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0110 PIONEER PATH - Health
110 PIONEER PATH, A= 128 004.004 ° ° O e o o k a e N� ° f iuMassachusetts _ . Official Inspecti For = mn Form _Not Voluntaryfor p e rms a Disposal�s 5r m. y1,0 Pioneer Path joftathart Giro r e ,& ersr iniolrntipm 11 _ _.. ..... im-OW ry 'West Barnstable insp echon resuaff must be Submitted on this f0yffla In specution forM ray not be alter:a� , Way-pie See coutplaWneuschoCklWt as the eTKI of the torte - v�'l�rr !Si 58 hn . era A. f speic r InforM- alion on one o mpww. Sean .249nes , ,fIi r Cufsor,,400 WA kL-Y. 7411oIden'.Lane diess slate .. .__. p ocwn 77' 2 8 0 5m nQsti't rn4qi1,GOrr�, 1 m_. Lhwnse MuMtAor [tol f►Ih�t. 9 vau ( a roved sKerac irispe a in 4 t1 I'an �arithr: i tl ti t� ("1Titte : (310 CMR 15e01 ; l ht CSOne insp t is Sege d p t l i;the rwldr s of MY listed above,the information re t i;bels�rr true,. rate end cnmpt es.Of'�ne fire inspection, and the ins ' was perfr rmed based on my lrairrirug:and Of in the prop . f mc�tiari crud.maiiiten n --site se nse disposal sys rr . After wnd t ng this insp ion I have�crrdne th2t thO system. X 2, 3 Neoft puffer Evatuabon by the i_ -e7 Aping Authonty 4, [ il The,systern irrspec'tdr shsnii subs a ropy of this inspection report to e., ppr ring Auffiodly(mod of t� ttt� r Cl� within [i days of s prang this inspection,. If the systeTn has a design flow of 1Ga it qjpd.or gr�r,the ills and the sys rru r�rrner h 11 submit, 1e reps T isr ottO rr ienralg office of the DER The original fora should be ant try the•sy rAvner and' pfes t Me buyer,it Opplicable,end the approving authority.' please :This report only describes caed a�at the tit inspection and under the eondirti use at that tl is i p Linn,doe not addmss howlthO Wstefn will Pel!fcm in t>he.tuture,under lhe!5am,e oT diffmPt n iCim.is of use- Title Official 1, ` i Form, System Fprm -Nbt for V-at.vntarf ,rcr Subsuvf=e:Sewage ioneer Path Jonathan Gilmore der a Nxm iiftmWWn is U 8arc slabie � �� 4iris 1 R ,m :w . InspecUon SummarY Inspection u nary: rntPle 9,, .. and all ofend _ . M Per I m$we not fx and any ingonnationi whir-h indiC-0109 th ,any of e f it r t,�r d s ili is in 10 CMR 15.303 w,in 310 C-MR 16.304 aft.My Wuale Criteria mot avaluaW are indicated below.. Con rnentsl.- Te pffoparty d at 110 Plioneef Pajh W455t'8wnstabW is steed by a Title V septic system con5istinq of 1000 gallon septic;Rank,4-istriblyton box and 2 500 goIan 1 =ast I�, h chamberst1�� ,yet AJtho � the Worn AAA found to lae in properl cking curudit►on,at the#mC OfinVe P does riot guarantee MU perf :: m a r i irni or iOne cacr use. or more.system COMPOnerits as desctibed in the Condd " ..nat Face s inn need to be 0aced repaired'The system upon WMPI) o�f`t1be r+ lace, - t or repair,:as apprM d bY j,he Buard of Heatfh9 wilt Pass. O the b€ fdc` e ", " r" ar°nevi t tecrr�en0d" f K KID)for the fioila irk_ r tie It"r�trt deterLB`Meck" plewive expo_ T"ne septic tank is rra tat d i ° or�the septic�Dnk(WI rner metal of note is ctuc�i* unsound, exhibit substantial infi tic�rt.uc eAltrat�n.car tank faU i tr minebk. System-h a ll ass inspection if a i 1 tank e. le nth a img peptic tanfc as approved by the � f Heai _. i 'on if'it is s1ru r 11y not leaking and if a Oeffftatg Of npliance imdica�t nq Ulat Irk is,law than 210 Years old is avbi[abta- Y del N Explain below): lh4i Ad�G e�e7rxm1b i Title 5 official Inspection Form: :Subsurface Saimige DiSPOSal System Form-Not for Voluntary � 5 �s S �. .mperty Addw,4 art e �I�rh owler CMff WW .m � f9 poge. tea.- C.-Inspection ummary (cont.) Pump charnber pu ; aEarr- ,not op naG. System III;pass,r�rth rd Heal appf 7 i pint 0jSrMs,are re-paired. [� otysemb n of smago backup Or bTeak out or high statir,air: level in the disUibubo t box dui to o' en or obstructed pipe(�.)or due,Io a bfdken. sedled or uneven distriW ion boy. +Ys M- Wial pass insperIon if(with Opproval of Board of, HealkhY 'jn&en pipe(s) are replace [ Id NO(Explain Wlow): Y N O(Explain ),: ' r7tr9;1C�1�7�1 s�rnowed u ait> Iu�ic box iMy EIN s leveled or r aired pumping Mote than 4 tares a year due.try` kor t or obs�uct pip (s)...T The�� F� �' � sysLeM gill pass ift$ tin if(with,op al the rd t f b = b pipe(s . replaced I �' NO(Explain t ): obgtnjd [ate is removed Y N ' ; NO(Explaih W40wy 3) FAir er F-waluat rn is RegUir bar Board of Health: Condibans eat Which requilt furrther,evalualibn by the.Board of Meath art seder to detemirde f the s t n is failirm;to pr�oted public h l h ' 'Or tip a nr%rortrrrent. a, yst willPW5 unless Board of!HeAtth t mines in agcordance wii h 310 CM fly_ (l)(blth the system is R f1JnCf'v0 'n9 tm'a it manner which Mill et pe�lfc i�ea .Q safety and the orwFironm =: - .N 301- TAiia'�(,j�r3bryy{+gryprrtaue Commonmgeafth of Mai chuseft I Inspect oni Form bsurtaCe , age Di p l Form-Not r° s3lal r ' �rr 110 P aneer Path: .did Own Er oemems Nye 655 021 Vie�bi�,6 t _�_ l marts of�r ton fir lorE�Aly Ip GpFTat2 BarnstableG� $rid Inspection Summary cant) Cesspool or privy is.withih 60 feet df,2 surface water GeWpooii or is within 60, of abordering vegetated vmHand or a salt rr at sh Via. SyqWrn will fail ulrC the Board of K lth!(amd�r�t�e�i ter s� atier�if any) d; rminea 'I t S.y jn is ia�nl5 ling In a ffmnnurti .t P ' Pu I-kcal v and eiivimvli ent: The systems,has a sebtic tarok and soil abserptibn system (.SAS)and the SAS is within 100 het c .ff fir'�up'ply �trr"hr�l�r��, u;rl'2ce w t r SUpplY- The system,has a seplic tank and.SAS,and the i�,a�rithi��Zone y; �f� taut is Qatar supply. The system a stir tank and SAS and the S is y in.50 f t�E pr�at�W. supply Well. �� `O, The� m has�sew tank and and tide is.lesstan 1 00 fit but 50 g t or more fngo`If1 as private water'up ,11"F- Method used to de rAI -drL5t IC0 This system p sis if the well:WTI,"analysis, perform at a D�� ceri �d � �or�, far i t lifiarm t ti iln it ee at nt ar d't a prg-se=epf arnminfa nitrogen and nikr l n;Rro en is eqUal to OT lass lhara ppM, Ar il-d no catlher failure criteria ark triggered-A OGN of the analysis rntMt be attached to tit.form. C: Ow 4) Syst It Failuac Criteria ApOftable to"All yr5t a u:Fftu Q'r°'No!o to each e f t fa lle riatg tie 9 ift� ";err : .Yes No Barku:p of serge into factlitY or system;COMPOnerat dace tooverloaded isr � clogge.d.SAS or cesspool Discharge or pondirig off a u�errt the s4rrl a ltl grand or surfac �rattar'S M1 ial Inspection Form - Ana Title 5 Off Saar -P6ot f td um ry Assessment Smb Tface sewage Disposal: Y :11.0'Frioncer jongtan Gilmorema Wj668 tier er's N mqu West Barnstable _ �...�. i� � ry� _�.�.�: �— Z;p� 'alp��—1mFwbn Yes Alta Static liquid level in the distri tiorn brag abme M invert dace to an ovefloado or clbgged SAS or cesspool !Liquid dearth in cesspo6l w than 6P k I m invert or.avrarklab�le Vduane is. thart3�dayfl Required pumping mr than.4,times it the tact year i 'r due to dogged obstrtucted!pipe(sj= 14,umber of time.-5 purnp ; Any portion of the SAS, s oli or;�ivy� high 9rouurd r ef�ua �. Arly pvrt on of ces-,,I pool or prWV is wwi in 1,e IPet of a 15kgrface vtater supply or " tribulary 10 a Anyr sur r water supply, p .ton•raft�: s oI ar prissy i. wdhin , i rn 9 ubli s l l IY lAny pGoiOn of a.cesspool or privy is witt'iri50,%at,.of a private water supfalY we11 [ n: .;por n of �pf ivy is less.than '100 f tt but greater than aQ Erg ftom Pr vate !ate'super welt Myth no a table water qualifg 3r tPis- ' ; tcm pa .it ttua well wate r a�fy"i% fumed at a'DEP aedified, be latoi ., r fecal [ff bacteria i prod:the p � of ammniA roar of WW R,11trate ui gen is,eq uas mar II thafl 5 P{ , hided that no der fatputt Cfiterja are gg0 -A copy of the aumtYs is and eftin Of CuStOdY Must be anached to thi ford,) rri is a CmSpOD,serVing a%CiI4% ith a design now of 2000 gpd- re The cyst date;.II t*ve d rmino that a or - of the at a f2il� El Crit�'ia moist a� n in 310 MR 15.303, therefore System fai .Tkne system L-r should owtact the Board of Health to d rea i t will he nece. ry to cOrrO the 12RUM La s mW Tyr!�ca' i�der alarg,e ttern tare ey gem ruvru $ems a{aC B`u a qd ugn Bow;1� 00- t � ,66b gp : For a system . rut!in t tlnesr`'ym"or"ram°t e ref a foal it ,,in, ddiipiC�i to 41a quest4ons in Section CA. Yes Nb the system is wifhin 466 f0et,(A a-,uriace drinking;war SUPPLY the system is Withirn 200 feet of a tributary to a,sufface drinking%vM, r SUPPl" the systerni.is IMated in a nitrogemosensitive,:arez Q nWrim vvelllhe3d Pratection E Alyea-I` 'A)or amapped Zone I I of a public water SUP'ply **Il Too 5QW.Wtry+ officialCommonwealth, of Massachuffm0s - f Nott r �la� r rests Inspection, ,.: �U'b,sr,rfzace S��'��poGelSystem 110 Pioneer Pam Fi—epfttj Ad(I M-4 wee � 2�9 �1 rcq�i for c� "t _�W .,,M ._- t�tc,.m as v Qa4e of fthon� _�. C. Mspecti on Summary (Cwt.) if you hmm arawered�y 9to any question in; ction 0.5 the system is considered a significant threat or answered gny question in SeCbon,Cod above the large systm has file,Thy ar t I e sy k n corm ider d igrjiltcint t'h ;t a tion;C.5 or Wed, owneTIr ender G.4 stall u s upgrade the in =cordance wftb MU CMR The systOM Own. should contact the approp nate fegiDnal office of th- aiii nt. 6, You iodic ye` sm cw Ond" r each a he follo 1t9 forr Ic��pectf�r�- Yes No Fj El Pumping r f r ,m was,l:*o sided by. the own,,=upantL or Bcafd of Heaftb Were any of the system cDmP0 nfffn purnped,but in the pfMioLjS,two e.I "? Has one stor�n,��wed n�rr l fio%vs try erne p t-Oous two k,permed'? I ;re large volumee-of w V been;irtWoduced'to recently tlyt ores.pert t f. this iGnspection? vVem'RS!lit s f the system,obtained and examined? (,'If they were.nest avaitable now as WA) %�as lit,e fa,cili,ty aid dwelling insperAed to.T:siqrvj.�of s beck up? the site in-pe d fut signs of Weak 0vP VVF e ail zystemcorrtporwnts, excluding the SAS, Emoted Win:sitte ' Were the septic tank marr'holes uncovered,.open,ed, a nd the inn ri fink or tees, material df cOnGtrue�na irct �r the ocandn t bides di err-sions, depth of 1 -uid, depth of siv and depth of scum? 1+f s the 18 C-110 owner(q uperuts if di resat from pier) PMidled%witn ir,,bma' on the p►'o inft nawe of vjbsurfgce see dis h sYs r"s? The sizeand locuffion of the 1 AbsOrPUOR SYStem, (SAS)cm thesAeMs been determined based on � FkisUng intii ri'tation. For exarrtplL-.a plan W the Board of Health, El I mined io'the fieft(if any. of the failure crrteria ref, Part C is ut'issue ,approMm i of-i tiance its un2cs tabi6)[a1q CM 1&302(5)1. 'G3c Gf al h-,wed bo Fq an CommoniweaHft of Massachusetts Title 5 Official, Inspection Form Suibsurface Se'Difp ' SWem, Form-Not f&VQlucwkarY stsrwt� 14 IPiorteeT Path. ....„„.M.„.�„.. µ..�..,,....._,��.. .,...,_.n,.._ ...._...M..,�_. OWT*f tiff-°5iNl� ifaugmVii6mis �C Imo. 8 2 1 v reqvbp.d for cagy OR page. _ D. System Infor mation 1,. Pmsidenfial RO W dili Ons: �V�am of rtci (r iqn)- �..�a._� Number Of 4 d s( ,al) 3 33a 1 DESI N kw based on 310 CMR 15.203 (forel=rPk-110 I JPd x 4 of bedrooms): 0 , Number of,ckirment r id s Does.re i I '� garbage grinde 'Y o yes. No Do icsiderce K water er try t Unit? e III yes,d scharges to: Islaundry on a sepraV2 sewage Sysjem7 p aclude laundry sysimm inslxm� yes Ko inkvmatkm bi this (t) Laundry ie `irts ? 'des. No Seasonal use's Yes No Water Te_ iir s if a - �� �last2 yes usage(90))=Privale Well 'fie Sump PLUMP un m" Last,date'Of U ': _ _ I 'Rao (5 il ^Fe®m re ! r r ggd�c A'ipst�eie- +i w'9fa Vic,-aavr.7f8EwR09t,! I com,rnonw eal:th of MOSSaC hUsOft TI' le 5 Official Inspecti Su bsulfacg� aB Sys'P N t fdr Volurtt r Asse rr�er� 11Q pionear'Palh, Jorkathon Gilmore C rtcr Owncrt Nero r � nibl tea 21' ,021west � . . D. systems . 2. Ummetc[a Indlat al Flow CO diiflOns: Type of EstaNishment Desio law(based on 310 CMR 15,204 Basis of design flow (S `1L., Grease'trap ftl' El Yes D No Water treatment unat presenV 0 Yes. Ell No DF yes, discharges to: Yes W Industrial waste t7oCdtng tartik pm6n V wad discharged ed to the TiW a syst ? Yes No Water r "readings, ®f available'. ,.....w. ....... Last die of Ocoupar tune, i (dewribO bOIDWY rt Taal€ fbr � r�i Source of in _ - slern pu part:of the ins liton? yes I � If Fins,tolurn rn d= �4R -size of tact ....._ ._. �..._ Howe k q n rai purnped dewr md? � m roudne, mv%menance Rmon for purrrpin Ccimmonmeaft, cyf Wesichusaft Title 'I 'on�,nspecti r " Subsurftce Sem9e nisposai Seem Form_INOt for Voluntary Assessu. DOMS 1.10 Pioneer NO p egg�iY jii6i Jonathan Ulnwrt Yl�'r �rrmP ��1rl�e 6581 �.... Dow UfI 0�, �4iii�t�+reu�r9� „�,.�.. _.._... w..,�..,_ .�� � dip 1e ern D. System 'Inf6rmatfion (coat_) 4., Type of m fic tank, disbibutioni box5 soil absorptibn sv n Single coal; OverRowcesspool I? iwy' Sha . sy-fern(yes or no)C'#yes,atharM Previous inspechOn records. Wany) frirtcaa�kiv I em ti, techrtdWy. MaCha Mph'of th#current operation and r �rL,tenai' a contract(to-be obtairWd trc m Sys rn own co,an a copy of]fit inspeclon of the UA sWOM!bY sYstefft OP"- tor under canbract 01 Tight tank. AUach.a pry 01 kt DE P AWOWO. n Other( iibe). Appro)(maW age of all:cOmpments,date imtalled Cif known)and souroO of inf.bmu,Gon- _Tpaired I"G M2001 per Mn r f WoT ___...._ �....__. e s wage odom debECtod Whenarriving at Unc sW I yes No 5. Bu7ddt Seer pocato on.s#e plany Dopm below grade. fact material of suction inn cast .. u. do tin; Distance.fc ri:privy s .ter Supply well or °comments(can condition,of jei�its,' ru . jing, e ` of ea I •): Joints i.n good r,ondidon;. no leakage, vented through roof. e. o1 mom a'l h f MassachuMft OfficialTitle 5, Inspection Form Subsurface 2ge.i s !%4j SysWin,,IFor mi- Not:I&VGdUntarY a M'5s rter" Ir Path ionec Oww"a Name Vet Barnstable TWIG wire rW ._ _.v fCoft D. system Information ( rit) 6. 'mac Tank ( Qn Silk plan):. Dep below grade: t mil El Ifterglass poiy' e D aw t nl) if,taink is metal, lift age: yew is a cvnfar iod by e C entificate Of rr�l 'nce? (' ha a y OF clrlifrce ) � � by es i - .. sus: @B Distanjee from top of sludge tD baftm!of GUNN tRe W beffle ..__® .. �� w... n27 -- curn thickness Distem from Uv aF scum w top of Out le 0 or tom: Distance Marro butt nn of scums bra Of outlet t or mite Cr Cpene ors and took How were!dirienslons deFerrnineP meas%jrernentsw M�. sarnr�ten (on !dung rrnCtilendti�lr�,r; inlet end condition,str+anarr 9rrit . liquid levels as rekWo d to 0%1610t invert evidence 6f leakage; el-) Mir"n , Teak.was purr ed f should li inspection and se r c ;qin every 2.Veers '1FOI water level was even wft Dint, qank,was not.lea.1cim �d s s 'ucturalty end, i T-tie 5 :Official loin Form Subsurface Sewage Disposal]SYstffn IFcaa m- Pilot fb'r Voluntary As ssments 1Ao Pion orPath Jonathan Gilmore Ma . 02668evvy t��iF1 ' ca m System in r> `on (oantj 7. Grease`trap Qqc=on site plan):, MaterLg of nstr . El concrete MOMI E fiberglasspolyethylene oliier(expiainr. Scum thicrkness Distance ftm rip Of scum to top of 0vtIeLtee or batgo DisWce from horn of scum to battorn.of mHel tee oT baffle Date of lastPufflPini: Corrnmergis(on pumping Tergmmend�dWs, IV �and outlet t or baffiu condroon, svuctutal integrity, liquid levels as rdWed tD cum ihived, avklencg of IeakaW" 8, TWht or Holding g Tank.(tank raust be pumped at timo of in- 'on)(late on sile plan).; Depth below gw 91am ial �]concrete and fik r ins polve"lens 0 rrftr(eXPWO Desionr Flow., it0M.:p Ixt fty � s Q �i turaijimi Finn f 1 De'a I Common Massach Title P bsu ce Sevragc DiSPOW11 SYSt9M Form-Not fOr Voluntary, Aw -5 MMS 110 piion oar Path Epp"Address jonat1w G. dame ��_ _ . .w ..... .. rw er*rs"Ham inkmoicM is MA. M,.. �._. qVeed for owmy .® �®�. .. D. System Informattron ,(cant.) of yes I' AlarPlu tom; —.-� .�-., _. Alom in ordw: ®; Yes No [gate of last pu g Corn man (candirtionj qf,alarm and llsaa.'SWitches. Attach py urn nt a rr ing Comtrraet(F jUtredij)_1�,Oo a r.Mr ? Yes ONO 9. D. Box present must be uparted)1la le on MW, ); Cep1h of fiquidl Mel above outlet 9narert. - Conz nent� (note if box is level,and distribution to,%jilets equal.any ev4cnce of solds carryover, any evric n 0�1e;mksV into or out 01 box, ): Disvibu6bn box.Baas.vide inspocMd rbrn tank and was faurkd and in gpod condition with norot. VVMw level:was!ean-With PuM ink with no -signs of p t ba - 5{�IUC9 BA: rr L^ra7:a�Ati :�1=�..31%� mPr�l!.