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HomeMy WebLinkAbout0109 ANGELA WAY - Health ` eyqAngela Way W. Barnstable _ U A = 133 066 5 t TOWWOF$r 1 T BLS LOCATION Assson�s r LOT JINST1 rT..�Tt's DTAAt &ptt6ME Y+tO. psir�iY�c � >zz I c: �cx- c `•'D�y?��_�'"`.te�f�f'S aize}ptkC,rr,.* (type)LF.4C7TG No..OF735)DjkooIws.L� buILOSR oft m R I1EtNIYTOa,X'k? CC�PJ�iai,;It�,S+� ,-- �.�;...4 w .�:-- �.w. 9�p:orstioaa��r,�,n�e Bctvieeta tSae. .• . �'C4f lYlaxlmumltsl�usreci01-auodwTater-Tablezot11s860oraOfL000hin 1 I�iv �u wata Supply V 491 [,c a�,hita� Acility may f�oi9s cxtst Fire cit ,3iC�ac within 2 feat of ltaaetiirf�Cucility) . .cla�s'cyE<UVet�anC9.a�t i I.eacittn�r��ci1(ty.(IE�ar+y.wctlandti exasC -FOCI +lith�n 3Q0 feet of lowbi cg Piacilirya, �lIV 7 1 13 p--.3 7 115 _�� TOWN OF BARNSTABLE E(- 2ee/ - Z�4/ LOCATION 1h 6e1#--f 404--V ' SEWAGE # VILLAGE A), &RX)S "4f ASSESSOR'S NAP& LOT 274P INSTALLER'S NAME&PHONE N0. 71-44 A)IIl/19-oIS 567-737 10%r SEPTIC TANK CAPACITY ZoGo LEACHING FACILITY: (type) CA (size) V 7� P� NO. OF BEDROOMS 7' BUILDER OR OWNER 77pi 4,10/d/fiTo5 PERMITDATE: a-Z COMPLIANCE DATE: 31 1�►° 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 1 Furnished by 11114WI S /,�)We7o a b -57 Q � a� I33 - o�� c � Commonwealth of Massachusetts Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 109 Angela Way Property Address Scott and Sarah Kolva Owner Owner's Name information is West Barnstable MA 02668 06/02/2021 required for every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. Inspector Information S filling out forms 5� �F ( y'I 7 on the computer, use only the tab Michael T Bisienere key to move your Name of Inspector cursor-do not Cape Septic Inspections use the return Company Name key. 52 Rivers End Road Company Address Teaticket Ma. 02536 City/Town State Zip Code . 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 06/02/2021 Inspectors 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 cam, Commonwealth of Massachusetts - Title 5 Official Inspection Form r= Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 109 Angela Way v Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) 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: This 4 bedroom home has an H-20 2000 gallon septic tank with a D-Box feeding 4 leaching chambers with stone. At the time of the inspection no visible failure criteria was found. 2) 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. Check the box for"yes", "no" or"not determined" (Y, N, ND) 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. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 c Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Angela Way Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 pipes) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 3) 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. a. System will pass unless Board of Health determines in accordance with 310 CMR 16.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 f - Commonwealth of Massachusetts Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ........... / 109 Angela Way v Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **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 must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form T l; Subsurface Sewage Disposal System Form -Not for Voluntary Assessments < � 109 Angela Way u Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® 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 'h 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 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. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply 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 2000 gpd- 10,000 gpd. ❑ ® 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. 5) 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 CA. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments c � 109 Angela Way u— Property Address Scott and Sarah Kolva Owner Owner's Name information is West Barnstable MA 02668 06/02/2021 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes" to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: 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 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 criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 c Commonwealth of Massachusetts x Title 5 Official Inspection Form ?= I� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments I « � 109 Angela Way v Property Address Scott and Sarah Kolva Owner Owner's Name information is West Barnstable MA 02668 06/02/2021 required for every page. City/Town State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 476 GPD Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d well water 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: occupiedDate t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 c Commonwealth of Massachusetts �n Title 5 Official Inspection Form 'T Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 109 Angela Way Vl Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: 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 below): 3. Pumping Records: 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: t5insp.doc-rev.712 612 01 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 c Commonwealth of Massachusetts x p Title 5 Official Inspection Form IT Subsurface Sewage Disposal System Form - Not for Voluntary Assessments >(n 109 Angela Way Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. 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) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: 2001 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: 48"feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line. 10 plus feet feet Comments (on condition of joints, venting, evidence of leakage, etc.): Water was flushed and it came freely. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 c Commonwealth of Massachusetts 1 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Angela Way L� Property Address Scott and Sarah Kolva Owner Owner's Name information is e required for very West Barnstable MA 02668 06/02/2021 q page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 3' 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: H-20 2000 gallon Sludge depth: 4" Distance from top of sludge to bottom of outlet tee or baffle 32" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? sludge judge Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): recommend the new owner put the septic tank on a maint. plan with a local septic pumping co. based on the future use of the home. At the time of inspection the liquid level was at working level and the tee's were in place. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 c Commonwealth of Massachusetts �x Title 5 Official Inspection Form !, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments e / 109 Angela Way v Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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.): 8. 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 per day t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form '= !� Subsurface Sewage Disposal System Form - Not for Voluntary Assessments /w e � 109 Angela Way v (Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) 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 co of current pumping contract(required). Is co attached? ❑ Yes No PY P P 9 PY ❑ 9. Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" 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.): At the time of the inspection the liquid level was at working level and there were no visible signs of leakage or solids carryover. l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �C 109 Angela Way V Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 Cit /Town State Zip Code Date f Inspection page. Y p o D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 4 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 c Commonwealth of Massachusetts c r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 109 Angela Way u� Property Address Scott and Sarah Kolva! Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At the time of the inspection no visible failure criteria was found. 12. 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.): 15insp.doc•rev.712612011 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 c Commonwealth of Massachusetts x Title 5 Official Inspection Form ±= i; Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 109 Angela Way V Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 }� Commonwealth of Massachusetts Title 5 Official Inspection Form =1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 109 Angela Way 'J a Property Address P Y Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. CityTTown State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately i J o ¢f\4 Ali R-I-Zs' gl-a9' 0-3-28 Sass C-4-34i > -35, S 7�la I i I i I i I I t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 c Commonwealth of Massachusetts p Title 5 Official Inspection Form b Subsurface Sewage Disposal System Form Not for Voluntary Assessments 109 Angela Way v Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) 15. Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 16 plus feet 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: You must describe how you established the high ground water elevation: I augered a hole at a lower elevation and shot it with a transit to show 4 plus feet of seperation. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form 11.11. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c / 109 Angela Way v- Property Address Scott and Sarah Kolva Owner Owner's Name information is required for every West Barnstable MA 02668 06/02/2021 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or 4 checked ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. A. General Information (� 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 Cityrrown State Zip Code 1-508-495-0905 S13971 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 maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation b cal Approving Authority 4-16-15 Inspector'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. li. t5ins•3/13 Title 5 Official Inspection Form:Sub )5ystemage 1 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is W. Barnstable MA 02668 4-16-15 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: System is in good working order with no sign of failure. B) System Conditionally Passes: ❑ One or mores components as described in the "Conditional Pass"section need to be system replaced or repaired.The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", .,no" or"not determined" (Y, N, ND)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. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 �1 Commonwealth of Massachusetts _ Title 5 Official Inspection Form ' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ 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 ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 page. CityJTown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** 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 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 ❑ ® 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 El ® 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 Y2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form m Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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. ❑ ® 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 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 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 criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ^M 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage Well 9 ( Y 9 (gPd))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 4-2015Date 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: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 5 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Owner--pumped 2014 Was system pumped as part of the inspection? El Yes ® No i If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Maintenance Type of System: Septic tank distribution box soil absorption system p P Y ❑ 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) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts m W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2001 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 36"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.): Good condition. Septic Tank(locate on site plan): Depth below grade: 24"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: 2000 gal 611 Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 26" Scum thickness 0 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 15" How were dimensions determined? Tape 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 in good condition with baffles installed and no sign of leakage. 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form ;m Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a ,M 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 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.): 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 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 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 ipage. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 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.): i Good condition with water at working level and no sign of back-up from chambers. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 I Commonwealth of Massachusetts m W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 109 Angela Way Property Address Scoff Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type. ❑ leaching pits number: ® leaching chambers number: 4-500's ❑ 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.): Leach chambers in good condition and holding 6" of water with no other visible stain lines. 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Angela Way i M Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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.): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 109 Angela Way Property Address Scott Kolva Owner Owne-'s Name information is required for every W. Barnstable MA 02668 4-16-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: 0 hand-sketch in the area below ❑ drawing attached separately r -, ' o ° y Y - n t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is required for every W. Barnstable MA 02668 4-16-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12'+ 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: You must describs how you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 I - Commonwealth of Massachusetts �N F Title 5 Official Inspection Form m - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 109 Angela Way Property Address Scott Kolva Owner Owner's Name information is W. Barnstable MA 02668 4-16-15 required for every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist . ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 No. / Fee V, / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipphratton for �Dtgaar *pgtem Com5tructton Vermtt Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) f Complete System ❑Individual Components Location Address or Lot No. t//3 ,4-1 6 9 "Al Owner'{ e,Addressard Tel.No. (..i.1I•G�.A Assessor's Map/Parcel L../' G / g � � S7� ,y, t� 2c.1 66 q tc�+l`• lop� Installer's�ne,Address, ��@l.l�o�4 � 2� _�f G Designej-rJ's Name,2�dress and Tel.No. V�GS Iran 1L lc,5 t }O Cc�aw Q�, �I"cd/ Fie-zew` Type of Building: Dwelling No.of Bedrooms T Lot Size /I / A-4L sq.ft. Garbage Grinder( ) Other Type of Building TT No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 26, t/,. gallons. Plan Date 2 c) F'ob d\ Number of sheets Revision Date Title l Size of Septic Tank Type of S.A.S. /N' C c s Cc�clut�Q tch;a� c�/tAu/.tia�\j Description of Soil Cj�"e. L�I�J✓� Nature of Repairs or Alterations(Answer when applicable) _ DESIGNING ENGINEER MUST SUQI=gVISE INSTALLAmON AND CERTl1=`r IN V e .i SYSTEM n ':�o i"-I CQRnAhICE TO P1 AK Date last inspected: Agreement: The undersigned agrees-to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Envir mental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b his and of H t . Signed Date I Y/24^191 Application Approved b Date MAY 6: ,ZZ3 Application Disapproved for the following reasons Permit No. Date Issued .� No. Fee n Entered in computer. --V THE COMMONWEALTH OF MASSACHUSETTS _ yes PUBLIC HEALTH DIVISION.- TOWN OF BARNSTABLE., MASSACHUSETT%', Z(ppYication for Mizpozar *pgtem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ]Complete System ❑Individual Components Location Address or Lot No. A-^ F 5 J '7 Owners Name,Address and Tel.No. Assessor's Map/Parcel M^ w� r �� '6 6 1t S CG -If". SIq��n. �� 02 S7 Installer's Name,Address,and T@l.No. t f OG Designer's Name,Address and Tel.No. �cc�n-� CG.,.S� S O �e�ard �d (l c�J '16^�{1�6� Type of Building:: ' I Dwelling No.of Bedrooms T Lot Size sq. ft. Garbage Grinder( ) Other Type of Building TT No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow y gallons per day. Calculated daily flow gallons. Plan Date 2 ic\o 0 1 Number of sheets Revision Date Title ;./ Size of Septic Tank t ° 6�1\. _004 b4_1 Type of S.A.S. fu << CcocNLk Description of Soil !S2 e- G� ✓� Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Envirot mental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued bythis and of H Ilt . -� Signed Date ( Y/P 7 D J Application Approved b Date MAY Application Disapproved for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of .Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( ) Abandoned( )by at has been constructed in accordance \ with the provisi`on�of Title 5 and the for Disposal System°Construction Permit No.Z 0 0(-Z 8 q dated Installef I�—N Designer &� QN The issuance of this permit shall not be construed as a guarantee that the syste will function s;designed. Date 1 31 '1 n�I Inspector � aw t� lw No. �-a I �� ----------Fe@ LI1J v- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ligool 6potem Con0truction Permit Permission is hereby granted to Construct(-- )Repair( )Upgrade( )Abandon( ) System located at 112, im!$e Ian tK�j fiU-, lea ry3,t.b and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Cons ction must be completed within three years of the date of this permit. Date: i Approved by r { TOWN OF BARNSTABLE CL 2e6/ - LOCATION //I lby6elAs* 404 SEWAGE # VILLAGE �� �GCI:�� ASSESSOR'S MAP & LOT �,/ INSTALLER'S NAME&PHONE NO. 7410 GfJ//// 56?',7-3 7 10W SEPTIC TANK CAPACITY O�CI LEACHING FACILITY: (type) (size) 4 76o P� NO. OF BEDROOMS BUILDER OR OWNER /I1'1I 4-()� PERMITDATE: 2-1 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility)/ Feet Furnished by �4�Ci I iS -Z- Z2� a _ Us �J b / T/ 'I ENVIROTECHLABORATORIES,INC. MA CERT.NO.:M-MA 063 449 Rte.130 Sandwrcb, MA 02963 908(888-6460) 1-800-339-6460 FAX(908)888-6446 CLIENT: Tim Williams LOCATION: 113 Angela's Way ADDRESS: 153 Center St. W. Barnstable, MA Yarmouthport, MA 02675 COLLECTED BY: DA Scannell - SAMPLE DATE. 5/4/2001 SAMPLE TIME. NA WATER SAMPLE TYPE: New Well DATE RECEIVED: 5/4/2001 LAB I.D. #: 0105084 WELL SPECS.: NA RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Analyzed Limits Coliform bacteria /100ml 0 0 9222 B 5/4/2001 pH pH units 6.5-8.5 5.78 4500 H+ 5/4/2001 Conductance umhos/cm 500 162 120.1 5/4/2001 Nitrate-N mg/L 10.0 1.70 300.0 5/4/2001 Nitrite-N mg/L 1.00 < 0.003 300.0 5/4/2001 Sodium mg/L 28.0 14.4 200.7 5/9/2001 Iron mg/L 0.3 < 0.1 200.7 5/9/2001 Manganese mg/L 0.05 < 0.008 200.7 5/9/2001 Volatile Organics ug/L See Report None Detected. EPA 524.2 5/7/01 COMMENTS: Low pH indicates high corrosive characteristics. WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. <=less than Date >=greater than onald J. Sa TNTC=too numerous to count Laboratory erector I I GROUNDWATER Groundwater Analytical,Inc. P.O.Box 1200 ANALYTICAL Buzzards Main Street Buzzards Bay,MA 02532 Telephone(508)759-4441 FAX(508)759-4475 May 11, 2001 Mr. Ron Saari Envirotech Laboratories 449 Route 130 Sandwich, MA 02563 Project: Tim Williams/113 Angela's Way Lab ID: 40835 Sampled: 05-04-01 Dear Ron: Enclosed is the Volatile Organics Analysis performed for the above referenced project. This project was processed for Priority One Week turnaround. This letter authorizes the release of the analytical results, and should be considered a part of this report. This report contains a project narrative indicating project changes and non-conformances, a brief description of the Quality Assurance/Quality Control procedures employed by our laboratory, and a statement of our state certifications. attest under the pains and penalties of perjury that, based upon my inquiry of those individuals immediately responsible for obtaining the information, the material contained in this report is, to the best of my knowledge and belief, accurate-complete. - Should you have any questions concerning this report, please do not hesitate to contact me. Sincerely, 11; ;I;o7k' Jonathan R. Sanford President JRS/deco Enclosures GROUNDWATER ANALYTICAL EPA Method 524.2 Volatile Organics by GC/MS Field ID-- 0105084 Laboratory ID: 40835-01 Project: Tim Williams/113 Angela's Way QC Batch ID: VM5-1506-W Client: Envirotech Laboratories Sampled: 05-04-01 Container: 40 mL VOA Vial Received: 05-04-01 Preservation: HICI/Cool Analyzed: 05-07-01 Matrix: Aqueous Dilution Factor: 1 Page: 1 of 2 Number 75-71-8 Dichlorodifl uoromethane BRL ug/L 0.5 74-87-3 Chloromethane BRL ug/L 0.5 75-01-4 Vinyl Chloride BRL ug/L 0.5 74-83-9 Bromomethane BRL ug/L 0.5 75-00-3.1 Chloroethane BRL ug/L 0.5 75-69-4 Trichlorofluoromethane BRL ug/L 0.5 75-35-4 1,1-Dichloroethene BRL ug/L 6.5 75-09-2 Methylene Chloride BRL ug/L 0.5 156-60-5 trans-1,2-Dichloroethene BRL ug/L 0.5 1634-04-4 Methyl tent-butyl Ether(MTB E) BRL ug/L 0.5 75-34-3 1,1-Dichloroethane BRL ug/L 0.5 ---540-20-7 2,2-Dichlompropane BRL ug/L 0.5 156-59-2 cis-1 2-Dichloroethene BRL ug/L 0.5 74-97-5 B rom ochlbo-r-o`methane --B-R--L- ug/L 0.5 67-66-3 Chloroform BRL ug/L F 0-.5 -.7.11-55-6 11111-Trichloroethane BRL ug/L 0.5 A 56-23-5 Carbon Tetrachloride BRL ug/L 0.5 ------------- 563-58-6 1,1-Dichloropropene BRL ug/L i 0.5 71-43-2 Benzene BRL ug/L 0.5 :��7�6--2-- 1,2-Dich.