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1503 ROUTE 149 - Health
1503 Route We' wBarnstable a.y -- - � A= 105: ����x �. � '�� ,•' is ` ,�, R Town of Barnstable P# ! 5 a b ' Department of Regulatory Services MASS. �� Public Health Division Date 3 a 16.19.A� ; 200 Main Street,Hyannis MA 02601 Date Scheduled Time Fee Pd. Soil Suitability Assessment fog- Sewflore Dispos l p� I + G . �S Performed-By:_I"t I C k cw-1 �►ylpr3.�k�I �T} eSC Witnessed By: v () W. LOCATION&GENERAL INFORMATION Location Address ( .5 d3 RZVTC [ W e�c Owner's Name QQAI - C— OY-rL _ 1/� Address 1503 RT I q-T UJ C3j Assessor's Map/Parcel: 10 5 �Fp�wcoc t✓Fplua,"SGS Engineer's Name IC Ci�@lr`.' 1'C t1G3Ce NEW CONSTRUCTION REPAIR x Telephone# 5,610 -4-I l- 82'-rt . 08-273-0377 Land Use I n. le c% -i1 n 1(vl Slopes(%) �-� Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well - ft Drainage Way - ft Property Line > ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands•in proximity to holes) r . t� Parent material(geologic)_-0I.0'tzlas Depth to Bedrock y 1 5"6 �1 A� Depth to Groundwater. Standing Viater in Hole: 7 I SG. Weeping from Pit Face 71 Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: jb1UJ ibSe"At-DA Depth Observed standir.g in obs.hole: -7z I Sid In, Deptlt to soil mottles., .:? In. Depth to weeping from side of obs.hole: `a 1 S'R ' in, Groundwater Adjuatment Index Well# Reading DEte: Index Well level Arj.&&tor, �-� Adj,droundwater Level,,,,, PERCOLATION TEST Date Thne,.�,�, Observation Hole# Time at 9" Depth of Perc Time at G" Start Pre-soak Time @ Time(9"-6") rS�e Pecs �+es x P� ��, a�e End Pre-soak F+•. 'L;# 10•-14- ��.0�1 �ile w� aur�nslci�i�. QC� Rate Min.nnch Site Suitability Assessment: Site Passed Y S Site Failed: Additional Testing Needed(YIN) Original: Public Health Division ` Observation Hole Data To Be Completed on Back---------- y ***If percolation test is to be conduc iad within 100' of wetland,you must first notify the Barnstable Conservation Division at lean°t one(1)week prior to beginning. Q:\S EPTIC\PERCFORM.D OC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Still Color Soil 0t7rer Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. onsistency.96•Gravel) I3"-301' 6 LS I Yv MI6 '30''-60 G-1 S Loom, '.,SY 61,& fib'=1.'�-`' ���, M-P S-.nJ 9,5-` gh DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color. Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o is en %Gravel) DEEP OBSERVATION HOLE LOG Bole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. C-onsistency.%Gravel) DEEP OBSERVATION HOLE LOG hole# Depth from Soil Horizon Soil Texture Soil Color Sol] Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Slopes;Boulders. Consistency, y Flood Insurance Rate Map: Above 500 year flood boundary No— Yes , Within 500 year boundary No V/1 Yes Within 100 year flood boundary No.✓ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? l/P"Ic If not,what is the depth of naturally occurring pervious matariall Certification I certify that on 1 C a (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training, p ti and a perie a escribed in�10 CMR 15.017. Signature 4 Datt 1 Q:).S.EPTICIPERCFORM.DOC TOWN OF BARNSTABLE LOCATION 15 03 ROUTE r q9 SEWAGE# Z16 �41,LAGE WEST eAAQ JbL6 ASSESSOR'S MAP&PARCEL l®5104P INSTALLER'S NAME&PHONE NO.CAMW ID6 64rr6EWS:69 SEPTIC TANK CAPACITY t a'506 LEACHING FACILITY.(type)(3) %00 q 4j- Cd4 (size) NO.OF BEDROOMS- - 4 OWNER PERMIT DATE: '' I COMPLIANCE DATE: 3® " o Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility. N A Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) NIA Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) tv 1A Feet FURNISHED BY � r z ^ � `lea 1 z A csu 10 o o LALO a 9 1.01O No. Fee 15410 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pphratlon for Misposal 6pstem Const urtlon Permit Application for a Permit to Construct( ) Repair(k Upgrade( ) Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. 1563 RT 149 We) Owner's Name,Address,and Tel.No. C.R0bCZ__ LY 7 4-6 Assessor's Map/Parcel 10 p dam( ',To q WEST p4) C.;;* Installer's Name,Address,and Tel.No.So?.-q-t7-82_71 Designer's Name,Address,and Tel.No. SOS-24 3-4cs377 641gw%t D a;-� cij is-C Tc- et emeY-_� _ Type of Building: f Dwelling No.of Bedrooms /Y Lot Size G(ot 3 sq.ft. Garbage Grinder( ) Other Type of Building R ea 6D&VT i (, No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) d gpd Design flow provided gpd Plan Date 3- !- l? Number of sheets ( Revision Date Title f c<L'O?S Ryur� 1Y9 /� Size of Septic Tank (500 C—c-�� Type of S.A.S.T�, goo C l ( Description of Soil Al en LA15V 1 e O u PGiI!4) Nature of Repairs or Alterations(Answer when applicable) hj — b fST'`k �$ (,.40 -0c-ftLs 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 Board of Healt . Si e Date 1 Application Approved by Date 3 Application Disapproved by Date for the following reasons r Permit No. / / ��5 Date Issued No. �� V✓ ► _ Fee �0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01ppYitation for Disposal 6pstem Construction Vertn't Application t n pp for a Permit o Construct( ) Repair(�j-� Upgrade( ) Abandon( ) ❑Complete System ❑Indtvidual Components Location Address or Lot No. 1563 RT 149 W„„ Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel 1 d S 009 t 1303 jtT 149 WEST ?W10ST"G115, In taller's Name,Address,and Tel.No.SO'&-q77_ 8 TT Desi er's N me,Address,and Tel.No. SOS-a-?'3-037'� 40i w t D &T1j*X1A(G1C -=uL S_r Type of Building: f Dwelling No.of Bedrooms Lot Size &(01 3V sq.ft. Garbage Grinder( ) Other Type of Building RG&ID&Vr 14(., No.of Persons Showers( ) Cafeteria( ) Other Fixtures UL Design Flow(min.required) '/` rd gpd Design flow provided gpd Plan Date 3- I- l'7 Number of sheets Revision Date Title 1563 R o u)m tog / Size of Septic Tank 500 G4U-00) Type of S.A.S. ( ,�j �G� C_06£c-t J Description of Soil a,em F I k)45 �f�� (� (70 /5c`a;- PC" Nature of Repairs or Alterations(Answer when applicable) USA bx/SreM& ISCV CZ46(,,aO -�Z- Tb A26W 9-a 0 ID`80K -to (a) Soo 4*4-L,00 tf-a 0 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 Board of Healt Si ed Date 3 Application Approved by Date 3 Application Disapproved by Date for the