HomeMy WebLinkAbout0067 PILOTS WAY - Health 67 Pilot's Way
Barnstable
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TOWN OF BARNSTABLE
LOCATION `6 W ax SEWAGE # 5 9 7 5
VILLAGE f3A rV%5+A I le ASSESSOR'S MAP & LOT U
INSTALLER'S NAME&PHONE NO._ . c�i-�- s S�� &LI 6012
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type) 6 SQQ qk� "'AW 3Or-i (size) 6`7 Y tLq.
NO. OF BEDROOMS
BUILDER OR OWNER QWk
7
PERMITDATE: 'S 0'9 C PLIANCE 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 r�
on site or within 200 feet of leaching facility) � 7��� Feet
Edge of Wetland and Leaching Facility (If any wetlands exist
within 300 fecLQf leaching facility). Feet
Furnished by
d
Ago
No. Sao C) J 5 2_5 _ Fee
THE:COMMONWEALTH OF MASSACHUSETTS Entered in computer:
b_�,PbBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es
Rpplication for T gpo!6aY *p5tem Construction Permit
Application for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components
Location Address or Lot No. t 1 ` 'P'111T s Owner's Name,Address,arid Tel.No.
Assessor's Map/parcel 2 t� 2 Boo
Installer's Name,Address,and Tel.No. Soe` e s q, Designer's Name,Address and Tel.No.
SCo� I �� f OjeeEr �%o22e
Type of Building: 3 bl T 963
Dwelling No.of Bedrooms Lot Size t�J 7-7 — sq.ft.. Garbage Grinder
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) /ci gpd Design flow provided �! 5 gpd
Plan Date Number of sheets Revision Date
Title `Tl'TZA�_ J`' L7('(6 ee,--A;r,1
Size of Septic Tank I Type of S.A.S.
Description of Soil gye& t�g,,,�_../ /j L O,g.,.,y SAvq
1 n/ ,ti''}r 4-6 LAZ3 1 a— 2--
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to lace the system in operation until a Certificate of
P P
Compliance has been issued by this of H
Sig Date
Application Approved by Date 1 1 1® 5
Application Disapproved by: Date
for the following reasons
Permit No. �00 5 S- Date Issued 11159 5
No. .$ :,,.:" (` Fee
T�E COMMONWEALTH OF MASSACHUSETTS Entered in computer: �es
� .PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Application for Th5pon �&pE;tetn Con.5truttion Permit
Application for a Permit to Construct Repair O Upgrade O Abandon O ❑Complete System ❑Individual Components
Location Address or L'ot No.` Lcr 1 �' �� //mil y Owner's Name,Address,apd Tel.No.
� Cal ����.��.�-A,-; �� I •�/77 ,Ze/G
Assessor's Map/Parcel 2 2 Q 66 � 2�� Z$ ® S�dP 7.� J,Z,
Installer's Name,Address,and Tel.No. SdB- g e t?' 3 8 9(/ Designer's Name,Address and Tel.No.
j Sy� QIC 10A•d o�,r C��� ENC;,
�O4T /4 ( OQ� §70 �13ar Kn f
f Type of Building: .� /-� ' �9 6 3
Dwelling No.of Bedrooms J Lot Size a00, 42,27 sq.ft. Garbage Grinder ( )
Other Type of Building No.of Persons Showers( )�'•Cafeteria( )
Other Fixtures
Design Flow(min.required)' .gpd Design flow provided & gpd
Plan Date Number of sheets Revision Date 1 I Z v p
Title i 5 C7 1 -E
Size of Septic Tank 13b o Type of S.A.S. T-t,N
i
'Description of Soil 026 SA6w9 Ci I L S C i „c cti>�fio��L
I N 7 i t4o Lx-S 1 + �--
Nature of Repairs or Alterations(Answer when applicable)
Date last inspected: `
Agreement: `
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Enuiironmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Rea r�of H„�alth. R
Sig e \ Date
Application Approved by Date
Application Disapproved by: Date
for the following reasons '1
i
_..ter'") '•,
Permit No. �� 5 S Date Issued 1 0 1 o 5
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed (k) Repaired ( ) Upgraded ( )
Abandoned( )by 5"d>ft 4 -rof?2 IF r
at , has been constructed in accordance
with the provis' of Title 5 and the for Disposal System Construction Permit No. 5 5 7 5 dated 1) I� .
Installer Designer CTGl Vq
#bedrooms 5 Approved design flow 5 S d gpd
The issuance of this permit sha noott be/onstrued as a guarantee that the systeRil will fu'tict' n�de g ed.
Date O Inspector
—.—————————�7 c————————————————————————————--————
No.
S -S / _ Fee C9
' --
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS
Migo$ar i§p$tem Con$truction Permit
Permission is herebyranted to Co. struct Repair Upgrade Abandon
g/ F` ��, (gyp � ) Pg � � )
System located at 6 7 � 1a �S �,�}� �. �r��`��9
and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty
t to comply with Title 5 and the following local provisions or special conditions.
Provided: Construction mikst be completed within three years of the date o his pe t
Date ` I I Approved by
I
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
'< 67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. Citylrown State Zip Code Date of Inspection
Inspection results must be submitted on this form. Inspection forms may not be altered in any
way. Please see completeness checklist at the end of the form.
Important:When filling out A. General Information
SIW�
forms on the
computer,use 1. Inspector:
only the tab key
to move your CHRIS NARDONE
cursor-do not Name of Inspector
use the return
key. BRIDGE HOME AND SEPTIC INSPECTION SERVICE
Company Name ,
27 TIFFANY CIRCLE
Company Address
WEST BRIDGEWATER MA 02379
'e°01 Cityrrown State Zip Code
508-580-0465 S1571
Telephone Number License Number
B. Certification
I certify that I have personally inspected the sewage disposal system at this address and that the
information reported below is true, accurate and complete as of the time of the inspection. The inspection
was performed based on my training and experience in the proper function and maintenance of on site
sewage disposal systems. I am a DEP approved system inspector pursuant to Section 16.340 of
Title 5(310 CMR 15.000).The system:
® Passes ❑ Conditionally Passes ❑ Fails
❑ Needs Further Evaluation by the Local Approving Authority
08-04-2009
Inspector's Onature Date
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board
of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or
has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the
report to the appropriate regional office of the DEP. The original should be sent to the system owner
and copies sent to the buyer, if applicable, and the approving authority.
****This report only describes conditions at the time of inspection and under the conditions of use
at that time.This inspection does not address how the system will perform in the future under
the same or different conditions of use.
t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17
i
I
f T
Commonwealth of Massachusetts
. Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
Inspection Summary: Check A,B,C,D or E/always complete all of Section D
A) System Passes:
® I have not found any information which indicates that any of the failure criteria described
in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are
indicated below.
Comments:
B) System Conditionally Passes:
❑ One or more system components as described in the"Conditional Pass"section need to be
replaced or repaired. The system, upon completion of the replacement or repair, as approved by
the Board of Health, will pass.
Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not
determined," please explain.
The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is
structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System
will pass inspection if the existing tank is replaced with a complying septic tank as approved by the
Board of Health.
*A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of
Compliance indicating that the tank is less than 20 years old is available.
❑ Y ❑ N ❑ ND (Explain below):
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
_ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
B) System Conditionally Passes (cunt.):
❑ Observation of sewage backup or break out or high static water level in the distribution box due
to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will
pass inspection if(with approval of Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain,below):
❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below):
❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The
system will pass inspection if(with approval of the Board of Health):
❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below):
❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below):
C) Further Evaluation is Required by the Board of Health:
❑ Conditions exist which require further evaluation by the Board of Health in order to determine if
the system is failing to protect public health, safety or the environment.
1. System will pass unless Board of Health determines in accordance with 310 CMR
15.303(1)(b)that the system is not functioning in a manner,which will protect public health,
safety and the environment:
❑ Cesspool or privy is within 50 feet of a surface water
❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
't aSubsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owners Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.)
2. System will fail unless the Board of Health (and Public Water Supplier,if any)
determines that the system is functioning in a manner that protects the public health,
safety and environment:
❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within
100 feet of a surface water supply or tributary to a surface water supply.
❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water
supply.
❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water
supply well.
❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or
more from a private water supply well**.
Method used to determine distance:
**This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform
bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or
less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be
attached to this form.
3. Other:
D) System Failure Criteria Applicable to All Systems:
You must indicate"Yes" or"No"to each of the following for all inspections:
Yes No ,
El ® Backup of sewage into facility or system component due to overloaded or
clogged SAS or cesspool
❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters
due to an overloaded or clogged SAS or cesspool
❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded
or clogged SAS or cesspool
El ® Liquid depth in cesspool is less than 6" below invert or available volume is less
than '/2 day flow
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17
` Commonwealth of Massachusetts
y Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
'< 67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. Cityrrown State Zip Code Date of Inspection
B. Certification (cont.) ,
Yes No
❑ ® Required pumping more than 4 times in the last year NOT due to clogged or
obstructed pipe(s). Number of times pumped:
❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation.
❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or
tributary to a surface water supply.
❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well.
❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well.
❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet
from a private water supply well with no acceptable water quality analysis. [This
system passes if the well water analysis, performed at a DEP certified
laboratory,for fecal coliform bacteria indicates absent and the presence
of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,
provided that no other failure criteria are triggered. A copy of the analysis
and chain of custody must be attached to this form.]
❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd-
10,000gpd.
❑ ® The system fails. I have determined that one or more of the above failure
criteria exist as described in 310 CMR 15.303,therefore the system fails. The
system owner should contact the Board of Health to determine what will be
necessary to correct the failure.
E) Large Systems: To be considered a large system the system must serve a facility with a
design flow of 10,000 gpd to 15,000 gpd.
For large systems, you must indicate either"yes"or"no"to each of the following; in addition to the
questions in Section D.
Yes No
❑ ❑ the system is within 400 feet.of a surface drinking water supply
❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply
❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection
Area—IWPA)or a mapped Zone II of a public water supply well
If you have answered"yes"to any question in Section E the system is considered a significant threat,
or answered "yes" in Section D above the large system has failed. The owner or operator of any large
system considered a significant threat under Section E or failed under Section D shall upgrade the
system in accordance with 310 CMR 15.304. The system owner should contact the appropriate
regional office of the Department.
t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17
Commonwealth of Massachusetts,
Title 5 Official Inspection Form
a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. Cityfrown State Zip Code Date of Inspection
C. Checklist
Check if the following have been done. You must indicate"yes"or"no"as to each of the following:
Yes No
❑ ® Pumping information was provided by the owner, occupant, or Board of Health
❑ ® Were any of the system components pumped out in the previous two weeks?-
El ® Has the system received normal flows in the previous two week period?
❑ Z Have large volumes of water been introduced to the system recently or as part of
this inspection?
® ❑ Were as built plans of the system obtained and examined?(if they were not
available note as N/A)
® ❑ Was the facility or dwelling inspected for signs of sewage back up?
® ❑ Was the site inspected for signs of break out?
® ❑ Were all system components, excluding the SAS, located on site?
® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank
inspected for the condition of the baffles or tees, material of construction,
dimensions, depth of liquid, depth of sludge and depth of scum?
❑ ® Was the facility owner(and occupants if different from owner)provided with
information on the proper maintenance of subsurface sewage disposal systems?
The size and location of the Soil Absorption System(SAS)on the site has
been determined based on:
® ❑ Existing information. For example, a plan at the Board of Health.
® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue
approximation of distance is unacceptable) [310 CMR 15.302(5)]
D. System Information
Residential Flow Conditions:
Number of bedrooms(design): 5 Number of bedrooms(actual): 5
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17
L
Commonwealth of Massachusetts
Title 5 Official Inspection Forma
o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. City/Town State Zip Code Date of Inspection
D. System Information
Description:
SEPTIC TANK, PUMP CHAMBER, D-BOX-AND 6 LEACHING CHAMBERS.
Number of current residents: 0
Does residence have a garbage grinder? ❑ Yes ® No
Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No
Laundry system inspected?. ❑ Yes ❑ No
Seasonal use? ❑ Yes ® No
Water meter readings, if available last 2 ears usage PRIVATE WELL
9 ( Y 9 (gpd))�
Detail:
Sump pump? ❑ Yes ® No
Last date of occupancy: UNKNOWN
Date
Commercial/industrial Flow Conditions:
Type of Establishment:
Design flow(based on 310 CMR 15.203): Gallons per day(gpd)
Basis of design flow(seats/persons/sq.ft., etc.):
Grease trap present? r ❑ Yes ❑ 'No
Industrial waste holding tank present? ❑ Yes ❑ No
Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No
Water meter readings, if available:
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17
Commonwealth of Massachusetts
f Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. City/Town State Zip Code Date of Inspection
D. System Information (cont.)
Last date of occupancy/use: Date
Other(describe below):
General Information
Pumping Records:
NO HISTORY
Source of information:
Was system pumped as part of the inspection? 0-Yes ® No
If yes, volume pumped: gallons
How was quantity pumped determined?
q t1/
Reason for pumping:
Type of System: t
® Septic tank, distribution box, soil absorption system
❑ Single cesspool
❑ Overflow cesspool
❑ Privy, Y
❑ Shared system (yes or no) (if yes, attach previous inspection records, if any)
❑ Innovative/Alternative technology. Attach a copy of the current operation and
maintenance contract(to be obtained from system owner)and a copy of latest
inspection of the I/A system by system operator under contract
❑ Tight tank. Attach a copy of the DEP approval.
❑ Other(describe):
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
` .67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. Citylrown State Zip Code Date of Inspection
D. System Information (cont.)
Approximate age of all components, date installed (if known)and source of information:
2006
Were sewage odors detected when arriving at the site? ❑ Yes. ® No
Building Sewer(locate on site plan):
Depth below grade: 5.5 FT
feet
Material of construction:
❑ cast iron ®40 PVC ❑ other(explain):
Distance from private water supply well or suction line: . feet
Comments(on condition of joints, venting, evidence of leakage, etc.):.
GOOD CONDITION
Septic Tank(locate on site plan):
Depth below grade: 5FT
feet
Material of construction:
® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain)
RISERS BEING INSTALLED DURING INSPECTION
If tank is metal, list age: years
Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No
Dimensions:
1 OFT D-5FT W-5FT D
Sludge depth: 10IN _
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17
1
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owners Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. CityrFown State Zip Code Date of Inspection
D. System Information (cont.)
Septic Tank(cont.)
