HomeMy WebLinkAbout0086 TANBARK ROAD - Health 86 Tanbark Road, Marstons Mills
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TOWN OF BARNSTABLE c�
LOCATION 86 I(l bC&rIC-- QCQ SEWAGE# V1
VILLAGE • @��� ASSESSOR'S MAP&PARCEL
�'S NAME&PHONE NO. 6X k_ -
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type)17�_v (size) I OW
NO.OF BEDROOMS
OWNER ,� \
PERMIT DATE: E DATE:. (_�! ,'Q
�
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
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Commonwealth of Massachusetts
4 Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for
State Zip Code Date of Inspection
every page. Cityrrown
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way.
Important: A. General Information
When filling out Z�
forms on the "9
computer,use 1. Inspector:
only the tab key
to move your Patrick M. O'Connell
cursor-do not Name of Inspector
use the return
key. Septic Inspection Services Co
Company Name
189 Cammett Road
Company.Address
Marstons Mills MA 02648
City/Town
State Zip Code
508-428-1779 SI 12855
Telephone Number License Number
B. Certification
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 mainnance Won si#e
sewage disposal systems. I am a DEP approved system inspector pursuant to Se•tion 15 340 of
Title 5(310 CMR 15.000).The system:
A
® Passes ❑ Conditionally Passes ❑ Falls ..r
7Z)
Needs Further Evaluation by the Local Approving Authority
rj
co
Ln
November 13, 2008
Ins ctor's Signature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority (Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the,approving authority.
****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.
08-282 Ddoley,doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
Tank is not in need of pumping at this time leaching pit has approx. 2" of effective leaching.
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):
El broken pipe(s) are replaced
❑ obstruction is removed
08-282 Dooley.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
wM 86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for State Zip Code Date of Inspection
every page. Cityrrown
B. Certification (cont.)
B) System Conditionally Passes (cont.):
❑ 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 pipe(s) are replaced
❑ obstruction is removed
ND Explain:
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.
08-282 Dooley.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M , ' 86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for State Zip Code Date of Inspection
every page. Citylrown
B. Certification (cont.)
C) Further Evaluation is Required by the Board of Health (cont.):
❑ 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**.
k
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform
bacteria indicates absent 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.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate "Yes" or"No" to each of the following for all inspections:
Yes No
El ® 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 SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than day flow
El ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
08-282 Dooley.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for
every page. City/Town State Zip Code Date of Inspection
B. Certification (cont.)
D) System Failure Criteria Applicable to All Systems (cont.):
Yes No
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
El ® 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 fecal coliform bacteria indicates absent 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
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® 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.
For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the
questions in Section D.
Yes No
❑. ❑ the system is within 400 feet of a surface drinking water supply
El f a tributar
❑ the system is within 200 feet o y to a surface drinking water supply
a El Area
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 question in Section E the system is considered a significant threat,
or answered"yes" in Section D above the large system has failed. The owner 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.
08-282 Dooley.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M , 86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for
every page. City/Town State Zip Code Date of Inspection
C. Checklist
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?
® ❑ Were as built plans of the system obtained and examined? (If they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
Was the facility owner(and occupants if different from owner) provided with
® El 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:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure crite
ria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
08-282 Dooley.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
w ' 86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for
every page. Cityrrown State Zip Code Date of Inspection
D. System Information
Residential Flow Conditions:
Number of bedrooms (design): 3 Number of bedrooms (actual):
3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):
330
3
Number of current residents:
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No
Laundry system inspected? ❑ Yes ❑ No
Seasonal use? ❑ Yes ® No
131,000 gal. _
Water meter readings, if available(last 2 years usage (gpd)): 179 gpd.
