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0011 CAPTAIN STUDLEY ROAD - Health
1 TOWN OF BARNSTABLE LOCATION SEWAGE# �0.0/ VILLAGE %Vk'S ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY /,00 LEACHING FACILITY:(type) (size) 3:5 } V NO.OF BEDROOMS . OWNER S 5,5Un�' PERMIT DATE: 3 1 `I COMPLIANCE DATE: *. Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility_(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY •Iy id 1 IZ iit, Cx c ? i• j; i � � 3(9-© � 3Y-`1 �r No. / 7v +; Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes � PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftplitation for Nspo8al *pstem (Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( bandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /'/ C19 d5T Owner's Name,Address,and Tel.No. MmAssessor'sMap/Parcel w�fn ---.06 �`�� Sz asev Installer's Name,A dress,and Tel.No. 4 4?4 C, �► Designer s Name,Address,an el.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Fa T(J-' Type of S.A.S. — 00 0- Description of Soil 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 d not to place the system in operation until a Certificate of Compliance has been issued by this oard of Health. A Signe Date Application Approved by Date / f Application Disapproved by Date for the following reasons Permit No. �� l Date Issued Ll a •� O No. / L/ ": .'* Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliration for Disposal �&pstrm Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(LY bandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. // 6_Af e r Ow er's Name,Address,and Tel.No. Assessor's Map/Parcel t'o O �j ^ YY\TA Tete 5 35 f Lj Installer's Name,Address,and Tel.No. 9�` G %'//,+ Designer's Name,Address,an 'del.No. -- o� So ar 6�;�v , �I n cU c/ ��cJS&Orr AJ (�J O r �S 7:�Jc Type-of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( Other Type of Building No.of Persons Showers( ) Cafeteria( ) * Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date - Number of sheets Revision Date Title Siie-of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: r 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 d not-to place the system in operation until a Certificate of Compliance has been issued by this oard of Health. n - Sigrie Date 40 Application Approved by "'iafe` f P Application Disapproved by 1`_ Date ` for the following-reasons Permit No. Date Issued --------------------------------------------------------------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO C Y that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded Abandoned( )by `O U S�i^v Ct 10 R at has been constructed in accordance tle and the with the provisions i or Disposal System Construction Permit No.9.010 '�-9 gated Installer J�' r d Aj , D A) Designer ,oe0 r j kJn V #bedrooms Approved desi o gpd The issuance of this perm'jh/l not be nst ed as a guarantee that the system w' � ctior�-a�esig�ned. ' *_ � �& / l Date Inspector No. c�oj l_l! - - - Fee �� t THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS Disposal 6pstem Construction Vermit Permission is hereby anted to Construct( ) Re air Upgrade( Abandon ( ) System located at / 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. i Provided:Construction.musff E bercppl ed i hin three years of the date of this perms. Date J �(( Approved by I I. � I f Town of Bamgable RepWory Services Thomas F. Ceiler,Director p:U ,} . Hea Dvion Thomas McKean,Director 200 Mam;.Street, Hyannis,MA 02601 Office: 508-.8,62-4644 Fax: 508-7904304 Date: 9 Sewage Permit#001 Assessor's Map/Parcel —� Installer&Deser Certification Form Des per: Wo r nc , Installer: w r< � ..v,� 'F.LS� .� L 12 Address: 2 W, C.rb S,S .e e1 1zd. Address: On 8 °t 1 I was issued a permit to install a � � (date) (installer) septic system at �Pfi�S M' l�j based on a design drawn-by (address) '-- � dated �8 (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. Stripout (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. Stripout (if required) wa, cted and:the soils were found satisfactory. o ti: PETER T. . . (In l er igna ) N6c`CIVIL ,� No:35109 0 � F�f97 � .. (Designer's Signature) (Affix Design PLEASE F TO BARNSTABLE;.PitJBIlIC HEALTH DIVISION CERT99CATE OF CO1VH?'LIANCE WILL NOT BE -ISSUED UNTIL BOTH THIS FORM AND AS. BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK Y.O.U. gAoffice formsldesignercadfication form.doc TO icTABLE LOCATION ,�� SEWAGE# VILLAGE A SESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY „^ LEACHING FACILITY:(type) ` ` �j (size) . NO. OF BEDROOMS OWNER . S PERMIT DATE: 3 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of lQS1J ing Feet f ili /' FURNISHED BY L� G ��^�.�f� 1�� � qj � � rj 4 i Town of Barnstable P# / 3� 4 Department of Regulatory Services i uartartNX i Public Health Division Date 1 200 Main Street,Hyannis MA 02601 Date Scheduled Fee Pd. 1�(ri d" SV- SudilityAssessmentfor,� Sewage Disposal Performed By: ''����" �'� SE(n Z Witnessed By: LOCATION&GENERAL.INFORMA UN Location Address C��- S,'_d l`fy 2y Owner'sNamc �SSQH . �(/1• S Address 11 111^Q� Sid k-f Assessor's Map/Parcel: 2.46--0 5 3 Engineer's Name M M. M• l` �ec'e✓�ttitc.�rt}c.f c NEW CONSTRUCTION REPAIR K Telephone# 4a g-7 3 9—t'I?ro 0 Land Use Sk � Slopes(%) ��Z— Surface Stones ` ��yv� Distances from: Open Water BodyI�ft Possible Wet Area�" Drinking Water Well ,?L ft Drainage Way 6M I A— ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) r� s PCC^ ' I Parent material(geologic) V S"` Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face /lJ Estimated Seasonal High Groundwater a i DETERNIINATI"ON FOR SEASONAL HIGH WATER.TABLE 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# Reeding Date: Index Well level Adj.factor Adj.Groundwater Level_ -- PERCOLATION TEST - • bate Tlme - Observation Hole# I 4f-c C Time at 9" µ Depth ofPerc / Time at 6" �r 2 Start Pre-soak Time aQ t 1 tme 9'-6' End Pre-soak —7 S '�4LU I RateMin./Inch 0�\ co�S�5 z-,,, Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original:Public Health Division Observation Hole Data To Be Completed on Back----- ***If percolation test is to be conducted within 100'of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEP OBSERVATIONZOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ` Consistenev.