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HomeMy WebLinkAbout0201 CAPES TRAIL - Health 201 CAPES TRAIL , 'W.BARNSTABLE A = 088 008 00A Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 201 Capes Trail Property Address .rf Rodney& Michelle Tavano Owner Owner's Name *" information is every West Barnstable Ma 02668 12/7/2017 required for eve page. Cityrrown State Zip Code Date of Inspection `f Inspection results must be submitted on this form. Inspection forms may not be altered in any a way. Please see completeness checklist at the end of the form. Important:When A. General Information / filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Sean M. Jones use the return Name of Inspector key. S.M.Jones Title V Septic Inspection Company Name 74 Beldan Ln. Centerville 'Ma 02632 City/Town State Zip Code 774-248-4850 smjonestitle5@gmail.com SI4522 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 by the Local Approving Authority 12/7/2017 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. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 201 Capes Trail Property Address Rodney& Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The dwelling located at 201 Capes Trail West Barnstable is served by a Title V septic system consisting of a 1500 gallon septic tank, distribution box and 3 leaching chambers. The system was found to be in proper working condition at the time of inspection. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. 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 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments y 201 Capes Trail Property Address Rodney & Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 page. Cityrrown 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 r- Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 201 Capes Trail Property Address Rodney& Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 page. Cityrrown 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 ❑ ® 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .�< 201 Capes Trail Property Address Rodney & Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 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 a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 201 Capes Trail Property Address Rodney& Michelle Tavano Owner Owners Name information is required for every West Barnstable Ma 02668 12/7/2017 page. Cityfrown 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 gpd t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 201 Capes Trail Property Address Rodney& Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 page. Cityrrown 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 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts w . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Capes Trail Property Address Rodney& Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 page. Cityrrown 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: Tank pumped at time of inspection Was systerr pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1500 gallons How was quantity pumped determined? size of tank Reason for pumping: routine maintenance 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): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 201 Capes Trail Property Address Rodney & Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: original system installed 11-12-2004 per town records Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 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.): Joint were ok, no leaks, vented through the roof Septic Tank(locate on site plan): Depth below grade: 1.5 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: 1500 gallons Sludge depth: --- 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts N - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M ,•'�` 201 Capes Trail Property Address Rodney & Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 page. Cityrrown 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 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 How were dimensions determined? Tank was pumped at time of inspection 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 was pumped at time of inspection and should be done again every 2 years for proper maintenance. Outlet tee intact, water level was even with outlet invert. Tank was structurally sound. 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 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Capes Trail Property Address Rodney& Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 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 l5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �t m 201 Capes Trail Property Address Rodney& Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 page. 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.): D-box was video inspected from tank and found to be in good condition with no signs of past hydraulic overloading. 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Capes Trail Property Address Rodney& Michelle Tavano Owner Owner's Name information is West Barnstable Ma 02668 12/7/2017 required for every i page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ 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.): s.a.s. consists of 3 leaching chambers. No signs of past failure, no lush vegetation. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts . Title 5 (Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 201 Capes Trail Property Address Rodney& Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) . Comments (mote 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form--Not-for-Voluntary Assessments 201 Capes Trail Property Address Rodney&Michelle Tavano Owner Owneft Name information is West Barnstable Ma 02668 12/7/2017 required for every State Zip Code Date of Inspection page. CitylTow+n 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. ® hand-sketch in the area below ❑ drawing attached separately I -4 C� Z '. A 5'3r � ISr r Z-sa a•i'3' - 1 - vw, �t-gym Wins•3113 Tits 6 o(fidel hspedion Farm:Subsurface Sewage Disposal System•Page 15 of 17 I Commonwealth of Massachusetts W Title 5 Official Inspection Form R Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 201 Capes Trail Property Address Rodney& Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 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 describe how you established the high ground water elevation: Groundwater elevation was determined by accessing Town of Barnstable groundwater contour map. 