TEST HOLE *l : 88.2 SEPTIC TANK PROVIDED: 1500 GAL. EXISTING MAINTENANCE OF THE SEPTIC SYSTEM SHALL
1500 GAL H-20 CONFORM TO MASS. D.E.P. TITLE 5 AND LOCAL
SEPTIC TANK HIGH CAPACITY CHAMBER
6" CRUSHED STONE OR SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS.
COMPACTED BASE `'?<� DESIGN PERC RATE ( 5 M/N/INCH
`y SOIL TEST P l T DA TA6i SOIL TEXTURAL CLASS - I 4. ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER
PROF l L E : NOT TO SCALE r'^ � ct - a AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER
' ! PERCOLATION __ INDICATES
NDI E S EFFLUENT LOADING RATE - 0.74 GPD/SF
THAN 3' IN DEPTH SHALL BE CAPABLE OF W 1 TH-
N " > - •, _ TEST ` GROUNDWATER 33O GPD / 0.74 GPD/SF - 446 S.F. REQUIRED
P:I4843- STANDING H-20 WHEEL LOADS.
TP r/ TP f2
PROVIDED: 20 HIGH CAPACITY INFILTRATORS
0' HORIZON TEXTURE COLOR 98.2 0" HORIZON TEXTURE COLOR 98.2 USING ACTUAL LEACHING AREA 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 PVC OR
LOAMY IOYR LOAMY IOYR APPROVED EQUAL.
A SAND 3/3 A SAND 313
BOTTOM - 12.$3'x 3!.25' = 400.9 S.F.
12' - - - - - - - - - - - - - - - 97.2 /0" - - - - - - - - - - - - - - - 97.4 SIDES - 31.25'x 2 x 11/12 - 57.3 S.F.
LOAMY IOYR LOAMY IOYR TOTAL - 458.2 S.F. 6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED
B SAND 4/6 B SAND 416
_ _ 95.7 458.2 S.F. x 0.74 GPD/SF- 339 GPD PRECAST CONCRETE OR APPROVED POLYETHYLENE.
Cl AAED-COARSE IOYR Cl MED-COARSE IOYR BOTH SHALL BE WATERTIGHT. D-BOX SHALL BE WATER
SAND 616 SAND 616 USING LOADING RATE ALLOWED BY GENERAL PERMIT TESTED FOR LEVEL WHEN THERE IS MORE THAN ONE
20 x 6.25'-125'x 4.73 SF/FT - 591 S.F. OUTLET.
44" 591 S.F. x 0.74 GPD/SF- 437 GPD
7. BEFORE CONSTRUCTION CALL 'DIG-SAFE%
1-888-DIG-SAFE AND THE LOCAL WATER DEPT.
FOR LOCATION OF UNDERGROUND UTILITIES.
12 ' NO WATER 88.2 12 NO HATER 88.2
8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE
NYD ��\ DATE: OCTOBER 13. 2015 DES 1 GN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION
I I I TEST BY: STEPHEN HAAS
1 I I I I OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE
I I WI TNESSED BY: DAVID STANTON
137E it it II I I Q PERC RATE: r 2 MINIINCH CONSTRUCTION INSPECTIONS.
1 1 1 I I
II 11 I I i 9. EXISTING LEACH PIT TO BE PUMPED DRY AND
CBIDH FND , /I Q CA 11 II I I BACKF I LLED.
ioo-- 13. 984} S.F. 11 i II
r
25' SM. CORNER OH
1 _�C0I4VENTIONAL Et-100.33
H `„ IREPLACEAENT AR EXISTING l I i 11
ro m 1 LEACH PIT
EXISTING
T +99.5 sEPrlc TANK DECK EX 1ST I NG
WE G
z Irn,
m 2a- K OS-L t N
1 \
/ ,� I
/ w / / I
22 \ .r. :.i :: SUN ROOM
1 I O
99.7 1 \ 1 1
C) 20'
W'• I I I � I a �>���
98.5+
A GARAGE
99.5
TPs2
98.5+
- UP 415-I
SHED \ �.�'�..- \ „ - - . - $ 14
S EP T I C S YS TE M LYE' S / ON
/ ORB FND 29 OAK R I DOE ROAD MAP l 1 8 . PARCEL 46
_ V
BARNS TABLE . ( OSTERVILLE ) MA
PREPARED FOR :
L EGENO
q� Q°gyp ■ CB CONCRETE BOUND MA R K F= L E7 T C H E R
-W WATER L l NE
O SCALE : l 20 OCTOBER 29 20 / 5
OCUS 'P°gyp HYDRANT
m
--G GAS L l NE � 1
OHW- OVER HEAD WIRES S T E P H E ! V /`"'^'� . H A A S
# LIGHT POST ENGINEERING , I NC
-E- UNDERGROUND ELECTRIC LINE `: P . O . B o x 16
a -T- UNDERGROUND TELEPHONE LINE
�N t -CTV- UNDERGROUND CABLEVISION LINE i�,i / 1 Sc) u t h D e n n i s MA 02660
�- r/� t{���'� ( 508 ) 362-8 'I 32
+40.4 SPOT ELEVATION
..---40------- EXISTING CONTOUR
L O C US MA P 0 I 0 20 40 94"01 PROPOSED CONTOUR JOB NO: 15-051