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HomeMy WebLinkAbout0108 FIELD ROAD - Health 108 Field Road ------ _ Marstons Mills A. 150-028 Town of Barnstable Regulatory Services o� Richard V. Scali,Interim Director • enRr►srnat.E. • MAM Public Health Division i639' 0. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: ��` Sewage Permit# V/02 `36 O Assessor's Map\Parcel l 5� Designer: S fLV N Installer: f2OO f\AN rl5 Address: jb� Address: - 0 , O-L�0 U24=tw 1(4�__ /�W On l /3 r15qf)2_was issued a permit to install a (dat ) M�(inst ler)`` septic system at 6 t AD I�ft-0 based on a design drawn by (address) dated (6 a'��1�• (designer) P_ , 5 v fVe� 1'f�v I certify that the septic system refere ced 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 in 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 compliance with the terms of the I\A approval letters(if applicable) r ���� OF X D R. E: M at r's Signature) (Designer's Signature) N�FAR4a� t�l l PLEASE RETURN TO BA STABLE 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 down cape engineering, incSIEVE SOILS ANALYSIS 108 FIELD ROAD MARSTONS MILLS, MA.xlsx DATE OF REPORT:10/22/12 JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 108 FIELD ROAD MARSTONS MILLS, MA' LOCATION: EAS SURVEY TESTHOLE SIEVE ANALYSIS Weight Sample(Grams): 270.7 SIZE :WEIGHT RETAINED ', % RETAINED % PASSED -------------.............(sum ............................................................ 1" 0.0: 0.0 : 100.0% i .__-----------1......................................................}--------------_------*-----_------------ 3/4" € 0.0: 0.0% 100.0% -------------:...... .....:---------------------=------------------ 1/2" 0.0` 0.0%: 100.0% •-------------p.....................................................}--------___-_-------y.__--_-----------_ 3/811 '..............................................�:0.€--------------0.0% 100.0% 0.0: 0.0%: 100.0% 1......................................................}---------------------1..................................... -- ...........................................51....... ---------19.0% 81.0% -------------- ----...................................... 20 175.7 ..................................... #40 .233;5-------------86.3% 13.7% -------------- ----:..................................... #50 245.2: ..................................... #80 € 260.8: 96.3%: 3.7% ------------- .........................................I...........;-------------------- ....................... . ............ 100 : 263.0: 97.2%i 2.8% -------------......................................................,---------------------}------------------ 200 266.5: 98.4%: 1.6% -------------:............................................... . PAN: 267.4: 100.0%: 0.00 SAMPLE: € 270.7 NOTE:TEST ON PASSING#4 ONLY, 16.9% RETAINED ON#4<45%O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-2 (SILTY OR CLAYEY GRAVEL&SAND)(UNCOMPACTED PERCENTAGE OF MATERIAL PASSING#4 SIEVE #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% CLOSE #100 0%-20% OK #200 0%-5% OK SAMPLE CLOSE TO MEETING TITLE 5 FILL SPECIFICATION >98%SAND RESULTS: PERMEABLE MATERIAL-CLASS 1<2 MIN./IN. MATERIAL on9 NONCOMPACTED a cy SOIL DESCRIPTION: COARSE SAND WITH TRACE SILT DA.NIELA. Gn G OJALA c1 CIVIL ° NO.46502 ` 2 i ` T 112 y0- Lz 1 Za- I ! j 17 m t t k � t - t • 1 -t TOWN OF BARNSTABLE. LOCATION to J�J A!-LJ) )a SEWAGE# -VILLAGE/YJc,•S?a,4 f, ASSESSOR'S MAP&PARCEL R , —y a INSTALLER'S NAME&PHONE NO. � SEPTIC TANK CAPACITY LEACHING FACILITY. (type) a y (,Z V j)< 4 (size) // ;L y NO.OF BEDROOMS 3 OWNER Y" PERMIT DATE: // ) 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 leachin facility) Feet FURNISHED BY i 0 1 ad o 13uM it 3 l A 3 -79 a -33�"� 135 _ �� No. � a 36o Fee G v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 0(pptitation for Misposaf *pstrm Construction permit Application for a Permit to Construct( ) Repair( Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components XLocation Address or Lot No. �/ro F'r d AW A • Owner's Name,Address and Tel.N�o. T S r� C Assessor's Map/Parcel )h t7 -"b. ' �Oa S� ME /j� r 09 l�,p(�j p-or� /��r�/cad C//17�� ,f D 8 346 p Installer's nnName,Address,and Tel.No. Designer's Name,Address,and Tel.No. IMF n Ike r 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) 3 3 gpd Design flow provided to gpd Plan Date (tl x ,?. Number of sheets 3 Revision Date Title Size of Septic Tank 9 D Y 4 Uo 0 L� Type of S.A.S. 2 y v�C l/! L l� �� It yy Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: ` The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in f r accordance with the provisions of Title 5 of the Environmental de and not t place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Si ned Date. Application Approved by 2 Date Z. Application Disapproved by Date for the following reasons Permit No. ;)Lo f 2 — 3 0 Date Issued t 1 2 r IN r� t 'r• 3 ? a No. (� 3 U Fee V� -,-. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWNS OF BARNSTABLE, MASSACHUSETTS 2pplifation for Bispo8af 6. stem Construction Permit 1 Application for a Permit to Construct( ) Repair( Upgrade(}) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /o-F F,'P 441W 4Q'W. Owner's Name,Addressj and Tel.No. 7;' f o N X /LIB ion i� ,79, B /y,� /08 F,'PP� rol'� /h'�rJ/o� �/Yl�� ,,so83--o 36a ,7 Assessor's Map/Parcel )5 n b �i Installer's Name,Address,and1 Tel.No. Designer's Name,Address,and Tel.No. ye r Type of Building: { Dwelling No.of Bedrooms `, Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons .. Showers( ) Cafeteria( ) Other Fixtures J~� Design Flow(min.required) 3 gpd ' Design flow provided t0 gpd Plan Date- I-f) q ,Z Number of sheets Revision Date I 4 Title G t s Size of Septic Tank /(J 0 D )( 4 /U o 0 Type of S.A.S. Description of Soil EEr Nature of Repairs or Alterations(Answer when applicable) �. r ; 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 Environmenta�C•de and not to'place the system in operation until a Certificate of Compliance has been issued by this Board of Health. / +..,� Signed_ Date Application Approved by %In Date 41 4 2— Application Disapproved by ` Date for the following reasons PermitNo. U 2 ' (U ' Date Issued-------------------------------------------------------------------------------------------------------------------------------------- t TH E COMMONWEALTH OF MASSACHUSETTS ''. BARNSTABLE,MASSACHUSETTS Certificate Of Compliance T THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(�) Upgraded( ) `1 Abandoned( )by 0.d r?,, r-1 It etc = X at /o g r-.