Sump pump? ❑ Yes ® No
Currently
Last date of occupancy: Occupied
Commercial/Industrial Flow Conditions:
Type of Establishment:
Design flow (based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow (seats/persons/sq.ft., etc.):
Grease trap present? ❑ Yes ❑ No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
Last date of occupancy/use: Date
Other(describe):
08-282 Dooley.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for
State Zip Code Date of Inspection
every page. Cityrrown
D. System Information (cont.)
General Information
Pumping Records:
Tank pumped 18 months prior to inspection.
Source of information:
Was system pumped as part of the inspection? ❑ Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
Reason for pumping:
Type of System:
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
Approximate age of all components, date installed (if known) and source of information:
Compliance date: 1/17/89
Were sewage odors detected when arriving at the site? ❑ Yes ® No
08-282 Dooley.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for
State Zip Code Date of Inspection
every page. Cityrrown
D. System Information (cont.)
Building Sewer(locate on site plan):
1'
Depth below grade: feet
Material of construction:
❑ cast iron ® 40 PVC ❑ other(explain):
Distance from private water supply well or suction line: feet
Comments(on condition of joints, venting, evidence of leakage, etc.):
Septic Tank(locate on site plan):
2'
Depth below grade: feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No
------------------------------------------------------------------------------------------------------------------------
8.5' long x 5.2'wide- 1000 gal.
Dimensions:
4"
Sludge depth:
Distance from top of sludge to bottom of outlet tee or.baffle 26
2„
Scum thickness
6"
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle 12
Measured
How were dimensions determined?
08-282 Dooley.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for State Zip Code Date of Inspection
every page. City/Town
D. System Information (cont.)
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tees intact and clear, liquid level found at bottom of outlet invert. Tank is not in need of pumping at
this time.
Grease Trap (locate on site plan):
Depth below grade: feet
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: Date
Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain):
08-282 Dooley.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Ma- Mills MA 02648 November 13, 2008
required for State Zip Code Date of Inspection
every page. City/Town
D. System Information (cont.)
Tight or Holding Tank(cont.)
Dimensions:
Capacity: gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
`Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
Distribution Box(if present must be opened) (locate on site plan):
0,.
Depth of liquid level above outlet invert
Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
No solids or high stains.
I
Pump Chamber(locate on site plan):
Pumps in working order: ❑ Yes ❑ No
Alarms in working order: ❑ Yes ❑ No
08-282 Dooley.doc-08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 11 of 15
Commonwealth of Massachusetts
t Title 5 Official Inspection Form
o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for
every page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.):
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
Type:
® leaching pits number:
One 6x6 pit.
❑ leaching chambers number:
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
Leaching pit was found 2/3 full at time of inspection with a high stain line 2" below top set of holes in
pit Leaching pit has 2"of effective leaching
08-282 Dooley.doc-08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is required for Marstons Mills MA 02648 November 13, 2008
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Cesspools (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 ❑ No
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy (locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
08-282 Dooley.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15
Commonwealth of Massachusetts -
: Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is Marstons Mills MA 02648 November 13, 2008
required for State Zip Code Date of Inspection
every page. Cityrrown
D. System Information (cont.)
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.
Tanbark Road
ater
ervice
/ / / , / , , / / ,1./ / , , / , r , / , ,
%
8/ /6,,1*/,1*,1,,1//1*/,1//1
r r r r r r r
% % % % % N N 11 N N 11 N N/N N N N N I N
23
27
40
• Commonwealth of Massachusetts
w Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M 86 Tanbark Road
Property Address
Michael Dooley
Owner Owner's Name
information is required for Marstons Mills MA 02648 November 13, 2008
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope
® Surface water
® Check cellar
® Shallow wells
30
Estimated depth to ground water: feet.
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: Date
❑ 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:
USGS topo map and town GIS
You must describe how you established the high ground water elevation:
Town groundwater contour map shows water at el. 35 and topo map shows property at el. 70.