Distance from top of sludge to bottom of outlet tee or baffle 251N
Scum thickness 21N
Distance from top of scum to top of outlet tee or baffle 41N
Distance from bottom of scum to bottom of outlet tee or baffle 251N
How were dimensions determined? PROBE
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
TANK SOUND LIQUID LEVELS PROPER ALL TEES IN PLACE
Grease Trap(locate on site plan):
Depth below grade: feet
Material of construction:
❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Scum thickness
Distance from top of scum to top of outlet tee or baffle
Distance from bottom of scum to bottom of outlet tee or baffle
Date of last pumping: Date
t5ins-09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 10 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form - Not for Voluntary Assessments
M y 67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. Cityrrown State Zip Code. Date of Inspection
D. System Information (cont.)
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,
liquid levels as related to outlet invert, evidence of leakage, etc.):
Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan):
Depth below grade:
Material of construction:
❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain):
Dimensions:
Capacity:
gallons
Design Flow: gallons per day
Alarm present: ❑ Yes ❑ No
Alarm level: Alarm in working order: ❑ Yes ❑ No
Date of last pumping: Date
Comments (condition of alarm and float switches, etc.):
Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No
t5ins•09108 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17
l '
f
Commonwealth of Massachusetts
W Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form- Not for Voluntary Assessments
67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is BARNSTABLE MA 02630 08-04-2009
required for
every page. CityTrown State Zip Code Date of Inspection
D. System Information (cont.)
Distribution Box(if present must be opened) (locate on site plan):
Depth of liquid level above outlet invert, 0
Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any
evidence of leakage into or out of box, etc.):
ALL CONDITIONS GOOD
Pump Chamber(locate on site plan):
Pumps in working order: ® Yes ❑ No
Alarms in working order: Z. Yes ❑ No
Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.):
TANK SOUND PUMPS AND ALARM WORKING PROPERLY
Soil Absorption System (SAS) (locate on site plan, excavation not required):
If SAS not located, explain why:
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
't 67 PILOTS WAY
i
Property Address
COMMUNITY BANK
Owner Owner's Name
information is BARNSTABLE MA 02630 08-04-2009
required for
every page. Cityfrown State Zip Code Date of Inspection
D. System Information (cont.)
Type:
❑ leaching pits number:
® leaching chambers number: 6
❑ leaching galleries number:
❑ leaching trenches number, length:
❑ leaching fields number, dimensions:
❑ overflow cesspool number:
❑ innovative/alternative system
Type/name of technology:
Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of
vegetation, etc.):
SOIL AND GRAVEL AROUND CHAMBERS DRY NO SIGNS OF FAILURE
Cesspools (cesspool must be pumped as part of inspection) (locate on site plan):
Number and configuration
Depth—top of liquid to inlet invert
Depth of solids layer
Depth of scum layer
Dimensions of cesspool
Materials of construction
Indication of groundwater inflow ❑ Yes ❑ No
t5ins•09/08
Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
°y< 67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
Privy(locate on site plan):
Materials of construction:
Dimensions
Depth of solids
Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation,
etc.):
t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form-Not for Voluntary Assessments
67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is
required for BARNSTABLE MA 02630 08-04-2009
every page. Cityrrown State Zip Code Date of Inspection
D. System Information (cont.)
Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to
at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet Locate
where public water supply enters the building. Check one of the boxes below:
❑ hand-sketch in the area below
❑ drawing attached separately
&A1LP-6(
r
v 5 ; .
i
c3N�A�t�aSC
t5ins•09W Title 5 Official Inspection Forth:Subsurtaos Sewage Disposal System•Page 15 of 17
L
r
Commonwealth of Massachusetts
Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA ; 02630 08-04-2009
every page. Citylrown State Zip Code .Date of Inspection
D. System Information (cont.)
Site Exam:
® Check Slope `
® Surface water
® Check cellar
❑ Shallow wells
Estimated depth to high ground water: 8FT
feet
Please indicate all methods used to determine the high ground water elevation:
❑ Obtained from system design plans on record
If checked, date of design plan reviewed: pate n
❑ Observed site(abutting property/observation hole within 150 feet of SAS)
❑ Checked with local Board of Health-explain:
❑ Checked with local excavators, installers-(attach documentation)
❑ Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
PROBED HOLES NEXT TO LEACHING CHAMBERS TEST PIT RECORDS
Before filing this Inspection Report, please see Report Completeness Checklist on next page.
t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17
Commonwealth of Massachusetts
V Title 5 Official Inspection Form
Subsurface Sewage Disposal System Form -Not for Voluntary Assessments
M , ' 67 PILOTS WAY
Property Address
COMMUNITY BANK
Owner Owner's Name
information is required for BARNSTABLE MA 02630 08-04-2009
every page. Cityrrown State Zip Code Date of Inspection
E. Report Completeness Checklist
® Inspection Summary:A, B, C, D, or E checked
® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed
® System Information—Estimated depth to high groundwater
® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file
t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17
Town of Barnstable
Regulatory Services
Thomas F. Geiler,Director
K Public Health Division
9. & Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer & Designer Certification Form
Date: Sewage Permit# Assessor's Map�Parcel
a1� a
�'1. Installer:
Designer: t�p _
Address: 1 t Address:
On was issued a permit to install a
(date) // (installer)
_ 1
septic system at b l /, 0 V v based on a design drawn by
(address)
dated
(design
I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
a
I certify that the septic system referenced above was installed with major changes (i:e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State & Local Regulations. Plan revision or t
certified as-built by designer to follow.
AA Zs�f
�,\A OF
o OJALA
(Installer's Signature) CIVIL u; =
No. 30792
S T E��
ASS/O N A L ECG\
(Designer's Signature) (Affix Designer's Stamp Here)
PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF
COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE
RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU.
Q:Health/Septic/Designer Certification Form 3-26-04.doc
r
No.f-'v�b � THE COMMONWEALTH OF MASSACHUSETTS FEE
y.
BOARD OF'- HEALTH
bw*� OF A-r r1S�zl b�
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application fora Permit to Construct(pair ( pgrade eo<Ahandon ( ) - ❑Complete System []'Individual Components
!I �� o FS �✓ o� C��s P
Location Uwnu%Name
i7 -7 l� oi-z
nta�t' �,�t Gt't • ,Zq 3 IVdre
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.gy p 1p GLot N Telephone Y
�� t Inxtallc1�N;uno /l ���I Cc,I CE b LD esignc ame
Q—�Ug—7:300 Address A Addrc�ti
Telephone It Telephone N'
Type of Building: C i ylq U-- a,AJ t-(L vl CGx t5'r) 'Lot Size�,fv SAW 2.S Sq-feet-
Dwelling—No.of Bedrooms ✓► Prb QaSLOd — np-- Garbage Grinder ( )
Other—Type of Building rSar,-J No.of persons Showers ( ), Cafeteria { )
Other fixtures
Design Flow(min req ired) _�D Q gpd Calculated design flow�gpd Design flow provided �Og—g'pd
Plan: Dat Number of sheets / Revision Date
Title 9'fOV05eck 2 60 Ael e-G{'1cly a N
Description of Soil(s) N
Soil Evaluator Form No. l Name of Soil Evaluator Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS (,tjv,I ct t�, c.e ww 60AAP-i hwv- Ga it Iv SPOfit-
The undersign agrees to install the above se bed individual Sewage Disposal System in accordance with the pravislons of
TITLE 5 and fu rees not to lace the ay in Lion until a Cerf'fiicate of Compliance has been issued by the Board of Meahh.
Signed Date3 ` a ►b
Inspections VRJOSHUA ss9
M. �Nt
l o OUVVSm
-i
p�
FORM t - APPLICATION FOR DSCP DEP APPROVED"ISM 5/96 N',
l,Q'�` ; �v`c
6 rIL
W
THE COMMONWEALTH OF NIASSACHUSETTS FEE
l
BOARD OF HEALTH
OF ins ? f
APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT
Application fora Permit to Construe
I(P(R�pair ( Upgrade bairidon ( ) ❑ []'Individual Components
stem Complete S
p y
�j7 ( t O}3)wncrmu
�•. MaNbl'd�i 7 bt 2,C(3 7 7"'3 5—.
•1clephone#
`/ate t /1�- +��
/ r ins`allyy�lymnbya*�r . "/ictr 1�� C N1 �exi�ry�k
S
j� h t �c-G�"m��r1(jiJ Q(�, j'/Address
-7 gl g q dre
Telephone 11 1 Telephone M
Type of Building: S 1 Aef ' ►'t't-i� ob"k)e(�r+�S(Ix 15-r) Lot Size y'!o 57,40/1S S
Dwelling--,No.of Bedrooms �r�' " rp Pa5pd ' tiO rP-•- Garbage Grinder ( )
Other—Type of Building 3ar No.of persons Showers ( ), Cafeteria ( )
Other fixtures
Design Flow(min req ired) •gpd Calculated design flow No Add- d Design flow r vi e Now
Plan: Dat -2 3v l 6 8 gR g— p o d d gpd
Number of heets Revision Date
Title_ - l p o$? eQ e C� n ec fiory i A N
Description of Soil(s)
Soil Evaluator Form No., Xf I Name of Soil Evaluator Date of Evaluation
DESCRIPTION OF REPAIRS OR ALTERATIONS &"Ic1!2t� Stlt,'W (OArIALhLA-)- (3A n I-v SPpf'►c
The underst n agrees to install the above-desc be_d individual Sewage Disposal System In accordance with the.provisions of
TnU S and fu Hires of lace the sy te'rn in lion until a Cerii heats of Compliancc7o has bes 6oarel of Health.
Signed �` Dated ���N of Mks
Inspections) M• u+
O �•1
FORM t -APPLICATION FOR OSCP DEP APPROVED F RM 5/96 S�ONAL F
No.00 1 T E COMMONWALTH OF MASSAC_HUSETTS FEE T l
, f S�ti►evR�il�.� ► A, (,1. BOARD OF HEALTH
CERTIFICATE OF COMPLIANCE
Description of Work: Crindividuai Component(s) []Complete System
The and s•gned hereby certify that the Sewage Disposal System:Constructed(41-Repaired( ),Upgraded( ),Abandoned( )
by: n
'at l'► C 5 Q!Lj
has been installed in accordance with the provisions of D CMR I5.00 (Title 5) and the approved design plans/as-built
plans relating to application No. l cm dated 1 1'0/6 Approved Design Flow (gpd)
Installer
Designer: Inspector
�+ Date �!
The issuance of this certificate shall not be construed as a g nee that the sys in will function as designed.
FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM S/96
No. _Oq/_ THE av
COMMONWEALTH OF MASSACHUSETTS
FEE
�I �L& BOARD OF HEALTH
DISPOSAL SYSTEM CONSTRUCTION PERMIT
Permission is her gra}�ted to Constructt,,( ) Repair ( ) Upgrade ( ) Abandon ( ) an individual sewage
disposal system at MOTS w4i as described-
in the application for Disposal System Construction Permit No. .ZOi 6 ,dated 313��Za 6
Provided:: Construction shall be completed within three.years of the date of this mi .All local nditions ust be met.
Date 3/ 3�/ Board of Healt
FORM 2 - DSCP DEP APPROVED FORM 5/96
FARM 1255 (REV 3/98) HerW Hoses WARREN TM PUBLISHERS;-BOSTON
04/29/2010 THU 15: 41 FAX 5083627103 Barnstable CTY HealthLab --- Barnstable Health IZO03/003
n � "
CERTIFICATE OF ANALYSIS,. Page: 2
+` Report Far: Barnstable County Health Laboratory
\i7_.T H,y ^ Sally Desmond Report Dated: 4/29/2010
Desmond Well Drilling Order No.: G1056722
P O Box 2783
Orleans, MA 02653
Laboratory ID#: 1056722-01 Description: iWater=Drinking Water
Sample#: C� Sampling Location: 67yPilot's Way West Barnstable,MA ` Collected: .4/27/2010
Collected by: Customer P� s ' Rece'ved: 4/27/2010
EPA 524.2- Volatile Organics by GUMS (0 Ptt 013, ;,21�,6 2
s ITEM RESULT UNITS RL MCL Method Analyst Tested Note
Chlorobenzene ND ug/L 0.50 •100 EPA 524.2 yn 4/27/2010
Chloroethane ND ug/L- 0.50 EPA 524.2 yn 4/27/2010:
Chloroform ND ug/L 0.50 80 EPA 524.2 yn 4/27/2010
cis-1,2-Dichloroethene ND ug/L 0.50 70 EPA 524.2 yri' 4/27/2010
cis-1,3-Dichloropropene ND ug/L . 0.50 EPA 524.2 yn 4/27/2010
Dibromochloromethane ND ug/L 0.50 ' EPA 524.2 yn 4i27/2010
Dibromomethane ND ug/L 0.50 EPA 524.2, yn A/27/2010 }
Ethylbenzene ND ug/L 0,50 700 EPA 524.2 yn 4/27/2010
4
Hexachlorobutadiene a ND ug/L 0.50 EPA 524.2 yn 4/27/2010
lsopropylbenzene ND ug/L 0.56° EPA 524.2 yn 4/27/2610
: Methylene chloride ND ug/L 0.50. 5.0 EPA 524.2 yn' . 4/27/2010
Methyl-tert-butyl ether ND ug/L' 0.50 EPA 524.2 yn 4/27/2010 s
Naphthalene ND °..ug/L . 0.50 EPA 524.2• yn 4/27/2010
n-Butylbenzene ND ug/L 0.50 -EPA 524.2 yn 4/2 712 0 1 0
n-Propylbenzene ND ug/L;. V 0.50 EPA 524.2 yn 4/27/2010
p-Isopropy[toluene ND ugIL 0.50 EPA 524.2 yn 4/27/2010
sec-Butylbenzene ND ug/L 0.50 EPA 524.2 yn 4/27/2010
Styrene ND ug/L 0.50 i00 EPA 524.2 yn : 4/27/2010 i
tert-Butylbenzene ND v,. ug/L',� 0.50 EPA 524.2 yn 4/27/2010
Tetrachloroethene ND ug/L 0.50 - 5.0 EPA 524.2 yn 4 4/27/2010`�'
Toluene ND ug/la 0.50 1000 EPA 524.2 yn F 4/27%2010-
Total xylenes ND ug/L 0.50 10000 EPA 524.2 yn 4/27/2010 E
trans-1,2-Dichloroethene ND ug/L . + 0.50 100 EPA 524.2 yn 4/27/2010 j
trans-1,3-Dichloropropene ND ug/L 0.50 EPA 524.2 yn 4/27/2010 '
Trichloroethene ND ug/l 0.50 5.0 EPA 524.2 yn' 4/27/2010
Trichlorofluoromethane ND ug/L, 0.50 EPA 524.2 yn 4/27/2010
Water sample meets the recommended limits for drinking water of all the above tested parameters.'
€ \ F
'Attached please find the laboratory certified parameter list.{ Approved By�tWDirector)j
ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
04/29/2010 THU 15: 40 FAX 5083627103 Barnstable C.TY Health.Lab Barnstable Health 1Z002/003
a
�. CERTIFICATE OF ANALYSIS Page: 1
S :
Report For: Barnstable County Health Laboratory
39sshcxu Sally Desmond, Report Dated: 4/29/2010
Desmond Well Drilling Order No.: G1056722
1 P O Box 2783
Orleans, MA 02653 .