`,,A✓ /0 has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.)V 11 `3 b U dated Installer Designer #bedrooms Approved design flow 33 gpd � s } The issuance of this erm'�t shall not be construed as a guarantee that the system w}ill function as designed. } Date ( � ( Inspector_ / cam. .�/ s �' v , -------------------------------------------------------------------------------------------------------------------------------- r No. 70( Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 9ppstem (Construction permit Permission is hereby granted to Construct( ) Repair( ) Upgrade(: ) Abandon( ) System located at X /s7 27 Ar.P 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 ust be completed within three years of the date of this permit. " Date (7 Approved by �. f Town of Barnstable Department of Regulatory Services ]Public Health]Division Date 200 Main Street,Hyannis MA 02601 Date Scheduled b Lk'�1 1 ®� Time / / Fee Pd. b L) Soil Suitability .Assessment for Se a e Disposal Performed By: Witnessed By: /�� LOCATION& GENERAL INFORMATION Location Address ` 0I . Owner's Nartre--i-� b l�� MI LL_S 1 t e,--Nj (���,�� 1A Address - ( 46 Assessor's Map/Parcel: �1r �t���� sue « �� Engineer's Name '�- �-' S NEW CONSTRUCTIO N REPAIR Telephone# C � ZV -4, � � �°►� Land Use_ '� l�'jc sti o S-SIJI/U tx>.CJ Slopes(96) l l Surface Stones Distances from: Open Water Body OV A- ft Possible Wet Area '�a ft Drinkin WatezWcll g tga,,Ld I�ft Dralirage Way ft Property Une fc /ft Other 4 SKETCH:(Street name,dimensions of lot,exact 1 atlons of test holes&pere tests,locate wetlands-in proximity to holes) 1ry G� C_ Parent material(geologic) Depth t9 Bedrock Depth to Groundwater. Standing Water in Hole: v r� Z �. 7 y p g ��nl ���U�• Weeping from Pit Face 2 Estimated Seasonal High Groundwater/_90 ¢/.Bf DETE ATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standingm obs.hole: �Y� 3g � D / In, Depth to 5911 mottles: ,'.In, Depth to weeping from side of obs,hole: 72nZ_U� In, Groundwater Adjustment ft. Index Well# Reading Date:,---- Index Wclt loyal A�,ihetor Adj.Groundwater Leval,,,,_3,57 Observation PERCOLATION TEST bate Tbna____ ^�-Hole Tima at 9" Depth of Perc � Time at 6" Start Pre-soak Time @ �`s�S _T; a(9"-6") End Presoak Rate Min./Inch Site Suitability Assessment: Site Passed Sitp Failed: Additional Testing Needed(YIN) Original: Public health Division Observation Hole Data To Be Completed on Back--------- ***If percolation test is to be conducted within[100' of wetland,you Must first notify the. / Barnstable Conservation Division at least one(1) week prior to beginning. Q:\S EPTIC\PERCPORM.DOC DEEP.OBSERVATION HOLE LOG Hole# _�8' 96.-7 Depth from Soil Horizon Soil Texture .Sdil Color Soil Offier Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,,Boulders. • o i tc �y,96 Gravel) la Vd. /3 '- ZZ'' 36 ti /2D C' ZIS, /2a"--146 63 .T 6 i� Haves DEEP OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. o sis c.n '%Gravel) ►� 14 Q 6� . �/3Z c2 � a•s Gee .- =:` 2v �l / ' dw- DEEP OBSERVATION]BOLE LOG Hole#� Depth from Soil Horizon Soil Texture Soil Color Soii Other. Surface(in.) (USDA) (Munsell) Mottling . (Structure,Stones,Boulders. Cmaiatcnry.%Ormen DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Cositn y Flood Insurance Rate Map: Above 500 year flood boundary No— Yes e Within 500 year boundary No 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? -0 .5 y If not,what is the depth of naturally occurring pervious material'? Certification I certify that on -1 (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 traiWlpk expertise and experi a described in 10 CMR 15.017. Signatur Datb !a l9—lZ- Q:MnlaPERCPORM.DOC �� �� ��� ��. ��;� �� ��a� � �� A: P�oF1H*Er Town of Barnstable , ,, aarnstabie ,; ` Regulatory Services Department a�ameicacuv %BA B�.E., P Public Health Division 200 Main Street, Hyannis NIA 02601 2007 Office: 508-862-4644 FAX: 508-790-6304 Thomas F.Geiler,Director Thomas A.McKean,CHO CERTIFIED MAIL# 70081830000205009465 / OUYYLJZ 6/14/2010 OW-2— Louis Mendoza 108 Field Road Marstons Mills, MA 02648 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system located 108 Field Road, Marstons Mills, MA was last inspected on May 26, 2010, by Sean Jones, a certified septic inspector for the State of Massachusetts. The inspection of the septid system showed that the system "Failed" under the guidelines of 1995.TITLE 5 (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS. You are ordered to repair or replace the septic system within One (1) year from the date, you receive this notification. Failure to repair/replace the septic system within the deadline period will result in fixture enforcement action. ER OF THE B ARD OF HEALTH a Thomas McKean, R.S., CHO Agent of the Board of Health �C� o o� __ i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments s 108 Field Rd. Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 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 A. General Information filling out forms on the computer, use only the tab 1. Inspector: key to move your cursor-do not Chad Hathaway use the return Name of Inspector key. Hathaway Title V Inspections Company Name 1 Warwick way Company Address Mashpee Ma. 02649 Cityrrown State Zip Code 1 774 274 2581 12866 Telephone Number License Number C-) B. Certification I certify that I have personally inspected the sewage disposal system at this address and thatthe 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 onjsite sewage disposal systems. I am a DEP approved system inspector pursuant twSection-1:5.346-0f Title 5(310 CMR 15.000).The system: ❑ Passes ❑ Conditionally Passes ® Fails ❑ Needs Further Evaluation by the Local Approving Authority 5/26/10 Inspector's Signa a Date The system inspectors submit a copy of this inspection report to the Approving Authority(Board of Health or DEP) ' In 30 days of completing this inspection. If the system is a shared system or has a designifle�ii 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. L4 (0// (� � V t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewag isposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ` 108 Field Rd. Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 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: 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•09/08 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 108 Field Rd. Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 page. Cityrown State Zip Code Date of Inspection B. Certification (cont.) 3) 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 108 Field Rd. Property Address Mendoza Owner Owner's Name information is Marstons Mills MA 02648 5/26/10 required for every page. City/Town 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 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 '/Z day flow t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 108 Field Rd. Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 page. Cityfrown 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 El Elthe 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 108 Field Rd. Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 page. Cityfrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , g 108 Field Rd. Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 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 . Seasonaluse? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): Detail 200817000 2009 11000 Sump pump? ® Yes ❑ No Last date of occupancy: dec. 2009 Date Commercial/Industrial Flow Conditions: Type of Establishment: Res. Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 l i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , g 108 Field Rd. Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Dec. 2009 Date Other(describe below): General Information Pumping Records: Source of information: no info 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 108 Field Rd. Property Address Mendoza Owner Owner's Name information is Marstons Mills MA 02648 5/26/10 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1980 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 1.25' Depth below grade: feet Material of construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line 20+: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): .25' 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 8'6"L 4'10"4'3"deep Dimensions: 4" Sludge depth: t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 108 Field Rd. Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 page. Citylrown State Zip Code. Date of Inspection D. System Information (cost.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 27" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 20" How were dimensions determined? sludge judge and tape Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): inlet tee and inlet pipe good condition outlet pipe has concrete baffle needs new PVC tee and baffle at time of new SAS install tank shows no signs of leaks or cracks Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 f Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 108 Field Rd. Property Address Mendoza Owner Owners Name information is required for every Marstons Mills MA 02648 5/26/10 page. Citylrown 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ( 108 Field Rd. Property Address Mendoza Owner Owners Name information is required for every Marstons Mills MA 02648 5/26/10 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 at bottom of invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box has heavy solids carriedd over from tank cover has dark black staining on it soil shows heavy discoloration around box and over the cover 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: dug up flow defuser cover black dicoloration on ceiling of flow defuser.. defusers are still 3/4 full of water even though house has been unoccupied since Dec 2009 t5ins-09108 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 M , 108 Field Rd. Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 page. Citylfown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 8 flowdefusers ❑ 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.): Hydraulic failure 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-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 108 Field Rd. . Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 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•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , ° 108 Field Rd. Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 page. Citylrown 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 y fir' is�b�r A� / 133 C3 L� 0o, t5ins•09/08 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 "< 108 Field Rd. Property Address Mendoza Owner Owner's Name information is required for every Marstons Mills MA 02648 5/26/10 page. Citylrown 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: perched water feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: propery is elevated compared to abutting properties but signs of preched water and weeping water on slopes of property origanal septic was put in at a high elevation and graded up to test holes and possiable monitering well may be required for new S.A.S Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 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 , 108 Field Rd. Property Address Mendoza Owner Owner's Name information is Marstons Mills MA 02648 5/26/10 required for every 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 t5ins•09108 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 SEW LOCATION A E PERMIT N0. �. ,vvrS d�l� a -� `7 6 VILLAGE d `aag' INSTA LLER'S NAME & ADDRESS J. A G MEC'ElRos Trucking & 'Bulldn7gjz g 142 Corporation Street B U I'L D E R OR OWNER 11YU111115, 8 DATE PERMIT ISSUED �'�� � DATE COMPLIANCE ISSUED / p 0 m o ,eo'o®a Z, %2 0-r ..7..