following reasons Permit No. C� 0 5 ems'-'- Date Issued ---------------------------------------------------------------------------------------------------------------------- -------- ------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO C RTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( � Upgraded( ) Abandoned( )by PP,Q l DE en.3j AL,98:5 at I/1,( has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit N6�Cl 7` �S 1 dated 3 /�// Installer Designer �Gt1eS�<�UG- #bedrooms f Approved design flow J� L�L�0 gpd The issuance of his p rmit shall not be construed as a guarantee that the system it fund ion as designe . Date 311 (� Inspector A -------------------------------------------------------------------------------------------------------------------------- - No. c " Fee ,,c 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal �6pstem Construction Permit Permission is hereby granted to Construct( ) Repair(( Upgrade c Abandon( ) System located at ! ® AC7(/TC 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 in st b completed within three years of the date of this permit. Date 7j / ( / 7 Approved 43/09/2017 17:06 5082730367 15364 P. 001/002 Town of Barnstable Regulatory Services �n�eHErre�c,�. Richard V. Scali,Interim Director 6 MAM Public Health Division 01 Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-962-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: 3-9-� Sewage Permit# aAOf-7—o5s; Assessor's Map\Parcel Designer: SC _o tOcertn ' T11C,. Installer: Qaujiaf- t�4�c�cis Address: 2 e 5`ICTAr1b-fXf i h wa Address: 153 Co,�;�., Trask LuarfAftaoiIHA az53$ HGs �e, N(� o2ioy9 I On 3- I - a of CQee,,d& ErAt+ce([ was issued'a permit to install a (date) (installer) septic system at 1 6 3 goufIt 1 y 9 based on a design drawn by (address) —S C ae.c i dated )4 a,166 1 , 20 17 / (desig er V l certify that he septic system referenced above was installed substantially according to the design, w ich may include minor approved changes such as lateral relocation of the distribution b x and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that he septic system referenced above was installed with major changes (i.e. greater than I ' lateral relocation of the SAS or any vertical relocation of any component of the septic stem) but in accordance with State & Local Regulations. Plan revision or certified as-bi ilt by designer to follow. Strip out(if required)was inspected and the soils were found s isfactory. I certify that 1he system referenced above was construe nce with the terms of the 1 A approval letters (if applicable) o � JOHN L os CHUR ILL JR. VIL (Ins lEeigrat N .41 A PL Asigner's Sig iat (Affix 169igne s St mp Here) AS RETURW TO BARNSTABLE PUBLIC HEA H D S N. CERTIFICATE. OF COM.PL ANC ILL NOT BE ISSUED UNTIL BOT11 MIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PURMC HEALTH DIVISION. THANK YOU. QA$epdc\Designer Cenifics ion Forth Rev 8-14.13.doc LOT 1 ryy � a a ; A a ix} // -M ,p0 LOT 9ti��} •'� r N382203"WDw n• 6'533� r t tt x Cora •( ` Ml 4 LOT 3 : E Y x Y 4 Res zON Tni$ +IOTE INPEOTTON Pian u; 1'ar FLO©t1 ank Use onim. T01 �fABT f $' REGISTRY OWNE2- . ,?R�GIf4:.L_ N�1Qi9 QG9 _.SCALE:1 50 .` r : � E 'A�i� d�, � Il; �u�LnlriG ��► �� YsANKE - SST 1 IONDN THIS1N IS LOCATEDN TI3El GRUtIND 'ASS 4 CONSTLTAI�TTS fY SHO. RM PAtIR 4 'Q THE; ZDNIN y3� SE'TBAGK'REQUIRE TS OF THE x 4�H '(SMITE i} 'OWN OFY �����Z� _�. rAND THAT �HDUSTRY �tOAII� �: 'tD0F5 !} I,TEI`I'IiNx 'HES SPECIAL FI�OD HE►ZARA ' �[ARSTONS' Z�ILLs MA A�84s .} IO fN THE H U:D kIAP DATE'D ,�BS 42$=0055 T 250001 0015 C --FAX...: r49,n 553. THIS PLAN NOT`MADE 'FROM AN I_,STRU' NT 25539 DAF' AI1L..`- M i __ ____ _ SUB Y NO TO U E FO _ : C LEFT 51DE ELEVATION 21'-6 1/2" 1'-011 3/4'x9 '/2' LVL 9'-9 1/4" 9'-9 1/4" Ider above unit, FZ502 FYVG 12068-4 I © I I , � IIII I� I � C14 6'-5 314"---', � IIII = co w - - � IIII rn 3 � oNr -�Ilil I I I v ' (V � I 4xb post up ---------- EXISTING 5TUDY 11 II II FLOOR PLAN Scale; 114"=1'-0" - TOWN OF BARNSTABLE / LOCATION /,.S 10 3 ILI 9 SEWAGE # '9 VILLAGE Gt/+ P&"' /e ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY / c d Sa/ LEACHING FACILITY: (type) I..✓l;L 7A,l/kill (size) S NO.OF BEDROOMS— , BUILDER OR PERMTTDATE: /U'Z '"°� COMPLIANCE DATE: /O— 30'9 0' Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r - (Are r- 1 � 0 AI 1 TOWN OF BAFNSTABLE e LOC ON ®3 21 S &qGE #e n r J VII.I,.A A-S E R & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY is o (1 Ia/ LEACHING FACELITY:(type) I M'1-1 L MA&RS (size) NO.OF BEDROOMS,/ BUILDER ORq9 PERMITDATE: rU'Z 7 _ COMPLIANCE DATE: /O— 3C2 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r r t,y No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ve PUBLIC HEALTH DIVISION —TOWN OF BARNSTABLES MASSACHUSETTS Rpprication for Mtzpoml *p6tem Conotructton Permit Application for a Permit to Construct( )Repair( )Upgrade(,�.)Abandon( ) WompleteSystern ❑Individual Components Location Address or Lot No.1°5 D 3 T` Owner's Name,Address and Tel.No. Assessor's Map/Parcel oV t ! ot4v Inst er's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. % p--_0_0 1?�L ,,- 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 Lk`y gallons per day. Calculated daily flow "1 ks gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank (e�vt-� Type of S.A.S. Description of Soil � p Nature of Repairs orkiterations(Answer when applicable) IV t c(Kr-e /f f✓ �s �. Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has be Wl' T �yt �of�Healt��.� Signed Date <� Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued No. � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLES MASSACHUSETTS application for Digpogar *pgtem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade Abandon( ) Womplete System ❑Individual Components Location Address or Lot No. 