-I-o-roethane BRL ug/L 0.5 79-01-6 Trichloroethene BRL ug/L 0.5 78-87-5 1,2-Dichloropropane BRL ug/L 0.5 74-95-3 Dibromomethane BRL ug/L 0.5 75-27-4 Bromodichloromethane BRL ug/L 0.5 10061-01-5 cis-1,3-Dichloropropene BRL ug/L 0.5 108-88-3 Toluene BRL ug/L 0.5 10061-02-6 trans-1,3-Dichloropropene BRL 79-00-5 1,1,2-Trichloroethane BRL ug/L 0.5 127-18-4 Tetrachloroethene BRL ug/L 0.5 142-28-9 1,3-Dichloropropa BRL ug/L 0.5 124-48-1 i Dibromochloromethane BRL ug/L 0.5 106-934 1,2 moethane BRL ug/L 0.5 108-90-7 1 Chlorobenzene BRL ug/L 0,5 630-20-6 1,1,1,2-Tetrachloroethane BRL ug/L j 0.5 100-41-4 BRL ug/L 0.5 Ethylbenzene meta-Xylene and para-Xylene BRL ug/L 0.5 95-47-6 i ortho-Xylene BRL ug/L 0.5 10042-5 Styrene j BRL ug/L 0.5 75-25-2 Bromoform BRL ug/L 0.5 98-82-8 Isopropylbenzene -BRL ug/L -.0.15111 106-Wi Drornobenzene BRL ug/L 0.5 79-345 1,1,2,2-Tetrach loroethane -BRL ug/L 0.5 Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 ---------- ,.GROUNDWATER ANALYTICAL EPA Method 524.2 (Continued) Volatile Organics by GC/MS Field ID: 0105084 Laboratory ID: 40835-01 Project: Tim Williams/113 Angela's Way QC Batch ID: VMS-1506-W Client: Envirotech Laboratories Sampled: 05-04-01 Container: 40 mL VOA Vial Received: 05-04-01 Preservation: HCI/Cool Analyzed: 05-07-01 Matrix: Aqueous Dilution Factor: 1 Page: 2 of 2 ._` S 1Yurt�5er - 1na 7- N 96-18-4 1,2,3-Trichloropropane BRL ug/L 0.5 103-65-1 n-Propylbenzene BRL ug/L 0.5 -------- --- - — 95-49-8 2-Chlorotoluene BRL ug/L 0.5 108-67-8 1,3,5-Tri methyl benzene BRL ug/L 0.5 106-43-4 _; 4-Chlorotoluene BRL ug/L 0.5 98-06-6 tert-Butylbenzene BRL ug/L 0.5 .. .. 95-63-6 1,2,4-Trimethylbenzene BRL ug/L --0.5 - 135-98-8 sec-Butylbenzene BRL ug/L 0.5 541-73-1 1,3-Dichlorobenzene BRL ug/L 0.5 99 87-6 4 Isopropyltoluene BRL upfL 0.5 106-46-7 1,4-Dichlorobenzene BRL u L 0.5 95-50-1 1,2-Dichlorobenzene BRL ug/L 0.5 104-51-8 n-Butylbenzene BRL ug/L— 0.5 — -------- - — — 96-12-8 1,2-Dibromo-3-chloropropane BRL ug/L 0.5 120-82-1 1,2,4-Trichlorobenzene BRL ug/L 0.5 � 87-68-3 Hexachlorobutadiene BRL ug/L 0.5 91-20-3 Naphthalene BRL ug/L 0.5 87-61-6 1,2,3-Trichlorobenzene BRL ug/L 0.5 .:QC Sc�i�rogate C�tpotlffiflds�_G _ .a „�, 1,2-Dichlorobenzene-d4 —j 101 % 70-130% —4-Bromofluorobenzene I 100 % 70-130% Method Reference: Methods for the Determination o�Fg'anic Compounds in Drinking Water,Supplement III,US EPA, EPA-600/R-95/131 (1995). Method Revision 4.0. Anatyte list as derived from 40 C.F.R. 141.40 and 40 C.F.R. 141.61,and additional analyte MTBE. Report Notatim-is: BRL Indicates concentration,if any,is below reporting limit for analyte. Reporting limit is the lowest concentration that can be reliably quantified under routine laboratory operating conditions. Reporting limits are adjusted for sample dilution and sample size. Groundwater Analytical, Inc., P.O. Box 1200, 228 Main Street, Buzzards Bay, MA 02532 CAPE COD ENGINEERING, INC. Robert M. Perry, P.E. 50 LeIand Road Brewster,MA 02631 Tel./Fax 508-8964861 bobperry@capecod.net January 31, 2002 Town of Barnstable Health Dept. Board of Health 367 Main Street Hyannis, MA 02601 Re: Septic System Certification for 113 Angela Way, Barnstable, MA r To the Health Department, Based upon my information,knowledge and belief the septic system has been constructed in general compliance with the approved plan. This certification does not include a property line survey. Please contact our office should you have questions. Sincerely, Cape Cod Engineering, Ina Robert . Perry, P f TOWN OF BARNSTABLE � �ETMETO OFFICE OF i BOARD OF HEALTH y MASIL p oo 1639,A�9� 367 MAIN STREET May 10, 2001 HYANNIS, MASS.02601 Timothy Williams 153 Center Street Yarmouthport, MA 02675 Dear Mr. Williams: Your request for a variance from the Board of Health Private Well Protection Regulation, Part XII, Section 3.00, provision #13, is not granted. You testified that it would be very difficult to access the area where the proposed well is to be constructed due to the steep grade and excessive number of trees in the area. Therefore, you requested permission to obtain a disposal works construction permit and a building permit application sign-off, prior to constructing the well and prior to obtaining well water laboratory analysis. The Board of Health requires laboratory analysis of the proposed drinking water before a disposal works construction permit and before building permits are issued, to ensure that the foundation and house are not constructed before it is known whether or not the water is potable. If you should have any questions, please feel free to telephone 862-4644. Sincerely yours, Susan G. Ra , R.S. Chairman Board of Health Town of Barnstable SGR/bcs william �FTME f DATE: FEE: BARN3PABM y MA-% 039. � REC. BY Town of Barnstable SCHED. DATE: Board of Health 367 Main Street, Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION Property Address: Assessor's Map and Parcel Number: 1 .;3 •—06 4 Size of Lot: /t Wetlands Within 300 Ft. Yes -,A _ Business Name: No Subdivision Name: 6adicth F^n m , APPLICANT'S NAME: .. UJA`N"44.5 �-� PAIS Phone C&y 37 f-6L/ Did the owner of the property authorize you to represent hun or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: \�w� �.. ,�,y,,� Name: Address: �5, �h • Y�nr>"�� nB� Address: Phone: sas) Phone: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(Maya ach if more pace needed) —e�,on (3 � Pl}TT l 2,S e�-3 a 5"k of a-e S Co�}�n���.,.,, a� /Lo&t/F -Fa-7 vi ulf, 3 _` ®� fu aft iu c NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System ❑ Checklist(to be completed by office staff-person receiving variance request application) _ Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request — Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/leasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. Q:/WP/VARIREQ -8500 Phone: (508) 428Construction Fax: (508) 428-8508 • Fm To: Sophia From: Timothy C.Williams Fax: (617)482-8013 Date: April 12,2001 Phone: (617)482-4977 Pages: 4,inc.cover Re: Well location CC: 0 Urgent ❑ For Review ❑ Please Comment ❑ Please Reply 0 Please Recycle -Comments: Thank you for talking with me earlier today. I have enclosed three site maps. Site map #1 is a town map displaying your house and my vacant lot. Site map#2 shows our house location, which we are maintaining to the front edge of the yard. Site map#3 shows the overall neighborhood and the relationship of our two parcels. As you can see, if the fax is working with any clarity,your well is very dose to my lot. Our proposed well is sited in.dose proximity to you"necessity. Proposed and existing septics have to maintain a separation distance of 159, leaving us with no alternative but to locate our well to the rear of the lot: Our problem is we will have to build a road to the rear of the lot if we access from Angela's Way because the slope is too steep for a wheeled vehicle. surveyed our options and it appears possible to move a light drilling rig down your driveway,across the front of your house and toward your well and approximately 30'beyond onto our property. I would gladly repair any damage to your property though I believe the risk to be low. I thank you for your consideration iin this matter and look forward to hearing from your Should you have any questions, please do not hesitate to call me at the office or on rry cell phone at 505.737.1048. Regard Tim Williams ' I \ W _ Q } i rlr • Q 9 d 3 = �' td yam. G 58 sW Y 7 F C 1 r C e 0 C2 W ■ � ■ ` sa} a LLA Y6 S �t �Y 0 O 6 a O C `s C O MIIs Z Y e �� i • S II 1 ( 1 �7 ■ e m O a • P �N ; tl4a , \\ , r.• If. I / ,'/ ,�, ..� •� \ \ ��ice,'' / 00 \\N— C.0 /:�i� 03 / , f • �yyy: , N { Y J \' � \ / \ .;�-•-J�� --=yam.=_.>_.-� f 00 ° \ lie `K \�0 Na nU / 4 OP cF� G6 i Al r19 \Z1 ho r` X RA q roe c:'r Ic/V U N IDd. 1pp • %+�' I c�Ar2a�E IC' �.�eCl! - .