Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0030 LANCASTER WAY - Health
30 Lancaster Way, W. Barn. Lot 9 A= 110-004-010 I r I I� i t I No. 4210 1/3 BLU ESSILELTE 10% d 0 O 0 0 j . late items 1,2,and 3. A. Si ature your name and address on the reverse &44 ❑Agent t we can return the card to you. 0 Addressee ' 4this card to the back of the mailpiece, ec 'ved� e) C.� of el' he front if space permits. ' GC 1 9ddressed to: Is delivery address different from item I? ❑Yes HINSON, BANIEL J & KATHERINE, A TRS address below: ❑No 30 LANCASTER WAY WEST BARNSTABLE, MA-02668 ��IO�I 11�111111I»TI I I III I I I I i III �uNICype ❑Registered MaiITM. ❑Adult Signature El Priority Mall Express® ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted 5909402 1933 6123 1785 69ertified Mail® p�livery 13 Certified Mail Restricted Delivery �Retum Receipt for ❑Collect on Delivery Merchandise lumber(Transfer from service iabe)) ❑Collect on Delivery Restricted Delivery 0 Signature CorifirmationrM 015 1730 0001 4987 6858 d' El Signature Confirmation {l Restricted Delivery Restricted Dellvery(t,; i811,July 2015 PSN 7530 02 000-9053 Domestic Return Recicel✓pt� CD •• M Ln • co mc-m ms+ Certified Mail Fee E M§9P= Extra Services&Fees(check box,add fee as appropnateJ�, P1 ❑Return Receipt(hardcopy) $ �: `' 0 ❑Return Receipt(electronic) $ t' 0 .(]Certified Mail Restricted Delivery $ 'r'PostmarkT'Here E:3 ❑Adult Signature Required $ }v ;.Y ❑Adult Signature Restricted Delivery$ M Postage m $ Total Posta i HUTCHINSON,DANIEL J&KATHERINE A TRS Lrf $ 30 LANCASTER WAY r-3 Sent To WEST BARNSTABLE,MA 02668 r-3 StreefaridA Ciry Stafe, ti Town of Barnstable Barnstable Regulatory Services Department �`ca�P �STAgM 0 D MAW ,�� Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7015 1730 0001 4987 6858 February 6, 2017 HUTCHINSON, DANIEL J & KATHERINE A TRS 30 LANCASTER WAY WEST BARNSTABLE, MA 02668 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 30 Lancaster Way, West Barnstable, MA was inspected on 1/22/2018 by Brett Hickey, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: O Leaching facility with standing liquid level at or above the invert pipe (per Town Code 360-20h). You are ordered to repair or replace the septic system within two (2) years from the date you receive this notification. r r Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH omas cKean, R.S., CHO Agent of the Board of Health I� I Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\30 Lancaster Way West Bamstable.doc Town of Barnstable Regulatory Services Department Public Health Division 200 Main Street,Hyannis MA"02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A McKean,CHO Feb 6, 2007 Rev. 5111116 DEADLINES TO*REPAIR FAILED.SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) .An`y'marked in the ❑is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑Discharge or ponding of effluent to the surface of the ground w . ❑Pumping more than 4 times during the last year not due to clogged or obstructed pipe. :. ❑Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE(1)YEAR DEADLINE CRITERIA. ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑Any portion of the cesspool within a Zone 1 to a public well ❑Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis."(This system passes if the water analysis indicates the well is free from pollution). TWO (2)YEAR DEADLINE CRITERIA q Single Cesspool ❑Any"conditionally passed systems" (broken cover,relocation of a pipe,relocation of a driveway due to H-10 components, etc) o Leaching pit or cesspool with high liquid level, <12"below inlet (per Town Code §360-9.1) P(Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: WSEPTIMDEADLINES TO REPAIR FAIL SYSTEMS.doc Commonwealth of Massachusetts r/fir 0/0 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments I; M 30 Lancaster Way Property Address i Katherine Hutchinson Owner Owner's Name =r,' information is :X' required for every W.Barnstable MA 02668 1-22-18 �.� page. City/Town State Zip Code Date of Inspection NI 0 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 filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Brett Hickey use the return Name of Inspector � key. p Excavation Company � Company Name 14 Teaberry Lane Company Address Sandwich Ma. 02644 Cityrrown State Zip Code (508)477-0653 S113747 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 Evaluati n by the Local Approving Authority 1/22/18 inspectorvgrgnature 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 4°yucwvS i Commonwealth of Massachusetts - Title 5 Official Inspection Form " Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W.Barnstable MA 02668 1-22-18 page. Citylrown 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: 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•3/13 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 ,M 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W.Barnstable MA 02668 1-22-18 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 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W.Barnstable MA 02668 1-22-18 page. Citylrown 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 '/2 day flow t5ins•3/13 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 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W Barnstable MA 02668 1-22-18 page. Cityrrown 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 o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 30 Lancaster Way Property Address i Katherine Hutchinson Owner Owner's Name information is required for every W Barnstable MA 02668 1-22-18 page. Cityrrown 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 and occupants if different from owner El ® Y owner( P ) 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): 5 Number of bedrooms (actual): 5 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 594 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Dorm Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M '< 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W Barnstable MA 02668 1-22-18 page. City/Town State Zip Code Date of Inspection D. System Information Description: I 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 Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d n/a 9 ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: current Date Commercial/Industrial Flow Conditions: Type of Establishment: YI Design flow(based on 310 CMR 15.203): Gallons per d P Y(gP ) 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W.Barnstable MA 02668 