° Gravel) to M 'Z- DEEP OBSERVATION HOLE:LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. _ onsistcacy,° 6 g-3 ' S c_ r'-e sq �. DEEP OBSERVATION HOLE LUG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling (Structure,Stones,Boulders. % DEEP OBSERVATION HOLE LOG Hole# Depth from SOB Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (M-11) Mottling (Structure,Stones,Boulders. Flood Insurance Rate May: Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes_ Within 100 year flood boundary NOr- Yes_ Depth of Naturally Occurrine Pervious Material Does at least Our 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? CerNfleation I certify that on 1'l (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 tr ' ing,expertise and experience described in 310 CMR 15.017. Signature Date !Y[' Q:\SEPTIC\PERCFORM.DOC �ti 4 DEED RESTRICTION WHEREAS, Peter Sisson of 11 Cant _Studley-Rd Marston Mills MA.is the owner of 11 Cats Studley Rd located at 11 Cant._Studley rd. )Viazston s A WHEREAS, Peter Sisson . as the owner of said lot-Has-agreed to a restriction as to the number of bedrooms which-can-be-included in any home-built Barnstable nasaid lot as of Health condition to obtaining a disposal works construction -Pre- permit in compliance with 310 CMR 15.000_State -Environmental Code, Title V,Minimum Requirements for the Subsurface Disposal-Sanitary Sewage; WHEREAS,the Town of Barnstable Board of Healt h,as.a-precondition to granting-a-disposal.works construction permit for septic system in compliance-with 310-CMR-15.200,-State Environmental code;title V, Minimum Requirements-for the Subsurface-Disposal-of Sanitary-Sewage,and authorizing the issuance-of a b m g permit-for the construction of a single family home on this property,is requiring that the agreement for the restriction on the number of bedrooms in house constructed-on-the-lot be put-on record with-the Barnstable County Registry of Deeds.byrecording-this document, NOW,THEREFORE, Peter Sisson does hereby-place the following restrictionon his above-referenced land in accordance with his agreement with.the Town-of-Barnstable Board of-Health whic h restriction the land shall run with and.being binding.upon all successors-in title: 1. 11 Capt. Studley rd may have constructed-upon the.lot-a-house containing-no-more-than. two . (.2) bedrooms. Peter Sisson . agrees thatxhis-shall be permanent-deed-restriction affecting home . located on 11 Cant Studley rd. Marston Mills MA,.and-being-.shown on the plan recorded in plan book 274 a p ged 4477 For title of 11 Cant. Studley rd..Marstons Mills MA 02648 See-the-following deed:Book_-5362,page 315 . Executed as a sealed instrument 20 dayof. June. 2003 Owner's signature Owner's signature \� Owner's signature - , � n�j y Printed:06E24-2003P®T15.45:33 BARNSTABLE COUNTY REGISTRY OF DEEDS JOHN F. MEADE, REGISTER Trans#: 259847 Oper:JEANNE Book 17143 Page 340 Inst# 73328 Ctl#: 2893 "Rec:6-24-2003 @ 3:44:30p BARN 11 CAPT SbDLEY ROAD DOC DESCRIPTION TRANS AMT 1 BARNSTABLE TOWN OF RESTRICTION 10.00 rec fee 10.00 Surcharge CPA $20.00 20.00.00 State Fee $40.t0 20 Surcharge Tech $5.00 0.00 Total fees: 75.00 Ctl#: 2894 Rec:6-24-2003 @ 3:44:30p DOC DESCRIPTION TRANS AMT POSTAGE FEE ------ Mail per page fee .50 *** Total charges: 75.50 ` CHECK PM 10098 75.50 r F Town of Barnstable �`"F' O Regulatory Services Thomas F.Geiler,Director �� snRxsrnet.e. 9 MAS& Public Health Division tb q Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: �Jl Sewage Permit# 23� Assessor's Map\Parcel 12&L6b Designer: U!�:)A tyouN�s Installer: o rJ Address: (P2 W. HYA0QJt`A909.:T CIO— Address: ou . iAY,ANNtS r MA 02(vot mmx--. X i On 3 Z9 C O-KS rLIC�IY7 was issued a permit to install a (date) (installer) septic system at I I CAPTA)Q STUDL*y e—D, Pybased on a design drawn by (address) dated Zo/O 4- e e v 3I z, I u. - (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. 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 is stem) but in accordance with State & Local Regulations. Plan revision or certified Wilt by designer to follow. t %�pITH Of :G� . ri r signature) LI esigner' ha ) (Affix De amp 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 BARNS TABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc i C� �, G�`� � �, , � . . � -•. i r .. � .. rl � � a . ,' •i }[. r �! bR � . • �i. ♦ ' ` • � � ` l xR i t` r ,r.. „M .yr' ♦. . �� i.i u c i•n + , a� '� � f`, �(• r S.•�i t4 Z� � 11�•�,1 • d � ";4 y �1 TO OF BARN TABLE LOCATION ! ;nl,� C} SEWAGE# //v! ,r ,VILLAGE ASSESSOR'S MAP&PARCEL ' INSTALLERS NAME&PHONE NO..r J-U SEPTIC TANK CAPACITY 1600 LEACHING FACILITY: (type)_Cj4/1- 0 ` 'j size l O NO.OF BEDROOMS OWNER E S 2 PERMIT DATE: 3 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any, wetlands exist within 300 feet of le.�ing f ility)- Feet FURNISHED BY y Zz- 4f a V M 8-3--c3,0 t3-L f 3 l � NAV6THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ZIppricatiou for 30iqu al *pgtem tonotruction permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System []Individual Components Location Address or Lot No. L Owner's Name,Address and Tel.No. ✓ S O ti ils f/ C�cyA f S�-z�c�% Assessor's Map/Parcel m Id-C, r!/ Installer's Name,Address,and Tel.No. 70 Designer's Name,Address and Tel.No.. J.I S Pr I -YO NS- 56i -a1Y - � �s— Type of Building: Dwelling No.of Bedrooms 2— Lot Size ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria{ ) Other Fixtures` z� /� Design Flow ZT q I : 6 P l gallons per day. Calculated daily flow �l�X --gallons. Plan Date Number of sheets l Revision Date Title � Size of Septic Tank 1006 Type of S.A.S. 8-ef- 5�00,_ 4 Description of Soil L"_�� !4 ' v�T (22— �O f/ I >( Nature of Repairs or Alterations(Answer when applicable) t P R S pr--S D A Date last inspected: Agreement: The undersigned agr es to ensur a con tructi and i enance of the afore described on-site sewage disposal syste in accordance with the provisio s o e 5 of iron nt Code and not to place the system in operation unti at- cate of Compliance has d by thi Signed ate v A4-- Application Approved by ate 4VO_f�p Application Disapproved for the following re so 1 Permit No. Date Issued --------------------------------------- �> No. U WMI ., Fee G•;' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for biq;po$al *patent Contt'rUction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) El Complete System El Individual Components Location Address or Lot No. gw�sOwn is Name Addre end Te. o. otj Assessor's Map/Parcel M 1 OZ(o �� /i'I �S 61)5 kn/l�� § i/5.a y Installer's Name,Address,and Tel. O. f �O tv Des ner's Name,Address and Tel.No. S 6 c M V�-3*P t_ C_ ti-n n 15 Je :�..