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HomeMy WebLinkAbout0034 FAIRHAVEN LANE - Health 34 FAIRIIAVEN LANE, MARSTONS MILLS Lot i5 A 149.332 d - n COMMONWEALTH OF MASSACHUSETTS ExECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION JAN 2 0 2004 TOWN OF BARNSTABLE TITLE 5 HEALTH DEPT. OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION MAP 1 A Property Address: �G1 ,Y`/TG v� L-g H� PARCEL Q)-I�) (-N)O `L civ h ,' /yl Od6�3� LOT Owner's Name: A ire ' a Owner's Address• r 14zi,,z a,-? s hl OV6 4� Date of Inspection: I;x 1021 0 Name of Inspector. (please print) �Y l"p lei/l Company Name. C- V,a — Ec—1 Mailing Address: O Asrbse /d L��t f vhAp Telephone Number: 69 S� 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 pursuan=Passes 15.340 of Title 3(310 CMR i5.00o� The system: Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails J Inspector's Signature: Date: The system inspector shall subm a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.Nam 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 ins pection and ender 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. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(c ed)ontinu Property Addreas: �7 F�I r/�(-r h `/Z>/ H i Owner: vE2:::� Date of Inspection: a r o h pection Summary: Check A^C D or E/ALWAYS complete all of Section D A. Sy 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: Y:or ConditionallyPasses: 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.N"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is suncturatiy unsound,exhibits substantial infiltration or ex6ltrauon 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 struchwAly 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 m 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 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 prpe(s)are replaced obstruction is removed ND explain: f Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:. _34 ve 1, Owner: //i V Date of Inspection: C-, Further Evaluation is Required by the Board of Health: /v 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 CM 11303(1)(b)that the system is not functioning in a manner which will prbtmt 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 L System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is fmctioning 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 I00 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**.Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,for conform bacteria and volatile organic componuds 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 ppn,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: + Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: F?,r/510vp h /— /I/ Owner. S�-v �✓a,� /� Date of Inspection: li 1 D. System Failure Criteria applicable to all systems: You most indicate`eyes"or"no"to each of the following for all inspections: Yes No AWm of sewage into facility or system component due to overloaded or clogged SAS or cesspool Z _ or ponding of effiueut to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool — /Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or V 1 d depth in cesspool is less than 6"below invert or available volume is less than y day flow prmrlang more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number 9f 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. a_ po 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. — Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system Passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other far'lure criteria are triggered.A rigge Dopy of the analysis must be attached to this form.j es/No The system f(Y ) y a�7s.I have determined that one or more of the above failure criteria exist as described in 310 CUR 15.303,therefore the system fails.The system owner should contact the Hoard 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 indicate either`yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) \ye system is within 400 feet of a surface drinIdng water supply system is within 200 feet of a tributary to a surface ddnldng water supply ystem is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped e 11 of a public water supply well ered"yes"to any question in Section E the system is considered a significant threat,or answered n above the large system has failed The owner or operator of any large system considered a at un 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. Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B �j CHECKLIST Property Address: �Ac�� 0 Owner. Date of Inspection: l� Check if the following have been done.You must indicate`yes"or"no"as to each of the following: Y No I onving information was provided by the owner,occupant,or Board of Health. Were any of the system components pumped out in the previous two weeks _ -zthe system received normal flows m the prewous two week period e large volumes of water been introduced to the system recently or as part of this inspection Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for sips of sewage beck up Was the site inspected for sigmas of break out _ Were all system components, the SAS looted on site Were the septic tank manholes umooveted,opened,and the interior of the tank inspected for the condition of or tees,m erial of construction,dimensions,depth of licltrid,depth of sludge and depth of scum 7as the facility owner(and occupants if Jiffi, from owner)provided with information on the proper m of sewage disposal systems The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Y50'/no i _ Existing information.For example,a plan at the Board of Health. Determined in the field(if any of the faflu a criteria related to Part C is at issue approximation of distance is unacceptable)[310 CN R 15.302(3)(b)} f Page 6 of II. OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: I.- 94 ►.k ` /v s �Y/s Owner: / ,✓ti h Date of Inspection:--- C ,:9-1 zo FLOW CONDPPIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example. 110 gpd x#of bedrooms): Number of current residents: f Does residence have a garbage grinder(yes or no):�0 Is laundry on a separate sewage system(yes or no): [if yes separate inspection required] Laundry system inspected(yes or no):/vim Seasonal use:(yes or no): L09 Water meter readia ,if�e(last 2 years usage(gpd)): Sump pump(yes or w): / Last date of occupancy: _14'r, COMMERCIALA NDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): Basis of design flow(seats4 sonstsgft,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 Pumping Records Source of information: Was system pumped as part of the inspection(yes or no): If yes,volume :_____gtk ms—How was quantity pumped determined? Reason for pumping OF SYSTEM _Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool —hivy —Shred system(yes or no)(if yes,attach previous inspection records,if any) _In novative/Altanative 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 nrstalled�if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): Page 7 of 11 OFFICIAL FORM INSPECTION F — NOT FO R VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: .1421 .11 �t hS , �/ r /�.J, Date of Inspection: �� 0 BUH,DING SEWER(locate on site plan) Depth below grade: 31 r/ Materials of construction: cast iron �/4p PVC other(explain). Distance from private water supply well or suction line: Comments(an condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:_" (locate on site plan) ri Depth below grade:�9 Material of construction: 4/ ncrete_metal fiberglass_imiyethYlene other(explat) If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) 0 r Dimensions: r- Sludge depth: , Distance from top of sludge to bottom of outlet tee or baffle: 33� Scam thickness: L efs / IV Distance from top of scum to top of outlet tee or baffle: 9 V Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: 1�a /G R o Comments(on lumping recommendations,inlet and Dull or baffle condition,structural integrity,liquid levels as rAoted to outlet invert,cyideqce of l �C); 11 GREASE TRAP: (locate on site plan) Depth below grade: Material of construction:_concrete metal fiberglass_polyethylene_other (expo): Dimensions: Scam thickness: Distance from top of scam 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 lumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related 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 SYSTEM INFORMATION(continued) Property Address: Gl Owner: S(.� /I v G Lj Date of Inspection: 0V TIGHT or HOLDING TANK: must be pumped at time of inspectionXiocate on site plan) Depth below grade: Material of construction concrete metal fiberglass_ pohvftlene other(explain); Dimensions: Capacity- rallons Design Flow: fflllonstday Alarm PFCSMA(yes orADm Alarm level: Alarm in working order(yes or no): Date of last pumping Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: T/(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert 4(J/t✓"t A Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage�,�ft,or out of box,etc.): / ,/� / / U,` , � Is ��yiPi/ /v !7 S o�Cam' /j'O L PG 4::1:-� PUMP CHAMBER�L(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.): r Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) r L/f/ Property Address- Q,r � tiG n. � Owner. ti iya,. Date of Inspection: 01 L SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type g PiK number number.eachmg