`. G THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH 09 17��40A)................0F_ RA..k).S.T4.T,3.L .......................................... for Utz ogal Workii Cfoustrurlt�art anttt ,���ltrtt#tlan � ' / lication is hereby made for a Permit to Construct (v) or Repair ( ) an Individual Sewage Disposal System a Location-Address t o. ... . .ls/S.._..... 4AA ----------•----.--.---•-------•----- � �.. - -- ner -----------------------------------•-Address Installer Address de of Building Size Lot...... --------Sq. feet aDwelling—No. of Bedrooms--------? .........................Expansion Attic ( ) Garbage Grinder (NC) p,, Other—Type of Building ---------------------------- No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures -•---------•----•---------------- - W Design Flow............ .......................gallons per person per day. Total daily flow............ - -_ .................gallons. WSeptic Tank—Liquid capacityjaos?_gallons Length................ Width................ Diameter-............... Depth................ x Disposal Trench—No. -------%-------_-- Width... -4?.......... Total Length---2--e> ...... Total leaching area..6Qa_�......sq. ft. Seepage Pit No.---_____--_-_----_ Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (�) Dosing tank ( ) i90G q '-' Percolation Test Results Performed by---K1r,*A1,D-...���-�'�OAIVK......................... Date s�!°�.Z� 3 1'y ' aTest Pit No. 1__je,1-....minutes per inch Depth of Test ----- Depth to ground water../_O$.......__... Test Pit No. 2._A5_Z---_minutes per inch Depth of Test Pit___ -------- Depth to ground water.40. `.............. ----- ---------------------------------------------------------------------- --..-----.../�8.........-----------------------------....----------- Description of Soil-- .-� � > ��.Q__5�1117,�}!.. 4.,V------ �.. ....C6.4,1V..Si9.N I v ............... A '��'....... rat�.v ,L---•------------------- x ------•----------------- Y V Nature of Repairs or Alterations—Answer when applicable.---� ----------------------------------------------------------------------------------------------------------------------------- 'e.....? 9-................................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in I accordance with the provisions of'THE y g g p y 5 of the State Sanitary Code— The undersigned further agrees not to lace the system in operation until a Certificate of Compliance has b en issued by the board of health. Signed. ...................•-- -----------......._..........••�-��.••-• ----•••---•-.................... Date Application Approved BY __ .. • •-------•-••-•---------------------- -------------- ate Application Disapproved for the following reasons---------------------------------------------------- ---•---------------------------------------------------•--- --------------------•------•---------------•----------•-------------•-•••-----•---•-•-------•----------•---•--------•-•-••--••-•-.---•------•--•••••-- ------------------------------------------ n , Date 9 � PermitNo......................................................... Issued..- ---D��a+te--"-»-----..........•------------ , �'. , 3 a.. f •.b � fY '7 � Y.., .i � t�`K a aZ .. +�". ba •. # Novembaer9'", 19 7.9 t t� 4. �. Mr .Lams Mendoza - r. .f P. 0 Box 355 BuZzards'�Bay MA, '02532j r kDe'ar,Mr, Mendoza. i.:c#'. a f• You are, granted-, permission to t a nstalx, a`Septic system ©n I ots .%y end 22 Field Road;u..P ,easantf,Place,; Marstons Nii"lls; .with the foliow ng 'conditions• ' `x a a ,k+ t• N.0 S' ` 1. .�.The system must°'b6v 1% taped in str ct accorc?ance with g R. :x<the• s�tbm teed en-'i'* oring ?plans • # a' �,, Ali* .oam, subsoil, and .clay 6 all` .be r6moved beneatnthe =f leaching facility aria;`1 q;gfee ' in ,a ,l dire ons, from the' .eaching ch be �an loan,Fun rs` c1,replaced° with c coarse granular.'material. t A� 3. . All -dther •requirements of Ti a 5, R'State Environmental: ode and" Town of`Barnstable Hcalth.;regulat .ons 'musst` be " strictly 'adhered'"to. ' rt , x , s,�approval 'does °not coriet tute. a;",gua antee ,th t`l r a the system Pi , Will`�funetlon properly. truly 'your. 4 J S�. r,&s.{. "k. ems,.. •••q k ! + 4 J aN a 4 � �' Y-x ert L:n Childs cha rman s , A. •W. :Man scam, M**­w%D. Ann, Jane ,E l;baugh , ? � u6 ..A f 1 -. •yt P HEALTH TOWN .OF BARNSTABLE � �;+`� Ul�Yi�/K�`t z•it >{ ��.�v �' 4'� �s 4ti+,�"1 4 F� �i� S f'��,*t` z �..x a , f-T 7 4 1� iJ#.y a.. F y ..; 'y_ ., 7r ._.�.�` tit. .rY- •r ,N P,. THE p �� i BAB9STABLE, o° ��-/�//I /y���/// ��/�9 �'• y 1639 p0 i639. 0 MAY P. 0: BOX 368 HYANNIS, MASSACHUSETTS 02601 November 6, 1979 Board of Health Town of Barnstable Hyannis, Mass. 02601 Re: Project for Louis Mendoza Lots 21 & 22 Field Road, Pleasant Place Subdivision, Marstons Mills Gentlemen and Mrs. Eshbaugh; The Conservation Commission has inspected the above-captioned site. . There are no wetlands or ditches close enough to the site that would cause it to fall under our jurisdiction. Past experience with properties in this. subdivision indicate that clay lenses prevent proper drainage and septic system functioning. Site inspection revealed that there is widespread dense clay at the site, in a down-gradient position from the proposed septic system. With the shallow field-type system proposed for the site, it might well mean that some effluent could strike the clay layer down-gradient, ride over the clay, and break out in one of the down--gradient ditches, or in part of the subdivision drainage system, causing potential public health problems. The Commission hopes you will seriously consider the area-wide problems before granting any permit for this lot. Sincerely, Arlene M. Wilson Chairman AMW/dm S ' No......................... r ES.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .............OF...........� .C�!v"! ?7LL�- .......................... ApplirFa#ion for Mipoii al Work, Cfomitrnrtion ramit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: WY �teld �o�d- l�lo --- -- -------------- ------•-----. ...----..........------------------------------------------ -- - ......