-7'F® 6?70 ,# Type of Building: n - Dwelling No.of Bedrooms Z Lot Size ' S �`��s ft. r Garbage Grinder( Other e of Buildin (] No.of Persons Showers( ) Cafeteria( ) • _ Type g Other Fixtures Design Flow 41 ' 6 P b gallons per day. Cal lated daily flow gallons. E Plan Date Number of sheets Revision Date t Title 1 Size of Septic Tank E of S.A.S. mil% r ` �� � c, Description of Soil Z' $ // `3 / n /�' l� ' v �-- �o Nature o Rai or Alterations(Answer when applicable) PR+�d S S 'Date last inspected: 1 Agreement: The undersigned a ees to gns e t consi uctio and m 'nt Hance of the afore described on-site sewage disposal system/ in accordance with the pro�sionsl o 5 of t / 1�ironme tal ode and not to place the s stem in operation until Certif- cate of Compliance has been-r this o d,oYiH¢' J 3 - Signed /�� Z Date Application Approved by Date Application Disapproved for the following reas ns / Permit No. Date Issued �20Du�S THE COMMONWEALTH OF MASSACHUSETTS J _ J BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, th t be O�ngsite Sewage Disposal System Constructed( ) Repaired ( )Upgraded( ) Abandoned( � b,�• g/ at has e constructp Li accordanced with the provisions of a d�the for Dis osal System Construction Permit No. Or� -'-:dated (o Installer 0 ) P y Designer The issuance of this t shal of be construed as a guarantee that the ystem wr 1 f c 'on a desi d Date inspector THE COMMONWE LTH OF MASSACHUSETTS Z �� PUBLIC HEALTH DIVISION ABARNSTABLE.,MASSACHUSETTS Diopont *p$tem Con.5trUction Permit- Permission is hereby gra�t d� o Con—ct ) epai )1/Up.�/r�d � Aban g System located at O e !z �Jf and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction `ust co pleted within three years of the date of this . Dater Approved v by )4 ) � � Lt COMMONWEALTH OF MASSACHUSETTS JD EXECUTIVE OFFICE OF.ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION APRs TITLE 5 T o;Fv F��R ?007 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS tioF TTge�F SUBSURFACE SEWAGE DISPOSAL SYSTE PART A CERTIFICATION % Property Address:. 1JOA, j , Owner's Name' Owner's Address: Date of Inspection: Name of Inspector: please print) f b_ IAO— IC I Company Name: Mailing Address: ,O-i' � 112W Telephone Number: �•y�;F� harp CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported. below is true,accurate and complete.as of the time of the.inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of,Title 5(310 CMR 15.00.0). The system: ___V/Passes Conditionally Passes . eds. urther Evaluation by the Local Approving Authority ails Inspector's Signature: Date: 2 ' G ' The system inspector shal submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the. DEP.The original should be sent to the system owner and copies sent to the buyer,.if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will.perform in the future under the same or different conditions of use. I Title 5 Inspection Form 6/15/200.0 page _ i Page 2"of 11 . OFFICIAL INSPECTION FORM—. NOT:FOR VOLUNTARY ASSESSMENTS. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM -� PART A CERTIFICATION (continued) Property.Addressi f Owner: .l Date ofPnos_p�ee&ction: L� Q j Inspection Summary: Check A,-B,C,D or E/ALWAYS complete all oi`Section;D A. ystem Passes: I have not found any information which.indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below.., Comments: 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 20 years old* or the septic tank(whether metal or not)is structurally unsound;exhibits substantial infiltration or exfiltration or tank failure is imminent: System will pass inspection if the existing tank is replaced with a complying septic tank as'approved by the`.Board of Health. *A metal septic tank will pass inspection.if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the-tank is less than 20 years old is available. ND explain: Observation of sewage-backup or break.out or high static water-level in the distribution box due to broken or, obstructed.pipe(s)or.due to a broken;settled or uneven distribution box. System will pass inspection if(with . approval of Board of Health): broken pipe(s)are replaced obstruction is removed . distribution box is leveled or replaced ND explain: The system required pumping more than4 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 Page 3 of 1'1 OFFICIAL INSPECTION.FORM-NOT FOR YOLUNTARY'ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: "�� r jrl � - Owner: L {it Date of Inspection: & a M C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of-Health in order to determine if the system, is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b).that the system is not functioning in a.manner which.will protect public health,safety and the environment: Cesspool or privy is,within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a.manner that protects the.public Health,safety and.environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The.system has a septic tank and SAS and the SAS is within.a Zone 1 of a public water supply. The system has a septic tank and SAS and.the SAS is within,50 feet of a private water supply well.. The system has a septic tank and SAS and the SAS is.less than 100,feet but 50 feet or more from a private water supply well's*. 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 compound_ s indicates that the well is free from.pollution.from that facility and the presence of ammonia iiitrogen and.nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A-copy of the analysis must be.attached to this form.. 3. Other: AIL 3 Page 4 of 11 OFFICIAL.INSPECTION FORM'" NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION,FORM PART A CERTIFI'CATION'(continued) Property Address: K Owner: Date of Inspection: D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No/ Backup of sewage into facility or system component due to overloaded or-clogged SAS or cesspool Discharge.or ponding of effluent to the.surface of the ground or.surface waters due to an overloaded or clogged — � gg SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or, / cesspool 1✓ Liquid depth in cesspool is less than 6 below invert � _ 9 P P n rt or available volume is than /�day flow Required pumping more than 4 times in the last clogged_ q P p g t year NOT due to clo��ed or obstructed pipe(s).Number of times pumped _ Any portion of the SAS,cesspool:or.privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. sl; Any portion of a cesspool or privy is within a Zone I-of a public well. _ Any Portion of a cesspool or privy is within 50.feet of a priv ate water supply well. Any portion of a"cesspool or.privy is less than 100 feet but.greater than 50 feet from a private water supply pp y well-w rth no acceptable water qualityanalysis. Thins stem asses if the well water`anal si Y I Y P y s, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen.is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form:] (Yes/No)The system fails: I have determined that one or more of the above'failure criteria exist as described in 310 CMR.15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to'correct the failure. E. Large Systems:, To be considered a.large'system:the