Laboratory ID#: 1056722-01 Description: Water-Drinking Water
Sample#: Sampling Location: 67 Pilot's Way West Barnstable,MA Collected: 4/27/2010
Collected by: Customer Received: 4/27/2010
EPA 524.2- Volatile Organics by GUMS
ITEM RESULT UNITS RL MCL Method# Analyst Tested Note
Dichlorodifluoromethane ND ug/L 0.50 EPA 524.2 yn 4/27/2010
Chloromethane ND` ug/L 0.50 EPA 524.2 yn 4/27/2010 }
Vinyl chloride ND ug/L 0.50 2.0 EPA 524,2 yn 4/27/2010
Bromomethane ND ug/L' 0.50 ' EPA 524.2 yn 4/27/2010
1,1,1,2-Tetrachloroet6ne ND ug/L 0.50 EPA 524.2 yn 4/27/2010
1,1,1-Trichloroethane ND ug/L 0.50 200 EPA 524.2 yn 4/27/2010
1 ug/L 0.50 EPA 524.2 yn 4/27/2010 l
l,I,2,2-Tetrachloroethane ND �
1,1,2-Trichloroethane ND ug/L 0.50 5.0 EPA 524.2 -yn 4/27/2010
• a
1,1-Dichloroethane ND ug/L= 0.50 EPA 524.2 yn " 4/27/2010
1,1-Dichloroethane ND ug/L 0.50 7.0 EPA 524.2 yn 4/27/2010
1,1-Dichloropropene ND ug/L 0.50 EPA 524.2 yn - 4/2712010 J
1,2,3-Trichlorobenzene ND ug/L : 0.50 EPA 524.2 yn 4/27/2010 E
f 1,2,3-Trichloropropane ND ug/L D.50 ' . EPA 524:12 yn 4/27/2010'
1,2,4-Trichlorobenzene ND ug/L 0.50 7.0 EPA 524.2 yn 4/27/2010
1,2,4-Trimethylbenzene ND a ug/L 0.50 EPA 524.2 yn 4/27/2010 .
1,2-Dibromo-3-chloropropane ND ug/L 0.50 EPA 524,2 yn 4/27/2010
` 1,2-Dibromoethane(EDB) ND ug/L 0.50 EPA 524.2 yn 4/27/2010
1,2-Dichlorobenzene ND ug/L 0,50 600 EPA 524.2 yn 4/27/2010
1,2-Dichloroethane ND ug/L 0.50 . 5.0 EPA 524.2 yn 4/27/2010
,c ug/L 0.50 EPA 524.2 yn 4/2712 0 1 0
1,2 D1 hloropropane ND
1,3,5-Trimethylbenzene ND ug/L 0.50 EPA 524.2 yn 4/2712 0 1 0
1,3-Dichlorobenzene ND ug/L 0.50 EPA 524.2 t yn 4/27/2010
1,3-Dichloropropane ND - ug/L 0.50 EPA 524.2 yn 4/27/2010
1,4-Dichlorobenzene .- ND ug/L 0.50 5.0 EPA 524.2 . yn 4/27/2010
2,2-Dichloropropane ND ug/L 0.50 EPA 524.2 ,yn 4/27/2010
2-Chlorotoluene ND ug/L 0.50 EPA`524.2 yn 4/27/2010 11
4-Chlorotoluene ND ug/L 0.50 EPA 524.2 yn 4/27/2010
Benzene ND ug/L 0.50 5.0 EPA 524.2 yn 4/27/2010
Bromobenzene ND ug/L 0.50 EPA 524.2 yn 4/27[2010 '
Bromoehloromethane ND ug/L 0.50, EPA 524,2 yn 4/27/2010
Bromodichloromethane ND ug/L 0.50 EPA 524.2 yn 4/27/2010
Bromoforin ND ug/L 0.50 EPA 524.2 yn 4/27/2010
Carbon tetrachloride ND ug[L 0.50 5.0 EPA 524.2 yn 4/27/2010
ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
04/29/2010 THU 15: 40 FAX 5083627103 Barnstable CTY HealthLab - Barnstable Health 2001/003
_............ .................... ... . _....�......_........... .. .. ...._. ._.... .. ....._.. _.._.._...
I
y..
y pF 9A��
:. CERTIFICATE OF ANALYSIS Page:
Barnstable County Health Laboratory
gceu '
Report Prepared For: Report Dated: 4/29/2010
Sally Desmond
Desmond Well Drilling Order No.: G1056722 -
P O Box 2783
Orleans, MA 02653 - -
Laboratory ID#: 1056722-01 Description: Water-Drinking Water
Sample#: Sampling Location: 67 Pilot's Way West Barnstable,MA Collected: 4/27/2010
Collected by: Customer Received: 4/27/2010
Routine
ITEM RESULT UNITS RL MCL Method# Tested
Nitrate as Nitrogen 3.9 mg/L 0.10 1 10 EPA 300.0 4/27/2010
Copper 0.36 mg/L 0.10 1.3 SM 311 lB 4/29/2010
Iron ND mg/L 6.10 0.3 SM 311113 4/29/2010
Sodium 15 mg/L 1.0 20 SM31 11B ' 4/29/2010
Total Coliform Absent P/A 0 0 SM9223 4/27/2010
Conductance 180 umohs/cm 2.0 EPA 120.1 4/27/2016' ;
pH 6.1 pH-units .0 SM 4500 H-B 4/27/2010
Water sample meets the recommended limits for drinking water of all the above tested parameters.
Attached please find the laboratory certified parameter list. Approved By:
( irector)
— — —.. �;.
ND-None Detected ^RL — Reporting Limit MCL—Maximum Contaminant Level �.
Superior Court House, PO.Box 427, Barnstable,.MA 02630 Ph: 508-375-6605
No. Fee------=
BOARD OF HEALTH
TOWN OF BARNSTABLE
App[icat ion_*r Construct ion Permit
Application is liereby made for a permit to Construct ), Alter ( ), or Repair- )an individual Well a
Location Tress Assessors Map and Parcel
W�
/ n
Ownepr ', ----__---_-_—_---- Address 'p yam-" -- ^r
W40
Installer — Driller Address
Type of Building
Dwelling (___ _
Other - Type of Building No. of Persons---- ---------------
!f /
Type of Well ���' ----- Capacity--!--�--------'�--`---
Purpose of Well---- --! �----
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Heobh. Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation ti a ertificate Af Co Nance has been issued by the Board of Health.
Si ne . < _ _ --ll�3
g ®— — � d e
Application Approved By -
/ date
Application Disapproved for the following rea s:----_W------- ---------------------------------
Permit No.- --� -- Issued--- -- -- - - tssJ ---_dVe —
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate ®f (Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed �tered ( ), or Repaired ( )
Installer
at- / 7 t LO( — ---——-- -- ---
has been installed in accordance with the provisions of the Town of Barnstable Boa g Health Well Protection
Regulation as described in the application for Well Construction Permit Nor -- a e ------ -----
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE-------- -- - — Inspector—__--- - - -- —- ---
_
No.-jAa 9-6- n✓ .. Fee------
1 BOARD OF HEALTH
TOWN, OFF BARNSTABLE
2(oplicationArftl ConotructionVermtt ;
Application is hereby made for a permit to Construct �), Alter ( ), or Repair°,(,�,'-,)a individual Well at:
-�' LoT'S k) a-/ l.;yZ' ---- ,-� =° Orr)
Location — Address _ -Assessors Map and Parcel . -
t , w
I Owner Address
Installer Driller Address
Type of Building
j Dwelling
Other - Type
Building- ----------------- No"of Persons-------------- -
Type of Well—L-- w �_——__ Capacity--/ --—---
i
Purpose of Well---
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of He ltl, Private Well Protection Regulation - The undersigned further agrees not to
it place the well in operation til a ertificate of Co . Hance has been issued by the Board of Health.
I� Sign-
— 7awz
Application Approved By ��Al -- �-
�� � •:./ date
i
Application Disapproved for the following,reaso s:------------------------------------- -
ate
l"./�
Permit No. _ _ ` - — Issued----------------
date I
t BOARD OF HEALTH
I
TOWN OF BARNSTABLE 4y
Certificate of Compliance
I
THIS IS TO CERTIFY, That the Individual Well Constructed (�), Altered ( ), or Repaired ( )
L_ '=c " L. --� y --te r!
by a Installer --
x p,at ILois
has been installed in accordance with the provisions of the Town of Barnstable Board of Health P �a Well Protection
i Regulation as described in thef application for Well Construction Permit No. � j ! --t-la a -----
..
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE Inspector
- - P — - -- --—-----, --___ -------- -
BOARD OF HEALTH
,r TOWN OF BARNSTABLE
Ve[[ Contruct ion Permit
. " -
No. - _ Fee- —
Permission is h-reby granted 1)�Sfim ka.
to Construct ( Alter ( ), or Repair ( ) an Individual Well at:
No. — �+ --- --- ------- --------- - - --
Street —as shown on th �aapp ica 'on for a W(elll' Construction Permit
No.-5`-�'—�'` / Dated M
_ /� _
f)-X11
(oard of Health
DATE— e —
w , , ,
AsBuilt Page 1 of 2
LOCATION 6 7 1` ��}S W�1 Y. ' SEWAGE#
VILLAGE L7V4trMS}1h�-�e A'tS-SESSOR'S MAP&LOT
INSTALLER'S NAME&PHONE NO, S£e Irsfxtt< SCi& 3(og Cv qn
SEPTIC TANK CAPACITY LSCO.^904M1•9-i I5CW AAA
LEACHING FACILITY: (type) a 45CO 4Ak "yk►+13vrA (size). C-57 Y '22
NO.OF BEDROOMS S
BUILDER OR OWN$ To VA
��
j PERMIT DATE:' r S 4' CO LIANCE 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 �J
on site or within 200 feet of leaching facility) ��1�� Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
j within 300 fep4 leaching facility) Feet
Furnished by .A
Q
S d
i
r `
-
http://issgl2/intraiiet/propdata/prebuilt.aspx?mappar=217024B00&seq=1 3/7/2016
Nov 09 05 03: 38p Des moJq .E':CdQNTY
e11 Drilling 5082401003 p. 1
NQti-09-2005 I4.44 BAR LAB 5063627iO3 P.02
CERTIFICATE OF ANALYSIS
Barnstable County Health Laboratory
Itcpor1 Nita: 11M/1063
Report Pr(Inared�Y
Sally Desmond Order No.: C0533642
Desmond`Nell Drilling
P 0 Box 2783
brlcans, MIA 02653
Likooratary tD Atty�• 0533642-hh -
V1 OeSe'ripriota: Wq(Cr.UrinhigedV,yler
Sample 0; 33042 �iMlltin6 JA4411on 67 PiloGway Bar,1S10blil.MA
CGdhcteQ: 1i17JSO45
Colleried by: P4.D. No p 21*7 rrrc.l 24 Received: 1012003
1 "PA ,f.1
LAR: laUs�prrlCs
Nitrate as Nitrwgen 4.9 OWL 0,10 to EPA 300A) LAP 1111/200)
I.A 8: A9eeada
Copper � (, my/L 0.10 1.3 SM 1 1 tYs LAP I1/8RU0y I
Iron CiRL MgJt, 0.10 0.3 SM 91 Ila x LAP 1119=03
Sodium 16 ,,,art. 1.0 20 SM 31 e,LA LAP 11/94001
1..4d: Mbcsyhid�ngy
Total Colilorm Abscnt PIA 0 0 309 AF 11l71�OOs
LAQ: PvlySkIll Chrnri07/y
C'ondattance 1$O umohslcm 10 EPA 120.1 uC`3t 1012005
pH 6.3 pH.utlils 0 r!'A t50.1 15c;13 11i7*005
�MA 524.2- Vofat'ile Organics by trCIM
ITF.fvt p5[1LT UNITST 1L Method q !dn" alyz Tested _Note
1.I,t,x-Tetrarchloroethalne 13RL uyl, ir.s
_ EPA 524.2 y„ i1/8/2005
1,1,E-Ttiehloroetbarla BR1L 200 MIA sza.a yn* 11,'er2003
1,1,2,2-Tetrachloroetbanic ERL ui'J►. Vs EPA s24.2. yft 11Bla0os
E,1,2-Trichlorgetha:tte BRL upJ1. 0.3 5.V EPA$24.2 yn 1 UOr 05 i
1.E-Dlehlorottlaane RRt ' ustt 0.5 LVA 524.2
yat 111RROi13
I,1-Dltiblor0ethclac BAL t4t/L 0 S 7.0 E14A 524-. yn t 14120W
1,E-�iChlormpropcne RRL aRlL 0,3 srn 1;41,2 yn 111MMo5
1,2J-7'rlchlorobenzorle BRL ug1L 0.5 rvo524.7 ya 11/91"5
1.2,3-Trichloropropane C;R.L ua/L 0.5 r-;rA saa.a yn 11412005
AL - itcpott6►t Limit
MCL-M:uciroum Contuminntt Loci -
Suptrior Court House, P0.1lox 427, BareistAblc, MA 02630 Ph:505-375-4605 .
i, ,
r� T
Nov 09 05 03: 38p Desmond Well Drilling 5082401003 p. 2
NOV-09-2005 14:45 BAP,N57ABLE COUNTY LAB 5083627103 P,03
b CERTIFICATE OF ANALYSIS
cu Barnstable County Health Laboratory
Repoli Mired: l I09iz)op
' ReexSrt P�eez+re�,l�`Or:
Sally Ocsmond Order No.: C0533642
Desmond Well Di-Ming
P O Box 2733
Orlosns, MA 02653
1,2.4.Trichlorobenzear BRL ug/p 0.> 70 EPA S24.2' yn I IM21Jos.