1-22-18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date j Other(describe below): General Information 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: 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W.Barnstable MA 02668 1-22-18 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: 1995 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.): At time of inspection building sewer appeared to be in good working order with no sign of leakage. Septic Tank(locate on site plan): 1' Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gallon Sludge depth: 2 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W Barnstable MA 02668 1-22-18 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 34" Scum thickness 1 Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): At time of inspection septic tank appeared to be in working order,baffles present with no sign of back- up.Liquid level equal with outlet invert. Tank is in need of pumping at this time. Grease Trap (locate on site plan): Depth below grace: 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W Barnstable MA 02668 1-22-18 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 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required,for every W Barnstable MA 02668 1-22-18 page. Cityrrown 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.): At time of inspection d-box appears to be in working order with no sign of carryover. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No" Alarms in workinc 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 Dorm Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is W Barnstable MA 02668 1-22-18 required for every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: (2)4'x6' i ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): At time of inspection leaching appears to be in hydraulic failure both pits water level above the inverts. i 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 �M 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W Barnstable MA 02668 1-22-18 page. Cityrrown 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 N Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is W;Barnstable required for every MA 02668 1-22-18 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 wo 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: Z hand-sketch in the area below drawing attached separately O i AI;.21 �1 =�:2 A s 'A O 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 M 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W Barnstable MA 02668 1-22-18 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) i Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: No Gw 156" feet Please indicate all methods used to determine the high ground water elevation: I ® 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: Plan on file at BOH. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 30 Lancaster Way Property Address Katherine Hutchinson Owner Owner's Name information is required for every W Barnstable MA 02668 1-22-18 page. City(rown 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 OF BARNSTABLE r'-LOCATION 30 Lcx \ca s4 t r CJAY SEWAGE#Zp 1$ - O qS VILLAGE W. &rasaaJlc ASSESSOR'S MAP&PARCEL 110 - q- !O INSTALLER'S NAME&PHONE NO. c, B E Xcr�uaa o 4 t1'1- O L53 SEPTIC TANK CAPACITY LEACHING FACILITY.(type) 50QgGJ LI c C Q) (size) 13 X WZ x 7- NO.OF BEDROOMS S OWNER c � c Oft PERMIT DATE: 2- Z I- 18 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 Ai , 131911 B1 _ 21 , $„ AZ. 1y ' '9of (32-. IL,,3„ REAR A3. 23'3" B3• Z5 '3" . 2 7'3" 8y - 0 i No.C;W(6 v `v Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppliLation for disposal *pstritt Construction 30Prutit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.,30 L6n ca5 ' Own is ame,Address,and Tel.No. 17 q4-�3 g Assessor's Map/Parcel Ild —®0q <--� �°�r ' o lo ( S Installer's Name ddress,and Tel.No. Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures / - Design Flow(min.required) -5� gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil i Nature of Repairs or Alterations(Answer when applicable) 2-0 d if 2. o L, c 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 Certificate of Compliance has been issued by this Boar of 1 Signe Date s� Application Approved by i Date 4 ( g Application Disapproved by Date for th.t following reasons Permit No. lr:- — y(gs_ Date Issued ------------------------------------------------------------------------------------------------------ i No.(�)O/ i �v t/V Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ptJYication for Misposal 6pstem Construction permit Application for a Permit to Construct( ) Repair Upgrade Abandon Complete System ❑Individual Components Location Address or Lot No.,30 a 4, Y J O er's Name,Address,and Tel.No. Assessor's Map/Parcel O —BO Zj Installer's Name„Address,and Tel.No. Designer's Name,Address,and Tel.No. B-1 P �x ca uaqjn _ 77 /a-hee /)q -9 07 q-II G Type of Building: 0 Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) U` gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title h Size of Septic Tank Type of S.A.S. Description of Soil L ' Nature of Repairs or Alterations(Answer when applicable) zU d 2U 6-ha(--n bet 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 Certificate of Compliance has been issued by this Boj Signe Date App4�cation Approved by Date- � 62 O Appation Disapproved by w _. Date for th, following reasons ♦ /mow`F Permit No. �� �� Date Issued (91 D 7 t - - - ------ 1 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(ti/) Upgraded( ) Abandoned( `f a � }�LcAQ a '} ( 0 n /'� at 30 tinratA,,,_7-,/ q has been constructed in accordance with the pmws.ons of Title 5 and the for Disposal S/Stem Construction Permit Nook'/ ' 'G`/5 dated a/�2 h a� Installer L (/ V Designer h `f #bedrooms Approved design flows gpd The issuance of this permit hall not be construed as a guarantee that the syste��Will; c'b si ed. Date Inspector, Nor 2f� __0i G F - ee - d -- f THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Veposar 6petrm Construction J)erinit Permission is hereby granted to onstruct ) Repair ) Upgrade( ) Abandon( ) System located at J V 06 (Q l i and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be comp eted.within three years of the date of this permit. Date / � � Approved by f Town of Barnstable Regulatory Services Richard V. Scali,Interim Director * anxrtsrnai.e. Public Health Division 163q Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: 3_L _ 1 A Sewage Permit# 2 61$ o 1I S Assessor's Map\Parcel i 1 o - Ll-10 Designer: FW-c=A4 EnvironnnV_Mo.l Installer: Q i, 8 EXC<XU,3 1;ors Address: _420 Aox !g1 Address: ►y TcaScrr!4- L.J �o►r rr�o y-11�aor--1 �o i'c 5�1 oR o•1 c On 2- Z9- V9 .