08-282 Dooley.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15
TOWN OF BARNSTABLE
LG`�. -''.'I03� or 142-- `7r N13A1 j SEWAGE # 99
VILLAGE IS�l�iZ57lS V� 1!(11!5 ASSES OIt'S MAP & LOT
INSTALLER'S NAME & PHONE NO. V ",Del :7
SEPTIC TANK CAPACITY
LEACHING FACILITY:(t7pe) (, Pf (size)
NO. OF BEDROOMS .0 PRIVATE WELL O UBLIC WAi
BUILDER OR OWNER. �PNEI (.ems'
DATE PERMIT ISSUED: 7`
DATE. COMPLIANCE ISSUED::
VARIANCE GRANTED: Yes No /�
,
L`7
NO...O Fps......... .............
THE COMMONWEALTH OF MASSACHUSETTS
j BOAR® W HEALTH
------......f�.w"f....._--OF........ ..................... j C�
Appliration for Uiipusal Naar 0 Cnnnitrttrtinn rrnti#
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at �'
,CvT fa /0NA,CK. F04 0j,�sranr3 f�cs
........... .......................... -.I.... ...- .......- �`
/ Lee on-Address Lot :\o
$t 5/0 cA/rc7z
Owner�A j Address
---••-••....-J' -- N
Installer Address
UType of Building Size Lot._2�df.3�®........Sq. feet
Dwelling—No. of Bedrooms............................................Expansion Attic (Y ) Garbage Grinder (A/)
Other—Type T e of Building No. of ersons____________________________ Showers
a YP g ---------------------•------ P ( ) — Cafeteria ( )
Q' Other fiNtgres ..--•--•---•-•• -•------------- .
W Design Flow............................................gallons per person per day. Total daily flow.......:��.............-_•..........gallons.
R. Septic Tank—Liquid capacity./..gallons Length................ Width---------------- Diameter................ Depth................
Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
a Percolation Test Results� Performed g w�'F"r� Date..�!j d� ________________
I a T_ A,oI,C
Test Pit No. 1................minutes per inch Depth of Test Pit..................... Depth to ground water.........................
�Z4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------_-.__--_____•____-
a --•••-•---••-----------------•--••- --------------
•-------------------------
-----------------------------------------------
•---__----
O Description of Soil-- _ --------5A,-,IV,).......W7---••-•��T C���---------------------------••-.
W
----- ---•----•-•----•-----•--------------
--------------•------•-------.--------•--•---------------•--------------------------------------------------------
V Nature of Repairs or Alterations—Answer when applicable _____ _________________________________________________________ _
..----•-•••----•...............••-•-•--•-----------•------•---------•-•--•-•-••--------•••-•-••-•.... ................................................................................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of -T 5 of the State Sanitar Code—Th ndersigned furti:er agrees not to place the system in
operation until a Certificate of Compliance has n iss a by t e board of health.
Signed--- ....--�--,A�.. 6 4Y�yJ t Da
�i ------- - •---------•------- ----------•------------••-•---•---------• ----- ---- ,.fie.....-•----•--
Application Approved By. - - =(�' • --•-•-- •• . ..�.........•---••-----•--••--- .................l _l.......
- - -------
Date
Application Disapproved for the following reasons----------------•------•--------•----•---------------------------------------------------------------------_-•---
....•••-••-•--••----•-••••••••-•--•-•-•---•••••••--•---•--•••...-••-------•-•--•-.....•---•••-•-••-------------•----•--••----•--•-------•-••-•--••---------••--------••--•----••----••----••------------
Permit No..... _______________ Issued........L_P 7'
No.. 4..
^ THE COMMONWEALTH OF MASSACHUSETTS
BOAR®,19F HEALTH
......
. ppliration for Dispatia'l Mor s Tunstrnrttott Prrntit
Application is hereby made for a Permit to Construct ('v ) or Repair ( ) an Individual Sewage Disposal
System at:
... ...—........... ........ ......_... --•--x -•!-•-=-•---•- --• ----••. --..........