1,2,4-Trimethylbcozene DIM 451i, 0.5 ernst4.r� y„ 111812005
1,2-Dibramo-Xchloropr6pa BRL uc/L 0.5 F-PA 524.2 yn 1IM2005
1.2-Dibromootharle(EDS) RRL %!k/L 03 Nn sa4.a
Ys t ll8i200S
1,2-nichlorobenzenc BRL uglL 0,5 600 EPA 524.2 yn t iM�1045
I,Z-Dichtoracthanc SRC, ciLlL" 0.5 s,u LVA 52A.2
1,Z-Drchlor9p+'ti�faOe �1tL uy/L 0.5 IF?A 524,2 yn !lBl2005
1,3.5-Trimethylbenzent ORL 0.5 ern 524.2 yo I ua�auus
1+3-Dichlorohertaeae BRL ugJL 0.5 CPA 524.2
yn i 1/8@Ob5
1,21-Diebloropropanc BILL ntlL as EPA seas yle IvArzcws
1,4-Dichlorobenzene 0.5 5.0 &A 52,4.2 ya I vsr2O0s
2,2-Dichloropropane BRL 0,5. r rA 5242 yn 11ls/2005
2-Chlorotopaepe BRL 0.5 ErA524.2 y„ rvenuos
4-Chiorotolueite UR1L udl.. 0.5 EPA 324,2 rn i t/Mc05
Benzene 13121, uSk .0.5 5.0 FVA 524.2 yn 11/V2005
Brornobeezaae BRIv as FPA524.2 yn OV2005
Dromochlorometbane NRL vIVL 0.5 rPA 124.2 w .y�j 11/12005
DromodichloroMethane BRL Uell, 0.5 CPA 524f 2 yn. I lgnoos
Bromoform BRL uVL O.s EPA 524.E y„ :r/er_c4s
Bromomethane BRL k4l, r 0.5 r:pA saa.t ' ye 11m12005
CaPbOn tctraehloride 13RL uK/L 0.3 S.o CPA 524,I yn a ullrzOas
Chlorobenncna 1iRL ugJL 0s 100 Fen 524.2 r► MEMO'S
Cbloroethane ,BRL vWL 0.1 EPA 5242 yn '1rxRoo5
Chloroform 131tL ey/6 0.5 s24,2 yn :. i iry200s
Chloromethane BRLugrf, 9.3 kPA 526.2 yu 11184005
ci9-1,Z-11ich1oroetbeoc g31l1: ubll 0.5 70 EPA 524.2 ya !1412005
eis-1,3•1Hch19ropropeee IBKL cr/L 0.5 LIPA124.2 ye 11/e/2005
DibromOChlorumethane HRL uy/c:, 0.5
LVA 524.2 ya 1 I/b/2005 -
DibromoMetbane BRL- ugn. 0.5
L?A 524.2 yr 1 liS2005
KI. a Roxyting Limit
MCL Ntaximum C40winani Leval
Superior Court Mine, PO, BOX 427,Sarastaale, MA 02630 Ph:503-375.6605
Nov 08 05 03: 38p Desmond- Well Drilling 5082401003 p. 3
NOV-09•-2005 14:45 BAaNS,TASLE COUNTY LAB 5e83627103 P,04
'of old
CERTIFICATE 'OF ANALYSIS "ge 3
Barnstable County�llealth L abotitory
t�AM`.y _
Report UJI144lt 11101200 t
Re
rt 1're ared For:
Sally Desmond ]Order No.: C0533642
Desmond Well Drilling
P 0 Box 2783
Orleans, V!A 02653
Dicblorodiiluoromethane BRL nor, p.s CPA 524.2 yn r e Moos
Ethylbenzene BR1.. ,r/L 0,5 700 evA sx4,2 yn 1:/8/2005
Helachlorobatadienc BRL gar?'. us EPA 524.2 . yo 11/0005
Isopropylbenrone ORL UJVL 0.1 FPA 524.2 yn ":1/er2n05
Methyl-tent-butyl ether 1;RL. up/L" 0.5 EPA 524.2 im 11/d/2005
i Methylene chloride BRL upfl. U.3 5.0 EPA 524,2 yn a lnihons
n-Butylboameae BRL „g/i 0.5 eras 324,2 yn 11/9/2005'
n-Propylbonzene 13?{tL u;JL o..s EVAsan,2 yn avart0os
Nuphtbalene BAL F.RA 524.2 y11 , 1 utnoos
p-150propyltoluene HRL .. vy/L 0.5 CPA 524,2 ys l t/t/2W5
3cc-Butylbe=ne BRL ug/L _os
EPA$24.2 yn 11/9/2005
Styrene ]], uPJf. n.5 :00 FPA 524.E yn !1/8/20f)S
ter(-Butylbenzene BRL ui/L 0.5 DAsza.z yn 1u8R05 ,
Tetrachloroethese BRL air. 0.5 sA fnA 524.2 yrk . 1 i/8J200s
Toluene BRL nalL 0.5 1(00 EPA 524.2 Vol 111w005
Total xylene5 BRL ug/L 0.5 10000 LPA 524.2,. yn 11IV200S
trins-1,2-Diehloroelhenc BRL uglL 0:s aoc> . [iPA 524.2 ri► a urf/t0os
trains-1,3-Dichloropropene BCtL ug/L 0.$ r.rA s24,2 . y,� MUM
rsr M
TrichloproetlAene BRL ur/L 0.5 S,0 CPA s24.: y„ nrbnoos ,
TrlchPor®4larorornethaate BRL uglL o.5 FPA sza:z yn uia;zrins
Vinyl chloride RRL q)L 0.5 2.0 : ,PA 524.2 yn ,rrgRgp9 ,
- __...
Approved By
(LK octor)
s Rt. - Rapaning,.iMis .
MCL�Maximum Cunu,minnnf[.Cull .
SuporiorCOUR l•lottse, P0,Box 427, Barnstable, MIA 02630 Tab:-S ti-,75-6(po5
TOTA_ p.Q4
r
�d,
- ---- w -------l�lo.-------- �- . ..Fee------- - -----
BOARE
TOWN OF BARNSTABLE l
application-*rIvell Con5truct ion Perm it
Ap lic lion is uct permit to reby made for a pe Construct (fi� r:( :),]or Repair )a in( n i 2.�- a -- - BOO
Location resi ssesso nd am el
---- ------ ----------------------------------------------------------------------
Ow er Address
-�1z2
Installer Driller Address
Type of Building
Dwelling —1 -- �r------------------------------
Other - Type of Build ing No. of Persons------------------------_--_—__________
li Type of Well--��SZ�f,C -- — ---------- Capacity --
Purpose of Well------- OZ�? �--- -
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 P tection Regulation — The undersigned further agrees not to
place the well in operation unti er ' e.of has been issued by the Board of Health.
Sign- L ✓� —®sI
--fie �-------
- U date
Application Approved By - -- -- j
date
Application Disapproved for the following reasons: If ------------------- --------------- --_
date
Permit No. Issued--
— —; date---------- —
BOARD OF HEALTH
TOWN OF BARNSTABLE
(Certificate Of Compliance
THIS IS TO CERTIa, That the Indi idual Well Constructed (Altered ( ), or Repaired ( )
by---- -- '2 � L � _ —--—— -- --— — --—— ----— — — —
. / In_CL
Iz
has been installed in accordance with the pro4sions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. ---- -----Dated---- ----
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE---- - -- Inspector------ - - - --------------
.�r�+ .._..-.�-.�.� ,t�"".`.—r='-'^.'=..Yu�,�+ - -- •.:-.�—.•.;r•;-�-'T�..�M^w .�..+.�s+=w.r.a.--`..,:�.�r..-�-lcs ,._r.. ----- - - - i
/ ee
39
------- --
B O A RfF—FMEr4 l F
w TOWN - OF BARNSTABLE
A ` ZippCicat ion-*rVell Cootrutt ion Permit 1
Ap he tion ti's reby ade for a permit to Construct (G r ( ), or Repair ( )an in rnzlual`W Il
Location - Address ------- RO
k, Assessors Map and_P_arcel
Owne'r 9 Address
f__'AeY__CX�;4?__9
------- ---A-- -130 y
Installer — Driller Address
Type of Building 0(3ollen7
Dwelling---- - -- -- -------------------
Other - Type.of Buildin No. of Persons=------- -___-_—___—_—__-____
Type of Well— Ci�sP�------------;---------- Capacity----
Purpose of Well --;P 7n64 _= - f
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
g, place the well in operation until,a-Cert' e.of ` has been issued by the Board of Health.
Signe - L/
— date
Application Approved By `//�� =-- -- /
- � date
Application Disapproved for the following reasons: ----------------- ___—__________—__ �
date .
Permit No. Issued---- --- -- --- _ ___
----date ------ ---
�'Pis.!YH¢4T(I J09i�iAI.Y�?il�liAG3ili3� - 0IIr4q,¢aT,��•G!$9id35aB"4bSit9a�Y.e£tae4Bt 3 - - - .. -
- ,, - - - w ,-, Rl��}M4GLi1d?A8Sti8 ReTe"-V&`BiBi�ule`t10 L86?iFi9f1l6�ci?c1a6.9 `Sie�sa4ief•i66s�i�EafS!2;tiE�sat.4 y
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate Of Compliance . .�,
THIS IS TO CERTIFY, That the Individual Well Constructed (Altered ( ), or Repaired ( }
bY— --
Installer
at Lc
has been installed in accordance with the pro4sions of the Town of Barnstable Bo'ar�of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. --` ----- Dated---=- ----
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY. \; e
N,%
DATE---- r Inspector------ - ---——Y —-- --
:y.7Ls'.3'33'!!tr�ie?1fs4:.QeliTw¢i9i4�T�+1i9i¢i4G�i�G7rlY+?i9iQi'.13Q+'1f4Y4�4Lf70GRafiODQGei.4i8bQb?".iAiTis+J$815¢Gopsg¢.y¢tf2irR6Mi9i!?'.iAy?: dpa<•y?•iwao�Q4b904i�i¢6•Ri±i.�l�eegvepcCme?i Ei?sa
BOARD OF HEALTH
TOWN OF BARNSTABLE
. well Con!9truct ton hermit �
No. --'—/' �:J
{ Fee
Permission is hereby granted
to.Consct 4Y',-'Alter-( ), r Repair ( ) an I-di -idyual16,
?s•s>^::m G :Ltte-appiication to<'a"'vbellF Cons ruction Permit Z
No.- ! - � �(J �T ------ Dated—
---------------------
d
(� � �Board of Health
DATE y //
Massachusetts Department of Environmental Management
Office of Water Resources 3 7 9 4 3
TYPE OR PRINT ONLY Well Completion Report
1. WELL LOCATION GPS OPTIONAL LATITUDE LONGITUDE DATUM
Address at Well Location: Property Owner/Client:
Subdivision Name . Mailing Address:
rr ,
City[Town: _ �_�� City/Town: ,' � ' 5 � ;�g Cj '
Assessors Map �' t Assessors Lot#: NOTE: Assessors Map and Lot# mandatory if no.treet',add ss available
ihj 2 cw "C� �3 A 1113105
`
Board of Health permit obtained: Yes El Not Required ❑ - Permit Number Date Issued
2.WORK PERFORMED 1 PROPOSED`=USE #„ 4:DRILLING METHOD
r
CN New Well ❑ Abandon Domestic ❑ Irrigation - ❑ Cable ' . , ,,Auger
❑ Deepen ❑ Recondition ❑ Monitoring ❑.Municipal ❑ Air Hammer,.. ♦] Direct Push
❑ Replace ❑ Other El Industrial El Other. ElMud'lRota �,❑ Other
5.WELL LOG Water Unconsolidated Consolidated 6.SITE SKETCH.(use permanent landmarks with aim -)
Bearing co CD Other Rock Type l
From (ft) To (ft) Zones 5 cnan
m Material Description `
7. WELL CONSTRUCTION 8. CASING Y
Total Depth Drilled From (ft) To(ft) Casing Type avid Material Size I.D. (in) Well Seal Type
Date Complete
1 ! ILIt G�
9. SCREEN
From (ft) To (ft) Slot Size _ Screen..Type and Material Screen Diameter
10. FILTER PACK/GROUT/ABANDONMENT MATERIAL 11. ADDITIONAL WELL INFORMATION
` I e Developed? IN Yes ❑ No
From (ft) To (ft) Material Description Purpose
Fracture
` !'> Enhancement? ❑ Yes �9 No
Method
ate? x Disinfected? -M Yes ❑ No
12. WELL TEST DATA(ALL SECTIONS MANDATORY FOR PRODUCTION WELLS) 13. STATIC WATER LEV L(ALL WLL$J
Yields"Time Pumped Drawdown to Time to Recover Recovery to pth flow ri -
Date Method (GPM):,,. (his&min) (Ft. BGS) (hrs & min) (Ft. BGS) Date Measured rou d S S(-T-,'.)
14. PERMANENT PUMP(IF AVAILABLE) 15.NAMEIADDRESS'OF PUMA ITA94TIOWCO
VC
Pump Description -��"� Horsepower '~ N
Pump Intake Depth `� (ft) Nominal Pump Capacity (gpm)
16. COMMENTS - N
a -
17. WELL DRILLER'S STATEMENT IThis well was drilled, altered, ancVor abandoned under my supervision, according t -applicable
rules and regulations, and this,rd6ort is compete p nd cotrect to the best of my kno ledge.
Driller:all i Supervising Driller Signature: sr.� t c� C�' Registration #:L
Firm: Z)� � r^t� �ty� Date: /o Rig Permit#: }
NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion.
_BOARD OF HEALTH COPY, ....-
CERTIFICATE OF ANALYSIS Page: 1
Barnstable County Health Laboratory
�ssncttus�'.
Report Dated: 11/9/2005
Report Prepared For:
Order No.: G0533642
Sally Desmond
Desmond Well Drilling
P 0 Box 2783
Orleans, MA 02653
Laboratory ID#: 0533642-01 Description: Water-Drinking Water {
j Sample#: 33642 Sampling Location 67 Pilots Way Barnstable',MA—j Collected: 11/7/2005
!I
Collected by M.D. Map 217 Parcel 24 Received: 11/7/2005 }
Routine
i ITEM ` RESULT UNITS RL MCL Method# Anal st Tested Note l
i
1 LAB: Inorganics
Nitrate as Nitrogen 4.9 mg/L 0.10 10 EPA 300.0 LAP 1 tn12005
LAB: Metals
i
Copper BRL mg/L 0.10 1.3 SM3111B LAP 11/8/2005
Iron BRL mg/L 0.10 0.3 SM 3111B LAP 11/8/2005 f
Sodium 16 mg/L 1.0 20 SM3111B LAP 11/8/2005
j LAB: Microbiology
Total Coliform Absent P/A o 0 309 AF i inn0os
j LAB: Physical Chemistry
Conductance 180 umohs/cm 1.0 EPA 120.1 DCB 1Il7/2005
E I
pH 6,3 pH-units 0 EPA 150.1 DCB 11/7/2005
i
i
EPA 524.2- Volatile Organics by GCIMS
ITEM RESULT UNITS RL MCL Method# Analyst Tested Note
i
LAB: GUMS
1,1,1,2-Tetrachloroethane BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
1,1,1-Trichloroethane BRL ug/L 0.5 200 EPA 524.2 yn t 1!s/zoos
1,1,2,2-Tetrachloroethane BRL ug/L 0•5 EPA 524.2 yn t 1/moos
ug/L o.5 S.o EPA 524.2 yn 11/8/2005
1,1,2-Trichloroethane BRL
1,1-Dichloroethane BRL ug/L 0•5 EPA 524.2 yn 11/8/2005
i 1,1-Dichloroethene .
