Loading...
HomeMy WebLinkAbout0080 WEST STREET - Health 80 West Street Osterville A=.139-071 / 1-7 { No. Fee 90- THE COMMONWEALTH'OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS „— J�Ilication for ]Disposal 6pstQUn ConstructI0nverttYlt Application for a Permit to Construct(ter-Repair(ji) Upgrade( ) Abandon( ) Eltomplete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No.. Assessor's Map/Parcel 139 —611 Installer's Name,Address,and Tel.No.-j a 7?GY 7 7 De gner's ame,Address,and Tel.No. / CCA,0 12a11/� = AT rjzfow $-A 4_33 Type of Building: Dwelling No.of Bedrooms Lot Size ��i6�� sq.ft. Garbage Grinder ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided (e(a gpd Plan Date Dkconla.r 31. Zut3 Number of sheets Revision Date Title 5 W/N I YWA Size of Septic Tank GOO k1 Type of S.A.S. 5•'sto A Description of Soil:V§m rm`a 0-s,hie ue*iZ, i111to swo tole,Z1% W-N C tl"M mF D w-7 MCI Z 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 (,pmpliance has been issued by this Board of.H'eart4 ed'- Date Application Approved b Date Application Disapproved by Date for the following reasons Permit Date Issued 1b No:f�CJ w Fee THAZOMMONW'AL 'OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Application for a Permit to Construct �Re a r<' U rade -' Abandon om lete System Individual Components pp (�� p (t) pg ( ') ( ) E p Y ❑ p Location Address or Lot No. Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 169 -61 t Installer's Name,Address,and Tel.No.-!51 Uv c'/77G%e /7 7 Des gner's Name,Address,and Tel.No. Sv1� �titiv'ttuV3 Sn.. l c+�i G /� pos�crv�1 S�1iA uZ� Sod-`t 1 v-33 Type of Building: Dwelling No.of Bedrooms (Q Lot Size i��(oZ,B sq.ft. Garbage Grinder 0) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures (a.Design Flow(min.required) �D gpd Design flow provided Q. (0 gpd i Plan Date�Qc�,,\�3l. 7-at3 Number of sheets 're—V 0mDate— Title S t yC R-,�n ynpq!iA Q�NZyvVQ�\�j ` - Size of Septic Tank ISOa kS Type of S�A.S. 9-- AO Q-A tVjw\WS 1 ti 1Z.40"Y,5b"*G" Description of Soil 13a8Z� C1'�1�� l��E 1.ttY� SNK) IWQ,Z11 " F Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: k 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 - mpliance has been.issued by this Board a t . e Date ::5 _:C /7 A plication Approved b Date j Application Disapproved by Date i for the following reasons Permit No. �G —�/y'7 Date Issued /kj --- ----------------- ---------------------- - --- ------------ --- - —-------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS i Certif itAte of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(---) Repaired( ) Upgraded( ) i Abandoned( )by at 60 lae mJ,05\,x-y has been cops r c �rg ance with the- provisions of Title 5 and the for Disposal System Construction Permit T�. i ce�'�''�dated �� Installer #bedrooms �� Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the syste as de 'gned. Date _ Inspecto - - - - - 1 - - - - - - -- - - - - Fee- 1.6 --TH'E"COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstem Construction i3erm[t Yg ('� p ( ) Upgrade( ) ( ) Permission,is hereby granted. \_ Repair rade Q U Abandon System located at cyD W C)trc. , 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'con'ditions. ,, ovided Construction must a co pieced within t" ee year of the date of th A�perrnit. pp Date 3� 1P A rov Town of Barnstable `"E'O'�'b Regulatory Services Richard V. Scati, Interim Director + BARNSTABLE, MASS. Public Health Division 0390.iDrFn " Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form q Date: U I �� Sewage Permit# Assessor's Map\Parcel Designer: SuA1t'N4h � ;k�r Installer: ;eoh S KCRva4!d� Address: 7 park" kol /Po 8,-X Address: AA /2a On 12 -i 0116 !(oh`S L''Kc9v��;b� was issued a permit to install a (date) (installer) �r ,nr ` ` - septic system at V y Q T ST, based on a design drawn by CA (addr ss) SLI dated Zl1L i� 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 ' ce with the terms of the RA approval letters (if applic ble) �S�of ss� L `yam g R WLAND o IVIL (Inst er's Signature) v r - SIONAI. ' r (Designer's Signature) �;- - '(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 BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASeptic\Designer Certification Form Rev 8-14-13.doc 44-- '�Coo[� I J TO of Barn sabie :p Department of Regulatory.services' f bPubhc Health Dinsion d . )>++nss Date t� / rEo 39. 200 Main'Street,Hyannis MA 02ti01 1 Date Scheduled Time /: _ Fee P d. ►soil S ,da 40 Assessmentfo S a e Dis o By: -C r % p sal Performed Witnessed By: LOCATION&GENERAL INFORMATION C, C� f IV e rx, .:. ;✓/, Location Address , �j� GI%laST eT' /}r Owner's Na 1 ji 1V-5 l�jf/reLt �%,4�,t L AddressU l Uey7- Sf As Map/Parcel 2 ds /1^Y l3� 7I Engineer'sNamc.Sw/1V(I/ I��tr/d f. NEW CONSTRUCTION i� REPAIR r LI Telephone# Land Use:_ � Slopes Surface Stones �f/C ►.�' Distances froOpen Water Body f1 possrblc.Wet•Area tt Drinking Water Well ft Drainage Way -_—ft Property Line Other ft S]KC'TCIi:(Street name,dimensions of lot,exact locations of test holes&:perc tests,locate wetlands In proximity to holes) "90 Parent material(geologic) Depth to Bedrock Depth to Oroundwater. Standing Water in Hole: �--� Weeping from PI Fpce /Uo4 Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL MGTJ WATER TABLE Method Used: Depth Observed standing in obs.hale In. Depth to$gll mottles] 1n. Depth to weeping from side of obs hole: In,, Ornundwater Adjustment f, Index Well# Reading Date: Index Wcll igvel �'A ,factor ., dl -Adj.Groundwater Level PERCOLATION TEST b�tp 12 s� ,tyn,e° wo Observation Y Hole# � ..... .-.-- Timo at 9" nn — Depth of PC' 3 Time at G" Start Pre-soak Time @ 0' Tim©(9"-G") End Prc-soak . 5`OU 7'1y Rate Min./inch _<22ai4 5;, ,2A Site Suitability.Assessment Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division - Observtition Hole Data To Be Completed-on Back-------- ***If percolation test is to be conducted within 100' of wetland,you must first no the Barnstable Conse vation Divisio t na 1�' east one(1)week prior to beginning, Q:1SE PTICIPERCFORM.DOC I)EEP.OBSERVATION HOLE LOG Hole#_f Depth from Soil Horizon. Soil Texture .Sdil Color: Soil• Other Surface(in:) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. i ten Y.Y6'Gravell DEEP OBSERVATION ROLE LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil. Other Surface(in.) (USDA) (Munsell) - Mottling (Structure,Stones,Boulders. f, o is en %G e .4-41 wYf� lz DEEP OBSERVATION HOLE LOG Hole# 3 Depth from Soil Horizon Sol)Texture Soil Color Soil Other' Surface(in.) (USDA) (Munscil) Mottling (Structure,Stones,Boulders. Consistency, Gravell IL 6iv C z�� v R DEEP OBSERVATION ROLE LOG Hole# _ Depth from r Soil Horizon Soil Texture Soil Color 5011 Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Cositn p. ��� /v1. SQ It,Yq ZI/ _ Flood Insurance Rate Map: Above 500 year flood boundary No— Yes Within 500 year boundary No Yes ~ Within 100 v r flood boundary No.