Location Address r'Lot No
-----------•-•------ ........-•-.................................................... ................. ------
r
Owner Address
.. . .-.. G ------------•-•-•-----------•-- -------•-------------•---..I...........---.....-------.._..-!-•__-:.. --------......_..-•------
Installer Address
U Type of Building S� Size Lot____�__:___��........ q. feet
g— .................................. Expansion Attic (Y' ) Garbage Grinder (/tj)
.., Dwellin No. of Bedrooms ________
9k Other—Type e of Building _______. No. of ersons____________________________ Showers
0.1 YP g --------•------•---- P ( ) — Cafeteria ( )
Other fi'�ctures
W Design Flow................ _______.________,_____gallons per person per day. Total daily flow....... ..........................gallons.
R: Septic Tank—Liquid*capacity.&��__gallons Length................ Width................ Diameter................ Depth................
xDisposal 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 ( )
a Percolation Test Result Performed b c''' ,-<4�a,t x ��c t ,.�G c� ___ Date__f a ___:;°._ '
Y •--------------•--•. ------------------•---
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_._._`"......(..........
rL, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-.-________________-_--.
Descriptionof Soll--- ---------.........-----------.......-•----------••-•-----------•-------------------------------------•------------------------------------------...-----------..
x
U
w
UNature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________
..-•--••-------------------------------------•---------------•-----••-•-•--•---•-•-•---.....----•------------------------•--•••----•----•--------•••---------•----------•------•--•-----•-••------•----
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
TT'�^
the provisions of T t of the State Sanitary Code—�Th undersigned furti:er agrees not to place the system in
operation until a Certificate of Compliance has li n issueq►by the board fjof health.
l'.'"' 4 't t!'
Signed.................... --•-•--•-------•---•--------•-------•----- -•--f....... .................
Date
Application Approved BY-'Z/{ 1.�._(--1-� ! f - _.%..:._..... r�
Date
Application Disapproved for the following reasons:................................................................................................................
----------•---•--------------------------------------------------•--------------------------••--•-------•--------------•---------•••-----•••---••--------•----••-•--------•-----•--••----------•-------
Date
�_ < / / -S .
Permit No. 1 =�+ Tssued_.... - -
..
Da
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
..........................................OF................................................................................
......
ulertifiratr of font Ii�anrr
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( )
bY---------X:..y.-------•` ra- � f ....... .................
Installer
/r,��,� fr�rt, g;an. 1.
at..............................................................................................I.......................................................................................................
has been installed in accordance with the provisions of TITIE 5 of Th State Sanitary Code as described .n the
application for Disposal Works Construction Permit No------ __—: �__---------- dated---.-.-__/-.-.__/.. .__ _ ___________
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE C NSTRUE® AS A GUARANTEE T AT THE
SYSTEM WILL FUNCTIQN SATISFACTORY.
DATE--__---- - L f...........................•---------_-•---- Inspector...�7_ /X. ( .(1(`(/i ,-
THE COMMONWEALTH OF MASSACHUSETTS
t BOARD OF HEALTH
7 li�u�i jA' r�n,+sf ,cpt..c�
�f �L.. .........................OF.._-----...... ..._.._..._._.._.....•__.........___............._ ........_..
I1._.J FEE..........
Disposal lVarko T5onstrurtion rrutit
Permission t hereby granted---------`�-=----.-_--•-------•------....--•---..........--......------------....................................................--........
to Construct (1 ) or Repair ( ) an Individual Sewage Disposal System stem
at No
� �+T ' ��� (:,,N/3�i+t.k ft U `�1) P , %it), I P-i. aa.S
Street
as shown on the application for Disposal Works Constructer //Permit No.
f,�!��S �___ Date ...__�_�'_.�•'f �__ ..........
Board of Health
DATE............. .........................................
FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS
VO
jl2
Commonwealth of Massachusetts
Executive Office of Environmental Affairs
Department of
Environmental Protection '9Ilk
4�
f�
���
WIIN rCoxe�
am F.Weld "e � .