�/9. D _�..: ' _ ._ w I--- ._ --•— • � v � 0 � � ra• 8 ti: �� 1 � I Iis r �\ J pRLrlE1rYE Xi j NG � � \ , 35 SIC J � Full ruo lam IV. 6 P9 it o.w�dnOb ylb� s . „ /y Y i ( If Anoo'� s �i --� � I 4 46 7 j 4 s� has j all i` 7r p0 Oc I ® 4' �► 4 c• 4► o u O M 10q 7p90 2.2 F L �• Myy i,� 9S 05' 'I pM 11'� Owool V { ® G LS 'ri1o1 WbY9 LVPA �L O►VIJA SVC �d 1 t �O NMOl --- - --- ---- ------- No. - Fee— -- BOARD OF HEALTH TOWN OF BARNSTABLE App[ication1brVerr ConaructionA3ermit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: l Location — Address Assessors Map and Parcel --- -- -------------------- Owner Address &AAS Installer — Driller q 7 7 a l i Address Type of Building ` Dwelling --- — -------- Other - Type of Building ------ No. of Persons-- --------------- Type of Well °A'4'� , . — Capacity---- Purpose of Well Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certifica a .of Com fiance has been issued by the Board of Health. Signe �`^ � —� ----- Q date ff�uv Application Approved By — — -- Gate Application Disapproved for the following reaso - - -------------- -- - --------------------- date r Permit No. Issued -- --/H/0 ------- -- ------------ dat BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by--- -- --- -- — --------—— --- -------- _ — Installer at— — — ------—---- -- - - -- -- ----has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. --------Dated--------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE - Inspector No. --------'-------- � Fee=----------- ------- � 1 BOARD OF HEALTH TOWN OF BARNSTABLE Application for Met[ Cootructionpermit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: I� /L Location — Address + Assessors Map and Parcel Pa l A o e s cLa ----- Owner -- -- -- _--------Address — ----- ---------------------------------------------------------------------------------- Installer — Driller / �' Address Type of Building "� - Dwelling _----- -- ------- ;ti Other - Type of Building -- No. of Persons------------ ---------- T e of Well S` n�'^ , — Ca acit Purpose of Well-- — `—L- "` •Agreements The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The ` Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to .place the well in operation until a Certifica a of Compliance has been issued by the Board of Health. : a �.. l/ Q date Application Approved By1�t — — ----- date Application Disapproved for the following reaso -- --- ---_—_—__----_—_--- — -- -- -_—__________—____-___--- date •� J Permit--No./4mw — Issued—�` - J_- - -- --- -- dat BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( ) by--- — - --- --— — ---—— -- ----_—__- Installer at--- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. --_----Dated---- ------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--- - -- Inspector------------- -- ------ ---- BOARD OF HEALTH TOWN OF BARNSTABLE - Veri Construct ion Permit No. - f,f fee— ----------- Permission is hereby granted ---�1 - ---� --__—=a --to Constru t ( Alter/( or Repa�i1/r� erg) anindividual .W 11 at: No. Street �� - e•- as shown on the applicatio filar II Construction Permit -, No. - _.,. Dated ---------------------- A - �� o�e th DATE B � y (/ � ._ --- 1 r 1 52'-7 3/81, 5 112" 8 -------------- -------------6-3--------------------- ----------------------------------13'-0 112 ---------------------------------- ----------------------------------------------------------19--5112- -------------------------------------- ---------4'-2-------------------------------------9'-27/ ............. .. .......... ---------------------------------12' 2 ------------------------------— --------------- ---------------- ..... ---- ------------------ CA MCC oto ............ 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F-12 A ...A I... 1 c R 3 `-- ErXlaTi N CiMNTIOU R. r_L6VA710N5 � 1 1 ro.bk. -"x � X 1<>S C?CI 13Tt N c3 5 aOT -w- VVATCt2 LINE= �ST NOLm LOCAI7ON 111E-IU. 1: J] B andkvm In1Rs ® PI�oFl�151iD ko0 SEMVanl r 11 I`�YPFa¢TY LINr. 3J.12o ( !»„n .,nA 2slvA P�seO OISi'TRJBUIIGN BpX � PFeor�SED SPC7T' ELLa VA7)O N I 1I� Psto? ep SsA�s 'UNosczarlo(JNc� uT1L1TY urz y w F L L. �L u i.v n 2 --f�-- P A P IF R T Y 1 AI E i n i 1 GENERAL NOTES Vl , cif W GI,(UI.WE CONTA( I I V , l \ Drpu tr(.rowe/.rer.c w16wd EWaOatrd!1, h I. ELEVATIONS REFER 10 AN ASSUMED DATI'M. ELEVATION BENCHMARK IN t^ 1 e ,..end».tr, , A'PK' NAIL SET IN THE ROAD PAVEMENT ALONG THE BERM EDGE WHERE Z � Prrc test data:rre-rr1y�r.d tl�d Q'1"Aryth 12" io e"u J m.o 3o vc Q-to."u X •e r S see. SHOWN ON THE:PLAN. NAIL El_-100.00 2. ALI,CONSTRUCTION MATERIALS SHALL CONFORM TO THE STATE SANITARY CODE TITLES N A D TOWN OF BARNSTABLE:HEALTH DEPT. ! } 't REGULATIONS. :3 !� Q 3. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE HEALTH DEPT. ' vx"r- .0" I N 1 t� f 4. NO PERMANENT STRUCTURES ARE PERMI IIFED OVER THE 100%RESERVE C �` s L o E I 1 4 !. } ' f - '�-- 1NF 7t i�:._,v .. AREA. S. INSTALLATION CONTRACTOR SHALL VERIFY ALL SOIL PIPES' ELEVATION [� •- ' S"r�T/caw S AND CONDITION PRIOR TO MAKING CONNECTION. 6. UTILIZE DIGSAFE AND ANY OTHER NECESSARY UTILITY MARKOUT SERVICE TO LOCATE AND PROTECT ALL UNDERGROUND UTILITIES DURING w r rl fig '� A'E'£p CONSTRUCTION. 7. A SFI. PERIMETER EXCAVATION IS REQUIRED TO REMOVE ALI. UNSUIT ABLE SOIL ENCOUNTERED. SOIL TEST INDICATES THAT NO \ PERIMETER EXCAVATION IS NECESSARY PROVIDED THE SAS IS CONSTRUCTED BELO% I HE'B'SOIL HORIZON.REPLACE ANY PERINIFA FR / <, EXCAVATED SOIL WITH CLEAN SAND CONSISTENT WITH TITLE S SPECIFICATION.CONSTRUCT THE SAS IN THE NF% MATERIAL. ii cc'.••1 QEC K 108 e ( I E l ' _ _ / 8. INSTALLER SHALL CONTACT ENGINEER AT 508-896-4861 AT TIME OF >:- j ,oRvvc� v r ° Boa f EXCAVATION TO VERIVN SOIL CONDITIONS ENCOUNTERED AND ALSO Al r-A�- COMPLETION FOR SYSTEM CERTIFICATION. 1 / ` 9. CONTACT ENGINEER IF ANY QUESTIONS OR DOI FITS ARISE'RIA ARDING - 7 ` �4 SOIL CONDITIONS ENCOUNTERED DURING CONSTRUCTION. 10.NO KNOWN WELLS EXIST WI THIN 200 FT.OF THE PROPOSED SEPTIC C NV zF SYSTEM OTHER THAN THOSE SHOWN. NO KNOWN SEPTIC SYSTEMS EXIST N mR �3G /C/v /V / (� ( ( / \� WITHIN 200 FT.OF THE PROPOSED"FIT OTHER THAN THOSE SHOWN. 1 - QR C ( h Q ( ' y 41 11.LO( US:ASSESSORS' MAP 133,PARCEL 066 12.PORTIONS OF THE SITE:WORK FOR FOUNDATION EXCAVATION AND GRADING IS PROPOSED WITHIN 100 FT.FROM A WETLAND AREA. OB"FAIN 1 ` r- i �\ � `_1 _�►• u G E 7$ CONSERVATION COMMISSION AUTHORIZATION PRIOR TO PROCEEDING _ WITH ANY WORK. \ ; 13.THE WORK LIMIT SHOWN SHALL BE FITTED WITH A PROPERLY DUG IN SILT FENCE PRIOR TO ANY SITE EXCAVATION. THE SILT FENCE SHALL REMAIN ' f / i 12 7. , F \, \ ` �� _ - _✓ Z IN PLACE IJNTtI.THE EARTH SLOPES HAVE BEEN STABILIZED WITH pP^f i Vr 1 Pr?lrJrRVE EX�; r/�G l ) ` -� ADEQUATE VFGFIATIVECOVER. I A ( T/F Cr S _ ._ 3 S`1 SEI 7 [C SYSTEM DESIGN DATA 'b-� H1 DRAULIC LOADING -4 BEDROOMS I I ) CPD/BEDROOM X 4 BEDROOMS ­W.0 GPD � , , - dd11' ( L14 .4 \\ _� SEPTIC TANK SIZE-440.0GPD X 200/w-E80GAL. Piz J �' �' SLepE , �# `., \ -� ��, ` _ _ �-- _ 8` PROVIDE "ftGAI_1ANK;� 20D0 G«1 PERCOLATION RATE-LESS THAN S M )' /Jz 7J0 ��-- BOTTOM AND SIDE%ALL LOAD RATE:=0.74 GPD/S.F. j '-._ . ' \l� c B & SIDE AREA:2(2')( I I.0' )(40.0' )=204.0 S.F. BOTTOM AREA: 11.0'X 40.0'=440.0 S.F. f' 1 CAPACITY:644.0 S.F.X 0.74GAL/S.F.=476.6 GPD 11� \ �G orb (RESERVE AREA DIMENSION OF 33'X 12.8' X 2' DEPTH =448 GPD I A 1 \� 1ti� 1 THIS DESIGN DOES 11'OT ALLOW FOR GARBAGE DISPOSAL USE, E-9GE rF /�.1 �,Fi.>Eni r=T �1'C�C_ - , __ �\ 4-30-0 ► RFv/s1rni /a N , �' ELF✓. EXrE,vp Mvo�ck L .»� T, /1LTE�1 ,yo (SSE FocrP-� in IV f T FL,Jc /OO.O /1 l v w L o c r,, -- -- -- - ---- - - MkscONsrRL(110N SE T-TI C SYSTE pQ0FI LE- SASFtICONSISTSktA'4 FACTI- RDBYS ORIV P(.