� -Yes- Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious_rniterial exist in all areas observed throughout the area proposed for the soil absorption system? pervious atarial1If not what is the depth of naturally occurring Certification 7&// r xamination a roved b e I certi that ondate I have assed the soil evaluator a th fT (date) P PP Y Department of Environmental Protection and that the above analysis was performed by me consistent with; the required trainin ,expertise and experience described in�10`CMR 15.017. �. Signature Datt; 1,, ,� Q:1S.EPT0PERCF0RM.DOC �0 (f (J UV � • wiz . Tow' of Bar P#nstable V� VIE ' Departznient of Regulatory Se, ces >< �,B� r Pubhc Health D;<vision Hate o� MARS. 200 Main Street,Hyannis MA 02601: • Date Scheduled Time - Fee ee Pd. ► oil;Sditaba� ty Assessment for ►� ' age l�ispostal / , Performed•By C�� Witnessed BY: V LOCATION&GENERA,L M1 ORMATION.Csixtt,,e f N-e jIlt_ I.bcauon Address G1/6-5T ST , Owner's Name ,�.ti+C--S t�r/✓�'Ge;v�:,gµr� L fie_uy�r I Address. Os4u i /Jr,.�l1 UvaL S ,- Assessor's Map/Parcel !'3.9 .t 7� "• Engrncer'sNamc j; l NEW CONSTRUCTION r �^ REPAIR' Telephone# hand Use: �rLf (i/�"r?L Slu_:.CS 96 �Ad S P ( )f r•, , �; •, urfaceStones` Distance§from: open Water Bat + - p y ft Possible VYet Area n Drinking Water Well, ft ` I Diatnaga Way ft Properky I na 1 St' ft Other ft • i 1 SIMTCH:(Stine[name,dimensions of lof"exact Ibcationsrof[eat holes&per:teats,locate wetlands In proximity to(roles) I p , I,• - - ' 1 r f I • I` Pb I j • .. 4'.. 't y'.lt' i "3a i 1� �� •i,;E! t r+', �� ,'''t'�� 2Ty�+ ;�� r , ., � i:, - - ' .tit`4 C vx' aft,Ir •�..t N• ?f r a"Ji"P ° k LlY . •fir y `V,r, 1 .''..t {F !'yay9,{C ss e.r ,�•Y y� r 0. rt Pareut material(geologic) �f/�wc2 5�i Depth to Bedrock Depth to Groundwater. Standing Water in Hole " Weeping from Plt Food, tio� Estimated Seasonal High Groundwater DETkI M NATION°FUR SEASONAL)MGM WA,'i'ER TAK + 0 ` ' Method Used. Depth•Observed standing in obs°hole: Iu,. Depth tr)sgll tnottlest hL 'Dcpth to viceping from side of obs:hole: 'In, ©routitiv+gter AdJutlftne nt f1: Index Well#: Reading Date . -:. Index Wp11 level _ _,._ Adj,f toot Adj.Groundwater LeYr I PRCOL,A XON'�FS r/Loo > - T T DR 12 a-9 ')t'icuu Observation Hole 4l .n Tinto at y" Depth of Perc 3 Tlmc a[61 Start Prc-soak Tlma 'TIM0%(9 End Pre-soak 7.1y RateM(n:/Inclr 4,p 2i►i, ice, Site Suitability Assesstuent: Site Passed. r� Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed-on Back- ------�= ***If percolatiou test is to be conducted witIuu 1.00' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\S EPTIC\PERCFORM.DOC DEERIOBSERVATION HOLE LOG Bole .. Depth from Soil Hhriz ri Soil Texture Sdil Color Soil• Other Surface(in:) : ' °a(USDA) ' (ivlunseiq Mottling (Structure,Stones;Boulders. toY.96'(irayel) (� [ a, 1T L, € 59<IL{ /Q 5giro� +G�S IF t i I' � i• O]�SER�ATION HOLL LOG Flole# 2 Depth from Sol'Horizon,. Soil Texture Sall Color Soil Other Surface to . � i { : .I (USDA) •• _.(Mansell) , . =Mottling.`. (Structure,Stones,Boulders. o ed e 9 !s " i. s/6 { I - ; DEE OBSERVATION HOLE LOG--��' Iole# ` 3 Depth from f Soli Horizon` Soil Texture Soil Color Soil }" Other l (USDA) (Munsell) Mottling (Structure,Stones,Boulders. • Surface(In , E 7• 'r �. :� .t. 0 Ol to O (3 19 16 i t . t •i • DEEP OBSERVATION HOLE LOG dole# Depth from : Sod Horizon' Soil Texture - Soil Color Soil Other Surface(in.) I (USDA) (Munsell) - Mottling (Slrticture,Stones;Boulders.. ,. a / Co si t 0 r Ifr`�' r - ,^, ;59 '.a` lb yi;, Z/� ► •`�s t- /'" I .,I Flood Tnsiirance.RateMap:` _:Above 500 year flo4:i boundary No— Yes _-- - - Within 500 year boundary No _ Yes Within l!00 Year flood boundary No. 'Yts , Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious titerial exlst in all areas observed throughout the area proposed for the soil absorption system? If not,what is the deptlrof naturally occurring pervious matarial t �.. . . Certification j . 1 Lcertify that onj 7 !! P-0 f.'Z (date)I have passed the soil evaluator examination approved by the S Deparkment of Environmental Protection and that'the above analysis was.performed by me consistent with' the required trainin expertise and experience described in 110 CMR'15.017. 2 +` Y- Date sp Signature Qi\Sl?PTIMF.RCFOftM.DOC Y € .. I t : 1 t 1 COMMONWEALTH.OF MASSACHUS.ETTS.` EXECUTIVE OFFICE'OF ENVIRONIVIEIVTAL.AF.FAIRS s DEPARTMENT OF ENVIRONMENTAL PROTECTION { _ - .. TITLE..S OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION a Property Address: 80 West Street i Osterville.MA 02655 Owner's Name: Janes Biv-hn aine �7 Owner's Address: I V Date of Inspection Afiri1.27:.20 '2 Name of Inspector. (Please:'Print)..James M. Ford Company Name: James M Ford A Mailing Address: P.O.`Box:49 . Osterville'M'4` 02655-0049 Telephone Number: (508) 8624400. j CERTIFICATION STATEMENT' I certify.that I have personally inspected the sewage disposal system at this address and that the.informationregorted± 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.ao Section 15.340 of;Title 5(31;0 CMR 15.000). The.system; asses ;4 onditionally Passes eeds Further Evaluation by the Local'Approving Authority, ails . Inspector's Signature: Date. ._ .May 1.2012 . i The system inspector shall sub t a copy f this inspection report to the Approvi Auihority'(Board of Health o,r DEP)within 30 days of completing this inspection. If the system is a shared system,or has a design floe; of 10;000 gpd or.greater,the inspector.and the system owner..shall subinit`the report to•the appropriate regional.office of.the . r 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 ****Tliisreport onlydescribes:conditions at the time of inspection:and under the conditions of use at that time..This inspectioii does not address how the system will perform m the future under the same or different conditions of use. ' Title 5 Inspection Fonn 6/15/2000p.agel.age 1 Page 2 of I x' OFFICIAL INSPECTION FORM-.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION` (continued)' s Property Address:. 80 West Street ' Osterville MA Owner: _ James Burlin ame i % i Date of Inspection: - April 27, 2012 r I Inspection Summary: Check A;%C,Wor E/ALWAYS complete all of Section D A. System Passes:, f ✓ I have not found any information which indicates that any of the-failure criteria described in 310 CM R E 15.303 or in 310 CMR:15.304:exist. Any failure criteria not.evaluated are indicated below. I Comments: s B. System Conditionally Passes:` One or more system-components as described in the"Conditional Pass" section need to be replaced or, repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements.:If"not determined";please explain. The.septic tank is metal and over 201years old*;or the septic tank(whether metal or.not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank.failure is imminent. System will pass inspection the } existing tank is replacedwith a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leakin and if a C p nce g erti icate of Com lia indicating that the tank is less than 2.0 years old is available:, - ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or ' obstructed 1 pipe(s).or due to a broken;settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced s ND explain: The system-required pumping more than 4:times a year due to broken or obstructed pipe(s). The system will pass inspection,'if(with approval of the Board of Health):' broken pipe(s)are replaced obstruction is removed ' ND explain 2 i - Page 3 of 11 OFFICIAL INSPECTION;FORM NOT FOR VOLUNTAR Y ASSESSMENTS ll SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A F CERTIFICATION,..