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 Commonwealth of Massachusetts r�UVTitle 5 Official Inspection Form I. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 201 Capes Trail Property Address Rodney& Michelle Tavano Owner Owner's Name information is required for every West Barnstable Ma 02668 12/7/2017 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 TOWN OFBARNSTABLE _ 4 LOCATION L y / ' SEWAGE # `P'�OOZ VILLAGE 4�0' % ASSESSOR'S MAP & LOT 88�00 — 0� INSTALLER'S NAME&PHONE NO.A9L1,4-&e1e L!q-e, /7/—77/&6 SEPTIC TANK CAPACITY 11�DD LEACHING FACILITY: (type®��L ���% � o (size) 01 7174e, NO.OF BEDROOMS '// BUILDER OR OWNER Of PERMIT DATE:,//--/ O COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facili ) 1 Feet Furnished by l ;�is-Z �O��Z t Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �/ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for �Bigpozal *p5tem Construction Permit Application for a Permit to Construct( )Repair( upgrade( )Abandon( ) El Complete System ❑Individual Components Location Add s or Lot No. p2 D/ it/ Owner's Name Address,�nd�1.NoA. Assessor's Ma /P`X&w r Installer's Name,Address,and Tel.No. Desi ner's Nam ,Address apd Tel.No. SQ �, �(aGJ S�� . 17 Type of Building: Dwelling No.of Bedrooms `_`' Lot Size 4 3 6 D sq.ft. Garbage Grinder( ) Other Type of Building Okg­ � No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 4 lv�_D gallons per day. Calculated daily flow J� gallons. Plan Date //4T' /0, Number of sheets Revision Date Title &.zx- oP Size of Septic Tank ISO0 /Type of S.A.S. . A111�7� Description of Soil -t- l Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Health. Signed / ,/v L Date Application Approved by Date a o Application Disapproved for the following reasons r Permit No. 2 013t- ' 0 Date Issued I -------------------- No. �UV(_I� U/ . �' � Fee /-0 t Y — THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:✓ �- Yes PUBLI.0 HEALTH D.NISION -TOWN OF BARNSTABLES MASSACHUSETTS- 01pplicati6n1o=r Migpogar *patent Construction 3dermit Application for a Permit to Construct( )Repair( ✓)upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location or Lot No. pZ O/ df/ Owner's Name,Address and Tel No. Apt-. l G OG i c it✓� Assessor's Ma /Pel aarc 4 �oo ��o C � to.--�G 3 � Installer's Name,Address,and Tel.No. Designer's Nam ,Address apd Tel.No. 44 1- �Iram 44-10, Type of Building: Dwelling No.of Bedrooms Lot Size 4 3 60 a2 sq.ft. Garbage Grinder( ) Other Type of Building *&�L4 e No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1L<�O gallons per day. Calculated daily flow S J` gallons. _ Plan Date //�R/P Cl Number of sheets Revision Date Title &<z e.j ,.-A ' ' �. .� Size of Septic Tank /S©D a-MI Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 7'� u Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance,of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by,this Board of Health. ' Signed ✓�/ Al Date Application Approved b'y Date 1 Application Disapproved for the following reasons Permit No. ?oo -I b 0 1 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( t/S Upgraded( ) c Abandoned( )by /)yslt[/l,yr E XOA VA-776k, 1 NL at ;R D t Ce. 14" aN<, -zL� tt/ 1,-d� has been constructed i. accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.2 Lo Ll '6 d� dated t Installer s Sur A-A)d E E�XrA M-7-74 N 4 LAIC , Designer � The issuance of this pe t shall not be construed as a guarantee that the system 11 nction gas designed. Date r t r I I J L/ Inspector �)�t No. �GU 1-1 Fee 100 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Mi!gpogar *p.5tem Construction permit Permission is hereby granted to Construct( )'Repair(PI�Upgrade( )Abandon( ) System located at Q01 Cd,4 Q 0 U and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of thi e itc Date: I I 1 Z ��L _ Approved by �.^� O l. i own of Barnstaate -INE y °w Regulatory Services • ___._. Thomas F.Geiler,Director 9$ KAM Public Health Division F0"gip Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:.508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: /IC> U Designer: W ,Pra I VW- K •Installer: o ,e L _ PF Address: Address: ►z On was issued a permit to install a (date) (installer) septic system at 20 Ct ¢c S 'Itzpcl based on a design drawn by l l (address) dated It p (designe Y---,certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. b t w of q�q (Installer's Signature) °A� WINSL SP046 0 4; 00 020363 iD Go TE%z (Desi er s' a e) (Affix Designer's PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form Town of Barnstable P# D Department of Health,Safety,and EnvironmentahServices k 11`► Public Health Division Date Q. 367 Main Street,Ilyannis MA 02601ABM f rfpµpl�, Date Scheduled Time Fee Pd.' /ov Soil Suitability Assessment for Sewage Disposal_ n�9 Performed By: t o�F_�N A SS O Z. Witnessed By: D Ut yly A M )D R N N Di l XVERAIFOIt1V�A'li` 1� Locnuon Address 1 �L Owner's Name�.. 