system must serve a facility.with a-design flow of 10,000 gpd to.15,000 .gPd• You must tindicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no _ _ the system is.within.400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well If you have answered"yes"to any questibn in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304..The`system owner should contact the appropriate regional office of the Department. ,4 Page 5 of 11 OFFICIAL INSPECTION FORM-:NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST: Property Address: / tea(, Owner: Date of Inspection: -'3 3)b Check if the following have been done.You must indicate"yes"or"no'.'as to each of the following: . Yes .No �_ Pumping,information was provided.by the owner,.occupant,or Board.of Health Were,any of the system.components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? Have large.volumes of water been introduced to the system recently or as part of this inspection? V — Were as built plans of the system obtained and examined?(If they were not available note as N/A) t ' Was the facility or dwelling inspected for signs of sewage back up? V 7_ Was the site%inspected for signs of breakout? _ Were all system components,excluding the SAS,located on site? Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of.liquid,depth.of sludge and depth,of scum? Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes no V' 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 15302(3)(b)] 5 L . Page 6 of 1 I OFFICIAL INSPECTION-fORM—NOT FOR VOLUNTARY>ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION`.FORM PART C SYSTEM INFORMATION Property Address: a Owner:. ri Date of Inspection: Ma/p J FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design)!,.a Number of,bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 11:0 gpd x#of bedrooms):0,PO Number of current residents: (. Does residence have a garbage grinder(yes or no): � Is laundry on a separate.sewage'system (yes or no��if yes separate inspection required] ` Laundry system inspected(yes or no): 1— Seasonal use: (yes or no) 77 Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no): Last date of occupancy: COMMERCIALANDUSTRIA�LD' Type of establishment: .. Design flow-(based on 310 CMR.15.203): gpd Basis of design flow(seats/persons/sgft,etc :): . Grease trap present(yes or no):_ Industrial waste holding tank present(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: OTHER(describe): - GENERAL INFORMATION O Pumping Records Source of information: Was system pumped as.part of f e nspection(yes or no����t- If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy _Shared system(yes or no)(if yes,attach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained froth system owner) _Tight tank _Attach a copy'. opy of the DEP approval _.Other'(describe): roximate age of all components,date 'nstalled(if known)and source of information`. /9A,S Were sewage odors-detected when arriving at the site(yes or no): IV 6 Page 7 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 0 /b /414 Owner: ��n Date of Inspection: BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_cast iron _40 PVC other(explain):--- Distance from private water supply well or suction line: Comments(on condition of joints,denting,.evidence of leakage,etc.): SEPTIC TANK: (locate on site plan) Depth below grade: Material of construction: Vconcrete_metal_fiberglass_polyethylene —other(explain) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: Sludge depth: ' Distance from top of sludge to bottom of outlet.tee or baffle: 3 Scum thickness: Distance from top of scum to top of outlet tee or baffle: y /� Distance from bottom of scum to bottom of outlet tee or baffle' 1,3 How were dimensions determined:, v--)� 4,4,;� Comments(on pumping recommend tdtiions,ftillei and outlet.tee or baffle condition,structural integrity, liquid levels s related to outlet invert,evidence of leakage,et : U&iL'6L4 , GREASE TRAP/ p'jlocate on.site plan) Depth below grade:_ Material of construction:_concrete_metal_fiberglass__polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,uilet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage, etc.): 7 Page 8 of 11 " OFFICIAL INSPECTION.FORM L NOT FOR VOLUNTARVASSESSMENTS SUBSURFACE SEW AGE DISPOSAL'SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: A Owner:, Date of Inspection: 3 TIGHT or HOLDING TANK:/_ E-Vtank must be.pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene oth'er(explain): Dimensions' Capacity- gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of lasrpumping: Comments(condition of alarm and float switches, etc.): DISTRIBUTION BOX:Z(if rese p nt must be opened)(locate,on site plan) Depth of liquid level above outlet invert:[�z Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover,any evidence of 1. kage into or out e of box, c.): dot L PUMP CHAMBE 'r(locate on'site plan) Pumps in working order(yes'or no): Alarms in working order(yes or no):. Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 v Page 9 of 1 I OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE.SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM:INFORMATION(continued) Property Address: Owner: Date of Inspection: 3 SOIL ABSORPTION SYSTEM (SAS):. (locate on site plan,excavation not required) If SAS not located explain.why: Type • ' leaching.pits,number: c leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, et ): -/D v ,.,et 7 CESSPOOLS:/ 2�(cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: 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: ocate,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.): E 9 Page 10 of I 1 i i 'OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL:SYSTEM INSPECTION.FORM PART C SYSTEM INFORMATION(continued) Property Address: 06a Owner: Date of Inspection: ��� SKETCH OF SEWAGE DISPOSAL.SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. b c� V 10 Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESSMENTS. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C . SYSTEM INFORMATION(continued) Property Address: � / ' ILIA Owner: Date of Inspection: SITE EXAM. Slope Surface.water Check..cellar. Shallow wells Estimated depth to ground water feet Please indicate(check).all methods used to determine the high ground water elevation: Obtained from system design.plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators, installers-(attach documentation) Accessed USGS database=explain: You must describe how you established the high ground water elevation: 11 TOWN OF BARNSTABLE LfJQATION ll SEWAGE # VILLAGE VM4LS4101 Yhs ASSESSOR'S MAP & LOTS INSTALLER'S NAME fa PHONE NO. 01,nllc .41 SEPTIC TANK CAPACITY ® (� LEACHING FACILITY:(type) 1p 1( (size) �CIOn GG NO.,OF BEDROOMS PRIVATE WELL OR PUBLIC WATER I BUILDER OR OWNER S 014 DATE PERMIT ISSUED: lhTAC DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No du.) /I v 1 A c � c 13 A ,� D - 30� e , ASSESSORS MAP N0: No. PARCEL NO: Fzcs.... ............./.... THE COMMONWEALTH OF MASSACHUSETTS / BOARD OF HEALTH TOWN OF BARNSTABLE Appliratilan for Bi-npoml World Tomitrnrtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage, Disposal System at: j /J.......... __.....