The URL can be used to link to this page

Home My WebLink About0148 TANBARK ROAD - Health 148 Tanbark Road Marstons Mills P A = 100 016001 li TOWN OF BARNSTABLE LOCATION 1q8`77,nbw,k. ')�-J S£;�#-:]�S� t VILLAGE_f . (►rl,d lS ASSESSOR'S MAP&PARCEL IN&TER'S NAME&PHONE NO. SEPTIC TANK CAPACITY l 000 LEACHING FACILITY:(type) "r' (size) 1000 NO.OF BEDROOMS J OWNER CaWAO Ujo- PERMIT DATE: DATE.�,SP 11,01840 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 R,Y16 \ - f - 4 • 4 4 4 4 ♦ 4 \ \ 4\ 4 4 \ 4 4 \ 4 4 \ ' r J I F ! F F r 1 f r r f f r J F r F f •F41♦Fh14 /\ \r\ \ F•Jti/\ F J f f J ! f J f f J f 1 F F f ! F I f J I ! F f • 4 \ • 4 \ \ 4 \ \ \ \ 4 4 4 \ \ 4 \ \ 4 -- ' - 69 . K13 32 Fater38 �N'� Service y A Tanbark Road Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is Marstons Mills MA 02648 November 18, 2009 required for State Zip Code Date of Inspection every page. City/Town Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important: A. General Information When filling out forms the computer, r,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 ten 189 Cammett Road Company Address Marstons Mills MA 02648 tango City/Town State Zip Code 508-428-1779 SI 12855 Telephone Number License Number LU C3 03. `"'B. Certification P. .° Ef-- I certify t at 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 y011 was erformed based on m training and experience in the proper function and maintenance of on site t P Y 9 P P P aw.f CD sewagedisposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of .� �::; Title 5 (;310 CMR 15.000). The system: .,. t Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority November 18, 2009 . In ector'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. 09-244 Ramos-Wade.doc-08/06 Title 5 Official Inspection Form Subsurface SewagjDsal Syste?P gel of 1 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is Marstons Mills MA 02648 November 18, 2009 required for every page. City/Town 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 4' 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): ❑ broken pipe(s) are replaced ❑ obstruction is removed 09-244 Ramos-Wade.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is Marstons Mills MA 02648 November 18, 2009 required for every page. City/Town State Zip Code Date of Inspection 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: t 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. 09-244 Ramos-Wade.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °7M 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is Marstons Mills MA 02648 November 18, 2009 required for every page. City/Town. State Zip Code Date of Inspection 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**. 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 a 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. 09-244 Ramos-Wade.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 M 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is Marstons Mitts MA 02648 November 18, 2009 required for every page. Cityrrown 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. ❑ ® 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 ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner 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. 09-244 Ramos-Wade.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 w 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is required for Marstons Mills MA 02648 November 18, 2009 every page. CityrTown 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.- 0 ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 09-244 Ramos-Wade.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 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is required for Marstons Mills MA 02648 November 18, 2009 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 Number of current residents: Unknown 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 Water meter readings, if available(last 2 years usage (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: Currently 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): 09-244 Ramos-Wade.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 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is required for Marstons Mills MA 02648 November 18, 2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Pumped 2-3 months ago. 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: Permit date: 1/31/89 Were sewage odors detected when arriving at the site? ❑ Yes ® No I 09-244 Ramos-Wade.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 ., 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is required for Marstons Mills MA 02648 November 18 2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): 2' 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): Depth below grade: 1 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 ----------------------------------------------------------------------------------------- -------------------------------- Dimensions: 8.5' long x 5.2'wide- 1000 gal. Sludge depth: 2 Distance from top of sludge to bottom of outlet tee or baffle 28" Scum thickness Trace Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Measured 09.244 Ramos-Wade.