BRj., ug/L 0.5 7.0 EPA 524.2 yn 11/8/2005
1
1,1-Dichloropropene BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
I 1,2,3-Trichlorobenzene
BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
1,2,3-Trichloropropane
BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
RL = Reporting Limit
MCL=Maximum Contaminant Level
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
Page: 2
9� CERTIFICATE OF ANALYSIS
Barnstable County Health Laboratory
Report Dated: 11/9/2005
Report Prepared For:
Order No.: G0533642
Sally Desmond
Desmond Well Drilling
P 0 Box 2783
Orleans, MA 02653
BRL ug/L 0.5 70 EPA 524.2 yn 11/8/2005
1,2,4-Trichlorobenzene i
1,2,4-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 yn 11/8/zoos
1,2-Dibromo-3-chloropropa BRL ug/L o.s EPA 524.2 yn 11/8/2005
1,2-Dibromoethane(EDB) BRL ug/L 0.5 EPA 524.2 yn 11/8/2005 j
i 1,2-Dichlorobenzene BRL ugn 0.5600 EPA 524.2 yn 11/8/2005
4 1,2-Dichloroethane BRL ug/L 0.5 5.0 EPA 524.2 yn 11/8/2005
I �
{ 1,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 yn 11/8/2005 j
1,3,5-Trimethylbenzene BRL ug/L 0.5 EPA 524.2 yn 11/8/2005 !(
1,3-Dichlorobenzene
BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
1,3-Dichloropropane BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
1,4-Dichlorobenzene BRL ug/L o.s 5.0 EPA 524.2 yn 11/8/2005
! 2,2-Dichloropropane BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
2-Chlorotoluene BRL ug/L
0.5 EPA 524.2 yn 11/8/2005
4-Chlorotoluene
BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
Benzene BRL ug/L 0.5 5.0 EPA 524.2 yn 11/8/2005 f
1
1
Bromobenzene BRL ugfL 0.5 EPA 524.2 yn 11/8/2005
Bromochloromethane BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
Bromodichloromethane BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
I
Bromoform BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
Bromomethane BRL ugh 0.5 EPA 524.2 yn 11/8/2005
i Carbon tetrachloride
BRL ug/L 0.5 5.0 EPA 524.2 yn 11/8/2005
Chlorobenzene BRL ug/L 0.5 100 EPA 524.2 yn 11/8/2005
Chloroethane BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
Chloroform BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
Chloromethane BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
i
cis-1,2-Dichloroethene BRL ug/L 0.5 70 EPA 524.2 yn 11/8/2005
cis-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
Dibromochloromethane BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
jug/L 0.5 EPA 524.2 yn 11/8/2005s/2oos
Dibromomethane BRL
RL = Reporting Limit
MCL=Maximum Contaminant Level + '
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
f
. R
Page. 3
CERTIFICATE OF ANALYSIS
Lro
Barnstable County Health Laboratory
•.'r�CHi3��
Report Dated: 11/9/2005
Report Prepared For:
Sally Desmond Order No.: G0533642
Desmond Well Drilling
P 0 Box 2783
Orleans, MA 02653
Dichlorodifluoromethane BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
Ethylbenzene BRL ug/L 0.5 700 EPA 524.2 yn 11/8/2005
Hexachlorobutadiene BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
1 Isopropylbenzene BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
r
Methyl-tert-butyl ether BRL ug/1.. 0.5 EPA 524.2 yn 11/8/2005 j
Methylene chloride BRL ug/L 0.5 5.0 EPA 524.2 yn 11/8/2005
n-Butylbenzene BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
n-Propylbenzene BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
Naphthalene BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
p-Isopropyltoluene BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
i
sec-Butylbenzene BRL ug/L 0.5 EPA 524.2 yn 11/8/2005 i
Styrene BRL ug/L 0.5 100 EPA 524.2 yn 11/8/2005
1
i tert-Butylbenzene BRL ug/L o.s EPA 524.2 yn 11/8/2005 ff
Tetrachloroethene BRL ug/L o.s 5.0 EPA 524.2 yn 11/8/2005
1
a
Toluene BRL ug/L 0.5 1000 EPA 524.2 yn 11/8n005
Total xylenes BRL ug/L 0.5 10000 EPA 524.2 yn 11/8/2005
trans-1,2-Dichloroethene BRL ug/L 0.5 100 EPA 524.2 yn 11/8/2005
trans-1,3-Dichloropropene BRL ug/L 0.5 EPA 524.2 yn 11/8/2005
Trichloroethene BRL ug/L 0.5 5.0 EPA 524.2 yn 11/8/2005
Trichlorofluoromethane BRL ug/L . 0.5 EPA 524.2 yn 11/8/2005 7
Vinyl chloride BRL ug/L 0.5 2.0 EPA 524.2 yn 11/8/2005
�I
Approved By: _
(Lab D'ector)
q/
O I USAL
RL = Reporting Limit
MCL=Maximum Contaminant Level
Superior Court House, PO.Box 427, Barnstable,•MA 02630 Ph: 508-375-6605
i'
20 5 NOV 15 PH 2: 22
�IY�SJ
i
s � �
JAJ
r/51/1
Town of Barnstable
-Conservation District att: Rob Gatewood, Administrator ��— 1
200 Main Street
Hyannis, MA 02601 May 16, 2005
Dear Mr.Gatewood,
It has come to our no ' e at a hearing was Id by your office regarding a
change in the order of co itio s for 67 Pilots Way, W st Barnstable.At that time a
revised plan was prese ed Thomas Reilly. As ab ers with a long standing interest
in this parcel, we are iting express our frustr ' n and disappointment that we
were not notified Of
s meetin . ' ' al conservation meeting in 2001, along
with several others p esent, we expressed deep concern about environmental issues
pertaining to this pie a of property.There is a twenty year history of environmental
concerns for this pie a of land. Your minutes of that meeting should reflect the level of
concern that was exp essed at that meeting by members of the public as well as the
members of the commission. The changes that were made to the resulting order of
conditions will have enough of an impact that there should have been notification to
abutters that have expressed concerns.
A more troubling aspect of the changes is the fact that Mr.Reilly presented a
plan to your department that is in direct violation of a court order dated July 29, 2004.A
copy of this court order was given to your office on May 16, 2005. The court order
states that any house constructed on that lot must be at least 120 f.qet from the edge of
the salt marsh. The plan presented to you in.March 2005 has the house situated only
84.5 feet from the edge of-the salt marsh.Mr.Reilly clearly misled your office by never
revealing the existence of this court order. His continued disdain for following the
wishes of the conservation commission is evident with the current cease and desist
order that you served him for violating the order of conditions, dated May 9, 2005.
In light of Mr.Reilly's lack of honesty regarding the existence of the court order
as it pertained to the siting of the proposed house, and his disregard for and violation
of the existing order of conditions, we request that the conservation commission revisit
their decision of March 18, 2005. We would like an opportunity to discuss our concerns
about this fragile piece of marshland.
Respectfully Yours,
Sherry Greene-Starr
Gordon M. Starr
c.c. Ruth Weil, Town Attorney
Art Traczyk,Planning Department
.Paul Roma, Building Inspector
John Abodeely, Chairman Conservation Commission
n &Wynn, P
• ATTORNEYS •
Irastable Road
isMA
665 -3 601 August 2, 2004 4.-
)8)775-1244
)899.3003
www.wynnwyan.com
h K.Balaschak Michael.D. Ford, Esq.
E.Enright,)G P. O. Box 665
M.Grimmer West Harwich, MA 02671
A.Martone
McRoy
F.Mais Re: tia�r Lewis
�DaY r. ile No. 28330*1
O'Malley
E.Pones
l J.Print Dear Michael:
a G Richardson
i s
i Rosa* Enclosed for recording please-find an attested copy of the Agreement for
Rosa*
:Sorgi,Jr. Judgment in the above matter. The Agreement for Judgment will need to be
1lenwro marginally referenced for both lots. Please record and provide me with a
.Walsh stamped copy. Also,you will be sending me a le"fer as to when your clients will
ynn be improving Pilots Way..
Md ' Thank you for your assistance. Please call me should you have any
ohcrt 4 Steadman(&&-)questions concerning this matter.
s A.Maddigan
Imes E McGillen,ll Met.)
Imes).Nixon(Rat) Very truly yours, '
WYNN &WYNN, P.C.
d:
cinuetm and Rhode idand
Robert F. Mills
RFM:cfl
cc: Gordon & Sherri Starr'
Ruth Weil, Esq.
Affiliate Office: Raynham 90 New State Highway 9 Raynham,MA 02767•(508)823-4567
SUPERIOR COURT
• BARNSTABLE SS
RED.. .:A 2 9 2004
COMMONWEALTH OF MASSACHUSETTS
[::�j 4o 4
04W
BARNSTABLE, ss. -SUPERIOR COURT
C.A.NO.02-710
GORDON STARR and SHERRI GREENE-STARK, )
Plaintiffs )
V. )
WILLIAM H.LEWIS,III. and THOMAS REILLY )
and GAIL NIGHTINGALE,THOAW A.DEREIMER,)
JERRX GILMORE,DANIEL M. CREEDON AND - )
RON S.JANSSON,in their capacity as'Members of the )
Town of.Barnstable Zoning Board of Appeals, . )
Defendants )
AGREEMENT FOR JUDGMENT
Now come the parties in the above-captioned matter, acting by and through their
respective counsels of record, and hereby stipulate and agree that judgment shall enter as
follows:
1. The Plaintiffs agree,upon execution and filing of this Judgment,that their appeal
of the variance(Appeal No:2002-14,-dated October 23, 2003)a copy of which is
attached to the Complaint as Exhibit A, shall be deemed dismissed,with
prejudice.
2. The Defendants,William H.Lewis,M. and Thomas R.Reilly(hereinafter"Lewis
and Reilly"),hereby agree as follows:
a. The property which is the subject of the variance, (which property is
shown on Town of Barnstable Assessor's Map 217.as Parcel 24) (the
s "Premises")and the adjoining property, currently owned by Shelter Realty
Trust;(which property is shown on Town of Barnstable Assessor's Map
217 as Parcel 30 and Town.of Barnstable Assessor's Map 237 as Parcel 4)
(the "Bayside Funding Lot").shall be used together for single family-
residential purposes as hereinafter set forth.
b. The Premises shall be used.for the location of not more than one single-'
family home and accessory structures as may be permitted from time to
time.under the Barnstable Zoning Ordinance, including without limitation,
a barn, and a paddock area for horses owned by the owners of the
premises.
c: Any single family home to be constructed on the Premises shall be set
back from the edge of the salt marsh at least the distance (120 feet) of the
approved single family home as shown on the plan approved by the
Conservation Commission in file number SE3-3837.
d. Lewis and Reilly agree to improve Pilot's Way from Route 6A to the
access easement to the premises to a width of at least 14 feet,with hard
.packed bluestone with drainage to run down off of the access easement.
e. Lewis and Reilly agree to cause the Bayside Funding Lot to be restricted
by the grant of a Conservation Easement or Restriction,which Easement
or Restriction shall provide that no building or structures shall be located
anywhere on the Bayside Funding Lot, other than fences and other than
accessory structure(s)to the single-family home on the Premises,which
accessory structure(s)may only be constructed in the area shown on the
sketch.plan attached hereto as Exhibit A, excluding however accessory
dwelling buildings or structures.
f. Lewis and Reilly agree that any lighting.placed on the.premises or the.
Bayside Funding Lot shall be directed away from the Stares property and
onto the premises and the Bayside Funding lot.
3. All parties.agree that this judgement shall be recorded in the Barnstable-County
Registry of Deeds and recorded in-the chain of title to the Premises and the
Bayside Funding Lot and shall touch and concern the title of these parcels and run
with the.land for the benefit of the plaintiffs'property located at.85 Pilots Way
which is shown on Barnstable Assessor's Map 237 as Parcel 65.
4... All parties agree to-waive any rights of appeal they may have to the entry of this.
Judgment.
1
Respectfully submitted, Respectfully submitted,.
Plaintiffs, Defendants,William H.Lewis,M.
and Thomas Reilly,
By tPpir attorne , By their attorney,
Ro ert F.Mills,Esq. Michael D.Ford,'Esq.
Wynn&Wynn F.O.Box'665,72 Main Street
300-Barnstable Road West Harwich,MA 02671
Hyannis,MA 02601 (508)430-1900
(508)775-3665 BBO#174440
BBO#542732
Respectfully submitted,
Defendant, Town of Barnstable
By its attorney,
A tme copy,Attest tuth J. W 1, 1 `Asst. Town Attorney
Town HallLY67 Main Street
n � � IerIC Hyannis,MA 02601
(508)862-4620
BBO#519285
Dated: . July 20, 2004 .
EXHIBIT A
. ASSESSORS MAP'217 ..LOCUS RAILRU►0
• PAPCELS 024900 t 02410100 r
OWN or WCONW.
R9JJAM N t[MS■
MAIN STREET
REST OARNSTARIE•MA.07e60 NWTC 6A
OECD BOOR$260 PAN.,.112
TMS SURVEY COMPLIES"IM TIC PROVISIONS SET PLAN BOOK 459 PAGE•1, 2�' CRPC COD
rORTN IN 250 CMR 0.04 AS ES'ABIJSPIED Of NNE ♦J "UNITY
BOARD OF RECISTRAnDI1 OF PROFESSIONAL[PIONEERS 2omwCI'RT - COIL f.0
AND LAND SURVEYORS. FRONTAGE-150'
AREA-43560 SF- IN
•1011"IR 2 ACRE RESOURCE.
PROTECTION OVERLAY DISTRICT
. I [KIT 6
SEWER& FRONT- 70'Set
T
1 I REAR `t 5' . ...
MOM ZONCS 'r!`C'BARNSTABLE LOCUS MAP SCALE 1-- 1000'
COMAIT PANEL 2560t'00/1 0
JULY 2.1992
ARTHUR F.Ct ARK ET AL. i S RS•0)'Se'
7 r"n N LINE) �'� o +� �_ N W4
DEED BOOK 2075 PAGE 62 bte.e+ (CdAPI+
. - �"� ► -� ••� (COY =
PUrA DON LINE) �9 t
OF SO4 OF 763
" YARSIN QIP.VN �00
1 E
Q
N �
1 =MS k i C
M,
1 N ; AREA
1 eLL74
.BARNSTABLE LAND 1B"��FUNDINIS' 'TRUST INC. PARCEL 7 O.B.6915 P.B9DUD OR.109] PO.2691
�.
PLAN OR.102 PO.56 1 1 w '�g •Area f o r
1 II eAYsq[FIRNDNC 1PIG location of
I w N S! 3.61!A(71Cf N
all! _ accessory
'"WSm buildin s or
DEED DOOR a»6,PALS si.
S e0,,• 1 1 .\ P' s v, .PLAN em 400 PACE 30 s t r u C u r e a
�• z �gl 1� 0 I LON-51E."NTIA NHS}y] IT
Ct
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1
39
0. I�.( I 2•'��W CM
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• � CA Ca.._66' —•- ll 296.e6 , ASPNALT'!k R.R.Mf AUTXOR_ J�.OS•�0'!d' rFo R,�q�� N D w
WD PROPOSED IV RmE_.�
]56.fr P_
44
.I SI/! -
GARAGE
u 1 p s+ •m r• g-r
s 1/r s,a s'/ KITCHEN
LAUNDRY = a 2--51 SCREENED
PORCH I
!_ OI
MU ROOM UP
__ I
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I
5-0 I Y 6'-S I 16-0' 11=i
g 3
1n PANTR s
MAIN FLOOR PLAN
SCALE yr- r-w I I BATH I DINING AREA
.. I 1 i
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{ I II
FOYE
II .� Q i
i
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LIVING AREA
STUDY
STOR. b'
- �' Y- 11'-f0' 1 Y-B' ]1 b •.. 14 C Y 6' '
SY_D'
E� I
- •.� " PORCH TO BE SUPPORTED
ON POSTS
I PORCH
i I
1 STOP UHDATNIN UNDER PORCH
AND RETURNPOUND
TO MAIN HOIeSE
THE USE OF THESE PLANS FOR CONSTRUCTION OR ANY OTHER
H R PURPOSE WITHOUT THESE CONSTRUCTION DOCUMENTS ARE PROVIDED �. i/ _` .PLANS
WRITTEN PERMISSION FROM CONNOR BUILDING Co.IS PROHIBITED. DO NOT AS INSTRUMENTS OF SERVICE AND ALL DESIGN / (,.(J
SCALE THESE DRAWINGS,THEY MAY NOT BE TO EXACT SCALE. USE ONLY THE PRELIMINARY INFORMATION SHOWN HEREON IS PROVIDED IN C9
DIMENSIONS SHOWN. OWNER AND CONTRACTORS SHALL CONSULT APPLICABLE NO. RenyoN DA E CONFIDENCE AND REMAINS THE SOLE PROPERTY OF
BUILDING CODES TO INSURE THAT PLANS AND DETAILS CONFORM TO ALL CONNOR BUILDING COMPANY. THE USE OF THIS -
DI SMAM DESON B-M-05
REQUIREMENTS. THEY SHALL VERIFY ALL DIMENSIONS BEFORE PROCEEDING WITH`: DESIGN AND ALL INFORMATION PROVIDED ON THESE`
CONSTRUCTION WORK AND SHALL NOTIFY CONNOR BUILDING Co.OF ANY 02 %ANRflt a+ ¢� DOCUMENTS FOR ANY PURPOSE OTHER THAN THE a//�vN HOMES
DISCREPANCIES BEFORE WORK IS PERFORMED. CONNOR BUILDING Co.SHALL NOT SPECIFIC PROJECT-NAMED HEREON IS STRICTLY
BE RESPONSIBLE FOR ANY ADDITIONAL COST OR STRUCTURAL PROBLEMS PROHIBITED WITHOUT THE EXPRESSED WRITTEN A
RESULTING FROM THE FAILURE TO FOLLOW THESE PL
ANS AND DETAILS. CONSENT OF IT
BUIL DING CO
MPANY
ANY.
t
Connor eu,/e,My Co. Redly Residence A I03
A
• ri-r a _
b +
7-2 llr r-T R-6I T 7V=7
' ]1 ]In'
STORAGE
F . •• ,'C 1 0 O•I GOWNr_x
MASTER BEDROOM -
+ MASTER BATH
]1n. OPEN DECK I'
* STAIR
___ CABINET SHELVES ° . j
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_. � e•-6• r-z 1qWAL.K�ITN
SECOND FLOOR PLAN s, s1n• I sInSCALE: VN'- I'-0'- • WALK—IN CLOSET
- - BEDROOM -
OFFICE I • "
+ i HALL « y ,
L44D.0
(BALCONY b CLOSET CLOSET
b
. � O� � 10-0• '-�,z• iz,z•
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WARER
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• � CHIMNEY ,� -_
I'
CHIMNEY
If
i
BATH
�. BEDROOM
1.