GovernorAMw Paul Celluccl David B,S {
LL Governor
�e $ URFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
Tip `r PART A -
�� CERTIFICATION
Property Address: Address of Owner. 75,90 1-.re.•O- b r-
Date of Inspection: .1 y er f. (If different)
Name of Inspector. W.E. Robinson SR
Company Name,Address and Telephone Number. ( 5 0 8)7 7 5-8 7 7 6
W.E. Robinson Septic Service
P.O. Box 1089 Centerville MA
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 inspection. The inspection was performed based on my training and experience in the proper function and
maintenance of on-site sew disposal systems. The system:
Passes
_ Conditionally Passes
_ Needs Further Evaluation By the Local Approving Authority
Fails
Inspector's Signature: 1 Date: c-�-
The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(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 Department of Environmental Protection.
The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority.
INSPECTION SUMMARY:
Check A,B,-C,or D:
A] SYS PASSES:
I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303.
Any failure criteria not evaluated are indicated below.
B] SYSTEM CONDITIONALLY PASSES:
or'more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,pease
00 on
Indies no,or not'determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined",explain why not)
The septic tank is metal,cracked,structurally unsound,shows substantial infiltration or exffitration,.or tank failure is
imminent. The system will pass inspection if the existing septic tank is replaced with a Fonforming septic tank as approved. .
by the Board of Health.
(revised 11/03/95) 1
One Winter Street u „Boston,Massachusetts 02106 • FAX(617)556-1049 is Telephone(617)292.5500
�AJ Printed on Recycled Paper
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address:
Owner.
Date of Inspection:
G_.2-
1-63 C. .
BJ 8Y TEM CONDITIONALLY PASSES (continued)
Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)
or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of the Board of
Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is levelled or replaced
The system required pumping more than four 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
C1 FURT IER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH:
ditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the
lic health,safety and the environment.
1) STEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A
WHICH WILL PROTECT THE PUBLIC HEALTH AND 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.
Z) S TEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)
D NES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND
S AND THE ENVIRONMENT:
The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a
surface water supply.
The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well.
_ The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well.
The system has a septic tank and soil absorption system and is Iwo than 100 feet but 50 feet or more from a private water
supply well,unless a well water analysis for ooliform 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.
3) OTH
(revised 11/03/95) 2
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(oontinued)
Property Address: _
Owner.
Date of Inspection:
D) 87TEM FAILS:
ve cedetermined that the system violates one or more of the following failure criteria as defined in 310 CUR 15.303. The basis for
determination is identified below. The Board of Health should be contacted to determine what will be nessary to correct the
�
Backup of sewage into facility or system component due to an overloaded or dogged SAS or cesspool.
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or
cesspool.
Static liquid level in the distribution boa above outlet invert due to an overloaded or dogged SAS or cesspool.
Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow.
Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).
Number of times pumped
Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply.
Any portion of a cesspool or privy is within a Zone I of a public well.
Any portion of a cesspool or privy is 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for
ooliform bacteria,volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
El LARGE SYS FAILS:
The foll wing criteria apply to large systems in addition to the criteria above:
The m serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public
health safety and the environment because one or more of the following conditions exist:
_ 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
system is located in a nitrogen sensitive area(Interim Wellhead Protection Area(IWPA)or a mapped Zone U of a public
r supply well)
The owner or for of any such system shall bring the system and facility into Bill compliance with the groundwater treatment program
requirements of 14 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information..
(revised 11/03/95) 3
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
I f
Pnwerty Address:
Owner.
Date of In.peedon:G���t-fir G
Check if the
folloowwing have been done:
Pumping information was requested of the owner,occupant,and Board of Health.
_I�T6ne of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates
(/during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection.
_built plans have been obtained and examined. Note if they are not available with N/A.
_- " facility or dwelling was inspected for signs of sewage back-up.
