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HomeMy WebLinkAbout0032 WINGFOOT DRIVE - Health 32 Wingfoot Drive Barnstable A = 349 - 078 , COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTACAFFAIRS . DEPARTMENT OF ENVIRONMENTAL,PROTECTION TITLE 5 OFFICIAL INSPECTION:FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFAGESEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 32 WINGFOOT DR WEST BARNSTABLE,MA 02668 Owner's Name: CHARLES SAUNDERS Owner's Address: 14651 WEST EAGLE COURT FT.MYERS 33912` Date of Inspection: 12/14/00 `` C1����® ,,Dt i, Name of Inspector: (please print) �i JOHN GRACI Company Name: SEPTIC INSPECTIONS i p, Mailing Address: P.O:BOX 2119 TEATICKET,MA.02536. oF�AR�STpgLE t 10wHEpR�-TH DEP Telephone Number: 508-564-6813 FAX 508-564-7270 - CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address.and that the information reported below is true,accurate and complete as of the time of the inspection:The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am'a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: X Passes Conditionally Passes Needs Furt a Evaluation by the Local Approving Authority Fails Inspector's Signature: ,1 4 ' Date: 12/14/00 The system inspector shall submi ,a'copy of this inspection report to the Approving Authority(Board of Health or DEP)within system. 30 days of completing thls inspection. ty design is a shared system or has a desi If hen now 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. Notes and Comments = # ` THE SYSTEM PASSES T1TLE.V INPECTION.RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEMS USEFULL LIFE. v ****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. ' . . t Title 5 1ncnrrtinn Form 6/1 SOWN) -'1 Page 2 of 11 OFFICIAL INSPECTION.FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM {� PART A A. CERTIFICATION (continued) Property Address: 32 WINGFOOT DR WEST BARNSTABLE,MA 02668 Owner: CHARLES SAUNDERS Date of Inspection: 12/14/00 Inspection Summary: Check A`,B,C,D or E/ALWAYS complete all of Section D A. System Passes: vt, X 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: THE SYSTEM PASSES TITLE V INPECTION.RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. + A 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. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. n/a 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 oh is available. ND explain: n/a n/a Observation of sewage backup or�'reak out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled'or uneven distribution box. System will pass inspection if(with approval of Board of Health): . _ broken,pipe(s)are replaced _ obstruction is removed _ distribution box is leveled or replaced ND explain: n/a n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): _broken pipe(s)`are replaced obstruction is removed ND explain: n/a it Page 3 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 32 WINGFOOT DR WEST BARNSTABLE,MA 02668 Owner: CHARLES SAUNDERS Date of Inspection: 12/14/00 ` C. Further Evaluation is Required 6y the Board of Health: t _ 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(l)(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 r 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 n/a . ,a performed at a DEP certified laboratory,for coliform bacteria and **This system passes if the well water",analysis,p ry, volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. a ` 3. Other: n/a t ., i� � •j it w:el Page 4 of 11 t k OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM }' PART A CERTIFICATION(continued) Property Address: 32 WINGFOOT DR WEST BARNSTABLE,MA 02668 Owner: CHARLES SAUNDERS Date of Inspection: 12/14/00. 'L D. System Failure Criteria applicable to all systems: ` You mist indicate"yes"or"no"to`each of the following for all-inspections: " Yes No _ X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool X Discharge or ponding of effluent to the surface of the ground or surface,waters.due to an overloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool X Liquid depth in cesspool is less than 6"below invert or available volume is less than 'h day flow X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped n/a. X Any portion of the SAS,cesspool or privy is below high ground water elevation. X Any portion of cesspool or privy'is within 100 feet of a surface water supply or tributary to a surface water supply. _ X Any portion of a cesspool or privy is within a Zone 1 of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well. X Any portion of a cesspool or privyis 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facii 't:x ity 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.] (Yes/No)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.. s,`F.. E. Large Systems: F ; To be considered a large system the' systemmust serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X 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'systim considered:a significant threat s 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. , e�< Page 5 of 11 t tt' OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST gsi ' Property Address: 32 WINGFOOTjDR WEST BARNSTABLE,MA 02668 Owner: CHARLES SAUNDERS. Date of Inspection: 12/14/00 Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No ` X _ Pumping information was provided by the owner,occupant,or Board of Health X Were any of the system components pumped out in the previous two weeks? S • O lip X Has the system received normal flows in the previous two week period ? X Have large volumes of water been introduced to the system recently or as part of this inspection ? X Were as built plans of the system obtained and examined?