�- ! . .�. ..............-�--------. ........................................................ //�� Location-Address or Lot No. ----- ---------------------- •--------- • -----•-----•--------------Gc ------- Owner Address Installer Address UType of Building Size Lot............................Sq. feet . , Dwelling—No. of Bedrooms____________________________________--------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons................... Showers Cafeteria ( ) 04 Other fi to ------------------------------- Design ' d ----- - -Flow........... ... 4..._..._ allons er erson r da Total dail flow----... gallons. WSeptic Tank—Liquid capacity. (` allons Length......6....... Width-.--- ------- Diameter................ Depth_. __--•---._. x Disposal Trench—eN�. .................... Width -/.-__---_------ Total Length-------_.._..�_._._ Total leaching area....................sq. ft. Seepage Pit No...................... Diameter_.... ._----_--.-- Depth below inlet................ Total leaching area._QlD_<Q..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed bY------------------- ...................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water...................... . fi Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ a ' ✓Q _.._Description of Soil I 1 � 1 'y ...1--- •------...... G�� r ! ------Chia ..... W ............................................................ ----------------------- ........................ UNature of Repairs or Alterations—Answer hen plicable..... ....'. . o _.... .--_-- ...... ... ............. . .. . .............................................................. . Agreement: The undersigned agrees to install the aforedescribe n i idual Se ge ispo System in accordance with the provisions of TITLE 5 of the State Environmental o e The e igned f ther agrees not to place the system in operation until a Certificate of Com 1' nce h e issued y t e board o health. Signed --- --- ..... ... .......e. ........ --- ------ ------------------------ ------------ ...........�..,�. Application Approved By .... ... . . .. .. �..... . Dace Application Disapproved for the following reafonr- ------ ----------------------------------------------- ------------------------------------------------ .................................................... .................... ...- ----------------------------------------- ------....----......---------------------------- ........................................ Dare Permit No. ..:..15. Issued -------------------------------------------------------- ------ Dare f� t t I1..........-.. 1 _ �. Fss..... .................... % THE COMMONWEALTH OF MASSACHUSET,TS / BOARD OF HEALTH Ll TOWN OF BARNSTABLE Appliration for Bi- ruittl lVnrkii Towitrurtiun 11amit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at ........11..........C a.Q.i C4 111........c =L 06-ml w / Location-Address l ' or Lot No. p� S QG'l �....� If P Owner i Address ----------...... •----- ------------------ Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms------------ -------------- -------- - Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons------------------------ Showers ( ) — Cafeteria ( ) a' Other fixtures -------------------------------_...................................................................................................................... W Design Flow-------?��A!-?-------gallons per person per day. Total daily flow. ---------------------_____________________gallons. WSeptic Tank—Liquid capacity-,gallons Length-----X------- Width.--_r.__----- Diameter---------------- Depth__.?� __.. x Disposal Trench—No. .................... Width.................... Total Length---_________r..... Total leaching area....................sq. ft. Seepage Pit No-------�e---------- Diameter..... ---------- Depth below inlet-----C........... Total leaching area_._0___6(--?..sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1----------------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........................ Description of Soil..... �------ V -•-- ,-„_-,lea n lio..• r�/i+�c�k.. ry •----•---•-'-------------------••--------'--._...__----...-------------- . �t--•--- •-• U Nature of Repairs or Alterations—Answer when applicable._....____1.��,.__� � _�______.e,_..... .......... ..------•-'---......--•-•-----------•-•••-••--•-•--•••-•'••• ...... --- ------------------`-`�('-� `Gr ''' __�._. Agreement: � �L The undersigned agrees to install the aforedescribed/Individual Se ,�ge/Disposal System in accordance with the provisions of TITLE 5 of the State Environmental ode��The undersigned further agrees not to place the system in operation until a Certificate of Com 1 nce had jeeri'issued y/ e board o health. Signed"........... �'L. ...:....<............ ......... ... . ................ ........................ /.C1�=1 .�- ApplicationApproved By ..............:... ..... �.......__.-•-.... ...� .__.......r� ._. ............................... ... ' ---------------------------------..............................................................---------Dace--------------- Application Disapproved for the following rea.rons� ......... .................... . ------------------------ ----------------- ----- Dare Permit No. ---- ---- �..�.............._.... ..... Issued o�a ............ THE COMMONWEALTH OF MASSACHUSE17S `f ' BOARD OF HEALTH TOWN OF BARNSTABLE Ger#t£tett#e of Graptiance THIS�hSFO CTiRTIFY, T at the ividual Sewage Disposal System constructed ( ) or Repaired ( ) by '� / ... .. � . . ..... ---------- -- ------------------------------------- ----........_....-------------------------- -............. �.... .-- a-... + .... In4rell It .. IJ...... ► i n 1 I .( a� ) ...... ---------------------------------------------------- J1- .s:.. .�..f..�-o V ..... L! ` In has been insttalled In accordance with the provisions of TITLE 5 of T.e State Unvvi bnmental Code as described• the application for Disposal Works Construction Permit No. .............. ..... dated -------...__--------------- --...._..... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE . `'°'..../. "'.... 7� .--_------- --- Inspectoiv---- �, THE COMMONWEALTH OF MASSACHUSETTS E3OARD--.OF HEALTH 5,..