_L/fie system does not receive non-sanitary or industrial waste flow
Lfhe site was inspected for signs of breakout.
system components, excluding the Soil Absorption System, have been located on the site.
septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or
tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.
size and location of the Soil Absorption System on the site has been determined based on existing information or
approximated by non-intrusive methods.
he facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Sub.
Surface Disposal System.
(revised 11/03/95) 4
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOAM
PART C
SYSTEM INFORMATION
Property Address: g rf117 h lr (0 177,o 'cshlxS p7,d
Owner. �-
Date of Inspection
FLOW CONDITIONS
RESIDENTIAL:
Design flow: 3 3 A s 11ons
Number of bedrooms:--?- /
Number of current residents:
Garbage grinder(yes or no):L-d
Laundry connected to system(yes or no):
Seasonal use(yes or no): z. U
Water meter readings,if available: I Q y 'Fr
(6I q S' )30 a qw•/ J
Last date of occupancy:
COMMERCIALANDUSTRIAU
Type of seta lishment:
Design flow: ons/day
Grease trap p nt: (yes or no)_
Industrial Wa Holding Tank present: (yes or no)_
Non-sanitary discharged to the Title 5 system: (yes or no)_
Water meter , if available:
Last date of panty:
OTHER( be)
Last date f occupancy:
GENERAL INFORMATION
PUMPING RECORDS and source of information:
4rt . -r,4 I Ct Q 3
System pumped as part of inspection: (yes or no)__,�t- a
If yes,volume pumped: gallons
Reason for pumping:
TYPE, O$6Y'STEM
Septic tank/distribution box/soil absorption system
Singls cesspool
Overflow cesspool
Privy
Shared system(yes or no) (if yes,attach previous inspection records, if any)
Other(explain)
APPROXIMATE AGE of all components,date installed(if known)and source of information: 1 d
7
Sewage odors detected when arriving at the site: (yes or no)_A:i O
(revised 11/03/95) 5
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(oontinued)
Property Address: ` I,
Owner. Q AJ)
Date of Inspection:
SEPTIC TANK:"
(locate on site plan)
Depth below grade:Material of construction: create— —metal FRP—other(explain)
Dim
Sludge depth: 4 „
Distance from top of sludge to bottom of outlet tee or baffle: .3 7 �
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: J 1
Comments:
(recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,
evidence of leakage,etc.) �a of e a A aC ► Tr s ��10 - ,p d e
0 y
GREASE _
(locate on site tan)
Depth below
Material of co on:—concrete—metal—FRP—other(explain)
Dimensions:
Scum thickness:
Distance from to of scum to top of outlet tee or baffle:
Distance from m of scum to bottom of outlet tee or baffle:
Comments:.
(recommeadatio for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,
evidence of ,etc.)
(revised 11/03/95) 6
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Addreex
Owner. V V Cr e 0 e 7-le-
Date of Inspeotion:
q
TIG OR HOLDING TANK:_
(locate site plan)
Depth be grade:
Material of n:_concrete_metal_FR.P_other(e:plain)
Dimensions:
Capacity: one
Design fl gallons/day
Alarm leve
Comments:
(condition of' et tee,condition of alarm and float switches,etc.)
DISTRIBUTION BOX:
-+-,Z
(locate on site plan)
Depth of liquid level above outlet invert:
Comments:
(note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.)
PUMP C ER:_
(locate on )
Pumps in vaor ' order:(yes or no)
Comments:
(note condition pump chamber,condition of pumps and appurtenances,etc.)
(revised 11/03/95) 7
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: _F 6 7� In
�� f�'J 9/'�C�0 rl�
Owner. f I J9J7
Date of Inspection: f /J
Q51 /
SOIL ABSORPTION SYSTEM(SAS):
(locate on site plan,if poss131e;excavation not required,but may be approximated by non-intrusive methods)
If not determined to be present,explain:
Type:
leaching pits, number:
leaching chambers, number:_
leaching galleries,number:
leaching trenches,number,length:
leaching fields,number,dimensions:
overflow cesspool,number:
Comments: (note condition of Boil,signs hydraulic f�O, level of ponding conditio of vegetation etc.)