(AST,[%( ORI:QtA PLAN SHOWING PROPOSED �NO �J,L�- DRYW ELLS AS YIANLFA('TI'RED RY SNURII►RECAST,IMC.UR Cpl AL, F. le<)D E + ►I.A('ED END-TO-END,CENTERKD IN A N FT.LONG X 11 FT M IDE 7. S _ F,,IANLNOL'_ 5 COVER- MfN 01A-24' FXCA%ATION,SL'RROINDEDRI'S."TOIK-DIAMETER,DOU1111- 1B'4� MANHoL� WIT14 CONC-2ETE 3 NASHFDSTONY. SET PRECAST UNIT WE INLET INVERTS 10YHF �pvaLcR FT2AME Z3QpU6NT SUBSURFACE SEWAGE DISPOSAL SYSTEM UV H r u 1a TD W ITV41 N (ia' OP 2' _AY E,R -�, -� FLEVA I IONS SHOWN 4RO1TD[D All 01RER ELEVATIONS ARF IN - J►ccoRDANrEWrtTIrllEnwN. w1T-Hj.N 6'toF FI►.lISHGD G�DI- )Pq0 IDE FOR A PROPOSED SINGLE FAMILY RF.SIDF.NCE AT iFlN13F-t e D ¢ADE /As I s-rrJ N t= Im V. // /�-�� 17 ?AN CLEAN ' oR.E>v� 113 ANGELA WAY, NVEST BARNSTABLE, NIA -_ MAN . �, ASSESSORS' N1AP 133; PARCEL 066 � /'_ o ' LOGATiG ,i ' . _ / a ~.. PREPARED FOR n �Il a m ED C3 J o a o Ea ( E» m 0 TIM AND MAGGIE WILLIAMS IH� • i/S•co -- .. ' I ', -t o CM o ca moo- r= c= = a =o a = ED c-� o r� INV.=/ 4.25 r II-�, ��--�----II r I53 CF.\TIER STREET �� - O. �' �' - , L•t•` •.. l� a L1 Q o Q Q a 1- C_ Q Q 0 Q Q U = t� Q ' 4 0" T3n,FFL� r�n,Ne - . .• YARMOUTHPORT. NIA 02675 u4u1D o a a❑ c a a a r1 Q L7 508-375-0457 O 15 0 or 3/4r, lb ) LEVEL F6TQ BUTTON 13C1�C • • _ 1 ° � �- IS 1'r.3 s12�NL - 6 ) 3/4- I yZ` -r �bL� EFBI#Z,UARY 20,Z001 SCALY I" 21►' TANK _ _ - 2NVERT ELGN/ol7DM15 _ 8 -- - rT�M of f y r u. v PREPARED BY _ was,}-+ o s-rn►.1 -- --- -- ----- _ STD M _ CAPE COD ENGINEERING, INC Or ALL �UTL6TS TLC -� RO�c�T!s!. in - ro • ,. • �: < <` o a . � �e>,+A o ,�5, , 2 " . BE -r,,41-r SAME OR. � ' � , f.LEV' r c �. --- -- " ROBF.RT M. PERRY. PF. ;., ' r- I S "RVISE o a '1 ,. o Y a a • , • • -------- - PERRY - _,�iIN`tR I/JET Noce : • t - i 2,s,obo v SO I,EI.AND ROAD ._tlVC�' AND CERTIFY I ;iTING u5E RoTATIN WIE:R 4- ALL plrc � ec �Ooc 6'l/u1 OUrL�TS TYPICAL LOCH S STM-M CRC-�-�EGTIaN CIVIL ' 4' P,V.C TIGHT TA 1L Y �. 1 So�1µT CAtp�l /� L�oN� C>�rrLET PIPG-s SH4,LIL B� -^� `��`��' N E3RF.VIL'STFR. MA 02631 SYSTEPA WAS INSTALLED IN STRICT pRGC�.6T S2Cl/yFOQCCD �N N1,16 LEVEL VZDPZ AT Leasr /� iDE // -Z /� E-r S r TF1. - t0R-8�6-4R61 'ORDJ�NCETOPLAN. Two FecT. �� a -- -- job 4 LOCUS MA L Oc-7-1'd.v OF.TA/L T� .0 6'7- k i Dk EP OUSl R,AtlO IIOL[ .1 \O �' ' /�K Trq Data IANI'ARY 34,2111;%mama B.,(.bk Health Drpt. �?( PERLORMED BY ROBLRT M.PIRRY,►E. j drill►(ia.) ►.ctru• kiturt color madirt °t►er 120.0 tt.. I. A ued b.r• 7.SYR} j] C S /f� 't 1. ri 11t.7-117. IJ-)2 B .ead b»m tOYR l.' "t � ( . 117-3 116 32.16d C laam rand 2.11Y 64 \ - 8 Pa-,ot�uavtw (:IACLU WrCONTA( I W^Y 4v , 76 / Depth/a Gw.1„tNrc..l found T,B.ta"1 tt •h rc,u.d.atrr. N Prrt trtt d . Grc test t: n• i /A .t I Scale: I in.a,.- nft. /Q• \•� - I' /• I nt D.:r 11,I 4RlM YQOI;Wewr„'q.rn,tablr ltrthb l)ryt. Pi RH,RMFU h)ROUI RIM PIRRt r F L E C-5 E N LD i? C'Po E D r+r,ati0a d,P:h rin l T h-t- cr,t.,t- -I" �arli.t °lbcr P20 P[�76D ll - P \ <11 ( 1 \ I _ - C.�ON-RD R. UNt R_� t�sEsO RCSLRVG Ai?EzA N )vfL L j CC/,? T/ On/ V t t t •^� uu-tl+. -12 ndlt„a r.�Ri r.►wr. -"x - Ex!-mT1 Nc� coNTc)u p, C xxx i X11EMNm SPclT -LBVAIJON5 n ' _ �' ` \ �. I `G -w WAT,�w2 L.INis & r'ST HOLD! LOCATION V ! {' / . e �� �\ ,` ` {t1.1-117. {2-)2 B andlu.m 111'RS' ® p��t�D /!S �. V \ i I ^ SI:M pL Ps�P 6ZTY LINE. / 2 .4 1 'ti ` 1 111.5-111. ]1•12° (- loam,,-d LSY vA P'RCpjs m o oICyTI�.I$V-nQ1� l \ I gox �P(rcFinset7 sir ELL VA7)O N f 11I1 �o Res is C SAS L �v N C>6u.Aa W.Ou 14 t> UTt LI T y Jf- fib -(. �� ;, \ '' ` \ �• _ _ � - - --- ---- GENERAL NOTES Depeb twGmu:GIA(l e4 H"F 1"ift('7 L ELEVATIONS REFER TO AN ASSUMED DATUM. ELEVATION BEN( HMARK IS -- Ire d*I# F "*:cd 04 E.tilw72" Nirh r11-w 9-rr r A A`PK' NAEL SET IN THE ROAD PAVEMENT ALONG THE BERM U'l)( :U HERE. � �,� � •. �/ ( �� ti ,t 'Z , � t I Prrc teat da4.Pn-aaal►ed.wd eirrd.6i�)2"depth.l!"w Y-in f..ir.]•ta[.t!"t•P i. •.�s,rr. SHOWN ON THF:PLAN. %AIL El_c 100.00 T 'rl 1 j n R(en.al lu.RATE I.ISSTNA*1 S MPI bNow thr 1 n J.�th 2. ALL C()tiSTRI'CTION REATFRIAt.S SHALL CONFORM TO THE STATE I -L i � 1 d SANRARI ("ODE,TITLE 5 AND TOWN OF BARNSTABLE HEALTH DEVI. - �� S kI I REGUL%I1()NS. ( 3. ANY C 11%\(;I S TO THIS PLAN MUST BE APPROVED Bl THE:HEALTH DEPT. f t 4. NO PERM tNE NT S1'R[('(L RES ARE PERMITTED OVER THE IUO AREA •�.RESERVE �Lc V�r✓T 11 .. J . S. INSTAF IA TION(ON-IR%(-TOR SHALL VERIFY ALL SOIL PIPES'ELEVATION �[p ti� / _. ✓\ i AND CON UI IION UR10k 10 MAKING CONNECTION. 6. UTILIZE: DiG'1AFE AND \NV OTHER NECE:SS.ARZ I CILITY MARKOUT SERVICE TO LOCATE kND PItOTF.('T.ALI.UNDFRGROUND IITILITIE.S DIRIMI TL 9/✓ CONSTRUCTION. 6 S jt >� - t. .._. . ....>.,_. - -�!• .I I 7. A SFI'T.PERIMETER EXCAVATION IS REQUIRED TO REMOVE ALI, UNSUITABLE SOIL.ENCOUNTERED. SOIL TEST INDICATES THAT NO e / PERIMETER EX( \ -('I ION IS NE(ESSARN PROVIDED THE SAS IS { TPAC f: CONSTRUCTED k I 11F X t ! L.O�i'THE'B'SOIL HORIZON.REPLACE ANl"PF:RIML"fER �1 { kv FL O y C 1 ti F1 N G- t I 1 EXCAVATED SOIL%N ITH('LEAN SAND CONSIS FENT WITH TITLE 5 FILL 1 ( ! \ SPEC'IFWATION.ICON STRIIC'T THF SAS IN THE NEW MATERIAL. ,�Vp T!!' �' Frtil O/!. /Da ;' •fl 1 / R. INSTALLER SHALL(ONTA(I ENGINEER AT 508-$96.4861 Al TIME OF T S / o Q / oa f_ - -- -�• EXCAVATION TO SFRIEI 'NOU CONDITIONS E\(.OLNIERED AND ALSO AI rvA �• f ,/•,'' C�/41 /?!6 + \;x �LE I/p. d _ 4r ice•-- - J , _ „� PFIr:C rj COMPLETION FOR'S1 S I ENI CERTIFICATION. I 1... � lv 9. CONTACT E:1tiGFNls',E:R1F'A\V Ot1Fi(> � �R'!'Q STr� R* t ATtTCc'fi !;'i +y } I j 1f j` .A :L C i :'vi i :�iv t\l l)t ',It RED b1:R17ta:('U1 S1 RU( 1 IU\. ! �' t "`z(j f�lL CEL1Ar� I S n E / , / I ► / t / \ram 10.NO KNOWN W FU.S EXIST W iTHIN 200 VL OF THE PROPOSED SEPTIC \\WW 4 SYSTEM OTHER THAN THOSE SHUWN. NO KNOWN SEPTIC SYSTEMS F:A 1,I I 11,. t ! p \ >I ! ►, ! >\ y WITHIN 20A f '.OF THE PROPOSED W'FLL.OTHER THAN THOSE:SHOWN. iL IA(US;ASSESSORS'NIAP 133.PAR(TI.066 R l8 \ 14' S_�• ; ) I 12.PORTIONS OE THF:-MIT NORK FOR FOUNDATION FACAVATION AND .... GRADING IS PROPOSED WITHIN Lao FT.FROM! :I.A till AREA. OR'fAfN 7� CONSERVATION COMMISSION At"IHOR17r- 't41O). O PROCEEDING /,,,-o' � G •` WITH ANt'WORK_ t' I$ I Q. 1 13.THE WORK LIMIT,SHOW N SHALL ' r ITTED N ITH, rPI:RLY DV r \ �•-_. rp GIN Slt:l t�� ; '/ Q _s.. t:-- -r - C4_-. ` \ r� \` '� _'----- J FENCE PRIOR T'O ANN SITE FXf /ATEON. THF S11 f EE E SHALLRENAIV \ , 1 7�. i. �, _- �. _ �,,-� ZIS PLACE I NIILTHEEARTHStA ylr � LtI � X/J) NG \ \ -- tDEQUATE NEGF."FATIVECONI R- f I t • -__j- �1 v �i �. \`� SEPTIC S N ` F 1:11 DESIGN 1 ep .� iIl ultal 1.1 1 OAU1`G - 4 RF;UItUOMN 4 I / �/ \.` ?C► �•- ~ - _.. ����.- f�4 110 GPD/BFra'.003a X 4 E3EDROONIS -440.0 (;PI) .1 - SIZE -44U.0GPD "-.X 200 - RRo U. . _ -- ., � ---_ NK SL PR< Dl: 1504)GAL. IANk: PF:RC:OL.ATIOi RA I E- I.F SS THAN 5 N►PI !0 BOrTO, IANDS11)EkkA11,LOADPULIF-lk!I(.i`i) � 1 _ %IDE ARLA:2 11.0' 40.0' 'r-A/i T 7'1 t� 1 `• ,�� si "� -_� `-_ BOTTOM AREA: i I ff \40.0'-440.0 S.F. `. Iv A 11l' S.F. X t1.74 ,1 ./S.F.=47 , ; � 0 CAP C' : 634.0 C: 1 6.6GPD l0 ~i4 (RESERVE AREA DiX1I:NS10\OF 33'\ 12.8' X 2' DEPTH=448 GPD) THIS DESIGN DOES ALLOW FOR GARBAGE DISPOSAL USE. 94 ___ .. � --.- � -•-F---r-_`-,r------' F��f F r.c /�.,. .ten•,�:..�• .. c`_' ,,��• EL.E✓_ 'EN�fl.JfA,�.' ` zc- kt1`.C0=UrtI0N s� T� r 1 c _ !S ST & NA -T- 0 F I I- t= SAS CO1SASTSOf(4)R-104 P.PRECAST COh(RMtLAPHIN( PLAN SI�O`��'1NG PROPOSED DRYVPELLS AS MANLFAC'I;:RLD BY SHORt'.t rRICAS1,IKt.OR LQ1 A i G <)Q ►IA(-tD END-TO-END C tNTF RED IN A 41 FT.(ANG X 11 r-r "IDI •�. L-6 COVER- NI FXCAYATION,SL'RAOI �DED5V%,'T01ti�DtAMtTFR.D0t'5tt -.J8-¢pMANN�I-E. AiT14 c�ot�CQeTIz St'BSt RFACF. SEWAGE DISPOSAL SY'STE1I OANWOtN.01A-Z4' 3 WA.S/ttDSTONL SET►.WCASTUNITMf INIAIINNTUTSTOTHF ��vL.rR ,F �jO�E �)(�NT f�' U!d►NY U�10 WITWt4 _ _ .r- -AYtR �� ' �1 '¢ E1.FV.ATIONSSH(TCC014114.%C1 ETH(TTHER IIFPIAVVrAiltl!wSaRFr'r / NiT{-IIN Y6"��F ram-11�11SHG� ��ADE /�R�'FIDE FORA PROPOSED SINGLE FANIILN' RESIDENCE FINI15HE1> GRADE .JASI4ED S'SL?NE 1wY• I� - - -- w�� /4. 7 - --- F -- - --- - - - oR w•�r 113 ANGELA WAY, WEST BARNST4BLE, NIA !'2""N CLEAN ► ' -- - - _`�.