4 ... - ) i1��i C` h 1,Ul�W i S N OW 14 ) L -4 Address I C L) F 1. W tSV, Assessor's Map/Parcel: M�p g$ �CS. �ZIZ 9 Engincer'sName L �\W7t)_R\l MSOG . NEW CONSTRUCTION V REPAIR Telephone N 5 D� -2 B 3-4(Al� Land Use S 1 N GLI ZM�_W)? U Slopes(%) z G�o Surface Stones N•'' Distances from: Open Water Body N^�� R Possible Wet Area 'M M. k ft Drinking Water Well N A—' •ft Drainage Way gftl� R Property Line IC) + tt Other R SKETCH: (Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) r s i -s y Parent material(geologic) PRO GL J\CIA�, , oplJ j�C j1 Depth to Bedrock Depth to Groundwater: Standing Water in Hole: S Weeping from Pit Face do Idt-- Estimated Seasonal High Groundwater N•A D 7 R1VTtNATY0IV)�'QR SEASONAL f T7G 'WATER TAT3LE ; Method Used: - - - _ Depth Observed standing in obs.hole: in. Depth to soil mottles: in.' Depth to weeping from side of obs.hole: in. Groundwater Adjustment R. Index Well N 'Reading Date:_ Index Well level..,--- Adj.factor Adj.Groundwater Level `PERCQLATC+(7�I�1 T]CS` nnu Tlnt r Observation lole N I Time at 9" rl Depth of Perc Time at 6" ---- Start Pre-soak Time® Time(9"-6") End Pre-soak Rate Min./Inch S M I N S J t)J Site Suitability Assessment• Site Passed y Site Failed: Additional Testing Needed(YIN) N Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy,___npplicnnt_ t llLl�1' UI3Sx,Ix�V �xU1.i PDO 1L,OCx IzUIC # Depth from f..Soil Horizon Soil Texture ! Solt Color Soil' r ; Other' = Surface(in.) (USDA) (Munsell) Mollling (Structure,Stones,Doulderes. i 6 y a DAM loviZ 3 8 -4� 4 S� ' r I r ..:...>:.::.:.:...:::.>:.::.:::.:...�.::.::.::;...:.�.�::.:...:::.:....::.::.:.::.�::.::r.1:.:.:.,.:.y.:.:;....:.,..;:::.::•::::::r::::.�:•::.;,.;;.may.::. .. ` - i r DL��..aBivA�rrtrt�zaz,r zoo z�0�� �� v Depth fionl ;Soil I lortzon Solt Texture Sall Color Soil , Ulhcr Surface(In.) r (USDA) (Munsell) Mottling (Structure,Stones,Bouldeies. t .r, d t i .•: I 0 5 o A L CAM ) C,\? JOYZ,S (� 4��-I�}9'� C Fl�l Sfa1J� ►o y�' (oJ3 ����1� 5u� Y , ' �. i F i. Cli .X#S)J1ZvA:�' . r Depth from Soil Ilorizon soil Texture Soil Color SolI. Other i Surface(in.) (USDA) (Munsell) Mottling (Slructurc,•Slones,Boulderes. , e , • r � i i 1 ' S D )'PQIS ..RVAIAONIULL,O� hXtlleft; .. Depth from Soii Ilorizon Soil Texture Soil Color Soil Surface(in.) USDA Other (USDA) (Munsell) Mottling (Structure,Stones,mouideres. e Eh2od Insurance Rate Maw Above 500 year flood boundary No Yes' Within 500 year boundary No Yes i t Within 100 year flood boundary No— Yes Wirth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? `1�S If not, what is the depth of naturally occurring pervious material? Certification I certify that on U,- (date) I have passed the Soil evaluator examination approved by the Department of rnviroi nen I oIection and that the above analysis was performed by the consistent with the required Irht if o )crt o d experience described in 310 CM It I5.017. Signature Date ��� TOWN OF 4AW9959tt LOCATION: VILLAGE: Wgnrt LOT # : PERMIT # : INSTALLER' S NAME• INSTALLER' S PHONE LEACHING FACILITY: (type) .3;e 6 GF�L LK (size) NO. OF BEDROOMS : I BUILDER OR OWNER: 1aavLo. PERMIT DATE• E= 3) •�j`J COMPLIANCE DATE: q': ����� DRAW DIAGRAM ON BACK 7y D . L� -zj/ Q- 04 Y -I? TOWN OF 4MN9MWft Nl LOCATION: CAPCS 19A/L- VILLAGE: LOT # : E3 PERMIT # : INSTALLER' S NAME: INSTALLER' S PHONE # : 42z e 0?-910 LEACHING FACILITY: (type) 3ryoo CPL C (Size) NO. OF BEDROOMS: BUILDER OR OWNER: Ako�iprt&bu PERMIT DATE: ' :3),T7 COMPLIANCE DATE: q': 7-3%5 DRAW DIAGRAM ON BACK j r i B A At `fo-o A-Z- q7-6 A-i 6?-o �d1s� A4 `7S- � g+ 28 0 S �7 3L-'� No. Fee THE COMMONWEALTH OF MASSACHUSETTSI Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Rpprication for �Diopozal *pgtem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) l Complete System ❑Individual Components Location ddress Lot Np Owner's Name,Address and Tel.No. (508) 7 7 8—4 7 00 I.W , Lot 8, Capes Trail Monomoy Realty Trust Assesso ' Map arce West Barnstable, MA Map 88, Parcel 8-2 20 Trottingbred Lane, West Barnstable, MA Installer's Name,Address,and Tel.No. J. Holler & Son Designer's Name,Address and Tel.No. Earl Lantery 5 Captain Kidd Road, Sandwich, MA 02563 Advanced Technical Solutions, Box 99 (508) 833-0374 Sandwich, MA 02537 (508) 888-4029 Type of Building: Dwelling No.of Bedrooms 4 Lot Size 43,602 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 110 gallons per day. Calculated daily flow 440 gallons. Plan Date 3-8-99 Number of sheets 1 Revision Date Title "Sewage Disposal System Design for Timothy Hinckley R.T. , II" Size of Septic Tank 1,500 gallons Type of S.A.S. Description of Soil HOLE #1 — 0-8" 0—A, Loam, 10 YR 3/3; 8"-48" B, Loamy Sand, 10 YR 5/6; 48"-144" C, Fine Sand, 10 YR 6/3, Gravel 5%. HOLE #2 — 0-6" 0—A, Loam, 10 YR 3/3; 6"-48" B, Loamy Sand, 10 YR 5/6. 48"-144" C. Fine Sand 10 YR 6/3. Gravel 5% Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Bo d Signed Date 8-31-99 Application Approved by Date — Application Disapproved for the following reasons Permit No. Date Issued - No. — P"�' � A. ; Fee 1' - THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS ti Yication for Mig ogal stem Conotruction it +t, Application for a Permit to Construct( )Repair( )Upgrade,( )Abandon( ) Complete System ❑Individual Component Location Address or Lot No, Lot 8, Capes Trail Owner's Name,Address and Tel.No. (508) 7 78-4700 '.: Monomyy Realty Trust Assessor's Map/Parcel West Barnstable, MA 20 Trottingbred Lane, West Barnstable, MA Map 88, Parcel 8-2 Installer's Name,Address,and Tel.No. J. Holler & Son Designer's Name,Address and Tel.No. ,Earl Lantery 5 Captain Kidd Road, Sandwich, MA 62563 ; Advanced Technical Solutions, Box 99 (508) 833-0374 '.* Sandwich, MA 02537 (608) 888-4029 Type of Building: Dwelling No.of Bedrooms 4 Loi Size 43,602 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 110 gallons per day. Calculated daily flow 440 gallons. Plan Date 3-8-99 Number of sheets 1 Revision Date Title "Sewage Disposal System Design for Timothy Hinckley R.T. , II" Size of Septic Tank 1,500 gallons Type of S.A.S. Description of Soil HOLE 4 1 - 0-8" 0-A, Loam, 10 YR 3/3; 8"-48" B, Loamy Sand, 10 YR 5/6; 48"-144" C, Fine Sand, 10 YR 6/3, Gravel BR; HOLE #0 - 0-6" 0-A, Loam, 10 YR 3/3; 6"-48" B. Loamy Sand, 10 YR 5/6; 48"-144" C. Fine Sand, 10 YR 6/3, Gravel 5% , s Nature of Repairs or Alterations(Answer when applicable) s. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-.site sewage disposal system-_- in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Bo d o 19a.W. , Signed Date 8-31-99 Application Approved by Date - r: Application Disapproved for the Yollowing reasons Permit No. - r Date Issued ---------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS ` BARNSTABLE, MASSACHUSETTS t a (Certificate of (Compliance THIS IS TO CER ,that the On-site Sewage Dispo ystem Constructed( Repaired( )Upgraded( ) Aband ned )by !at i has been constructed in accordance y with the provisions of i e 5 an the for Di posal System Constructi n Permit No. dated c Installer Designer J 411 A G 1}(^ The issuance-of&Se sha not be construed as "guarantee that the y to ill functionas/d sign�l y� / �\ Datev� r Inspector —f/� r 111�" +,� r f- �� —!-------------------------------------- No. r Fee join THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS lwi5po5ar *potent (Construction Vermit Permission is hereby granted to Construct( , -Repair( )Upgrade( )Abandon System located at 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. 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Y '. � 1.9• {•' {/\ �{. ^. — �,I.. 10' 1.O'• ^y - y L11=WK>:i wRl tJ;t 1' N �sr��g t ' � t.y Iltnt• .'INvull�Y pCD.N a(1MI,t nIr.AM t wr-It.1NtNV iM�lt � { Page: 1 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Prepared For: Report Dated: 7/30/99 Sollows,Jeffrey Order Number: G9903069 Jeffrey Sollows 20 Trotting Bred Lane West Barnstable MA 02668 Laboratory ID#: 9903069-01 Description: Water-Drinking Water Sample 1h 03069 SamMine Location: Lot 8-Capes Trail,W.Barnstable Collected 7/29/99 collected by: C Stiefel private well Received 7/29/99 EPA 524.2- Volatile Organics by GUMS ITEM RESULT UNITS MDL MCL Method# Tested LAB: GC/MS 1,1,1,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 07/29/1999 1,1,1-Trichloroethane BRL ug/L 0.5 200 EPA 524.2 07/29/1999 1,1,2,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 07/29/1999 1,1,2-Trichloroethane BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 1,1-Dichloroethane BRL ug/L 0.5 EPA 524.2 07/29/1999 1,1-Dichloroethene BRL ug/L 0.5 7.0 EPA 524.2 07/29/1999 1,1-Dichloropropene BRL ug/L 0.5 EPA 524.2 07/29/1999 1,2,3-Trichlorobenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 1,2,3-Trichloropropane BRL ug/L 0.5 EPA 524.2 07/29/1999 1,2,4-Trichlorobenzene BRL ug/L 0.5 70 EPA 524.2 07/29/1999 1,2,4-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 1,2-Dibromo-3-chloropropa BRL ug/L 0.5 0 EPA 524.2 07/29/1999 1,2-Dibromoethane(EDB) BRL ug/L 0.5 EPA 524.2 07/29/1999 1,2-Dichlorobenzene BRL ug/L 0.5 600 EPA 524.2 07/29/1999 1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 1,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 07/29/1999 1,3,5-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 1,3-Dichlorobenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 1,3-Dichloropropane BRL ug/L 0.5 EPA 524.2 07/29/1999 1,4-Dichlorobenzene BRL ug/L, 0.5 5.0 EPA 524.2 07/29/1999 2,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 07/29/1999 2-Chlorotoluene BRL ug/L 0.5 EPA 524.2 07/29/1999 4-Chlorotoluene BRL ug/L, 0.5 EPA 524.2 07/29/1999 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 w, Page CERTIFICATE OF ANALYSIS �rsgct us-`Mj Barnstable County Health Laboratory Report Prepared For: Report Dated: 7/30/99 Sollows,Jeffrey Order Number: G9903069 Jeffrey Sollows 20 Trotting Bred Lane West Barnstable MA 02668 Laboratory ID#:1 9903069-01 Description: Water-Drinking Water Sample#: 03069 Samaling Location: Lot 8-Capes Trail,W.Barnstable Collected 7/29/99 collected by: C Stiefel private well Received 7/29/99 Benzene BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 Bromobenzene BRL ug/L. 0.5 EPA 524.2 07/29/1999 Bromochloromethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Bromodichloromethane 0.5 ug/L 0.5 EPA 524.2 07/29/1999 Bromoform BRL ug/L 0.5 EPA 524.2 07/29/1999 Bromomethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Carbon tetrachloride BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 Chlorobenzene BRL ug/L 0.5 100 EPA 524.2 07/29/1999 Chloroethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Chloroform 29 ug/L 0.5 EPA 524.2 07/29/1999 Chloromethane BRL ug/L, 0.5 EPA 524.2 07/29/1999 cis-1,2-Dichloroethene BRL ug/L 0.5 70 EPA 524.2 07/29/1999 cis-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 07/29/1999 Dibromochloromethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Dibromomethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Dichlorodifluoromethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Ethylbenzene BRI, ug/L 0.5 700 EPA 524.2 07/29/1999 Hexachlorobutadiene BRL ug/L 0.5 EPA 524.2 07/29/1999 Isopropylbenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 Methyl-tert-butyl ether BRL ug/L 2.0 EPA 524.2 07/29/1999 Methylene chloride BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 n-Butylbenzene BRL ug/L. 0.5 EPA 524.2 07/29/1999 n-Propylbenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 Naphthalene BRL ug/L 0.5 EPA 524.2 07/29/1999 p-Isopropyltoluene BRL ug/L 0.5 EPA 524.2 07/29/1999 sec-Butylbenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 Styrene BRL ug/L 0.5 100 EPA 524.2 07/29/1999 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 pF IIA '� Page: 3 CERTIFICATE OF ANALYSIS i� MI s Barnstable County Health Laboratory �9�SACk141St�`f. Report Prepared For: Report Dated: 7/30/99 Sollows,Jeffrey Order Number: G9903069 Jeffrey Sollows 20 Trotting Bred Lane West Barnstable MA 02668 Laboratory ID#: 9903069-01 Description: Water-Drinking Water Sample#: 03069 Sampling Location: Lot 8-Capes Trail,W.Barnstable Collected 7/29/99 collected by: C Stiefel private well Received 7/29/99 tert-Butylbenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 Tetrachloroethene BRL ug/L 0.5 5.0 EPA 524.2 07/29/19§9 Toluene BRL ug/L 0.5 200 EPA 524.2 07/29/1999 Total xylenes BRL ug/L 0.5 10000 EPA 524.2 07/29/1999 trans-1,2-Dichloroethene BRL ug/L 0.5 100 EPA 524.2 07/29/1999 trans-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 07/29/1999 Trichloroethene BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 Trichlorofluoromethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Vinyl chloride BRL ug/L 0.5 2.0 EPA 524.2 07/29/1999 Routine ITEM RESULT UNITS MDL MCL Method# Tested LAB: IC Lab Nitrate 0.8 