'S 0 3 Owner's Name,Address and Tel.No. Assessor's Map/Parcel 0,1 � I�-vo�i Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Ci Type of Building: Dwelling No.of Bedrooms 4 Lot Size sq.ft. Garbage Grinder OtherN Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures �t Design Flow �� �l \Cy gallons per day. Calculated daily flow ( gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 5 U D V4 (o�+'� Type of S.A.S. ���-, �pLl�l`j ` . Description of Soil &Q-Q S) t 1 Nature of Repairs or Iterations(Answer when applicable) 51 L23f Y ~f/t/if y t✓ GG/' Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described�on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has be"-,' sue �is �of Health.Signed Date Application Approved by Date ,Application Disapproved for the following reasons Permit No. ✓ Date Issued THE COMMONWEALTH OF MASSACHUSETTS ,11 BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the.On-site Sewage, isposal System Constructed( )Repaired( )Upgraded� ) Abandoned( by �'t Sly Z at �� W IAS as a constructed in accordance with the provisions°f itle 5 and for Disposal System Construction Permit No. 4 dated Installer r��,f. 4r� Designer The issuance of this ermitt sha 1 not be construed as a guarantee that the sy n 'vill f ctt' as design Date �Q"3 0'/ Inspecto ", C. � 7 ✓j'A 1 \ No.--��—��—--------------- -- '_+. ---Fee �2 / THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS lwigoga[ *pgtem Congtruction Permit Permission is hereby granted to Construct( )Repair )Up de(?C,) ,andon( ) System located at '0 T '�R l�- and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction st be co7oleted within three years of the date of tt�d� Date: Approved by � 1 rr J r i I tu9A7 1 NOTICE:.This Form Is To Be-Used For the Repair Of Failed Septic Systems Onik: t , -, U 7 k G iCERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) t 1 *, ✓.1?- ,hereby certify that the application for disposal works -' concernin the 4. i t onstruction permit signet!by me dated 1 b`��`-� g - t meets all of the r property located at _ S Q.,..3. property �"l, U,��,�1�-5�,�- � ,ell following criteria: .y n c ere are no wetlands Ibeated within wo feet of the proposed leaching facility There as tttf ptiv,tte wells within 150 feet of the proposed septic system q k h Va There is tte bid iit Me*and/or change in use proposed N� (%: `Men are no vatfatiM"iested or needed. `� . r r ; ffthe proposed ieatli'ing Ne lity will be located within 250 feet of any wetlands,the bottom of the x 'fit proposed Ding facility will pat be located less than fourteen(14)feet above the maximum adjusted z t 5 r i F grotiedwater table ele"tion: #E } lii aae cotnpietre the fe�lit�rvf29. J S t 1G� , } A)I"a1~ nd Elevation(according to the Engineering Division G.I.S.map) ; Y i.id x i s�` ♦�}� x $)ObsetM O dwaEer'fable irltvation(according to Health bivision well map) 1 ATE r .�,,„��x ¢ •t - a 'R ♦'s _ ~`� = L:ICENSEb SEP11C S` StEM INS"I'ALLEit IN THE TOWN Of BARNSTABLE NUMBER 94�rt (Atbnelt a sttetdi plan et!' I peed tetra:Also if the licensed installer pwesses a certified plot plan, y'��� �'�� '°��s�: =this piati should be sinittedj: - 'xr `w1 Kos tiiillA g{Itfer �t �' t � 1 vi, :#�$..r .izw+wrun..,.,, ..,. a...... ,.,n.......4: .w..�Aakdwsm•.-...,e P....... - .. ,...... <-etni. 1 .:- 4 � © �� ���� ���� �� < <�� � ��� i� � L O'Z A T 10N SEWAGE, PERMIT NO. Vfif L A G E I N S T A LLEI'S NAME i ADDRESS ,7 ,i e)aodal 1167 725�^.s- BUILDER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED Z.2 Z�4 4 .� l �r��� �' --( � � /�v � 5 �- o- �`� �. ;Y� Y� t -� No. _ 6 . THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 11/............."OF........a-A.K.N.S.Y.A.F447-----•--......_........_........ Appliratinn for Dhipus al Works Tamtrnrtinn Vamit Application is �er`eb�y_made for a Permit to Construct ( �or Repair ( ) an Individual Sewage Disposal System at: b(�__tt7 lSD3 , ..... .. ............ .. _ .../J.,/,&------------------------------- Ow Address W Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms.......................__...__._._.....Expansion Attic ( ) Garbage Grinder (Ajb) Other—T e of Building No. of persons_.______--_-•_______________ Showers — Cafeteria Q' Other fixtures -----------•... -•------------• -=--------•---•--•...--•--- ....................................................................................... W Design Flow............S.S.....................gallons per person per day. Total daily flow.........:13_.4?..................gallons. WSeptic Tank—Liquid capacity_1156tallons Length-------_------- Width................ Diameter................ Depth................ x Disposal Trench—No Wi�...�.........._.. Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter-__-_-U__-__-_-_- Depth below inlet...-......_..._. Total leaching areao�- C ..sq, ft. Z Other Distribution box ( ) Dosing tank_( ) ~' Percolation Test Results Performed by---------� ........... ...................... Date..... /.`f: Z---__. aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water________________---____. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-------------........... a' •-•••-•-•----•-•-------------••-•-•••-•--•••----....._...............-•••-•••-•-•---•-•-•---•--•---.._..._._.......-------•-•............................... ODescription of Soil....................................................................-----•-----------------------------------------•--------------------'............................. W •--•--------------------------------•------••-•--•••-----------------------------------•-•-••-••---•--------------------------------•-----------. ....................................................... UNature 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 L I':LE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................................................................................... Date Application Approved By•••-•.... -.sue. y � �1 �'f�--'4?1-_---- ate Application Disapproved for the following reasons------------------------•----•-•-----------------............................................................. - ---------------------- --------- ---------- ---•--------------------------------------- ... ----------------------------------------------------------------------------------------•----------- Date PermitNo................................•••--........------------ Issued....................................................... Date Fps.... ..6. ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......... .! 