[3 fl CXCax,,0 A o^ was issued a permit to install a (date) (installer) septic system at 3o Lon co.s(address) based on a design drawn by (address) dated 2-ZG- 1$ (designer) _ I 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. Strip out (if required) was inspected and the soils were found satisfactory. 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-n accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed in co m fiance with the terms of the IAA approval letters (if applicable) 114 of414 boa DAVID cyGN D. FLAHERTY JR. C ;(Designe r's Si ) No..1211 G�STE��O Affix Desi rier s Sfain Here s Si ature) ( g p ) TURN ARNSTABLE 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:\Septic\Designer Certification Form Rev 8-14-13.doc t - s i Town of Barnstable r# DepArtment ofRe&,1Atory Services: 's ? Public Health Division Date DTP` 200 Main Street,HyarmisMAQ2b6.t - 1l"1. Date ScheduIed Time Fee Rd: Soil Su�tabil' .Assessi�:ent�`or Se 'e➢is o'sal �'` ` Performedlly_'_����,�_ ,. Ritneased9yr , r Loealton Address yA j� j 04iner'sName ` �J J jiv Y i l� { Address � - fj - .. Aaseisor's Map.'Pareel, 1� '!'".�� EdPir>eer's Name• �� + IiPf i.. y r� N�.CONS1RliCTION REPAIR...- � -TtlePhone#..:, Distances from:. Operr Wafer'Body R Poasible Wat Area'____ _R :Drinking Water Wep $: DrairMv A aY-�...,.:.�__..._ _JR Property Line R %er__ R . SKETCHt`(Stroat nvae,dimenvions of lot,exabt loaatinrm:of iest,hole&*Pere tests,locate wetlands iwprminvty to holes}:. - - - „Parerrtmatarial(gologic) +" /1. .. . Depth to Oroun:lwaw:Standing Water in Holt ..__..N .._.. 'Weeping from Pit Face.—::. Estimated Seasonal high Giiivadwaier r;: DETERMINATT�iv'FU12 SEi#SONAL HIGi T WATER TABS E- Msthod ........_....... Depth Obsetved'staridmg m olrs.hole° iii. Depth to Soil morales; irt. Depth to wasj ing Fran a de;of obs hole m Groundwatar Adjustmem fl, - - 'Index Wtil#,;i Readmg Date:_,,, Index-Well kvd :. Adj,factor -Adl„Groundwai-Level ,ate PERK OLATIONTEST uaie"' iie Oi sorva6ofi hole# Time .:: - Depth ofYere•� __ �� .Time it IS` Start Prc-sonic Tune�• �? Tune{9-ti)' IV _.._.... jgt, Prrsoak�_ U+:Z L BitesuitablRate Min-"04'L' litg=Assessrt�nt:''SttePassedh____ siteFa _ .. ..Additional Testing Needed(YiN) orgihal;PubligHeilth-Div soon• Observation Hdte`M' to To Be Completed onBacl --- - * *If pereotatton testis to be conducted within 10Q'of wetland,you:must first notify the Barnstable Consecvation,Divlsian aOiiist one(1)week•prror to begitttiing. , _ 9-\SEMOMCFORM DOC rs- w _ DEEP OBERYATCONI�OI E I O,GWE #:"Note - ➢epih from': Srnl F[onzon Soil Texture".a Soil Color ..,foil Surface (Ma Stones.Boulders. v I Z x .' DEEP OBSERYA4TION HC3I,E LUG ofb llepth from Soil'Honaon Sod Texture Soil Color Sail r (munWl) 'Willin- S - t Willing (tructurg,•Siones;Bouldeis: _ . e Oran ) .. ------------- DEE2'OBSERVATION HOLE LOG Hole#, b8pth firm Qott`HMzon, Soil Ttre a (Munseo Soil Other - Soil or Surface tn) A ) cldottli 9 (Structure,Stones,Boulders. QBSERVAI'IUN,H(dI E..LUG dole • Depth from_ : Soil:I oriWn Soil Texture: Soil Color Soil Other suriece(in:).. - (USDA) 0munsel[) -Mottling (Structu O;.Sfones,Boulders-. - - Flood'Insu"aae,Rstc'Ma". "Aliuse500yanr':floodboundary 1Yo,„ Yea ___ 'Within 5oU ear bo :. .. q tnulary Yes within 100veai:flood-bound&ry Nd Yes - i.entd of lY'ataraitv:Occarrin =t'eriious Materiai" Does at least four feet`ot natui ally oociuring pervi at extyK�n all.areas observed throughout the area proposed forthe Boil absorption system? If not what is the depth ofnaturatly ocoumng pe us tnatetial? Ce"Meation n�7 I certify that on !j- Q((cite)I'liave p>isser3 the soil:eyaluatvr examinaiion approved by the I?eparanent of Envi tal Protection and that the:above analysis was perforated try me consistenrvidth the regwred: inmg cruse and expo' ee d embed in 31(},CMR I r019. p� Signature Date Q:,SEPnC+PERCFORM.DOC Commonwealth of Massachusetts Title 5 Official Inspection Dorm Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °f 30 Lancaster Way,West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way,West Barnstable MA 02668 September 25, 2012 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. Important:When filling out forms A. General Information on the computer, O (� y only the b 1. Inspector: key ke to move your cursor-do not Troy Williams use the return key. Name of Inspector Troy Williams Septic Inspections Q Company Name 19 Hummel Drive Company Address South Dennis MA 02660 Cityrrown State Zip Code (508) 385- 1300 S1682 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 16.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority S �, �,ka.....` September 25, 2012 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. /3 t5ins•11/10 TiUe 5V.Iecmon form:Subsurface Sewage Disposal System•Page 1 of 17 � a. f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments "< 30 Lancaster Way, West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way, West Barnstable MA 02668 September 25, 2012 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: System meets minimum standards set by Massachusetts DEP at the time of inspection only.This inspection is not a guarantee or warranty on the future working conditions of leaching, pipes, components or the future structural integrity of said components and only represents conditions found at the time of inspection only. 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): N/A t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 30 Lancaster Way,West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way,West Barnstable MA 02668 September 25i 2012 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 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): i ❑ 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): N/A ❑ 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): N/A 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: h ❑ 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 9 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form•Not for Voluntary Assessments °l 30 Lancaster Way,West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way, West Barnstable MA 02668 September 25, 2012 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: N/A 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 %day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 or 17 Commonwealth of Massachusetts Title 5 Official -inspection