� o•� a ==� I _ 15ACt4"r--!L L LCt.D T/ON ASSESSORS MAP 133; PARCEL 066 � PREPARED F OR I �` -- • , o o m o1&a a n cI o o L-1 o>-� Tt�t AND �IAGGIF WILLIAMS INv• //�•CD/ -_-__ t - T • .• CJ C]Q 0 C] o C7i o 1� C- Q C-I o Q= o I53 CENTER STREET 1114 09 ,.'" Q C7 LE1 CI F-1 Q CI Q�I q = CI C3 =1 Q . .• YAR OU1'llPORT, NIA 02675 L ov D bAF FL E 9TCDN e o 0 0 o a a o o a ,.:7 C1 0 0 o Q o= Chi o S08-3 7 5-0457 j ! LEVEL reraTF31BUT =•`N T3t�x -- FFBR[JARY 20, 2001 SC:ALLF - 1"=-20 r j'L Za ( ! - ; n g. -_ '1 o rTo n t Q� PREPARED BY ettnw TANK 1=-MV4,710NS _I wnsHEo STa►,� . -- --- sYS r�r�t CAPE COD FNGINFF.RING, INC. 7F ALL OUTLETS Tt� -�.. • r• tJ;t •` , • a i t t . ' 3 �- -- - - - ----- ---�:j - -- - -----. - - -- � V - R RY PE i e ESE 11,4M `Arnt= oR r __ -___ OBERT Ni. PER RV, NO T t • V • ' ° {° , t l • • o- ° ° Lj S� Gdc--TA n N rid W I E R -- -- - ---... 4r _ �-L Ptl't IA at OUT-L�Ts P1CAL L-I:AcH S src-ry cRr� -SecT►oN 50 VSTER.LELAN ROAD q-' (0 rV.0 .TIGHT Sa__...TANIL �__-___-- -----.Y _ 13RE�'�'STER, 111A 02631 3o1KT. cAry l --LJT'LET PlF'L--s SHALL 8r= - sc•,_i.- �f18-8.6-4861 T� ( E V E L Tb R AT t_e�asT , , . `E'1" (► YRCCA�T T2L`IAjF.ORGCD GpNCt•L1=T t T1No FLeT '�'.G' ^ ;' : �' ` >'?I '"� a � h F Cc fa � T C.. /V i T,s y. l .. ... ). r � /'RcP -IF �2 �� ,Db e'f'L 4 _ LOCUS MAP 1 h o c.a T-/a^1' 00 OETA/L To Irk- O ` ' /'. �/� X - Y)k EPOMfR3'AiIO♦Ifo lF a l _ N \ T,,t Date-J,VI kF( 3e•2°eL%it.m R.r.,uAlr Hall►Drpt. / PIRFORMID l3 RORF¢T M.PF RRY ►L. 0 drpt\(ta.) °aruoa lequrr ,ulw n.lflins i wh" 1 t /Gti 1 ^ t 12e.e Ile. S-15 A and I.-Im 'S\R 3. ` " �©/�Osf•0 �/�`� / �`� `l, �/ �� A / Iie.7-I17. I5-32 R ,anA ioarn 101Ft � �� \\ (•/`S/ u7.3-IIM 32-16! c k.rw ane zyt e.13\ (` - 4 ko I p� I1Nt;e�a l v `� � �� \ �,� G / 6 ►■r,.l wterw (J Al'LU I(F C ONT A( I vv^tit I Depth 1.(w••adwNrr ael found 61un■l,d Hind 91...J..t„. N'A - 'rE ram' •11 P.n.tm data See M.t.2 I / I �. Scale: I in,R \\ •`\ ` DEE►ORNE¢3 A 170 N I1111.E .2 2,-c ft. i /Q• �� ` ` t A/q n e E,C 6 ; 1-1 Date JANLARY 3e,Seel;Wq.w:Ran,taM14 11ra116 Ikpt --------- !t Iq R F.49 /. / A rkRFORIwFD BY¢c3sE¢IV, r M.rcRRV,P E L E v E N D %N 1 , rte`ad^• MPNti�) brae. trat.,r Col., .wW.s Oct.- -�}- PrRoPos6D fZc>NMtJP_ UNLi n )vfiC [ CG T"/CIA4 �R 1 �IZOR7iED QL�SGKVG AJ?!;A 12e.o Ile e-12 A .a.d is a a i si R 3: coW.tea - " - �XI DTI NG eoNTO U Q x x x i i!X!I!M NG3 SPCYT Q \ -w- VVATLLGZ L 11.1<r j ,'MST HOLA Lx>C�•TJON / r - 2 Q � � t l+o l n. 1: 3: R ...d Ia■r. lei¢s: T \ R� ® i PRw r�SeD o O.SEPTIC I TANiCi �, Pi�DP62TY LINE. (III 1 11 ` 1 p In.3-ue 12 tzo t W. .,r.d 2.sr ay f � f� 5e'D DIS'1R mo-naN (3qX xx x FIR 0FOS6D 5Pt=P1 LZV.� 1 PROP�6�p SAS �' -- F_VNDBR4 UNW-0D UTILIT �_ t air y F^r E L re- ' ,r:,,c.>,. --�- P F?•G r ,nr y [ a t • � i - ti CFNFRAL NOTES (► , O\ ` 1 , �Ij 1 v., .,m,lr.,,r 1,t,t 141 H F c u.1,t I --- -- _i� �� ! V ` C7 »pla 1•t.,,..d..n, ■00 w 1...J 1,,,.a.d H.fA N > i- ELEVATIONS REFER TU AN ASSUMED DATCM. FI.EVA T ION BENCHMARK iS O '>; ; N //D .m,■ ,ea, ►..w.rw..a I, ,e . 7 J,1•te : „p- . a 3u v „ • N A 'PK'MAIL SET 1N THE ROAD PAVEMENT 11.UN(, THE BERM EDGE WHERI Vl SHOWN ON'1 lit PLAN. NAIL I L- 100.00 r t Kr ri •!il,�R t 1 F •t l"111 411111 n,l...ra,3 d,p,° 2. ALL CONSTRI(T1ON MA TFRIALS SHALL CY)NiFORNt TO THE S7 ATE SANITARY CODE,TFTLF S ANID-1 OW N OF BARNS?A BLF.HEALIII DEFT. (Dl� REGULATIONS. 3. ANY CHANGES TO THIS PLAN MI S i HE APPROA ED Bt 'Tilt Ili_ALTH DEPF. 1 ` 4. NO PERMANENT STRI'CTI,RFS.ARE PERM171 D OVER Tilt- 100%RESFRN't. ! /L ;t o E N AREA. i � 1NF7",e113� 5. INSTALLATION CONTRACTOR SHALL.I FRIFi ,ALL SOIL PIPES, FI.EVATION ! NFLAG TO 3: / N S l �1✓ //Z i, ► u / AND CONDITION PRIOR TO MAKING C'O%NF( f10N. w t , ' I 44 1 /// 6, 1TILIZE DIGSAFE AND ANN 01HER NE('ESSARI I TII.TL1 MARKO(PT C' SERVICE 10 LOCATE AND PROTF(•7 ALL I NDFRGROi'NI)l 111 (TIES DURING 1'0q E[� 6 s JT / t ._. - _„_........ .Z.'t -mac., _ - ` ! W E 7-.1 -0-L L CONSTRE'CTION. l -� 7, A SET.PERIMETER EXCAVATION IS REQUIRED 10 REMOVE ALL A / UNSUITABLE SOIL FNC'OL'NTERED, SOiL TEST LNDICATE:S TRAT NO /o�s Pf11^ �EO Y SU PACE i lK 1 PERIMETER EXCAVA FiON 1S NE(TSSARI PROL IDE:D THE SAS IS fff >C ; /; CONSTRUC1ED BElAN THE`B'SOiL HORIZON. REPLACE ANY PERIMETER r' FL FL 0 o / i EXCAVATED SUIT.WFTH CLEAN SAND CONSiSTEN T W'LTH TiII E 5 FILL. / I `7 (~. J l � �i / � /l / SPECIFICATION. THE SAS[!I THE NFW MATERIAL.g• INSTALLER SHALL CON i A('T ENGINEER AT SOIL-896-4Rb1 AT l INI OI 00 _--. - � ? EXCAVATION TO VFRIFi SOIL CONDITIONti ENf l It N I I`RI tl ItN1) s I NO A I 1 la � F� - �� `�• \. l ?,4 -}".' \ /a�cl.?f�- COMPi FTIO'y FOR eves c.. St ill[3 - r ^ S 9. (ON TACT ENGINEER IF ANY QUESTIONS OR D()(BTS ARISE REGARDING t �Fc tL c FL A `gl T 1 SOti.CONDITIONS FN COUNTFRFD DI--RING(ONSTRIX110N. 10.NO KNOWN WELLS EXIST AN'ITHIN 20O FT.OF THE PROrQSED SitiPI'K /1� `✓'tom SYSTEM OTHER THAN THOSE SHOWN. NO KNO%N SEPTIC SYSTEMS EXIS7' ,V c. t � 1 r � 1 �. F( s J W(THIN 200 FT.OF THE PROPOSED WELL.OTHER HER 7 H•A!V THOSF'CHUW';A. i �1.0 1 I. 1,0( US: ASSESSORS' MAP 133,PARCEL A66 18 ] ' 1 1 /11 ; t \ 1 12. PORTIONS OF TH .SITE WORK FOR FOUNDATION EXCAVATION AND ` GRADING IS PROPOSED W 17'HIN 100 FT.FROM A W FTL.AND AREA. OBTAIN 78 CONSERVATION(YO%lOMISSION AUTHORIZATION PRIOR FO PRO('F.EDING }� �• -• 4! / , - WITH ANY NORK. ��' ttf. P Q • I ' t `' ` i �� t .\ __ _ 13.THE AAORK L1MI'i SIIOW:1i SFiAL.L BE FiTTE D VIFFH A PROPERLY DIiG IN SI1,f t - - F` , s , , \ \' -~ / FENCE PRIOR 70 ANY SI TE:E X(AVA'TiON. 1'HE SILT FENCE SHALT.RFA/AIN l { \ ` -_ ✓ L IN PLACE I-N'T 11 711E EARTH SLOPES HAVE:BEEN STABILIZED A;17IL ADEQI A7 E VEGE 1ATIVE C(IVER, re-?F�s ls' `� - _ __..-__. -_�` SEPTIC St'STEM1i DESIGN DATA 3 � / t �4�_1' - NI'DRAULIC LOADING - 4 BE:DR(N)"miIS zl<' C-� \ 110 GPD/BE:DROOI*t X 4 BE'DROONN 4 1 1 \. SEP71(''I AN'K SIZE 440.OGPD\ 200".= 8816AI 200. "lopE �( E♦ `- � ���^ O _ rAl. TANK• ` •` `_ PFRCOL.A"11ON RA1 F- I.F SS'TH AN 5 MPI �' 1•• ______w.. _ ._ _ BOT-FONI.AND SIDE.wALL 1 OAD RATE-(04 GPD'�.F // \ 10 \ _ 'J 1 a / ! +� s �- \ 1�Jr�1� .:.,,�; cg �i{7 SIDEARfA: 2(2')I i1.0' 11400 1= IOd.OS.F. (i7-il 7-rI "-t-- �`"_--' - --� ,� ` BOTTOM AREA: I1.0'X40.0' 440.0S.F. (APACITY: 644.0 S.F. X 0.741GAL/'S.F. = 4-76.6 (AID \rb (RESERVE AREA DII1FNSlOti ON 33'a 12.8' 2' DEPTii = 418 GPI)► 14 THIS DESIGN DOES NOrAI.I.OW FOR GARBAGE DISPOSAL UNI p ! I 1 /l i V C* _ /`1 w /T / -- ___-- --..-_ - - -- &t'UONSTRUMON T I C S y S T L M _F Q O'F i L 1~ SAS CONSISTS OF(4)H- d RATED,PRECAST CONCRETE 11ACHIVI• , L_C DNYWELSASMANEFAVY RYSBYSHOREVPRECAST,[NC_OREQIAL• PLAN SHOVING PROPOSED i/7. - FiIANI40LL� COVEF2- MtN pl/1-��}' AA PLACED END-TO-�:.D'ME91 %'TID INFT.IAMR.DOT1SIDl E%CAVA1TO14t. SETP1XC4ST NrrPIP INUMETLR,DOCLLE- _....18Ma,MHOL.E. trJ(TI-4 cr3r�c.czETF SUBSURFACE SEWAGE DISPOSAL SYSTEM �j I 3 WASHEDSTONE. (ETPI:[CASTI'NfIP[PEINIETINVERISTOTTIi �AV�R 7��1r(E (3QpiK�NT U4NT UP�C WITHIN G" �r 2 _AY I-R /8-� -� ELEVATIONSSHOW'NP OVIDEDALL OTHER ELEVATIONS ARE IN � �E pRC E,iDE ACCOMANCEWrMTHEPLAN. 'NITi•-41P; �''o� Fi�IsHGp FOR A PROPOSED SINGLE FAMILY RESIDENCE !: Fl .414 Yl�nJ T , �- o�,�' ram' AT INv= �` - % �- I j t, �- a�•�Ew,�r 113 ANGELA WAY, WEST BARNSTABLE• N 12 rraly CLEAN lncq rw.v + ASSESSORPRE'.PARED FORARCF.I. O66 n ❑ a ❑'**o a t-j u a E-1 ❑❑ED gl n❑❑ c:1❑ a TINI AND MAGGIE WILLIAMS --- IPJV.•/ fir.s _; , r , ' m m 0 C7 C1 ❑❑' i L= L� ❑ L-1 =C-3 El ❑C] ❑ r=1153 CENTER $/>,F FLE o �" / 1'� + YARMOU THPORT, A 0267 LIQUIG 1 31aN� �._ o ❑ ❑❑ ❑ ram =_ ❑ ❑ ��1:1 m=aQ�aa ❑ 2 114 o ,f, ` 508-375-0457 A 0•5, or 3j411 TD ) LEVEL -DIQT;a BUTICN 13OX _ i } _ -_- -- --. FE[3Rl :1RI' 20, 20Q l SCALE- 1"�20' y`t �:T2ONe: _ - 6 j 3'.i.