1..i...........0F....... ..a .N; 1 ................................ Appliratinn for Disposal Murks Tonstrnrtion Prrutit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at: .._...�.! ' - ...................lo&��'r-l f.•......... ..._....._................._..-- ••-• ---•---• --................._......._. ht Location-Address or Lot No. /[................... f ............................. -----....:-•----•------........._.._.._....._.......... ..................................................... O Address ............ ........ - . ..................................... ....•--••--•-•----------•- . •--- -----•--------------• ........... Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (46 Other—T e of Building No. of persons............................ Showers — Cafeteria PaOther fi ures ••••••---•••----•-••••---•---•---•-•......-••-•••• •• . - W Design Flow................:. 5....................gallons per person per day. Total daily flow........... ...3.P..................gallons. WSeptic Tank—Liquid*capacity../ :S' allons Length................ Width................ Diameter................ Depth................ Disposal Trench—No •---•-•-------•. Width................... Total Length..._._._..____._... Total leaching area....................sq. ft. Seepage Pit No----------�''�__.. Diameter._�0'...... Depth below inlet....��................ Total leaching area.c2.;., ..sq. ft. Z Other Distribution box ( ) Dosing tank—( ) ~' Percolation Test Results Performed by.__....... ...........<A00f t7"w-.7..........•.•......... Date...... _ .+ 4✓''. .__.. aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water....................... Gz, Test Pit No. 2................minutes per inch Depth of Test Pit..................... Depth to ground water........................ ---------- --------------------------------•----•--•---------------.......--•-••------•--•......•---......................................................... ODescription of Soil..............................•-----•-•-------•-------------•------•---•---•---------------------------------........------------------------..........---•---••---•••-- x 4t, U ---.....••••••-•-•--•-•-•-•------•-•.....................•...•....._........................••••••--•--...,...----•-•-•--•--•---•-••••---•••---•--••---•-••...•••--•••-•-......-••••--••--......_..••-- x --•----------------•-..... .................................................................................................................•-........................................................ 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 TIT E 5.of the State Sanitary Code=The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................................................................................... ................................ D Application Approved BY----•-----� ,.-, '�..�-k':'� ����. .�. ..._....�e!' _�.� Date Application Disapproved for the following reasons:................................................................................................................ ..........•-••••••-------•-•-•••-••---••--••--••---•-----•-•---...---•••......._..•----------••......•----•••••-•--•-•-••-•--••-••••••••-•-•••-•-•-••----------•-•--•••-•-••-••-••-----•-•---••---...._ Date PermitNo......................................................... Issued_...................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........ .......OF......... ✓v!a ..... ............................................. Trrtifirtttr of f omplianrr THIS IS TO CER IFY, That the Individual Sewage Disposal System constructed or Repaired ( ) bY-•-••-•...••. - =-•----••-- ---•------•---•---•----•-•--••----------------------•----------------------•--------------------•--•---------•---••-•-•---•--•---------.-- I staller S._ J has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No-------&4 _ .>S........ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............................................1 A.�W............ inspector..................... .k::�. ................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..;r.":,F':.?+.�,.............OF...... ................................ No....cr"e✓- FEE....r .?............. Disposal Vorkg Tnntrnrtion rrmit Permission is 1}ereby granted ......-..:::.. - - ---=------------------..................................................................... to Construct ) epair ( ) an Individu Sewage Disposal System , = -' ', ----------- s e r Street as shown on the application for Disposal Works Construction Permit No..................... Datedf-........................................ .-«,.:��-'C�•�---�'�-•---f`-"-"�-vim' --- ----------------------------•-•---- Boa � alth DATE --------------------------•................................ FORM 1255 HOBBS & WARREN. INC.. 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VL"hS. _ oD w ��o1irL � olz �IS�oSAL SYjS �� I 1 T o � co>v Sfi61�, Crto r3.1 S761,1c.7 LLB (a C lZ LVM +'it `Mrt SS Cr►/�,(�oYV . \sv�`l tYLZj�J� o l 45;5-C 00 r�❑❑ r G' O ,7 Sc A`\-- Lor ' o/ P�jN OF/has I� •n J_25 •ov 1 L.,r•. z t o / Al A , No.26575 p �FSSIONAI ENG, s i J4 LIT D � _ �o x3 33o G.� O• '' .. � It`1 F1oW S�-Prte j 3 3 0 . �'• D. V t 'x- C1 - 1, Zs� i 'm ti S (, „� � 6 ' g''0�• �! L 3;�uE. ��s�6�Jco -6a3Y � LA 4jTv" Ls Jo �lrl6l i rt� XS � x /• a `� 7� L 0.0 AT ION !��'J S E illl A C E PERMIT N0. 09 �� VILLAGE I N S T A ELER'S NAME i ADDRESS c� /I13 eJW,o d dl SUILDEIt OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED I g FTHE 1pk, Town of Barnstable O • EAaxsrnsM Department of Health, Safety, and Environmental Services 9� MAS& Public Health Division ArFD"A°�A P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health November 23, 1998 Pat Nolan P.O. Box 607 Centerville, MA 02632 ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5. The septic system owned by you located at 1503, Route 149, West Barnstable was inspected on October 5, 1998 by, Troy Williams a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1.995 TITLE 5 (310 CMR 15.00)due to the following: • Top broken on cesspool #1. Cesspool was unsafe with a possibility of the cover falling into the cesspool. • Cesspool#2 was found structurally unsound and in need of replacement. You are ordered to bring the septic system into compliance within sixty (60) days. Therefore, the constuction of replacement septic system component(s) must be completed on or before January 19, 1998, First, you must hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of a proposed system to the Town of Barnstable Health Division Office (Town Hall, 367 Main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5. In the meantime, you shall ensure that no raw sewage backs-up into the dwelling or discharges onto the surface of the ground or into surface waters. You must maintain the system by hiring a licensed septage hauler to pump the septic system whenever it is necessary. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. ER OF HE BOARD OF HEALTH iomas A. McKean, R.S., C.H.O. Agent of the Board of Health q\health\dbfiles\titles i.doc nolanhvp/q/Is .� � Town of Barnstable • Department of Health, Safety, and Environmental Services + BARNSfABLE, 1' �0� Public Health Division ilk Public Main Street, Hyannis MA 02601 Office: 508-790-6265 Thomas A.McKean,RS,CHO FAX: 508-790-6304 Director of Public Health T0: C-)- Pbx toy-7 DATE: Nj�>J 1'7, 1 ST LULSECii(0 � - ��(0 3-Z ORDER TO COMPLY WITH 310 CMR 15.00, THE STATE ENVIRONMENTAL CODE, TITLE 5.. The septic system owned by you located at )W.3 12vTb- I-Y9 LtrsV r,�s, l,44_ was inspected on by �o4 —a Massachusetts licensed septic inspector. The inspection of your septic system showed that your system has failed under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • t7 6Z.A Ca&h i U"�'Scz� wL S c11�1 WISUv o5F reP1Qc AA-+. You are ordered to bring the septic system into co fiance within tear$ he des % Therefore, the construction of replacement septic stem ent(s) must be completed on or before �c 1�,! -'y a .First, you must hire a licensed Town of Barnstable septic system installer to submit a sketch diagram of proposed replacement septic system component(s) to the Town of Barnstable Public Health Division Office (Town Hall, 367 Main Street, Hyannis) that will bring the septic system into compliance with 310 CMR 15.00, The State Environmental Code, Title 5. In the meantime, you shall ensure that no raw sewage discharges onto the surface of the ground or into any surface waters. You must maintain the system by hiring a licensed septage hauler to pump the septic system whenever it is necessary. Any person aggrieved by any order issued by the local approval authority may appeal to any court of competent jurisdiction as provided for by the laws of the Commonwealth. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health yv,�imwsrimwuu.a� /o s- C s e r TROY WILLIAMS 19 SEPTIC INSPECTIONS o �o Certified by MA Department of Environmental Protection SI (50 85-1300 19 Hummel Drive G South Dennis, MA 02660 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIR DEPARTMENT OF ENVIRONMENTAL PROTECTION Op� ONE WINTER STREET, BOSTON, MA 02108 617-292-5500 WILLIAM F.WELD TRUDY CORE Govemor Sccrctan- ARGEO PAUL CELLUCCI DAVID B.STRUHS Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commissioner PART A CERTIFICATION Property Address: f s O 3 RC? ,y q W� 13 -' Address of Owner: n Date of Inspection: /0/'S/98 (If different) Pwt /l�o��h Name of Inspector: Troy Williams t?V. (30), 6 O 7 1 am a DEP approved"�em inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: Troy .Williams Septic Inspections L'L� � ; (!c� Ma Mailing Address: 19 Hummel Drive. South Dennis , MA 02660 263� Telephone Number: ( 5-0-8) 3-8.5-1.3.0-0 0 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The system: _ Passes _ Conditionally Passes Needs Further Evaluation By the Local Approving Authority ZFails — � I ,fin. Inspector's Signature: .S G�/fJ[ .�r-� Date: The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. INSPECTION SUMMARY: Check A, 8, C, or D: AJ SYSTEM PASSES: A114 I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. COMMENTS: B) SYSTEM CONDITIONALLY PASSES: *//q 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. Indicate yes, no, or not determined (Y, N,or ND). Describe basis of determination in all instances. If'not determined',explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the.tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. - (—i—d 04/IS/11) Paq• 1 or 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM cE PART A 1503 Route 149, West Barnstable,NURTIFICATION (continued) Property Address:Pat Nolan Owner: October 5, 1998 Date of Inspection: B) SYSTEM CONDITIONALLY PASSES (continued) A//4 Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health). Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: NIA Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: — Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public,water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet r more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds ndicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen i i equal to a less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1503 Route 149,West Barnstable,MA Owner: Pat Nolan Date of Inspect ion:October 5, 1998 D) SYSTEM FAILS: You ust indicate ei;,,er "Yes" or "No" as to each of the following: 1 have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No, Backup of sewage into facility or system component due to an 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. IV,1-13 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 112 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet fro.rtl a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for / coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. C rV 4.J•1 Sc+4 G/;r.,f C/o i../ti��.,✓d � J ; ►, �/ h 7� C- E) LARGE SYSTEM FAILS: N/A S You must indicate either "Yes" or "No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: 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) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (1-1—d 04/25/97) .. o..