_. Location-Address NoLoo`sMe-Indama . S ? ................ .. ..........._....................•................ -.. ...-••• Owner Address ........................•---•---•----•----------•------•---...-----•-------•----•-------...._...._ ..........---------------•----•-----------......-----------..._:-•- ......•......-- � Installer Address Type'of Building Size Lot..42. boo..____Sq. feet U Dwelling—No. of Bedrooms............. ..........................Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures -----•---------------------------------------- <11 W Design Flow............................................ per person per day. Total daily flow__._......_.._--- Zn---------_..... WSeptic Tank—Liquid capacity iao®-gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No. ................... Width.................... Total Length.................... Total leaching area....................sq. ft. _IF-ld C�)Diameter_�'X_Zo'. Depth below inlet..o°q��_____. Total leaching area._��......sq. ft. Z Other Distribution box (X) Dosing tank ( ) 9 y19°lq #C414 4-� '-' Percolation Test Results Performed by._1Z4C_k-1''�_.��+&I!-ba mid_-.Q .r___.._...__ Date_. -P�S2'. 1.�.14'�`._.0 ,aa Test Pit \To. 1--�--�___ __m ^��+P ^Ar Depth of Test Pit_O .��------ water--- ----------- •Depth to ground water.... ®'. ......... --------•----------------------------------------------------------------•-----.........-----.--..._......................................................... 0 Description of Soil....... e-...0f5?- x --------------------------------------•-•-------•---•- W -•--••---------------------------------•-------••-------------•••--•--------------------•--•-••-----------------------------------------•••------•------------------------••-•----••......------.._..... UNature of Repairs or Alterations—Answer when applicable............................................................................................... --------•-------------------------•---...-------------------------•-----•---....----................------------------------------------------------------------------------------------------.....----• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with TITL E, the provisions of T_T'E 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 ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons-----------------------------------------------------------------------------------------------••--------------- -----•---•------•--•--•-•.........---•--...•-••-------------------•------•------•----.........-•------•----•--------•-•-•---•--•--•-•--------•-•--•------•--•------•••----...••--•-----•............... Date PermitNo......................................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................................I.,.......OF..........................................I............I........................... Trrtifiratr of TontpliFatta THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by.................................................................................................................................................................................................... Installer at............................................................................................................................................................................... has been installed in accordance with the provisions of TITLE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated---------------------------- ................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............................•---------------------------...-••------------_.---- Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ...................................OF.................................................................................... No......................... FEE........................ Disposal Workii TUonotrnr$ion Vamit Permissionis hereby granted----------------------------•--.....--------------•------------------------------------..........-----.........._......•-------•............. to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo....................................................................................................................... Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... ..........................-••---....•--------------•---•-------------------•----•--------.....-----•••-- Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC., PUBLISHERS L a No........................ FImg.............................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH OU—)+n.-- ........OF...........��,..>.��r.v�� ' -- Applirotion for Uhopooal Workti Tonotrnrtion ramit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: ,, • ' i �1eI� �� - fUrt4ons M1l `7 L•O�Z1 2Z 1 pie� u ,s .ln+ PI6-r-c"r ................„„.............................................................................. .......................... ................................................. _........._........_...._..._._..._............ Location-Address- � u{ ............................................................. ...... 2 Owner Address ................................................................................................. .......•-•----•----------...........-----•-••••...........------..........----•---•------•-•-•---- Installer Address QType of Building Size Lot.....41.Z.aqv-.....Sq. feet Dwelling—No. of Bedrooms.--..._.....z-..........................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building No. of persons............................ Showers — Cafeteria a Other fixtures ---------------------------------------------- Design Flow...............................- ............gallons per person per day. Total daily flow--...............Z?o.---...........gallons. W WSeptic Tank—Liquid capacity kgon._gallons Length................ Width---------------- Diameter.....---........ Depth................ x Disposal Trench—No- -------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. C-=1 e.id-(0 Diameter Z4 I K. . Depth below inlet..!?A_R...._.. Total leaching area..?