(continued) ;a Property Address: 80 West Street) t Osterville.MA . Owner: James Burlingame Date of Inspection: Abri127. 2012 i C. Further Evaluation is Required by the Board of Health, �- Conditions exist which require f irtlfer'evaluation by the Board of Health in order to determine if the`system.- is failing to protect public health,safety or%e environment. f 1. System will pass unless Board of Health determines in accordance.with 310 CMR 15.303 (1)(b)that the . i system is not functioning in a manner which will protect.public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water " Cesspool or privy is within 50 feet.of a bordering vegetated wetland or a salt marsh` i I , System will fail unless the Board of Health(and Public Water°Supplier,if any)determines that,the system is functioning in a manner that protects the public.health;.safety and environment The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surfamwater supply or tributary,to a surface.water.supply. ' The system has a septic tank and SAS and the.SAS is within a Zone a of a public water supply ; i l The system has a septic tank and SAS.and the SAS is within.50 feet of a private water supply:well.' r The system has aseptic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a. private water supply well**.:Method used to determine distance "This system passes if.the well water analysis,performed.at a DEP certified laboratory, for coliform bacteria 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.; . l II a ;{ .3• ..Other 3 e 1 , 1 s Page 4 of 11. OFFICIAL INSPECTION FORM=NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE,SEWAGE;DISPOSAL SYSTEM INSPECTION FORM n E PART A CERTIFICATION (continued) h Property Address: 80 West Street` j k Osterville.MA _ j Owner: James BurliUaine Date of Inspection: Avril 27. 2012 D. System Failure Criteria applicable to all:systems: You must indicate either"yes"or"no to each of the following for,all.inspections:. Yes No _ ✓ Backup of sewage into facility or.system component.due to overloaded or clogged SAS or cesspool _ ✓ Discharge or ponding of effluent.to the surface of the ground or surface.waters due to as overloaded or ' clogged SAS or cesspool ✓ Static liquid level in the.disfribution box above outlet invert due to an overloaded or clogged SAS or cesspool t ✓ Liquid depth in cesspool is less than 6' below in 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 i gg p p ( ) ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation ✓ An portion of cesspool or— . y ri p p p _vy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of°a cesspool or privy is within a Zone 1 of a public well. ✓. Any;portion of a cesspool or privy is within,50 feet of'a private water supply well. j ✓ 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 thati the well:is free from pollution from that.facility and.the presence'of ammonia Q nitrogen and nitrate:nitrogen is equal.to or less than 5 ppm,provided that no other failure`criteria r are triggered.: A copy of the,analysis must.be attached.tothis form.] No (Yes/No)The system fails I have determined that one or more of the above failure criteria exist as i described in 310 CMR 15 303;therefore the system fails. The system owner should contact the Board of Health to determine what i-vill,be necessary to correct the failure. l E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• ; t You must indicate either"yes or"no"to each of the following:. i (The.following criteria apply to large systems in „addition to tlie.criteria above) Yes No - _ the system is within 400 feetof a surface.drinking water supply — _ the system.is within 200 feet of a tributary to a surface drinking water supply — the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area IWPA)or a mapped . Zone II of a public water supply well , If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section.D above.the large system has failed.. The owner of: tor of any large system considered a significant threat under Section,E:or failed under Section'D.shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4: Page 5 of.11 OFFICIAL INSPECTION FORM,NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST. Property Address: 80 West'Stjeet Osterville MA 4 t Owner: James Burlinizaine. Date of Inspection: Anri127: 2012 i Check if the following have been done: You must indicate,"yes"or"no"as to each of the following: I Yes No ✓ Pumping..information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the.previous two weeks'? Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ' ✓ Were as built plans of the system obtained and examined? (If they were not,available note'asN/A) { ✓ Was the facility or dwelling inspected for signs of sewage back up-? r ✓ Was the site'inspected'for-signs of break out:?' i Were.all system components;;excluding the SAS,located on site? j ' , { ✓ — Were.the septic tank manholes uncovered,opened,and the interior'of the tank inspected for the condition of the baffles or tees,material of construction;dimensions,depth of liquid,depth of sludge and.depth of scum.? ✓ Was the facility owner(and occupants if different from owner)provided with in: on the proper maintenance of subsurface sewage disposal systems? ' 1 The size and.location of the Soil:Absorption System_(SAS).on the site has been determined based'on: } Yes No i ✓: 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)]. . j 5 • I ' u .:. Page 6 of 11 l OFFICIAL INSPECTION FORM-NOT.FOR VOLUNTARY' ASSESSMENTS J SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION t Property Address: 80 West Street Gsterville.MA ' Owner: James Burlingame Date of Inspection: Anri1:27:2012 FLOW CONDITIONS i RESIDENTIAL , Number of bedrooms(design): 2 Number of bedrooms(actual): :..2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 Number of current residents: 1 t Does residence have a garbage grinder(yes or no):,, N/a Is laundry on'a separate sewage system_(yes or no): NI [if yes separate inspection'required] Laundry s stem inspected,Y. , p (yes or no): :1zo Seasonal use(yes or no): no Water meter readings,if available(last 2 years usage(gpd)):. Unavailable Sump Pump (Yes or no): No Last date of occupancy: Cyrrently COMMERCIAL/INDUSTRIAL ` Type of establishment: Design flow(based,on 310 CMR 15.203). gpd Basis.of design n fl s g ow(seats/persons/sg/ft etc;.):, Grease trap present.