-. ... ,� f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST 1503 Route 149,West Barnstable,MA Property Address: Pat Nolan Owner: October 5, 1998 Date of Inspection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes, No — Pumping information was provided by the owner, occupant, or Board of Health. _ None of the system components have been pumped for at least two weeks nora flow rates during that period. Large olumes of water have not abeen nd hntroduced into thee system hs beenrsystemeceivingrecentlylor as part of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. .�L The facility or dwelling was ins pected s— g petted for signs of w g sewage back-up. . — The system does not receive non-sanitary or industrial waste flow. V/ — The site was inspected for signs of breakout. �C — All system components, excluding the Soil Absorption System, have been located on the site. Adz9 The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of baffles or tees, material-of construction, dimensions, depth of liquid, depth of sludge, depth of scum. / The size and location of the Soil Absorption System on the site has been determined based on: V — The facility owner (and occupants, if different from owner)were provided with information on the proper maintenance of Sub-Surface Disposal System. NI.9 Existing information. Ex. Plan at B.O.H. Y — Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable) (15.302(3)(b)) (r—i..a 04/2s/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1503 Route 149,West Barnstable,MA Owner: Pat Nolan Date of Inspection: October 5, 1998 RESIDENTIAL: FLOW CONDITIONS � Design flow: yyo g•p.d./bedroom for S.A.S. Number of bedrooms: Number of current residents:_(_ Garbage grinder (yes or no): Yt.S Laundry connected to system (yes or no):_PO55; y Wt f I Seasonal use (yes or no): NO Water meter readings, if available (last two (2) year usage (gpd): � Sump Pump (yes or no): it/0 Last date of occupancy: COMMERCIAUINDUSTRIAL• A)/M Type of establishment: Design flow:_ gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_ Non-sanitary waste discharged to the Title 5 system: (yes or no) Water meter readings, if.available: Last date of occupancy: OTHER: (Describe) Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: IP ^u r•,•� I 4 1— 9 a GY :h f o O S 4�. •, ..t Ti•o,t !i a K, O a./h .L✓ System pumped as part of inspection: (yes or no) Ala If yes, volume pumped: gallons Reason for pumping: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool (a ) Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) I/A Technology etc. Copy of up to date contract? Other APPROXIMATE AGE of all components, date installed (if known) and source of information: r><c 4- q y of _r 5. u,� kn0L;oPN . ��s b�� I s Sewage odors detected when arriving at the site: (yes or no) JVa (revised 04/?5/971 - - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1503 Route 149,West Barnstable,MA Owner: Pat Nolan Date of Inspection: October 5, 1998 BUILDING SEWER: A///3 (Locate on site plan) Depth below grade: Material of construction: _cast iron _40 PVC _ other (explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK: N//? (locate on site plan). Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene —other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) GREASE TRAP: /V/19 (locate on. site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene —other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, etc.) (r—is.d 04/25/97) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION 'FORM PART C SYSTEM INFORMATION (continued) Property Address: 1503 Route 149, West Barnstable,MA Owner: Pat Nolan Date of Inspectionptober 5, 1998 TIGHT OR HOLDING TANK: //6q (Tank must be pumped prior to, or at time, of inspection) (locate on site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene —Other(explain) Dimensions: Capaciry: gallons Design flow: gallons/day Alarm level: Alarm in working order_Yes;_ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches, etc.) DISTRIBUTION BOX: /V14 (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, etc.) PUMP CHAMBER: A1119 (locate on site plan) Pumps in working order: (Yes or No) Alamo in working order (Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) (revised 04/25/971 _ _ _ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:1503 Route 149,West Barnstable,MA Owner: Pat Nolan Date of InspectiorOctober 5, 1998 SOIL ABSORPTION SYSTEM (SAS): / (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type. leaching pits, number:_ leaching chambers, number:_ leaching galleries, number: leaching trenches, number,length: leaching fields, number, dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) Ifwo f dt J h ,7. o-w A T o f L S-5 / t Al. ,�+ , ✓r^ t a// o✓t.ilC/ f r- U t.✓ CESSPOOLS: (locate on site plan) Number and configuration: ',') k"_. C-*-s S 1 s, Depth-top of liquid to inlet invert:_ S//' 0;o Depth of solids layer: 3" Depth of scum layer:_ r`4 ) Dimensions of cesspool: (ems s,,,ou ( K 1 ;J xs C s shoo 1 �` Z f �X S < Materials of construction: 1� 5,,,o 0 f S(o Lt Indication of groundwater:_ /VONI inflow (cesspool must be pumped as part of inspection) O �✓ {/�✓ c<—s s / /+ m Comments: C(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) G ( w f w, /l y� II-- .�• L/�O If_f� U h (d /` �> �✓f �...-� o-�-Kr� S1 0, i � s A S nt wu �a�.,. Inc;..,�. o >� Y•-�- a�,�c-c vr.� -'� .f 7l✓�rr f'7/v-c� f I y ✓v� t p.�.. ,.t q h..� r F PRIVY:_ / ► . 1 cc > Lt'cvc py. S r a�-, u✓c�T Uw is No (locate on site plan) y< '�O``� f .�vrt -T Materials of construction: Depth of solids: Dimensions: Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) 1—i—d 04/25/97) . ' •= P.q• a of io L_ I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1503 Route 149,West Barnstable,MA Owner: Pat Nolan r Date of Inspection: October 5, 1998 v f,�~ 1��t1 SKETCH OF SEWAGE DISPOSAL SYSTEM: j0 vst include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) , LJ,t1 F� Fv�cLaA - s' dos> / T MN. �rDy Iu` �aS}pc V,' 4A�`'; 33t �5I I ca 1 33 64 V( cf.f 1 -rlC K L Paq• 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 1503 Route 149, West Barnstable,MA Owner: Pat Nolan Date of InspectionOctober 5, 1998 Depth to Groundwater _ Feet adjusted high groundwater level Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record / V Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators, installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. Must be completed) 41 (r—i.