CESSPOOLS:4and
(locato plea)NumbYfiguration:
Depthd to inlet invert:
Depths yer.Depth r:Dimenf pool:
Matero on:
Indicadwater:
w cesspool must be pumped as part of inspection)
Comments: condition of soil,signs of hydraulic failure,level of ponding, condition of vegetation,etc.)
PRIVY:
(locate on site p )
Materials of n: Dimensions:
Depth of solids:
Comments: (n condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.
(revised 11/03/95) 8
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property,Address: �C �9�'�Si�,S
Owner.
Date of Inspection: G ;ty_a�, L
SKETCH OF SEWAGE DISPOSAL SYSTEM:
include ties to at least two permanent references landmarks or benchmarks
locate all.yells within 100'
r
�2
DEPTH TO GROUNDWATER
Depth to roundwater. 12-"k feet _
method of determination or approximation: S j 6 1 l S )C" e/
(revised 11/03/95) 9
9*11 7A OF 7
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e Lo nr A a
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OWNER or tLSReOLA
NILLts
O L1A�AK tNoatA►LMT
p�ww rt /11M1•r4a ww; TOTAL alaY1T0 ILOe
LOCAM M MAP �� r;NNNa NA►NOI R r UK•N•N let UIL OAWMAmy:_L et) aw .., AA1.
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UUa t MID M 1000 OF AV1R►M r RNat AM
a
KYeAUOM!FOR M KWKWAOI 1sOiK Or KOAM
1000 OALLI)t/SEI11C TANK I r I r I r I s ALL oeMINOR iw wrs Mwa K w TOaposim,
„. I a AN"N AMM LMTt um To OOO COVERSTOawm
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N 1l.0 710 axe ife if.e 70.9 700 7t.D 73.0 74,5 7A6 7f.e 70.0 71* 1eO 7b0 74.4 1-14.4 b1►.e 7so - led 7Zo 1L0 )
73.0 74.0 7t•� 7j.f 7}0 71•r 74.L :m.0 )<s 7f•7 143; 73.0 73A AR4 i1 0 61,0 9b.S 1f.S N
~v 1 12 ee INITIAL ISSUE UCT
NO. DATE DESCRIPTION BY
PERC TEST 1 PERC TEST 2 PERC TEST 3 PERC TEST 4 PERC IEST S SEPTIC SYSTEM DESIGN
LOT 113 LOT 125 LOT 131 LOT 149 LOT 14L1E&V^ZLAL- on MARSTONS MILLS WOODLANDS
MO 9110m lNlr eun w m wA1" w NAw i:mo�ft wr0>•a Now BARNSTABLE, MASSACHUSETTS
AAe /tlet
:.w e.a "' a"' `� �` WOODLANDS ASSOCIATES REALTY TRUST
NINe eAse r EF.
NrA NYt1IAt McMa Mr gOsa RMA�.awe Woe SCALE i• a 4D
am Ru UAa alwa .rr*AM onsI, �/~NNE NALIe MOAN mum JOB NO. 1338
Is e1101 rM NIA O M NMK
f
� ►AYC
OAR a/taa tIIT a�N OAR OF SK 1Q►� OAR Or MC L MT-q" N LD L rr
oUla�tY AAI�e OU®r WI®tr �A�c DAR Or talk TWJf DAB„�rM .r ,`•y.¢
PINCOAIM MR 31�MM•ANON PotooLAUoM RAII SLMLA"m Pa00<AI M RATE SLML0MpN erNNLOLv tr ��• O
raOOAIM RAII 31-M*40M =UONRAII SLMLAW"
PERCOLATION SOIL TESTS 1801E MIZDGB & TWO &WdWS INC.
aaem U1111M Tess mmi =sw+me
See TI= 111IIT elitM C3Xl1%XV= MA oee�z
I
OW rrAMM w. SHEET 7 OF 7
r
MARSTONS MILLS
I
LOT 130
WAM as
oouu to
LOT 129
aa.