(yes or no):. Industrial waste holding'tank;present(yes.or.no) Non-sanitary waste discharged to the Title 5 system(yes or no):. ` Water meter readings,if available: Last date of occupancy/use.: e OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unavailable Was system pumped as part of the insp ection(Y es.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 t Single cesspool Overflow cesspool Privy Shared'system(yes or no) (if yes,attach previous inspection records,if an Innovative/Alternative technolo y)c 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,date installed(if known)and source of information:. Date of installation 8/ M ver as-built card Were sewage odors detected when arriving at the site (Yes or no); No: i r k Page 7 of 11 OFFICIAL INSPECTION FORM'.-NOT FOR'VOLUN I'ARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM j PART C 4 SYSTEM INFORMATION.(contiriued) i Property Address: 80 West Street Ostervilk MA Owner: James Burlin anre - { Date of Inspection: April 27, 2012 i BUILDING SEWER(locate on site plan). Depth below.grade: Materials of construction: _cast iron 40.PVC other(explain): i Distance:frorn 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: 8" t - Material of construction: ✓ concrete. ° metal _fiberglass._polyethylene - _other(explain) - �.: , . , ; �"` If tank is:metal list age: Is age confirined'by a:C.ertificate of Compliance(yes or`no) (attach a copy of certificate) :Dimensions:, _ 1000Qa1: ; Sludge depth:. 2 Distance from top of sludge to.bottom of outlet tee or.baffle: 30" Scum thickness: 4 Distance from top of scum to.top of outlet:tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle:' 10 How were dimensions determined: `Mecisu�inQ stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural.integrity,liquid levels as related to outlet invert;,evidence of leakage,etc.). The tees were present. The liquid level w:as even with the outlet invert. There did not a ear to be any.signs oLleakagag. GREASE'TRAP: None (locate on site plan) Depth below grade: Material of construction: —concrete:_metal' fiberglass _polyethylene her (explain): Dimensions: Scum thickness: Distance from top of scum to top.of outlet tee or baffle:. Distance from bottom of scum tobottom of outlet tee o.r baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle,condition,structural in liquid levels as to outlet.invert;evidence of leakage,etc) Page 8 of 11 OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY.ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM` PART C. 'y SYSTEM INFORMATION(continued) Property Address: PO West Street '- I Osterville MA ' y Owner: James Burlingame Date of Inspection: Anri127. 2012 { TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection).(locate on site plan) Depth below grade: Material of construction: _concrete:_metal fiberglass'_polyethylene _other(explain): Dimensions: Capacity: eallons Design Flow: gallons/day Alarm present"(yes or no): Alarm level: Alarm in.working order.(yes or no) Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓'° (if presentmust be opened)(locate on site plan) Depth of lipidlever above'outlet invert: Even Comments(note if box is level.and distribution to outlets equal,any evidence of solids carryover,any evidence of. leakage into or out of box,etc.): ` The poly D-box was normal no si,-n of failure froni'leach field., PUMP CHAMBER: None (locate on site,plan) Pumps in working.order(yes or no).- Alarms in working order(yes.or no) Comments(note condition of pump chaimber,,condition of pumps and appurtenances,etc,): _ 4 8 ' Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C . SYSTEM INFORMATION(continued) Property Address: 80. 7est Street » Osterville MA Owner: James Burlinyanie Date of Inspection: 4yril27. 202 R j ;SOIL ABSORPTION.SYSTEM(SAS): ,' ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type - r, leaching pits,number:. leaching chambers,number: ✓ leaching galleries,.number: 3-infiltrators'ver asbuilt leaching trenches;number,aength: leaching fields,number,dimensions:: overflow cesspool,number: Irmbvative/alternative system Typefname'of technology:. Comments(note condition of soil,signs:of hydraulic failure;level of ponding,damp soil,condition of veetation,etc.):: r _There did not appear to be any signs of failur e g CESSPOOLS: None (cesspool must be.'pumped as park 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 groundwater inflow(yes or no): Comments (note condition of soil;signs of hydraulic failure,level of ponding,.condition of vegetation;etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs.of hydraulic failure,level of ponding,condition of vegetation,'etc) f 9 i 1 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM i PART C SYSTEM INFORMATION (continued) Property Address: 80 West Street Osterville MA . Owner: James BurlinQmnze Date of Inspection: April 27. 2012. SKETCH OF SEWAGE DISPOSAL SYSTEM.t 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,entm.the building:. A- , ao n a 3 � 33' �5 o e y 3 Sa a�' .. 10 i Page 1.1 of 11 4. OFFICIAL INSPECTION FORM:-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C . ''E x SYSTEM INFORMATION(continued). Property Address: 80 West Street Osterville.MA i Owner: James Burlingame Date of.Inspection: 4pril 27, 2012 j . t SITE EXAM .. Slope Surface water Check cellar Shallow wells - Estimated depth to ground water 20+7= . feet Please indicate (check)all methods used tq 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'local•Board.ofHealth-explain Topogravhic and water contours mays Checked with local excavators,installers-(attach documentation). Accessed USGS.database-explain' You must.describe how you established the high ground water,elevation: Using Barnstable topographic and water contours mgL the neaps were showing approximately 20 +/ to ground water at this site. r This report has.been prepared oiily for the-septic system and comporier:tsdescribed herein. This septic system has been' inspected and passed as of the date of tiispection..This report is not warranty orgiiaraittee that the system will fiuiction pr•opei-ly in the future. T/iere ha.ve'been no warranties or guarantees;.either expressed,written:or impliedI relating to the septic system, the ilispectiori,this,reportandlor:any components of the septic system which have not been located and inspected 11 ::. -71 ®� K � ............... THE COMMONWEALTH OF MASSACHUSETTS APPROVED BOARD OF HEALTH ft=tZ---k=ftXMnnZTOWN OF BARNSTABLE Wi urk.6 T> witrurtion Famit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal S stem at 777/7///���I FF `C/ ! -.... ........... lye_•.._.