chambers, leaching galleries,number: leaching trenches,number,length: leaching fieldls,number,dimensions: overflow cesspool,number: - innovativetaltemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): CESSPOOLS:&,(-Mspodl must be pumped as part of inspectioWocate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer. Depth of scam 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: (locate on site plan) Materials of contraction: Dimensions: Depth of solids-, Comments(note condition of soil,signs of hydraulic failure,level of pomiing,condition of vegetation,etc.): r Page 10 of I I OFFICIAL.INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(cominu4 Property Address: �Ci i r NG v� z— 4 owner: �� o•�f ,�/s Date of Inspection #1 SKETCH OF SEWAGE DLWSAL SYSTEM Provide a sketch o€the sewage disposal system including ties to at least two permanent ramenm landmarks oj benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the h afing. /Jou ski use 63 // -- 2s 3 ;F d A3 - `-t � _ r I I 31l AN 63 L+�-'l < I o 0 6�- 3-Y Page I I of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: J r l�G v+ Z—Al Owner: wr Date of lnspection• SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water S I 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 OObserved site(abutting propertylobservation hole wi 150 feet of SAS) hecked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You mast d7 r, ,,tw you established the high ground water elevation: �- - 3 , e5� 71 3� of .S f�D��g , —ONyOF BARN TABLE h't`Q' LOCATION SEWAGE # J/7- .,57 S 7 VILLAGE k ld�, ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITYl LEACHING FACILITY: (type) 2 262 Ltec\o%C"S.{*e=g) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: J -. -°1 ?� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 all Ar � � FIcs � " THE COMMONWEALTH OF MASSACHUSETTS i� BOARD OF HEALTH TOWN OF BARNSTABLE Appliratinn for Diripuiul Wmr1w Toustrnrtinn Frrntit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal Syst `at ....... ... ...... .................................................... hon-: r• s o No. ...............•.... •... ............................... O lddr ......•......... ..... .... ....... dL ` ¢ W --� DILL,-�1_I �1�: . �..----(....... .................................!.-_®_�OX �o7�l.�-�5�+ �'®a kvv 4 Installer `14 4/C/�V/`IOVISv-ram py� Address // d Type of Building Size Lot....`.�.!.6 Sq. feet by� Dwelling— No. of Bedroom''s-�--TT-__-_--_-_------:-. _----_---Expansion Attic ( Garbage Grinder (Alo 4v :No. of ersons---------------------------- Showers — Cafeteria p`'�., Other—Type of Building _ __._ .. .. . p ( ) ( ) Other fixtures -------------------------------- -- - Lj' W Design Flow...................lt1 ....._........gallons per er day. Total daily flow.......... 3 g g� P P Y Y gallons. WSeptic Tank—Liquid capacity./MgalIons Length---------------- Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing t2V( 9` �li57A.v---..... Percolation Test Results Performed by........ ...... ..... .............. .. __. .._._._.__... Date......... _ a Test Pit No. I----------------minutes per inch Depth of Test Pit.../Z......._. Depth to ground water_----.....��. 4q Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ GL' - ---------------------------------------------•--•-----I •-......................................................... 0 Description of Soil........... . ..4----_ x W .............*-----*-------------------j............?.................................................................................................................................... UNature of Repairs or Alterations—Answer when applicable.................:............................................................................. •.............•---..........----............._...--•--------------------------------................----.....-----•-••--_._......----••-----•-•••••........__.........••--••••-•--•-•••-................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersi tied further agrees not to place the system in operation until a Certificate of liance ha been ed by th of health. Signe :... . ..... ... ... .... ...... . ...................... ................... .............. Date77 Application Approved By .-.... '.. ........................................ . ..........:................_99 -� .p...� t/� Application Disapproved for the following reasons: ............... . .... ............................... .............................................:........................ ........ .............. ..... ... . . . ............................... ................ . .......................................--.... --.-- ....--....