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 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is required for Marstons Mills MA 02648 November 18, 2009 every page. City/Town State Zip Code Date of Inspection 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.): Tank is not in need of pumping at this time, liquid level was found at bottom of outlet invert with tees intact and clear. 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): 09-244 Ramos-Wade.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;w 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is required for Marstons Mills MA 02648 November 18, 2009 every page. City/Town State Zip Code Date of Inspection 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): Depth of liquid level above outlet invert 0 11 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 present, liquid level at bottom of single outlet pipe. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No d Alarms in working order: ❑ Yes ❑ No 09-244 Ramos-Wade.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is required for Marstons Mills MA 02648 November 18, 2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) j 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 had one foot of standing water with a high stain line one foot above current level. Pit has 4'of effective leaching. 09-244 Ramos-Wade.doc-08/06 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 ° 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is required for Marstons Mills MA 02648 November 18, 2009 every page. CitylTown 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.): 09-244 Ramos-Wade.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts • Title 5 Official Inspection Form ? a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is required for Marstons Mills _MA 02648 November 18, 2009 — -- every page. City/Town State Zip Code Date of Inspection 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. \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ 69 13 3 r d 38 2 ,k ater � Service Tanbark Road • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° 148 Tanbark Road Property Address Maxine Ramos-Wade Owner Owner's Name information is required for Marstons Mills MA 02648 November 18, 2009 every page. Cityrfown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to ground water: 20+ 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: Topo map shows property at el. 70 and town groundwater contour map shows water at el.35. 09-244 Ramos-Wade.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 TITLE 5 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION MAP - I'0� PARCEL Property Address: 148 Tanbark Road LOT Marstons Mills,MA 02648 Owner's Name:Jane Guilfoyle and Edward Goodwin Owner's Address:2 Hickory Lane "il r Canton,MA 02021 Date of Inspection:9-12-02 Name of Inspector:(please print)Janet E.,DuPont Company Name: Wind River Environmental Mailing Address: 120 Great Western Road South Dennis,MA 02660 Telephone Number: 508-760-4827 CERTIFICATION STATEMENT sF �� I certify that I have personally inspected the sewage disposal system at this address and that t ok information reported below is true,accurate and complete as of the time of the inspection. The i on O was performed based on my training and experience in the proper function and maintenance of on ,yvFy �lj� sewage disposal systems.I am a DEP approved system inspector pursuant to Section 15.340 of TitoTT9 (310 CMR 15.000). The system: X Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: L& c Date: The system inspector shall sub it 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. OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 148 Tanbark Road Owner:Jane Guilfoyle and Edward Goodwin Date of Inspection:09/12/02 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: _X_ 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 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 s obstruction is removed ND explain: OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 148 Tanbark Road Owner:Jane Guilfoyle and Edward Goodwin Date of Inspection: 09/12/02 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 tic tank and SAS and the SAS is less than 100 feet but 50 feet or more ys septic from a private water supply well".Method used to determine distance "This system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 148 Tanbark Road Owner:Jane Guilfoyle and Edward Goodwin Date of Inspection: 09/12/02__r_-____ D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all inspections: Yes No X_ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _X_ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _X_ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _X_ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/Z day flow _X_ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped X Any portion of the SAS,cesspool or privy is below high ground water elevation. _X_ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone 1 of a public well. _X_ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _X_ 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 failure criteria are triggered.A copy of the analysis must be attached to this form.] Na (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 indicate 