�1_.._.. Lortt -:\ddress or Lot No. u.�..l \ ................................................... EF•`1-- .f ��' 'er� �v a�[1d$ress ,a114 -- ---------•--•. (-....•• -•-••- ---_-- "--�!�•-•---•-•---.... •••----••-----•----••••----...-••--......•..•-- Installer Address Q Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ------------------------------------------------------------------------ -------------- ---•-----•-•-----•----••---••----•-••....••---............... W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length------------- - Width.....----------- Diameter---..-..-_----- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No-------- ------------ Diameter.................... Depth below inlet..--................ Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by------- ------•-------•...........----••--•-•--•---------•----•-•--•-•••-• Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GZq Test Pit No. 2................minutes per inch Depth of Test Pit...----............. Depth to ground water.....................--. P4 .... ----------------------------------------------------------- •........ -•--•--------------- ........ ... --------- -.................. ..... ------ ---..---------- 0 Description of Soil......................................................................................................................................................................... x x --•--•......------•--•-------------------•----•-••-------•----------•-------•---...................=------------/- _ -------- . ..... - U Nature of Repairs or Al erations— swer when applicable.......- .�. S -.. ........................ 00 [....�.............. E-.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance ssued 4befie boarfl of healt . Signed ... ....... ... ..... .......: % ' �.......... —� ApplicationApproved By ................. .... -- 2�............................................................................. .... ----.----- Application Disapproved for the following reasons: ....................................................................... ..... .. .......................................... ...................... . . ................................ - - .....................................................................--............. -- . ... ........................................ q Date PermitNo. ........1..3�...V.4..' ..................... Issued ......................................................----.......... Dme iy �..4j..�. ..�. �y��.+.+�:-� .+.+`..r y�-M_..�,y.- Y �„i<-`e.�-''v-••-vr�v--•.v..—•. r �._ v.`�,,:minas,�.-.;--w..,rvr,...v'<„�'..` .-... .. Sw--H a' d.. _rr ry __ fh a A. (5 7 - O� NO.. -.1.�.�" Fss:. D................ f THE COMMONWEALTH OF MASSACHUSETTS f BOARD OF HEALTH 1/ ; i TOWN OF BARNSTABLE.16-77� 1 7-AVv1uttti1 n fur Dt.5pl` .sa1 Wurbi Tomitrnrftun Prrutit t Application is hereby made for a Permit to Construct ( ) or Repair ( �-) an Individual Sewage Disposal System at: .............................................o '5t.•..... -------------•---•-••-. .......................................................J t l-� .................................. Locat' c -:\ddYcss or Lot No. ............q /�/ r Oar crw��/9 /5 /y/—/� [}j Installer Address Type of Building Size Lot............................Sq. feet 1-4 Dwelling— No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) e a Other—Type of Building ............................ No. of persons.........:---------......... Showers ( ) — Cafeteria ( ) dOther fixtures ..................................................................................................................................................... I, W Design Flow...........................................gallons per person per day. Total daily flow..._-_-_--.._--__--__-..._..........___..gallons. Septic Tank—Liquid capacity-__-.----__.gallons Length---------------- Width................ Diameter---------------- Depth................ W Disposal Trench--No. .................... Width.................... 'Total Length.................... Total leaching area....................sq. ft. x Seepage Pit No.................:... Diameter.--_-._---._ ---.--. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) `~ Percolation Test Results Performed by.......................................................................... Date................................. •...... Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a --------------------------- -----------------------•--••-...--------------------.....------•-•-•----------•-•---........_...._-----.....__....-----.......... 0 Description of Soil........................................................................................................................................................................ x x ----------•--------------- -----------------------•-.................------------.......----- ................ ------- ••--------•--- --•-•- U Nature of Repairs or Alterations—Answer when applicable.-_-.-._ U ._�-CJ. ......._. _t� ��P� Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance-hras be -n�sued by fhe board of health. Signed ..1�/�/�,- �e;/ �� f:-.L % � �J Application Approved By ................ d ...� .. .. _., ....... ...................... ... .. ....... Nre ................................ /. ... -.._ Application Disapproved for the following reasons: .......................... ........ . ............................ .......................................... .. q - Dace � i Permit No. 7-3.-.... ----------------------- Issued ........................D.. .......................................... • arere � ��-.-- ------:_———— --�-o.�-�.- -._.s.m — ®�..s.�_.� _.__—s---,--_-_._..•..re._..------— ——— --. .w THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (IT difirate of Cfomplianre THIS IS T -C!ERTIFY/That the In idual Sewage Disposal System constructed ( ) or Repaired y .........................l------------ ---------------------------------. ................... ............................... at ....v�� ................f... ./f S/ - ` _.C... .�"......J!.......I. ....... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ... 7J,_�f!> ...._.... dated ........................................._. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. .............. ...1.= Inspector ---------------- DATE ........... ... ......_.... .............._ _--_- ---.__,_,-------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE © G No..`1 .-_. a FEE �1................. �Permission is hereby granted_ �/,f, ��n--------------- ---- f.---------------..--.------------•-------------------.----..---- to Construct ( ) or Repair ( an Individual_Sewage Dis osal_System C) c at No. v� !'C�F ••---•--�� S�r�/tom qq �Jf._... ��-------.......................................... shown on the application for Disposal Works Construction Permit No.l_•YOrl__ Dated........................................... g B DATE-----•-•---..