�9 {wr_F3api7 12"-IL,j I Common Commonweafthi of,Mtssachusetts spec o Titte 5 Official In ti n Form Sullrlraceoi Fwm,, -Not fpr VoluntM Amra 10 Pioneer rPath Jonarnsn Gilmo _ ..,. OWMr cart Name fbff dcn is . Barris bl CHIUTWM iP a fib __ D. SysteM, Infdr ation (aunt.) 0n pamp Chi&ml (locate on s plate): Pumps hi s wWrig crdor: � 'rye IN S Comrn"Ls(note corndetiort qf pump charriber, =ndifion aFpUrnps and appurtenances,etc.): -If pLj or,, rrrs; not in working ordec..sy5trn ice, ortaiJ' ion d SS . 1 ti, Safi! �ti , ���� ��4r ors�i� �l�n, ex.c ° rat r�q�rret��= If SAS rva kxated,extern re in`= Type:. Ihiu 102&ing aarnbers le: ping galleries naumbor: king Irendnes nur61' waching:fields number, dimensions: ow cesspoot 0 inno ativoJallernaativa sys 71P�4d#t� 7 , ge3�C'd'af'evrzs "Sda+° fk : pop 93:cf9S commonwealth of ' _ :flu Subsurface image oispa sal Form-No0br Volurm"AsW-6,5MC AM n ptewPath Zion" Gilmore t .. _u fequirdi for rts1E]Ie . D. system information (cord) I.,. s L Co a (note conditionof salif,signs.of h sulk,`oitur0, Imml of pondirig, clam soil,a d` vegeWion, ekc-): S. risis :aE r a t]Radh er t in a 'act 2,55' Vena— LewhingJacAlrdy was not . or e=avalcd dire dine from hOU50. 12. Cesspools(raasspool must hie pumped,5 part of inspection) (1 on site Plar 1). i NuF and con -ur ". Depth-lop,cif liquid to inIVI inveft DePM of SOWS IaYeT op,p,m of scum kayw Dimensions,of 'M fials of Construcfm Indication of groundwater inflow yes C-om me ( di. dF I9 se sns.off hy�tau.1ic I`aifuTe, level of,por4i%, c nail ofn a _gym Commonwealth; of MASS80husetts Title Official Inspection Form Subrxurface Sewage.Di-_pOsaj Systm IForm-Not ll�r Volu nta.Ty Assessments Jonathan GiLMO M. Owwr System information (Porte) 3. 6se ansite pIrLo materials of canstpxtan' th af Aids C�arrn u�ts (nolip condign iod soili, sins of hydraulic f�,M ure, level of poncO g. condi.Wn ef vegipllation, Td.je:?i CWAW Mn Folyfi SORAMIt,S'W,q�ea'iseY ".`It'dg 9,y 9F� amrr onyweafth of Massachuscft TRW ffiillI Foy Subsurface + This c3 mill p t lF -NcA for Volun Assessments i ftidres , Joinathan GRMWe Mgr Darn irc try ikai I Me; Q .e� [��air ltior€�+e� .,.�a� ��__ � .. buW Zip ode _ 14. Sketth tOf SeW9919 Di> sat ¢� i t 11i R wide a, ': Gf the s e d S l Sys , including to,at least t t landmarks, c . Leto all III%+ 1htn 100 feel Late where Public -(Su'PP Y car~ tt*building-Check one of the boms WIOW' hand-sketch in the area tWI drawing , IL �i. z' t i 7 Ak5 5 CtIMI i ikM f+.ario,SdztPhM X n V—a SY�p°^'`I? p 16•i�9� ffidal 'Inspection F ormi bsu a Savage Dispel ��FOrM �lpt for^�o1a1a,tary,, sera is 111,0,pioneer Path Jf.GdMCM ,..�... d�,.,._.... .v:,..,�...... .. ..._....._..�_ e� te��hLu�e Data '►l" t .rMtAt __. _� _ e�Uit� o�e� cay9'ra�iW �p�Gt2oC 1) (cono 15, site m; D Check Slop Sums water bk c& ' sholow,Wells Estimated.dell1h W high,9Mund f: ree PI se indiCalle all metbods used to,detenr�w the h7jq,n ground m ater elevatiOW El iri trni stern igra plans on retd If checked.:date,of design plan m Observed site( butting , i 5Mation bale within 150 feet ref SAS) Checked with lost 180ard o'Health- explain:. (� Checked WO WA OXCavOICIS. irastalle .(at h d men n) sed USGS database explain- y-u rarnst do ibe how you e!stamished the high ground watef ekAmb= rndw . was established thy' iri town amst lol giro rudBeftm w ur maps. filar V_5 1pspL-c lean:Reps,'please see Ropor2 COM pletenM Checklist on Md Page- T.YiB;§i CSF�4�,11 k'aee;t�v�Y Fes!'iy¢marlaatiC 79y�1 �P a g9�&8�.. ryyy.-. 7Y7t edP .. I Commonwealth of Mas-saChuseft = ,f Tit ail p � � �r SubsuFface:age Disposal 'F -Not for Vol nt� ssess'Mcnts rIff OwmesM nI ri g91 1 i;� mst ma ._. .. .. - _n,,� 1 CiLynow E Report Completeness Checklist erip't all 4PPii b1f.Gmtong Of tbir-'fc inclus rrof- Lq . ,k 'ImfspamF InIbrmatiortz Compfe4o all fields in this,SeCbOTI, C lnspecdon S'ummary; 1, 2,3, of 5 completed as appTOP(riatc 4 (, ailoiarO GT rja)and 6 (C kl t)compl " D. SySiom Gnifotmadona For 6; T ightf'Holding Tank.—Plumping contnWt Mc For 14e Sketch of SewaqQ ()i put7,m System drawn on pry: 16 cr afte;hed For 15: 'ExpLanation of c.sfimat di dam tro high groundwaler iindudkd i I i ' �P, •Ate, �'!ffi�3A$ CERTIFICATE OF ANALYSIS Barnstable Count Hecilth Laboratory a� Re ipWr&. JonstheAn G! r 'C+leaee 4i 1' �5' 1 ";lth s Int ark JRgnort��# �: l 1 1 bo Pion r Path 5'Ommter. jcxntmn Gilmore W. Bwnst- lei 'WA -026W RE Kit erripl #a ti i pled: 1111 , 14 ® = J ll nAdidr0a. 1.1 9 r '�_kh.lkr, : r s eceara 07d11d� '1 14A-3 '4 nlc ! tiara: Tuan Mound: ndk-ad Sample Loca .fl e RESULT- UNITS RL a>1 :- T TED `rra�E 11 i Phi Nitrogert 5;5 s {L 0..10 10 EPIA.MOO CL 0211 =1 10-s01 Capper 0.79 'Ir 0.10 1 GPA 20DA CL +020 MM-1 12.07 0.10 0-1 EPA 2002 0211 2k202f, 12:07 !ran I?� nesP 10 b. FPA 290.8 rL a. I r2a21 12:07 I 7 2.5 20 Eip;A 7�"�[h S L 02�'32'2021 12A7 radium Tall1, 1ir Ew PIA a � t 1d21 9 c6ndJe n,ce5 26 pH 6.3 H A7 25C €.5•s.5 am 4501 L� o2�lii�z��1. ��:�9 fad 411sad �f dlA�pc rameRr rr d rJf��r'r r �c P;]r dricokia AlschWl plLmse And MiD Wouv td °QqrffinpwuwWwr tint, Approved. By,, 'ua� Mans rl . ND Now DeLected RL = W.pmfnp L A MCL MaOnam CAMLUMiMnl l c7acl M5 Anaon Street PO.Box.4r a Barns[v'W, MA 0263D M 605 P e: 1 0 1 I F TI 1 . T E OF' ANAL, SO Barnstable County H al`th L :bor for ( _ Redp�r4t 3naOmn Gilfn 7arl�klt��iltrrc �g @ll�I�di:' .�{t?�i]?1 110 Ptrteiy Rath star i = Jonwhom01(nore IAle fie,. �+1A� i ne RE Kit rra Q fi Sampled; ii j= 1�4M ; Sim 'l_d MEftd EPA.52�4- PAlul = T - 4 `� 1 A MWIV670 rani"by GcIms- AM& MDL I-mc—L Pa TP f t 'L ggIL Fta 1 u�L M�ia�t.�a€c IRA p�3nlgflt�mracrti'� � - ' t if f ND ND 4 _NO em Mmma,-IWur*rT*Mme ND o top CLM OMIMMMntLe'we No _ate, 0•.`,� fm .1.$,2rTrK�11 nfi Yam' �.p ' ND NO 9�1,- Irk tali Q s� ;���p�presm,� i NO 1,1PRS, I+ Pr ND P� o��l-irttyll9tr' d ���rTri Ch9PC� Ca$E rusND 1 €�.JO i, , t�ldi i D� v,50 n,�Mtylbfame f �i.5 MD 0.50 k.2,44rWIMMObefflene9.5i1 r_b__ LY 140 WD _1,2-DICHOMWOMM _.. M �I,9� � &tie rM �P ®' 1. D e PAD_ �,�� Tat �� �a - 1�3�"srirn — N� u.3 TrDGAI - 0-50 ND ND-1- S rigidND NO GM Co4�mr1 FI + QC L 4�C17 ..__..... .vim..., --. —. tj.DithIorobermc l[ Q h5+o .,._ �# rtts�tr�ita�r�rtsgttd95 """ g 1313 6r�ma�b NO do ne iiprrr�tsm 14D_ MCI carban k rmMade N.D. . 5.ii9BSO Ivt � re: W t Approved By; AttaCi 4j Fi'7i►l ft.lauriotay ce.tfkd ParI lift, (Lab L7imaaf) It :I�tisz Eii D = r i L.i�n h4 L=I+� AMton G0 ank I. d: 3JL95 Mafn SbnWt, PO. III 4,27a SaTmstabW MA 02530 t:;SID 375-6 5 x or 1 CERTIFICATE OF ANALYSIS .. Barnstable County Health Laboratory (M-MA009) ��.. Recipient: Jonathan Gilmore Order No.: G21123961 Jonathan Gilmore Report Dated: 02/18/2021 110 Pioneer Path Submitter: Jonathan Gilmore W. Barnstable, MA 02668 Description: RE Kit r ID#: _Laboratory 21123961-01 Matrix: water Drinking water Sample#: Sampled: 02/11/2021 14:25 By: JG Collection Address: 110 Pioneer Path,W.Barnstable Received: 02/11/2021 14:45 By: Veronic Sample Location: Turn Around: Standard Routine ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED TIME Nitrate as Nitrogen 5.5 mg/L 0.10 10 EPA 300.0 CL 02/12/2021 10:01 Copper 0.79 mg/L 0.10 1 EPA 200.8 CL 02/12/2021 12:07 Iron 0.26 mg/L 0.10 0.3 EPA 200.8 CL 02/12/2021 12:07 Manganese ND mg/L 0.025 0.05 EPA 200.8 CL 02/12/2021 12:07 Sodium 17 mg/L 2.5 20 EPA 200.8 CL 02/12/2021 12:07 Total Coliform Absent P/A 0 0 SM 9223E RG 02/11/2021 18:58 Conductance 260 umohs/cm 2.0 EPA 120.1 LX 02/11/2021 15:29 pH 6.3 PH AT 25C NA 6.5-8.5 SM 4500-H-B LX 02111/2021 15:29 Based on the results of the parameters tested,the water is suitable for drinking. Attached please find the laboratory certified parameter list. • Approved By: r (Lab Manager) ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level 3195 Main Street, P0. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page: 1 of 1 rna CERTIFICATE OF ANALYSIS � 'err Barnstable County Health Laboratory (M-MA009) Recipient. Jonathan Gilmore Order No.: G21123961 Jonathan Gilmore Report Dated: 02/18/2021 110 Pioneer Path Submitter: Jonathan Gilmore W.Barnstable, MA 02668 Description: RE Kit Laboratory ID#: 21123961-01 Matrix: Water-Drinking Water Sample#-. Sampled: 02/11/2021 14:25 By: JG Collection Addr: 110 Pioneer Path,W.Barnstable Received: 02/11/2021 14:45 By: Veronic Sample Location: Turn Around: Standard Analyst: LX Method: EPA 524.2 Dilution: 1 Date Analyzed: 02/16/2021 @ EPA 524.2- Volatile Organics by GC/MS Result MCL M L Result ( MCL N D Parameter ug/L ug/L ug/L Parameter ug/L ug/L ug/L Dichlorodifluoromethane ND 0.50 Chloroethane ND 0.50 Chloromethane ND 0.50 Chloroform ND 80 0.50 Vinyl chloride ND 2.0 0.50 cis-1,2-Dichloroethene ND 70 0.50 Bromomethane ND 0.50 cis-1,3-Dichloropropene ND 0.50 1,1,1,2-Tetrachloroethane ND 0.50 Dibromochloromethane ND 0.50 1,1,1-Trichloroethane ND 200 0.50 Dibromomethane ND 0.50 1,1,2,2-Tetrachloroethane ND 0.50 Ethylbenzene ND 700 0.50 1,1,2-Tdchloroethane ND 5.0 0.50 Hexachlorobutadiene ND 0.50 1,1-Dichloroethane ND 0.50 Isopropylbenzene ND 0.50 1,1-Dichloroethene ND 7.0 0.50 Methylene chloride ND 5.0 0.50 1,1-Dichloropropene ND 0.50 Methyl-tert-butyl ether ND 0.50 1,2,3-Trichlorobenzene ND 0.50 Naphthalene ND 0.50 1,2,3-Trichloropropane ND 0.50 n-Butylbenzene ND 0.50 1,2,4-Trichlorobenzene ND 70 0.50 n-Propylbenzene ND 0.50 1,2,4-Trimethylbenzene ND 0.50 p-Isopropyltoluene ND 0.50 1,2-Dibromo-3-chloropropane ND 0.50 sec-Butylbenzene ND 0.50 1,2-Dibromoethane(EDB) ND 0.50 Styrene ND 100 0.50 1,2-Dichlorobenzene ND 600 0.50 tert-Butylbenzene ND 0.50 1,2-Dichloroethane ND 5.0 0.50 Tetrachloroethene ND 5.0 0.50 1,2-Dichloropropane ND 0.50 Toluene ND 1000 0.50 1,3,5 Trimethylbenzene ND 0.50 Total xylenes ND 10000 0.50 1,3-Dichlorobenzene ND 0.50 trans-1,2-Dichloroethene ND ioo 0.50 1,3-Dichloropropane ND 0.50 trans-1,3-Dichloropropene ND 0.50 1,4-Dichlorobenzene ND 5.0 0.50 Trichloroethene ND 5.0 0.50 2,2-Dichloropropane ND 0.50 Trichlorofluoromethane ND 0.50 2-Chlorotoluene ND 0.50 Compound %Recovered QC Limits(%) 4-Chlorotoluene ND 0.50 1,2-Dichlorobenzene-d4 99% 70 130 Benzene ND 5.0 0.50 p-Bromofluorobenzene 890/ 70 130 Bromobenzene ND 0.50 Bromochloromethane ND 0.50 Bromodichloromethane ND 0.50 Bromoform ND 0.50 Carbon tetrachloride ND 5.0 0.50 Chlorobenzene ND 100 0.50 Approved By: Attached please find the laboratory certified parameter list. (Lab Director) ND= None Detected RL = Reporting Limit MCL= Maximum Contaminant Level 3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page 1 of 1 CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory .sty Report Dated: 2/l/2006 Report Prepared For: Judith A.DeMarco Order No.: G0634431 Coldwell Banker,Jolly,Macabee&Wienert P O Box 1147 E Dennis, MA 02641 Laboratory ID#: 0634431-01 Description: Water-Drinking Water Sample#: 34431 Sampling Location 110 Pioneer Path West Barnstable,MA Collected: 1/31/2006 Collected by: J.A.D. Map 14374 Parcel 347 Received: 1/31/2006 Routine ITEM RESULT UNITS RL MCL Method# Tested LAB: Inorganics Nitrate as Nitrogen 8.4 mg/L 0.10 10 EPA 300.0 1/31/2006 LAB: Metals Copper 1.9 mg/L 0.10 1.3 SM 311113 2/l/2006 Iron BRL mg/L 0.10 0.3 SM 311113 2/l/2006 Sodium 28 mg/L 1.0 20 SM 3111B 2/l/2006 LAB: Microbiology Total Coliform Absent P/A 0 0 309 1/31/2006 LAB: Physical Chemistry Conductance 380 umohs/cm 2.0 EPA 120.1 1/31/2006 pH 6.7 pH-units 0 EPA 150.1 1/31/2006 Sodium level is above the maximum contaminant level. Those on a low sodium diet may wish to consult a physician. The water may present aesthetic problems(taste,odor,staining)due to Copper s Approved By: �� FLa Direcrto4,r) CD C" CD -0 —t Q-3 RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 COMMONWEALTH OF MASSACHUSETTS lop` EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ldja2 00y TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: �0 /,91Oneer 2S G in r Owner's Name: Owner's Address: / 0 `— i0✓leQ 4 Date of Inspection• 9 0 t ' Name of Inspector:(please print) / -/2e v,li /Ue.�� • -; Company Name: .f4-, Mailing Address: Siv OD Telephone Number: CERTIFICATION STATEMENT I certify that I have personally c� P inspected th Y u�sp a sewage disposal below is true,accurate and complete as of the time of the .al synspecstemorL a�address tionand that the ' onnation repotted training and experience in the Proper function and maintenance of on site sewage was performed based on my approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.disposal. sys am a DEP Passes Conditionally Passes Needs Further Evaluation by the Local ApprovingAuthority Fails �' Inspector's Signature: �- Date: 7'/-4 q The system inspector shall submit a copy of this 1DEP)within 30 days of completing this inspection.mIoard of Health or f the sy them is a steed system oruthority has a de�gn now of 0,000 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. Notes and Comments ****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. Title 5 Inspection Form 6/15/2000 page 1 � w Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address:. /�� 9 o h g /'e y CAS A� /I Owner: Date of Inspection: o,— Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Sectio n D A. Syste asses: I have not found any information which indicates that any of the failure criteria described in 310 CUR 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 „ section need to repaired.The system,upon completion of the replacement or repair,as approved by the Boardf Heeaalth swill pass Answer yes,no or not determined rmmed(Y,N,ND)in the for the foll explain, owing statements.If `not determined"please 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. ND explain: 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 obstruction is removed distribution box is leveled or replaced ND explain: 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 obstruction is removed ND explain: Tifln Tnonnnfins�Fnrml./icYlnnn 1 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 0 Owner: ZVe C Date of Inspection: p C. Fu er Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order is failing to protect public health,safety or the environment. to determine if the system 1. System will pass unless Board of Health determines in accordance with 310 CMR 15303(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 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 and volatile organic compounds indicates that the well is free from pollution from that facility 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: Titles C Tnanantinn Fnrm A/1 i/7AAA Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: / 0 Owner: E eS ���f lei /h,4 Date of Inspection: ®r D. System Failure Criteria appuca le to an systems: You must indicate"yes"or"no"to each of the followingfor all inspections: ec ' _.msp bons: 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 ogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or f� 1 � 'quiddepth in cesspool is less than 6"below invert or available volume is 1_. 1C Required Pumping more than 4 times in the last year NOT due to es than%day flow �tm�s pumped clogged or obstructed pipe(s).Number �y portion of the SAS,cesspool or privy is below hi and w — Any portion of cesspool or privy is within 100 feet of a surface water elevation. water supply. supply or tributary to a surface 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. y portion of a cesspool or privy is less than supply well with no acceptable water ql00 feet but greater than 50 feet from a private water uality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 are triggered.A copy of the analysis must be attached to thisform.]that no other failure criteria (Yes/No)The system fails.I have determined that one or more of the above failure described in 310 CMR 15.303,therefore the system fails.The s as system owner should ontact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be con sidered a large system the system must serve a facility with a design flog,of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) es 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 We Protection Area—IWpA)or a mapped Zone II of a public water supply well If you have wered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Sect n 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. Title f i.....e..