LOCATION MAP \ :I sr/ � �
11
C►� 4 70.6 `J LOT 12t d
t(R OT}32 4 7 j 7 { t $4 . 1ene s
G �►� tam s00
,• 13 `
' \ �11.1.--CD7'1'17,
LOT 31 '
s
d /1% T" \� `F\LOTf3@� 'e �� �.ti dt•o
! ..LOT / li1
'/ + 15a 'b .4� � ♦ �asa3s 10 �,� 124_%-' Y � oc
..� ' � 1�I , /M•'d•� o IAA` �\ Y � `
LOT 106 ' I 1 — h „ 1 �`� 13 `. y y AT to v ,
`� P aaaY 90 • \spy d LOT 123
r-- P +► r- .• „oaK yI LOT 126
i>ao s
i4e +ano s
`' yrs 11.b I 1 1 -\="s11 9 i 1!
LOT 149
/ �� tas9 s i * ^ a LOT 136 p.�
dab I
"Zol
`� & i/ i I 1 11.9as
' '/A' w q• LOT 122
�\` „� >tt 41• 'r, / ..- LOT 13 L 135 �e!j Y ��' \� v� +'.i LOT 121 aPstM6 j
' ' tOt00! s
LOT 107 LOT 148 rje I ba 1 1 M 1 ♦a - ' ,S �� y 7los W�` I e
��.�' \ S Ial Lj t' OI.
� ta s.9 e , � ..� �1 � -Ire t 140' � � p Y � �•
?LOT 147
.6
�
e
o► i 1 0, • Y soo `
LOT�142 P :e iiOT}a1 ;. \`� %.- �•
IeIIy �1�. sa. -'�� "m eyd Y . LOOTT1220
ao.sr u o tY•, y -'V ��A fi, '07h43`1 / _/�'' "It ..�, `` viYt0oa91s► N $ < ro� a I I t
I st1 4► N A o*
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`• b ~/ sa4A f 145 1� S LOT 115 40• _ �'� i "-P�CLo1.A•nw.l �LfT. RESJt+rc.
i� ' ' �1•h'+�102M s a�oT '7A Of 7 I�IL •La6�Np-. .
/ 1•I LOT 146 I Bona ar ��1. � a 1�o11
I LOT foe '•�? Hasp►' r/''/ , .. Y r 14,d 101
LOT 116
,AP �. �� , ' ? LOT 113 �o. �• .a 'r Steel v
as. L tales a►
/ 111 �• r I ��•i a• y
• �� �} Y"• LOT 111 +aTrnts 1�d '' U� LOT 114
lif• " 10 ¢ 11 a s6 o,Fw.e o.1 Rlortc E 9nMmo.as
^ 20
I 1 bi �lIr 1ti o r I 1 3 11 29 88 FINAL BLDG. AND SEPTIC LOCATIONS PAL `
1 1Lo Y��, 8/aa BUILDING LOCATION
1114 y 1 10 12 88 INITIAL IS ELK
NO. DATE DESCRIPTI Illy
�\ e•M� - „1 BUILDING LOCATION PLAN
LOT 110 MARSTONS MILIS WOODLANDS �
� r
LOT 109 11.M s I BARNSTABLE, MASS CHUSETTS
WOODLANDS ASSOCIATES US
\ SCALE: 1" 50' 1 JOB NO. 1338/(=-io ✓ ~. y4 L_-
o so too t•'^'J l\`"
9 ..�
L v f
18VY, E[DME A ►AGNEE AMOMfk INC. ^
sums m m uvnee nm un
889 REST mm sna= C'ENTERV= MA OU32