Dorm Subsurface Sewage Disposal System Fong-Not for Voluntary Assessments �Y 30 Lancaster Way, West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way,West Barnstable MA 02668 September 25, 2012 page. Cityrrown 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- 101000gpd. ❑ ® 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 a1arge 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•11110 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 s 30 Lancaster Way,West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is 30 Lancaster Way,West Barnstable MA 02668 September 25,required for every 2012 page. Cityrrown 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? ® El available 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): 5 Number of bedrooms(actual): 4+1 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 550 gpd t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °< 30 Lancaster Way, West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is 30 Lancaster Way,West Barnstable MA 02668 September 25, 2012 required for every _ P page. Cityfrown State Zip Code Date of Inspection D. System Information Description: I i I Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): private well Detail: Well is 150'from leaching. Sump pump? ❑ Yes ® No Last date of occupancy: occupied . Date CommerciaUlndustrial Flow Conditions: Type of Establishment: N/A Design flow(based on 310 CMR 15.203): N/A Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): N/A 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: N/A t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 , Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 30 Lancaster Way, West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner owner's Name information is 30 Lancaster Way,West Barnstable MA 02668 September 25 2012 required for every , page. Cityrrown State Zip Code Date_ of Inspection D. System Information (cont.) Last date of occupancy/use: N/A Date Other(describe below): General Information Pumping Records: Source of information: Last pumped in 2008 per info from owner. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system rP 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-11110 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °f 30 Lancaster Way, West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way, West Barnstable MA 02668 September 25, 2012 -- 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: Tank, d-box and leaching were installed on 5/3/97 per compliance. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): . 18" Depth below grade: feet Material of construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: N/A feet Comments(on condition of joints, venting, evidence of leakage, etc.): Lines were found clear at the time of inspection. Septic Tank(locate on site plan): 18"with riser to 6" Depth below grade: feet Material of construction: ®concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 6'X10.5'X6' 1500 gallon Sludge depth: 4" t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewege Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ° 30 Lancaster Way,West Barnstable M-110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way,West Barnstable MA 02668 September 25;2012 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 2,8° Scum thickness none Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? probe/measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pvc inlet and outlet tees were found present and in working order. No evidence of leakage or damage was found. Tank was not in need of pumping at this time. Grease Trap(locate on site plan): Depth below grade: N/A feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): N/A Dimensions: N/A Scum thickness N/A Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A Date of last pumping: N/A Date t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< 30 Lancaster Way,West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way,West Barnstable MA 02668 September 25, 2012 page. Cityrrown 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.): N/A Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: N/A Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): N/A Dimensions: N/A Capacity: N/A p gallons Design Flow: N/A 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.): N/A *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11/10 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 30 Lancaster Way,West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way,West Barnstable MA 02668 September 25, 2012 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 level 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 found level and in working order. Flow to both pits was present. 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.): N/A Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 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 p 30 Lancaster Way, West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is 30 Lancaster Way,West Barnstable MA 02668 September 25, 2012 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ® 2-4'X6' pit with leaching pits number: 4'of stone ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pit#1 was found with little water present with a visible stain line approx. 2"from the bottom. No evidence of hydraulic failure or problems in the past were found at the time of inspection. Leach pit#2 was found full with water level below inlet invert. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration N/A Depth—top of liquid to inlet invert N/A Depth of solids layer N/A Depth of scum layer N/A Dimensions of cesspool N/A Materials of construction N/A Indication of groundwater inflow ❑ Yes ❑ No !Sins-11110 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 °Y 30 Lancaster Way, West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way, West Barnstable MA 02668 September 25, 2012 page. Citylrown 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.): N/A Privy(locate on site plan): Materials of construction: N/A Dimensions N/A Depth so th o f solids N/A Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/A t5ins•11110 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Forums Subsurface Sewage Disposal System Form-Not for Voluntary Assessments I 30 Lancaster Way, West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way,West Barnstable MA 02668 September 25, 2012 page. Cityr 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: ® hand-sketch in the area below ❑ drawing attached separately v��cr .