------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) _ uct. cj,19 qq , '"' Percolation Test Results Performed by 2��hcc,rc3-----i-rUce-nlc---Plc-.-------- Date._. _P{? :_ l_� `...�- s Test Pit No. LIkA......minutes•.pe-r rock. Depth of Test Pit-1z-•"-9+. Depth to ground water.--`.---�..-.-----. Test Pit No.72s_(C?Iminutes per inch Depth of Test Pit._P ....... Depth to ground water.---)_0`.4_......... •----------------------------------•-------------•-•---------------•----..........--------------•-•-........................................................ 0 Description of Soil.....�ee....0ah V .............................................---.........--------•--------------•-----••--•---------------------•--•--•------------...-•--•---•--•--------------•-•----------•--•-•.._............... 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 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 ApplicationApproved By.................................................................................................. ........................................ Date Application Disapproved for the following reasons-----------------------•-------------------------------------------------------------------...--------•-•-------. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .....................I................OF..................................................................................... Trrtifiratr of Tantlilionrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by....................•--••-••---------------••------------------..._............------•-------------•-------...--•-----•---•--•-------.....-•-•-•----•-............-•-------....-•---•----•-•--•••... Installer at----••--------------------------------------•---------------------•---------------•-------------------.-----------------------------------------------------------------------------_----------------- has been installed in accordance with the provisions of TIT t.E 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No----------------------------------------- dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............................I......OF..................................................................................... No......................... FEE........................ Disposal lVorko Tonotrnrtion rrntit Permissionis hereby granted............................................................................................................................................. to Construct ( ) or Repair ( ) an Individual Sewage Disposal System atNo.........---------------------------------•--------------------•--- --------•---------••------.--------------------------------------------------••-•--------------------------------•------- Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... ----------------•-------------------------------------------------------------------------••-•----•----- Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS W 26 ? / 2r3 �a - « 6/Ac. ' 07 f e... J u ,9c. 3 .rQ � 'p Nam. s^a h• I i \a I�h. ♦ iA�Q ��'+Q .,..yV� ��aJ,.�1 t Y'T�"ark j I: VIC 10 Ojs Ila dyN i 1I `� .� Y�� ^i� 4 FJ•�`�, it C � roe FORT! 2' COICON'WEALTH OF MASSACf i'WSETTS T RMlliATiott. OF APPLICABILITY OF THE WETLAND PROTECT,ION ACT DETE G.L. C.131 . s. 40 DATE: October 31, 1979 TO: Tony D'Angelo 9 Main street Buzzards Bay; Mass. 02532 . Pursuant to the authority of-GA. C.131 s.40, the n*�*,cmAat.E coNSExvATION- coru�Iss.ION has considered your request for a applicability together with the plans submitted with it and determination of PP has made the: 'fol1aWinq, determination: The area-. shown on the plans is not subject to fast etAct and shall 2 The entire area shown on the: vlens- fis subject requi re'a filing of the.tJoti ce of I me Ct•to the Act and shall 3. [` ] Only the area described below is sub�e require a filing of the Notice of Intent:- plans--- is subject to .the Act but the Proposed work is 4 c The area shown an the pl or altering, and therefore a Notice of not dredging, f illing,:, removing, Intent is not required. The determination that the work is not subject to the Act shall expire within one, (l) year, from the date herein. 6. This determination does not relieve the person requestsn9 the determination from complying' - all- other apolicable federal , state or ordinances, by-laws, and/or regulations. 7. Failure to. comply with th is. determination and with all related stftuthe said _. other'�regulatory measures shall be deemed cause to revoke or modify . determination. g, No work may be:. comme �ed under this determination until all appeal periods n have elapsed•. - ISSUED 8Y: T Quality En.gineerinq issues a negative oro superseding: Where'. the Department, of` Environments inati"on; you are ;.hereby notiPie& of your dateriqhtof�thef su arsedin?ndeter determ day fron the vided;.i t is made; within- - I ( d- Envi neeri na. `urination of the Department of=Environmental Quality { V k = - y 1 k , 2 _� .. ..�x. _�. ,. . .,.,._... .... .._.. .�._�-...av�`.k�.Y�sa.��"s^�:a'.._�_...:w>_,�s�:�6.x.L.:a �'.u".•"s`�"�'.__ ,z.,_ .... . - .. ...' t - 1[ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION A lication O Map �:� Parcel pp p Health Division — 6 -- Date Issued Conservation Division .Application Fee I ` Planning Dept. Permit Fee JJ Date Definitive Plan Approved by Planning Board I� Historic - OKH _Preservation/ Hyannis i i Project Street Address Village / c ���o�•s Y tMj ✓� I to 2 � Owner �� Cr I 4�- Address n Telephone S� --� � Permit Request (r� e ' �c " 2 . �G c r ! c'i, v e E t'o o/ Q" !� eesTr'k S e o /o,-eoaf' 4��i� �7 Ptl�i �rr T��oa.