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 II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered"yes"in Section D above the large system has failed.The owner 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. OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE IDISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 148 Tanbark Road Owner:Jane Gullfoyle and Edward Goodwin Date of Inspection:09/12/02 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No _X_ _ Pumping information was provided by the owner,occupant,or Board of Health __._ X_ Were any of the system components pumped out in the previous two weeks? _X_ __._ Has the system received normal flows in the previous two week period? _X_ Has large volume of water been introduced to the system recently or as part of this inspection ? _NA_ Were as built plans of the system obtained and examined?(If not available note as N/A) _X_ _ Was the facility or dwelling inspected for signs of sewage back up? _X_ _ Was the site inspected for signs of break out? _X_ Were all system components,excluding the SAS,located on site? _X _ 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 _ Existing information.For example,a plan at the Board of Health. _X_ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 148 Tanbark Road Owner:Jane Guilfoyle and Edward Goodwin Date of Inspection:09/12/02 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):_NA� Number of bedrooms(actual):_3_ DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): NA_ Number of current residents:_24_ Does residence have a garbage grinder(yes or no):no Is laundry on a separate sewage system(yes or no):_no [if yes separate inspection required) Laundry system inspected(yes or no):_ Seasonal use:(yes or no):yes with occasional winter weekend use Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no):No Last date of occupancy: current COMMERCIALANDUSTRIAL 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: 2000= 18,000 gal 2001=20,000 gal. Last date of occupancy/use:current OTHER(describe): GENERAL INFORMATION Pumping Records 12/3/96 Source of information:Barnstable Water Pollution Control Was system pumped as part of the inspection(yes or no):No If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM X_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:_ 12 years old per owner Were sewage odors detected when arriving at the site(yes or no):No OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 148 Tanbark Road Owner:Jane Guilfoyle and Edward Goodwin Date of Inspection:09/12/02 BUILDING SEWER(locate on site plan) Depth below grade:_39"from top of foundation Materials of construction:_cast iron _X_40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.):_Conditions normal with no signs of leaking,_ SEPTIC TANK:_(locate on site plan) Depth below grade:_25"with 12"riser Material of construction:_X_concrete_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:_1000 gallons Sludge depth —4" , Distance from top of sludge to bottom of outlet tee or baffle:_2+'_.. Scum thickness:_0-1" Distance from top of scum to top of outlet tee or baffle:_10" Distance from bottom of scum to bottom of outlet tee or baffle: 12"+_ How were dimensions determined:_Probe and tape measure Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tank appeared to be sound with no evidence of leaking,tees in place with sufficient difference between invert levels for flow across tank. GREASE TRAP: (locate 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,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 148 Tanbark Load Owner:Jane Guilfoyle and Edward Goodwin Date of Inspection:09/12/02 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): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Equipment for excavation broke down on site and d box under gravel driveway. Inspection done by use of sewer camera.,clearly shows water at invert of outlet with no obvious evidence of crumbling along sides. One outlet pipe leading to leach pit. Depth of liquid level above outlet invert:liquid at 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.):box appeared to be sound,flush test performed with water flowing through to pit. PUMP CHAMBER: (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.): OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 148 Tanbark Road Owner:Jane Guilfoyle and Edward Goodwin Date of Inspection:09/12/02 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: SAS located by probe. 4'below grade. Able to get sewer camera through from d-box and observed no standing water in pit,water flushed through readily absorbed by bottom. Height of pit measured by using camera cable length from bottom to inlet pipe. Type —X_leaching pits,number:_(I)6 ft.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.):Bottom of pit 10' below grade,found no standing water,ground surface dry with no unusual vegetation 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 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 construction: Dimensions: Depth of solids: i Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.): OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 148 Tanbark Road Owner:Jane Guilfoyle and Edward Goodwin Date of Inspection:09/12/02 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. e �q r d C _ �. 