mg/L 0.1 10 EPA 300.0 07/29/1999 LAB:Metals Copper <0.1 mg/L 0.1 1.3 SM 311113 07/30/1999 Iron 0.1 mg/L 0.1 0.3 SM 311 IB 07/30/1999 Sodium 107 mg/L 1.0 20 SM 3111B 07/30/1999 LAB: Microbiology Total Coliform Absent P/A 0 Absent P/A 07/29/1999 LAB:Physical Chemistry Conductance 585 umohs/cm 1 EPA 120.1 07/30/1999 pg 5.8 pH-units 0 EPA 150.1 07/30/1999 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page: 4 o w', CERTIFICATE OF ANALYSIS iG Mi 5 Barnstable County Health Laboratory Report Prepared For: Report Dated: 7/30/99 Sollows,Jeffrey Order Number: G9903069 Jeffrey Sollows 20 Trotting Bred Lane West Barnstable MA 02668 Laboratory ID#: 9903069-01 Description: Water-Drinking Water Sample#: 03069 Sampling Location: Lot 8-Capes Trail,W.Barnstable Collected 7/29/99 Collected by: C Stiefcl private well Received 7/29/99 Note: Based on the results of the parameters tested,the water is suitable for drinking but has high levels of sodium.Persons on low sodium diet should consult their doctor. Approved By. (Lab Director) 713alei Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 f / A Fee-- - BOARD OF HEALTH TOWN OF BARNSTABLE AppiicationArVell Con0ructionpermit Application is hereby made for a permit to Construct ( ), Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Map and Parcel Owner ��- Address Installer Driller Address �— — Type of Building r Dwelling �(y �/�U g — -- Other - Type of Building----------------------------- No. of Persons----------------------------__-___-_______ Type of Well--- ------- - 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 Certificate of Compliance as been issued by the Board of Health. Signed date } Application Approved date Application Disapproved for the following reasons: ----__-- ----------- — - ---- --------------------------------------------------------- i date Permit No.-JrlG`'� G- � ----- Issued----- - -�-_ -L_ date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well C� ),structed (1- Altered ( ), or Repaired ( ) l Installer 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. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------ —-- Inspector------ - - - - Fee--1-S2--�1-�-=� BOARD OF HEALTH TOWN OF BARNSTABLE 0[pplicat ion-*rVell Con5tructionA3ermit Application is hereby made for.a permit'to Construct 'Alter ( ), or.Repair ( `)an-individual Well at: 16catlon - Address` Assessors Map and Parcel Owner , Address ---- ----- ------- ------- ---_ ------ -- -- - - I . Installer Driller :4ddress Type of Building Dwelling- �Lt>���/�(J9----- Other Type of� Building-------------------------- No. of Persons------------------- Ci'L�*r i? ----- Type of Well --- ---i--- . — Capacity----------------------=---------- t Purpose of Well ----— - - ------- Agreement: 4 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 Certificateof Compliance as been issued by the Board of Health. Signed '—`—— -- -- - ---- . _�.V date '. Application Approved date Application Disapproved for the following,reasons:-----=-- -------- ----------=---- --- I �. -� • — date 4 Permit No. ""' —L�. — Issued---- —`- i date "tati#itil[i2Y2i4w2i1i4i2i1iQ.i2:2iFi�i4i9s90S`i@i'3i-'!i@82B@4?d4EYEY!'sl6lS2i4i!49Y189d14964d1i212i.2iSi9iB6A3K Ji W Qi@i@iBEYi�iT6@i96•1Y165c+liTiWs6l6li'li4Y�i4tiSi?a2E3i2i2iib4d9i,T BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO C RTIFY, That.the Individual'We11 Co structed (k<Altered ( ), or Repaired ( ) r ` Installer -- at V has been installed in accordance with the provisions of the Town of Barnstable Boaaardd.of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. bate ;!,gr—'= � THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. 4 DATE------- -- - — Inspector-___---- ---- —- — TMi�i?tBTAt?.i1.:1ME�i�:it4M9i�i}sxiAai6i.4iib5{f}.��yeii4.yAtQpRypmgiCi4i4hIS4.ifF&HTif245t1►A4i9i^a{4ia[i]Ri(k'EiBiT.E@iV Wt:icClnfaaSvAi+F'bRo46PbFi4A2iSi2i:Ai}ib2iAilq.!$•auSi+Fi4dY4t!iE`i4fiLi.!?iRbbei�+ 1 j BOARD OF HEALTH" i TOWN OF BARNSTABLE well Congtruction]permit No. Fee Permission is hereby granted A14,to Construct Alter ( ), or R pair an Individual ll at: / Street as shown onn the �apaylication forr a Well Construction Permit .� No.--� �� -� — — Dated - ---------------------- J'Q — Board of Health ( ` DATE Ir , 4 � } CERTIFICATE OF ANALYSIS Page. gssn�► s��`y; Barnstable County Health Laboratory Report Prepared For: Report Dated: 7/30/99 Sollows,Jeffrey Order Number: G9903069 Jeffrey Sollows / 20 Trotting Bred Lane West Barnstable MA 02668 Laboratory ID#: 9903069-01 Description: Water-Drinking Water Sample#: 03069 Sampline Location: Lot 8-Capes Trail,W.Barnstable Collected 7/29/99 Collected by: C Stiefel private well Received 7/29/99 EPA 524.2- Volatile Organics by GC/14'dS ITEM RESULT UNITS MDL MCL Method# Tested LAB: GCIMS 1,1,1,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 07/29/1999 1,1,1-Trichloroethane BRL ug/L 0.5 200 EPA 524.2 07/29/1999 1,1,2,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 07/29/1999 1,1,2-Trichloroethane BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 1,1-Dichloroethane BRL ug/L 0.5 EPA 524.2 07/29/1999 1,1-Dichloroethene BRL ug/L 0.5 7.0 . EPA 524.2 07/29/1999 1,1-Dichloropropene BRL ug/L 0.5 EPA 524.2 07/29/1999 1,2,3-Trichlorobenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 1,2,3-Trichloropropane BRL ug/L 0.5 EPA 524.2 07/29/1999 1,2,4-Trichlorobenzene BRL ug/L 0.5 70 EPA 524.2 07/29/1999 1,2,4-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 1,2-Dibromo-3-chloropropa BRL ug/L 0.5 0 EPA 524.2 07/29/1999 1,2-Dibromoethane(EDB) BRL ug/L 0.5 EPA 524.2 07/29/1999 1,2-Dichlorobenzene BRL ug/L 0.5 600 EPA 524.2 07/29/1999 1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 1,2-Dichloropropane BRL ug/L 0.5' EPA 524.2 07/29/1999 1,3,5-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 1,3-Dichlorobenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 1,3-Dichloropropane BRL ug/L 0.5 EPA 524.2 07/29/1999 1,4-Di6lorobenzene BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 2,2=Dichloropropane BRL ug/L 0.5 EPA 524.2 07/29/1999 2-Chlorotoluene