°- IYZ` ¢>"T�J�I..ti � 135Ww TANK) - ZNvERr 1`�GUAI1oNS w��H�p �-�� _ f-- s TAM of PREPARED BY . ' ,. , of ALL n(JTLeTS - I - - ----- -- -- �s _ rr�� a,. . ' ,� a ;° e : e : , 3 oR H- -.541 ELEv�N( (:1 PF'COD E1VGINEERING, INC. -` ' c° • •1 e - .- , ISE TUE SAME -- wort . czn ran ti w eR C. -- - - ---- --- ¢� ' - --- _ - - - - ROBERT r1. PERRI", PE aL� Plrc ro et �uT`ET� jl; 50 LELAND ROAD P(CAL LEAci s-i 7 c=t�v�s-SEcTiory BRE«STER, MA 02631 .0 TV.C .TIGHT �ME-n 1 - -T .1t< �--- -� -�n-I ¢' -- a .' -TOI µ-r a�r►>�1 T� 44A,L<•J N S c�l1TLET PIPE=_ -iH.4LL BB -NO •6CAti 6 PRCCAsT �MlA1t=0IZGCD �NC�ETt LEVEL FbF2 AT LEAST :�tyr TEI.- SnB-$96-4�61 T1nro /�i/ ' !'/2 E l A S T vN / r"`S • I�b i p�-),Qc 4 E, 4 LOCUS MAP _ Ek > 7- 000 1 (_ DEl OBSERVATION HO[[ Ix � 11 k Tr,t Daw JANUARY M MI;WMttte:Ram"altt Ht.11fi Dept. 0 / PERFOR,AtED{Y RO{ERT M.►ERRY,I.E. !\�• A v// ~,� Y fib - / <Se.•twa dM(fi(N") Mrvew !nt►rt rater matlial I wt\rr Irl �0 ` , POSE j/ + I 120o n1. a-Is A loaq 7.1YR1 Is-32 a ,.nd Ia.ta 1.1RS' 33 la• ,..d 2.5Y 6,41 / C IC-4r�,v !f CJA /1/.IGfA A 1 /6 DepU tOt ­4Gaau l leuwd [.dented IIi}fi}rawwdw aro' F'A red duat S<e n nt•1 s e ,-• cE,(. �6 ; ' /e DELPORstlt%AT10%flotra2 �---- - Scale: I In,az,,-olt. Tat Date JANI ARY K 2,101:Witaro:9.nstablr f1r.NY.Dept r PI-RFORM[D BY ROBFRT M ►ERRY P Jr., L N D E G E o1 - - -�---- - -- I .,nation depth(m.) kortme tetra,. cuter wt.low•� ate<r -� -- P2oPos6D CO b NTUQ, LJNL E•R, IPROFOSC-p RtStRVC A"CSA 1 a Ir. --max- EX1371 NCa CONTOU Q, CXI t3TTNGi 57pT �! 1200 I[1 • IS A "ad b.tn 7.51R3 G -- Q L I�l ft xz>t r_LHVAT)aNS \` ' \ ._(._•� It , , ` IIa,O -11'. -w VVATe I3-31 { uwdlnata 101RS; ( $T HOLAR LOCG.T10N os O S EPT1C TAN �jP&2T1( U N E ` p +I'3 110 11 lla ( I..w.,.nd I�ls. `r 56D OiS'RJBUTiQN B4X Lzx� IIPFit SED sR7r F_L.LVA-n 11 1-Tl �O Pt�6 C°D S AS ve t r- U N C)s2A RAtJ N q Lfrl L I T�( h D, >vfcc �C ' �.,o1►>.� (rt� AIR L ( i GENFRAL,NOTES trriaF'.1mar'lal •over 1. ELEVATIONS REFER 1 O AN ASSUMED D:1T('M. ELEVA"I ION BEN(' a 1 I` lMprfi to Lrouodwaar eet t•aad E,ritwerrd Ht}fi ynundwatrr ♦a HMARK IS i�� � Q Pr tra data preatu►ed ud rimed.w "2"drplfi'.12 t••'m 3 m•w ltl,e<.:,-1.e"i• A'PK' NAIL SET IN THF' ROAD PAVEMENT ALONG THE BERM p mtw s Ilk SHOWN ON THY PLAN 1 EDGE W HERE . N.AII.f.l..= 100.00 q t I P[R(UI alr(i�Rt fT•1 f>�lllal!Itt'I Ar+ur tnr I n arptfi 2. ALI,CONSTRUCTION MATERIAIS SilXLL CONFORM TO THE STATE: 6 SANITARY C'ODF,TITLE S AND TOWN OF BAR.NST'AFILE:HEALTH DFPT. \ ll Q REGULATIONS. t y}�tiT 3„ � Q 3. ANV CHANGES TO THIS PLAN MUST BE APPROVED BY THE HEALTH DEPT. _ Lf 61 4. NO PERMANENT STRUCTURES ARE PERMITTED OVER THE 100%RESERVE:�-•'� �` /4 ((ll s✓.v ! 4{ AREA. INSTALI"ATION CONTRACTOR SHALL VERIFY ALL SOIL,PIPES' E l.1.VA 110N f L p -y � _. - , ( - � t � � � � � � FLAG• S rsa Ti U/v S 1 tt AND CONDITION PRIOR TO MAKING CONNECTION. 6. UTIIJZE DIGSAFE AND ANY OTHER NECFSSAR\ UTILIIN MARKOI 1 SERVICE TO LOCATE AND PROTECT ALL 1'NDERGROUND ITT1LFTTES Dt R1V(; CONSTRUCTION. z�• f `I ! 7. A SET. PERIMETER EXCAVATION IS REQUIRED TO REMOVE ALI. h Z�rawt ♦ nfZ� G r7 UNSUITABLE SOIL F_NCOI;NTERED. � _ � / /� S � / \ SOIL TEST INDICATES]HAT NO v j l 1 ,,tt / PERIMETER EXCAVATION IS NECESSARY PROVIDED THE SAS IS rAAC 1 f CONSTRII(`TFD BELOW THE 18,SOIL HORIZON.REPLACE ANl'PF-RIMFT F:R l / FL o w G 3 vFL L /�/ Cr ; ' 0 t ! ' EXCAVATED SOIL W'TTH CLEAN SAND '� `• t f / ' -♦ �,�r � / !• / � CONSISTENT W ITF1 TITLE S FILL. �L \ / % ✓✓ ♦ -� \ SPECIFICATION.CONSTRUCT THE SAS IN THF: NFN MATERIAL. ,AID r rr !0=. 1{ r �/ A. INSTALLER SHALL CONTACT ENGINEER Al 508-Av(14i161 AT TIME OF �X r 0 _ Q {._ - - `' EXCAVATION TO N ERIFI SOIL CONDITIONS (x. O 0 ONDITIONS ENCOUNTERED AND ALSO AT /r �M ( c�Rr2 f E , �"� �/!, Q _ __ ti w-- -- , -= L - pq�a C t-� COMPLETION FOR St'Sl FM('ERT1F1('A T70N. f r c,4 i7 Q � j - \\_ yJliE:SIIONS OR DOl F)'FS AkINF kF:I:AR INC, D / (F%!G C F!t cJ?� � l /A & SOIL CONDI I IONS ENCOI:NTERF.D DURING CONS rkUC T"ION. U / 1' . NO KNOWN V%YLIS EXIST WITHIN'200 VI.OF THE PROPOSED SEPTIC N i. F ( f `Z,Q S1'STE:!1I OTHER TH•(N THOSE SHOWN. NO KNOWN SEPT1CSYSTEMS F.XIS"I �. N sr 1' *` l W'IT'HIN 200 Fl.OF TILE PROPOSED W ELL OTHER THAN THOSE SHOWN. 1 , I hf r 1v 11 1,0( US:ASSESSORS' MAP 133,PA RCEL 066 (8 z4r $-Gt t \ 12. PORTIONS OF THE SrrE WORK FOR FOt;NDATION FX(AV.A IION AND 76 GRADING IS PROPOSED N rl-HIY 100 F1 FROM A W FTLAND AREA. OB IAIN 76 CONSERVATION(ONI.MISSION AL THORIZATION PRIOR TO PROCEEDING P 1 1 /%iZ /�.? :Etv pfi W'ITHANV WORK. 13.T11E WORK I ►MIT SHOWN SHALL BE FITTED WITH A PROPERLY DUG IN SILT FENCE: PRIOR 10 ANT) SITE EXCAVATION. THE SILT FENCE SHALL REMAIN \ ` \�M1 IN PI.ACF. t NI it,THE F.ARTH SLOPES HAVE. BEEN STABILIZED WITH ,0e f �L .FE,tr✓£ ti�X J S r'yN G ;4 I ' >. \� 1 _ , ADEQUATE VEGETATIVE,('Oti't:R TR E. ��Q r, � ` "s' - S' eta I � ~•-.-��` �.- .__- _ SEPTIC_' SYSTEM DESIGN DATA \ / �\ ` __ �_ I1VDRAI�LIC LOAU1\G -4 BEDROOMS D/BEDROOM X 4 BEDROOMS =440.0 GPI) ; ft� 1 .4 \ � •. � .,_` _ -_� SEPT I<'TANK SIZE-440.0(; r: PROVIDE 15(NI GAL.. TANK; � �` ` - .` PER(OLk I FON RATE-LFSS THAN 5 MPI ND! \ -� BOTTOM AND SIDEWALL,LOAD RAI E=0.74 GPD'SA. I o , ! t \��' 'O6 ` \� _. ___ ---" - - _ 3 SIDE:AREA: i(2')( I1.0' )(40.0. )=204.0 S.F. (/t,d 5 ell I 1r1 ( -�_ _ BOTTOM.AREA: I1.0' X 40.0'=440.0 S.F. s�n .- --,�_-. o Z S_eD . O d ' G �___• . _- y� ,_ yr CAPACITI': 644.0 S.F. X 0.74GAL/S.F. =476.E GPU ` 1l 11io • _ q Z (RESERVE AREA DIMENSION OF 33'X 12.8'X 2' DEPTH =448 GF'I)) THIS DESIGN DOES ALI; )"' FOR GARBAGE: DISPOSAI, 1 ,I � -vex_____• r�o �� - i6 /9 N cr F_ L A L��9 Y �' `ti✓Lz ENi N/1/iJ�ii(- SETL� � RC`V. 4 6 G ! s7v/sr wELL � Oc4r/oA� SE (�T I C S �( ST E Nl PROF , LE SAS CONSISTS OF(1)t -2012ATLD,PRECAST(ONCRPTF LF.a(H1�1, _E,+p yr„C�L`c_ DRY WELLS ASMANtFA TUBED BYSHORLY PRECAST.INC.09EQUAL, PLAN SHOWING PROPOSED F• C' R x)J7 F PLACED END-TO-F'D,C[NTERED IN A 60 FT.LONG x I I FT.11IDF + [1CCAlAT10N,SCRRt.uND[D{YY.'TOIK'DUMET[R,DOI:{lI- Se� MANNoI_L WITH CQNc�ET� SUBSURFACE SEWAGE DISPOSAL SYSTEM 7. S - ►,,(ANI4OL L` COVE R- MIN 014� . I _3 WASHED STONL SE' ►RECAST UNIT PIPE►NUT INVERTS TO THE -pv�.R Q�E '� ���„�'r 'Q I�J' U4Nr 1.1�TD WIT7.41N�' OP. Zr ._AY E1Z E I_E V A TIONS SHOWP/ROVID[D A LL 01 H:R EI_E:VA T ION S ARf IN uRADE ,vRo v/DF FINISHISD GL7ACiE r IASI�Cd S7L�rVE A000DANC[WTTHTHEILAN. WiT}iIN roof Flt.tist �eD FOR A PROPOSED SINGLE FA'� ILY RF,SIDENWE 4I YCiv r AT IN1R. .2 - " oLc e 7-0 t , s i _ - ( - w�� ,¢. --- - {--� ---._-- CLEAN _ o�/vE'wwY 113 AVGELA WAY, WEST BARNSTABLE. :f l . . MAV.- NAn>< . BACK I L '' Lc�GN T�a.v s F ASSESSORS MAP 133; PARC'E1. 06 J ,� t_ _. - ��., --_ - - _ - - _ -_ • i o � PREPARED FOR �. //s•co �- ca cs non ( ��QC] TINT AND MAGGIE WILLIAMS N _ r • a - �, C7 G Cl G7 C C� C� C1 C7 Cl C� 0 C l C= M f� 153 CENTER STRUT 4 • .. • . 1 Eel - e G'`� �- /l C` +,'" a Cl C� 0 0 C1 Q E31 C C Q C� C7 Q�C1 I� Q CI L� Q . .• YAWMOUTH PORT. 51A 02675 t 4 o B/�FFLE .=,�N� aoa❑ cr_ 0 c Q � a �aQa ��aaQ ,LIQUID ? 508-3,5-045, p.5' or 3/4" •b I LEVEL PGT'Q 6UTIC+IN T30x _. a FEBRU A Rl 20. 2001 SCALE - I" =20' 1 JY2: Ski TX�[JISLF_ ' Beww TANK Z7vvEFz� E`��c Tlorvs wn HEc� 5-ro►1 oTTnn,� of ( PREPARED BY , A OF ALL nU rLZTS Tb - -- - -------- � '- - ---- - _ E ST w \Y (!t{> , INEF_R/rti'G, INC 1 � I �1v1 ••y (3 E TL-o M: SA M E j. c o a usE RnTAT1 N c v�/iER r. - ---- --- --- --- ¢r. � ' ROBERT M. PF,RRY, PE ALL PIrL` 10 e� COUTLET� � 50 LELAND ROAD PfCAL LEACI-) S STI�,.t CQL�Stc-SECTION .�_ 4 cp r V.C TIGsHT _I�t-I c `ra IL 40 BRENVSTER,MA 02631 3'O1N-r _ I • _ S^ O �L(ON8 OUTLET Pi PG- SrlaLL B� 'IVO �atl{A.L.G- I ^ t Ir rr.t PRGCA£aT QCtAjFORGCO �NCi2ETt LEVeL FbF2 AT LAST I�Rc71� /.DE �7/"� ,'YG ��?�' eAS T e.,1v! T,s �lr TE[,- 508-896-1861 F Y