� �1C vt�n.J�A. -J .Nove Qp�vo VJ Square feet: 1 st floor: existing proposed 2nd floor: existing i'S(?3 proposed Total new i Zoning District Flood Plain Groundwater Overlay Project Valuation �' 010 Construction Type I Grandfathered:CQ C ❑Yes Vd No If yes, attach supporting documentation. Lot Size Dwelling Type: Single Family Two Family ❑ Multi-Family units) Age of Existing Structure Historic House: ❑Yes No On Old King's Highway: ❑Yes o Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new i Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil" Electric ❑Other l New Existing wood/coal stove: ❑Yes ❑ No I Central Air: ❑Yes ® No Fireplaces: Existing 9 i I Detached garage: ❑ isting ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ • I Attached garage: existing ❑ new size _Shed:-'0/existing ❑ new size�'dOther: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ 'i Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use j � i I APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Tn �� 41 Telephone Number w Address e > License# Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i i%� D ��'` o? E� � SIGNATURE ATE ` I SYSTEM DESIGN RAISE COVERS TO WITHIN 6" OF FINISH GRADE OBSERVATION PORT(S) TO GRADE DESIGN FLOW SILL ELEV. 101.17 INISH GRADE 24" MH COVER TO GRADE FINISH GRADE 3 BEDROOMS AT 1 00 GPB/D IM GPD ELEV. 100.4 ELEV. 100.3 GROUND ELEVATIO 100.2 GRADE ELEV. 100.2 100.1 ELEV. 100.0 3:1 MIN REQUIRED SEPTIC TANK 0' FORCE �� �� ����� Tnp _ 1' OF COVER 99.6 - 6'CADS= 0.01 TOP ELEV 99.27 330 x_2__ _ 660 GAL. 2 PVC SCH 40 SEPTIC TANK REQUIRED = 1„900 _GAL. 4" Pvc SCH 40 2"MIN-3"MAX 5'@0.02 2 MI-'N 3 M ,h LEXISTING S.T. TO REMAIN = 1.000__GAL. =98.37 10"TEE 14"TEE INV•= 10"TEE " SIZE OF LEACHING FACILITY REQUIRED INV.= ?,,&lteL 98.01 -10 DB6 SET "QUIK-4" LOW PROFILE LEVEL DESIGN PERC RATE <2 MIN./INCH GAS BAFFLE INV.= GAS BAFFLE )-BOX BOT.95.6 LONG TERM APPL. RATE 0.74 GPD S.F. 98.18 > 40MIL / 97.91 INV.=99.11 \IlNV.=98.88 4-1" LIQUID LEVEL 4'-1 ' LIQUID LEVEL INV.=98.94 cr w POLY LINER "T" REQ. a � 4'x100' SIZE OF LEACHING SYSTEM PROVIDED: ,:• / PLUG TOP 24.0' ( ) �f BOT. ail 1 22' x 34' OVERDIG ,n ui 98.6 330 : 0.74 SF/GPD = 446 S.F. MIN. REQ. 0 93.37 o e a USE (24) QUIK 4 LOW PROFILE 1 ELEV. 93.5 ppT DATUM : EXISTING 1,000 GAL TANK TO REMAIN PROPOSED 1,000 GALLON PUMP CHAMBER CHAMBERS TPTALING 96 LINEAR FEE MOTTLES TPIT#1 USING 24 STONELESS UNITS 48%34"xJt't1STONELESS BED FORMATION INFILTRATOR - 24 QUIK "4" LOW PROFILE SEE SHEET 3 FOR DETAILS ( FOUR ROWS OF SIX PANELS ) VERTICAL DATUM: BARN. GIS - MSL± CONSTRUCTION NOTES: 4 . SF / LF X (4' x 24) = 453.74 S.F 453 BENCH MARK USED: NAIL SET IN TREE 2 OBSERVATION PORT 74 x 0.74 G/SF = 336 GPD ELEVATION 100.00 1. CONTRACTORS / INSTALLERS.SHALL VERIFY GRADES AND / SCREW CAP TO GRADE 12-0125 ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING 336 GPD PROV > 330 GPD REQ. = 6 GPD RES. WORK ON THE SITE. SAND FILL SITE 8c SEWAGE 2• NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE NO (GARBAGE DISPOSAL / GRINDER ALLOWED) WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT P_13771 IS REPAIR PLAN 3. VEHIOCULARAITRA TRAFFIC, PARN SUCH KING OFOVEH VEHICLES N FROM ANDOPLACING IATE AUTH. o 0 D.T.H. #1 ia D.T.H. #2 Q MATERIALS OVER THE SEPTIC TANK IS PROHIBITED. DATE: 10-19-12 DATE: 10-19-12 GROUND .08 GROUND GENERAL NOTES: --2.83' -�--2.83'--}---2.83'-�--2.83� MOTTLES 0EV.93 56 7 MOTTLES ®EV.93 36.3 FIELD ROAD 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS 11,32' N FOR SUBSURFACE DISPOSAL OF SEWERAGE. END VIEW A A 2 ACCESSAT LEAST ONE 0 FINISH GRADE, WITH ANY REMAINING I CERTIFY THAT I AM CURRENTLY APPROVED BY THE 10YR 4/3 POINT OVER K TEES A LL BE LOAMY SAND LOAMY OYR 4/3 D M A R S TO N S MILLS, M A ACCESSIBLE WITHIN 6 ACCESS PORTS BROUGHT TO WITHIN 12" OF FINISH GRADE. DEPARTMENT OF ENVIRONMENTAL PROTECTION TO CONDUCT 4" 4" DATE: 10-29-12 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE SOIL EVALUATIONS AND THAT THE RESULTS OF MY SOIL B B CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE EVALUATION ARE ACCURAT AND i ACCORDANCE WITH 310 LOAMY SAND LOAMY SAND APPLICANT: UNDER OR WITHIN 10' OF DRIVES OR PARKING AREAS THEY CMR 15.100 GMUST WITHSTAND H-20 LOADING. 15. 10YR 6/6 22,E 1OYR 6/6 24" Mr. TI GR AN GI CH U N TS 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION - ---- OF ALL UTILITIES PRIOR TO ANY EXCAVATION. EDWARD . �E,ItERTIFIEDISOIL EVALUATOR MEDIUM SAND 36 SILT LOAM 108 FIELD ROAD 5. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE 2.5Y 7/4 36„ 2.5Y 5 3 OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. 38" ELEV =92.3 48° MARS TONS MILLS, MA 6. FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER GROUNDWATER ADJUSTMENT Cd-2 C-2 FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. SILT LOAM COARSE SAND 7. SEPTIC TANK SANITARY TEE'S SHALL BE CONSTRUCTED OF OBSERVED MOTTLES 2.5Y 5/3 72 2.5Y 6/6 SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE" ELEVATION 93.5 108" 20% GRAVEL THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND _ ELEV =86.7 120" WET LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. C-3 C-3 132" SHEET 2 OF 3 8. THE INLET PIPE INVERT ELEVATION SHALL BE NO LESS THAN COARSE SAND 2 INCHES NOR MORE THAN 3 INCHES ABOVE THE INVERT ��SH.OFATq� 2.5Y 6/6 CLAY ELEVATION OF THE OUTLET PIPE. j o`'� DA., � 1090 GRAVEL 5/SPB PREPARED BY: 9. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES " _ - 180" 156" E A S SURVEY, INC. 10 BAFFLE, 4 OUTLET IN INCHES INSANITARY DIAMETER SHALL AND CONSTRUCTED EQUIPPED WITH OF 4"GAS PVC t ELEV =81.7 ELEV =83.1 11. ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND O. 1140 INDICATES DEEP B.O.H. 141 R T. 6 A SHALL BE SLOPED 1/4 INCH PER FOOT MIN. EXCEPT FOR THE P p DTH #1 TEST HOLE DON DESMARAIS �/ FIRST TWO FEET OUT OF THE DISTRIBUTION BOX WHICH SHALL �G/STE""� SOIL EVALUATOR P. O. BOX 1 / 2 9 BE LEVEL Sq' 1,TAR\PN INDICATES ED. STONE 12. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION _ / P-1 SIEVE SAMPLE BACKHOE OPERATOR. SANDWICH , MA 02563 TO EAS SURVEY INC. FOR B.O.H. AND DESIGN ENGINEERS REVIEW, D �Gf♦`y RODNEY FISHER AND APPROVAL. 38 INDICATES MOTTLES SOIL TYPE: 1 PH. (508) 888-3619 13. MAGNETIC TAPE OVER ALL COMPONENTS. 7.5YR 6/6 DISTINCT & COMMON PERC RATE: <2 MIN. PER INCH LOADING RATE: 0_74 GAL/SF/MIN CELL (508) 527-3600 ...► 72" INDICATES GROUNDWATER SIEVE ANALYSIS BY DOWN CAPE ENG. LOCUSJ c DATA n T ^ BENCHMARK /-� f-1 s NAIL SET IN .