THIRD FLOOR PLAN
SCALE; V1'• 1'-0'
THE USE OF THESE PLANS FOR CONSTRUCTION OR ANY OTHER PURPOSE WITHOUT THESE CONSTRUCTION DOCUMENTS ARE PROVIDED `� PLANS
I� WRITTEN PERMISSION FROM THEY
MAY
BUILDING TCo.O IS PROHIBITED. USE
NOT PRELIMINARY AS INSTRUMENTS OF SERVICE AND ALL DESIGN / �
DIMENSIONS
THESE DRAWINGS,THEY NAY NOT BE TO EXACT SCALE. USE ONLY THE NFORMATION SHOWN HEREON 15 PROVIDED IN C/.®'
DUILDIN0N5 SHOWN, OWNER AND CONTRACTORS SHALL CONSULT APPLICABLE No. REMRON DATE CONFIDENCE AND REMAINS THE SOLE PROPERTY OF .
BUILDING CODES TO INSURE THAT PLANS AND DETAILS CONFORM TO ALL 0 601ENAnc o69SN 6 tl-QS DESIGN BUILDING COMPANY. THE USED THIS Iy' Z HOMES
REQUIREMENTS. THEY SHALL VERIFY ALL DIMENSIONS BEFORE PROCEEDING WITH az P,iB E<xsaN ¢u_� DESIGN AND ALL INFORMATION PROVIDED ON THESE /v
CONSTRUCTION'WORK'AND SHALL NOTIFY CONNOR*BUILDING Co.OF ANY DOCUMENTS FOR ANY PURPOSE OTHER THAN THE
DISCREPANCIES BEFORE WORK 15 PERFORMED. CONNOR BUILDING Co.SHALL NOT SPECIFIC PROJECT NAMED HEREON IS STRICTLY ry /A`
BE RESPONSIBLE FOR ANY ADDITIONAL COST SE STRUCTURAL PROBLEMS 5 PROHIBITED WITHOUT THE EXPRESSED WRITTEN R c I I I y Residence /"t 104
RESULTING FROM THE FAILURE TO FOLLOW THESE PLANS AND DETAILS. CONSENT OF CONNOR BUILDING COMPANY.
Connor Buldmg Co. _
9/23/200S
I '
i
JT
tt-a'
II'-• _I•
GARAGE
�l
§ • p G • a 1 r
- ~ r-,- d-51 T ffi-r IB-r
51/T sI/r Siff KITCHEN 5Ilr
i LA NDRY �,�I - ,II /s'-5! ' SCREENED_
PORCH
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--
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04 I V4 I 5-5 ,6-B' ,A=T
c 31/2- PANTRI s I s In .
!-
b I
MAIN FLOOR PLAN 9
• • SCALE: W. P-C' j BATH I DINING AREA
CLOSEt c i
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NFOY I I n
I
i
r
- OARER
nl
LIVING AREA ~
STUDY
STOR. e I
. :� r- a'-,D• lit
ONRPOHSTS BE SUPPORTED
r I
PORCH
Im
^` STOP FOUNDATION UNDER PORCH
AND RETURN TO MAIN.....
THE USE OF THESE PLANS FOR CONSTRUCTION OR ANY OTHER PURPOSE WITHOUT THESE CONSTRUCTION DOCUMENTS ARE PROVIDED t PLANS
WRITTEN PERMISSION FROM CONNOR BUILDING Co.IS PROHIBITED. DO NOT AS INSTRU G
MENTS OF SERVICE AND ALL DESIGN / D TS f�
SCALE THESE DRAWINGS,THEY MAY NOT BE TO EXACT SCALE. USE ONLY THE PRELIMINARY INFORMATION SHOWN HEREON 15 PROVIDED IN (.� CCC /
DIMENSIONS SHOWN. OWNER AND CONTRACTORS SHALL CONSULT APPLICABLE HD. " REMSION DATE. CONFIDENCE AND REMAINS THE SOLE PROPERTY OF
BUILDING CODES TO INSURE THAT PLANS AND.DETAILS CONFORM-TO ALL m somunc DEsw R n 6s CONNOR BUILDING COMPANY. THE USE OF THIS _
REQUIREMENTS. THEY SHALL VERIFY ALL DIMENSIONS BEFORE PROCEEDING WITH '" DESIGN AND'ALL INFORMATION PROVIDED ON THESE`' G HOMES
OT �c
CONSTRUCTION WORK AND SHALL NOTIFY CONNOR BUILDING CD.OF ANY m nx REMaav ¢� DOCUMENTS FOR ANY PURPOSE OTHER THAN THE / MES
DISCREPANCIES BEFORE WORK IS PERFORMED. CONNOR BUILDING Co.SHALL NOT SPECIFIC PROJECT NAMED HEREON 15 STRICTLY
BE RESPONSIBLE FOR ANY ADDITIONAL COST OR STRUCTURAL PROBLEMS PROHIBITED WITHOUT THE EXPRESSED WRITTEN A .
RESULTING FROM THE FAILURE TO FOLLOW THESE PLANS AND DETAILS. CONSENT OF CONNOR BUILDING COMPANY.
1� I I I Residence
J n C f\ 103
Connor Budding Co. I� 1� U J
.. anannnc
n
3,4
I
Y-t 1 S-7' E-3 I 7A'-Y
yin'
STORAGE
h
. .
1
ER
• .. • O O - r
DOWN
s
MASTER BATH
MASTER BEDROOM s-A i Y
5-0 1
31/2• OPEN DECK I'Q
« 4IJ
t STAIR
LABMET SHELVES "
_ s
y
e
•
y S - -' ` l,9-6 a 7-P 1 4 10 1Y-2•
SECOND FLOOR PLAN s 1 s In• s I A 31 s 1/v
SCALE: vW, r-y -
_ WALK-IN WALK-IN
CLOSET _ CLOSET
r
i
BEDROOM
OFFICE
w
I - HALL'
1 � .
k
,r
• Y \ DOWN
° e I �p - - _I BALCONY -- - CLOSET. CLOSET g
o
Dune
WAITER
BEDROOM
_ CHIMNEY. 'I,i f y
` f CHIMNEY
BATH �p
BEDROOM
THIRD FLOOR PLAN j
SCALE: w•- r-01 -
THE USE OF THESE PLANS FOR CONSTRUCTION OR ANY OTHER PURPOSE WITHOUT THESE CONSTRUCTION DOCUMENTS ARE PROVIDED PLANS
WRITTEN PERMISSION FROM CONNOR BUILDING Co.IS PROHIBITED. DO NOT AS INSTRUMENTS OF SERVICE AND ALL DESIGN
SCALE THESE DRAWINGS,THEY MAY NOT BE TO EXACT SCALE. USE ONLY THE PRELIMINARY INFORMATION SHOWN HEREON 15 PROVIDED IN
DIMENSIONS SHOWN. OWNER AND CONTRACTORS SHALL CONSULT APPLICABLE NO. REASON oA E CONFIDENCE AND REMAINS THE SOLE PROPERTY OF `
BUILDING CODES TO INSURE THAT PLANS AND DETAILS CONFORM TO ALL o stisunncoEmcN oz PUN REeaaN ¢�_�R_„_� CONNOR BUILDING COMPANY. THE USE.OF THIS HOMES
REQUIREMENTS. THEY SHALL VERIFY ALL DIMENSIONS BEFORE PROCEEDING WITH DESIGN AND ALL INFORMATION PROVIDED°ON THESE
CONSTRUCTION-WORK AND SHALL NOTIFY CONNOR BUILDING Co.OF ANY DOCUMENTS FOR ANY PURPOSE OTHER THAN THE
- DISCREPANCIES BEFORE WORK IS PERFORMED. CONNOR BUILDING Co.SHALL NOT SPECIFIC PROJECT NAMED HEREON iS STRICTLY ^
BE RESPONSIBLE FOR ANY ADDITIONAL COST E STRUCTURAL PROBLEMS PROHIBITED WITHOUT THE EXPRESSED WRITTEN1/23/2005 Y RGIIIy ResidenceRESULTING FROM THE FAILURE TO FOLLOW THESE PLANS AND DETAILS. CONSENT OF CONNOR BUILDING COMPANY.
Connof Building Co.
- r- s I _ s r-t s I• i-rc s I
r
' ! , TACK ROOM i -
W, - • ( WASH ROOM GRAIN STORAGE I
•
Y
I � �
Y I
I `
I
• - - 1 j I' STOP.AGE STALL 3 STALL 7 STALL I I q
- .. # s:/r sip• n - sVt slp' 1i
MAIN FLOOR PLAN
sru:w••r-a
` y I
• I
THE USE OF THESE PLANS FOR CONSTRUCTION OR ANY OTHER PURPOSE WITHOUT THESE CONSTRUCTION DOCUMENTS ARE PROVIDED FLOOR PLAN
WRITTEN PERMISSION FROM CONNOR BUILDING Co.15 PROHIBITED. DO NOT AS INSTRUMENTS OF SERVICE AND ALL DESIGN - Cam/SCALE THESE DRAWINGS,THEY MAY NOT BE TO EXACT SCALE. USE ONLY THE — INFORMATION SHOWN HEREON 15 PROVIDED IN /DIMENSIONS SHOWN. OWNER AND CONTRACTORS SHALL CONSULT APPLICABLE sO. RNSION DATE CONFIDENCE AND REMAINS THE SOLE PROPERTY OF vi /BUILDING CODES TO INSURE THAT PLANS AND DETAILS CONFORM TO ALL CONNOR BUILDING COMPANY. THE USE OF THIS
REQUIREMENTS. THEY SHALL VERIFY ALL DIMENSIONS BEFORE PROCEEDING WITH DESIGN AND ALL INFORMATION PROVIDED ON THESE / HOMES
CONSTRUCTION WORK AND SHALL NOTIFY CONNOR BUILDING Co.OF ANY DOCUMENTS FOR ANY PURPOSE HEREON
OTHER THAN THE w S /fI DISCREPANCIES BEFORE WORK I ONAL CST CONNOR BUILDING Co.SHALL NOT SPECIFIC PROJECT NAMED HEREON IS STRICTLY
BE RESPONSIBLE FOR ANY ADDITIONAL COST STRUCTURAL PROHIBITED WITHO
RESULTING FROM THE FAILURE TO FOLLOW THESESE PLANS AND DETAILS.
UT.THE EXPRESSED IUR17TENCONSENT OF CONNOR'BUILDING'COMPANY':'
Connor BmlEmo Co. - REIIIy HOf52 Barn A 10
2 .
- I'- 51 T-C )1 i SI
TACK ROOM -_
s _ e WASH RODM. ' GRAIN - STORAGE
I - _
i
i i
1 r
f '
.. 4 _ 4 jj
5TORAGE I STALL 3 STALL 9 STALL I
i
1 5'n" 31n• - "' �i/T Sin•
404
r MAIN FLOOR PLAN
5GL:V1'.p-o' r _
. I
r i j
THE USE OF THESE PLANS FOR CONSTRUCTION OR ANY OTHER PURPOSE WITHOUT THESE CONSTRUCTION DOCUMENTS ARE PROVIDES FLOOR PLAN
WRITTEN PERMISSION FROM THEY
MAY
BUILDING TO IS PROHIBITED. DO NOT AS INSTRUMENTS OF SERVICE AND ALL DESIGN SCALE THESE DRAWINGS,THEY MAY NOT BE TO EXACT SCALE. USE ONLY THE — INFORMATION SHOWN HEREON 15 PROVIDED IN DIMENSIONS SHOWN. OWNER AND CONTRACTORS SHALL CONSULT APPLICABLE No. vxgav nA E CONFIDENCE AND REMAINS THE SOLE PROPERTY OF I BUILDING CODES TO INSURE THAT PLANS AND DETAILS CONFORM TO ALL CONNOR BUILDING COMPANY. THE USE OF THIS
REQUIREMENTS. THEY SHALL VERIFY ALL DIMENSIONS BEFORE PROCEEDING WITH DESIGN AND ALL INFORMATION PROVIDED ON THESE CONSTRUCTION WORK AND SHALL NOTIFY CONNOR BUILDING Co.OF ANY DOCUMENTS FOR ANY PURPOSE OTHER THAN THE /J ( HOMES
DISCREPANCIES BEFORE WORK IS ONNAL COST CONNOR BUILDING Co.SHALL NOT SPECIFIC.PROJECT NAMED HEREON IS'STRICTLY all
BE RESPONSIBLE FOR ANY ADDITIONAL COST OR STRUCTURAL PROBLEMS PROHIBITED WITHOUT':THE EXPRESSED WRITTEN
., !��
RESULTING FROM THE FAILURE TO FOLLOW'THESE PLANS AND DETAILS.
Connor 6mldrna Co. CONSENT OF CONNOR'BUILDING'COMPANY. Belli Horse Barn
y 102
LEGEND SEPTIC DESIGN. TOP FNDN. AT EL. 23.0' SYSTEM PROFILE NOTES
ACCESS COVER TO WITHIN 6' OF FIN. GRADE (NOT TO SCALE)
100.0 PROPOSED SPOT ELEVATION GARBAGE DISPOSER IS NOT ALLOWED AccEss covE:R (WATERTIGHT) ro 1. DATUM IS NGVD Lars ono
RA11R
16.0 MINIMUM .75' OF COVER OVER PRECAST � WITHIN 6' OF FIN. GRADE
100x0 EXISTING SPOT ELEVATION DESIGN FLOW: 5 BEDROOMS @ 110 GPD = 550 GPD 2% SLOPE REQUIRED OVER SYSTEM 30.0 - 32.0' 2. MUNICIPAL WATER IS AVAILABLE
USE A 550 GPD DESIGN FLOW ' �� RUN PIPE LVEL 2" DOUBLE WASHED PEASTONE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. !-
100 PROPOSED CONTOUR 15.0 FOR FIRST 2'
b
SEPTIC TANK: 550 GPD 2 = 1100 PROPOSED 1500 Jam' 3' MAX. 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H-10 &
100 EXISTING CONTOUR O 14.0' GALLON SEPTIC 13 75' o 81TEE H-20 CHAMBERS 20USE A 1500 GAL. SEPTIC TANK TANK (H- 10 ) GAS o 5. PIPE JOINTS TO BE MADE WATERTIGHT.USE A 1500 GAL. PUMP CHAMBER CELDWATERPROOF BAFFLE 28.59' 28'4`_
og D O S C7 O O D O 0 �
LEACHING: MIN 28.17' C] 0 ED 0 0 171 CO 0 0 0 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. RTE 6A
( SLOPE) \_6' CRUSHED STONE OR MECHANICAL 80 � 0 � M 0 0 0 0 0 ENVIRONMENTAL CODE TITLE V.