19 �_� Sw OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 148 Tanbark Road Owner:Jane Guitfoyle and Edward Goodwin Date of Inspection: 09/12/02 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_approximately 60 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: _X_Observed site(abutting property/observation hole within 150 feet of SAS) __Checked with local Board of Health-explain: _X Checked with local excavators,installers-(attach documentation) _X__Accessed USGS database-explain: You must describe how you established the high ground water elevation: Checked with Barnstable BOH Map of approximate water table showed water to be found at 35' A.S.L. Property elevation is approximately 95' A.S.L.per plan on file Barnstable BOH for#23 Tanbark Road. Installation of new leach pit being done when I premarked property for dig safe. Bottom of SAS is 10'below grade Property monitored by well SDW 253 Zone B. Adjustment for 6/21/02 is 7' TOWN OF BARNS T ABLE '':.00ATION %Iy �� J��. SEWAGE # VILLAGE 0091 ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO.��/'1�G� YcS641 SEPTIC TANK CAPACITY /,00® 1eL LEACHING FACILITY:(typ0 � � (size) /ago, CRe NO. OF BEDROOMS PRIVATE {WELL OR UBLI ER BUILDER OR OWNERy�ei✓ �'l�J� DATE PERMIT ISSUED: DATE COLIPLIANCE ISSUED: VARIANCE GRANTED: Yes .No N-Y 4/ M i ` THE COMMONWEALTH OF MA==°CH"==^ ^= ` ��K~�� " �" ~�� ~" HEALTH " " , � _--�� ^*' -_-��F-'��/- � ~°m� r � �� °� ��c� ��4��4��u� �� Application is hereby made for u Permit to Construct (v') or Repair ( ) an Individual Sewage Disposal System at: 0.4 R41Zjm&Aj,� J C�� _ Vx � �� +�~'m'c�� ---'��' ' /�d. �v� Jva ��' � ......................-.......................................................................... ..........-......................j'---..---.............................................. »°�^ �»°/ A««=" � ^ ------------------------------------------------' ------------------------------------------------' Instal 1= Addres s Type ofBuilding Size Lot 'Sg. feet� Dwelling of Bedrooms............................................ Attic (Y) Garbage Grinder (/V) 04 (]dzer--Iyyo of Building -----------'-' No. of persons............................ Showers ( ) -- Cafeteria ( ) Otherfixtures --.._--_----'---.-.-------_-----_--.---------_-_-_------------------_-' D�a�� Flow............................................. yccy�rxouy�rduv Totu da�y8o� . ogallons '. _- ------..............................__'_ 04 �cy6c Iau�--I. �6�cupac��.1---'.galoos Length................ Width................ Diameter_.-_--- Depth................ Disposal Trench--',\To. .................... Width.................... Total Length.................... Total leaching area--------'--sq. ft. Seepage Pit No'------- Diameter.................... I)cotb below inlcL---------' Total leaching area..................sq. ft. � Other Di� �Distribution ) ~~ Percolation Test llcaolto Performed~ '�-�-'�/'�^/c^------- D�c-"�v��'��-------' � Test Pit No. l-.��.��--.minutes per " Depth' Test Pit Depth to ground water. ...__- ~~ Tca Pit No. 2-----..-..minutes per inch Depth of Test Pit..--------- Depth to ground water--------_- ` ou -----.----'------- --- ......................................................../* o � ,� �� v� � �� /C3 | ^ D�scc�u�oo S --. ---'�'�-'------ ----'��-'-'...................-------------------- --------_-'_---_-__'-'-_--------'---.------------.----------_-----'----------------_-'-'--_-----'-- ...............-------- ............................................................................................................................................................................... U ` Nature of Repairs or Alterations--Answer when applicable.--.-------_---------_---_--.------------- '--------'--'-----'---'-------------------'--------'---'----'-------------------------- 8grero`cot: The undersigned ugccca ,o install the uforedcscribed Individual Sewage Disposal System io accordance with ' the provisions of7I'l E 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance AA ----_-.-- ---��'.��...---- pp ��= Approved ^ y=4__-__-��=_ ______' "=" ' Application Disapproved for the following reasons:................................................................................................................ � -�................—.....................................................--- __- ___-___' Date J Permit No' Date ` 3 7M- No..... FF$............ZJ.......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH --................................. ..... ------------------------------------------------ Appliration for Disposal Works Tonstrnrtion Vrrmd Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ....__.... - '._/.................... ••....-•-•--••--•-•........--••---•-•--•... •-•----•--------•........................ C17 (..(,..i eq it r'r k Locatioy-�1d11F s /'°.C . 13rs�f 1 E✓` °£�I°tvITe- v *t (rp .....................................................v---......------•........._.._•..._...._._.... ..........-•..................................................................................... Owner Address a ••----•.. ........ Install er Address Type of Building Size Lot__ . ..`f'-�-------.