�S U`jam,-., 1 w��•,�N� O 3 �.� d )L y _ 0 P' 4- l t5ins•11/10 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 30 Lancaster Way, West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is 30 Lancaster Way, West Barnstable MA 02668 September 25,required for every 2012 page. Cityrrown 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: 20.0'+feet Please indicate all methods used to determine the high groundwater elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed. 3/9/93 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: SDW 252 Zone B 47.5' 2.4'adjustment You must describe how you established the high ground water elevation: Test hole recorded on plan showed no water found at 14.0'. Hand augered 4'below bottom of leaching with no water found at a depth of 13.5'. Groundwater adjustment at the time of inspection was 2.4'. Bottom of leaching at 9.5'was found not to be located in the high groundwater elevation at the time of inspection. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments I "f 30 Lancaster Way,West Barnstable M- 110 P-004-010 Property Address Maureen Dunn Owner Owner's Name information is required for every 30 Lancaster Way,West Barnstable MA 02668 September 25, 2012 page. Cityrrown 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 I t5ins•11/10 Title 5 Official Insp ection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE LOCATION LoT 9 (Ancml e Qtwi EWAGE # VILLAGE A QY) SWL'e ASSESSOR'S MAP & LOT i INSTALLER'S NAME & PHONE NO.� -O 5-.4 _ SEPTIC TANK CAPACITY I S-©O gcC l LEACHING FACILITY:(typea V'[Ts (size) �cet. sfone NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER` . BUILDER OR OWNER A CAv DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: S- 3 Q 7 VARIANCE GRANTED: Yes No A C,� w . 1 o d OWN OF BARNSTABLE LOCATION Lc I G L n Te bu/ EWAGE # fv3� VILLAGE ASSESSOR'S MAP & LOT 0/0 INSTALLER'S NAME & PHONE NO. gg,, C'1-UQ !S��Z -O c-� 0 SEPTIC TANK CAPACITY LEACHING FACILITY:(typea PI TES (size) reef- s�-UhC NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNERREFI:; 4CA (, DATE PERMIT ISSUED: 3 -.2 Q - 9-�- 'DATE COMPLIANCE ISSUED: S- -3 s 4 7 VARIANCE GRANTED: Yes No '- �� � _ o � � . � � �• f No......... :..�� Fes$..../ t,19 ®. ...... THE COMMONWEALTH OF MASSACHUS T y BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiott for Ui_rpoottl Works Tonotrur#inn. Fautit Application is,hereby made for a Permit to Construct (�j) or Repair ( ) an Individual Sewage Disposal System at: �.30 �ANCAS SIL A-1w 6An,� ) A5SEs5 ptiS �p110_..._. : ... . _. LocationA res ................. ... ^ 1 � � ._..-Owner ddres fl t - - - ----_------- h �d�sl d Type of Building fix Size Lot..3 6' L y Sq. feet fi'- - ..._.. V Dwelling—No. of Bedrooms.......... ...---••---•-•-----------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ---------------------------- No. of persons.-.._...---- _------------- Showers ( ) — Cafeteria ( ) QOther fixtures --------------------------------------•---------------...-•----------------......------. -----------•----.........----.............--...........••.... W Design Flow........... ..........................gallons per person per day. Total daily flow..-.......S SD....._.........._.... 11�s WSeptic Tank—Liquid capacity-_- :00-gallons Length---1- �-._._-_- Width..la�_------ Diameter-------------_. Depth.....'.£_... x Disposal Trench—No. .................... Width....-...----------.- Total Length.................... Total leaching area..._...............sq. ft. Seepage Pit No. T!4�0........ Diameter-----1.1.�....... Depth below inlet................ Total leaching areaJ1,T .1!rl�t.sT.4t:- i Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Resul Performed by.._._'C DNm /Y)C L.- .1AOw Date....__�._'.�._� ............. ,4 Test Pit No. I.OZ. .L---minu es per inch Depth of Test Pit---15 6..._.._. Depth to ground water...l.11VAle------- fr4 Test Pit No. 2....z------minutes per inch Depth of Test Pit..- Depth to ground water../V)/.!!�... _ aV........... ----------------------------------"•-'--.......--••'--'------ O Description of Soil.....0.!.2q.....T-af •-Sd. .....Li -- IM....S!.L l... .1 ..S -------!07-__15.6 5!1 r M�-p....S.4A_V7..........V_1-......Q.' 3� r4 $V3 30--.a`f.'' St i,Y7 1 -•�r°N?:7a:' ........................ ------------- ---------------------------------------- -------------•'----••---------•--•---•-•--.....-------------------•------ U Nature of Repairs or Alterations—Answer when applicable.................. ............................................................................. ---------------------------'--•-----.....--.---'-.------•-----..........._..---••---•--•--•••'-'•-'...._--•-•--•--•••--...........-----------.......--•-•--•................--•--..........._......---- Agreement: ` ` The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to placF the system in operation until a Certificate of Comp ' ce n is ed he o rd of G Signe � .- ....... .... .. .. ........... ._......- .. ......-...t_w :.._..Application Approved By ..... ----v��------- ..... -- ----�--- -- -3— ` — ---- ................................... ...... -Date Application Disapproved for the following rear s: ------------ --------------------------------------------------------------------------------------------------------------- ...... ..... .................. . ......... Date Permit No. � --� .................. Issued ...........5.....y ,. .. Date fir, 4THE COMMONWEALTH OF MASSACHUS TTS( BOARD OF HEALTH .. I TOWN OF BARNSTABLE ` Alip iratiolt for Ubj i tl Workii Towitrurt"ton 1hrutit Application is herby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: .......(...4_ ..... _._...� A N GIB ST 2 �vA'1 � �3 A /� A'Ss Q S p(U MA p !1-D P�aCJE .......................................................... ....... •-- ------ ----•- -----•-----------•-•----... Location-Address orkLot No, Owner \ Address �, I`-•---"----_-_-- Wit ---�..1I Z --..:.... �;-- ...... �_ 'mot L yt Cc, j�7� /L�da, ss�"<'`" " b/ It6al er d Type of Building C� Size Lot_-3.z.4 4__._..Sq. feet Dwelling—No. of Bedrooms________..______________________________Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) 04 Other fixtures _______________________________ ___ W Design Flow.......... __________________________gallons per person per day. Total daily flow_._________r�___51_C.�____.__..___._____gall ons. WSeptic Tank—Liquid capacity.I5(�0_gallons Length---i_I---------- Width__G{.