SIDES: 2 (56 x 11) 2 (.74) 201 GPD COMPACTION. (15.221 (2]) $ 2' M 0 0 0 0 0 0 M a o 26.17' �.
DEPTH OF FLOW = 4 1 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE
BOTTOM 57 x 11 (.74) = 464 GPD ( % SLOPE) ( 1 � SLOPE) .E
TEE SIZES: 3/4" TO 1 1/2" DOUBLE WASHED STONE USED ,FOR LOT LINE STAKING. o`
TOTAL: 899 S.F. 665 GPD INLET DEPTH = 1Q-
OUTLET DEPTH = 14" 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
USE (6) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) LOCUS MAP
+ + � + LEACHING 9. COMPONENTS NOT 'TO BE BACKFILLED OR CONCEALED WITHOUT
WITH 3.0' STONE AT ENDS AND 3.1' AT SIDES FOUNDATION 30 ST 1 CHAMBER 360 D BOX 27 FACILITY 7.17 NSPECTION BY BOARD OR HEALTH AND PERMISSION OBTAINED NOT TO SCALE
FROM BOARD OF HEALTH.
10. CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE ASSESSORS MAP 217 PARCEL 24
MA LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR LOCUS IS WITHIN FEMA FLOOD ZONE
APPROVED DATE BOARD OF HEALTH BOTTOM TH 2 EL. 19.0' TO COMMENCEMENT OF WORK. Al EL 12 AND C
OLD TEST HOLE LOGS
DUCK
#1 D ENGINEER: A. H. OJALA, PE
SALT MARSH , I��
WITNESS: _ED_ BARRY (BOH)
%Y�\�. ALARM AND CONTROL PANEL DATE: 5/22/01
/.
TO BE INSTALLED INSIDE < 2 MIN INCH
PERC. RATE _ �
BUILDING. ALARM TO BE ON
AL
to
#1 :---4ia.a1' COMPUTATION LINE PR GATE r %' ��; SEPARATE CIRCUIT FROM PUMP CLASS I SOILS P# 9986
���� TA DUCK
2 #3 `_ --' `.PROP. �,''
# �- R�-LLocI of tLEV. ELEV.
4 4 '
4 -- �' ��-'� TRAIL %�\ i\ I 1 2
\�`�o _ -- ,-_-._ _ D_ _ _• •1� , , - ''lam ��\i 16.0 �" 32.6 0" 31.0
` _- ~- - eJ ` ' /�; ��� INV. 13.7' ORG/LOAM UNSUIT. ORG/LOAM UNSUIT.
2%TRANSE TS XISr TRAIL �. 'i ; ' �� i `�
BANK - '----------��'-'moo �` : ---' �� ��. �I �\ IN 1500 GAL. H--10 S T 9 g
6 ` 2" PRESSURE LINE 10YR 4/2
TOWN a ANCIENT TRAIL !------- /; g �� 4 �`\ " ++ 10YR 4/2
FLOODZONE A EL. 12 -- ,�-'- - - - -�AStiQQTING �LINQ 'oy-- SIT �t-1p'L '�.\� �j �� �\ 700 GAL,+ SLOPE 70 DRAIN BACK TO PC B
�! .\ .\o ' ALARM ON RESERVE WEEP HOLE B
i -----M' - FLOAT SWITCH La/
, ' Ii `� 1 SETTINGS: //
\\ ` \\ �; PUMP ON CHECK VALVE " 5Y/6 6 UNSUIT. LS UNSUIT.
' _ _ _-- _ i -♦'� �� P 6.5' WORKING RANGE 8+, 28 / 30++ 2.5Y 6 6
X . `\#2 MYERS WHV5
, s. PROP. 5 BR 4 t �\ \ \ 6.5" C1
---- - .-• oe DWELLING \q t� \ \ 1, \ _ ++ SY"SUBMERSIBLE
(ORE EQUAL) P PUMP LS
F� ♦ \ \ T.FDN=23.0 \ \ I \ ` I'U M F 1
-- -. - - e� �\ \\ sLAB EL=22 5 ♦�\\ \ \ �e�� # APPROVED `FOR 28.5' TDH �� UNSUIT. LS
UNSUIT.
11 o o ,•`LpFOOTPAA4 (TO BE / _ � `� ��� �\ °� �♦�' `. o �. `mil oc o ooC�o aoc�a
`,l �� - , 2.5Y 6/4 - 2.5Y 6/4
\y MAIPJV INFO BY MO�IING) \ \ \ \� cn++ /,rr /..!;/./ 97 fi "i" r,� r
�,. / ._ • . WA �RPROOF 1_ 2 a
t EXIST. WELL g �\ -•�' o \ \�• \/ D�\ \ # C2
c� m\
PUMP CHAMBER C2
t NOT TO SCALE MED COS
5�9 ,� `.\% \ \ ; �/ \\ c� i �� ( ) PERC /
♦ \ i 16,
\ o f MED/COS
o / En
_ `' \, i• \ , r1 2/5Y 5/4 2/5Y 5/4
- '=2 90- i j 1 r� ,ri Igo► f
CAMP .' / i /�' i Ij / i __i 144" 20.6' 144" 19.0,
DSO' ,' //l l #12it/ #1 #2 #� / , `,
i I f o�J it NO GROUNDWATER ENCOUNTERED
7.
# , Ii I/ BOTH SEWER AND WATER LINES TO
ISOLA D WETLAND I- , i , , I• I / BE CLASS 150 PRESSURE PIPE
I I I -PROP. PAD p\OCK �\ \ �g0 ``� �` \ \ #g "� .•-' i i 1 i, �`, 0.0, / ----�
I t \ \ ice' 1
co roo
AL
t 1 \ \ O \ /
-��= - - -- -� TITLE 5 SITE FLAN
. 0.
I i \ i o LOT 1 \ \ \` / / •�- ?�'.,e� #9 \ OF
1 t \ 4.6f ACRES _ - \ \ J
\ \ I O v (UPLAND) IF
- \ -\
Nf'-\ `` ` _ __.� - ; I�Iuj _ #.� LOT , 1 PILOTS WAY
' I z I BARNSTABLE
0 1
/ PREPARED FOR
NOTE. STONE WALL TO BEY__�
' D � 1 1 \' RE-CONSTRUCTED AFTER '�'/Oc � ' i I -_�_ I \ y .
INSTALLATION OF SEPTIC
1 1 i // SYSTEM
1 1 -._'. _ ._ . L .- . _..._. . � RESER� TOM REILLY
\ \ ,
�___ , I I 1 ► \_ _ _'- \ \\ i I \ APRIL 30, 2001
1\ t; �`•�..,�i ``2 i �. REV. MARCH 18, 2005
REV. SEPT. 26, 2005
--------
\ \ REV. OCT. 5, 2005 (BARN)
PROP. BARN j 1 I I, - " #12 REV. NOV. 2, 2005 (MOVE ST)
I I DH FND °� I I �. i' !�TH1 ,o/ �I '' `\ \� \`%" ` \`�
00
_ '�', .,
L 1\ . N t,, I \ // 'i �y 1 ``� \\ \\\ ``\ \' SCQIB:1"= 40'
�6.91 �.- .\ �\ \ 13
0 20 40 60 80 100 FEET
`
290.19 I !t 20''ACCESS +SEMENT`•,�•_ lo
`V
BENCHMARK: STK off 508-362-4541
\ fox 508-362-9880
29,A' \ EXIS NG STOP &---_-__
- =�_ , _ ARNING SIGNS
IL 1 1 ,I, - t
1 - MASS.' - - I T
S• down cape engineering Inc.
EXISTING CROSSING TRANSPORT
Y /
' 1 _ 298.84' - `\ (ASPHALT dt R.R.TIE) AUTHORITY
NoF/a�sss 'A OF
1` '► ARNE H cy� CIVIL ENGINEERS
ARNE LAND SURVEYORS
OJA �
s
CIV ,
N ° 939 main st. yarmouthport, ma 02675
01-008
DATE l�SS10NAL 8N Wa
01-008_SP
r
SYSTEM PROFILE NOTES
LEGEND SEPTIC DESIGN. TOP FNDN. AT EL 22.0'
ACCESS COVER TO WITHIN 6" OF FIN. GRADE (� 1' �) 1. DATUM IS NGVD Loa,s �
ACCESS :.OVER (WATERTIGHT) TO
100.0 PROPOSED SPOT ELEVATION GARBAGE DISPOSER IS NOT ALLOWED
/F18.0�' MINIMUM .75' OF COVER OVER PRECAST WITHIN s" OF FIN. GRADE 2. MUNICIPAL WATER IS AVAILABLE
100x0 EXISTING SPOT ELEVATION DESIGN FLOW: 5 BEDROOMS ® 110 GPD = 550 GPD _ 2X SLOPE REQUIRED OVER SYSTEM 32.0
USE A 550 GPD DESIGN FLOW ? 19 0 �- FRUN OR PIPEFIRS 2� 2" DOUBLE WASHED PEASTONE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT.
100 ' .
PROPOSED CONTOUR - PROPOSED 1500 �' f 3' MAX. 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H-10 & SO
SEPTIC TANK: 550 GPD (2) = 1100 GALLON SEPTIC d' -
� 100 EXISTING CONTOUR � 15.75' TEE H-20 CHAMBERS 20 � �
USE A 1500 GAL SEPTIC TANK 16.0 TANK (H- 10 ) GAS 28 27• 9.0 5. PIPE JOINTS TO BE MADE WATERTIGHT. z
0 28.44 pppp pppp
USE A 1500 GAL PUMP CHAMBER
MIN o 28.17' p p p p p p p p p o 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. R1E 8A
LEACHING: (?z SLOPE) ems` CRUSHED STONE OR MECHANICAL pppp p pppp ENVIRONMENTAL CODE TITLE V.
SIDES:2 (47.5 x 10.83) 2 (.74) = 172 GPD 1 COMPACTION. (15.221 [21) 2' p p p p p ED p p ED 26.17'
DEPTH OF FLOW - 4 �-z SLOPE) �z sLo:,� 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE
BOTTOM 47.5 x 10.83 (.74) = 380 GPD TEE SIZES: 3/4" TO 1 1/2" DOUBLE WASHED STONE USED FOR LOT LINE STAKING. d
TOTAL: 747 S.F. 552 GPD INLET DEPTH = -1•Q-
OUTLET DEPTH = 14» 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
USE (5) 500 GAL LEACHING CHAMBERS (ACME OR EQUAL) 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT LOCUS MAP
WITH 2.5' STONE AT ENDS AND 3' AT SIDES FOUNDATION 10' ST 10' PUMP 356' D' BOX 12' LEACHING 7.17' INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED NOT TO SCALE
CHAMBER FACILITY FROM BOARD OF HEALTH.
10. CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE
ASSESSORS MAP 217 PARCEL 24
MA LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR LOCUS IS WITHIN FEMA FLOOD ZONE
APPROVED DATE BOARD OF HEALTH BOTTOM TH 2 EL 19.0' TO COMMENCEMENT OF WORK. Al2 EL 12 AND C
TEST HOLE LOGS
OLD
DUCK
fi% �BU ENGINEER: A. H. OJALA, PE
AL
/
SALT MARSH •/ ;�I WITNESS: ED BARRY (BOH)
; \\ ALARM AND CONTROL PANEL DATE: 5/22/01
I AL TO BE INSTALLED INSIDE - < 2 MIN INCH
PERC. RATE -
. D / T BUILDING. ALARM TO BE ON I 9986
' `
� AL I \-=81;(COMPUTATION! LINE #g �= �-- - ,� /r_,��� N � SEPARATE CIRCUIT FROM PUMP CLASS SOILS P#
W
i /0 ��
#2 \ /l.'r� �\ \ ELEV. ELEV.
5 '� i/ �' PROP. �l,J�i' �\ - PROP. SCR. PORCH 18. 0" 32.6' 0" 31.0'
J RE-LOCATION OF i \ \ W/ 2ND STORY DECK OVER /O&ATRAI O&A
�A ` ' ORG/LOAM UNSUIT. ORGY UNSUIT.
100 .�'� i
21X17 ST TRAIL �� _ / ► / / \ INV. IN 15.5' " 10YR 4 2 /I-OAM
j .
I
- - - - - -� �� �'�' / , 6� �/ i \\ 1500 GAL H-10 S 2 PRESSURE LINE CK TO PC 9" / g" 10YR 4 2
I \ _ ANCIENT TRAIL - V _' /
I , - _ _ _ - -TO_§HOOTING BOND -� 7 -- - L N \ \ ALARM ON 550 GAL+ SLOPE TO DRAIN BA B
- 1 \ \ FLOAT SWITCH RESERVE WEEP HOLE �j S UNSUIT. LS UNSUIT.
I
- � 1 SETTINGS: PUMP ON " CHECK VALVE //
\ � -� / -- - - ' - - - - - .j �`- - - s PROP. 4 BR \ \ ;,
'"�6 ' DWELLING \ \ \ AL 6.5" WORKING RANGE 8 28" 2.5Y 6/6 30" 2.5Y 6/6
PROP. THRUST / ♦ 2 ` V9 6.5" MYERS WHV5 ClI 8' ► SUBMERSIBLE 1/2 HP PUMP C1
BLOCK ( \\ ♦ I �• ` \\ 1 \`IY3 PUMP OFF 11" SYSTEM (OR EQUAL) LS LS
I / / _ - _ \ `\ _ =,r: \ \ #4 0000o APPROVED FOR 28.5' TDH �j UNSUIT /� uNSUIT.
I CL /ti°FOOTP (TO BE I \\ �1 '' , ' , ��,'� ) ; ;;� �'\ v o00 000 �oo0 0000 0000 /2.5Y 6/4
I // MAII4.TA NED BY MOWING '� \ ♦ _ ti r ,~�� I �! \�• r 60" L%.6' 72" 25.0'
\ i ` A V ^ /a
I / , - � .Y - \� PUMP CHAMBER'` 05C2
\ /� \ �'�• •�. / F, PUNT ,,.- 2
/ �.��' �• '-• •� \ \ / �� " \ t / \\ ,1 ' \ (NCT TO SCALE) PER MED/COS
` ,I / MED/COS
1 r /' / \ 1 :,�: _ * isAL
I I - w .=' �T:: `' PROP ) I 2/5Y 5/4 2/5Y 5/4
/
1440
CAMP // / r 1ti �' J 120.E 144 19.0
1 I / V2/ III #2
NO GROUNDWATER ENCOUNTERED
AL AL
NNIJ AL / pop
ISOLA WETLAND / I : .:- /
CV
AL
I / 11� I I 1 t" \ / A o
I 1 \
� w - '-.-' AL
TITLE 5 SITE PLAN
I I ` Nam O `N - - - - - - - \ PROP SILTATION CONa
YY Ir \�
� � -`c' 1� ��. Itg`\ .� OF
�
' I $ � ym � \ LOT 1 PILOT'S WAY
Igo
IZ I 1 I FgsF �� 4` BARNSTABLE
I 9' PREPARED FOR
M1 l.i
I I 1 /, ;Y.