•d 04/15/97) V o Paga 10 or 10 ..mac . vim/ 60/ 'B13 �f g�RM BAR NSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT Q � V � I SUPERIOR COURT HOUSE B�RNSTABLE,MASSACHUSETM 02630 AS$ i� PHONE:362-2511 Client : NOLAN, PATRICIA L. i r LAB337 Mailing P BOX 60'7 Collector: PATRICIA L. NOLAN �Address : CENTERVILLE, MA 02632 � Affiliation: OWNER Telephone: 428-4482 Type of Supply: Well Depth: Sample Location: 1503 RT. 149 Date of Collection : 09/23/98 Town: WEST BARNSTABLE j Date of Analysis : 09/23/98 I -=PARAMETERSAMPLE RESULT RECOMMENDED LIMITS^ Total : Coliform Bacteria ABSENT PH 7 . 7 0 Conductivity (mir_romhos/cm) i l82 Iron (ppm) < 182 500 Nitrate-Nitrogen (ppm) I 0 .0 . 1 0. 3 sodium (ppm) 10.Q Copper (ppm) 42 2C.. t? 1 .3 BASED ON THE ANALYSES PERFORMED THE FOLLOWIivG ADVISORIES ARE GIVEN: X Based on the results of the parameters tested, the water is suitable . for drinking but has high le�/els of sodium. Persons on a low sodium diet should consult t$eir doctor. I I i i i Thomas F. Bourne, Laboratory Director" t I I i I i TFITNI P.O:=' TOWN OF BARNSTABLE LOCATION f SU T l y SEWAGE VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMUDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility)- Feet Furnished by'--c(,J-.- I t �, , ja/S°'" q YJ ✓aP� � �Z APPLICATION FOR PERCOLATION TEST AND OBSERVATION PITS LOCATION 7- �. T � NO. VILLAGE /� +5° �/ 5 i +,� DATE APPLICANT FEE _ (No n-r £ur able) ADDRESS 2 7 r, TELEPHONE NO. ENGINEER _TELEPHONE NO. c�.?5 DATE SCHEDULED (Applicant' s signature) . . . . . . . . .. . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . • •. . o • • • • • o • . o . . . . . • SOIL LOG •SUB-DIVISION NAME P'0 f �` U 1�1 '\.a h� DATE Z o f'^ / ) TIME 0 ' 3� EXPANSION AREA: YES ✓ NO —P , & LA /jTv--k- . ENGINEER. .TOWN WATER VePRIVATE WELL tj (�, e Y-i, a/ BOARD OF HEALTH �-r -� b ..I EXCAVATOR SKETCH: (Street name,etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes) �T i qq NOTES: 27 1 I! PERCOLATION RATE. �- 5 T 1�1�'J �"� �''� ryJ �'�• TEST HOLE NO: # ELEVATION: TEST HOLE NO: #� ELEVATION: 91' X osknk-s7 " k-044 L F-AwY�b-cry. 2+-- ��.43 S r l 2 3 4 4 5 5 NIA- -- e�A�sr 3 �►�0 6 . -6 ,Q 0 8 g� 8 9 9 10 10 M _ C,o Ad1,C i 11 11 S�zry )ko✓a %,VIC 12 vo 12 C��-✓+r1 . 13 1113 14 15 15 16 #Q �2� 16 w' lazes SUITABLE FOR SUB-SURFACE SEWAGE : LEACHING FIELD_ LEACHING PITS_✓_ LEACHING TRENCHES UNSUITABLE FOR SUB-SURFACE SEWAGE . REASONS : NOTE : ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED IN ENTIRETY BY P . E . AND RETURNED TO BOARD OF HEALTH 'COPY: RETAINED BY APPLICANT T.O.F. EL.= 100.8'± FINISH GRADE OVER D-BOX= 100.6'± PROP.VENT WITH CHARCOAL FILTER TO ABOVE GRADE FINISH GRADE OVER CHAMBERS= 100.0' - 101.2' GENERAL NOTES PROVIDE H.D.P.E. RISER SLOPE @ 2%MIN. OVER SYSTEM 3/4"TO 1-1/2"DOUBLE WASHED w/COVER TO WITHIN 6" REMOVABLE WATER-TIGHT COVER OVER STONE TO CROWN OF PIPE 1. UNLESS OTHERWISE NOTED,ALL SYSTEM COMPONENTS AND CONSTRUCTION OF F.G. (TYP OF 2) RISER TO WITHIN 6"OF FINISHED GRADE 4"SCHEDULE 40 PVC INSPECTION PORT WITH ACCESS METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL FINISH GRADE = 100.2'± 5"DIA. OUTLET STONE OR GEOTEXTILE FILTER FABRIC S) MIN SLOPE 1% BOX TO F.G. (SEE NOTE 19) 2"OF 1/8"TO DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES. cLD FND. EL.= 1 OO.O'± F.G. OVER TANK EL. -\ TI 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE 20"MIN.ACCESS 1 DESIGN ENGINEER: COVER(rYP.OF 3) " 4,50'MAX TOP OF SAS= 95 80' PLACE RISERS ON ALL EXIST, IG 4„ PROPOSED 4" CHAMIBERS WITH ...�.,�,�,h',� � SEE NOTE 21 5.40'MAX 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL / SEV%1ER PIPS �_ _ - PVC SEWER PIPE 94.80' SEE NOTE 21 INLET PIPES TO 6"OF "F7 SYSTEM UNLESS OTHERWISE NOTED. / _ :1W. 1 L_ I BREAKOUT EL= 95.30 j FINISHED GRADE 6 3 3"DROP MAX L 95± ---1 4. TO PREVENT BREAKOUT,THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN 2"DROP MIN MIN.SLOPEa1y, PROVIDE WATERTIGHT o ELEVATION =95.30' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS.UNLESS A JOINTS P.71ni T4"PVC IN FROM o 40 MIL GEOMEMBRANE LINERIS PLACE AT LEAST FIVE FEET FROM S.A.S.AND THE TOP OF 14" '- PTIC TANK 4"PVC OUT TO O o o = = 0 THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. 11 LEACHING FACILITY 000 oo 0 5. SLOPE ALL SOLID PIPE AT 1.0%o MINIMUM. CONTRACTOR CONTRACTOR SHALL 95.22' 12' . 6" ' o0 0° 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL VERIFY SIZE 48" VERIFY CONDITION OF TEE 95.05 2 00 0 o 0 0 0 0 � 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK j AND CONDITION OF EXISTING TEES GAS BAFFLE 6"CRUSHED STONE o 0 o FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION.SYSTEM IS EXISTING SEPTIC AND REPLACE AS OVER MECHANICALLY oo 00 NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE AND DESIGN ENGINEER. 5 OUTLET DISTRIBUTION BOX 8.5' (TYP) �- 4.0 4.0' 4 4.0' .83 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 100.00 n___.r__ _�._ ___._ TO BE INSTALLED ON A LEVEL STABLE 33.5' (TYP-) ESTABLISHED ON'THE CORNER OF CONCRETE PAD,AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET = < 87.00' EXISTING 1 ,500 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. 92„80' GROUND WATER ELEV. 12 83' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION 3-500 GALLON H-20 CHAMBERS 5'MIN. CHAMBER END VIEW THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT CROSS SECTION VIEW 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES SEPTIC TANK PROFILE H-20 DISTRIBUTION BOX DETAIL TYPICAL CHAMBER PROFILE CHAMBER DETAILS TO THE DESIGN ENGINEER. 'CONTRACTOR AN ACTOR TO NOTIFY E EXISTING ELEVATION I'RI{ r 10. ALL JOINTS WHERE PIPE ENTERS AND EXITS CONIC.STRUCTURES SHALL BE MADE WATERTIGHT. TO ANY V��JC}RK� NQTIPY EI�1GI1`vEEI�IF DIFFERENT. NOT TO SCALE NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING TEST PIT DATA RE w PP 1 ANT IS TO OBTAIN SUCH DETERMINATION FROM NOTES: Maw .i REGULATIONS. OWNE A L C a APPROPRIATE AUTHORITY. • + a., i -}, t+ 4 PERC NO 15266 - ..�y - -g :` :ry ' ALLCOMPONENTS SHA L WITHSTAND H-10 LOADING UNLESS LOCATED 1.