__----_ Diameter---------------- Depth_. E .1.. ` x Disposal Trench—No. .................... NAidth.................... Total Length--------_........... Total leaching area...... ............sq. ft. Seepage Pit No...Dw0--------- Diameter-----LI..-------- Depth below inlet...... .......... Total leaching area.11as.{a/l2.sq:ft:. z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Res m Performed by.-___-T_H� t�--_m_-- t-�C�y` .__. Date...... t Test Pit No. 1_l? 1 minutes per inch Depth of Test Pit___1_�-�......_... Depth to ground water.... Test Pit No. 2....:?-______minutes per inch Depth of Test Pit--- Depth to ground water_.fVU./I ........ R+ .................. ."---------"""...-"-""-•...........................................•-----....------------------------------...........--••------..... O Description of Soil.-- Z Z SAL)2.............................. K"-"1-J"- .-_ _ .-""S.S� -.5f v /'1 �? S�..n .. `a7 -.-I F> . ........ S-�n'2..""----------------•"••-" ........................... --"---------------------- --•--""-"-------------------"-------------•-•-•---•--"--------.........U Nature of Repairs or Alterations—Answer when applicable................................................................................................ -•----....-"•.................."---"--"--""""-"------------"-"-"-"-"-----•----------....._.....---••----..._..------------------...-•--•-•------------•------........_..-----•--•-..._.........._....--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. ne Sig u _ .... ...... (>� .... �� y f ! � � Date ---. .� = � 9 3 .: ..�S .... Application Approved By - );" / y... ,/ !Date Application Disapproved for the following real n.f-, ------------------------------------------------------------------------------------------------------------------------------------ - - - ---------------------- ------------------__------------------................ Date Permit No. �15-------.-`U3..�---------------------- Issued ------------s....�1�... .--...--.... ---- Dare --------- --------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (�ex#ifiratr of Tompliance _THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( !/) or Repaired ( ) by 1 ' l c 4 d` c t;t4 c i t o r )f - --- . -- �----- ---- -- - --- � y / la.Iler ---. at - f f '.'..T__-.�-�<L_?r'"c �c" '.- / .� ---'/.- c -_KCv11 % y • r� ---�..------------ ------------------------- --- uP t� has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as`described in the application for Disposal Works Construction Permit No. -�z .-lCa�' _--------------- dated .. .� THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARA TEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. C � t DATEr - - Inspector -_. -'�, � -C-GG- - `- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH '_/�34 TOWN OF BARNSTABLE FEE........................ Dispopttl_ orkii Tonitrurtion "motif Permission is hereby ranted : ..................................... to Construct ( ✓)1-1 or Repair ( . ) an Individual Sewage Disposal System at No.z:�2:!..,F r! /F'd J F ' fz={ f'�,f'- -- ---`- ----- --/--� Street r as shown on the application for Disposal Works Construction Permit No___ -i_____ _6 Dated_____- _..._.._........ ....................................... --------------------------------------------------------- oard of Health DATE---........................-................................................... FORM 36508 HOBBS 6 WARREN,INC.,PUBLISHERS -004 --0/0 No. - - ` --- Fee--- -- ----------- BOARD OF HEALTH TOWN OF BARNSTABLE Application-*r Melt Con5truction-Vermit Ap lica ion is her by made fo a permit to Construct ( Alter ( ), or Repair ( )an individual Well at: Location Address Assessors Map and Parcela ---------- _ O er Address Installer — Driller Address Type of Building n�� v Dwelling- - -- /C --------------------- 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 Certifi ate .of is s been issued by the Board of Health.. f �/c Signed - - --- - - - �- --- - --- ate-- -- 11 Application Approved By- - --�'-- — - --- -------------- date Application Disapproved for the following rea s:----------------------------------------------------------------- -- - - ------------ -- - — - — ---_ _ - - --- - - - - -------- ----- __— date ..a --_ —-- Issued--- �1 � ------ ----------------- Permit No. --- — ----- ade BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Comp[iance THIS IS TO C>ERRTIFFYY, Th the Individual 'Well Constructed ( ), Altered ( ), or Repaired ( ) bY--------- - ----------- -------------------- ----------------------------- --- --- --_ staller at- ---1 � � �- -- - t- ®-----------------------------------------------------.--- has been instalfed in accordance with the provisions o the Town of Barnstab a Boaro of Healt rivate Well Protection Regulation as described in the application for Well Construction Permit No. _- -t'"`---- -Dated------------------------ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- - - - —-— - - -— --—- Inspector-------------------------------------------—-- ----------- —'Y � icy„�r'�✓.6+i �1 •. fe$ ....re.��\ � � � �s00 4 --©1DA. No ---- - Fee---- -- - - BOARD OF HEALTH TOWN OF BARN STABLE A 0[ppticat ion-*rWell Cootruct ion Permit Ap lication is her by made fora permit to Construct (�'f Alter ( ), or Repair ( )an individual Well at: --- - --- --=------------------------------- ----P -------------- -------- -------- Location A -----ddress Assessors Ma and Parcel ------- -------_ _--- �'�- .`'�---1�- '^ ------------------ O er Address 1 -!_------------------------------- ---- -------- ��----------- Installer — Driller Address Type of.Building ��/ !!! Dwelling-------v---- - �1`" --------------------- Other - Type of Building---------------------------- No. of Persons------------------------- r 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 Certifi ate .of lia s been issued by the Board of Health. Signed - - - -n = - as �------ —- - -�--- 0 ate Application Approved By -` date Application Disapproved for the following rea s:-------------------------------------------------------__—__—_________ — ----_ — _— - — ------ - - --- -- - - - -- --------------- date .a -- Permit No. ----- ----------- Issued------ ` -- �--------------------------- da& BOARDTO.F H'EALTH�_. TOWN OF BARNSTABLE Certificate (Of Com0riance THIS IS TOy�CERTIFY, That the Individual We Constructed ( ), Altered ( ), or Repaired ( ) by--------- 1 F0. - --------- --- -------------------- - - -- —--- - --- - - ftaller ------ --- -- --------- ---- --- ----- has been insta ed in accordance wifh`�the provisions oxv, Town of Barnstab a Board of Healt rivate