--.......... ...................................... Permit No. ...��� ....� ........................r1l Issued ..............................--.........................ate..... Dare 9 q / -5 TOWN OF BARNSTABLE ` ' I 'I �/ - v .3 �c a GE # LOCATION SEW A VILLAGE Ik 'Il T —ASSESSOR'S MAP& LOT INSTALLER'S;NAME&PHONE N0. �' J Qe.��� Cqu SEPTIC TANK CAPACITY s 2 s��. �. : L't C�,. ze) l`I X'1lS F • LEACHING (tYPe) 3 NO.OF#EDIkOOMS BUILDER:OkbWNER ..� !� ►1 „�c d q ;:;' PERMTTbATE: I 01 COMPLIANCE DATE: Separatiori`Di i i a Between the: Mu amuji. usted Groundwater Table and Bottom of Leaching Facility Feet Private W*r Supply Well and Leaching.Facility (If any wells exist Feet on sttt qr within 200 feet of leaching facility) ; Edge of Wetland and Leaching Facility(If any wetlands exist Feet within:100 feet of leaching facility) - . Furnished.by ' _—• ''`.. A s.. .'+.._, ....r 3 3 P_ a f Z- ... . THE COMMONWEALTH OF MASSACHUSETTS / BOARD OF HEALTH yl� ".V_X ,r TOWN OF BARNSTABLE Appliration for Uiripuiul Wnrk,i Towitrurtiun 1hrmit Application is hereby made for a Permit to Construct (L-� or Repair ( ) an Individual Sewage Disposal Sy st at: .......I.............. ........ . ............ --------------------------------------------------- Lo pion-:\eiilress n� or.+Lot No. 1 Address ......... .- ....... -��;-�`.. - ti - .... Address Installer V f ` (;o f l t � Consfr�c�-` f 3 , 6� / v Q Type of Building Size Lot_______________ ___ __Sq. feet c� Y Dwelling—No. of Bedrooms______________----__________-___.___-------._Expansion Attic W)) Garbage Grinder (uU) aOther—Type of Building 14 No. of persons____________________________ Showers ( ) — Cafeteria ( ) d Other fixtures ........................................ ---•--.....'---._.........__... W Design Flow...................�1��--____-.___--_-gallons per per-s©n-per day. Total daily flow------------?>-•m......................gallons. WSeptic Tank—Liquid capacity.000galIons Length---------------- Width-.--_--_-_-._..- Diameter................ Depth................ x Disposal Trench--No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------.---_--.-.- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.' Z Other Distribution box ( ) Dosing tank '~ Percolation Test Results Performed by........ . .......... ............. Date........!21/`3 /- � Test Pit No. 1................minutes per inch Depth of Test Pit---/ ......... Depth to ground water.....A�. 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ aU ••-.......- ----� ......................7....................................................................."...--.............. :--�O Description of Soil..............A �7l�r x ------------- ---•-••----------------------------------------- -•----•----------------------- -----• -------------------------•----•--............-•.._.....--..----- R W UNature of Repairs or Alterations—Answer when applicable-------------------------------................................................................. ....----•-•-------------------------------•-----•--•----.....•---•••-•••------•-•-•-.....-••-•.--••--•--••-••......•••---•--••-•----•-••••-••-•...--•-•-••---•••••-••-•-----•-•-•-•-•••-----............ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code —The undersined further agrees not to place the system in operation until a Certificate of Com, liance ha 11 bee ks ed by the oa of health. Signe . ........... ...............:: .:....::.......:.......-._ w 7 .. r, ' - . ..c Application Approved By ..............0 J ......_.................... .................� . Application Disapproved for the following reasons- ----------------------------------------------------- •..................................................:....---.................. ........ .. ...................................... .. ... ...................................... . . .................................................... .. ... ............--- ............. Dare Permit No. ...-��� ��. -v�'-.................. Issued . ... ................................. Due THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certifirate of Comylianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( V/) or Repaired ( ) b ..........) ................ at ................ ._/.. ...._.... ! ! ,1w1...... ��`t�%Ltd............. 1.-.... ......................................... -.......... 4 has been installed in accordance with the provisions of TITLE �f The State v�i onIe+n-�1 ode as described in the application for Disposal Works Construction Permit No. ._...L j-- '�-�,,�L..�r� d ...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. -�� DATE.............._..._..�._Z...-= `�I. .. ./�a..._....