�----.�."__/...-�------------------------------ . oar d of H ealth FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS TOWN OF BARNSTABLE �,(�,4 OCATION e 5+ S+ SEWAGE# to 4(t `VILLAGE �-�-���j ,¢_ ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. �pYtac CcxJQiQ�a SEPTIC TANK CAPACITY 15*V LEACHING FACILITY: (type) 5k !f�00 (size) X �J� X Z NO. OF BEDROOMS OWNER PERMIT DATE: G 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 an tlands exist within 300 feet of leach Feet FURNISHED z _ _ G 3Z3 " 5 49' k TOWN OF BARNSTABLE ` LOCATION MO - SEWAGE # �� VILLAGE 't��/y ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO.U,Zj� O 510 SEPTIC TANK CAPACITY (j LEACHING FACILITY:(type) fRil �®tdr-S (size) NO. OF BEDROOMS, PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER (} U\ DATE PERMIT ISSUED:`; .� DATE COMPLIANCE ISSUED:�j! '—� VARIANCE GRANTED: Yes No J _ . i� �� � � � .. 1� '� �+ � � ��® o � a / S �� � ,� � � � �°a . .. , . , �. r���� /����s TOWN OF BARNSTABLE - UNDERVROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. ADDRESS OF TANK: V I LLAGE: A,5)2 Y1z Number ®trmmt MAILING ADDRESS ( IF DIFFER/E�NT FROM ABOVE) : /J OWNER NAME: 4 D /1�'�✓� � PHONE: 7Ad-; r YAa Z INSTALLATION DATE: - BY: INSTALLER ADDRESS: _ CERT.NO. *TANK LOCATION: (DROCR I 0= TANK LOCAT I Oyu W I TH MKORM.CT TO �LJ NO CAPACITY TYPE OF TANK -5G EiFL AGE ���r/ YRS. FUEL/CHEMICAL TESTING CERTIFICATION C ] PASS C ] FAIL DATE T LEAK DETECTION [ P CHECK IF N/A TYPE/BRAND �UA&r Of / Ood,-�C Ti9/VA ZONE OF CONTRIBUTION C ] YES [ P!] NO DATE TO BE REMOVED '2 FIRE DEPT. PERMIT ISSUED [ ] YES C ] NO DATE CONSERVATION Ek CHECK IF N/A DATE BOARD OF HEALTH TAG NO. [ ] DATE * PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD _. .,�. ,. -i• t{ t4�r...,,�3.�P-•. Vic-:,..�i 4:.�- �i.fi 1:,�,'aG+..,..n... �-. 'J;" •F +",,:s .y TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL ,.STORAGE REGISTRATIYON.', MAP NO'. —% ' PARCEL NO. ADDRESS,'OF TANK: 0 41.' -- -- -"- :V I LL-AGE':" 41 2- .E J 1 Num ba r^ atr.040t 1,+ MAILING ADDRESS (,IF DIFFERENT FROM ABOVE) : OWNER NAME P6 N.A A. 2) �1 < <, . �. t :t PHONE: !41 , i • INSTALLATION DATE: I KISTALLER ADDRESS: {.1" r *TANK LOCATION: (OMOCR I OM TANK-L:OCAT I ONE'"�W I TH-F4K=PKCT TO �WU ILo ITVO)- 3 t CAPACITY TYPE OF TANKS AGE 'Wl YRS. FUEL/CHEM I CAL 'L1 /.. ;I - "7 7 TESTING CERTIFICATION [ ] PASS [ ] FAIL .DATE �- ! 1 t LEAK DETECTION CHECK, IF. N/A TYPE/BRAND 'lSa14 1 ZONE OF CONTRIBUTION C ] YES C ] NO DATE TO BE REMOVED 4 t i FIRE DEPT. PERMIT ISSUED ' C I ^YES C ] NO DATE CONSERVATION Cl`]]CHECK IF N/A DATE BOARD OF HEALTH TAG NO. [ ,] DATE �c PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD .,- �. .... . .-.-.. R..w.✓�.�'."''......+- .: ..Ov y -+:ti. ..-+.....-y tiw.r..^.+^,.,^�+ r---=^^'ft, f*16'r'.-.s.�vKv.'""" r-+Ccrts'•3':'r'�-nr.-r _....1,y1..PS7(>` . ,..:`"' ..-R.e. TOWN OF BARNST�ABLE : UNDERGROUND; FUEL 4A " 'C' H' EM I CAL-;!'9T,ORAGE REG I STRiAT I ON MAP NO.. �' s�'! HPAR.CEL? +NO '�{ L''"t r • Y- by ''"'S Y . k �.. 1^ — 41- f. ADDRESS' OF TANK: "�. - zVI,LLAGE': Number w � {�;t'r��t MAILING ADDRESS ( IF DIFFERENT 1.4 ' OWNER'`NAME: t—,PHONE: ft INSTALLATION DATE:, BY: -� I NSTALLER ADDRESS: Al -CERT:NO *TANK LOCATION: Pf ,. (DtOCR I•t TANK�L.CCfiT ION' W-I TH—FRWORIECT .-TO OU I LD Z NO >i ,. .. . ' CAPACITY TYPE OF TANK G= AGE � � YRS.. FUEL/CHEMICAL I.CAL Ads' ��? ' y. TESTING CERTIFICATION [ ] PASS C ] FAIL f ,DATE LEAK DETECTION CHECK-)IFt.,N/A T P'E/BRAND ZONE OF CONTRIBUTION [ ]AYES [ ;] NO DATE''TO BE REMOVED ' FIRE DEPT. PERMIT ISSUED [ `] .AYES [ ] NO ;DATE CONSERVATION CHECK IF N/A DATE. BOARD OF HEALTH TAG NO. C J DATE * PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD ' �7.5' -�d � TANK �� �p� ��1 �//� RRt''N f} �� ��ll _ • F �, f 1 '. t __. __.____�_ - _ ._. _ _.___ �._. ...., , • r.:3_.-.f-.�.. �.a- ; ,,;�`'"^v�'•'1Y+o" :.�i-,,.-�..-....:,.v�r ,'ri.,Wi,.:o:=r„.y�,-•+ .+ r._... .,r•" a,.,; i`.t�,ter'-a'i'R:tii;�+'{`r'ti„f�'m,°•, `''Y� ,... .: � - -�`SF ':,.rN'Y�.'f`�p.` 11ay.. TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP -NO. I�.1a PARCEL NO. D Q-A l t .. ADDRESS OF TANK: �l ! / ,l /la ,�.�',/64_ `� b'l VILLAGE:' Number MAILING ADDRESS' ( IF DIFFERENT FROM ABOVE) : / OWNER NAME: ��-r'.s,r.r/�. _ 7� r✓rr G rz. /� PHONE.- �- r INSTALLATION DATE: tl �./'' ' 'By: Oz �Z '`y1..� �6� " � . 1 l INSTALLER AiJDRESS:��/a. .. CERT.NO. L *TANK LOCATION: �//i'%nt .•- `(bk=&A I•S TANK 1_OCAT I ON W I TM NKUPIECT TO aU I LD I Nm) _ CAPAC I TY Q T-) TYPE OF TANK AGE '°5�C' YRS. FUEL/CHEM I CAL c TESTING CERTIFICATION [ 7 PASS C ] .FAIL DATE LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION ['/YES C 7 NO DATE TO BE REMOVED FIRE DEPT. ` PERMIT ISSUED "' [ ] YES C ] NO DATE CONSERVATION C 7 CHECK IF N/A DATE `? BOARD OF HEALTH TAG NO. C j 71 ] DATE * PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP'-NO,.- —__.J '�)- L-1 PARCEL NO. L-'3) �. ADDRESS OF TANK: - /-/f �-��' `�f= � VILLAGE:� r �/"l � � G..vt�re�r�r .�1 l� � � _ a�� • ,/ ��2..�r� MAILING ADDRESS ( IF DIFFERENT" FROM ABOVE) .: jfj( �" `� G• �4 OWNER NAME: l `�a� ..ti' � 'ciG:atr., a2�� '�t PHONED . INSTALLATION DATE: -_1`_'r� :/ '. 1a,r .1 '`BY T.r._^�GTALLER ADDRESS: �1 f %t:a�jx!}~.� .r ` ^r` f CERT.NO. *TANK LOCATION: +— .^ - (D i Y C R I W K, TAN K LOCATION W I T H R 6 Big C C T TO O U I L D I N C-) - CAPACITY � r1 TYPE OF TANK : - AGE �� YRS. FUEL/CHEMICAL r t TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION [/j YES [ ] NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ ] YES [ ] NO DATE CONSERVATION [ ] CHECK IF N/A DATE BOARD OF HEALTH TAG NO. [ ] DATE PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION .ON THE BACK OF THIS CARD J �-:. �� �2�� ��� . -- ��� -, �� l TOWN OF BARNABLE — UNDERGRUUND FUEL AND CHEMICAL STORAGE REGISTRATION 6 MAPS-NO. (J / PARCEL NO. lf9 TAG NO f ADDRESS OF TANK:, Ipe,vk_, VILLAGE: N u m b e r •t r��t MAILING ADDRESS ( IF DIFFERENT FROM ABOVE ) : OWNER NAME t 1 PHONE: INSTALLATION DATE: T_ BY: INSTALLER ADDRESS: -CERT,NO. *TANK LOCATION: ABOVE BELOW Ge, D Q O Z a G T A N K L T Z O N W I T H 1�Q O P Q C T T O O U Z L D Z N O) ICAPACITY CD TYPE OF TANK AGE YRS. FUEL/CHEMICAL TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE 4 LEAK DETECTION [ ] CHECK IF N/A TAPE/BRAND ZONE OF CONTRIBUTION [ ] YES [ NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ ] YES [ ] NO DATE } , CONSERVATION [ ] CHECK IF N/A DATE y} ti HOARQpF HEALTH TAGNO.,.:;[.- DATE PLEASE P OVI,DE; SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD ;,...� � .t - --.-.......-.z.. ....a.- .....-�+,k,.:� , awr :?`•- "<e, .yr { .'a "Y`zj,`;� .rx=_,IP r't^'':. ^'..,,a. 3ias *, w:, a:.,� T• -fi t , 'TOWN OF BARNSTABLE - UNDERGRUUND FUEL AND CHEMICAL STORAGE REGISTRATION C ., /'t MAP:.N0. 