�:._r-- i 1,,_.. f ' Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B I CHECKLIST Property Address: //D 4�0 h e-er A Owner:_ f Date of Inspection: 9 p Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No J r'- g information was provided by the owner,occupant,or Board of Health _ ny of the system components pumped out in the previous two weeks? Has a system received normal flows in the previous two week period? _ ave large volumes of water been introduced to the system recently or as part of this inspection? TWere 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 gns 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 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: Ye no 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(3)(b)J T41a 4 inannr*inn V-411 C/)nnA 5 Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM i � PART C SYSTEM INFORMATION Property Address: //O `�l o e�� -,[.(� j„/P./ err Owner: 144-1 c Date of Inspection: p RESIDENTIAL � ` FL W CONDITIONS Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): ';. Number of current residents: 0 / Does residence have a garbage grinder(yes or no): 0 C ` ` C Is laundry on a separate sewage system(yes or no)70 [ify�separate inspection required) Laundry system inspected(yes or no): Seasonal use:(yes or no): 11-4 Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no): Last date of occupancy: /v m COMAIERCIAL/INDUSTRIAL Type of establishment: w Design flow(based on 310 CMR 15.203): d Basis of design flow(seats/persons/sgtetc.): r ` 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/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspectio es or no): If yes,volume pumped:_gallons_How was quantity Reason for p ' g" q ty pumped determined? P. S TN SYSTEM eptic 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/Altemative technology.Attach a copy of the current operation and maintenance con obtained from system owner) tract(to be _Tight tank —Attach a copy of the DEP approval —Other(describe): Approximate agLgf all components,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): / TWA f Tnonanfinn L......[iei�nnn Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: //0 'al o o e-e' P�f Owner: Date of Inspection: ,� BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:_ ast iron 4 PO VC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:=(ocate 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 a Certificate of Compliance(yes or no):_(attach a copy of certificate) � � Dimensions: X Sludge depth. Distance from top of sludge to bottom of outlet tee or baffle: -2 9 Scum thickness: 0 _ Distance from top of scum to top of outlet tee or baffle: v-7 Distance from bottom of scum to bottom 99f outlet tee o baffle: i How were dimensions determined: Qo Ie A4M 5 ,- Comments(on pumping recommendations,inlet and outlet tee or baffle condition'structural integrity, as r lated to outlet myevidence of le ga,etc. : liquid levels �j !'cn✓1 !r 07.1 �IQ"Tc ka 4 11,-1' 4-1 6`7 GREASE TRAP:Z4Coc ate 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(on pumping recommendations,inlet and outlet tee or baffle condition,structural into as related to outlet invert,evidence of leakage,etc.): gnh'�liquid levels Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SY�STEM INFORMATION(continued) Property Address:�� )/ 0 oe Pi.- Owner: / iP c el Date of Inspection: d� 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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:_Z0 f,4-7 q L— Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into r out of box,etc.): r PUMP CHAMBER:&(locate on site plan) ) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: //0 �p ✓Iw e s ,� �/� Owner: /� �2 l Date of Inspection: ^J p SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why. Type leaching pits,number:_ ,�-0 0 q // C 44 Pill leaching chambers,number: 5 leaching galleries,number: leaching trenches,number,length: S�a 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.): ii —I I �/ 7., O —lop D B rCiw CESSPOOLS:AL/(-Cesspool must be e PAP d 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 or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PAY: /" (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.): Title C i.. .,,,r:__n__ ell r .... A Page 10 of 11 • OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: / 0 I I o`'"✓ /z Owner: /fie C�Afi7 1' Date of Inspection: 01 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. 1�z_ /96 i� a o ` / /9 \t i 3 ' (01"e r �e�ov C-rhCd Title i Tncnnnfinn Pd%rm A/11Z/)AAA 10 ' Page 11 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 0 o"I o h eell, 4 14-1 �✓er�- .� Owner: Date of Inspection: 9 o n SITE EXAM Slope oZ�p Surface water * Check cellar O,, Shallow wells Estimated depth to ground water T G fleet Lo '� Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: 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) T9 Accessed USGS database-explain: You must describe how y u established the hi h ground ater e/levadon: t O r"1 (J jr :gAj.--1-7— , O � rr lOv1 Titlo Iq � � J^ � � •-�inene..r;.... L•...,.eitex�nnn tt I (. LOCUS t a� i g 92.17' CONTRACTOR TO CONFIRM SUITABLE SOILS IN AREA OF PROPOSED LEACHING FACILITY PRIOR NOT TO SCALE TO INSTALLATION NY OF ANY ABLE PORTION L OF LOCATION MAP F 5' AROUND ENCOUNTERED. REMOVE OR MAP 128 PARCEL 4.4 LEACHING FACILITY AND REPLACE WITH CLEANASSESSORS I MED. SAND. ENGINEER To INSPECT AND CERTIFY IF ENCOUNTERED. 49't STED GROUNDWATER .CTED AT EL 43.V:k N T : NOT ALLOWED I. DATUM IS APPROXIMATED FROM GIS SPOT EL. :PTIC DESIGN, (GARBAGE DISPOSER IS NOT AVAILABLE_ :SIGN FLOWI 3 BEDROOMS (1 00 GPD) = 330 GPD 2, MUNICIPAL WATER IS NOT AVAILABLE ;E A 3n GPP i1EC1GN FLOW 3. MINIMUM PIPE PITCH TO BE 1/8' PER F00T. 4. DESIGN LOADING FOR ALL PRECAST UNITS-TO BE AASHO ha_: ,. 7PTI� 330 GPD (2) = 660 5, PIPE JOINTS TO BE MADE WATERTIGHT. SE A 1000 GALLON SEPTIC TANK (EXIST) 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. EACHIN I ENVIRONMENTAL CODE TITLE V. 118 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE SIDES, 2(30 + 9,83) 2 (.74) USED FOR LOT LINE STAKING. IOTTOM 30 x 9`83 (';74�= 218— R. PIPE FOR SEPTIC SYSTEM T❑ SCH. 40-4' PVC. 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT TPD TOTAL! 454 S.F.SF 336 INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED JSE 2) 500 GAL. LEACHING CHAMBERS (ACME OR FROM BOARD OF HEALTH. -QUAL) WITH 2.5' AT SIDES, 4' AT ENDS, AND 5' 10. PUMP & REMOVE (OR FILL W/CLEAN'SAND) EXISTING LEACH PIT. IETWEEN UNITS BENCHMARK: USE TOP TITLE 5 SITE PLAN FNDN THIS AREA AT EL 99.3' OF 110 PIONEER PATH IN THE TOWN OF: y 6.3 (WEST) BARNSTABLE PREPARED FOR: BORTOLOTTI CONSTRUCTION/SCHOFIELD 30 0 30 60 90 97.6 BOARD OF HEALTH MA SCALE: 1'. = 30' DATE: NOVEMBER 5. 2001 VED DATE off 59-I52.4941 1e.me X2-9m 1%,Of ate o AnNE �r )Wn Cape engineering, InC• s OJAIA s H• 3 avil 3 O.IAIA CIVIL ENGINEERS "°5 LAND SURVEYORS JA P.E., P.L.S. UATE �n:�n St, yarrlouth, ma 02675 ARNE H. 0 LA, r TOP FNDN EL. 99.3' SYSTEM PROFILE ACCESS COVER TO WITHIN 6' OF P1N. GRADE (NOT TO SCALE) ACCESS COVER (WATERTIGHT) TO MINIMUM .75' OF COVER OVER PRECAST WITHIN 6' OF FIN. GRADE 2X SLOPE REQUIRED OVER SYSTEM EL. 97.2' � RUN PIPE LEVEL 2' DOUBLE WASHED PEASTt]N� FOR FIRST 2' \ EXIST1Nt 1000 GALLON SEPTIC 95,7E TANK (H-�0 ) AS ,19'. FL 94.36' C7L� 00 OOOC 94.17' 0000 0 000C 6' CRUSHED STONE OR MECHANICAL C7 0 o 0 0 0 O m C C13WACYIOK (15.221 E23) 2' Ip 0 0 c3 0 0 00 C DEPTH OF FLOW 4' ( 2t SLOPE) (�_SLOPE) TEE StzEs, 3/4' TO 1 1/2' DOUBLE WASHES INLET DEPTH . 10' OUTLET DEPTH . 14' FOUNDATION- EX151. - SEPTIC TANK 62' D' BOX 4' - LEAI FAt. 100.0 PROPOSED SPOT ELEVATION EXIST. WELLI 100x0 EXISTING SPOT ELEVATION 00 PROPOSED CONTOUR - 100 -EXISTING CONTOUR +92.6 e � I I 92.3 93.9 WELL ------------ LOT 13 ` \ WHITE BIRCH'NAY �QQQ'S + S + 93.3 9\2 VACANT + .4 \ 9 . {93.5\ w o 0 92 \ c o 95 4.3 O r \ + 03. N +94.4 $ 6.2 b �� 96.4 EXIST. 9d 1 DWELL. 97 9 +9 . �CK +96.44 GRA DRIVE I 06F +95.1 98.5 2 95.9 EXIST. +99.3 GAL SEPTI +97.7 + 9g9 6 SE)D TANK(R +103. /0 9 LOT 2 ro .5 44,287t SO. FT. 9 1.02t ACRES + D1.3 o• 2 0' + .2 +93.2 � a A 97.8 + 3. o 8 O1 +103.4 AI �^IG TOWN OF BARNSTABLE LOCAT.ON l d Y 1,4Mrfi� t SEWAGE # D/ VILLAGt ASSESSOR'S.MAP & LOT, INSTALLER'S.NAME&PHONE NO. Aar�e/a�i�i CeiwS><nr�ioQ/ 4��8�9�6 SEPTIC TANK CAPACITY Ood GwC LEACHING FACILITY: (type) 1'6D Cy C Cam .f (size) NO.OF BEDROOMS BUILDER O Ow.N�R PERMITDATE: // -7 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) ��y Feet Edge'of Wetland and Leaching Facility(if any wetlands exist _r within 300 feet of leaching facility) Feet Furnished by 4 /V - - - 1 nr�t0' • 61 TOWN OF BARNSTABLE LOCa JN //d 9/ear+,— tf SEWAGE # 01 7�t" VILLAGt hk A-'*c 1-2& ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. �or7�/O��i. �ows><.�r><ioc/ �/a8•d9�6 SEPTIC TANK CAPACITY 'I dod GAL LEACHING FACILITY: (type) Y00 61 644w ,- j �•2� (size) /2•S sac..2!''X?' NO.OF BEDROOMS D BUILDER O O R PERMITDATE: // 7 COMPLIANCE DATE: wo / Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet' Private Water Supply Well and Leaching,Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) J_ Feet Furnished by `�Duil 4/je %� �_ 6 � 4 a lam` �`, �_ s_ Q �.1 'q o. 1 I �� No. �' '� Fee - r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYtcation for lDtopozal *pgtem Com6truction Vermtt Application for a Permit to Construct( )Repair( )Upgrade(l/)Abandon( ) ❑Complete System—P—individual Components Location Address or Lot No. /J® Q peer/ 7 Owner's Name,Ad sss an Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. /0'r 01�1 CDC s�'�' / 41e -77/ Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder Other Type of Building tiJ� �l�' No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow / gallons per day. Calculated daily flow 4731&) gallons. Plan Date % O Number of sheets Revision Date Titled &// Size of Septic Tank 49im /"PX"A!0q Type of S.A.S. 2 ��O�Q G a-* 11 01 i Description of Soil RIY161 X Z a Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees io ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued bI his o d of ealth. / Signed Date ///71� Application Approved by ` Date 4 1 G' U Application Disapproved for the following reasons Permit No. 0 a / — ?4. Date Issued 4& e. U o i `70 5 ,. �,` -.t No. -�'.; �, ,,�!.� � ..,� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - T0,WN OF BARNSTABLE, MASSACHUSETTS . A 1 Application for �Bilpogal bpotem Conotruction Permit Application fo a Permit to Construct( . )Repair( )Upgrade(1/)Abandon( ) O Complete System �dividual Components Location Address or Lot No. //D QIo�O�/` C�'�— Owner's Name,Address and Tel.No. Assessor's Map/Parcel W, 'eklow'-ehle Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. /0'r 10/o I�`1 Cogs �ou�� eq e Z , Type of Building: Dwelling No.of Bedrooms Lot Size yy�Zg7 sq.ft. Garbage Grinder(10 Other A, Type of Building/�t�JrJl�Lr'A'c No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow //� gallons per day. Calculated daily flow , gallons. Plan Date Number of sheets / Revision Date Title t 17-L° 5- 2?0 917!1 , Size of Septic Tank LOW Type of S.A.S. ©©�9/ G D•` /- Description of Soil 0/Y��X z- Nature of Repairs or Alterations(Answer when applicable) �/�``/f u}�j�✓��e Date last inspected: Agreement: The undersigned agrees to ensure je construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued/by, his o d of ealth. Signed Date Application Approved by ° Date Application Disapproved for the following reasons Permit No. 90 o Date Issued ( /U THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (tertificate of (Compliance THIS IS TO CERTIFY,that,the On-sit Sewage Disposal System Constructed( )Repaired( )Upgraded( Abandoned( )by ©� /4 �/ ©�.5 at / /e�,veex ?,O �i'//IS ��(� has been constructe ,in 4ccordance with the rovi'sio s of Title.5'"d the for Dis osal System Construction Permit No. 2 W I- A Sedated 1( 6 (/ installer p y Designer The iss ce of this permit shall not be construed as a guarantee that the system will,function1as�designed . Date I I lit I),") I Inspector �rn,�i ,1_nl, A)<4, P� 4 No. o,UU ! ' 70,.5_ -----------------j y�.. , y Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS IN.5pozar *p!5tem Construction Permit Permission is hereby granted to Con struct( )R pair ' )Upgrade(r/)Abandon( ) System located at /Ae woe)i 47`"/f /rt/, and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this ermit. Date: °7 o Approved by 1 ILE No.462 08,21 '01 AI, 1 :32 1D:BORTOLOTTI C01,lSTRUCT1i. ,, FAX:50,13 42 9399 PAGE 1 is 'I • \ l '+'± NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only, PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM 0SA t_d , hereby certify that the engineered plan signed by me dated t t l o , concerning the property located at l o Ft o ."elE/L fA-T - meets all of the following criteria: • This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. The soil is c.assified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or may conduct preliminary tests at the site without a health agent present. s There is no increase in now andlor change in use proposed 'mere are no variances mquested or needed., * The bottom of the proposed leaching facility will not be located less than fourteen (14) feet above the maximum adjusted groundwater table elevation. LAdjust the groundwater table towing the 1!rimptor method when applicable] Rose complete the following: A) Top of Gmund Surface Elevation (using GIS information) � B) G,W. Elevation ' a + adjustment for high G.W. DIFFERENCE BETWEEN A and B SS SIGNED : DATE: t 5 o NOTICE Based upon the above information, u repair permit will he issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered peptic system plans. G;health inlder:peroeimp r tr CERTIFICATE OF ANALYSIS Page. , iv ,m Barnstable County Health Laboratory Report Dated: 09/17/2001 Report Prepared For: Order Number: G0111655 Alfred P.Schofield 110 Pioneer Path West Barnstable, MA 02668 0111655-01 Description:Laboratory ID#.• p Water-Drinking Water Sample#: 11655 Sampling Location: 110 Pioneer Path,West Barnstable Collected: 09/07/2001 ollected by: Alfred Schofie Received: 09/07/2001 Routine ITEM RESULT UNITS MDL MCL Method# Tested LAB:IC Lab Nitrates 10.2 mg/L 0.1 10 EPA 300.0 09/07/2001 LAB: Metals Copper 0.3 mg/L 0.1 1.3 SM 311113 09/17/2001 Iron <0.1 mg/L 0.1 0.3 SM 3111B 09/17/2001 Sodium L 21 .. mg/L 1.0 20 SM 3111B 09/17/2001 LAB:Microbiology Total Coliform Absent P/A 0 Absent P/A 09/07/2001 LAB: Physical Chemistry Conductance 251 umohs/cm 1 EPA 120.1 09/07/2001 pH 5.9 pH-units 0 EPA 150.1 g9/07/2001 Note: This water sample exceeds the recommended maximum contamination level for drinking water due to high Nitrates.Water sample has higher than average level of Sodium. Persons on a low sodium diet may wish to contact their physician. Approved BT � -- (Lab Director) 017 hC)61 a Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 r CERTIFICATE OF ANALYSIS Page: Barnstable County Health Laboratory Report Prepared For: Report Dated: 08/29/2001 Order Number: G0111480 Eric Nelson 186 East Water Street Rockland, MA 02370 Laboratory ID#: U 111480-U 1 Description: Water-Drinlung Wate Sample#: 11480 Sampline Location: 110 Pioneer Path W Barnstable MA Collected: 08/27/2001 Collected by: Eric Nelson )v-1 --04/004 Received: 08/27/2001 Routine ITEM RESULT UNITS MCL Method# Tested LAB: IC Lab Nitrates 9.9 mg/L. 10 EPA 300.0 08/27/2001 LAB:Metals Copper <0.1 mg/L 1.3 SM 3111B 08/29/2001 Iron <0.1 mg/L 0.3 SM 3111B 08/29/2001 Sodium 22 mg/L 20, SM 3111B 08/29/2001 LAB: Microbiology Total Coliform Absent P/A Absent P/A 08/27/2001 LAB: Physsiical._C_hc:M_ Conductance 251 umohs/cm EPA 120.1 srLarzw'i �- pH 5.9 pH-units EPA 150.1 08/28/2001 Note: The water sample has higher than average levels of Nitrates. Monitoring is recommended(2-3 times per year)to establish any upward trends. Sodium level higher than average.Those on low sodium diet may wish to contact physician. Approved By: c��►^�— (I,ab Director) s-/2g ZOO/ Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 DATE: 7/13/96 i PROPERTY ADDRESS: •110 Pioneer Path' West Barnstable,Mass . A 1 1996 02668 HEALTH DEPT. TOWN OF BARNSTABLE On the above date, I Inspected the septic system at the above address. This system consists of the following: 1 . 