IDc I 1 1 \ I 5 REMOVAL OF UNSUITABLE SOIL
I \ /REQUIRED AROUND PERIMETER OF
\ I I LEACHING FACILITY, R. RE _ 1 \ TOM REILLY
SUITABLE son LAYER. REPLACE - TH2 \ 'fir`' 1 t,
INITH
i \
I I I1 I REMOVALITO INSPECT AND
- 1- - - - - �� \ \✓/ APRIL 30, 2001
REV. MARCH 18, 2005
DH FND I I ( I // \TH7 • 2
I c00 I I - I _ `\ \ \ 0 20 40 60 80 100 FEET
_ \ .,) \ \
N I
CCESS
20- IA
ENT Ci
~ ~ ~ BENCHMARK: STK I
_~ SET-ATEL 29.A' \ off 508- 2-9b41
fax 508-362-9880
~ EXIS�iNG STOP I
ING SIGNS 1 ♦ `.� ~ ~~ ` � � `` I GNs
MASS, BAY down cape engineering, inc.
(ASPHALTSTING &R.R.TIE) TRANSPORT tNOFMA�� o`'��ARNENG Itk or H �cti�
1 1 ?ITY CIVIL ENGINEERS
29s.s4' ~ ~ _ aaNE oJ�` LAND SURVEYORS
H CIVIL v,
I OJA{.L4� Np.30792
939 main st. armouth ort, ma 02675
Y P
DATE A P.E., P.
i 0 >-0 0 01-008_SP
r
i,
1
LEGEND SEPTIC DESIGN: TOP FNDN. AT EL. 23.0' SYSTEM PROFILE NOTES
ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCAM
100.0 PROPOSED SPOT ELEVATION GARBAGE DISPOSER IS NOT ALLOWED ACCESS COVER (WATERTIGHT) TO 1. DATUM IS NGVD LOCUS oAo
16.0' MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF VIN. GRADE
100x0 EXISTING SPOT ELEVATION DESIGN FLOW: 5 BEDROOMS ® 110 GPD 550 GPD 2% SLOPE REQUIRED OVER SYSTEM 30.0 - 32.0' 2. MUNICIPAL WATER IS AVAILABLE
USE A 550 GPD DESIGN FLOW RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. !-
0 100 PROPOSED CONTOUR \_1 5_.0' FOR FIRST 2'
SEPTIC TANK: 550 GPD (2) = 1100 PROPOSED 1500 �` 3' MAX. o
4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H-10 &
100 EXISTING CONTOUR GALLON SEPTIC 13 75' a I TEE H-20 CHAMBERS
20
USE A 1500 GAL. SEPTIC TANK 14.0 TANK (H- 10 ) GAS o0 28 42°' 29•0 5. PIPE JOINTS TO BE MADE WATERTIGHT.
USE A 1500 GAL. PUMP CHAMBER WATERPROOF BAFFLE 28.59' �� 0 0 s,
LEACHING: 21N 28.17' p 0 ED 0 M 0 0 0 0 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. R-M 6A
( % SLOPE) �_i CRUSHED STONE OR MECHANICAL 0 0 0 0 0 0 0 0 0 ENVIRONMENTAL CODE TITLE V.
SIDES: 2 (56 x 11) 2 (.74) - 201 GPD COMPACTION. (15.221 [2]) $ 2' 0 0 0 ED 0 0 0 0 0 26.17' e
BOTTOM 57 x 11 (.74) - 464 GPD DEPTH of FLOW = 4 ( 9; SLOPE) ( 1 % SLOPE) 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE
TEE SIZES: 3/4" TO 1 1/2" DOUBLE WASHED STONE USED -FOR LOT LINE STAKING. o
TOTAL: 899 S.F. 665 GPD INLET DEPTH = 10"
USE (6) 500 GAL. LEACHING CHAMBERS (ACME. OR EQUAL) OUTLET DEPTH = 14" � 8. PIPE FOR SEPTIC SYSTEM. TO SCH. 40-�4" ..PVC.
WITH 3.0' STONE AT ENDS AND 3.1' AT SIDES FOUNDATION PUMP LEACHING
9. COMPONENTS NOT TO BE BACKFILLE� OR CONCEALED WITHOUT LOCUS MAP
30 ST 1 CHAMBER - 360 D BOX 27 FACILITY 7.17' INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED NOT TO SCALE
FROM BOARD OF HEALTH.
10. CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE ASSESSORS MAP 217 PARCEL 24
MA LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR
APPROVED DATE BOARD OF HEALTH TO COMMENCEMENT OF WORK. LOCUS IS WITHIN FEMA FLOOD ZONE
BOTTOM TH 2 EL. 19.0' Al2 EL 12 AND C
OLD TEST HOLE LOGS
DUCK
#11D _ ENGINEER: A. H. OJALA, PE
SALT MARSH
WITNESS: ED BARRY (BOH)
,
ALARM AND CONTROL PANEL DATE: 5/22/01
` TO BE INSTALL M INSIDE
PERC. RATE _ < 2 MIN/INCH
�,_ _ �_ / BUILDING. ALARM TO BE ON
AL
#1 --'418.81' COMPUTATION LINE T DUCK / /�`.? � SEPARATE CIRCUIT FROM PUMP CLASS I SOILS P# 9986
#2 #3 \`` % a`; -----' Rac AI of ELEV.
-_ - . ' TRAIL / / r'-�� \ I\ EL ELEV.
4 `5
------ - _-•- ----9 ..... i �� -~` • \; 0" T 32.6 0„ T 31.0
16.0
ORG/LOAM UNSUIT. UNSUIT.
x TRAIL INV. IN 13.7 /
ORG LOAM
2°loiRANSE TS -------------%> `� i ' / �! ` `�
/ TOWN BANK � o , 6 . ' � � \ 1500 GAL. H-10 S T 2" PRESSURE LINE 9 10YR 4/2 �
ANCIENT TRAIL 6 �I \ \`�
FLOODZONE A EL. 12 - -- - -i8SH9QTINCL BUNQ O -��` ,�'�- (---_----------�,�02• �10' �j \ `
`` �' - \\ \� ALARM ON 700 GAL.+ SLOPE TO DRAIN BACK TO PC B
----- / j1 . . \ + RESERVE WEEP HOLE B
I • �, ,_�-w-_��- _ ---____ % .� ----`- .' ,' ii \\ \\ . FLOAT SWITCH UNSUIT. LS
------ - -, ►�--- ��------ ` �! `\ `\ `\ 1 A SETTINGS: CHECK VALVE // UNSUIT.
PUMP ON ���
)_22 \ 6.5" WORKING RANGE 8„ 28" 2.5Y 6/6 30„
X \ ,/ tS`. ' Fr20P. 5 BR +r'\ \�\ \` #2 „ MYERS WHV5 2.5Y 6/6
r,to' �R `� • \ DWELLING �\ �1fll `� 6 5 SUBMERSIBLE 1/2 HP PUMP C1 C1
-------- Rd'' `. \ \ a \ ► PUMP OFF 1 1" SYSTEM (OR EQUAL)
I `1- FOOTPAAq - ___�--- P ♦ \ \
` IF y' ,-- SLAB EL.=22s \ . \ LS
-' \ • %W \ `� APPROVED FOR 28.5' TDH UNSUIT. LS UNSUIT.
,. \� , •\ \ _ v Ep` ,.. aooaoo 000a oaoa 000c� 2.5Y 6 4
o o p s TO 9E / `. \ ��� ) °\ �� \ ��� `mil ooa c�oac:�a
\D MAIyT?GNEO BY MO NG) \ /
` VVA I trZPRUC�t- oJ" / 27.6' 72" 25.0'
2 5Y 6/4
I EXIST. WELL ,'' �! �\ \�` \\ \ ►NE o o _.�� / \ �. #5
, \/ �\ PUMP CHAMBER C2
5�BvrFET\\ �� ` 1 i !/ \\ c� ► / NOT TO SCALE)
) PERC MED/COS
,,•y i \``�.' \\ �/ `♦ \ ♦ i�, o MED/COS
411
} / -- o� W �; i s • icg / D► / 2/5Y 5/4
20.6 144
CAMP �S, �,�'' i /�'�' #4 i I / i i �._� / 144"
l - 55
95.77' N� it #1 1� -#i" l i ��./' �,' � ;'' #6 NO GROUNDWATER ENCOUNTERED
i i 2 `•� 07
J1 Ix 1 #7
I i ! , ! I/ 1/ BOTH SEWER AND WATER LINES TO
ISOLA D WETLAND ,
I 1 I I �` .�\ I •0� \ / •\ / � % . I / BE CLASS 150 PRESSURE PIPE
I I I _Pli PAD OCK I \\ g0 \ \ \ #9 / w
_ -_---`` l I / ♦ I 1 / \
1I 1 c^ -' IL 2 I / I I \
♦ / N
LOP `� \
AL
vi
I� •� TITLE 5 SITE PLAN
I .�\ PROP. $iLTA
\ I O `o LOT 1-0 8 \ \ ----------_-� ..� ����
\\ \ 1 I o v 4.6f ACRES -___ ��. \\ �� f / � `, �G'` � #9 \\ DF
I I 0 C7 (UPLAND) ------ , - \ \ �
o I � o ; ��\ ____ _ LOT PILOT'S WAY
I I ► / M�lv, : ; ` I \ BARNSTABLE
O I I I . � , , .� I \ \
NOTE: STONE WALL TO BE
I D I ' \I I RE-CONSTRUCTED AFTER �Y/Q ` J` , I _ PREPARED FOR
I 1 / INSTALLATION\ of SEPTIC F I _i \
/ / ,_L -.'• -•-._._ .i.- . _ .- ._•+ _ _ ti -'RESER - _r=7H�
TOM REILLY
/ -�� \ ----+----------- `\ p e
- \\\ \\,� }�, �.•••••••„ ���` ► APRIL 30, 2001
I I / __ I 1 1 -�'� 1 �; ••1 ? 1 T REV. MARCH 18, 2005
1 / \\ 11 1 _ ----- i ��� I #11 REV. SEPT. 26, 2005
PROP. BARN �, __��"- -`` 1 � I �.--
REV. OCT. 5 2005 (BARN)
I I DH FND °: ► I ► / i I ►{ �� �`� `� ` �`. ,
I 1 \ / ► ` #12 REV. NOV. 2, 2005 (MOVE ST)
TH1\
/ L=1\,26.91' w ; / \ / I _ `�, ` \ Scale:1 = 40
IL
40
10
� , , �•` •�_ � 0 20 40 60 80 100 FEET
- 290.19 1 II 1 20 1ACCESS 94SEMENT �• a
I i
���__ BENCHMARK: STK \ ..
off 508-362-•4541
' I fox 508-362-9880
EL. 29,d \ I ---
- • - �� � 1 EXIS NG STOP &----
AR�VING SIGNS
► ►
MASS
ExlsnNc cRosslNc TRANSP AY down cape engineering', inc.
(ASPHALT do R.R.TIE) AUTHOR/
Rss9 ,SA OFAtigs
ARNE H cya ARNE °� CIVIL ENGINEERS
I I o OJA LAND SURVEYORS
// _ '0 N cl ° 939 main st. armouth ort ma 02675
� Y P
01-008 DATEss ION AL
01-008_SP
SYSTEM PROFILE NOTES
' LEGEND SEPTIC DESIGN: TOP FNDN. AT EL. 23.0'
ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NO1 TO SCALE)
100.0 PROPOSED SPOT ELEVATION GARBAGE DISPOSER IS NOT ALLOWED ACCESS COVER (WATERTIGHT) To 1. DATUM IS NGVD _ LOCUS Rh\�opo
/716.0' MINIMUM .75' OF COVER OVER PRECASTWITHIN 5" CIF FIN. GRADE2. MUNICIPAL WATER IS AVAILABLE
DESIGN FLOW: 5 BEDROOMS @ 110 GPD = 550 GPD 42% SLOPE REQUIRED OVER SYSTEM 30.0
100x0 EXISTING SPOT ELEVATION _ -----
USE A 550 GPD DESIGN FLOW RUN PIPE LEVEL 2" DOUBLE WASHED PEASTONE 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. !-
100-o PROPOSED CONTOUR 15.0 -.._FOR 'FIRST 2'
PROPOSED 1500 Q / r r
SEPTIC TANK: 550 GPD (2) = 1100 3 MAX. 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H-10 &
100 EXISTING CONTOUR GALLON SEPTIC 13.75' QJ I TEE H-20 CHAMBERS 20
USE A 1500 GAL. SEPTIC TANK 14.0 TANK H- 10 29.0 a
x ( ) GAS a 5. PIPE JOINTS TO BE MADE WATERTIGHT.
USE A 1500 GAL. PUMP CHAMBER : WATERPROOF BAFFLE 28.59' �� �- =-:`I.2 °9 I: aaao � ooaa �
LEACHING: MIN -8 28.17' 0 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. R� sa
( % SLOPE) �6" CRUSHED STONE OR MECHANICAL ENVIRONMENTAL CODE TITLE V.
SIDES: 2 (56 x 11) 2 (.74) = 201 GPD COMPACTION. (15.221 [2)) I� O 0 0 O O
99 $ 2 q � � � 0 00 � � - 26.17' �.
( ) TDEPTH EE SIZES:O FLOW = 4 1 ) ( 7PE) 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE
BOTTOM 57 x 11 74 - 464 GPD ( % SLOPE 1 % st 3/4 TO 1 1/2" DOUBLE WASHED STONE USED FOR LOT LINE STAKING. °P
TOTAL: 899 S.F. 665 GPD INLET DEPTH = 1�
ourLET DEPTH 14" 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC.
USE (6) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) LOCUS MAP
r. WITH 3.0' STONE AT ENDS AND '3.1' AT SIDES PUMP 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT
FOUNDATION ' LEACHING ,
30 ST 1 360 D BOX 27 7.17 INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED NOT TO SCALE
CHAMBER FACILITY FROM BOARD OF HEALTH.
10. CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE ASSESSORS MAP 237 PARCEL 24
MA LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR LOCUS IS WITHIN FEMA FLOOD ZONE
APPROVED DATE BOARD OF HEALTH BOTTOM TH 2 EL. 19.0' TO COMMENCEMENT OF WORK. Al2 EL 12 AND C
y TEST HOLE LOGS
.OLD
DUCK
y #11 D ENGINEER: A. H. OJALA, PE
K SALT MARSH ., I�; "-_-
WITNESS: ED BARRY (BOH)
X,' \ - ALARM AND CONTROL PANEL DATE: 5/22/01
TO BE INSTALLED INSIDE _ < 2 MIN INCH
`..\ PERC. RATE - /
AIL
�' � BUILDING. ALARM TO BE ON
#� \---4is.a1' AMPUTATION LINE ,, i ,' - SEPARATE CIRCUIT FROM PUMP
CLASS l SOILS P# 9986
PR91' GATE \ to
� TO DUCK \ `�
\\ ``` OG -'i'0 `\\PROP. �/
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BY GRAPHIC PLOTTING ONLY, THIS PROPERTY IS LOCATED IN
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