0 PARCEL NO. / 1`7 +'r TAG NO./ `7. ADDRESS OF TANK: 3c lozr���.� t" 1.--'r # -. VILLAGE: �111 AA all s' MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : f f ` OWNER NAME: .c t.- c.0 ! 4 PHONE: ! INSTALLATION DATE: BY: } 4 INSTALLER ADDRESS: o �'/ -CERT.NO. , 7 *TANK LOCATION: ABOVEr BELOW , J ' _ (DCaOR'II a 'TANK. t-OCAT I ON WITH Powomm CT TO nu I LD I NO) CAPACITY ' TYPE OF TANK `' _'AGE YRS. FUEL/CHEMICAL TESTING CERTIFICATION C ] PASS. [ : ] FAIL DATE I LEAK DETECTION .[ ] CHECK IF °N/A TYPE/BRAND � � � � Oe('`-o-^� ul d ZONE OF CONTRIBUTION C ] YES �N0 DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ ] YES [ '] NO DATE .. CONSERVATION [ ] CHECK IF N/,A� DATE "BOA R,Q F HEALTH TAG 0=..�,[ �''�7 ] DATE # PLEASE 0VIDE/ A SKETCH SHOWING THE BANK LOCATION ON THE BACK OF THIS .CARD TOWN-.�'OF BARNSTABLE — UNDERGHUUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO? "�'U j PARCEL NO. r . l ' TAG NO. c 1 , Z ADDRES tS �OF TANK�.. � � �� �� � � i'�: 1 ., t � � VILLAGE: MAILING ADDRESS: ( IF DIFFERENT FROMt ABOVE ) OWNER NAME s lr�( f °n PHONE! Fr -6 ; ,I INSTAL A J ON DATE s r 1BY: INSTALLER AD DRESS: .'� 11 �� ICERT'.NO. *TANK L' OCATvION: ABOVE 11BELCW � ( iyO R`;as TANK {�OCAJT ION W I TH RQOPQCT 'TO aLJ I LD I N_ O) CAPACITY TYPE OF TANK y°° AGED r YRS. ;FUEL-%CHEM I CAL TESTING CERTIFICATION [ ]° PAS�S C 11i3 Fi' IlL� DATE Ir � ,✓' LEAK DETECTION [ ] CHECK IF 0A TYPE/BRAND ZONE OF CONTRIBUTION [ ] YES {({ [U,/, 'N0 DATEi TO BE REMOVED FIRE DEPT. PERMIT ISSUED C ] YES [ ] NO ! DATE ., CONSERVATION C ] CHECK IF N/A'f DATE BOARD' OF, .HEALTH TAG NO. [-i DATE �k PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION _ON _THE! BACK OF THIS CARD rI !' UTERIOR WINDOW SCHEDULE DESIGNATION A AC C C C D D E - F G N Ml J N L M N •O P Q Q It g WINDOW TYPE Picture Double Hung [element Ceument Cexemmt Casement Casement •C.—t Double Hung bauble Hung Double Hung pwOlOy Awning Double Hung Doubt.Hung Picture Doebl.Hung Double Hung Double Hung Double Nung Double Hung ODu-Hung Double Hung Double Hung ' ' 2'115/8'x5'-0]8 3'15/"x8]/8' 2'55/8k4'8]/B • ]/8 2'15/8x4-0I/8'UNIT SIZE M x HI 5-111/4k6'-0]/8' 2-115/8k6-07/8 2-A 3/8V-A 31r 2i31VA2.431W 2'-,118- 43/8 2-43k'-43/8 2.1115/1-11]/8 -0 5 8 2 k S-08 ke 1 8 . -0/8 WINDOW HEAD HEIGHT -1D 311 -Y T.1 T-6518' 13.1118' -058 6-5111 T65/8" TID 3/4" -3/P T111/2" T.11112' T.11" I]3/I 825/16 6'101/8' 6'101/8 6181/eAOESUBFLOOR 7.10314 6-101e ]<511, ]'.9311 6'101/8 III { QUANTITY 1 2 2 1 1 1 2 2 1 . 2 1 g 2 2 • 4. 1 2 2 1 6 1 i 1 3 2 u MANUFACTURER Mtlersen AMersen ArWenen AMersen AMersen A— An4enen A.— MAelsen M4es.n M4e0en M4er3en A.— M4eOen Md— AnUereen M4ersen AMerten AUNN, n AMersen AMereen Mtlmun AMerzen AnOersen SERIFS 400 400 400 400 400 400 400 400 400 400 400 ADO 4. 4W 400 400 4. ADO 4. ADO (/] W � NOTES k Q e i= U FRONTELEVATION yy UU All E W ui w ,rll � o 16 _ -------------------------- __ —_ ----- - 16 1605 NBEREDK�:ssD .N I � a - A4.2 II I • £ d / B 3 FLOOR PLAN CHANGE 2 NEW OOPMER W/SHED ROOF OVER, h I—N NING FORMER HIP ROOF { H OVER BATHROOMS I SHED SECT ROOF OF 14 - —_—_—_ 1 ,: . 1 ____ ______}___ 13 —._._.— _—._._ i••A cn S o F A'2U1- � '� ♦y: cci)i yt � J r;3 QUEEr BA771 BATH _—_—_—_— fi; SCALE:"A. vvz I 2B, o TT = I 1 I DATE:12/28/16 I 'J II �'� � REVISIONS: O ? ,� I �1I i �,: SECOND �,, 1 /J --j --- ------ I- ------- ';a I "'" FLOOR 1 PLAN G� -- __ LI - -- 38 O O BD yr O - hI i OII' FLOOR AREA CALCULATION 1 SCALE:1/4" 1'- SECOND OFLOOR PLAN M.2 \�` ROOF PLAN A2.2 I EMERIOR DOOR SCHEDULE , DESIGNATION AA AB ABt � AlAC1 AD •, AD1 qF AF1 AG AG1 � M AR • DOOR TYPE Inswi�French Dow Fixed Siseli Inss"ing French Door FixM Siselighs Irtwing French Door Fixed SidNi t Irl ,French Door Fxed Sitlelight Imwiry Fm.h Door Fi>ieC SitlN'h[ Inswin8 French Door Inswing Fire Ra[ed Do9r ImwinB French Door A 1�` • ISirq{le Hinged) 011 (Double Hinged) (Single Hinged) Bh 9 ISirlgle Hinged) (single Hing ) (Sirgle Hinges) (Single Hirged) (Sirgle Hinged) UNIT SIZE(W z H) 9'-DxR 3'-0kT-101/," 2•-OYT-101/4' 5-111/,'kT-111/P 2'-61/rr-111/2" T-01/8YT-111/T T-01/nr- 111/2" 31-01/81z7-111/T 3'-01/8"zT-1,1l2" 2'-8•x7-111/2" 2'-BkT-it 1/2" TPx6'-8- 3'-PxT-P 3'-PxTP GROSS FLOOR AREA(WA)CALCULATION QUAIPITT 2 1 2 1 2 1 2 1 2 1 ' 2 1 1 1 FLOOR NAME GROSS AREA ' AWJUFACNRER TBD AMersen Md—n Md— A.— A —n Mdersm Mde—n AMe— Andersen Md—n TBD TBD TBD BASEMENT 1,354.93 SERIES d00 ,00 q00 qp0 400 400 ,00 GARAGE 639.33 NOTLS FIRST MOOR LIVEABLE 2,400.N .._... ........ .. SECOND BOOR LIVEABLE 1,1BI.T] _ ._....... ........_—_____.... ......._—__—__—............. ......._.—__ I� __—._ ..........._ I--P' 5.578.05 sS It I-' FRONT EIF 6 F ON(SEE PlAE6 r 1 T Y MOOR FOR DOOR ® O U �• rA W D�� Qyy E o w a 2 C Q F � a M.1 T ____________________ _ __ _________ ___ ___ __ __ ___ ___ __ ___ _ _ ___ -------------------- 16 _ _—_—_— —_ _—_—_— —_—_ — _ 11, F C.E. j, MAS EERDROOM - - RVRI�GHrfD isl6 I s I j 1 MB EZN CM ASSDC.,NC. 2 i A4.2 ---------------- 77 7- QB i j O O Q O O Q Q I b O i i I O a WALK-IN CLOSET O ® ® , 0 o AT. - CO MASTE AOR R DR bl COURTYARD NG -1'YARD ''❑ LI IN RO M �o I ZI ✓,• \ A33 � / �i \`� � I i i � LAUNDRY ❑ O O m ----------------------- ry CLOSET / I\ I I I�` /�I ' SCREENED PORCR I // II O 112 I I EE 1 I F If ,� _ z DINI ,QOOM L_.—.—.—.—. I —.—I — .—.—. U - / SCALE:1/,• 1'.P•1' , _I--I i HALL I ENTRY 1 t.-- / / b 101 n DATE:12/2/16 I I 8 GARAGE: Ell �� i Ns. _— it 1 / REwslo a� i ___-_ __ _______ ______ _ _______s ____ _ -- _ _ ______ CLOSET / STUDY ENTRY PORCH r KIT(t I /I HEN I I ---------------- I FIRST FLOOR W �� I d LAY LAN 110 @9 9 I as-2 -------- ------------- ----- 2 ---------- I r...- 6. 2 I OI .�:Y.. Z \ S 8• O O O 32 P O O 3 2a P .1. FLOOR AREA N CALCULATION . gT-n" j i I A3.1 FIRST FLOOR PLAN 2 C fie) A4.1 18'�61/2' 16 -—-—-—-—-—-—-—-—-—-—- —-—-—- r --- — : :4 I . r—___-----r--------- C.E. I _ I I I - I COµVVNDHlfD 2016 EAEMICNI A650C..INC. I . 1 I . III J H -- , _ K --- M } N I I I I i I I : I ---------I r--- __ 14 EEL] ri a If I ---- --------- --o �� to I I I I III I I / I BASEMENT II 001 I i j I _-_-_-_-___- 12/28/16 2 ¢ II ur I _ I _ -Ae.t xEvmoNs: I ° I I I F. o.'. . r rI ' ---� I 1 e —-—-—-— I ---0 I—T 3 / ' ��� I i l I I I v � I BFLOOR ASEME NT U b I ---- ------ --- PLAN ------ ----------- IJL I I u'a aw 210 12."3. _—_— --_24 _0" ----__---_—__ 1311' FLOOR AREA CALCULATION 2 I 2 ( AC.1 Aq r A2°O BASEMENT FLOOR PLAN ZONING: et OVERLAY DISTRICT: Demo/Rebuild AP - Aquifer Protection District 240-91 Nonconforming Lot r " ' F 3• �R i Lot Coverage 20q Required Wo`l� ZONE' s r " Lot Area 18,628sf Ub��c e 18,628x207.= /f 0u�t P 1 Jeri RF-1 3725.6sf Max Lot Coverage Allowed {N 8��6 �� �Itid�r�(d Area (min.) 87,120 SF er „. 