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE .. , David W.Stanton,RS 12. SEPTIC SYSTEM L PROPOSED LEACHING SYSTEM TO ENSURE CONSISTENCY WITH TEST PIT DATA INSPECTOR. _ ,. ( UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT,DRIVES,OR : µ <, -r EVALUATOR: Michael Pimentel EIT CSE SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF HEALTH IF s ; gw i ,# TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING. ; Oct. 1999 SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. C.S.E.APPROVAL DATE: 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT,DUST AND FINES. DATE: February 15,2017 2). ENTIRE PROPERTY IS LOCATED OUTSIDE THE LIMITS OF A DEP APPROVED ZONE 2 MAP 105 WITHIN THE GROUNDWATER `"5 PI 1 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE . " TEST PIT*AND ESTUARINE WATERSHEDS.. PROPERTY IS LOCATED ,' "`�.�...,., �,�,,. �. � ,, .. ;�r �.,� � ,�, � LOT 008 ` - " [ �3 MATERIAL 1N AREA BENEATH AND FOR 5 FT.ON ALL SIDES OF LEACHING FACILITY. PROTECTION OVERLAY DISTRICT. PROPOSED THREE(3)500 MAP 1 O5 �W `" ` YJ7�� GALLON H-20 LEACHING LOT 001 4 � "°\ s ELEV TOP= 100.80' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, r CHAMBERS WITH AGGREGATE ,� � f <87 80' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). \ w ` \, :;. . ELEV WATER= LOCUSw� ► _ 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN ► PERC RATE- 2 min.4nch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. �h �j f '- N ,° DEPTH OF PERC= 18. PROPOSED PROJECT IS LOCATED WITHIN. gu' o, PROPOSED .. ' . \� . < PROPOSED H-20 ti �' �� 10 5eQ� TEXTURAL CLASS: 1 ASSESSOR'S MAP 105 LOT 009 3 INSPECTION PORT h e' ,w t 10 DISTRIBUTION BOX EXISTING ^sL„ il" ( F 'Tf '�I U' tNN .'„ , f BOULDER(TYP) OWNER OF RECORD: GRACE LYTLE SYSTi i (LE. S INFILTRATORS) E 24' 16„ "\ t�� /L,� ' \ r* r :, . ABANDONED (APPROX. L�3ATiC�N} - 6 '`. N I e od\\1 y �. �\ `,`may;\" p" - 100.80' \ M , t Loam Sand ADDRESS: 1503 ROUTE 149 Air r L .--' / ' `` , \ ► A Y h o- y r / / Cl \ 10Yr 3/2 WEST BARNSTABLE,MA 02668 a 6" ,� (3) ``� .,� 03� � �y y y . \�� / � µ a\\�+,, ) ��.";� 12" 99.80' 8„ \y 12" \ ,10$ '" - ��\ r I ✓p I FEMA FLOOD ZONE X _ \ O 101, \ f 3 '% \ Loamy Sand B 10Yr 5/6 COMMUNITY PANEL# 25001 C0534J (2) PROPOSED VENT PIPE; EXACT 12' P r 17. DEED REFERENCE: BOOK 11884, PAGE 92 \ ':_ '00- LOCATION PER OWNER \ // 't �;._ 1 s. 30' 93.30 / f duRty `` 18. PLAN REFERENCE: PLAN BOOK 290,PAGE 97 Silty Loam ` - O TP 2 / I / / �I rgr�tiu n�5 • ,, C-1 .2.5Y 6/6 19. A 4"PERFORATED SCH.40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A �.. ---_ 101, DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3 OF FINISH GRADE. A 95.80 74' ON THE-TOP TO ALLOW FOR INSPECTIONS. � REMOVABLE THREADED CAP SHALL BE?LACED _ zz -�- . 2 \ o 25 27 1 10 r 20. OWN A /CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL EXISTING D-_BOX TO BE f *. O � o � , � a \ ER/APPLIC APPLICANT C TRACTO H LE f �- of b. ABANDONED t4. * .J REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT. \ ,/ - a, C-2 21. IN ACCORDANCE WITH 310 CMR 15.401 15.405,THE FOLLOWING LOCAL UPGRADE ��ONC. PAD --_ Z2 a / O� f Medium-Fine Sand APPROVALS ARE REQUESTED FROM 310 CMR 15.221 (7): EXISTING 1;a C GALLON HC-1 a a r 2.5Y 6/1 (1,) A 1.50'WAIVER(3.00'-4.50)FOR THE MAXIMUM COVER OVER THE DISTRIBUTION BOX. SEPTIC TANK TO BE 10i 12 fzl, cb (2.) A 2.40 WAIVER(3.00 -5.40)FOR THE MAXIMUM COVER OVER THE LEACHING SYSTEM. UTILIZED I"kTHIS' DESIGN 10 „ r !Vtl ^J LOCUS PLAN ! O�DOQ BRICK PATIO ®� 701101 SCALE: 1"= 1000' 156" 87.80' LEGEND I \ 50xO EXISTING SPOT GRADE \ II HC-2 � � _ No Mottling, Standing or Weeping Observed V 100 'FELINE VP) DESIGN 'DATA - - 50 - EXISTING CONTOUR ! ( 50 PROPOSED SPOT GRADE 'Perc rate in C-2 soil per Perc No.798,dated _100 --- i \ �P NUMBER OF BEDROOMS (EXISTING) 3 10-14-81 on file with the Barnstable Board of rt PROPOSED CONTOUR NUMBER OF BEDROOMS (DESIGN) 4 (per Septic Permit No.98-695) Health. O/H%W EXISTING OVERHEAD UTILITIES #1503 GRAVEL DESIGN FLOW 110 GAUDAY/BEDROOM EXISTING Benchmark DRIVEWAY TEST PIT DATA Corner of Conc. Pad \ � 3 TOTAL DESIGN FLOW 440 GAL/DAY GAS EXISTING GAS LINE `` 3-BEDROOM Elev. = 100.00' MAP 105 I DWELLING 00 DESIGN FLOW x 200 % = 880 GAL/DAY PERC NO. 15266 ! Approx.M.S.L. �..- � W W EXISTING WATER LINE LOT 009 T.O.F=100.8'± \ Q ,�� INSPECTOR: David W.Stanton, RS 1 USE EXISTING 1 500 GALLON SEPTIC TANK 66,387 S.F.± 1 , I \ f n�0`��� EVALUATOR: Michael Pimentel, EIT CS E .�. TEST PIT LOCATION i A& } 400 C.S.E.APPROVAL DATE: Oct. 1999 -99. \ \ �� J� DATE: February 15,2017 �C} ( (3� EXISTING 1,500 GALLON SEPTIC TANK INSTALL 3 - 500 GALLON CHAMBERS w/ STONE I ham'° O ��� / TEST PIT#: 2 PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE SIDEWALL CAPACITY ELEV TOP= 100.00' p �w QJ (LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) = GALIDAY ELEV WATER= <87.00' ® PROPOSED H-20 DISTRIBUTION BOX (33.5'+ 12.83) (2) (2') (0.74 GPD/S.F.) = 137.1 GA L/DAY QQ PERC RATE_ - PROPOSED 500 GALLON H-20 LEACHING CHAMBER k k oy �- ,g8--~ BOTTOM CAPACITY DEPTH OF PERC= - _9$ _ `\ (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAL/DAY �\ - 318.1 GAUDAY TEXTURAL CLASS: 1 � (33.5'x 12.83') (0.74 GPD/S.F.) - ti, / o �� TOTALS: A 0" Loam Sand 100.00' REV. DATE BY APP'D. DESCRIPTION y TOTAL NUMBER OF CHAMBERS 3 y TOTAL LEACHING AREA 615.1 SQ.FT. 12" 10Yr312 99.00, PROPOSED SEPTIC SYSTEM UPGRADE ti TOTAL LEACHING CAPACITY 455.2 GAL./DAY Loamy Sand PREPARED FOR: ya �yvQ` B 1oYr 5/6N o�s���, CAPEWIDE ENTERPRISES -97 - p �� IL � _ 4/ 30" 97.50' CN, HILL lR. ���' �p `O `�2fi Oy v� C-1 Silty Loam C a8o LOCATED AT y� 2.5Y 6/6 / a 1503 ROUTE 149 /C A'O . 1ST 60" 95.00' s SWING-TIES yy WEST BARNSTABLE, MA DESCRIPTION HCA HC-2 �s SCALE: 1 INCH = 20 FT. DATE: MARCH 1,2017 CORNER OF STONE(1) 71.8' 64.5' C U.P.#70/100 0 10 20 40 80 FEET 9s C-2 Medium-Fine Sand CORNER OF STONE(2) 55.8' 61.3' \ -96 CABLE BOX RESERVED FOR BOARD OF HEALTH USE 2.5Y 6/1 PREPARED BY: CORNER OF STONE 3 68.3' 74.0' �9s ti JC ENGINEERING, INC. O / \ 2854 CRANBERRY HIGHWAY CORNER OF STONE(4) 81.9' 76.T EAST WAREHAM, MA 02538 SITE PLAN 156" 87.00' 508.273.0377 SCALE: 1"=20' No Mottling, Standing or Weeping Observed Drawn By: BJw Designed By:BJW Checked By: MCP JOB No. 3723 I