1 -1,000 gallon tank. 2.1-Distribution box. 3. 1 -1000 gallon leaching pit. Based bn my Ins.-K-ctlon, I certify the following conditions: 1 . This is a title five septic system-. (' 78 Code )' 2- The septic system. is in proper working order at the present time . 5IGNATUR!--: 14�4t Flame: J. P .Macomber Jr..__' _- -- i Company: J. P_Macomber & Son-Inc Address:_. _x_.6 ,------I_--,__ Cente'rvilLe LMass__02632 Phone: _50.&_Z.75._3338------- i THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY I` JOSEPH P. MACOMBER & SON, INC. Tank:-Ceupools-Leschflelds Pumped & InsUllad Town Sewer Connections P.O. box 66' Centerville, MA 02632-0066 775-3338�•'tc 775-6412 Executive Offlce of Environmental Affairs . Department of Environmental Protection Willia Gamennon F.W@Id Trudy Cox@ Ary@o Paul Celluccl s-rwryDavid B.Struhs LL Gown,or C4nvn4slorwr SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION PropertyAddreas: 110 Pioneer Path West Barnstable MdressofOwner. Date of Inspection: 7/12/9 6 (If different) Name of Inspector. Joseph P. Macomber Jr. Company Name,Address and Telephone Number. J.P.Macomber & Son Inc. Box 66 Centerville,Mass . 02632 508-775-3338 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 sew ge disposal systems. The system: Passes . _ Conditionally Passes _ Needs Further Evaluation By the Local Approving Authority _ Fails �,� L / Inspector's Stgnature�!�►�d' `;�• 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,B, C,or D: AJ SY9 PASSES: 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. BJ SYSTEM CONDITIONALLY PASSES: Aid One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair;passes inspection. Indicate yes, ,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,cracked,structurally unsound,shows substantial infiltration or exfiltmtion,.or tank failure is imminant, The system will pass inspection if the existing septic tank is replaced with a ponforming septic tank as approved by the Board of Health. (revised 11/03/95) 1 One Winter Street a Boston,Massachusetts 02108 @ FAX(617)556-1049 a Telephone(617)292-55M i�Printed on Recycled Paper V SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (oontinued) Property Addroaa: 110 Pioneer Path West Barnstable,Mass . Owner: Donald F. Richards Date of Inspection: 7/12/96 B)SYSTEM CONDITIONALLY PASSES (continued) Sewage backup or breakout or huh static water level observed in the distribution boat 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): broken pipe(&)are replaced obstruction is removed distribution box is levelled or replaced 1JQ 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 C1 FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: AID 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 60 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 PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply or tributary to a surface water supply. 4)0 The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well. &dp The system has a septic tank and soil absorption system and is within 60 feet of a private water supply well. /l1 ) The system has a septic tank and soil absorption system and is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. 3) OTHER' (revised 11/03/95) 2 failure. Backup of sewage into facility or system component due to an overloaded or cloud SAS or cesspool. ADischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool a!r) Static liquid level in the diotribution�4 �outlet invert due to an overloaded or clod i �:-S cr WASPool. Amak P w AZD Liquid depth in tasspe4is less than 6"below-invert or available 'volume is less than 1/2 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 60 feet from 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. El LARGE SYSTEM FAILS: The following criteria apply to large .rystenw in addition to the criteria above: ;i . The system serves a facility with a design flow of 10,0,00'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: the system is within 400 feet of a surface drinking water supply �JLIl the system is within 200 feet of a tributary to a surface drinking water supply M7 the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area(IWPA)or a mapped Zone H of a public water supply well) The owner or operator of any such system shall bring the system and facility into full comPLance 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., (revised 11/03/95) S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST PropartyAddr-- 110 Pioneer Path West Barnstable,Mass . Owner- Donald F. Richards Date,6f InspootIon: 7/12/9 6 Check if the following have been done: ,Pumping information was requested of the owner occupant, and Board of Health. ,None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. built plans have been obtained and examined. Note if they are not available with N/A ZThe facility or dwelling was inspected for signs of sewage back-up. , The system does not receive non-sanitary or industrial waste flow -- the situ was inspoctod for signs of broakout. t /All system components,A ecluding the Soil Absorption System, have been located on the site. Y 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 existing information or ap rozimatod by non-intrusive methods. facility owner(and occupants, if different from owner) were provided with information on the proper P P Per maintenance of Sub. Surface Disposal System. (revised 11/03/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART 0 SYSTEM INFORMATION 110 pioneer Path West' Barnstable,Mass . , o�tinen Donald F. Richards. ' FLOW CONDITIONS RESIDENTIAL.- Design flow: o Gallons • Numb-or of bedrooms: I Number of currant residents:% Garbage grinder(yes or to):. Laundry connected to system(yes or no):Y&—S Seasonal use (yes or no):AIP Water meter readings, if available: We &Igl ^ Last&w of occupanry:ZJI X COMMERCIAL/INDUSTRIAL.• Type of establishment: Design flow: u& galloaa/day Grease trap present: (y(:a or no)-42-& Industrial Waste Holding Tank present: (yes or no)A Non-sanitary waste discharged to the Title 5 system: (yes or no)&4 Water meter readings, if avai4ible: AIA Last date of occupancy:_ OTHER: (Descril-e) , Lvt dote of ---- GENERAL INFORMATION PU'AIPIN R::C'3_'.' ';' : gun• of uifo on: —1•-�'� '2 asc��� -, Alk B,rl�y �-1 �,� ,x�,4P� 7.rJd�r System pumped as part of inspection: ((yes or ao)� If yes,vol,une pumped: 41 ons Reason for TYPE OF SYST 1' _Septic tankldi:tribut oa box7soil absorption system Single cerspol Ql Ovutflow caupi l A Privy Shared syrtem (you or no) (if yes, attach previous inspection r000rds, if any) Other date installed (if known) and source of information: Sewage odors doLoct.d when turiviag at the site: (yes or no) (revised 11/03/95) 6 SUBSURFACE SEWAGE DISPOSAL'SYSTEM INSPECTION FORM PART C. SYSTEM INFORMATION (continued) Iroperty Address: 110 Pioneer Path West Barnstable,Mass . caner: Dohald F. Richards ate of Inspection: 7/12/96 EPTIC TANK: JGF7rO yi+ N 74✓� ovate on site plan) epth below grade: aterial of construction; concrete _metal _FRP —other(explain) imensions: / • ludge depth:_�_ istance from top of pdge to bottom of outlet tee or baffle: um thickness:_ 3 istance from top of scum to top of outlet tee or baffle: cs_ istance from bottom of scum to bottom of outlet tee or baffle._ omments: commendation for pumping, condition of inlet and outlet tees or baffle. depth of liquid level in relation to outlet invert, structural �rity, evidence of leakage, etc.) REASE TRAP. ijaNe cate on site plan) epth below grade:,,'o aterial of constnlrtion:NAoncrete _metal _FRP _other(explain) 1 AJt/f ' i ni thickness: un� thickness: istance from top vi scum to top of outlet tee or baffle:_'V11 istance from bottom of crum in honnm of outlet tee or paftle:'y'& mments: commendation for pumping, condil-rl of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural tegn y, evidence of leakage, etc.i wised 8/15/95) 6 f SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM TNiI . .:fiTI0D1 (ounlluu�: ; 110 Pioneer Path West Barnstable,Mass . Owner. Donald F. Richards Date of Inspaotio;c 7/12/96 TIGHT Olt IIO-. -Axe-, (locate on situ pLu.) • Depth below grade: AIR- Material of oonstr u tionvconcrete_metal_FRP_other(explain) Al# tiA Dimensions: NR Capacity: AJA gallons Design l: � ons/duy Alarm level: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) 0 tRevvt.•yLN..�7'aj . DISTRIBUTION Box-Is (locate on site plan) Depth of liquid level above outlet invert: Ve) Comments: (note if 1 and distribution is ual, evidence of solids carryover,evidence of leakage into or out of box,etc.) Box' is level;No eviedence of solids carry over•No evidence in or out of the box. PUMP CHAMBER:&jq/'td (locate on site plan) Pumps in working order:(yes or no)d/,4 Comments: (a condition of pump chamber;condition of pumps and appurtenances,etc. _/►lCI �I-YLI�A�IIf�� a (revised 11/03/95) 7 SUBSURFACE St:H'AUE DISPOSAL SYSTEM INSPECTION FORM PART C INFORMATION (000tinued) PropertyAddro" 110 Pioneer Path West Barnstable,Mass. . owner. Donald F. Richards Date of Inspection: 7/12/96 SOIL ABSORPTION SYSTEM (SAS): ..z (Locate on site plan. if po"118;excavation not rvquirvu, uuL uuty 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:1 leaching fields, number,dimapsions: f -- overflow cesspool, number: t Loamyn sanCl --fobmedium Sari ; 0 fs ghsalof?Ohll yi'Trauffc eTa °stir) pull All ve on normai. Liquiqep a ow TH—Vert pipe is 9,1 CESSPOOLS:1lQi e (locate on site plan) Number and configuration: — Depth-top of liquid to inlet invert: Al Depth of solids layer: AM Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: inflow(cesspool must be pumped as part of inspection) AIA Comments: (note condition of soil, signs of hydra- is failure, level of ponding, condition of vegetation, etc.) &d a'a4jddleS PRIVY:4VQAC.- (locate on site plan) Material of construction: Dimensions:_ Depth of solids: All? Comment,(note condition of soil, signs of hydraulic failure, level of ponding,condition of vegetation,etc.) A e (.�r*i-*tA)F5 (revised 11/03/95) 8 .I� "UBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(oontiaued) p,opO1.jyAdd,,,—, 110 Pioneer Pai 6h West Barnstable,Mass: Owner. Donald F. Richards Date of Inspootlow 7/12/9 6 ' L SKETCH OF SEWAGE DISPOSAL SYSTEM: • include ties to at least two permanent references landmarks or benchmark locate all wells within 100' Well Water 1 V V�,� p/oN�eQ� pg1'H cv: DEPTH TO GROUNDWATER Depth to groundwater. jL�+feet method of determination or a n: 8vstemt,ing jAjj2d in 1989 no water` encountered at 121 ' Plan n` 'i?e az• 2A health,. 4aa Ate_. (revised 11/03/95) 9 WHITE BIRCH WAY �- N/F GARY A. MILLER / 300.03' 64 60 58 _ "rAl• ACC EA EMENT~� INV 46.6 ,56 \ ` 50 `_ _ 58 W LL L 0 T 2 ; / 44,287 sq. ft.f,/ ---moo IQ I 0 I O , 54, / 1 i / P / ' ti o / C 299 / % //0 34 � � � � � � �� PIONEER '� ; 1 --,-- PATH ' •0 ' (50' WIDE) 60 < ,� 58 INV. t 50. V oQ/ 5860 , _ w THE CO:IV[MO EALTH OF MASSACHUSETTS DEPARTMENT OF ENVIRONMENTAL PROTEC TION BE IT KNOWN THAT r Joseph P. Macomber, Jr. Has satisfied the Department's qualifications as required and is hereby authorized to use the title CERTIFIED TITLE 5 SYSTEM INSPECTOR as provided in 310 CMR 15.340 and Section 13 of Chapter 21A of the General Laws. Issued by The Department of Environmental Protection. June 8, 1995 Acting Director of the ion of Water Pollution Control SI"js,1L, „iSTr'M' IN; r:C l'I ui�1S�6 110 Pioneer Path West Barnstable,Mass/ ' +�N►?r� ' Nnrt!' Donald F. Richards CL 1?TI1'I CATION C- iL uI iC,St�L t"i'Utt Joseph P. Macomber Jr',': COMPANY NAMF J.P.Macomber & Son Inc. Box_66 Centerville,Mass . 02632 ,....., COMPANY '1'Et.''t?IfUidi _ �tete L 508 1 775 3338 FAXl _ 08 790 1578 I certify that I have personally inspected the sewage disposal system at this address and that the irrfor•ntation reported is true , accurate , and recommendations ite of .inspection . The inspectiurr ti,u, hG:i1v: ;;,ad arrd ally recornrnendatio►rs regarding upgrade , rnaintenartce , and repair are consistenty with my training and expericr,ce in the proper function and maintenance of on- Check SPGJfl.n (�1grl/ n � ..1 ,. n Check orre : XXXXX-X-X- ystecri IIASSEJi The fails has not found any information wlti ..►; ir: icut _; that; t.} system fails ' to adequately health OI• Ole erlvir-011r11c,11t as defined in 310 CPiR 15 , 303 . Anyect public failure criteria not evaiLlAted are as stated it-, the FAILURE CRITERIAseetion of t h i.s r r, • �n Jhic}r I have conducted has found that the system fails r,I•,-, i ,:, �. i, ih1 is health and the environment, i.n A!'�orrinr,s ,t m ai t � ^to and as s eci f ical ly noted on .PART' C - FAILURE . this inspection form . ^ Inspector Signature ; 7/1.5/96 Date U n e Copy of this c ( w}7ere a t.ification must be provided to the OWNER, the BUYER` b'Plicable ) and the IIOnrtU OF tiEAL7't1, * It the Inspection FAILED the owner or•"operator shall upgrade within one Year of the dnte of the inspection , unless allowed or otherwise as owedo ' tha provided in 310 CtltZ 15 . 305 , L'uqui L6^g Number: Bottle # BC424A Date: Nov . 20 , 1989 sa BARNSTABLE COUNTY HEALTH AND,.ENVIRONMENTAL DEPARTMENT 7 .1' SUPERIOR COURT HOUSE p BARNSTABLE, MASSACHUSETTS 02630 J • DRINKING WATER LABORATORY ANALYSIS PHONE:362-2511 r �_Ext. 337 Client: Greenbri a-r Develo.pmentCollector: Sean O ' Brien Mailing Address: Route 28 Affiliation: other Centery i 11 e •`MA 02632 Time & Date of Collection,: 11/16/89 Telephone: Type of Supply: wel Sample Location: Lot #2 Pioneer Path Well Depth: 110 ' West Barnstable , MA Date of Analysis: 11/16/89 2 : p .m . PARAMETER x ' "SAMPLE RESULT 'RECOMMENDED LIMITS Total Coliform Bacteria/100 ml 0 0 pH 5 . 8 Conductivity (micromhos/cm)- , 88 500.0 Iron ( m) 0. 3 0.3 Nit-fate-Nitrogen ( m) 0 . 