BRL ug/L 0.5 EPA 524.2 07/29/1999 4-Chlorotoluene BRL ug/L 0.5 EPA 524.2 07/29/1999 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 I Page. z CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory Report Prepared For: Report Dated: 7/30/99 Sollows,Jeffrey Order Number: G9903069 Jeffrey Sollows 20 Trotting Bred Lane West Barnstable MA 02668 Laboratory ID#: 9903069-01 Description: Water-Drinking Water Sample#: 03069 Saint)lint!Location: Lot 8-Capes Trail,W.Barnstable Collected 7/29/99 Collected by: C Stiefel private well Received 7/29/99 Benzene BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 Bromobenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 Bromochloromethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Bromodichloromethane 0.5 ug/L 0.5 EPA 524.2 07/29/1999 Bromoform BRL ug/L. 0.5 EPA 524.2 07/29/1999 Bromomethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Carbon tetrachloride BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 Chlorobenzene . BRL ug/L 0.5 100 EPA 524.2 07/29/1999 Chloroethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Chloroform 29 ug/L 0.5 EPA 524.2 07/29/1999 Chloromethane BRL ug/L 0.5 EPA 524.2 07/29/1999 cis-1,2-Dichloroethene BRL ug/L 0.5 70 EPA 524.2 07/29/1999 cis-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 07/29/1999 Dibromochloromethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Dibromomethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Dichlorodifluoromethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Ethylbenzene BRL ug/L 0.5 700 EPA 524.2 07/29/1999 Hexachlorobutadiene BRL ug/L 0.5 EPA 524.2 07/29/1999 Isopropylbenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 Methyl-tert-butyl ether BRL ug/L. 2.0 EPA 524.2 07/29/1999 Methylene chloride BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 n-Butylbenzene BRL ug/L 0.5 EPA 524:2 07/29/1999 n-Propylbenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 Naphthalene BRL ug/L 0.5 EPA 524.2 07/29/1999 p-Isopropyltoluene BRL ug/L 0.5 EPA 524.2 07/29/1999 sec-Butylbenzene BRL ug[L 0.5 EPA 524.2 07/29/1999 Styrene BRL ug/L 0.5 100 EPA 524.2 07/29/1999 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 I 1 v �s. Page: 3 CERTIFICATE OF ANALYSIS Barnstable County Health Laboratory 7``SnCli�3`?t^/ Report Prepared For: Report Dated: 7/30/99 Sollows,Jeffrey Order Number: G9903069 Jeffrey Sollows 20 Trotting Bred Lane West Barnstable MA 02668 Laboratory ID#: 9903069-01 Description: Water-Drinking Water Sample#: 03069 Sampling Location: Lot 8-Capes Trail,W.Barnstable Collected 7/29/99 .ollected by: C Stiefel private well Received 7/29/99 tert-Butylbenzene BRL ug/L 0.5 EPA 524.2 07/29/1999 Tetrachloroethene BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 Toluene BRL ug/L, 0.5 200 EPA 524.2 07/29/1999 Total xylenes BRL ug/L 0.5 10000 EPA 524.2 07/29/1999 trans-1,2-Dichloroethene BRL ug/L 0.5 100 EPA 524.2 07/29/1999 trans-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 07/29/1999 Trichloroethene BRL ug/L 0.5 5.0 EPA 524.2 07/29/1999 Trichlorofluoromethane BRL ug/L 0.5 EPA 524.2 07/29/1999 Vinyl chloride BRL ug/L 0.5 2.0 EPA 524.2 07/29/1999 Routine ITEM RESULT UNITS MDL MCL Method# Tested LAB: IC Lab Nitrate 0.8 mg/L 0.1 10 EPA 300.0 07/29/1999 LAB: Metals Copper <0.1 mg/L 0.1 1.3 SM 3111B 07/30/1999 Iron 0.1 mg/L 0.1 0.3 SM 311113 07/30/1999 1SOdlum lO7 mg/L 1.0 20 SM 3111B 07/30/1999 LAB: Microbiology Total Coliform Absent P/A 0 Absent P/A 07/29/1999 LAB:physical Chemistry Conductance 585 umohs/cm I EPA 120.1 07/30/1999 pH 5.8 pH-units 0 EPA 150.1 07/30/1999 I Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page: 4 CERTIFICATE OF ANALYSIS ;a 9, �o v i» ' 9� ° Barnstable County Health Laboratory Report Preuared For: Report Dated: 7/30/99 Sollows,Jeffrey Order Number: G9903069 Jeffrey Sollows 20 Trotting Bred Lane West Barnstable MA 02668 Laboratory ID#: 9903069-01 Description: Water-Drinking Water Sample#• 03069 Samaline Location: Lot 8-Capes Trail,W.Barnstable Collected 7/29/99 Collected by: C Stiefel private well Received 7/29/99 Note: Based on the results of the parameters tested,the water is suitable for drinking but has high levels of sodium.Persons on low sodium diet should consult their doctor. 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I,_ ._ :: {. _ -. .:.— x= . .' r -.... 1. i .. .: . . _. :".. qq, i. -. !; 4 t r � � K f r i �;,; . �. ,:.. .,. `. . 40 RAID rm ----- _ — ---- —-- MYIW 11111 Hill HI 111111111 I UL aR-O" 24'-0" 2a'-o' Il u��q- z p lW.�l w FRONT ELEVATION REAR ELEVATION LEFT ELEVATION SCALE, I/8' s I'-O' SCALE= VW . 1'-O" SCALE, 1/8' - P-O' OGS VENT 2XM RIDGS BOARD 4v / ASPHALT I"W& S / \ w cm 941EATHIN6 6,J.HANtrE115 C;. - - `° — 3✓.�PLY410w RT4 INMP- 1 I-.A0114T16 1 t P.G. S T•�T DRIP LD6R IxS FASCIA ALUMIPI B GUTTERSAND AND DNGS,SPOUTS ,.,-:::_, � t,[ O PRtEtE�AND hpW.DINGb wal FIRE B.< 2wt.E 4rp.BOOMaETH MM.STUDS f ff" C. I h AND M"RAW Mr PLYHOOP SWAT1490 NG SPACE SINNG.ES 1 � (L lJ GARAGE z-T J PI0 C40 DOORS --- ------- ,.: Y GOMACT FlLL _ kt, M' RIGH7 ELEVATION SCALE. 1/8' • 1'-0' SECTION SHEET scaLE= va' - P-o" Al JOB- 0401 DRAWN BY: KW DATE- 1/15/06 . 24'-& 12'-0" Ir-d 24'-d //1� YYLYY-LL --------------------------- 57 Lip 'a 2 _ I I-------- a o - i I I d99 � _ I ILL 2a 10-11• 26 13'-1• UL ® z��J — (R 2442 a442 BAT14 1 —�• � I I I I I GAME ROOM o 0 GARAGE j I o � � n i 1 1 t"rTu+ nanaa I GARAGE _ ° / 1 *Iry I I OFFICE UN. CASM L --------�. I 4'-O' Ii'-d 4'-O" 12'^d 12'-d 3'-W 1i'-i• 9'_9• �a� 24'-0 aai !n W ,A4 z Q T (J FIRST FLOOR PLAN SECOND FLOOR PLAN FOUNDATION FLOOR PLAN SCALE- 1/40 1'-00 SCALE, 1/4' I'-O" SCALE- 1/40 1'-& SHEET A2_ JOB= 0401 DRAWN 5Y: KW DATE- 1/15/06 J. YS t2.4 _ + 4� 12 FLXING LY.YJN6 - V + } . '-t- 4-�d;4�1 I �® 'r-•—WK eNINGpE� _� �� -�_r RAKE z FRONT ELEVATION REAR :ELEVATION 'LEFT ELEVATION Upp� U_ z SCALE: 1/4" I'-O" SGALE: 1/4' •.I:-O" SCALE: I/-0° � V RIDGE VENT 202 RIDGE BOARD ASPHALT SHINGLES sm'CDX SHEATHING 14A 11 p�6 pC. E? / P 127 EF - , RIB INSUL. - - ---'PLTWOOD N RU9 INSUL. -- - -- -- u gnu 16 1-JOISTS 16 O.C. ^i CONT.VENTING DRIP EDGE - Irb FASCIA ALUMINUM GUTTERS AND DOWN SPOUTS FRIEZE BOARD AND MOULDINGS iJ 1 5/8 FIRE RATED . GYP.BOARD y —2X4 EXT.STUDS V IV O.C. BETWEEN A G RAGE _ Y PLYWOOD SHEATHING AND LIVING SPACE T WRAP AP(OR EQUAL)N.C.S GARAGE W.C.SHING w O LES TYF. �r PIT04 TO DOORS noel F f.... H_________—__—________—_____—__ __ ___________ LE- I II . S „ .._... ..::.:-,,r .. • Ir,yam._ 'IT.. Ir.