(If they were not available note as N/A) X _ Was the facility or dwelling inspected for signs of sewage back up X _ Was the site inspected forsigns of break out? X _ Were all system components,excluding the SAS,located on site? ` X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of const"ruction;dimensions,depth of liquid,depth of sludge and depth of scum? X _ 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: Yes no X Existing information.For example,•a plan at the Board of Health. X _ Determined in the field(if any of the failure criteria related to Part'C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] 3- . Page 6 of 1 I t , OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C << : SYSTEM INFORMATION Property Address: 32 WINGFOOT DR WEST BARNSTABLE,MA 02668 Owner: CHARLES SAUNDERS Date of Inspection: 12/14/00 1' e 9 FLOW-CONDITIONS RESIDENTIAL Number of bedrooms(design):3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms):330 Number of current residents:0 Does residence have a garbage grinder(yes or no):NO Is laundry on a separate sewage system(yes or no): NO [if yes separate inspection required] Laundry system inspected(yes or no)�'NO ` Seasonal use:(yes or no): YES Water meter readings, if available(last,2 years usage(gpd)): n/a Sump pump(yes or no): NO Last date of occupancy: n/a COMMERCIALANDUSTRIAL 3. Type of establishment: n/a :q Design flow(based on 310 CMR 15.203)jn/agpd Basis of design flow(seats/persons/sgft,etc.): n/a Grease trap present(yes or no): NO Industrial waste holding tank present(yes or no): NO Non-sanitary waste discharged to the Title; '"system(yes or no):NO Water meter readings,if available: n/a r' Last date of occupancy/use: n/a OTHER(describe): n/a a;r GENERAL INFORMATION s Pumping Records Source of information: n/a ` { Was system pumped as part of thes inspection(yes or no):NOf If yes,volume pumped: n/agallons' How was quantity pumped determined?n/a Reason for pumping: n/a TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspools` _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) - _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from t system owner) Tight tank Attach,a copy of the DEEP approval' Other(describe): n/a Approximate age of all components,date installed(if known)and source of information: 1971 Were sewage odors detected when arriving at the site(yes or no): NO r , t t Page 7 of 11 f. . OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 WINGFOOT.DR WEST BARNSTABLE,MA 02668 Owner: CHARLES SAUNDERS Date of Inspection: 12/14/00 Vt BUILDING SEWER(locate on site plan) Depth below grade:30" Materials of construction:_cast iron =40 PVC Xother(explain):ORANGEBURG Distance from private water supply well or.suction line: n/a Comments(on condition of joints,venting,evidence of leakage,etc.): TOWN WATER SEPTIC TANK: X(locate on site plan) R Depth below grade:24" Material of construction:Xconcrete_metal_fiberglass_polyethylene other(explain)n/a. If tank is metal list age: n/a Is age confirmed by a Certificate of Compliance(yes or no): NO(attach a copy of certificate) Dimensions: 1000G L 8' 6"H 5' 7"W 4'10" Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle:32" Scum thickness:0" Distance from top of scum to top of outlet tee or baffle: 8" Distance from bottom of scum to bottom of outlet tee or baffle: n/a How were dimensions determined: MEASURED Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural-integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): THE SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. GREASE TRAP:_(locate on site plan)' Depth below grade: n/a "` f Material of construction:_concrete_metal' fiberglass polyethylene_other(explain): n/a Dimensions: n/a Scum thickness: n/a Distance from top of scum to top of outlet tee or baffle: n/a Distance from bottom of scum to bottom of outlet tee or baffle: n/a Date of last pumping: n/a Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): n/a liiC i` iPage8 of I I a� OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 WINGFOOT DR WEST BARNSTABLE,MA 02668 Owner: CHARLES SAUNDERS Date of Inspection: 12/14/00 •a, TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons 4, Design Flow: n/a gallons/day x.,,. , Alarm present(yes or no): N/A Alarm level:N/A Alarm in working order(yes or no): NO Date of last pumping: n/a Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX:X(if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: LEVEL WITH BOTTOM OF PIPE 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.): DISTRIBUTION BOX IS STRUCTURALLY SOUND,HOWEVER THERE ARE SOME ROOTS IN THE D-BOX , f • PUMP CHAMBER:_(locate on site plan). r Pumps in working order(yes or no): NO Alarms in working order(yes or no):NO Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): n/a ti.p t Pit. y iS Page 9 of 11 OFFICIAL INSPECTION':'FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 WINGFOOT DR WEST BARNSTABLE,MA 02668 Owner: CHARLES SAUNDERS Date of Inspection: 12/14/00 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type 1000 GAL 6'X 6' leaching pits, number: 2 n/a leaching chambers, number: n/a n/a leaching galleries, number: n/a n/a Leaching trenches, number, length: n/a m/a leaching fields, number: nla n/a overflow cesspool, number: n/a n/a innovative/alternative system Type/name of technology: n/a Comments(note condition of soil ;signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): THE LEACH PITS APPEARS TO BE FUNCTIONING PROPERLY.SYSTEM SHOWS NO SIGNS OF FAILURE. ONE PIT WAS 1/2 FULL,THE OTHER PIT WAS EMPTY. CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: n/a Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a Depth of scum layer: n/a Dimensions of cesspool: n/a Materials of construction: n/a ` ' Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): n/a PRIVY: (locate on site plan) k,tjft,{ Materials of construction: n/a Dimensions: n/a Depth of solids: n/a Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): n/a f) 5�i • y Q Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 32 WINGFOOT DRI;WEST BARNSTABLE,MA 02668 Owner: CHARLES SAUNDERS Date of Inspection: 12/14/00 CO SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet.Locate where public water supply enters the building. fi 1 4 CGtreRS \0 CKOAe Page I 1 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEW,_ GE DISPOSAL SYSTEM INSPECTION FORM ` PART C SYSTEM INFORMATION(continued) Property Address: 32 WINGFOOT DR WEST BARNSTABLE,MA 02668 Owner: CHARLES SAUNDERS Date of Inspection: 12/14/00 I � SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 12+feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design"plans on record-If checked,date of design plan reviewed: n/a NO Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators;installers-(attach documentation) YES Accessed USGS database-explainan/a You must describe how you established the high ground water elevation: USGS MAPS AND CHARTS- 12+FEET - r 4 tk,it , -0r % €4 'a - Vt AC Vf r,nJf(C/o7 3 �J / I .ODD'✓e(' , �00`PG* QG�rrtnc+ � �lnlJ'Yy o.. y nj a ( ul tNtr r s •r frl Postage $ MA ol- p Certifiec►Fee p p Return Receipt Fee Po (Endorsement Required) ;0 p Restricted Delive Fee t rY. l a rr (Endorsement Required) e0 4y. p Total Postage&Fees -0<. 0 $ O I`- Street,Apt.No.; r��.... � Q� z or PO Box No. ^ City,.Sta to,ZlP�. �_.�................•--- h---- en�er✓. .c[.e. Olq O G3a.. jor AV IKE Town of Barnstable Barnstable Regulatory Services Department ;eficaNy + BARNSTABLE, MASS. 039. Public Health Division m `gym Arf0 MAt a 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.GeilerLeach pit is only3f )undwagter,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL# 7006 0810 0000 3525 5293 May 19,2011 ' ATTN: David Holt Today Real Estate 1533 Falmouth Road (rte.28) Centerville, MA 02632 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system 32 Wingfoot Dr, Cummaquid, MA was last inspected on 5/10/2011 by Shawn McElroy a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed"under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: • Backup of sewage into facility or system component.due to overloaded or clogged SAS or cesspool • Static liquid depth in cesspool is less than 6"below invert or available volume is less than 'h day flow. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. You are ordered to repair or replace the septic system within sixty(60) days from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action PER ORDER OF THE BARD OF HEALTH omas McKean, R.S., CHO Agent of the Board of Health M Q:\SEPTIC\Letters Septic Inspection Failures\1-1 SAMPLE 60 Day Deadline.doc Commonwealth of Massachusetts Title 5 Official InspectionForm Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cummaq uid MA 02637 5-10-11 page. City/Town 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 forma A. General Information 1. Inspector: Shawn Mcelroy Name of Inspector Upper Cape Septic Service Company Name " 29 Atwater Dr Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License.Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and_th the 48) 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 -1 sewage disposal systems. I am a DEP approved system inspector pursuant to Section ",5.340"of Title 5 (310 CMR 15.000).The system:" Va ❑ Passes ❑ Conditionally Passes ® Fails _ I ❑ Needs Further Evaluation by the Local Approving Authority '5-10-11 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,.if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Lk t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal ystem•Page 1 of 17 r Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ` xM 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) - Owner Owner's Name information is Cumma Uld required for every q MA 02637 5-10-11 page. City/Town 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:' 1 ❑ 1 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 l Commonwealth of Massachusetts Title 5 Official Inspection YForm Subsurface Sewage Disposal System:Form--Not for.Voluntary Assessments' . 