5 10.0 Sodium m) 10 20.0 I . Water sample meets the recommended limits for drinking of all above tested parameters. II . X X Based only on results of the parameters tested for this sample, the water is suitable for drinking' but may present the problems checked below: A. Water sample=has''higher than' average' levels of Nitrate. Future monitoring is recommended (2-3 times per year) to establish any upward trends. B. The low pH of the water may shorten the useful life of the house's plumbing. C. X Water may •present' aesthetic problems`(taste, odor, staining) due to iron D. Water sample has high levels of sodium. Persons on low sodium diets should P 9 consult their doctor. I III. Due to one or more of the reasons checked below, this water sample is unfit for human consumption: A. High 'Bacteria B. High Nitrates • , The..Barnstable County Health and Environmental REMARKS: Department shall not 'endorse any statements, interpretations or conclusions made 6y anyone else concerning these results without written consents, CC: Barnstable Board of Health /J CC: ,t'� E Laboratory Director 117/85 Explanation.of Test Results Total Coliform Bacteria Coliform bacteria are an indicator of the sanitary quality of a water sti v,. Water'supplies may,become contaminated from malfunctioning septic systems, cesspools and surface.runoff. A total coliform count of zero indicates that your water supply is safe and approved for human consumption. A total eoliform.'eount of greater than zero is most often the result of accidental contamination of the sample bottle through improper sampling methods. For this reason, it would be advisable to retest any well water that is not approved. pH pH is the measure of acidity oralkalinityof the water. On the pH scale,the number 7 is neutral,less than 7 is acidic and-more than 7 is alkaline. The pH of water on Cape_Cod tends to be acidic in.the.range of 5.0,to 6.5. Conductivity Conductivity is a measure of the dissolved salts in solution. Amounts in excess of 500 micromhos%cm are generally considered unacceptable and may have a laxative effect upon users. Iron The presence of iron in water in concentration of .3 ppm or greater may: give the water.a bittersweet astringent taste,cause an unpleasant odor, often gives the water a brownish color,and cause staining of laundry and porcelain. The average concentration of iron in Cape Cod's water is .2 - .6 ppm, Although the.presence of iron in water may cause the problems listed above, it is not considered deleterious to health. Iron may be removed by use of an iron removal system. Nitrate-nitrogen The Massachusetts Drinking Water Regulations have sct a-,maximum contaminant level for nitrates at 10 ppm. Excessive concentrations may cause methemoglobinemia (an:infant disease):a.nd have been suggested to.form potentially carcinogenic nitrosamines. Contamination sources include fertilizers, cesspool's and industrial wastes. Copper Due to the acidic nature of the water on Cape Cod, copper tends to leach from pipes. This normally does not present'a health hazard: however, concentrations in excess of 1.0 ppm may cause a metallic taste and/or a bluish-green stain on porcelain fixtures. Sodium A concentration of sodium over 20 ppm is only of concern m people who are on a low sodium diet. If the water supply has more than 20 ppm sodium, it is up to the people who are on such a diet to find another source of drinking water or contact their doctor.to determine-if consuming the water is advisable.:.Concentrations.exceeding 50 ppm indicate that there may be ocean water or road salt runoff water getting into the well.. r Department of Environmental Management/Division of Water Resources WATER WELL COMPLETION REPORT 4P WELL LOCATION /� ^� GEOGRAPHIC DESCRIPTION Address Lo7- 7 �oticp/ A X a`/ N. S E & of (feet) (circle) lCity/Town ijes--7- L n Well owned rif" /3/, ZoPMew7 (road) Address[ Po. �/p,� �/o (, S E W of n D(,3, G (mi.in tenths) (circle) Board of Health permit: . yes no ❑ • intersect. w/8`V_Uut& w ' a1,Sj /e (road). WELL USE WELL DATA Domestic Z Public❑ Industrial ❑ Total well depth ZQ r ft. Monitoring❑ ''Other Depth to bedrock—ft. Water-bearing rock/unconsolidated material: Method drillecJ el Date.drllled S t Uescr"iption / Water-bearing zones: + CASING� 1)`From To y Type Sc h 4JO w C r r• 2);From To Length 5L ft. Dia(1.D.)_ in., 3)4From To Length into bedrock ft. Gravel pack well: dia. Protective well seal: Screen: dia. Grout-a Other Slot*,4,'S�_length JL_from/o6 to/f0� PUMP TEST 4 Static water level below land surface s l ft. Date // /3 8 h „ Drawdown-&—ft after pumping_ hr. min.at_ gpn How measured 7-c-44 Recovery ft. after hr. LOG of FORMATIONS'. COMMENTS g Materials From To Driller uL D S! Mass.*Registration# ell SJ Ra' s S}GU Address Cc�Gi r CltyIT,own ir't k 4i+ ce /pia lt.aG',y I fl 4 signature of sup ervisin r -istered well driller ;: as Pr nt 7,rm/y 80ARD OF HEALTH COPY 'w.r';.,h...�G«`5�".Ji.^nctc.Y"°�at��aCd'4a``w�a,,541L4 .4i!ii2, 1 ��- � No.- Fee-�-----�--- BOARD OF HEALTH TOWN OF BARNSTABLE 2pplitationArVefr Con5truct ion Permit Application is hereby made for a permit to Construct ( �, Alter ( ), or Repair ( )an individual Well at: --------- 5! t _—PG ��2 —�j'�=arY `f--P-q--1/------ Location — Address Assessors Map and Pazcel -14 0 16,0X /Owner Address Q_!1rS ncN e�l_tv_e_G�Or, /t ----------------------- - o�r �"lo D —�'rdS� ''`t°' ---bad1-1-------- Installer — Driller Address Type of Building Dwelling -- — --------------------------------------- Other - Type of Building -_ No. of Persons-------------------_-----------------—____-_____-__ Typeof Well--1---PU ---------------------------------- Capacity------------------------------------------------ Purpose of Well--OOALesT�__44-IU 11' —__--_____________ Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a of Compliance has been issued by the Board of Health. Signed )ertificate date Application Approved By-----s% _✓L ___!h _ _ � ____ ate Application Disapproved for the following reasons:----------------------------_____________ _________ ------------------------------------------------------- -----------—------------------------------------------------------------------------ �+ date Permit No. -- Issued $f----------------------------------------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate & Compliance THIS IS TO CERTIFY, That the Individual Well Constructed (01, Altered ( ), or Repaired ( ) .... ---------------------------------------------------------------------------------------------------------------------- Y-- -#-- . ., --Installer has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No ~----- __��_ ___��7 Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------------------------------------------------------------------------------- Inspector—----------------------------------------------------------------------------- No. = -------'-------- Fee--'-'-- =--�''r-p-- --- BOARD OF HEALTH 9 TOWN - OF BARNSTABLE ZppYication_*r3Verr Con!9tructionpefmit Application ii hereby made for a permit to Construct ( -), Alter ( ), or Repair ( )an individual Well at: or j_-- ! 'ear _ 1 i r_& 1 ,-e-------- Gt,_(, ?,_S� -_ --PG a -P[� a,' y<, -=)`! Location — Address Assessors Map and Parcel iifC(31 er .���o1u�NT -tf O' - ------------- -------------------------------------- Owner Address -- °:l1�X fGU --� u'� �'-ti'� npe - -- - Installer — Driller Address Type of Building Dwelling--------------------------------------------------------- Other - Type of Building--------------------------------- No. of Persons-----------------_---------------_ _ Type of Well -- Purpose of Well--Qn._v_tfsT --------------------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a ertificate of Compliance has been issued by the Board of Health. �G�U -� �JSJ !l 7 Sg Signed--- --- ---- —--- --- � 19 — - date Application Approved By— -------- — _.�•/ ,.� a% _ te Application Disapproved for the following reasons:--------------______--____�___—____—____�—__________ ------------------------------------------------------------------------------------------------------------------------------------------------------—- - --------------------- j 4 date Permit No.- "' '' _—-— - Issued - r date ' BOARD OF HEALTH >, TOWN OF BARNSTABLE •• t r ' Certificate Of (Compliance z THIS IS TO CERTIFY, That the Individual Well Constructed (tl, Altered ( ), or Repaired ( , ) by------- a A __ - 1., ,. ,P------------------------------------------------- ----------------------------------------------------------------- ,s Installer at-- —---- `'- '—ram! - ------— ' _"— ___ -- — has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No, "-"" Dated --� - It t THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL- SYSTEM WILL FUNCTION SATISFACTORY.' t e DATE------------------—--------- Inspector-------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE • Derr �or��tructiou�efmit No: : -'- ,r' ±'.+--r Fee- -- --- � Permission is hereby granted 1! =�Sj '-^''P /----------- to Construct (�, Alter ( ), or Repair,( ) an Individual Well at: �---- ---•----- /-Ors�' l'/------`--�� J✓/Y� Street as shown on the application for a Well Construction Permit No.------A-------- ----- ----��-------------------------------------------- Dated-------_/_�,� � ,.a`Y t - Board of Health DATE / '' r Ato, ----�------------- - - `BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT LABORATORY REPORT VOLATILE ORGANIC , CHEMICAL ANALYTICAL RESULTS Client : GREENBRIAR DEVELOPMENT Collection Date: 11/16/89 Mailing Address :ROUTE 28 Date of Analysis : 11/20/89 CENTERVILLE, MA 02632 Type of Supply: WELL Well Depth (FT) : 110 Telephone : Sample Location:LOT # 2 PIONEER PATH, - WEST LAT. (DDMMSS) : Not Given BARNSTABLE LONG. (DDMMSS) : Not Given Collector: SEAN O ' BRIEN Map/Parcel : Affiliation: BCHED Analytical Method: 502 . 1=1 , 502 . 2=2 , 503 . 1=3 , 504= 4 , 601/602=5 Contaminants Anal . Result MCL Detection Meth . ug/1 ug/l Limits (ug/1) Chloroform 1. 2 . 40 0 . 5 i 'Only those compounds listed above were detected. Attached is a list of chemicals which the method is capable of detecting. Detection limits listed are our normal limits of detection . If we , report a smaller result then our detection limit was lower p for that analysis (ug/1 = micrograms per liter = Parts Per Billion) The Environmental Protection Agency has set Maximum Contaminant Levels (MCL) for the following compounds . This sample compares as follows : COMPOUND MCL (in PPB) Benzene 5 . 0 * level not exceeded * Carbon Tetrachloride 5 . 0 * level not exceeded * 1 , 2-Dichloroethane 5 . 0 * level not exceeded * 1 , 1-Dichloroethene 7 . 0 * level not exceeded * 1 , 4-Dichlorobenzene 75 * level not exceeded * 1 , 1 , 1-Trichloz:oethane 200 * level not exceeded * Trichloroethene 5. 0 * level not exceeded * Vinyl Chloride 2 . 0 * level not exceeded * Comments or additional compounds found: Eric BI-Prier , Ph.D . Laboratory Director { n BARNS:, E , I,,OCATION 's.t �-t e� Q u SEWAt,$ # 45°Y ~70 I VILLAGE ��. � . ASSESSORS MAP Sr LOT 04- UO'r, Co j . y INSTALLER'S NAME Sx PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(tppe) Le ellvv a 5" !(.a4 NO OI? PRIVA`XE WELL OR PUBLIC WATER BET�ROUMS 3. BUILDER OR OWNER__.G DATE PERMIT!&UEO: _-17Z `d9 f ATFt': COMPI IANCE ISS�JED�����. :VARIANCE GRANTED: Yes No ga, 4 i t y,, I ._ 4 A 'GOWN OF BARNSTABLE �- t� LOCATIt�IV_� Qt�i-( e� �� SEWAGE # ��'7d I VILLAGE_, �af�.5 "�lQ -- ASSESSOR'S MA.P & LOT INSTALLER'S NAME Si PHONE NO. SEPTIC TANK CAPACITY__�dd LEACHING FACILITY:(type) ���^ ���� (size) 1 i d L 5,% II NO. OF BEDROOMS -j (PRIVA.r'E WELL OR PUBLIC- WATER _ BUILDER OR OWNER__ &, DATE PERMIT ISSUED: q9 DATE COLIPLIANCE ISS'JEll_._���� VARIANCE GRANTED: 0 ,�C �!� •��. tip. �z ''9�/\ � A `Z i� t P ,s. — ---� TOVffl OF BARNSTABLE 100112 LOCA: ON VILLAGE Ma ST AJa</¢ = - LOT cb� NAME&PHONE NO'�/e i, WN010 VAe >'— SEPTIC TANK CAPACITY IAI) LEACHING FACILITY: (type) g1f �X (size) NO.OF BEDROOMS BUILDER OR OWNER SEDATE: 1 �l� 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 3 c n f c ty) Feet Furnished ba�-v Y/AC i y I s U ��s���� ' ��T t.Qr ����CC,��c S � �i ��i ; �� �� � ��� ���/' �� ���� � � ti v ;i No.- .i../ v Fims .`. ....... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH .toyoy .....--.....OF............ 1�'� % 1. ApplirFatiun for UiipuuFal Workii Tuntrurtiun ramit Application is hereby made for a Permit to Construct (X) or Repair ( ) an Individual Sewage Disposal System at: ....L.�.T.... ......�r.a.r f , -- .....................................------. ---- --------.......----------------------......... �f / Location-Address �/ J( ,( �( /� /j a r�or Lot No. .....!!(� �lS.�.�A.._.��yL��.:_...../...51 y'S/�..� �Sl....1.et!_� CC..:�} ""'C" ............. caner •------•---•...............................Address Installer Address d ,,/l ec,�Type of Building Size Lot___+ ..Ze._7..Sq. feet V Dwelling No. of Bedrooms........i .............................. (AV Attic � Garbage Grinder ( ) U 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 capacity.�.Q)..gallons Length---------------- Width................ Diameter--------,------- Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.---___-..._.._.______ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.. -.(loll�---- Date... 7 - i-10------------- aTest Pit No. 1.._L2....minutes per inch Depth of Test Pit____________________ Depth to ground water.._..................__. L% Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water....................... M .................. ... ..................••----.........---------------------•----•-•---.........---......•. O Description of Soil-------------•••--••6--f:.1.,Jam_.........-.-Q.P.:le.--•���1� ------- ---- x --------------J--c5 1/f . ...mc = . -- �5d _. U - f � 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 TITLE 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 b the board of hea th. rr Signed.......... --• ---1(....... -�-•-- Y ` D e Application Approved B ---- ---•-•-------------------------------------- l ------ Application Disapproved or the followingreasons:........................................ D to -- - ----_.--- O Permit No.__.... ...... V_.� Issued-...---- �)a _Date Date No..cam....�.. �v / .` . F>�s..`......�.`.�.•.� THE COMMONWEALTH OF MASSACHUSETTS ,,�'" BOARD OF° HEALTH ...............L _N.A .............OF.........TN.t <..I..A-y'?f.:.t...... Appliration for Disposal Work, Cfonstrnrtion runtit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ...I!.a1 � t�/o A�t. �..... . .................•••.......... ........... .- R,! .-•:-Location-Address or Lot No. �l/l 'r?�,1� �t i /l f 1�i110 ° ... r��Gx 5 /... �../`_nS�i!�, �l E ..;�.. r - - ................................................... Owner Il Address -- r..... :..... Installer Address d Type of Building Size Lot.... Q..�:.....�...Sq. feet v ...Ex Expansion Attic Dwelling=No. of Bedrooms........_-^:............................ p (V6 Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) P 1 Other fixtures -----•---------••-------------•... W Design Flow........................... .....•.........gallons per person per day. Total daily flow.........................��__.................gallons. WSeptic Tank—Liquid capacity.Jrl6__-gallons Length................ Width---------------- Diameter................ Depth-__-___--_---__ x Disposal Trench—No...................T. Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) '-' Percolation Test Results Performed by......14(ofA.__.�/ r- 1 AA_J_4 _ �� a - T- ------------- Date.... : -----•--y-•---•--------------.. Test Pit No. I---4:Z....minutes per inch Depthf of Test Pit.................... Depth to ground water.-__-----------------.-. (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-.-____----____----04 ._... -----------------------------•-----------•-------------------••---•---------------•-......._....--.........-----------------------------•...._.........---- D Description of Soil-•---------------- .............., <--- _16e-11 'fit " ��=--- W ---------------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------•-•--------•----•--- M. Nature of Repairs or Alterations—Answer when applicable,__-_------------------------------------------------------------------------------------------ -•--------------------------•----------------------------------•--------------------.................-----•-•---------••-•--•-•---------•---•--••---••---••--••--------------••-•------•-------...--•--• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State 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. f Signed / /_�.f� -'---- ..---------•------------------ ----, T 114�Date Application Approved By...-.-!................ F to Application Disapproved for the following reasons--------------------------------------------------------•---------------------------------------••---------.---•- Date Permit No.--- .••. l.----•----•-.•.... Issued-............ 1✓ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........I....... ..................OF..............'..? :.?t) .t:�� ........................ Trrtifiratr of Tontplianrr THE IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by = = t_!..ate/ :..... ....j. In pi �staller � at......................................t��:. l t ......................