3305.3 sf Proposed ¢ob 3021/ C �P Frontage (min) 20' Lot 9 2 P Width (min) 125' Floor Area Ratio 0.3 rye Setbacks: 18,628x0.3= 5588.4sf Max CBID Fnd , Front 30' '15 Gross Floor Area Allowed / / � e°�e Side 5,578.05 sf Floor Area Proposed e °t Rear 15' oh W AD ahw -22._ FLOOD ZONE. hw c o Zone X (Min. Flood Hazard Zone) Community Panel No. #250001 0757 J Ir ahw „ , l ( `� N July 16, 2014 Location Map: TBM Ei=19.8' NAVD Top of MAG NAIL 02 ,t -` DESIGN DATA 9. Single Family �j, /l i \\ �' t, i �•� -AN NBedrbag room @ 110erPD ASSESSORS REF: 0 ind �j c�eib �,• Total Daily Flow=660GPD Map 139, Parcels 071 Use a 1500 Gal Septic Tank BRB g0P°,� ,%/ c, / 0 �� ( Q LEACHING AREA P ORt !'' °pOSE �. W 20X5 660 GPD/0.74(LTAR =892 SF Required SEPTIC NOTES 0- Find } ^�/` / PR ¢t`� , ) 1.Location of Utilities Shown on This Plan Are A rox.At Least 72 Hours 0 � Sidewall=124.9x2 a 253 SF PP s ` ;=`' •"� , / �/ �� NWy Bottom Area=642 SF Prior to Any Excavation For This Project the Contractor Shall Make 2l L i•�' t Total Provided=895 SF(895x0.74=662.3GPD) the Required Notification to Dig Safe(1-888-3447233). 2.The Contractor is Required to Secure Appropriate Permits From Town LEACHING CHAMBER DESIGN Agencies For Construction Defined by This Plan. OJ Lawn / \ice O u 3.Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shall 0 '.. �� , ` � All Pipes to be Schedule 40. Use 5-500 Oral.Leaching Be Constructed of Class 150 Pressure Pipe and Shall be Water Tested to \ _3 / '� til Par el Area Chambers in a 12'-10"x 50'6'(with the corner taken out) �� 5 0 ? Double Washed Stone Field as Shower Assure Watertightness. In General,Water Lines Shall be Constructed in t E 628�SF Coordination With COMM Water,and Shall be in Accordance QR°p° 6 With 248 CMR 1.00-7.00&310 CMR 15.00. i ''E:--• 7,; 9 4.A Minimum of 9"of Cover is Required for All Components. -7 S.All Structures Buried Three Feet or More or Subject _ C to Vehicular Traffic to be H-20 Loading.It is the Engineer's i TH 2 35.0' Q '}°V -3 • f Fin sA Grader Recommendation that H-20 Always be Used, 1 � \ wn - �, _. , , 6 Install Watrttight Risers and Covers to Within 6"of Finished Grade Compacted Fill Filter Over Septic Tank Inlet and Outlet,D-Box,and One Leaching Chamber. 3'M . f �' t Fnd Fabric 7.Septic System to be Installed in Accordance With 310 CMR 15.00& 9- B/qHj. Q �; Md/Or 248 CMR 1.00-7.00 Latest Revision and the Town of Barnstable TH 1 ! + ,' / 05E P t �� o Poo Stone Board of Health Regulations. " , i �� �a, 1 FF=22.7 ?,0 P Of ��' o,• ! a/s"- t 1/2' 8.All Piping to be Sch.40 PVC. S�°UtR I x� P't' +'rn LEACHING Double Washed Le end. \ RE 1 EL' �� a Lot 7 CHAMBER stone 9.D-Box Shall Have a Minimum Insider Dimension of 22";and a Minimum <8 t F L. _i 1 Septic System ".✓" t�° Sump of6". Rock I 0 ,h Per BOH Card ^""'` 2 �""� .• � �� �' c'. 4'=10' 10.The Separation Distance Between the Septic Tank Inlets and s ` 'o Garden l MtN' 1 i TO BE ABANDQNED• - �. .,_ Holt Tree - o r : REIa ' .•. . "."" t2'- Io' Outle Shall be No Less than the Li rd D th.Inlet Tees Shall Extend _ !t iTl.i �i'... I Depth. y � �_ � � ��� � � �' CROSS SECTION OF CHAMBER a Minimum of l o"Below the Flow Line.Outlet Tees Shall Extend 14" •••�: /. 5.9 Below the Flow Line,and Shall be Equiped With a Gas Baffle. on 4 CR ER ire ' u j 20 %Se�boc r Deciduous NOT TO SCALE 4 �'eY°rd s PERC TEST: 13,821 1 � ti 4l / , � •��• O,yn PERFORMED BY:CHARLRS ROWLAND,ER-SULLtVAN ENGINEERING SOIL EVALUATORNO.13586 O O 20x !��:a. X 4 WITNESSED BY:DONALD DESMARAIS,RS.-TOWN OF BARNSTABLE %Coniferous ( rl N o ° I� e`les �S - DEceamER2s.zotz f a 1 PR0?0 X t Re eeJe TEST HOLE 1 EL 22.0 TEST HOLE-2 EL.21.5 try t)� I' i tr �t o Ft .v.Y......vRui: :: :::: . :':'::s�ricer :::' : :': :•::':::::::::...... :: :::: •Cedar "" /�_. _ I � i .•=� t;,..___..._.t;____ �e J,r9`A'129 ..............t�tr,.� •r: :r: tdEDa :'::::':::::':':: t->Jt /. Lawn G10 212 - ::::.aW'tatYER.l0YR.5Y6:'::• • ::::.aW.'LSYER107Bst:::::•::: ��� See Mote 6 (typ.) 'ririrrrrr:YEt... ... ...tD1VN'rr:•:::i�: i:'::YFLYQafSH1lROATtrrri:c:i•: ... :::. ff :::::................ ..... i t , F.G. EL. 23.00 F.C. EL. 22.5 F.C. EL. 20-22 14•::::::::::: ffii:SAtr ::::::}::irt F.G. 0 LAYER 10YR 72 C LAYER 10YR 72 �- Guy Wire f ! ro ��00 1� LIOaTGRAY LIGHrORAY NIED.SAND MIN. A 2• Flow Equilizers Mom'SAND 36• MCTEST 18.5 Light Post 1 -"')S-- 21 EL. 20.50 f As Required I -'"""- "�`w"'"' "�T Installer To Mag Nail ZO _�H n 1500 Gallon I • 11.5 IZ6' COULDE<2KN NOT N(LTA -0..4) 1.0 Confirm Prior EL,-t. PPRC RATE<2MINnN TAR-0.1 .�° 4 ,.:Q +a" To Any Work N-20 5 Top EL. 19.0 aR A aN x j Septic Tank H-20 -; El BRB 1 F ' M � Exisfing (See Note 10) D-Box 0 ,�E H-20 -Q Utility Pole ; ` Ir IV L Foundation Leaching TEST HOLE-3 E1-21.5 TEST HOLE-4 EL.2L5 ,n To Be Installed On Chamber oHw- Overhead Wires v :.....':::'w u+;Lrx.lonrv;:,:::::::: ::::.;:. 'usurg+ao...... ......... n.S1g r, -Stable Compacted dose 0 ® r$ Bedding."T"s. ''.::t&::: ... .-:.-::.;:.;.:,%:'.:::.-i+:,:..:;..:. '::.. ... ..•..... BLACK. ... .......: BLACK.:'::. :• ....... .... ..........:.....:.......;..:..•:• •...:;::.� .:•::.:�::':::::.MPD:SAND':.:::.:.:�::..2 p .:•::.: :.'AtPD:SANII'::::':::':::'::.:2 8 n r� ............. -1s- Elevation Contour Inspeetton Port. , ..1 t...::...era�ut:#yr?�s+trc;¢t;;itpta;ec IP d/ TLbf"$ &Boilers ANr#irsoi�at,le>$olls htn at_:, ;::;::..::Here L. ..... oYa st . ::.:: :::.aw LaYl3R.loYR 516:.::::.._ 1! i Fnd ��i�^,,. os Per Title 5 7t+a'IFter Foalnatat of 1.hii S.ystairi: ui ..;•....•...:'Yta:I.t1VYt4t!'$StO1VN::::::::• :'IfBtti(!A:!$It'ARi)Wt•1::.::.:::_. - ............ v •:'•.:•::'.MEit SAND.':•. :'::::. :20.2 4 '.....•:.::::::MI$r;3AND ::20.3 C LAYER IGYR 72 C LAYER IOYR 72 ,'• --. LIGHT OKAY LIOHPORAY No Groundwater NED SAND NED SAND Relocate Septic Tank 512612017 DEVELOPED PROFILE OF SYSTEM Per Test Hole tCTESr Relocate Septic Tank 512512017 NOT TO SCALE F. 1.5 30•COULD NOPT�MAn MAINTAIN Approx. Groundwater t • ILO I • PERC RATB<2 MUM(LTAR-0.74) 1.0 Peer T.O.B. Groundwater Maps NOORO A PNCOUMERED A Update driveway location 111812017 SITE PASSED Update datum and septic elevations. 111212017 Revision: Update proposed bld and change SAS 1 12 28 2016 TITLE Site Plan PREPARED BY. PREPARED FOR: NOTES: En •'neering& Henry daCunho Proposed Improvementssulleivan 1.) The property line information shown was consulting,me CapeSury Cho Kendall tie Welch compiled from available record information. At 508 428-3344•seci@sullivanen in.com 7 Parker Road Construction Co. p ~ g Osterville MA 02655 2.) The topographic information was obtained 80 West Street PO Box 65le Parker Road 874 Main Street from an on the ground survey performed on Ostervilie MA 02655 (508) 420-3994 (508) 420-3995 fox www.suilivanengin.com copesurv@copecod.net Osterville, MA 02655 071JAN113 3.) The datum used is NGVD '29, a fixed mean O rn,StF „_ i(Osterviile) a - ;at Draft: JOD Field: WHK/MJD 20 0 10 20 40 80 sea level datum. DATE: December 31 2013 SCALE 1 If-20 r Review: PS Comp.: WHK/RLH ,,..; CIL- , Pro jec t: 31016 Pro jec t: C515 I ,