--__.—. V W - - COMPACT 24'-O' l- - -- __- RIGHT ELEVATION w SCALE: /4' n 1'-0' SHEET JOB: 0401 DRAWN BY: KW DATE: 6/28/04 D 1 Y I I I i c� 24'_0x 24'-0' ....._— v 24 r— 2 2 ----------------------------- UP 26 I 2442 2442 I I I I I a4n2 � a442 I I I I I I I I I I 4 I I I I m I I I i GARAGE I A'CONC.SLAB o mI a' I 2442 i I P1TGH TowatD DOORS GARAGE I i t STORAGE I l 1 B'><4s'CONC.HALL i 1 I I 10'rlb"CONTINUOUS POOTtN6 TYP. I I I I 2442 2442 2442 2442 I ! j1G..r O.H. DOOR L------------------------� i 2032 2442 2032 —:� i 4,-0° Ib,-a� 4,-0' 12'-O" t2'-0' - —_ w F w W d � Q • FIRST FLOOR PLAN SECOND FLOOR PLAN FOUNDATION FLOOR PLAN Q SCALE: 1/4' - 1'-0" - SCALE: VA' - 1'-0" SCALE, 114" - 1'-0' 0 SE;EET JOB: 0401 DRAWN BY: Klv DATE: 6/28/04 -;oPo`�W 11` F1N_Gg CL rG4 . . � KIrQC,SsBURY H L L 1 L50: EX ti�i NG GR,EL, 16 2.0r ® 2 `1 .� 26101 Q t xx�c .I C)viz- F\ MoVE ALL l "PElW%60—s 9'O Trvl . .e4 P.,!c, rNJ i6)•S .thtid,l�o7` _/ tZavi�D . 5'1.5 Ttn/6, I{ r , _ /%i'�/,CL�6�' GAL I � .. � `.` +�,, . , ♦ � � �l1�Ijrrt?`�j,,,; .l .ti� � Jam,_ t C BAR FL-cop, r _..r. G 1 q1 -- T ruc ld v. MIA. 4., o ` SCAL - c+J� B t W + o �-lopz_ ; - DISPOSAL SYSTEM � eo �� � � I o E :RtS�os,nL SYsT�M ,'�o, BT Co CTE iN Sfr T CDT 8 v . Q C.coko AN c.E OF C oM MA of �AS S. I. p C OE_,- - 7 N R M. p .1T 3 C�-'C. t N1 r31/F-: ALL J NJ 1'E-R VJ oU S NtATERII�L S.:_5.,:.:.1?,ROU:�I D: SY�T�- Jv4 ' '• r- _ , SS -SS QR S M P%P '8 lJ T . J s 6 O 1 J 6 P F. . 01iJ IUD - 5 `SO. VEY. DATA-fRotA ;. F`lAq 0.51VOW H:IlL STATES VJ S TEST Pt rs PL-R^ T65f SH o ,�_ a UO\N N C ACE:: E t�l YJ>;ZN1©�i l-� M A D ATE .� 'E x IN - •DRtED. A _ � U DUST S: . � ���. '- � 1 G Rt�DL EARL ! �o_ USE 3-Qz� ?' ` LCP\ 1�($ C}-JA1V�,l�Ei S w,T►�:4'n;� 3f4'� ?OI Y2'� WASHED 1 Ei`} l�' LANTERY, 1R. �i 1 C�4.24_ No. p PEA STONE oN Ti P QC SIGN ' SzXD SC A L E: I'� ` SINGLE FAM L.Y DWELLING Wl Y}- REIDRoo M S � - � s-, " i � I P�C v No GI-WR-B A G E D1 SPOSAL I �'� (�AIL�j FL aW = / 1 a X = 940 G: P• D. 5J\WD i SEW�6F 01SPOStiI SYSTEM DZS)r" i Ar`t� Fa R. , SEE �� )C '�ANtt (� cam, REQD� ! ����E� ! ` Tl I�nOTHY H INCKLL`( R. T. `1' 0 G. P �. X 2 :D = 8 8 0 - GAts: , _ p 6 I I 1 GCtO 1` Fa'L MiC-10 T (� RQAD 1,5U) GAL i. A �IK . ?C- i CAN TEE RVILl- MA 026731a LEAcnIN C�l1\M8ER -S L O'� �, / C c� S >: 3 - � x8°XZ WI6GlNSL , C . + I` _ E �t= E CT IV E U� Pr}1 SNL`r,t 1 ? , !L r -. -, 1 S 13x3Z xQ.74 ASSOCQ eECH- SO` t U ION c I i 0TP, CA e TV ' CNSV_T GR AiSP.� :'A, . . 71 , Ft _ FLdt1R ,tw OF ALLAIN 8 KING BURY _ f�-oi'o��wl�t� FX s G2z v a �6 .,....,._ __.s,. Q Q ►� o J �- � >; •.A LJ M)Nr >= 1 1 � . m r►,1� 1.6 ,� .!h�.I loC�7 �'[Z 011�1�17 5�l.S::T L- � _,-__..... .,_ �� � �- � I _ _ r _ - m. _ - _ ._ ___ . :. �. _ - /A �1� .: _ _" • ..__._. -__.__ __..._ _ _ _.: T -�_ ,�, Sam- - f (Y=1 LE of-- D 13 P 0 S AL,-_,.-S Y S:7_ m� IZ O ES'I piS�aS�L S`{ST�M' i o-.,E3�._.,._Co-I' -(ZVCTE S1. _ �ST D ��c _ _ _ _ . ._. .._ - Q Ccv�Dl1N C.E o [✓ o� M. o� _. __.. _. __._,gym _ . __� �1 ... F: ... ..... �"1As s�. �N � IRah. CooE TAT f EMOVE ALL IM RERVI dUS- MATERIAL:S":5- -J�ROUI�-I3 . SY�TTtF1 t 3- A SsI SS-C R 'S M 88 CGS S 2,Z 9 , ZdNI1Jfi �� P. f'' �g B.M. T _ - - -- �- _ _ �. - l __.o - - _ 75 SURVEY - - _ __.._ I- - _ � FLAW ��..S JV pw t-j L L C STA T E.S ��, W�.�f' TEST s T P! r s � P-, RC T>= !G " St 1�13T1 gL� ; IHA z,/ DOWN CAPE. EJJE`G_ /ARMOvTI-� � I�/�_ p�5 i LXInTINCs DK E_D A U GUST 5 1 ,Y)-T. OkA (i)_ -USC 3 B'z 'x2' LE11C IA)NG CHAMEER5 w ,r►a 3/1- -ToI %" WASI4-'ED 640 - ,—) GOAL^ fr 1 G4.2 ` —164.2 STONE, w i \N Z of 5T0 PEA 1�E oN I I QC- SIGN SC A L - ' - S l�1J D i SI rIGLE FAAAI tY DWELLIi l-G WI 1} R£D9,oo_M S. - < s� „�� I _ z �Cv �l7 �; 6 - -.-1`Io__G.�R_5-K G.E-MSPOSAL' ..- _ _._,.__ • - -- - - -- _- - ----- - - - Fl y . o i BEW�6E�O1SPOSAL SYS IEM DE51GN JDAIt`� FL a W `f- _ �-40 G. P, (�_ _ + sn�N� ' I "N.O-, R EC i7� �jH OF hq I G'�i� >r 1. ��� _ T- T,, P, i�. ,c -2 .D = S:2 D __.GA)-S . = M �P V� s�9� 1 I`nOTH Y t� 1 �= HARRY `yG I G0n f AL MOt� 1 I� F�Dt�D i 1,5OLD . GA I- A-1`1K - 0, }C. -Z EARL �, � � CEN TERVILLE MA O263i i v LANTERY, 1R. y L � AGHING CF1M8ER S -- -- _ A � No.2s o ; aly I _' Pow O I S / CAPt S TF\/�lL • cJ S 1= :,3 - z' W 16G1N S L, C, f � SJo>`IE � FSsr _ L SND�rJ 1-1 1 LL ESI sy ES E f-5 E CTIV ' WEST BAIRUSTAC3LE� MA A-S S cc TECH. S 0 L U T I 0 N S 152,0— 1— ,q.pzo Noll{J CAPAC 1T'� - �� ( GALS . T)=SrcD: 3/z/99 ! Cn�sv'-T• tNG�R Sf P.� l"t�! • 13_ WEBBER CAlE- 3/ 8J9g pvJCr. 3899 ;20 / C Z - - fit,/,4/0 9'8 8 Pe L 00 8. 00 z -, D.— Fc N FLoo R - -rr i , 66 ,_� ► of AM -,`oPo�iWA �T/.GR,eL ALLAN �y 1_ ,Gso 4 DFX tis; G• GR.EL, 3 KINGSBURY�`k Tf o rE . PEE m o J;_ At_L f Mp>_wi�,tJ.s : *26101 " \y F.Y.C. r N J_ + C'_7 fo OV/�rZ ti�D S M .. / .� z ' •- 1►r�/ .�(p1.6 IG.AL- � E? f `-` � n ,� j. ������i u; �� � Y > F.FLcwk C c A /ST:Z �. N S'E 1 G V W, 161.0cow ' c 3 ? — '1�! a i m• TAIL 't o I w 2ol 0 l`71 J`/ a .o a J1 i 0 0 ILI- .n P R��L E of D IS P a S ARLe S Y S M- — a ' � 1 r T 1• M C o: R'E �;C�h15TRUC'TED. 1 N STR�c T v rCQX c, LDT 8 A € 4Q,:C .o�D Ah1 CE o C o M -TIT �. 9� F~ 'N1 A S. N J / g 4 .. .. . w i s C -T t ,r.�. . EMO.Vt ALL .1.M'PE-RVf�USAF:M t.5 } . •„ .. .,yam_ .. .r. ':. ' .. ;. -•,� � ._ _. �; . 3 A SS. S e: ,, ��. :ti SQR S.M� 88. PCs 6. F� � � r 5 :,SURVEY_ if1TA Fr�or� L11►.�" : SNO4I la :5�' -.� V! E - - W 5 $Y. T • -7- TEST PI rs � �>Rc TEST - DOW tJ C APB ENE _ 1�iZ4�1�J � ��6A_ pJ�rF_� Ex»r rlvc� o� Iw U'Gt�S*T 5- 1997 1 C3 RHb� A N A. n a ARL m 1 64 6 "- w ,r►k - j O A LANTERY, 1R. v z ; U.SL- . 