Well Protection Regulation as described in the application for Well Construction Permit No. Q � 4--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 Ver[Iton5tructionPermit ` No. --;--------- Fee-- — ---------- Permission is hereby granted- ► 1__l -------------------- -------------------------------- to Construct ( ) lter ( ), or epa' n�I. ividual ell t: No. - -- ------ I- - - - - -- —------- tr t as show jon�the I* or a Well Construction Permit No. ------ -- ------- = - D _— - - --- - ''- Board of alth DATE---- - - —_-- ---- =—— - N; F: 301. S:15 R. 15, FLOOD ZONE:_ C AR CI 4 :OCATION MAP � � ` — — — — — 106 LOT 9 S.F. - ' �0.70 ±AC.) _ _104 104 G — x1b — \ UTILITY CLUSTzR r / - - T E PROPOSED 178Lh, 88 YI RK AT p ' ' , ' , ' , ' , ' \ 'Be oLff 88.4 r i ' ' ' ' ' \ I 82 84 1. S ' ' ' , ' ' . - � -76 l 88 / 86 PO�S2'D i7B'LL / ' � i � ' ' • , ' , 10) ep, j 82 i i i / . AO 80 76 78 i 74 78 70 � J / 68 66 ING CONTOUR: SED CONTOUR: .............................. ING SPOT ELEVATION: 25S ED SPOT ELEVATION: 25 OLE: POLE: —O— LI NE: • 4 xrT ,1 MAR-31-95 FRI 16 :43 ENOVIROTECH LABS 508 888 6446, P. 04 VIROTECH LABORATORIES, INC. E� MA Cecc.No.; M-MA 063 449 Rce. 130 Sandwich,MA 02563 r (508)888-6460 - 1.800339-6460 FAX(508)888-6446 CLIENT: Reef Realty LOCATION: Lot 9 P.O. Box 186 Lancaster Way W. Dennis, MA 02670 W. Barnstable, MA SAMPLE DATE: 3-28-95 COLLECTED BY: Clifford Well Drilling DATE RECEIVED: 3-28-,95 TIME: 4:OOPM LAB I.D. NO. : E3-420 JOB TYPE: New well SAMPLE I.D.NO. 9 WELL SPECS.: 941 RESULTS OF ANALYSIS: Parameters Units Recommended Limit Result Coliform bacteria/100m1 (MF Method) 0 0 pH pH units 6.0-8.5 5.90 Conductance umhos/cm 500 98 Sodium mg/L 28.0 9.7 Nitrate-N mg/L 10.0 0.35 Iron mg/L 0.3 0.06 Manganese mg/L 0.05 0.007 Volatile Organics See enclosed report. EPA 601/602 ug/L None detected. COMMENTS: Low pH indicates high corrosive characteristics. Yes No WATER IS SUITABLE FOR DRINKING PURPOSES FQ# PARAMETERS TESTED. XXX U-Tt Ronald J. S96ri Laboratory Director LT = Less Than MAR—art^95 F 16 : ENVIROT9CH_ LAB�-____-„ 508 888 6446 P. 05 ':!------- =-------------gA_.-- SOS 7aa 4475:# 6/ 7 3-31-25 3:52 PN1 :1RCUNAWATER ANALYTICAL SNVIROT6CI; s GROUNDWATER ANALYTICAL Epp METHODS 401 and 602 Volatile Organics (GC/PID/ELCD) Lab ID: 10297-04 Field ID: E3420 Batch ID: VG2-0584-b Project: deaf/Lancaster Sampled: 03-28-95 • Client: Envirotech Received. 0329 95 Cont/Prsv: 4OmL VOA Vial/NCI Cool Analyzed: 03-30-95 Matrix. AqueouS CONCENTRATION REPO RTING(�9/L� PARAMETER (ug/L) 5 Dichlorodifluoromethane BRL 5 Chloromethane 5 Vinyl Chloride BRLBRL 5 Bromomethane SRL 5 Chloroethane 1 Trichlorofluoromethane BRL 1 1,1�-Dichloroethene BRL 1 Methylene Chloride BRLBRL 1 trans-1 2-Dichloroethene BRL 1 11 1-Dic loroethane BRL I cis-1,2-Dichloroethene 1 Chloroform BRL 1 1,1,1-Trichloroethane BRL 1 Carbon Tetrachloride BRL 1 Benzene 1 1,2-Dichloroethane BRLBRL 1 �Trichloroethene 1 11 2-Dichloropro ane BRL 1 Bromodichloromethane BRL 5 2-Chloroethyl Vinyl Ether 1 cis-1,3-Dichloropropene BRLBRL 1 Toluene I trans-1,3-Dichloropropene BRLBRL 1 1,1,2-TrichloroethaneURL 1 Tetrachloroethene BRL 1 Dibromochloromethane BRL 1 Chlorobenzene 8RL 1 Ethylbenzene 1 BRL meta-and Para-Xylene * 1 ortho-Xylene * BRL I Bromoform BRL 1 1,1,2,2-Tetrachloroethane BRL 1 1,3-Dichlorobenzene BRL 1 11 4-Dichlorobenzene BRL 1 1,2-Dichlorobenzene QC SURROGATE COMPOUND SPIKED MEASURED RECOVERY QC LIMITS a,a,a-Trifl 30 93 % 87 - 113uorotoluene 30 103 % 83 - 117 % 1.2-Dichloroethane-d4 30 31 BRL . Below Reporting limit. Non-target compound. Method References: Method 601 - Purgeable Malocarbons and Method 60.2 - Purgeable Aromatics. 40 C.F.R. 136• Appendix:A (1956). TOP OF FOUNDATION COVERS TO BE WATERTIGHT AND SEPTIC SYSTEM PROFILE Flaherty Environmental Services BROUGHT TO WITHIN 6" OF FINAL GRADE scale)EL. 60.0' EL. 58.0 (not to s INSP. PORT W I 3" OF GRADE CLEAN SAND P.O. BOX 81 2" of' to 1" DOUBLE WASHED EL.58.0t Yarmouth Port, MA 02675 4" CAST IRON or EQUIVALENT PEASTOWOR GEOTEXTILE �� 774.994.1166 O FILTER FABRIC MIN. PITCH 1/4" PER FOOT 4"SCHEDULE 40 PVC PIPE 4° SCHEDULE_40 PVC PIPE . . :. t VENT IF REQUIRED FLOW LINE (first2'to be/eve/) ° Ti c e L. 't _ 25' 1/0 5' 1% :e a .. . •.:•. : 4 ',•.�• .� ', •., . •. e b e —�. e e e e e e e ''...® . e C—I O O°O°OOOOC L.EXIST. 14, 0 0 0 0 0 0 0 0 0 0 0 EL.55.5' EL.55.25' 0°0°0Oo 0 0°0°000 �� ®� °°O0O°°°° EL.54.83' 0 00000 ® 0000 �•' ° o 0°0°0°°0°°0°0°°o G� © C� o d o c� o 0°0°00°0°c 2_0' EL.55.0' ° ° ° ° ° o ° o �aOr�c�LJ�Q. a Oo0°Oo0°° GAS BAFFLE EL.54,8' o 0 0 0 0 0 0 0 000°0°0°c 0°0°0°0°0° °0°0°0 .,°' 0 0 0 o EL.52.8' 0 0 0 0 0 0 0 0.5'CRUSHED STONE OR(H-20 D-BOX) SOIL ABSORPTION SYSTEM •v i 's; '•,,.'a., ,•:•°�' • MECHANICAL COMPACTION (4) 500 GALLON H-20 CHAMBERS 5_3' 1500 GALLON SEPTIC TANK WITH 4'STONE AROUND IN A (DATUM: ASSUMED) (EXISTING) ¢" to 1�" DOUBLE WASHED S ONE 12.83'W X 42.01 X 2'D CONFIGURATION EL. 47.5' BOTTOM OF TEST HOLE EL. 47.5' LOCATION MAP USGS ADJUSTMENT: N/A GROUNDWATER ELEV: N/A No TH 62 LOCUS L ,�a2b r 62 EXIST. 33. 60 15M GST TM_ GARAGE/ / EXISTING DEgC 9' C O 'v. NIS DWELLING V ., -`��{OF A14 ! PATIO 44.4' p� DA / � / 58 F E ,J 100, TO WELL D. 11 Gt -Ts s � 56 �AIY1T:,4t1 A LUT 9 TV\ 54 30,445 SFt � DATE.2/26/2018 REVISED: tps 54 SITE AND SEWAGE PLAN FOR D & B EXCAVATION, INC./ KATHERINE HUTCHMSON _ 30 LANCASTER WAY SCALE : 1 n = 40' WEST BARNSTABLE, MA REP PB 464 PG 96 PAGE 1 OF2 ..................................................................................................................................................................................................................... .. .................................................................. ................................................................................................................................................................................................................................................................................................................................................. GENERAL NOTES DESIGN CALCULATIONS SYSTEM DETAIL Flaherty Environments/ Services P. 0. Box 81 1. ALL PRECAST COMPONENTS TO BE H-10 Yarmouth Port, MA 02675 RATED. ALL COMPONENTS WITH ANY NUMBER OFACTUAL BEDROOMS 3(DESIGN FOR 5) 774.994.1166 ANTICIPATED VE FFI HICULAR TRA C TO BE H-20 RATED. GARBAGE DISPOSAL UNIT NO 2. THE DESIGN OF THIS SYSTEM DOES NOT ` ALLOW FOR THE USE OF A GARBAGE TOTAL ESTIMATED FLOW GRINDER. (110 GAL/BR/DAYX 5 BR) 550 GAL./DAY 3. MUNICIPAL WATER IS NOT AVAILABLE. REQUIRED SEPTIC TANK CAPACITY 1100 GAL. 4. ALL CONSTRUCTION TO CONFORM WITH 310 CMR 15.000 AND ALL OTHER SIZE OF SEPTIC TANK 1500 GAL.