•-••--•---...-•••- 7 , has been installed in accordance with the provisions of Tqf"zEl-' -7 Tae/State Sanitary C�d �e .i in the application for Disposal Works Construction Permit No......................................... dated......... .._.._.� �... THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GU RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE............................................ or_:------..•----•------............••.•---.. Inspect G' ........ .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I ..............:!. .......OF............ �...........................................................r3 No......................... FEE........---•-•.......... Disposal Works 0-onstrnr#ion rrntit Permission is hereby granted............ ..I....... _.1.52� r.I ..-•----••--------------------------------- ---------•-•......-•-... ............... to Construct (Y ) or Repair ( ) an Individual Sewage Disposal) System atNo..- .......................................� f � �...7........ ..... �C .... - Is c, --- Street i\ _I...- i`•�• - /j--- ' as shown on the application for Disposal Works Construction Permit No------------ ----- ted.._. .___ ---------------------------- r .......................................... - --------•---- .................................. . •.'• Board of Health DATE.---•--------------------•-------------••--••--------------•-......--•- FORM 1255 HOBBS & WARREN, INC., PUBLISHERS PART XII: WELL REGULATIONS SECTION 3.00 PRIVATE WELL PROTECTION ADOPTED 5/23/89, BECAME EFFECTIVE 6/1/89 TOWN OF BARNSTABLE '�� �• OFFICE OF , IIAI13TA13L BOARD OF HEALTH rasa ,, . 1639' \em 367 MAIN STREET '£0 MPY k HYANNIS, MASS.02601 TOWN OF BARNSTABLE BOARD OF HEALTH PRIVATE WELL PROTECTION Under the authority of M .G . L . Ch . ill , Section 31 , to better protect the public health of tae inhabitants of the Town of Barnstable , the Town of Barnstable Board of Health voted to adopt the following regulation' at its meeting held on May 23 , 1989 . The following regulations shall be effective and applicable beginning June 1 , 1989 : Section PART I -- 01: DEFINITIONS 02: REGISTRATION OF WELL DRILLERS 03 : WELL INSTALLATION, ALTERATION , AND REPAIR PART II REQUIREMENTS FOR WELLS NOT INTENDED FOR CONSUMPTION 04: WELL CONSTRUCTION PERMIT 05 : WELL CONSTRUCTION 06 : WELL DRILLERS REPORT 07: WELL DESTRUCTION Part III REQUIREMENTS FOR WELLS INTENDED FOR CONSUMPTION 08 : WELL CONSTRUCTION PERMIT 09 : WELL CONSTRUCTION 10 : WELL DRILLERS REPORT 11 : WELL DESTRUCTION 12 : WELL LOCATION �- 13 : WATER QUALITY 14 : WELL YIELD AND WATER SYSTEM DESIGN .15 : SUBMISSION OF WELL WATER TEST RESULTS 16 : WELL APPROVAL 17 : EXISTING WELLS SERVING RENTAL PROPERTIES 18 : TEST OF WATER QUALITY UPON TRANSFER OF REAL ESTATE PART IV 19 : TOWN WATER 20 : NON-APPLICABILITY 21 : VARIANCE AND ENFORCEMENT PROCEDURE OIL DEFINITTONS Abandoned Well : a Well t h a t ciao. r W o supply for a pericd of one year m C.,I e- es a- the wn_�z .L_declares his intention to use the . we i_1 a E7 I 1.- 1 P1-1 1 V i Ti.g water within one year. Board of Health: the Board of Health or its, Pollution: adverse effect on water quality --created by the intrnduction 'Clf any matter . Potable: water which is pure , wholesome and free from impurities that may cause disease or harmful i ph�y --ologiCz:11 effects such flint the water i s sale IF r human c o s u m 1t i Rented or Leased Pro-of-,rty: any dwelling used for habitation or business purposes by an occupant other than the owner, for the use of whi(--:h a fee i paid . This, includes- , but is U n ot limited to , campgrounds , motels , bed and breakfasts , and - a, used on a transient basis , as inns a, other ccomodationS us well as ;--c)m m u n i--t-y-t y p e buildings w I-,i h a r e rented to C o ITJ m"A n i ty Z r(.-,u p s. Well : any pit, pipe , excavation , spring, casing , drill -hole , or other -Source of water to be used for any purpose of -1 _ipplyin,g waL. r, an,' shall include dug well- , driven or tubular wells , drilled wells (artesian or otherwise) and C-priT-gs� ' gravel p ac k e d gravel walled well-- gravel developed and wash borings and as' further described inthe ._.__�:_ -4 i U, EFA �-IanUal Of In,-t-vidual Water Supply 'Systcms_ . For the purpose oT 'hese regulations , it shall include }loth private ,:jot'-ablt:- :l ied non-potablea wells . Well Intended for Hum.an Consumption: any well ur'lyiI_Ig fC,�- hUMan C-011SUMIDtion, bathing- , or washing purposes , i :' 110'• Othle-rWiSe -f -Ulat-z-_-d a- a--`pciblic Cqater system'' c o mm i n t y r n -)n-cD.rr-MUI!_JtY N,`ttet- supply) under 310 CMRL Well Driller: any person , firm , or cc-,rporation drilling , constructing , oz- destroying a water supply well . Yi(-,Id : Q!.j,,j 1- %i t-y, -F j - w.-a-e.r delivered per unit time which may fl b 0 CI t i n'- 11 1 y pumped from the well . 1 n2 = REGISTRATION a WELL DRILLERS All well drillers doing business in the Town of Barnstable shall annually file. with the Board Jf Health -a copy of their current well driller registration certific.ite issued by the Commonwealth of Massachusetts under Massachusetts (;anaral Laws Chapter 21 Section 16 and Massachusetts; Regulations 313 CMR 3 . 00 . 3( 3 -- WELL INSTALLATION. ALTERATION, AN-n REPAIR i) No well shall be installed, altered , or repaired except by a well driller who is rj istered with t - tl •.g _ i�•,1 ,.i:_ ;pia�.er Resources Commission Di .i "1.On of r mot, _ Water z�s,�urcF�s un�_ler. MGL• �,,,1 /2 1 16 land 313 CMF� 3 . 00 , eX�:ept Siherein an Owner chooses to instal !I' to have. inatailt:�d a hand-dri _n well to, be used for nui-:-putable purposes , - ) All wells shall be located on the same lot as the building they serve . PART II REQUIREMENTS FOR WELLS NOT INTENDED FOR HUMAN CONSUMPTION 0-' WELL CONSTRUCTION PERMIT - 1) No well or �= - - ---= group of wells with a yield greater than 5 gpm shall be installed, altered, or repaired until a Well Construction Permit Permit has been obtained From the BoarC! of Health. A permit so granted shall expi -•._, si ( 6 ) months from the date of issue unless construction has begun . 2 The fee for tlii� permit sra11 be --et by the Board of 1-eaitii ; the fie F i ea, } �;r11"C,`�i?�• ti'1.1Ct_On perinit shall be 3 ) Li appli _atioli for a Well Construction Permit shall be by the - o-tr" _tor JY• his -1"TP_.;:lt to the. Board f Health on farms furnished by the Board of Health . The well driller is reSpon-sible- for obt,aiIiing said permit p1,1, L L.C) ;truction . 4 ) Tlir _oc_.t�onand desigli C--,y t.iie water well must be approved by the Board of Health prior t-o issuanee of a Well Contruction Permit . Frior to approval , the. Board of Health reQu- res the fc 11owilig intormatiQ1-1 to be. ;submitted : a) the assessor' s map, parcel , and lot "lumber of the property on which the well will be located . ` b) design and capacity of theta water system , as described under WELL YIELD AND WATER SYSTEM DESIGN (Part III , section 14) . c ) purpose for which well is to be used . 5 ) Every well used for non-potable purposes and permanently equipped with pump piping and appurtenances shall be clearly labelled : "Non-potable water supply not for human consumption" . Permit Conditions : all permit: issued shall be subject to the conditions that all facilities shown shall be constructed in the location approved by the Board of Health:. All permits�rmits issued s`:aIl _�.be ubject to the reau_rementS of th`•se reguIati--)ns alld to Such fu-the�' nd i i n- a ' - ?;;l ji -hall cZ be . <-;7 t o 'he Board f H ��. 1 r r s 05 - WELL CONSTRUCTION (Wells Not Inended For Human 1 ) The Board of Health recommends that well construction meet the guidelines outlined in the New England Water Well Drillere. , A--soclatlon Ground Water Quality Control Well Const2'uc•tion Code . % ) All non-yielding holes which are installed in the process of constructing the well shall be filled so as not to act as a conduit to the groundwater . "3 )._--A---;petal tag shall be. affixed to the top of the well -- caS'L lg at the. time of ins-tallation, so that the. well may later be located if necessary by a metal detector . 06 . WELL DRILLERS REPORT Within t1hirty ( 30 ) days after completion of the construction of a.ny well requJ ring Permit , the fell driller shall bmit t the Board of Health a copy of ,Iie Water Well t p1e RepC„•t . 07 : WELL DESTRUCT-ON .1-!n of any well , well <«s truction e2'm-it i1'Il�._ b _ L!taiz-ed by t•I, ?[vl:eL' or Ili � TCI!t tr�111? r�_ t_i m,. �- _ .7 - _ - , Board c_ r _ _.!t:: .i!'- Jc *'_, of: i' `..i'' '-]--- requIre _1 to Plan `=i!_iW1i T t•iie iarl l l ,c_:a%lr_ il , -: �1!i�iiii= i rl 0:-Mat1ol! oIi th-!f and to numt -- fU 1,t!e property on l _ 'rf'll li_1!., tI--li- f.TNI l 1= 1(?(.:.y.t.='t i_l , prior to 1 ali'..F' cif fl 1 it will Cle"t 'l:c i iii permit . ! ) An7 aban,1(- ed well shall be fi!lea and sealed wit1, ��•mod:i p!_lddled clay, heat cement grout ; or concrete grout in such a mariner as to prevent it from acting as a chanriel for pollution to the groundwater . ,31) Wi t11in thirty ( 30) days after completion of the destruction of. any private well , tiie well owner or well driller acting as agent for the well owner shall submit to the Board of Health ;a report containing the following : a) the name of the owner of the well ; b) he �z_—o r ph c 1�Cat_ in ?f ne well ; ') any preliminary cleaning or redri.11—" , 7 • d) types , depths , and ma%erials of seals used . PART III REQUIREMENTS FOR WELLS INTENDED FOR HUMAN CONSUMPTION 03 : WELL CCNSTRT?CTION PERMIT N1- ell �.._.11 �;e 1litit•__il= a , 1+�I'=il , _ '_ repaired aIi%11 We11 Construct C'ii F-rm_t ti•_,-s been obtained from t11e Board of Health , which slial1 expire i?C ( 6 ) months from the date J1 1_SI.,,e Ulileti _ cC)nstrucct•_o?_ ::_.c e. un . IrI i _ :i?� r 'e it i•lii� perm, =: S,iial.i be set by t•rle Board 02 Healtli; the 'Lee. for eaC11 Well permit shall be $2J _0.0.. .. 3 ) An application for a Well Construction Permit shall be submitted by the drilling contractor or his agentr� to the Z(Dard (-f Health on form.`_ furnished by the Board . li e well . .. -iller i._ re -poll::ible tC?I' obtaini lig saicl permmi t. Pri nr to :cell construction . ? ) T1-ie loca t•ion , and des i7_-i _if the water well must be approved . by tl-�e Bo•:ird of Realth prior to is.suance of a well (�ori •tI';lc_t1<`n Dr_.a']TJlt• . rI"_oI' i.c_? approval , the Boar' of fl alfi•1 lr=s t•li f o 11 c i ng t• be .`'ubinitted : :1 ) t.1i a"e �•or� m: p , a _ i -and lo' number of file prc_)peL.t'g` Oii wn1Cli tl-re Well Will bF located . U i I le I. Girl l �1 l i �il(1 :�l.t' F *_' �; �1•e71 L!'� :) a t•e pi n (lra(;n by c. I'e�i=1,Ir pI' iff' e•i!= na1 (iiv11 ClI_ji t I r ji` +•r.-^L1 SaI1_ •:1: (D I., I'eg te—e(_l 1•and lry j�;_ _•h�'Nillg tll`. pI'i_?Dci=r'.d loC• t•loil of tiie Well in re1_, __?i t•� C�!1 ,_I 11, '� r'_ -.,i�J_', �:i�iii� , -•L,_,prL.t•'y' 11I1C , b1.111(_�111'? sewer lines , the subsurface sa:iitary di .pi? .•11 serji_' the lot , all other septic systems w V ithin 200 feet , and any other known pot�--nt•ial sources of contamination ithin 'GO feet which col:ld affect the well . . Such sources ll - !:.l e =aIi i r I c _ 1�- ; anti, LyT •..'l:t�� a 4 ' on ,11 I _ 1.1 t�. ti t y �: 1 ('"'l l i. JuT.!: yards ; municipal Sewage treatment facilities~ with oIi 1 to ri i tinnq;41 rlr nY•i Tn^e i,-�r - - - - r- �• � - -- J. ,, vL 1lUcii , car washes ; read salt stockpiles ; dry cleaning establishments boat . and motor vehicle Sere-Ice .and repair; cabinet 1 mal:i2lg; eleci..Z'ollic G1T'cllit a ,v�mbly ; meta— plating, finis11111g, Mid p<_?fishing; motor and machinery service -and assembly; commercial paint , wood pre ervin,=g , and furniture stripping; sites where pesticides and herbicides are regularly applied, including giJlf course and cranberry bogs (but not including pesticide application at single La,11i1y dwellings ) ; photographic procesSing ; printing; cheiiiical and bactieriologl.-Cal laboratories ; tran-S7�Ortatloll terminalS ; fu:ieral homes ; aI!y pr J nc'1 a 1 1_1:;e involving the sale , storage, or transportation of fuel or oil ; and any Use whict! involve-- as a activity the T),�P.I�f;:c_tUi'e , storage , :T'aI"!.`'p7rtatiJii or d1 ";poSal of to:i1 or hazardous, material_' . To meet this requirement , well location shall be shown on the same plot plan submitted to the Board of Health for approval of '(rptl`: s-ystem- installation � ) T'e`.1�:i•eT'S i C.-L ?ngi na�r' 01' rFtT1`: -red land surveyor must ctetermine andi mark= . tiie location of the well Otl tile lot prior to its installation . For e I.f'_g.eiic:J repair , ltera�.io.. , or replacement of an :�_btlt:j [•J=il , t-n'e B 6a1. of iZ^aft% m,qy waive the i egil '_reme-.nt.S " that -`a.�t;lte r)ian lie ---',mined and that the Iocat'Lon of the well be ._tal•fd on 1-he lot . o i er,Iit. t_i;ndi i i ons : All 1--�erwllts- shall be- C-I-ubject to the condit'Lons that all �facil shown sh,:ll be c oTls true_fed _n t:le loca t_or-, ap-c roved by the Board of Health . All permits ,,, -u a ed _ s1i.��1 _be: subiect to the T'ec71_liI-ellle1its of these r.='gulation- and to Such further C' Iitii-k o4 _ at t1i" ii.�a. _k c!f Hea 1 t1! ._i!all preS,crlbe . WELL CONSTRUCTION (Well._ Intended For Human Consumption) 1) Tii $to,gr'd of iealth rc _ .minend.� that well C' 11St•ruCticjn lTleet the gu—J deli e-S tiutI i n e d in t he Nec,� England Water Well ell D r i 11eT ._ A_�:,>< .iat_.i'_;rI Gr<_>�"1: .� r.a�;�r y._la' ity Contrt_,1 We11 Ccn_.tru;-'t __rl Cede . 2 T?ice i.`! `1.- 1 = 1 _ _ _ :w='L1 _. 1 'v=' �i!_�c_•V� �_ _ll!iCk �?'�zt 1. i1lg.leT' �.k"i• i. -t-11� �;uT'I�t�i; SO1,iT'�.f'S -:f con t•a.i inert,i-un and above any i•:!i<}tJil c:Giidlt•lOI1S offlooding by drama re or runoff from the . l s ur.c'o�lllck itl.g i%3ili:k , ll '1";`C 1':='C:3.te':_i _a IL'._ _ _k-psi_ �. _l Fi" i . r 3 ) Wells must be constructed so as t C-I ma,iit, �: natural protection against all known or potential pollution of the groUndw%ter and to exclu(le s11 known Sources of pollution from Mitering the well . 4) All non-yielding holes which are installed in the process of constructing a well must be fillecl so as to not act as a conduit to the groundwater . 5 ) A metal tag shall be affixed to the top of the well casing at the time of installation -so that the well may a !a ter be loco eei 1f ne. by a. i7:,` tall detect-F,or . 6 ) In area.- where Salt water or other pollutant intrusi-n is known or likely to occur , the Beard o� Health, working with a designillg ellglilee}', m:y "Jec�lfy T. yr l'1 _;C, re: level , pi-lmp-Mg rate , water st.:}raje capacity , or any c,ther Cc�IlStr.-i�:t'UIi palai;eter wl:ichl U�t be l`d tci eI!`Lire that Ida er Cif ail:-?qua to Quality is. obt•ainetd 10 . WELL DRILLERS REPORT Within thirty ( 30 ) days after completion of the construction Of any well , the well driller shall submit to the Board of Health a copy of the Water Well Completion Report . The Board of Health will not issue a Certificate of Approval f(--,>:' tl-!e well until this report has bee:! received . 11 . WELL DESTRUCTION 1) Prior to destruction- -of---any well, a well destruction pe;'Illlt i u-L. be oL`t_7ined by the C1GiI!^L' or ill". ag�ilt lroMl ti!c Board of Health . The Board of Health will require a site pull showing tilt.' well location, lIlcluding information on the assttssor_: map, parcel and lot. number for the property on which the well is located , prior to issuance of the well �tructioli pe>_'mit . Ally ando11ed t4tf11 Sli,zl1 1 r ; _led alld e pled th clean llll_ll e_l =lay, i,e=-:`• m,-'nt. _:ll _, `;r r'Ciflc: Y.e g�'011 :• lii S�Ic:ll - :i!ailllrl' %1 to P-"- eVeldt i _i'.:il a40ti 1�- as ;1 CIlailllel for l 1 ll`.lc_ii tC ti'le � ) �Aj i it tI- irty ( 30 ) daya after omelet ion of the d--t•rl1C:?iun o% -aII priv,?t i-;.