3 xSx2 L:Ek��1 1N CHAMI�I=RS l4-'nt3/4" 10! %" `rJA314E + ,,^ �l-1 f+ OF ?E�f\ STO1J �oT� / C4.Z — ! —tC4_ ;� o.2657 fi F { 0 E SIGN t L QRM l+ i C IV L /DL A I`;' S1�ND ! -s c C � 1 1" C; A B s 5' -f r , SING E FA1At L DWELL.tr1 G �J REDRooM Y +�L{ 1- 7 9 1 . i I P�Ev � j 10 GI�R�aAGE D1Sc. oSh ' ) . _ _ SEy✓�6E 1✓) SPC�I�� SYS T E1^ 0�. , S E P-T i C TAM l< N cx-. r �x vs� r) )`1\UTHY N )NCKLE`( R. T., T G_ P: il_ �c 2 _D 8 8 6/`�LS x . --- i A i GCVO i 1 L � Cwa i i= Pam; ID l,5OD GAL. A �1Y, — O . K- ( I CANT I?V';UL 1t'irr t�Lb � LEACHING C� \MSER S _ I I ! _ o +�_J ! CF.1 SF 3 - x°"xC' �•/ 16 I1�1S ► , L . Sorl� ► ; _ Q i 8 � _ . i 13 x 3 e 14 - 30� _ o— —' N -- —1 A Ss bCR 1 ECH_ S C�LJ 1 IDN CAP)f�c �K ----- — --- ! B V/ L I STAATDARD NOTES N 19' 1) THIS PLAN IS FOR THE INSTALLATION OF A SEPTIC SYSTEM. r� 2) ALL INSTALLATION PROCEDURES AND MATERIALS SHALL CONFORM TO 310 CMR 15.000, THE STATE ENVIRONMENTAL CODE, TITLE 5, AND THE TO WN OF 6�(LA rAY17 U __ SUBSURFACE DISPOSAL REG ULATIONS. R = 52.50' 3) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE OF A VAILABLE PROPERTY INFORMATION WITH RECORDED DEEDS L = 92.07' OR ZONING REGULATIONS. 4) TOWN WATER DOES NOT SERVICE THIS PROPERTY / \ 5) THERE ARE X EXISTING WELLS WITHIN 200' OF THE PROPOSED SOIL ABSORPTION SYSTEM. \ .R = 25.00' L = 21. 74' 6) ALL COVERS OF SYSTEM COMPONENTS SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE ?s sI � \\� 7) ALL SYSTEM COMPONENTS SHALL REMAIN ACCESSIBLE FOR INSPECTION. No STRUCTURES SHALL BE LOCATED DIRECTLY UPON OR ABOVE THE COMPONENT ACCESS LOCATIONS, WHICH WOULD INTERFERE WITH THE PERFORMANCE, ACCESS, INSPECTION R = 321.48, PUMPING OR REPAIR. \ �� L = 49.87' 8) NO DRIVEWAY, PARIUArG OR TURNING AREA, OR OTHER IMPERVIOUS AREA SHALL BE LOCATED ABOVE A SOIL ABSORPTION �-- Ex D/W �-� �/ SYSTEM, EXCEPT WHEN VENTING HAS BEEN PRO VIDED. 9) SEPTIC TANKS, GREASE TRAPS G CHAMBERS AND DISTRIBUTION BOXES SHALL BE PLACED ON A 6" STONE BASE \ � , DOSING H TO ENSURE STABILTI"Y AND PREVENT SETTLING. L D T S 10) OUTLET DISTRIBUTION LINES SHALL REMAIN LEVEL FOR A MINIMUM OF THE FIRST TWO FEET OF THEIR LENGTH. Existing \ 11) ALL SYSTEM COMPONENTS SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10' ZExisting Leaching Chambers ( Well to be removed ��, 602--- SR'• Ft' OF DRIVEWAYS OR PARKING OR TURNING AREAS, IN WHICH CASE H-20 COMPONENTS SHALL BE USED. 12) ALL BUILDING SEWER LINES SHALL HAVE AN INNER DIAMETER OF 4" AND SHALL BE CAST-IRON OR SCHEDULE 40 PVC. 5� °�� 13) THE DEPTH OF THE TOP OF ALL SYSTEM COMPONENTS SHALL .NOT EXCEED 36" UNLESS VENTING HAS BEEN PROVIDED. � ( in. 150' Radius 14) IN THE AREAS OF EXCAVATION, EXISTING GRADES SHALL BE REESTABLISHED UNLESS NOTED AS PROPOSED CONTOURS. M PROPOSED LEACHING FACILITY � __-- o ` �oN c � � 15) IF SOILS ARE ENCOUNTERED DURING THE EXCAVATION OF THE SOIL ABSORPTION SYSTEM, THAT DIFFER NOTABLY FROM \ THE DEEP OBSERVATION HOLE LOG, t CONTACT THE ENGINEER BEFORE PROCEEDING. 16) CONTRACTOR TO VERIFY LOCATION OF ALL UNDERGROUND UTILITIES. ToTA A� 3 ' 1Q, 'p10 See Exca va tion Notes� � `� � / �'"� `�a � • / o iz� 'G DES'IG DA TA DEEP OBSERVATION 4 HOLE' LOG Proposed x CIO Number of Bedrooms: Test Hote�#� o p (EL �� D-BOX °g 0 Garbage Grinder: N0 D p ev soil soil s ii < \f` 6 �th (eft) Horizon (U3 A) �M oloeell) Design Flow: 440 w (110 Gal/BR/Day x Number of BR) L] - (° �7.y Existing1,500 Gal `� z� .� U� ��,. s��sf - Septic Tank: u +� 1o`(gGjq Septic Tank P - 1, 500 2y c ! (Minimum - Design Flow x 200%) 16`6 �b`f _7t,,0 s lq Exist. � "�* �o� Leaching Area: �,�t - �i�-• �2"0 � j � 2,5_�_tfq-- sr / Sldewall: Deep Obs Hone Date. 1f/08104 Apo r Soil Evaluator. Ed Stone (2 Sidewalls x x _2__Ft} + Witnessed By- Pere Rate: 'k 2 MIN/IN 6) +?i (2 Endwalls x t Z''na3 FT x _ _Z'`t) is Soil Survey Descriftion: CARVER -- Geologic MateriaL• OUTWASH Bottom: I � " Depth to Standing Pater: NA _ Depth to Weeping Water: NA / •7 ( Depth to Mottling(Color): _Ft x Ft , } 1 � ' Est Seasonal High GW: NA } 2b Long Term Acceptance Rate (LIAR): 0. 74 vacs observation Well: NA Date of Last Measurement: NA Comments: Leaching Area Design Capacity: L4 5 S (Sidewall Area + Bottom Area) x LTAR _ Gal's (Provided) - _`�`t _.Gal's (Required) _ _L ___.Gal's Reserve l EXCAVATION NOTES Title Reference 15201/043 ---- --`_------- - 0 ��0 1) EXCA VATE ALL MATERIAL ABO VE SOIL HORIZON C (SEE DEEP OBSERVATION __—+C--_— —43 602f SF Flood Zone Lot Size ' nj 4j HOLE LOG) AT APPROXIMATE ELEVATION -7 b,0,, FOR A L4TERAL DISTAMCE OF 5' �J (WHERE POSSIBLE) IN ALL DIRECTIONS BEYOND THE OUTER PERIMETER14 OF THE LEACHING AREA. 2) FILL MATERIAL SHALL CONSIST OF CLEAN GRANULAR SAAD, FREE FROM ORGANICSITE AND SEWAGE PLAN MATTER AND OTHER DELETERIOUS SUBSTANCES, WHICH MEETS THE =&VRAL y, r CRITERIA PUT FORTH IN SECTION 15255(3) OF TITLE 5. PROJECT LOCATION 001 Capes Trail 3) SCARIFY THE BOTTOM SURFACE OF THE EXCAVATION PRIOR TO PLACEMENT West Barnstable, MA OF FILL INTO THE RETAINING STRUCTURE. , ASS87SSORS MAP 088 LOT 0021009 4) PLACE FILL ONLY WHEN BOTTOM SURFACE IS DRY. TOP OF I �r�- FTOP OF APPLICANT.' T r 7 7 EL 100.0 _ Raise covers to within 6" of J e� rey �J Oil 0 WS o `� � , � finish rode install risers as needed �' 201 Capes Tull •' `� "•'� N.G. GROUND SURFACE Ems._ g � E� GROUND SURFACE E�a�'�'_ `s,�c� e°y• ��'� h� � W. .Barnstable MA „ MIN , OUTLET PIPE LEVEL FIRST TWO FEET �`�o VENT REQUIRED c>)�' p' Tt1 96.0 2'1AiIN-3'VAX TOP EL ' M1N 2' LAYER DOUBLE WASHED � �Gt j Cj � � 4 PREPARED EY � INVERT EL D-Box lis•- f2' STONE S ( A & M Land Servlces 10 ' Z' I -- -� 15 Sunset Drive Existing '�� C <? .'r / . 14 95,2f -- — EFFECTIVE �� ~-- --- South Yarmouth, MA 02664 I q INSTALL INVERT EL ; : ct - , ; SIDEWALL o?� ( 508-394-2723 95.5 GAS s� STONE BASE INVERT EL b b N BAFFLE��tq,} �, �, LOCUS MAP INVERT EL b 3i4'- 1 1/2' DOUBLE WASHED STONE Proposed , tm INVERT EL t A 5 w ,rt t i{ 151,0+ +� of �'--�'� „of SCALE.' 1" = 20' DATE.' Nov. OB 2004 6" STONE BASE •D — Box INVERT EL BOTTOM EL �71MSL-nW ,N°1 ` ' k OypicelJ I ; �Q�� pW , Existing REV.1,500 Gal Septic Tank AsTIC�YS� T/rDr RTF�TA --WAS s° M. (Typical) ' 'Z c? FOR R � - ! F 12 EL 2.D BOTTOM OF TEST HOLE suRv °• N P D WG. NO. 3166 SHEET 1 OF 1 3� 5 ' I j