- TOWNOF `BARNSTABLE No..................... - FEE----._...__......._..... 1 Disposal I-V / kk ���not�r ill prrnnt Permission is hereby granted .: �/ �. �!--= - t"'"`" ! r-----------•--•'----------•-•------...--'---'---"---'._.....--•--- to Construct ) jr Re -air O an,�adi�ualevyagey isposal®System �° t ] t i�. ((....... - y-11-./ � ._ ..._.0 '-------------------------------------------------- / / street as shown on the application plication for Disposal Works Construction Permit No.-_-i- _.:__ _.'ated. ?_........................__._._n. / Board'of Health l_ DATE----•-••------- --�----�--=- --------------------------------------- _ FORM 36508 HOBBS Q WARREN.INC.,PUBLISHERS 94 LOCATION SEW&CtE PERMIT UO. VILLAGE — -- rs�✓ j �L ��7 — v I KGVJ 0 oQ — ImsTaLLEWS 1&ME e ADDRESS Q e2-T S 'D 0 Q- Co BUILDERS 1.1 &ME �- DDRE.SS RA DNTE PERMIT 155UED — — — — — — D ATE COMPLI &MCE ISSUED ; — _ — �J�f � iE .�� �� . ., , t -- _- S G 3- C-6 3-5 ,' - /23. G3 9 o � Y i ,Car 17 D t v � O 0 p 0 -/3- 7G a° o v oRo/? 7ooa a' 4.� ' 7-;F5 7- P/Po�? Q G FX p)9dJ6%/j A/ G3- OG - 3Syc/ CERTIFIED PLOT PLAN L O C A T I O N: S C A L E: / 9 0 D A T E R E F E R E N C E ,3,F/ ,,0 4 X o r / 7 A 3 SWO x/,cJ Qoor 07 /a19 Fay D A TT I H E R E B Y CERTIFY THAT THE B U I L DING R E G. LAND "a U v E Y O R SHOWN ON THIS PLAN IS LOCATED ON T H E G R O UND AS SHOWN HEREON AND THAT IT .nogg:_ CONFORM TO THE Z ON I N G BY - LAWS OF THE TOWN OF `_,�IF �F�� ^ WHEN C ONSTRUCTE D / I GEO?GE LOW,JR. y r 4) BARNSTABLE SURVEY CONSULTANITS, INC . WEST YARMOUTN MA55 . \� THE COMMONWEALTH OF MASSACHUSETTS BOARD HE ` .. ----OF.......... ........... .................... Appliratiuu -fur 43itipmal Works Toustrurtiuu Prrutit kAp 1plication is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: C�.•se.�o!' ---- Location.Address or Lot No. �sGU. .�.`............ wner Address -------------------- --•---------...... � s� Installer Address Q Type of Building Size Lot---..664W -.Sq. feet U Dwelling—No. of Bedrooms................It-7-----.-----.--.-_---.--Expansion Attic Garbage Grinder (��) P4 Other—Type of Building ._----4.o e...... No. of persons----------_---------------- Showers ( ) — Cafeteria ( ) a Q Other fixtures ................................................................................................_---------------------- W Design Flow............. -----------------------gallons per person per day. Total daily flow.--..........=2 j4?................. r 0 WSeptic Tank—Liquid capacity, -gallons Length-. ...�.... Width..`1.i e. Diameter---------------- Depth------_------_. x Disposal Trench—No..................... Width---.-----..---.----. Total Length.................-_. Total leaching area----------.----_--sq. ft. Seepage Pit No....................... Diameter.......�........ Depth belo inlet----- ------------- Total leaching ttre:t..a .-.sq. ft. Z Other Distribution box ( ) Dosing tank ( ) �f, x',-- .Z aPercolation Test Results Performed by-------------------------------------------------------------------------- Date---------------------------------------- Test Pit No. l................minutes per inch Depth of Test Pit.................... Depth to ground water...._...--------------. (14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...--.----.--.-----.---- a r = -- .. --• .....-..-... O Description of Soil.----d._7 �- `v!' � x -----•------------ --------------- .----.--------•-.......................................... ---•--------------------------------------------------------------------------------------------- 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 Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board o health. 9rir gned.--- ----- . ..... •. '-✓lam D to Application Approved By-----. ----- .-- ------•-•- c/ --- ----- --- Date Application Disapproved for the following reasons-----------------------•---••-•--••-•--........................----....----------------------•--•--............•- .................................................--------------------------------•---•---••--------•-•--••--....--•---------------..-•--•••--- --•-•------•---------------------.----------------.----- Date PermitNo......................................................... Issued..................... .................................. Date 7/No...--•'••. +� ....... Flnc....A� THE COMMONWEALTH OF MASSACHUSETTS BOARD O jHEA --------OF........... ...... Appliratiun -fur Dinpuiitti Works Cnunotrnrtion Vrrniit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at � � !.. of 16. 1-/ -- .............................................................� Location-Address or Lot No. ............:� -- /� - -- ---- �•--••-•-•-��-�-- ........ ........ Owner /Address /�Q .P� / .---••OLi ------•-•-------•---•---•---------------•- --'--------------�IY.C�.!�....�l......- -...... � .......................... Installer Address U Type of Building Size Lot _Sq. feet Dwelling—No. of Bedrooms________________ 2------------------------Expansion Attic Garbage Grinder (►,14) pa, Other—Type of Building ------- ..... No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures .................................................................••--.....__... ..................................................................... W Design Flow...............5 ......................gallons per person per day. Total daily flow............... O...U...._......_.....gallons. WSeptic Tank—Liquid capacitvloa4gallons Length_._cc-__-4„ Width._-Y.. Diameter................ Depth....--_-._...--. x Disposal Trench—No- -------------------- Width-------------------- Total Length___-___-____-..___-- Total leaching area....................sq. ft. Seepage Pit No...... --------- Diameter........4........ Depth below inlet...... ........:... Total leaching area.__�k?o__sq. ft. z Other Distribution box ( ) Dosing tank ( ) e j-�G/X- ,2 -/.,'- 7`. aPercolation Test Results Performed by.... ---------••--------•-------------------------•-----•--------•-------- Date.------------------------------•----._.. a Test Pit No. I................minutes per inch Depth of "Pest Pit.................... Depth to ground water.._-_--..-------._.----- �14 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water...--------------------- ----------7... (� --- ----- ---- O Description of Soil---- V _ti / �� ....`^._ ------------ o < ._ VW ------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------- 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 Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. f gned----• --•-'- ------ •-- V Date Application Approved By--•--- .. ........ -•-------- •� Date Application Disapproved for the following reasons-------------------------------------------------•-•----•-----------------_---------_------••--•--------••------- ---------------------••.........-•-.....---•----------------------•---------••-•----.----_._...--••-•-•••-----•--•-•---------------------•---------------..:----.---•-------•---------.----------------- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH !......O F........... . .ter :. �..� / Tntif irate of from linnrr T S IDS 0 CE IFY Th t the Individual Sewage Disposal System constructed or Repaired ( ) by �A... ...,. has een installed in accord<�fnce with the pr visions of ' r� e XI of The State Sanitary Code as described in e application for Disposal Works Construction Permit N &_ _ _ ____________________ dated._..___�3_-/ _.-__. . '... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIL NCTION SATISFACTORY. DATE--------- ............................... Inspector------ 57if...... ................................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD O. EALTH OF........ .... ^ ..................................... . /No. . ...... .. .......... re &Permis ion reby granted._... . ----__...............to Conor Re ai ( n I diw'du ew sal4zstcm P ) at or . ... 2 r' i"' UU �pn /�` Street / as shown on the application for Disposal Works Construction Permit o. ............. ... ate :! 6 �� J ...................... Board of Healt DATE..... 1255 HOBBS & WARREN. INC.. PUBLISHERS r L Revisions: Date. I I rn Cm Cm Section B-B C3 c (D 0 r -� N E r Z7 a rD 2a' •-8' '-2g• ��• C) ly tz— 1z 4'8 a•-z• -0�• 1•-10• a'-2• a'-erg' >` C Cu O 3n FWG120268 3 — z � m O V o c FAMILY 210 NO H T A 7 IO x 5'-0 O c 8'1 B• O I u U 1 DINING e e + 8'-4-x 11'-6' b H s KITCHEN --+ N 14'-2•x 6'.3" =� Ld . 21 2M 3868 BATH a HALL9•-0-x 7-6" 6'- x 10'-6" r-1 xW LIVING i' Section A- FQ 22•.10•x11•-6•UP V! LAUNDRY R 15'-5'x 6'-11' TO Oi Tv 224310 1 I2410 a•-z•—+ r-6•—�—a•-r �s—�-6•�•�e•�ss 16' 23'-4' V}�� 3W4 V Proposed First Floor Addition Existing First Floor (� 1183 sq ft U N O Drawn By: NAL Date:06-01-03 c Scale:1/4"=1' I Sheet: A-1 Wd 9664I1£OIL U9-13Ob'd-1 1300W IV 03SOdOkld NOSSIS-"-. , I t • " - Revisions: Date: rn 00 Cli x C i C � � C a Cn E I r.4 CV CO c 24' 2T-V U! —3'-B• 19-T � ~ 1_ Ca O �� yr CO � O r - - - - - - - - - - - -I 'a Q g I I I I I a I I Proposed s I I IL ) E I b ILi _ - - - - - - - - o = W Basement r' - - - - - - - - - - --- E 14'-8"x 30'8" F I: I I I CU Cn m cc II __j U II � II Ii F L� I I x I I Existing I I Basement F --Ir- , I '-8" s,.-T-S' L j I � � o — — — — — — — — — — — 16 2T-4 0 391-4• U'^) V/ Proposed New Foundation I 1200 sq ft U N O nnL L.J.. M Drawn By: NAL Date:06-01-03 Scale:1/4"=1' Sheet: F_1 WV 99ZOZ SW8 V9-1 30Vd-1'1300W Id O3SOdO'dd NOSSIS-.-. Revisions: Date: 0 n V N Co O Ln 0) X ^` C LL "W -0 p C O Co 47'-98• E N 00 LL O 4'-6' 3'•9' 7T4'--}2' T4'-2' � T-1' 3'-te' 6'-77" � � t 0) C I 37o Tw 243ro � Lo C_ :+ CI) to CN 'MS Q < a�":1gy-"xK � W rn Cn Faster Suite a 2wa O O m �m J IJA. -0 E Ow Master&iInQ ; ROOM to CU � F- 0 I U IAASi ER BA' a BATH 1 1'-6"x T- 2ece 210 p 68 tS 22 {F F } BEDROOM OPEN BELOW >4 M 2Q10 TW 26310 4'•2'—ice—7'-B'—mot 1'-10 23'-97' O 39 98' V/ Proposed Second Floor Addition and Renovated Existing (n Renovation Second Floor U 868 sa ft �O Drawn By: NAL Date:06-01-03 Scale:114"=1' Sheet: A-2 J� w r• - 102--EXISTING CONTOUR m W Top N x 100.98 EXISTING SPOT GRADE s A W EXISTING WATER SERVICE m = & m G EXISTING GAS SERVICE m E UNDERGROUND ELECTRIC TEST PIT D TOPFIELD DR BENCHMARK OLD STAGE RD LEGEND CAPT STUDLEY RD x 0 00 N� � o CAPT DEYOUNG LOCUS LOCUS MAP NOT TO SCALE BENCHMARK SET E�=9696 OR./BOTT. STEP CAPT STUDLEY ROAD 100.07 100.25 S.A.S. dge of pavement XISTING S.A. 101,00 TO REMAIN FOR SIDEWALK FUTURE USE :n 63�OfZ35" E 123.62' LOT 17 _.: DOG PEN o ��� � 1-928 O. MBL 126-053 • .r \ ' 21,642 tSF 103.00 �... : RO \ 1 .01 1 101,�31 ql, 8• `J`)Q2.73 pi p t;r 1 1�,00 CB 1 •��' 1 43 102.081 GARAGE :I:: ,:.J- - :/�`v 102,79 GARDEN VEST 1 100.07 STORAGE .. 10 ,64 101,35: I� ;_P02.06 0 INSTALL BULL RUN VAL VE / .. 101,58 — —EXISTING-SEPTIC- TANK - INV.(0UT)=98 68f O 106.64 �9,70 0 101.67 101,82to (o } SPA EXISTING �q<< o N HOUSE&11) x 101,70 100, ��•q.) N r.o.F=1o2.s5f Qj STONE _;k� 1 99,37 PATIO �p / O \E (o N 0) ' x 101.92 101.53 01.74 e 72 W 100.80+• — 'Co 0 99.02 LAJ v x 101,65 TRAMP x la, 7 101.46 0 PATI 0 J� 98.66 101,33' N � + x 101,62 � x 100,38 ABOVE � V GROUND 101,41 V POOL SWI��SET FENCE SHED 101,31 109.68' + 100.88 + 101.. Q S '06'35' / Q� CB 100.47 OF 44Ss9�yG 98,26 o PETER T. M E CIVIL N PROPOSED SEPTIC SYSTEM UPGRADE PLAN No. 35109 RfG/STEREO 11 CAPT STUDLEY ROAD, MARSTONS MILLS, MA 9�E I G� Prepared for: Peter Sisson, 11 Capt. Studley Rd, Marstons Mills;"°M74' OZ048 OWNR OF RECORD Engineering by: SCALE DRAWN JOB. NO. PETER E SISSON Engineering Works, Inc. 1"=20' P.T.M. 187-14 11 CAPT STUDLEY ROAD 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. MARSTONS MILLS, MA 02648 (508) 477-5313 8/1/14 P.T.M. 1 Of 2 u NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:97.$), FOR A DISTANCE OF 15' AROUND THE SEPTIC TANK PROPOSED D-BOX PERIMETER OF THE S.A.S. INSTALL RISERS & COVERS OVER INLET &OUTLET AND SET TO 6' OF FINISH GRADE INSTALL RISER & COVER PROPOSED S.A.S. SET TO 6" OF GRADE INSTALL RISER & COVER OVER EACH CHAMBER AND TLF.G. 2.65t SET TO 3' OF F.G. TO SERVE AS INSPECTION PORTS .=101.9t F.G. EL.=101.9t F.G. EL.=102.5t F.G. EL.=102.5VENT (CHARCOAL RECOMMENDED) ® S=1% (MIN.) L = 23'(MAX.)> 4"SCH40 PVC ® S=1% (PVC 2- LAYER OF 1/8" TO 1 2" 4"SCH40 PVC / DOUBLE WASHED STONE �a"I " 6 ®ONBaao OR APPROVED FILTER FABRIC) 14" 63aa00639 EXISTING 48" LIQUID aaaaaaa -3/4" TO 1-1/2" DOUBLE LEVEL WASHED STONE ADD PROPOSED 4' 4.8' 4' GAS BAFFLEINV.=97.40 INV.=97.23 INV.=98.68t D_BOX EFFECTIVE WIDTH = 12.8' EXISTING 3 OUTLETS INV.=97.00 EXISTING SEPTIC TANK 3-500 GALLON LEACHING CHAMBERS SURROUNDED WITH STONE AS SHOWN H-20 RATED TOP CONC. ELEV.=98.1 t NOTES: BREAKOUT ELEV.=97.5 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE INV. ELEV.=97.00 eaaeai INVERTS, PRIOR TO INSTALLATION. aaaaa aaaaa aaaaa 2) D-BOX SHALL BE SET LEVEL AND TRUE TO BOTTOM ELEV.=95.00 ease GRADE ON A MECHANICALLY COMPACTED SIX 4' 3 x 8.5'=25.5' 4' INCH CRUSHED STONE BASE, AS SPECIFIED 4' OF NATURALLY OCCURRING EFFECTIVE LENGTH = 33.5' 1N 310 CMR 15.221(2). PERVIOUS MATERIAL 4G.W. 3) INSTALL INLET & OUTLET TEES AS REQUIRED. (MIN.) ABOVE G. LEACHING SYSTEM SECTION 4) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE BOTTOM OF TP, EL.