-11 , the [Jell c�cdl!FT (jr car l 1 driller actinLr a a�-TeIlt• f,::)r t•i!e well Owl1Ci' --hall Submit to t},= .ep.-_ r. t_r,rt;,ii!i :i�T t.l'r following :Boar.l oi. Ht:,,�1t•}i a r the n:�Ine of tl:e ej(1Il r of the well ,- the 'seogT'3p!'!l:. loC•,,TiL,r-1 of ti-1C Wel 1_ - c any p r e 1im'_IlBry e l ,-,gin in g or re-dril l ii: , d ) types , e_lept.hl , and Iliatrr'ials .--,f seals used . r 1 19 - WELL LOCATION 1) In general , wells intended for h u m C2 0 i=, iti_,,+:2.'_:tl be located as far as possible from potential sources of contamination . The following inini,ruin distances are i•equ i red : Property line 10 feet Roadway 10, feet from edge of road layout not edge o% pavement) . LcaCI112?� ��atCil It feet , b;dt ^CC J1A1c'iiCi that this basin/drywell distance i-e ma::imized Jt_litj rlgh -Ot-way 50 feet , but i N C O[ I':.a i that thi dlstailc ea b :max'_miz-ed ^. i ✓Cpi•li lc C�ii2! 150 Test y. e.iDtic ,fti stributi on 100 feet. b :,x Subsurface drains 25 feet , but recommend that this distance be. maximized, as pollutants frequently travel :along the outside Oi •sUbsu r iace- drain pipes . Z ) where , in the opinion . of t' e Board of Health , adverse conditions exist , the above distances may be increased. In certain cases , the Board of Health may req,_Tii'e the owner to Ovi'.le additional me•ir:.= cf pr,te':_tl >n. `�?'iere possible the well shall be 'Loc-ate-d up theQZ''>14!1:1vi• T, J -t• + it _ _ i' arc"t�.1c=21 1rC71 �•:?Urce-s of co.1l tamirla.t ior'.` 130 WATER QUALITY riot to approVal- of the. we- l1 and appro,/al of a DiSpC:'sal y': Iir._ (� il� :Y'11C�•1':?i1 t'ei•!Ti_C• a �LDliC tlUfi , tilt Ci[J,1`r _� _._`. =hall _ �,:_ _. Fi•_. --_ = _.:fig - _ _ :' �i'i.1lTi _.. : = 11 a2i'� !-)!;;it• it. - I:U � `.•3tc i11_ = = 1ii1J l ZiOZ'at,= r.y tUY' 2laljr:_ Lc Niiil f.i1C L:c s•t, t•(.:; be bot-rie -Y ".I!e OW!iv'_• . Til^ 'i-e.-:,u1ts 'Jf all :i• l� - _= "�i:ill '_ _ t•ui_il!it; =l t..ir . :., " f He-aIt.I-- . :.t• : 1.1rN watc-r i21i_i.`"••t be it'- _ _ S �lc=I1i1J• l i i" >�-1 lii i_ rin c lifo , I. r',a -lt tei ` I1 , Ll a.l i,� I• V l� li'.- e.il•.la_ _�._. t')%,_' rl r' 1 n t y o,7(=! PH, C0I1dUc7.lvi%y , SOCI-iU:1 , ir;_,:1 . ail(] EtA methods J02 . 1/503 or t 502 . 2 or 524 . 1 or 524 .2 . These tests• _.lclU( - .. _ _t,_ p1.ir'- _ "".'Dle. ilal�-C3rb CiI1 a2!�l lip'==ar'l' !]%Ytl(=- irell a V analyses for petroleum hydroca�'bons or pesticides . TheBoard Of Health rJill deter:miihe potability of the well water using as guidelines the National Interim Primary r, r_ rt + a11CA JeoonU�ar y Lrin..�iig r'ra UGr :tu,....c.... �+ - . .. . Maximum Contaminant Levels (MCLs ) . The water quality standard_; for common parameters are as follows : Primary Standards Total Coliform 0 colonies•/100 ml . MF Nitrate E,e,condar'y Standard PH rtzcomme.nd .p i above 5 0 �Od 11.1m pp-n r �Ii U . p,M � ) shed the Board of Health de t ems I n�'ces sary , the Health. i`Csiit (�r it'ler aJjtit ^of t:._ L:''•f?._t J; '!e 1tr may be Present to witness the tal:_ng of a •:titer sample and/or may tale the 1 �re _t. to l?_� Stlilg laboratory i•i:? e.r samP - I1(_t _ 1iv e r t t.t lhe: self 4 ) The Board of Health further recommends that all well owners• have tlieir. wells tested at a minimum of every two ( 2) years , and at more frequent intervals when water quality problems are 1,-nown tO exlll t . WELL YIELD ADD WATER -SYSTEM-DESIGN. > efore appr )va1 ev,er'y We11 shall be. pump tested to yle1�1, . T�tie L'I.1m'ki, teSt hall in-lude a drawdown d.eterilil:le . testata ii1i1111I:11I?l pj1,".p;!:c r.a .:e of J gallon- per m-inute for r!e ( 1 ) hour . ,f t• !e Fi•Z t _ ;r� teRl , i-- I ucling Well , pl.lmp, I Cie _.cam l�il C l _ Sr le must tr_. adequate tr_; r � t - per ininut,e which equal' - . • >1. L11Jn- :1 i t.11c 11.1;nt-:er ��l W. t• i fi:•_tures i:.-tallyd ; iii addition , a:�,_l t.yr ( ?1 gpiil) Rll1;=t :1(-)t• ie le( y11cil: the peak demand f c'r e, l:jZ.g �i. 14 Ci_l.t'f Cct!1 d . F"r the purposes of this t.i_1L' _� ceri y W•iteti �,.lti t• , 111c udes faucr". f'.t ;Will: to i let. ,. bathtubs , washing n Masi!ines. , (-lisllw:,sher_ , a lU tll_ like . I 3) In areas where salt water or other pollutant intrusion V exists or is believed likely, and where the Board of Health ( in COnjUnction with a designing engineer, as outlined under well Construction) has determined a well Pumping rate which must be used to prevent further contamination , the Board Of _e a t+ „.�..7 p�Cii j ucSioii CL , 1.C1 ict LUL' i,ne au,iaing and water system served by the well , so that the water storage tank , number of fixtures and habitable space are compatible with the pumping capacity of t11e well . 15 _ SUBMISSION QZ WELL WATER TEST RESULTS 1 ) Prior to issuance of a Ce-rtifica�+e of A- 1 p.proval for a well intended for human consumption, the results of all water quality and yield tests shall be submitted to the Board of Health . The owner of the property which the Well will serve , or the well driller acting as agent for the OWller, e•hall Certify, on a form provided by the. Board of Health , the following: a) the location , and date the sample was taken , and the laboratory at which it was analyzed ; bJ treat the Water simple Whose analyeis Y'eSuls Were -lbmitted to the Board of Health was taken from the well for which approval ic. belie; -S,itlght , and c) the results of the yield test performed by the well driller. 16 WELL APPROVAL 1 j New we.ll_s "'vial l not be pla c e d i r i t o L.,Se for human ('Oil SUMP tJLOn 11I1til t1-1e' liar d ci?' He'a1th ha s approved . tii• potability and quantitv,..a.f _wate-r provided , and issuer a Crrtifi t.e. of Appr ;v;tl for tree well to the ownNY of the pY'operty which the well serves . A Certificate of Approval for a we11 will not be issued until : 1) the well Water has been shown to meet the water quality cr'_"t.eria C;1.1t1inC. ii. yhr reg1.11atlon: ; ?nd ) thF capacity of the wat.er .: +enl Jr, , r1 ���.11ai _ pee minute , has been demoli`trated to equ. .l the nUmber if fixtures installed . 3 ) I 1 -�Aditioti f0i well_ inst 1t �_I �t newly constructed :J 1 •�1 _ b1.liIding-S; , the Board of H lth shall require that a e Y'tifie i P� ;t P1•:-tii , dr Wn. by Y' J stt'red land surveyor or T + prL;fC��ti lUtl�l Cl i i 1 enginee-r ,, bt sllbli]it tt Cl to the Bo,-:ird of Health . ouch 'l -, p .t plan must show the actual 1-)catic_iil of the. well r%n- t1 e li t• as tilt-,cr' dist- c_s:Jdistances from 1 lot corners , and must show the Iocati�>Ii of i .e =.eft_= system, as installed, in relation to the well . The plot plan must also identify, by assessors map, parcel and lot number, the property on which the well is located . This Ce1' ledplatp121iifOrmatlGl may to included i h a required by the building iri S pFctor whlc i sh,Dws t•i?e toL. J at ion of the foundation on the lot . 4) The Board of Health shall not approve a Building Permit or a Certificate of OCCL1panCy until it has issued a Certificate of Approval for the well serving that building. 5 ) Wells which fail to meet some or all of the requirement- these. -egul-- 4 cD is may be 'prO ✓ec' by the Board of Heal`-, after a 't1e.^r_in.g at which a v•a_'1, nce from they :standard may be granted . 17 : EXISTING WELLS SERVING RENTAL PROPERTIES 1) The owner of every well intended for human consumption serving property which is rented or leased shall have its water tested at a state certified laboratory for tie following chemical and baeterio log i.ca1 standards at a minimum of once every two ( 2 ) years : total coliform, nitrate-nitrogen , pH, Conductivity , sodium , and iron ; and for EPA methods 502 . 1j503 or 502 . 2' or 5�'4 . 1 or 524 . 2 at a minimum of once every five ( 5 ) years . Where water quality protlemS are know1? or suspe ted to exist , the Beard of `Iealth may require more frequent testing, or testing for additional parameters . 2•) Results of all water quality tests shall be - -ni.�de�----_ available to all to-rants of the property and to the Board of _ Health? , by the o wI?er of the p roperty . i Iil �a �'c w�?er;_ the Hell watel does no-- meet the water quality ----ta11dard8 ;)Lltline.d abo ve tI e Board of health may q;"i1 the pr iperty 0wr�1' tC provide an alternative pp1'( ved source of d1'lli::l;?.g wc.trr ft 1' .tP"ie todealt•-_ . TES _Q� WATEE QUALITY QFON TRANSFER H R A T 1 ) Frio-I., to selling , Conveying , 01 transferring title to real Dl'opc'rty in the TUwn ?t Barns .able ; the. owner thereof .,h.jll liars t oted the w.- r of =vt pr'iv:ate potatle well ving th•_,t. Ur��prrty . A 'r' r ale i2'Oln each well shall be Submitted to •? state certified laboratory for testing for tii par?metf 1's L1tlined under Water Quality , above . This water quality test shall be performed not more than one ( 1 ) f. y +t - y ..._lr prior to transfer L._ h- pYi_;per ty FcF'�Ult•� of I.IIN water test shall be submitted to the Board of Heaitii l i to property transfer on a form provided by the Board of Health oil which the owner Will certify that the sample was t,ak-en from the well serving the property being transferred . Ili addition, the owner shall give copies of all water test results of which he has knowledge ( regardless of age of results ) for the private pe�aulr well iii UUeb Liuii to aily buyer and/or broker identified with the transfer . In the event that there is no buyer at the time the water is tested, a copy of all water test results must be given by ':.i'le oWile�' t0 the buyer before the _property is �ut ltildF'r agreement . J ) This rezulat iIl shall nCit apply to tl!.e conveyance or devise of aupr'ope--ty to a surv_ving spouse or to any of the heirs or devisees of the prciDtty owner , and further , snail not apply to a sale under dower of sale _n a bona fide mCiI +gag- affecting the p rope r+` 19 : TOWN WATER The Board of Health may at -its discret.ion require single family , multi-family, or commercial structures located within 300 feet of a municipal water line , to connect to municipal water . SON-APPLICABILITY Any well regulated pursuant to the Water Management Act , MGL Chapter 21G , which... coverns any well that withdraws an average volume of water in excess of one hundred thousand gallons of_- -� water per d:Jy, is exempt from file Regulations established ZJ_�_ VARIANCE ADD ENFORCEMENT PROCEDUBE � ) Tllr r; _ t He_.lti: .::ay ,_ r.y t11= ,�,p� ; ,,a :i( n of ai1y prci;rlS.1_i! of this a�` l�::ll wrt.'1 yr�`pe�.c.t• - to� any particular Wilrll , ill it, ?llllll tl , %llr eI"!ti�r'� !1]ellt thereof wnulA d0 an a,ifeSt• 11i ju,S'L i:e : provlde.t:: tl"Jett tiJ^ d e c i s Lun of the Board �$ I:"_._t.f Shall not• cC,nf__ W_Lh t•ile - plJ'i t, o_ these 7Ji!ilIiiu!Il c ta!id•jrds I1Ut' Wlt•li `lie. pr'ote��tloIl �Jr. h, rlall -ealtr! �iiCl li tiJeiit•'ai -'!,ia I 1'" � ) every reque—S fCir a . V;i1*1 n c e -.,hall be. made. in writing and sh:-1ll _ i:_.te th _ 7 va1'ianc requested and the ��_:_ _:.i(__ �r Ali 1,�'(� �i�,� tiie Boar(_l o He-a1t11 _'I1a11 L;r ill t. 1 L _L Al-lT deiilal Ci?- a varlaIlce shall 1so be in writing and shall state the reasons for the d e!-, , a 1 A, C. %py C?1 ally v,arianc_•e' gra21`'='d shall be available t? the pllulic at all r a-cna-ble flours iI1 tih officJ' of the ,own clerk oI' the Board of Nralth while It i- in effect . , Any v=rianc- or modiLication authorized to be made V by these reg!_ll:�tions may be su`�:jec.t. to t;!_lch qualification, t. ) pen- ' , , or ex 'i +i,.:'I; s the Board _f Health expresses in its grant . A variance or modification authorized to be made by these reculations may otherwise be revoked, modified or SLISpencyed , in whole or in part , oI11y : a : + ; a after the holder 11-,IiG L'�Vl II�A' uc 11 11V 1,111E I_l iI wry lrh� Ga1i_. has been giveI? an opportunity to be heard in conformity with the requirements -of- '10 CMR. 11 . 00 for orders and hearings . 4) As a condition of granting a variance , the Board of Health may require a restriction to be recorded at the Registry of Deeds when , _n '.he ,,pinion. of the Board of Health, knowledge. that the Well does not meet minimutn standards Would benefit futur poteiiti;al consumers of water supplied by the well . ';) Each se:-"',ion of these 1u1-es, and regulation` -.hall be uara'["e �� aily �•e=ti:JTi ; Z'e ui%tioTh, lip=tL';a,7r':_l ll e-Ilr nl�.� , claLIS_ , i='}ira`'if' (wit• word L:I t11�ue �u1es aTlJ L+eglll'•?`ioTis hail b ecl. red invalid for any reason , th-e remaindc'L of these. rules .c 1rid regu c�Th > "ih•_.11 C' !%•_._._ �... full forC:e anci e C , 1 The pL'vv i= -`-_- - -'- m - ; tat - Environmental ?- + i^ enforcement of these I - . �t . � ��r�2 �. . . 06132036265 "rev�kt1►' . , r 0 6 1,3,_0.3-8 2 6.5 _� , ��f)L'�.K01� 32 ��""T'w Rom,VT�.• A. y%� �;.'V .��)�� �' `j\.-'�•1-.i:.ice.t. "o- T e ' 0 6 1 2.2 0 3-8 2 6-5 POLAROH!, 3 tom.• r{ " ,_. w- �' r ' w �� R l -�'�,�,`�°�,r-' �j7� I �� is ;� ,� � R{� ♦K ' �`Y � x� L ",L� > ., ♦ M� i�„�,,,�, ' wti�� � t NZ6 t . '�� y �: .�r4 -ti;� Y :'�+•.�; �v. ''�S''K y, .y' 11.3 2 0 tt'Llwoub K i ? 4 �UFoLA -- ...._ _ _ ...._.. - �,:'� SNItJc�LE_ GAP — -� I <2 PINa PAD. o,N AS('I IAL'T- ROOF Ix8 SINE ('�D.--- 5141JC,LES 12 - I. _ 10�� - - GEDAR 12 �,a 8 _ . _.. . -_. .... -- I � - �.. .. I.. i �X STIt-ICE oU�•� FR I f1 L C1 CTC1 = C-1 C C� 1 L --- --- -- -- - - -- --� Col-O �O ...... - F--- X I rl Ca k._....,. __. S f lF_ 2 GAR c;l 9A64E tJEW ADDI j ION FRor--IT ALL Ns:IA ROOFING , SlDlt Ar+D TRIM OF - ToMArGN EXISTING, I IoUSE. r IE�J IJIrlooWs To 400 O(z Ec2LiA.L L-1/ In4 PINE °,LL rF_W GcnrIST'RUc-Tlorl Got-JF rRMTO sFaINCxLE�� T� �E>1UIFz�MtiNTS of THE MiIMAss S (ATE �uILDI?IGt GORE, OHS TWn FA `( f�bI E LUhIC7 GODS. E1 t � >EE DWC-4 FoR /aDDi ( IoNnt_ NOTES. i I a� Z - ----- -� I2442 �ILMnR.E I-Ic>�s>:- t�EI.J ADDITIL t Q I io PICNf;ER PATI ATE F5ARNSTAP5LE, M/a - _�.I APPROVED BY: DRAWN BY PJ.P,. . I .. .. .._ __. ... ---- ----__ I/GI - I� L .............._ .I 1 vEW �A R AG,F- SA : REVISED DATE: I O_ -IS 1 gRu�E A PET�RsoN gouRNE, MA - LE�T SIDS �L-E VAT IO� -0 ARG11i (FEZ TURAL DESIGaN 5a8-27�1 O��a pp A W ING N V MBER of 8 i I I ,4!5F, L.T ROOF ��_.._ _— Ix Z f-It-4i= Pia. cal SNirI!aL��� — I cb PIrIc PD. -- - - - - --- ------ -- - -.... - - I r� — 5 T rl LE.S 1Z o WEI-Il �T N R E _- - -- - E_ _ - - - - — - -- _ - - -- -- -- - - - L_! (_ _. _. ... _ . - - ---- - _ - r- - - L f 4 - ExISTII-4C�T IJEW Ar:DI ( IoN ------------- I 1 C�I LMOfZE 1-4OLISE - h,IaW Ac)DITIot-4 I to P1 I.JEE-K PATH 5A2r���TAP�LE, MA I SCALE:I�^7II�Ii III APPROVED BY: DATE: IO'�'I-�^ REVISED I3RuGE A. f ETERSot-J EouRNP-= ARGNITE-GTUIZAL D�SIVN 5og -2-�c�-o<I-io li.��L-F--VA-T I^rI DRAWIN/G/}NVMBEpR f^' i 1 I fi IT I o til ---- - -- -- - - -- -- E x 16 T I rd c, I Z G STUPWALL i GL05J "T I — ,i I JHSTa,L Do-W 3 INS p.LL. NEW 3°�GI� I i or- sTEP u p I L , M IN• oom 2-LxY� I 3�• r 1u� R 4� (. I NR RATED FIRE DOOR -.._� _' lo - i I AUovE -- �x.I�7"INCH F�oLI �E - N FIRECOPE — ' SNEET(zoGK@ I x ' cv j 6iA RACa E c EILIr-ICE ' I _U 2 CAR i CaAK.AC-iE CQ � 7i 10 -c N;3 _ f ___riE1".t AnciTln�� _W I I 1 � 3 j 90,-7o gDx_I CoriG(ZETE t , APR01-1 I �.. ._._ -._...._. ___......_. lol j I -- --- I I - NEIA A.DDITIor,I �LOn F, ff'L. A I I. } I �F%AAss,+�ti (fI C-TILMORE I�OLISE. APDITIC7l-I G PP Ito PIoNE-ER }-'.ATN PaAR.NsTA&L.>=. M/A N0 fG15S�P�V�W SCALE: I/G II_I'-OIL APPROVED BY: DRAWN BY f3.A P I ssioo� / t1 GATE: I0'11-I0j REVISED �,�r!��,L. >l�Ctl� 6RUGE A. PETEKSorI �,ourzNE, MLa. w « 2-2 jff� l��,"1Je-b �FLGIII (EGTLJRp..L- DESIGN 5og', 2`l��-04�0 •S' ,4L;,C jJ l•� fj•'{Yf`�% DRAWING NUMBER 1 iST FLoof2. (�L ArI 'J of 3 I I i i f i D tJ r-- -- ---�� I ---- ---- ,. 3! o II N!cil� WALL W/ WOOD GAP I � ! i ..._------- I 2 E.A I S T I rJ cq I-I o Lu S E L Roo LOW- -------- I I F B� { � 1 ST0 RP,C7E _UhIF!r!ISNED I i uNNeA7ED F !K rl E.5.1,1/n t_L Kt-1EE.r�F�L!..- I I E --jf! i j I I f ! i � -. ____ _=1 ----- -_ - .._ _ - -- ,I L 6 I I ! II I I 1.31-a 131 o'I i I I D IIOC E ! l to r-'IoNE.EFZ �'I�TI-I �A.RNSTABLE-,f✓1A s i SCALE: �'.,-[�>• DRAWN BY rJ,A.