----------------- ......._.... Inspector ............0........__.._............:... ....................................... THE COMMONWEALTH OF MASSACHUSETTS 'r 6tq BOARD OF HEALTH a TOWN OF BARNSTABLE No FEE....1 42f-.1........ Mipmat Worrkii Trrnitrurtirrn Vrrntit Permission is/hereby granted.••--W.-----` ' /s ------•-------------•-•---------•---------•-----.....-------•----....... to Construct ( [1) or Repair ( )/an Individua Sewage DispQ al System atNo.... � '`�..f` �r�r fit/t rr _.... r ............ !............................................... ..... Street .— as shown on the application for Disposal Works Construction Per .it No.. -S. Dated.......................................... d F•.... /. Board of Health DATE-----.. •--- ••- -- r� FORM 36508 HOBBS Q WARREN.INC..PUBLISHERS 4 TEST HOLE-LOG IDATE: SEPTEMBER 15,1994 P-8?OC' LxST I TEST BY: WELLER&ASSOCIATES I ' WITNESS: ED BARRY, HEALTH AGENT PERC RATE: <2 MIN/IN ' woo ! I \ 9q.o lu8 `I I -------- \\ loot II i DESIGN DATA BDRMS x 110 GPD DAILY SLOW:. (3 ) . - SEPTIC TANK: 3130 41?0 x USJF;: la GAL. PRECAST SEPTIC TANK . LEACHING FACILITY: USE: (;;. )4' x 4' GALLEYS WITH 2' OF STONE CAPACITY:, 522.a 4� t �a Or-- 0 LIU& `oJr o� ptSI�ITorJ o•/ 3/ " i�z '� SF:43z A1Za' tujr.7 PI`?Q "To t3r'- A' VIA, SC14� V�K, I . MINIMUM BUILDING SETBACKS_ SITE - SEWAGE PLAN FRONT: , 30' FOR SIDE: 15, Lc5T, 15 '�s41121 /EJ L,Oc MAQS�o►S H'LL5,H'kl 'REAR: ` 15' i PREPARED FOR ';BAYIDE.BUILDING., INS: y.. . . .. P��Of fill 1N OF hq \ DATE: SEPTEMBER23, 1994 SCALE: 1" =G �� ;--- ��, ; �� su4 y p`, t)ANIEL E. yG Zip ( �y \I iCIVIL r••1 41 1�e{�1i,,Bggpp y N. 32686Z w RUir PV , 71 , r L�—Qy� WELLER & .ASSOCIATES P.O.BOX 119 YARMOUTHPORT,MA. 02675 j (508)362-8131 I ! L Map; 149 pcl 33-2 . ! Test pit #P-8280' , J , . Wit-. Ed Barry - r . .-.-' -- _ .... _ - - ---- - _ -- _. _I l T- Made 9 _15-94 i - }. ._ No water eco' r►te ed ; t n u r. Perc. less 2 fnn: per7am 5.5 ,- L. 43 5F 4.g I --- _ a I I o 1 Septic= design ! ! n No. bedrooms 3` I Req. leach 330 pd t V Req tank- __.. 1a04L a 1 .- _-, -- --- --__:_ --- Leachinq; 9 : L 12x25 -320 5c.74__ 23 7 .�°; Lj Fairhaven Lane,f. 40 'Fai wide -b x2.=L51-x!.74 11 0 Totalleaching 9 .0 qPd , IL } . . - -... , r , _ + . : ; L } r l I 1 ! _'_ -. Profiles no scale ; L I , - 1 To 3 L L5 v�C _ � UI : . � �'�'d M G O O G•' v cv b .:¢ ; .J ei F �`• � I s I ' L. I Qro 04a Ap f t _. Cp 7 r / - ! r n-' ow, per I Use , I , �x4 ga'l leys �n ooeacpo� IIt A oo , I wit _.14'.,_of stone o:vim® Us:E z C: eb s• �jT4wI� o . a`lli A und; units. 40 - _ I`' No L. : r }-i-worlk--to-con-form—4_.: 1 to the -Minnnn� i►u�n. requireml nts . -. V , } . . . Site: plan: o-f: Land in Marston Kills', MA 1 I or JamesAntiosti } r F _ Being .100--rl as sTiown_.in bk 487Pg. q � - i Elevat1ions, are; on NGVD; t- 1 F - - 4IF Date Agent Barnstable board of Health --- r------'—_ Date- 12-23=97 -_ c Scale 1"=50 � All: Cape Engineering 4.9. 'H'a rbo r Ro'ad- 1 � - Hyannis, MA 02601 I NOFM . _ OBERT a • M FITZGERALD CIVIL No. 39791 %STE R 7-4 i R � 1f I _ -t - S i . _.I ff NA � 1 + 1 t1 I_� _..1.1-. ..Tr r 1_i i '. � i �, ' �„ �. -,..,e-...-�-.+---�-•--.,,�.._-. ,.-..�,..-.-...-3•,•,•...,, .<.•.. y..,no.,w•,.K.,...daw.-.,raw«,•i. - , A. I Map! 149- pcl 3 =`2 - Test pit #P-080 _} _._. i Wit'. Ed' Barry ------ _ _____,. _ .._.. _:_. _�_ __ __ Made 9 15-94 No water encountered Pert. less 2 'train pert" ij • ..J �. L_i r , l_ Ma tit U SL� LaT 7 S S A W/a,,,isL.A- A_ € o -.'._.__LI .�.:-.._• t} I ..SRO_.OIL MCI , 00 - _ - j Sa' - 3r i i : Septic design No. bedrooms I i I / Req. leaching 330s qpd _ - -- -- -Req-.-- tank- 15D-0=gal--.;! Leaching: ; 12x25 =32� c.74= 23 7.b'�1 Fairhaven. Lane ' 40 ' wide I5 x2:=.151 k4.74 = 112.0• - : t Totalleaching: 349,.0 9pd • E- Le O t - 1 , :Profiles no scale . . ------------------- ' , !-gt'Z'p VT �05► -- R ISti t�I t�C T10 L ij 0C1.oc ov I-P I ea m.:d- :a41 1 . - oN� - �OGOG �U7 c LFV , � I. _.. ._ - �n dJ a:t• �.++.'.. ..r"K.n:, I I" I � C'J.� � 'a �'I 4 ! foT TP 0 2. Useti-Sx4 gal}legs -. �. o cocs.v _ t �cx'o.�ao wi t : of stone" o.vey�vo Us.E al li a�rbund units. l i O ca v... ..Y o -Nbt , -wo-r"k to conform -- ' to th�imin3muih requireif► nti _ _ r Site P"lan of Land in Marston M111's MA For James; Antiposti 1 I N _ I t ._ Being lot 15 as shon_w _in bk-_.487 pq 66 i Elevations are- on NGVD - ram 1 ; . Date Agent Barnstable board of Health 1"=5:0-� - 2-23= Dat e .1 All 1 : 97 Cape Engineering d: i 49 Harbor Roa : ` ? :-r Hyannis, MA 02:601 OF Afj OBERT t FITZGERALD CIVIL o. 397910 �Q ?.4Q.J L ... I r S ONA ASS A I i 1 1. _ i 1 I 1 i I i - f i i ,. - I !_4 I _ i ", ��+n �ll��*► _r-¢--f--f--�--t-- �-�. c-"t-t-i-�'-rt-,-, t,i- ice. • L.-IJ L.T _....�..