-•Sq. feet U Dwelling—No. of Bedrooms----- ........:.............................Expansion Attic (V Garbage Grinder (/w) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) QI Other fixtures ................................-.......---- W Design Flow.........................................•_.gallons per person per day. Total daily flow............�_�............................................gallons. 9 Septic Tank—Liquid capacity-/u ei.o.gallons Length................ Width................ Diameter---------------- Depth................ 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__ �v' C rest t.j �. `..`_._.... --____ Date_.�ll a Test Pit No. I....!�:D-----minutes per inch Depth of Test Pit•-_1_'" •........ Depth to ground water_n_t_U,!'�f�-____--_-_. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.___-______-_-_..._-_--. Rr' .............................................•---••----...........-----•-------•--••----•----.....-......................................................... D Description of Soil---- r ``p(---•----•--� -").------..L` ......e/I{_ i rs c -5 x ---------------------•------------------------------------------------•----.•-_.. V . .-------------------•----------------------------------------------------------------•-----.....---------------------........._...---•-•. W ---------------------------------------------------------------------------------------------------------------------------------- ................................................................... U 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�T�. 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. { Signed c.`�n 5�� ' 1 d' g � . ............................... ----•--= =- ............. Date A A /1 �!--(__If-f:. 2._ .. � �_: 1--'f /-- PProved BY----l---=-••----- •- ��f _.•------•-•-•--...-•----------- - - - Date Application t ------ Application Disapproved for the following reasons-----------------••-----........................................................................................ ---------------------------------------------- �--------------------------------------------------------------------------------------------------------------------------------------------------------- Permit No.--------•--�--=- -'5•-/ / - ` � �1 / r ate ......................... Issued_--------------- --•-•--- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............................................. Trrtifiratr of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed O or Repaired ( } by_...__.4....2-=---••....r........ Installer t.............. . !n.fit-•- has been installed in accordance with the provisions of TILTU 5 of The State Sanitary Code as descr},to d in the application for DisposalrWorks Construction Permit No.......5.....�..................... dated_.-.._.--_--.--� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------------- ._'_ ........................... Inspector........-------------..... --- .......................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ,y �1 ................. L' ..r,�t, NO.....................%.... ?<' FEE.._....�il.. Disposal Works T.I.onstr ion amit Permission t he e1�y6 granted ............-.-•- ---.. .---- ------•-•--•..................................•---.......--.•...................... `f t� to Construct ( ) ot'Mepair ( ) an,Individual Sewage Disposal System at No C t." It) r ..t 3-Ia-) f.f'f tt. :tru"+y� y tt f S ----- as shown on the application r Dispo al Works Construction P �`Date „�____�_-Oj/ _ �P Q .... ............ Board of He a / / DATE.............•---•-••.......... . ---.......... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS or r+•. 40. SHEET 7 OF 7 A/ MARSTONS MILLS LOT 130 owes w t t� �\ � & LOT 129 t4tiw w LOCATION MAP SOPS) f % 7►B `;j LOT 12i i � w 6 as ��. � Ap ?,. 91. tan�s� too LOT 31 \ R" LOT 137 / ,' tor« ti� �� + �� 'IY,p �,1. - ` ; S• 'i \`I•�' ��`` LOT 108 It 14>} ^ l� I• ~' boy .� r d�i S7Y pAt< ��\ `Abl -'L01 325 1 `y;or LOT 123` s}.. LOT 128 tt,�o w �Ir 1 �i 1 M �,. '4 / +• y �_ < Mks 1.1 ' LOT aV. LOT 149 .lip. laws - X !.. �s LOT 136 LOT 122 LOT 13R Y L 133 Y t ��' / y A 1 \ 1 .1 >� " Lot 121 LOT 107 LOT 148 eiOT 147j / y� \ �� a ��;' LOT 119 >• ( �� F �.\ •ry�S �� 'LOT 141 \\`I 'r'` 1 1 1 I�ly \�l( •�1 '� '`OEM s I ' _ qp,C� .L' LOT 120 >' ! LOT 117 a x4 towrw LOTA43\\ r�lam w �.+• $ Ib 4 1 1 ,� +b 1pN 4 \ d tt►tei �� Y 101 Y < �1° a• V, 140ZLS ♦ t i� "lp T �i3O ''�� ';0 1� 'i�''� 4+ 1►pe \V, 1.5" SHEET 7A or- 1 FOIL sort. ut3 AWP �145 \/ 1 LOT 115 r a 7 T'w�o+•AM-A" -mar Rclwvrs. ' ram, r // !.S" to~T- 7A ei 7 FDIC •IJbfmb" �E 1 LOT 1de '. t% LOT 14 �anJ s �� OJT 'r�+meo w � 4t < �•0 � 10 1 16 of \. - - "• LOT 11E LOT 11S \P M..\' $ totes w too \ 0 Jr I 1!• y ' LOT 11i L4mt11 Y \{' LO 114 I + r w t I . 10. a •s ,o.r..,.o a4j Rowo E teueime•tr. Mal 3 11 29 88 FINAL BLDG. AND SEPTIC LOCATIONS PAL 11,0 1118/68 BUILDING LOCATION PLAN ON I P 2/811 INITIAL ILI ELX NO. 10 DATE DESCRIPTIO BY \ ytdi* t�• ,,re BUILDING LOCATION PLAN 1:+ MARSTONS MILLS WOODLANDS i \� LOT 109 LOT BARNSTABLE, MASS CHUSETTS �\ WOODLANDS ASSOCIATES US \ SCALE: 1" = 50* JOB NO. 1338/t JJF10 \ -r. LW, E LME h IWAGNO WOCU INC. o1al� umm mtm- nee La>lulaae BBo WIW MAIN STFM c=T=V= MA 026W