� DATE O'�l-18 REVISED 32Uc_E A. -'E7 E�cSnr�l P our,JE,M/� i L�- RcHITE—TLR,AL DESIc7N 5a G,,,4-1C? DRAWING NUMBER N� FL0ClR FL/ar! `'I � r,F i - 3Co1-nll - i , 1 N�3 f 3 x'k i�� F✓l�tftnv G ��to,6� Cie- C — ---- - - ---�- i _ t - I ---- n°N CI DR.or WALL FnR DOOR .....----------- 5 T 14 16 14 x 1 o'F-I I a N PC LI R E.D Gor-IGRETE FoUr4PATIOr4 WALL or! _ , -- — — "Q' W IDE x I�"pE EF GONG.Foorl G _O LIT 3O'x 3p' ALGG`%` I h1/ 2K I KF-y GR,� WL 5FAGE II�To NEW GRAWL SrAGF 1_ �I GnNGRETE SLAB W/ CIZ_ WIRE MESI-I 2EIIJFORGI�G, - _,_ N rI rDc L4 L x I-e L.0r1cI - I�- Z Ic MIL- Vff.f)s- Ir v - @ IS"o.c. dE�7. E�XISrIhIG, SAS M N" — Q' i � � < I. I c r1E.W Aovlriar4 ui I ! I -GRof-WALL FCR GARAGE P0096-1 Tlr�c� s I � � - - - - - - - cc,NGRETj�.... .. �.. .. ... .. .APFCprt _ n i ,1 I �i� F�=�LIIJDATIPh{ I�{OT�ES ---- ------ -- - ALL G o tJ G R e-T EE- To F'-E '�o0o PSI M t X Z<nl-Oj1 1,,4 -"/aLL 1211 1-4 IoR r�ULjS W'�JLx ---- - ----- --------- - .._... ... -...-- .-..... �'L A r E. W Al,1-I E(z S- ;a �-o"o.L.M A K 5 PA G 1 t-I DAMFFRc'OF E)(-TE- FoutJDA �IorI LR TO GTRADE AT GRAWL SPAGE r1EW Fc _Ir A(I: rl Ta g'' Lo11E.R ZNAh{ II I 1I C.xl�TI'-�G I-IoLISE Fc-�LIr1Pc--�'Ivr-! �.xo.cT Dir-lE-rl,rlor; �C7L_1I�DAT IC��I PLAF-� 1/4 = t-o �e.TR.r1,.dEo nr1TRAGTo¢. • _1ILMnRE� I �OUSE - NEl { AI7DI rfOtJ PioNE-EIZ Ioi^-Tl-I P�Arz.NST�.f3LE, MA e SCALE: 1/14'1—(rI1 OII APPROVED BY: rRRE AWN BY I�.l�/� .r { ~�•; P�`W DATE: Io-q'I VISED � Nee!s1E C,� f3RuGE A. PaTERSoN 5OL1f2-0E, Ma �' /�t �,=�t�l1 of/-". AiZGI ITEGTURAL D~SIGN 5ot3-2-14-Od-70 4/ DRAWING NUM BER FouNDA-(IOt-� �'l_AtJ ID OF 8 — L - - ----- — - 2 z Ic;ZI GE. I 7 !l_ExlsTirlG _� � _ --- --- . Kos _l �� LO i I % j I— w elf U11 vA _ I i O , !�- v I i JA s i 12 I-IDR. L/ Z-2xi Oor, i F FRAMII VL-q F'L-A '� i1= I ' rID , II I II R o� � � 1 -� 2 F L_ R F-R t✓I ! cq I If i I i k r i i I — i I i j R. :...Z 'A I %;,; �ILMc)t2� I IouSE - NEW AanlTlol-1 .HELE c„ Luc OAL Iy I Io F'IoIh1EER FoTI-I C'�AI�t-l5 ALE ILIA FLc�L�K �I\AmI�� f LAI `I /� — �'—�) . PPROVEDBY. .Vn'i4'1TE —It A __--__.._-..__ _ p C SCALE: j I— DRAW N BY j SSIONAL ENS' DATE: 10-9-18 REVISED 1 J/ ILC�/ � 5RUGE- A. PETEKSahi MA � Grc , c,i /„i;� ARGNITEGTURa.1 DESIGN 508-2'7�4-n`}-!O t .f�..�/� .4. L � DRAWING NUMBER } i !� CCC L/tL FRAMIr�IG FLANS rC� OF,5 ; I ---------- _.. { t i k i . i -- RIpvE /ENT t-I/ i �� 51-TINGLE VENT i - GorISTRUG -- ASPAALT ROOF oN IS FELT — x sT N 1-ICIUSE _- 'i F3EY�� I - -...- 12 �/ iraR.AG E - j uNFl. 151IED IZ •k3 ---3/={I T G r-'!'f bJooP KIJEEI-l a.LL . SUfSFLoaR onlLu- 1 /�C -12°CR 48)F.Cs. 2 INSULATION /�Lfp��W j 2x10 JOISTS(?IG'O.G. L -� /— --, Ft-,h 5TU1� -— -- - �7- 2xg 2"Ca-1IT. ALUH.STRIP E I FLUSH FRAME-C) j II W'A LL cods 1 rzuGriOrl __ C 5/8 FI RE GODS SHE-ETROGK OtJ I WALL GEpA(2 GLAF'f�O/aRDS and IK3 sTRAPPItJ4 - —' — TY/EK WRAP cr p GEDA� 51IINULES owl TYVGK JRP nr� I/2'GPx (LYW oor> onl GOx FLY WOOD OIJ - 2xCo STUDS @ 1�°a.G. w�z — 2x'f I i I;�cO r� IWII/T I�IGK GOEI�SGT!REE IEN SoLARG(!I tJC� 1' w, � %8 Ja I45T5N Ifoo�On.LP cl C oN SS1 . 1Co/2°CS2H'Ze-I)E-F1 WI RE GT,INKS UL. M Kp �- c ale '1 1 !C 14./1{�. t( {y ✓ L1R.A�y_p tttP4r L C:�kTZij /r� T^xg?16�� ✓��5 STE{� G R AIA L SPAr-E I C'N —---- J T. Ll SE�Tjc7r`I TNRu Muo 9ooNl S E G T I O t O R Ci A C�R E ------ " ---- ------...- - E i Dv W 4 �'a 1 r��p NICHELE �N j CUDILgAL_yyTT4 m �ILMoNEEORE I-InusE - NeW Ar�QITIorJ STa16Y7 I PlR PATH F3ARIJS (AP�LE, M/� . Nn C 1 1 SCALE: O q p ���^C•i$TEHF"��� I III 1 it APPROVED BY: OR-NBY �SS,OIiP�� u DATE: I CJ' -IC, - REVISED PF_TERSG't l &,DugOE, MA r, i� AS r� / Af?GNITEGTURAL PESIGN DRAWING NUMBER � r NOTES: GENERAL f 1. The Conlroctor shall verify all existing onif--.new dimensions and conditions of the site and report any discrepancies to the Architect before ordering material and proceeding with the work. f the Commonwealth of Massachusetts State Building Code, One and 2. All work shall conform to the requirements o Two Family Dwelling Code. 3. All sections. details, notes, methods, or materials shown and/or noted on any plan, section or elevation shall - apply to oil other similar locations unless otherwise noted. - ection agencies selected by the Ow 4. All work shall be controlled. Testing and insp wrier and approved by the Commonwealth of Massachusetts Materials Safety Board. All work shall require adherence to the requirements of ASTM designation E-329 entitled "Recommended Practice for Inspection and Testing Agencies for Concrete and Steel Used in Construction". - I 5. Design Live Loods: Root 25 psf + Drift Floor 40 psf Wind (Exposure. C) 110 mph 6. Structural drawings shall be used in conjunction with Architectural, Heating and VentiloGng, Plumbing, Electricol be referred to for size and location of and Mechonlcol drawings and specifications and these drawings shall openings, vents, pipes, inserts, hangers, etc. 7. Refer to "110 mph Guide to Wood Construction in High Wind Areas for One and Two. Family Dwellings", WFCM., by AWC for "General Nailing Schedule" and other connections. 8. Existing structural members shall not be cut, removed or altered unless' the Contractor has verified existing/new support conditions for adequacy and has notified the Engineer of any discrepancy. 9. The Contractor shall shore and/or underpin existing work as required to safely Install new work. This work shall be sibility of the Contractor and no act, direction or review of any system or method by the Engineer the full respon - _ shall! change or effect the Contractors responsibility. FOUNDATION 1. Footings shall rest on firm, undisturbed material capable of sustaining a bearing pressure of one (1) ton/sq..ft. 2. The Contractor shall retain a.professional soils engineer to verify soil bearing pressure. j 3. All granular fill material under slobs shall be placed to 95% relative density. jj 4. A i footing excavations to be finished by hand and inspected and approved by the testing engineer before any jconcrete Is placed. i - - 5. ackfiil shall be. placed to equal elevations on both sic-�s of foundation walls. Where bockfill Is on one side only work shall be shored or have. permanent adjacent construction in place .before bockfilling. t 6. Tie sides of oil beams, walls, footings, etc. shall be formed and concrete shoii not be placed ogcinst earth �cuts, 7. Footings shall not bear on frozen soil and all exterior footings shall be not less than 4'-0" below adjacent finish gro e. l CONCRETE f 1. q51 concrete shall hove on ultimate compressive strength of 3,000$/sq. In. at 28 days. Maximum 3/4" aggregate, ( air entrained. Submit mix design for review by the Architect. ..2. Reinforcing steel shall comply with the requirements of ASTM-A615 Grade 60 billet steel. ASTM-A185 for wire mesh: Bars shall be deformed to ASTM-A305. l 3. Concrete cover: footings and walls - Bottom 3". Sides 2". 4. All concrete work shall conform to the requirements of the American Concrete Institute Specificotion.AC1-301-84. 5. All. reinforcing to be supported in forms with necessary accessories and securely wired together in accordance with: CRSI Recommended Practice. for Placing Reinforcing Bars. 6. All reinforcing shall be lapped'40 bar diameters (1'-0" min.) except as otherwise noted.. LUMBER 1. Lumber Shall be in accordance with Notional Forest' Products Association "Notional Design Specifications for Wood Construction," latest edition. 2. Framing lumber.shall be Spruce-Pine-Fir No.,1/No.2, Fb = 875 /�/sq.in. (single member uses), E=1,300,000 #/sq• in.. 3. In general, members shall be doubled at all floor, wall and roof openings. 4. Provide steel soddles for members framed flush top. 5. Provide temporary erection bracing for roof and floor members. 6. Partitions and exterior Stud walls shall be bridged with 2x4 blocking at intervals not exceeding 6'-0". 7. All joist shall be bridged with l x3 double cross bridging at intervals not exceeding 8-0". 8. Nailing shall be in accordance with Massachusetts State Building`Code "Fastener Schedule.' 9. Lominated veneer lumber (LVL) min. design values Fla = 2400 lb/sq. in., E=2,000,000 /sq. In., (Fv = 250 #/sq. in) (Microllom LVL or equal.) 10. Provide pressure treated lumber for wood in contact with concrete or.mosonry. 11. Multiple LVL members shall be bolted together with 1/2" diameter through bolts at 12"o.c:, top and bottom (2 rows). 12. Double studs at all openings. t 13. Minimum size of miscellaneous framing members required to completework shall .be 2x8 @ 16". 14. Install minimum 6x6 wood post of ends of all beams. - a 47 il0 F'IoNt=ER PATN P�AfZrJ�T/-�.f�LE,r�Il�. - SCALE: APPROVED BY: DRAWN BY: - DATE:.! - I Lam. REVISED: � RUCE A E . R E T P E B # . ARCHITECTURAL DES SON BOURN MAIGN I 508-/ 9-46 6 DRAWING B S OF GENERAL NOTE 8 A Sq NOTES: INTERCHANGE 20' MINIMUM OR AS INDICATED ON PLAN 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.Q.E. _w BARNSTp'sk-E RD TITLE 5 , THE TOWN OF B�RNSTABLE RULES AND pS1ER���E 10' MIN. REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE; WHITE BIRCH WAY 10' MINIMUM AND THE REQUIREMENTS OF THIS PLAN. PIONEER PATH I. 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO T.O. FOUNDATION MIN. O BACKFlLL WITH a I'1/ .S C WITHIN 12" OF FINISHED GRADE. LOCUS �q.O GALEAN SAN � 5 �— MASONRY 3. ALL MASONRY UNITS USED TO BRING COVERS TO GRADE �ODSI t QE NSI SHALL BE MORTARED IIN PLACE. �R/� 4. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE ITCH 4' SG}i.'4Q PVC PIPE /4• PER FT. to IN. PITCH /8• PER N OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR 3 FLOW LINE 2• LAYER OF WITHIN 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING OPp QQ�` 1/8• - 1/2• SHALL BE USED UNDER OR WITHIN 10 FT. OF DRIVES OR GE R V S8.S 10• 2'-0• WASHED STONE PARKING. O\,0 51P 5. CAST IN PLACE CONCRETE TEES ARE SPECIFICALLY DISAPPROVED. 4'-0•^ 2• MIN. LEVEL 57 3 _ SANITARY TY'S WHERE INDICATED ARE REQUIRED. 3 LIQUID LEVEL ASHED STONE DISTRIBUTION v` 6. EFFLUENT PIPING FROM DISTRIBUTION BOX SHALL ENTER LEACH PIT BOX THROUGH SIDEWALL OR TOP ONLY. ENTRANCE THROUGH MASONRY LOCATION MAP Sl•o EXTENSION WILL NOT BE ALLOWED. GALLON SEPTIC TANK 61 I z I z 7. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEED RESTRICTIONS OR ZONIING REGULATIONS. OWNER/APPLICANT SHALL �• /� -) OBTAIN SUCH DETERMINATION FROM THE APPROPRIATE AUTHORITY. SEWAGE DISPOSAL SYSTEM PROFILE NOT TO SCALE BOTTOM OF TEST HOLE 1 470 8. HORIZONTAL AND VERTICAL CONTROL, SEE LEVY, ELDREDGE ---- OR LISGS PROBABLE HIGH WATER LEVEL & WAGNER. FIELD NOTEBOOK #_ 'A- 57 CURRENT ZONING INTERPRETATION: DESIGN CALCULATIONS : MIN. FRONT SETBACK 30 FEET NUMBER OF BEDROOMS 3 MIN. SIDE SETBACK S FEET GARBAGE DISPOSAL UNIT NOiV� MIN. REAR SETBACK I S FEET TOTAL ESTIMATED FLOW WHITE BIRCH WAY �- ( 110 GAL./BR./DAY X 3 BR.) 330 GAL. /DA'Y REQUIRED SEPTIC TANK CAPACITY jj.!S GAL. N/F ACTUAL SIZE OF SEPTIC TANK LNQ_GAL. GARY A. MILLER . LEACHING AREA REQUIREMENTS SIDEWALL AREA 2.5 GAL./S.F. .----------�'L BOTTOM AREA 10 CAL./S.F. 03 64 60 Ss --- — 56 PERCOLATION SOIL TEST LEACHING CAPACITY. (BOTTOM + SIDEWALL) :M GAL, 68-- - 300. --A�FaGE EASEMEN'T1 INV. = 46.6 (A - - - rn +`-�� DATE OF SOIL TEST S 418`3 21f('10 /2)(•(c. )(2.5) +TT C 10•/2)2 (1.0) 55U GAL. I WITNESSED BY RESERVE LEACHING CAPACITY t t \ Y 50 58 _-SAME� C)�A-.v.v vkt .v � -- W LL OBSERVATION HOLEO o L O T ELEV.= l� _ ELEV.=------ 44,287 sq. ft.t,� a ,; —0.00 -0.00 BREAKOUT CALCULATION: / Top 4 500501c o 68 ' l / 54,` ; HE1) SANID I ��, 1 // s6 �', w� SOME GoC3f3tE5 LEGEND: I EXISTING SPOT ELEVATION OOXO EXISTING CONTOUR--------00----- �� 35.0' t I I _I4 5 _ FINAL SPOT ELEVATION 00.0 - pf' -4 ; p FINAL CONTOUR F /r , �% . ; o NO WATER AT ELEV.�� 1•Q WATER AT ELEV. SOIL TEST PIT LOCATION ,�` ,� �' WATER W W Q � WILLIAM E. DACEY SEPTIC TANK ,2990 � , 0 / !! o DISTRIBUTION BOX 64 O PIONEER WATER LEVEL ADJUSTMENT: MIA PRIMARY LEACHING PIT O ! PATH RESERVE LEACHING PIT (50' WIDE) ` s6 1 TEST DATE WATER LEVEL 60 INDEX WELL f WATER LEVEL RANGE ZONE 1 Fs/2 ¢ 01TIAL ISSUE EK DEPTH TO WATER LEVEL FOR INDEX WELL NO. DATE DESCRIPTION I ' FOR THIS MONTH �BY ` ° �FN SITE PLAN & SEPTIC DESIGN e Iv. .00 Lgti��S WATER LEVEL ADJUSTMENT 4' 58 INV. 50',, o�j DEPTH TO HIGH WATER LOT 2 PIONEER PATH 58' / �� �, IN sa ! BARNSTABLE, MASSACUUSETTS / fO GREENBRIER DEVELOPMENT CO. INC. 60 APPROVED: BOARD OF_.H EALTH SCALE: 1., 40' JOB No. 1120 / 1120— 2 -SITE PLAN LEVY, ELDREDGE & WAGNER ASSOCIATES INC. DATE AGENT 0GUM I,91'il>S 0 9CHPl M PUPIN$RS LkND SURTMES , 889 WEST MAIN STREET CENTERV= MA 02632 i j I SYSTEM PROFILE TOP F N D N EL. 99.3' (NOT :� SCALE) --�•-�--�-� . ��____._ ';IJ WITHIN 6' O� FIN. GRADE ' ACCESS ^�711 r ACCESS COVER (WATERTIGHT) TO MINIMUM .75' OF COVER OVER PRECAST WITHIN 6' OF FIN. GRADE 2%- SLOPE REQUIRED OVER SYSTEM II 98.Q' L. 97,2' RUN PIPE LEVEL 2' DOUBLE WASHED PEASTONE I FOR FIRST 2' 3' MAX. -' EXISTING " r.. GALLON SEPTIC �� 95.0' K Focus TANK (H- 10 ) GAS ? 4, _�._ RVo aP K t� r oc 94. 9 ray Qn BAFFLE94.36 - EDQC;ICI ED ED a c ' b 94 0C . CCCC 6' CRUSHED STONE OR MECHANICAL _ 0 C] Q C 0 CI ED 0 0 ' COMPACTION. (15.221 123) a 2 O C-1 0 ED M E:I CI 92.17' � DEPTH OF FLOV x ( 2± % SLOPE) ( 1 7 SLOPE) TEE SIZES! 3/4' TO 1 1/2' DOUBLE WASHED STf1NE CONTRACTOR TO CONFIRM SUITABLE KlS IN INLET DEPTH 10 AREA OF PROPOSED LEACHING FACILITY PRIOR OUTLET DEPTH g 14' TO INSTALLATION OF ANY PORTION OF LOCATION MAP NOT TO SCALE SYSTEM, ANY UN_I IITARI F 1"I'V V IERED, REMOVE FOR 5' AROUNI) F❑UNbATI�N -- EXIST. SEPTIC TANK 62' D' BOX 4�` ~` t, LEAC'�N�i r� LEACHING FACILITY AND REPLACE WITH CLEAN E`�IL: TY MED. SAND, ENGINEER TO INSPECT AND ASSESSORS MAP 128 PARCEL 4.4 CERTIFY IF ENCOUNTERED. 49't "I -C- N 100.0 PROPGSED SPOT ELEVATION + EXIST. WELL1 ADJUSTED GROUNDWATER 100x0 EXISTING SPOT ELEVATION j 8 EXPECTED AT EL, 43.0'± I 00 PRPPDSED CONTOUR EXIS?ING CONTOUR + 92.6 I �• NC1 ES: 92.3 -- --- - - 93.9 N\ NOT ALLOWED APPROXIMATED FROM GIS SPOT EL. \ SEPTIC DESIGN, (GARBAGE DISPOSER IS 1. DATUM IS c, X . WELL \ ..� DESIGN FLOW: 3 BEDROOMS C 110 GPD) = 33Q GPD 2. MUNICIPAL WATER IS__NOT AVAILABLE _�„�;,,; `� IIcF A �n C.Pn T1F CTrN F-I nW 3. MINIMUM PIPE PITCF+ TO BE 1/8' PrR F'OCJT. SEPTIC TANK: 330 GPD 2 660 4. DESIGN LOADING FOR ALL PF'ECAS I UNITS TO T;L AASHO H--- _ `,� ,/'� / _ �^,�4--•`"."-- _� \ ,�,, < ) LOT 4 ' ( _ -�` - 5. PIPE JE]INTS TCi 13E MADE WATERTIGHT. WHITE BIRCH WAY a .0N� c>-`' \ 93.2 USE A 1000 GALLON SEPTIC TANK (EXIST) - � CONSTRUCTION DETAILS TO 13E 1N ACCORDANCE WITH MASS. pp (* •5 _ f- `�3.3 \ ,-� L.EACHI�IG: E.NVIRONMENTAI._ CODE TITLE V. +` .4 \ �" 2(30 + 9.83) 2 (.74) - 118 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE VACANT _ \ � SIDES: -- - - USED FOR LOT LINE STAKING. 30 x` \ - 9, 83 _ 4) 218 -FIG •Y �1-1-M T[1 _ CH. ,10-4 PVC.BOTTOM: R. PIP[ FOR .rEP i / p 0 454 o g 4.3 TOTAL.' S.F. ���_ GPD I i:OMPONE�JTS NOT TO BE $ACKFII_I_ED OR CONCEALED WITHOUT I +"I03.3� INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED USE (2) 5Q0 GAL. LEACHING CHAMBERS (ACME OR � rn 4 -- -------- - �`f�OM BOARD OF HEALTH. 9 sR R� !"`'� + 9a.4 ¢ �\ EQUAL) WITH 2.5' AT SINES, 4' AT ENDS, AND 5' 10. PUMP & REMOVE (OR FILL W/CLEAN SAND) EXISTING LEACH PIT. / ©\ BETWEEN UNITS 96.2 96,4- EXIST. 915 �' \ DWELL. 94.9 q5 BENCHMARK: USE TOP FNDNI THIS AREA 2 DRIVE GRA OF 110 PIONEER PATH EXIST. 100 -; IN THE TOWN OF: y,�, + 99.3 GAL SEPTI + 97.7 + 959� f 96.3 (WEST) BARNSTABLE SH D TANK (R USE) ©0 i ^, '0 9 6 ✓ '�" PREPARED FOR: -, + Io3. j J'so• 96 BORTOLOTTI CONSTRUCTION LOT '2o� Tp 5 6• 4-4,287f SO. FT. 96 T`�� ` 30 0 30 60 90 d' 1.02± ACRES 97.6 BOARD OF HEALTH �, J + o) "-��7L3 ^'�• 2 00' + 2 + 93.2 cp, `� MA SCALE: 1" = 30' DATE: NOVEMBER S. 2001 APPROVED DATE < orlF 508-362--VAl 97.8 0i t f,,. 50P 362-9"o A#-AA g + 3. o � 4�t� ofA1s� t�i or ,I,"`!•, + 103.4 r down cope engineering, InC. AnNP I-4, y�, ; AnNE oJAI_n CIVIL. ' : OJAI A CIVIL ENGINEERS Na. :�or �a 'ia LAND SL.IRVEYDRS 01-275 939 r1c)in st. yarmouth, mo 02675 i i