� E. � �SS240,. OAK E EEV THE 00.00 CURRENT OWNER TIGRAN GICHUNTS 0� �6' s ® �3268. G 96 PLAN REFERENCE 198-43 Z / DEED REFERENCE 26457-225 / /�Ps c PROPOSED / B-6 \ Io, x ZONING DISTRICT RF OVERLAY DISTRICT NOT A ZONE II s 9 Aar?yo 0,6 P P 2 , 52. FLOOD ZONE "C" 250001 /Q �' 36' 9 ABANDON �� / 9-15 EXISTING S.A.S. ASSESSORS MAP 150 j� � IN ACCORDANCE PARCEL 028 0/ o WITH TITLE 5 G _ � LOT AREA 41,930t S.F. �v �Ps 6 p_ ��' 1 0l PROPOSED OVERH �i9 OBSERVATION PORTS U7'10 PROPOSED 5' OVERDIG SITE & SEWAGE 5 �°c��� I S Lo °F�, 0 / 40mil POLY LINER REPAIR PLAN /�P °F�� � 6 PROZOXED4S0A.S. BPS �� LOTS 21 & 22 �� 9 �jN OF S #108 41 ,930± S.F. - - PROPOSED ��� DAR EN cti FIELD ROAD 1,000 GALLON IN G h� PUMP CHAMBER Y n o J� No. 1140 MARSTONS MILLS, MA DATE: 10-29-12 Q Lo m I t-� S41VI.TAR��� EXISTING 1000 6 APPLICANT: �cp 96 GALLON SEPTIC 0 30 45 60 Mr. TIGRAN GICHUNTS TANK TO REMAIN 108 FIELD ROAD M AR STON S MILLS, MA GRAPHIC SCALE: 1 INCH = 30 FEET rn SHEET 1 OF 3 ,L UPPER LEVEL FLA LOCUS - ROO ��� , r BH KITCHEN PREPARED BY: �� �04 _ �p��N�FSsq� MASTER W 0 E A S SURVEY, INC. �o�� EDWARD A. y�sl BED #1 BED LIVING ? TREE SOP OPT 141 R T. 6 A �/ , � STONE �' #2 ROOM N RACE LANE No. 2 9 P . O. BOX 1729 C� ° lo F is � BED BH SANDWICH , MA 02563 �` �_ �,�ti GARAGE 3 N PH. (508) 888-3619 CONCRETE BOUND �0 LOWER LEVEL 0 FOUND I o LOCUS MAP CELL )508) 527-3600y_, __1.2_0125 NOT TO SCALE: DOSING CALCULATIONS: DESIGN FLOW TO CHAMBER = 330 GPD REQ'D EMERGENCY STORAGE = 330 GAL PUMP POWER 4�~- 9 -10 -�4'I---- EMERGENCY STORAGE PROV'D = 675 GPD (2.7' x 250/FT) & FLOAT NUMBER OF DOSING CYCLES = 4 PER DAY / TITLE V (330 / 4 82.5GPD) CONTROL DEPTH PER CYCLE = 4 INCHES CABLES 250 G/FT x 0.34FT. = 85 GAL/DOSE + 2.5 GALLONS BACKFLOW DESIGN TDH = 10.24 FEET < 13 FEET PER CHART) IN, 4'-2" 5'-0" DESIGN GPM = 40 GPM -- s RUNNING TIME = 85 GAL _ 40 GPM = 2.1m Q�Q� +/or 2 MIN 6 SEC. (4 TIMES PER DAY) 2" PVC o Q,G P FORCE MAIN T ix TEE 24" DIA MIN. C.I. 4"' WALLS MANHOLE COVER BROUGHT TO FINISH GRADE BOLT ON COVERS 12-0125 QUICK RELEASE SITE 8c SEWAGE FIN. GROUND 100.0 WRENCH OPERATED GATE VALVE REPAIR PLAN i APPROX. 12" #1 0 Q TOP ELEV. = 99.00 4„ COVER Q FIELD ROAD 4 PVC SCH 40 VC SECURE CHAIN locc 'L o LL IN INV.= 97.91 EMER. a_ 2 M A R S TO N S MILLS, M A ALARM ELEV.= 95.21 OR. 32 _ . 0 1/4" WEEP HOLE NOTES: = o = CHECK VALVE M - w�- c� 1. PUMP CHAMBER TO BE PUMP ON EL. = 94.87 4 0° 0 2 SCH 40 DATE: 10-29-12 � �_ o w PVC THREADED "SHOREY." OR EQUAL APPLICANT: -4" `-�o PIPE PUMP OFF EL. = 94.53 .a w m 2 FLOAT 2 CONSTRUCTION SHALL BE WATERTIGH. ALL PIPE CONNECTIONS AND T. Mr. TIGRAN GICHUNTSI-BOT. INS. = 93.70 = 10 a(n � LEVEL CONTROLS 108 FIELD ROAD BOT. EL = 93.37 ¢ ON OFF + ALARM .., v o0 o cov o oa o v oov ..0000v �cou / ) 3. RAISE MANHOLE TO FINISH GRADE WITH M AR STON S MILLS, MA o�° � �`�°� ,��° ���°��° ° ° o MYERS 1/4 HP SEWER BRICK AND MORTAR. FULL OUTER SEWAGE PUMP (MODEL SRM4) MORTAR PARGE TO PROVIDE WATER 6" MIN. 3/4" TO 1 1/2" STONE OR EQUIVALENT TIGHT SEAL. 1,000 GALLON .4"x8"x16" SOLID LOCATED UNDER MH 4. POWER CABLES TO BE PLACED IN SHEET 3 OF 3 PR PUMP CONCRETE 'CONCRETE BLOCK CONDUIT IN ACCORDANCE WITH LOCAL BUILDING AND WIRE CODES. PREPARED BY: zHOF 5. PUMP AND ALARM TO BE ON SEPERATE �� R E �y ELECTRICAL CIRCUITS. E A S SURVEY, INC. BUOYANCY CALCULATIONS m 141 R T. 6 A BOTTOM OF TANK 0.1 INTO MOTTLES 1140 C 6. PUMP ALARM AC BE SET AT A CONVENIENT LOCATION ADJACENT TO THE BUILDING AND P.O. B 0 X 1729 TO BE BOTH AUDIO AND VISUAL. SANDWICH , MA 02563 SWN'TARINN PH. �(508) 888-3619 CELL (508) 527-3600 t �e»"oue -k-f( t.? -�� fr. ►� e orri4 ?�1!.rr � 4�or ck- x4� ccv�c.f cr- fC�` MSS- C) vi I e or��vr,cf c ,7 �ire ��C t becl a re�1 c wf clecc.� Gorr'Sc 5 tir,r.1 . fo pt VC, n ov`) -.ems+ _O_..-. t , q —77 _ 1 ry �, w� Gr e.lcvl- 3 gs.g3 gS.�It� � 95� 4�, � p , —_.__ 94 w / , —o —o—o—o— ro oSGa� rouno/ rofi/G HO �e/2. SG�9 LE : / = /O S �, C T 0 /V (/E 2T. SG.�9L � 0.' / 1 P P 9 P SCHEA7 40 P v C. ode FL o w EQUAL To SEPT/G r ,- 7ir,7um PGr foot) _ /000 GAG. SEPT/G TA IV�C z `. Tj A' v a. - S 7T�C— 57 H O L E_ L O G ---' 4::_' BEOAeOOM HaOL/SE• Or9T Avq.`�y14'i�t TEST E3Y • 21GriaZ2 F'A►P2.�'3A>`lkc r�E. n� dP—OS T� `= Z SZ.-� ` ---- iI/.vCA-,' -5'/ �s 5 - -' a %�;< >r,a•3:. K= 5E3.4 j SE TtG TRN� �� x / S 3� OATuM M.5•L. = 4s.aZ TEST HOLE- TEST HOLE n 53 N r, Ki r i L,VLY' {.ir err { 5 ,�`T'`.�' � i ¢ �...� - �.-t c� � t•�.t f` ! �t l.�iJGi`, �,E' C� `�•�"�Y'k'�': J ( 7 cx.,�r•rt _ I � _"�V ��Cke- N + l r Clca. C 1J I rz^,��cd t ELL ea. `,=. ..Y�: t tea... f" ; T t 1�� i VJ I-E( C4 CI AJ -- a - 0�0 U-�rn G ZZ e- e r-7 i r- G e r t r7 c� S Elev, -- 0,0C- G GIv%c- EAvCV%AJ AeS Fo,e rE. 6 A-v- YA A--n-1 o cJ 7-H , M fi S S. F- : �� �. ',- C •� 4 42 'A eEPA eEO FO�e : �k � � . $ GALE : A S S h/O ZAJll/ F �= Ste" ZAA9 Gam- S \7-'5 T-& /l00007 . APP�e O vE CO : _ — — — — — — — G Xidtir-7 47 Gorn70-ovr3 Bo�9� 0 OF HEf�G T/-/ —o--o—o—o — proFosto/ Gon-�-our5 S. 1c:L� b C>-rF- +- _-...._ _c_ov �_-vV-1 -4- +-��.-.-.---' --�I e-,- ,c ve,cc�ce,x Sa SG o tv, rc. bed Mo + Fsox e am 'e Inz _._-._ _ f F #t q(_.q3 Y t �5.93.-- -- g5.'Z4+ ��, 4•ia rovrr4} wtfi_ >r ley i _ --.. --- ------ - ----- _ - _ __ _. _ _ T-> - _ 1 G HOSE?/2. SC,9LE� : /O T1 O J A„ / • - - EST G r--- - - GXiStirr9 9roUrsa� Profi/G " SG / V S /9L / = /0 -o—o-o-o- ProPosGc� 9rour-t0/ Prod/G / _ SCHEO. 40 P- ✓ C. OR FL. OW EQUA�:TO SEEN/G rt�ir7irnLrn % PGr )FOOf, - `� -/N r r _ i S.17t ��,c � C� CNJ�htr3 'S /000 GAL. SEf=T/G TigNk Z' �-�' 3/4"- 5 CA L E- �' O" N n y _ # 7T. �4, / GA,1 TEST HOLD LOB BEOE?OOM /-�Oc�SE- OATS: i 4:Avq.�i,�s'15 TEST EiY• 2 !Gu�e-D �A+'Z3 L 4i.� J� .�U- t PEEP. G. � T C Z-r� M r- -/1A-1 1A.1 bV S S - �3 �. 1 �LOGt/ A-ATE- 27._(� GALS.�OAY ?2 x / S a !:Z ?C) TEST f-/O G. E . . 7-6 S T H 0,L E i-= 4S.GZ, 1n USE : yCa GAL. TANS !� `y _)��e. : ��'� 4' x LC-o. c-k t nc, C.h-a,rr�,s r : ""--r—x------ , -9(..2 so bso, 1 (A [� n�V i '�Y7 4 (� fie s 4 , rr5' k C T V V) Y V c,� ` � � C��...1..� 1 V'Y�4 SC.,et✓ rt i l t ! p i A-TEi 44 _ _ - _ O w n a P r7 *r7 G e / G ?.,. ,N4,E� C3�F d � C,v/L IA-1 AeS FOIE' P L AAJ� S Use VE•Yb�e S Ae TE-. 6 A-v- y��e 0 v rH , M s s. F = r - 1� '~` PEE' E P�i �P_ E!.� F O�2 • SGALE : AS SHo [A//V CP 97E : S T AJ Ste- h/l9 G � S \7-**"5 T& /%-"7 -9GP,20 vE- O : Xisfir-75i COr7tOUrs B0.9�eO OF He49 A4 —0-0-0-0 — P�-oPosco/ Gor -fOUrs � ��.: L /1-7A6s.