(EXISTING) APPLICABLE LOCAL, STATE AND FEDERAL CODES AND REGULATIONS. SOIL CLASS/F/CATION 1 42' — 5. INSTALLERICONTRACTOR TO REVIEW& VERIFY ALL ELEVATIONS AND DETAILS DESIGN PERCOLATION RATE <2 M/N./INCH AND REPORT ANY DISCREPANCIES TO EFFLUENT LOADING RATE a74 GAL./DAY/FTZ DESIGNER PRIOR TO CONSTRUCTION OR ASSUME ALL RESPONSIBILITY, LEACHING AREA O O O O 12 8 3' 6. INSTALLER/CONTRACTOR IS (2)x(42'+ 12.83)(29 =219 SF RESPONSIBLE FOR MAINTAINING SAFE 42'x 12.83' =539 SF WORK AREA, VERIFYING ALL UTILITIES 758 SFx a74 =561 GPD AND NOTIFYING "DIG SAFE" (1-888-344-7233) 72 HOURS PRIOR TO USE(4)500 GALLON H-20 CHAMBERS WITH 4'STONE CONSTRUCTION. AS DIAGRAMMED/NA 12.83'X42.0'X 2'CONF/GURATION 7. ANY CHANGES TO OR DEVIATIONS FROM THIS PLAN MUST BE APPROVED IN RESERVE LEACHING CAPACITY N/A WRITING BY FLAHERTY ENVIRONMENTAL SERVICES AND LOCAL BOARD OF HEALTH. 8. FINISH COVER OVER COMPONENTS IS NOT TO EXCEED 3'PER 310 CMR 15.000 (NTS) UNLESS SHOWN PER PLAN. 9. ALL ABANDONED SEPTIC SYSTEM COMPONENTS TO BE PUMPED DRY AND FILLED WITH CLEAN SAND OR REMOVED SOIL EVALUATION AND REPLACED WITH CLEAN SAND. ZH OF MAS TEST HOLE#1 P#15591 TEST HOLE#2 P#15591 S 10.ALL COMPONENTS TO BE PROVIDED Evaluator. David D.Flaherty Jr,RS,REHS Evaluator. David D.Flaherty Jr.,RS,REHS _ WITH WATERTIGHT ACCESS PORTS SE#2755 SE#2755 o A WITHIN 6"OF FINISH GRADE. BOH Witness: Don Desmarais,RS BOH Witness: Don Desmarais,RS Date: February 22,2018 Date: February 22,2018 F 1 E1 II.ALL SEPTIC TANKS, DISTRIBUTION 10 211 BOXES AND PIPING TO BE INSTALLED TH-1 ELEV.58.0' TH-1 ELEV.58.0' O/srEk� WATERTIGHT. 12.NO KNOWN WETLANDS OR WELLS 0--6- FILL 0%6- FILL SqN TARS N WITHIN 100 FEET OF PROPOSED (� LEACHING. Z 13,THIS IS NOT A CERTIFIED PLOT PLAN PERC AND UNDER NO CIRCUMSTANCES IS THIS PLAN TO BE USED FOR ZONING OR BUILDING PURPOSES. SITE AND SEWAGE PLAN 14.LOT IS SHOWN AS ASSESSOR'S MAP 110 6--126' C MS 2.5Y6/4 6%120" C MS 2.5Y614 certUy that on November 12,2002,I have passed FOR the examination approved by the Department of LOT 4-10. Environmental Protection and that the above analysis B & B EXCAVATION, INC./ 15.LOCUS PROPERTY IS NOT LOCATED has been performed by me consistent with the WITHIN AN AQUIFER PROTECTION G.W.ELEV.N/A G.W.ELEV.WA re3f0 CMR 15.0f8se,and experience descr/bed KATHERINE HUTCHINSON .30 LANCASTER WAY DISTRICT(ZONE II). BOTTOM TH->ELEV. 47.5' BOTTOM TH-2 ELEV. 48.0' WEST BARNSTABLE, MA PAGE2 OF2 MAP. 110 ASSESSORS ST HOLE LOGS NOTES ;4—io T E PARCEL: 1ERTIC. VERTICAL DATUM.. -ASSUMED FROM`QUAD (NGVD 1 s � ENGINEER: THOMAS McLELLAN P.E. _ 5- EN , 2. 11lUNICAPAL WATER IS NOT AVAILABLE. . CURRENT ZONING. RF WITNESS: WITNE DUNNING _ SYSTEM. , JERKY 3. SCHEDULE 40 4 PVC PIPE TO BE USED THROUGHOUT SEPTIC SY TE BUILDING 'SETBACKS. k DATE 3-9-93 & =-20 j PRECAST UNITS TO CONFORM WITH AASHTO H 10 H c1Y F. S. R. 15 4 ALL PR ST • _ , PERCOLATION .RATE. < 2 MIIN/IN & 6 MIN IN � LOADING SPECIFICATIONS.' S LOCU - _ _ ERWISE . . �. PITCH 1 4 PER FOOT ' UNLESS NOTED OTH -FLOOD ZONE.., C _lH 1 TH 2 5. PIPE PI .� _ . ( � 90.0 -9910- D BOX TO BE LAID LEVEL. ELEV: _. 6. FIRST 2 OF PIPE OUT OF TOP & ELEV. TOP & 7.-'.THE SEPTIC SYSTEM! HAS NO T BEEN DESIGNED TO ACCOMODATE THE :.SUBSOIL � SUBSOIL 96.5 8tr.0 , z4� so' o USE OF,A'GARBAGE DISPOSAL. SILTY I SILTY s YIN N ' !� E---- CONSTRUCTION DETAILS ARE TO BE IN CONFORMANCE WITH THE G 4 FINE FINE -8. ALL CON T SAND' SAND TAL CODE TITLE FIVE)-AND LOCAL foe- 81.0 84"> 9zo STATE of [ASS. ENVIRONMENTAL ( r - - f06 LOCATION MAP HEALTH REGULATIONS. ;. SILTY R OF ALL UTILITIES PRIOR . 9 - xE- ' 9. CONTRACTOR TO VERIFY LOCATIONS . : .LOT Frxa Fr S.F. � MEDIUM MEDIUM 50,446 ± _ z MIN/IN TO CONSTRUCTION. ' 090 + AC. _,fos SAND SAND -- CONDITIONS G EER TO INSPECT AND CERTIFY SUITABLE SOIL DI I • iD. DESIGN ENGINEER TO A :DEPTH'OF 4 BELOW LEACH PIT AT TIME OF CONSTRUCTION. _ fss" 7T A �s8" 8s.o . LOW 11. D-BOX;TO BE WATER TESTED TO ENSURE LEVELNESS .AND EQUAL FLOW. MODIFIED FROM .-104 12. SEPTIC .SYSTEM! AND,WELL LOCATIONS .HAVE BEEN MIODIF _ - _ HEALTH _ _ MASTER PLAN (REVISED 5 2 93) ON FILE WITH BARNSTABLE - - .. _ - - NO Ch0UND1IATER ENCOUNTERED GROUNDWATER ON LOT 5 AT ELEV.s"48J DEPT. ALL PREVIOUSLY APPROVED SETBACKS REQUIREMENTS REMAIN • IN-EFFECT.. 3 ; r o ...� - 104 - SEPTIC' SYSTEM DESIGN , .. .., � 1►ALK-OUT ,• •• .. - foz W ATE. . - ... .. DECK _110_ DROOM - GAL DAY sa � BEDROOMS AT GAL/DAY/BE �'S0 / t r .. .,102 PROPOSED \ SEPTIC TANK. , `� \ � •.... . . z4 5 BEDROOM d 550 S - 825 GAL DIIELLINc 5 UTILITY 'CLUSTER ,...• l • GAL/DAY 1.5 DAY z8� �+ GARAGE' USE GALLON :SEPTIC.:TANK _ o c► o ss' cos _ ..� _ foo LEACHING AREA. s OO o T f STONE PROPOSED DWELLING � .•.. � -. c`' ,. � � � USE 2 LEACH PITS (6 x 4) WITH 4 OF' T d _ 14 .AFFECTIVE DIAMETER x 4 DEEP) � 98 GAL DAY 9s_ _ ._. _ ,. � SIDE AREA. 1 x 4 x PI = 176 SF , (2:S) - 440 � _ D _ ,.... A. _ .0 154 GAL DAY �r � •.... _ � � 96 BOTTOM ARE x 7 x PI 154`SF (1 j � : TII f - - 94 TOTAL CAPACITY ,GAL/DAY 94. 7 � � � � � - 1188 GAL DAY �, � . s2 x 2 PITS � PROPOSED WE LANCAST ER �. o TION o , . SEPTIC SYSTEM S�'C 2 PEASTONE WAY o _� �l 8e 0 ' , i le 1 � 86 BENCHMARK AT 84 � OF 3 4" 1 1 ,2" MANHOLE \ 82 'WITHIN 12" ELEV. 93.4 . 6 99.0 COVERSWASHED STONE i 9z- g 78 , TOP OF FOUNDATION OF FINISHED .GRADE >, i 1 .CLUSTER , �UTILITY 9 � � , � 76 i f."5 i ✓ i 1 i EDGE OF PAVE , , , , r , o 70 , 88 . r 89:55 c�o ELEV. BOX 4 , 68 89.8 D 1500 GAL 8s I 89.08 ' , ., � ELEV 89.25 ' . SEPTIC TANK ELEV. 84.5 PROPOSED WELL � : , � �S ELEV. ,---+ —♦ELEV. .(LOT' fo) 84' , � ►• d, EL , � 1 / 4 / 4 . � � ll .t, TEE SIZES: 88.5 90.0 82 , -- � -� � - t�, _ INLET: 6" UP 10" DOWN ELEV. 14 80 . .' ' � � � c / ELEV. r DOWN LEACH PIT 6 x 4 WITH 78 7s � � � �. OUTLET. 6" UP, 19" ONE ss UNDER ;; , ) _ ( 4 OF STONE (14 EFF. DI". x 4 DEEP):(H 20) 74 72 , BASEMENT _ 70 BREAKOUT CALC. (89 68)/134 x 150 24 68 i / 66 SITE AND SEWAGE PLA N APPROVED BY. DATE: KEY: OCA ION EXISTING CONTO UR: L T CONTOUR: LOT 9 LANCAST ER WAY :PROPOSED T .ION.. ,. EXISTING SPOT ELEVATION.' 25.5 a. . : WEST BARly'ST ABLE. MA PROPOSED SPOT ELEVATION. 25 TEST H y OLE. i L PREPARED FOR- -0- UTILITY .0 h .POLE: c LINE. FENCE REEF .REALTY -� _ HYDRANT r _ . _ 1" _30' DATE. 3 18 95 McLELLAN ENGINEERING SCALE.. RETAINING WALL. DEYAREST RETAI � .t 24 SCHOOL_STREET P.O. BODY 463 PLAN BOOK 454 PAGE 96 . _ , REFERENCE: DENNIS, ASSACHUSETTS 02670 wasT JR P.L.S. DM # 93-02T THO�IAS Mlci,ELLAN PE-] JOHN Z.'DEMAREST ., > s f