=91.0 46 AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. (NO GROUNDWATER) SEPTIC SYSTEM PROFILE HOUSE (FRONT) GARAGE GENERAL NOTES: 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS A• � OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 3r LOCAL RULES AND REGULATIONS, EXCEPT AS REQUESTED BELOW: �• 6'. -310 CMR 15.405(1)(b): cS� co nj , _11_A_2_variance to the_ 3' maximum cover requirement, for 5' of _ �, 0) max. cover. S.A.S. -shall'be vented and-rated H-20. 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR i� 00 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE ��d DESIGN ENGINEER. dOo 5 p,5• 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING PO5v FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN PRO �i ENGINEER BEFORE CONSTRUCTION CONTINUES. ; �,���/� 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. �.j3• 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. S.A.S. LAYOUT 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8. THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. SOIL LOG 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. DATE: JULY 30, 2014 (REF#14,447) 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY SOIL EVALUATOR: PETER McENTEE SE#1542 THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING WITNESS: DON DESMARAIS R.S. CONSTRUCTION. HEALTH AGENT 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS ELEv. TP-1 DEPTH ELEv. TP-2 DEPTH IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 102.5 A 0„ 102 7 0" A 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE SANDY LOAM SANDY LOAM INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. 101.8 1 OYR 4/2 102.0 10YR 4/2 B 8„ B 8„ 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND SANDY LOAM SANDY LOAM IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY. 10YR 5/4 10YR 5/4 99.5 36" 99.9 34" C C DESIGN CRITERIA PERC 4/36' NUMBER OF BEDROOMS: 2 (DEED RESTRICTED) 4 SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: 4 MIN IN F-M SAND F-M SAND / 2.5Y 6/6 2.5Y 6/6 (0.74 GPD/SF LOADING RATE) DAILY FLOW: 220 GPD DESIGN FLOW: 220 GPD GARBAGE GRINDER: NO-NOT ALLOWED WITH DESIGN 91.0 138" 91.2 138" LEACHING AREA REQUIRED: (440 GPD) = 594.6 SF FEB 17, 2006, P#11226 REFERENCE PERC 4 MIN/INCH @ 30"/42" .74 GPD/SF SOILS OBSERVED ARE CONSISTANT WITH PERC ON FILE EXISTING SEPTIC TANK: 1000 GALLON CAPACITY NO GROUNDWATER OBSERVED PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS PROPOSED SEPTIC SYSTEM UPGRADE PLAN USE 3-500 GALLON LEACHING CHAMBERS IN SERIES SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES 11 CAPT STUDLEY ROAD, MARSTONS MILLS, MA SIDEWALL AREA: 2(12.8' + 335) X 2 = 185.2 S.F. Prepared for: Peter Sisson, 11 Capt. Studley Rd, Marstons Mills, MA 02648 BOTTOM AREA: 12.8' x 33.5' = 428.8 S.F. Engineering by: SCALE DRAWN JOB. No. TOTAL AREA:..............................................................614.0 S.F. Engineering Works, Inc. N.T.S. P.T.M. 187-14 TOTAL CAPACITY PROVIDED:0.74 GPD/SF(614.0 SF) = 454.3 GPD 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHMT NO. (508) 477-5313 8/1/14 P.T.M. 2 1-of 2 EXISTING 1000 GALLON TANK DISTRIBUTION BOX - H2O 500 GAL DRY WELLS - H-20 CROSS SECTION LOCUS PLAN ZONE II NOT TO SCALE NOT TO SCALE NOT TO SCALE NOT TO SCALE NOT TO SCALE BM 100.0 MIN 2% SLOPE 98.3 a N\\�\\� COVER TO BE WITHIN 6"OF GRADE MAX.36"COVER 2" 1/8"-1/2" WASHED S ONE RACE LANE 4"SCH.40 P.V.C. 3 MIlVIIvIUM 4"3CA.40 P.V.0 � � _ H - " Z {=5: O r o � o' o 0 0' o 0 0 r o C7 C] Cl r 1 3 4.9 C7 C7 C7 � C] C] C C] CJ C] C " 95 9 .9 a t o c 0 0 0 0 0 0' o 0 4 C] C Cl / m C] C C7 C7 C] C] C] C C] C] C7 \ o 0 'n O O O O �' O O O O O C e�dsti \2 5.3 r 9 C] C C] C] C C] C C] 3 -� 1.1 0 0 0 0 0 0 0 0 0 0 r \ C C s2.s C] C] CI C C] � C] C7 C] C] / C7 W 4.0 95.1 - .j CA PTAIN A I N ST W U.� D L\ EY MIN /. /� �.... /�.:.>: ....•%./�..+/�. . 2. 34' 2.5 2.8' 4.83' 2.$' UNDER } 39' 10.5' o 8.5' I 3/4"-1 1/2"DOUBLE WASHED STONE BOTTOM OBS 94.3 SITE SPECIFIC NOTES DESIGN CALCULATIONS GENERAL NOTES ALL PIPING TO BE SCHEDULE 40 P.V.C. LEACH PIT TO BE PUMPED AND EXISTING BEDROOMS 2 ® 110 G.P.D. ALL LOCATIONS OF UTILITIES SHOWN ARE AS -<, FILLED(REMOVE ONE IN DRIVEWAY) (DEED RESTRICTION 6/24/03) 220 G.P.D. M�� I MARKED BY DIG-SAFE AND ARE TO BE 7 40 ML VINYL BARRIER TO BE INSTALLED AS (V' 53 VERIFIED TI INSTALLER PRIOR TO N0. OF UNITS 4 CONSTRUCTION 1 SHOWN FROM ELEV.95.0 TO 92.0. P # 11,22C� DEPTH BELOW INV_ 2' THERE ARE NO KNOWN WETLANDS WITHIN j WIDTH 10.5, 150' OF THE PROPOSED LEACHING FACILITY LENGTH 39' UNLESS SHOWN. INSTALLER TO NOTIFY DESIGNER 24 HOURS C ACAS' THERE PRIOR TO BEGINNING OF JOB TO . BOTTOM AREA 198 100' OF THEN PROPOSEDPLOEACHING FACILITY.HI 4� SIDEWALL AREA 198 COORDINATE INSPECTIONS TOTAL SQUARE FEET 607.5 SF THERE ARE NO KNOWN IRRIGATION WELLS WITHIN 50' OF THE PROPOSED LEACHING r 449CAPACITY SIDEWALL 00.74 146.5 G.P.D. FACILITY FLOOR PLAN CAPACITY BOTTOM ® 0.74 .1 G.P.0. NOT FALL THIN A CAPACITY TOTAL 449.6 G.P.D. FLOOD ZONE AS SHOWN ON FIRM MAP THIS DESIGN DOES NOT REQUIRE VARIANCES /� SEE ATTACHED TO TITLE 5 (310 C.M.R. 15.00) OR BARNSTABLE NTHIS SYSTEM NOT DESIGNED TO SUPPLEMENTAL REGULATIONS. � S ACCOMODATE A GARBAGE ALL CONSTRUCTION SHALL BE IN ACCORDANCE DISPOSAL WITH TITLE 5 AND BARNSTABLE SUPPLEMENTA „- VD REGULATIONS. IN-LINE ELEVATIONS PROPOSED AS-BUILT SURVEY INFORMATION O INV. 0 HOUSE EXISTING PROPERTY LINE Con DATA ata is FROM 2003 INV INTO TANK EXISTING Yankee INV OUT OF TANK 95.8 DLLY INV INTO D-BOX 95.3 PLAN TO BE USED FOR INSTALLATION w TREE \G INV OUT OF D-BOX 95.1 OF SEPTIC SYSTEM ONLY / INV INTO CHAMBER 94.9 BOTTOM OF CHAMBER 92.9 NOT FOR DETERMINING PROPERTY LINES GARAGE rstWLH i�At�K- BOTTOM OF OBS HOLE 84.3 _ _.._, WATER TABLE NONE ENCOUNTERED ORNER OF STOOP 100.0 (ASSUMED) d SAS - 4 DRY WELLS REMOVE LEACH PIT / 10,5' X 39' SOIL LOGS DATE, OBSERVED BY: WITNESSED BY: AND D-BOX Feb 17, 2006 LISSOILA C.EVALU�TOR ONS OARD FMARAIS HEALTH ELEV. OBS. HOLE #1DEPTH tr( I Z Z 6 98.3 0" I FILL ° 13 ° 4 ML VINYL MEMBRANE TO 97.4 O" I B LOAMY SAND I BE INSTALLED AS SHOWN IOYR4/4 g6.3 24rr30 l PUMP AND FILL LEACH PIT CI LOAMY IOYR4/6 SAND 42: I 89.3 08" BENCHMARK SET C2 MEDIUM SAND Ril�h t cor. top Stoop 84.3 2.5Y 6/6 Q 68" E(.=100.0 (Assumed) NO GROUNDWATER ENCOUNTERED 7 V PERC RATE 4 MIN/INCH VARIANCE REQUESTS \• REQUEST THAT SAS BE 9 FROM GARAGE SLAB AND 13' FROM FOUNDATION. 40 ML VINYL BARRIER WILL BE USED L" 0FAi PLAN SHOWING: PROPOSED SEPTIC SYSTEM REPAIR IN BARNSTABLE FOR: DRAWN BY: LISA C. LYONS v t PETER AND LISA SISSON DESIGNED & CHECKED B C. LYONS REVISIONS: DESCRIPTION: DATE: ots** ��Q� c I I CAPTAIN STUDLEY RD MM NUMBER OF BEDROOMS 9/29/06 p�� RED S���` ` LOT#: SCALE � • �O P53 DATE:FEB 20,2006 LISA C. LYON , R.S. I CERTIFY THAT THIS PLAN CONFORMS TO LISA C. LYONS, R . S. (508) 790-9270 TITLE 5 AND BARNSTABLE B.O.H. REGULATIONS HYANNIS, MASSACHUSETTS (774)487-1638 (EXCLUDING WAIVERS SPECIFIED)