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt@ Today Real Estate-1:-800-966-2448) Owner Owner's Name information is Cumma uid 61' MA 02637 5-10-11' required for every q page. City/Town State Zip Code Date of Inspection B. Certification (Cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to.broken or obstructed_ pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ 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): t_ ❑ 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 Ell N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): • 4 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•11/10 ! - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name required for is y Cumma uid required for ever q MA 02637 5-10-11 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) f f 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: I ❑, The.,syste-m has aseptic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within:a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within'50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: '* This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.iA copy of the analysis must be attached to this form. 3. Other: I f D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No" to each of the following for all inspections: Yes No E ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ® ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/ day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments �M 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt @'Today Real Estate 1-800-966-2448) Owner Owner's Name information is required for every Cummaquid MA 02637 5-10-11 " page. City/Town 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: ❑ ®r 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 106 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 othei 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. 1'have determined that one or more of the above failure criteria exist as described in 310 CM 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 15,000gpd.- 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 t El ❑ the system.it;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. I� , t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ — Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Cumma uid MA 02637 5-10-11 required for every q page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? El ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): .. 3 Number of bedrooms(actual): 7 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x #of bedrooms): 330 t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form 7 Subsurface Sewage Disposal System-Form -Not for;Voluntary Assessments., 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate.1-800-966-2448) Owner Owner's Name information is Cumma uid MA 02637 5-10-11 required for every q page. City/Town State Zip Code Date of Inspection D. System Information _ Description: Number of current residents: 0 Does residence have a garbage grinder?. ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required],. ❑ Yes ® No Laundry system inspected? ❑ Yes 0 No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 years usage d Below Detail: 2005--808 gpd 2006--427 gpd 2007--326 gpd Sump pump? ❑ Yes ® No Last date of occupancy:,. 2009 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design•flow(based on al CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): , Grease trap present?, ❑ Yes ❑ No Industrial waste holding tank present? 1 ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings,if available: t5ins•11/10 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Ford Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448)' Owner Owner's Name information is Cumma uid MA 02637 5-1 - required for every q 0 11 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: - Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes,volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Officials Inspection, Form ;, L Subsurface Sewage Disposal System Form-Not for Voluntary Assessments,- , 4�M s 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt @ Today Real.Estate 1-800-966-2448) Owner Owner's Name information is umma uid MA 02637 5-10-11 required for every C q _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2004 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): . Depth below grade: 38" feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): x Distance from private water supply,well or suction line: feet Comments (on condition of joints,venting, evidence of leakage, etc.): Good condtion. Septic Tank(locate on'site plan): Depth below grade: 30" , Meet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age:, ' .,years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gal Sludge depth: 12" t5ins•11/10 - Title 5 Official Inspection Farm:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments wM 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Cumma uid MA 02637 5-10-11 required for every q page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 15" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with baffles installed and no sign of leakage. 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 II Commonwealth of Massachusetts .- .> Title 5 Official Inspection Form Subsurface Sewage,Disposal System Form -Not for Voluntary Assessments . ,. M 32 Wingfoot Dr Property Address - Bank Owned (Contact David Holt @ Today Real Estate1-800-966-2448) Owner Owner's Name information is Cummaquid MA 02637 5-10-11, required for every- page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grader ' 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•11110 - .. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Wmgfoot Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Cumma Uld required for every q MA 02637 5-10-11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 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.): D-box in good condition with stain line at 1" above outlet invert due overloaded field. Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No Alarms in working order: ❑ Yes ® No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): The pump chamber and the pump were checked and found to be in good working order. The alarm box was missing and not checked. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 a I Commonwealth of Massachusetts A Title 5 Official Inspection, Form Subsurface Sewage Disposal.System Form Not for Voluntary Assessments 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt,@ Today.Real Estate.1-800-966-244.8). Owner Owner's Name information is required for every ummaq C uid MA 02637 5-10-11 page. City/Town State Zip Code. Date of Inspection D. System Information (cont.) Type:` ❑ leaching pits number: 'leaching chambers =_ number. i 3-500's ❑ Teaching galleries 'number: leaching trenches number, length: J ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach chambers in good condition and empty at inspection with stain line at 4"below top of chamber. a. u 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•11/10 - Title5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt.@ Today Real Estate 1-800-966-2448) Owner Owner's Name information is Cumma uid MA 02637 5,10-11 required for every q page. City/Town 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.): r; 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.): 1 t5ins 11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Mass achusetts , Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments '. 32 Wingfoot Dr - 9 Property Address Bank Owned (Contact David Holt @ Today Real Estate 1=800-966-2448) Owner Owner's Name information is required for every Cummaquid MA 02637 5.10-11 _ , page. City/Town State Zip Code Date of,lnspection 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 .: �erv�n t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt @ Today Real Estate 1-800-966-2448) Owner Owner's Name information is q required for every Cumma uid MA 02637 5-10-11 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope r ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 12 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: ® Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: Original design plans show no groundwater at 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins.11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts. Tithe 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments'. �M 32 Wingfoot Dr Property Address Bank Owned (Contact David Holt @,Today Real Estate 1-800-966-2448) Owner Owners Name information is required for every Cummaq uid MA- 02637 5-10-11 page_ City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or checked ® Inspection Summary D (System Failure.Criteda 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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 ' TOWN OF BARN ABLE LOC'F4 t ION 3 o x r SEWAGE # VILLAGE �-t a D 14 �'zl ASSESSOWS MAP&LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK-CAPACITY /,) � LEACFIING 1=ACILI'I'Y: {type} Ch sh. .3 (size) NO.OFBEDROOMS 3 BUILDER OR OWNE PERMITDATE: _�_oCONWLIANCE DATE. L2::::� Separation Distance Between the: Maximum Adjusted,Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (if any guests exist on site or witk►in 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet o eaching facility) Feet Furnished by F 11 A �a a, �}-0- 37G a-0- /9'4" /-y-'/o'G'' �-�f a-F-336" �n6�, OWN OF BARNSTABLE LOCATION 3a W O SEWAGE 4. VILLAGE �� �( bit ASSESSOR'S MAP & LOT 3 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS -t �WWp C BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: ]L 1 C)O Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by o e No. QP I Y?- � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpiitation for Misposal 6pstrm Construttion hermit Application for a Permit to Construct( ) Repair*<Upgrade.( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.3 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel :34 C g) R�� Installer's Names,Address,and Tel.Now. (& gA46 5Q(©f) .1 Designer's Nam ,Address,and Tel.No. Type of Building: `��. Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 14Ln gpd Design flow provided gpd Plan Date Number of sheets Revision Dateo Title—�� Size of Septic Tank_--� Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) c��,,�`_ f~ L—� ey�,Q L G Date last inspected: Agreement: The undersigned agrees to ensure the construc ' n and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of t ental ode and not to place the system in operation until a Certificate of Compliance has been issued by this Board of igne Date Application Approved b Date 3 19— Application Disapproved by Date for the following reasons Permit No. G-0)Q Date Issued / h No. I .,Cj P . : Fee / Q THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: y PUBLIC HEALTH`DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppYication for wsposaY 46pstem Cons tructioll .permit . A lication for a Permit to Construct Repair(�U grade( Abandon( ) p ) pg ( ) ( ) ❑Complete System ❑Individual Components 6 !S Location Address or Lot No.3a �.�ct Owner's Name,Address,and Tel.No. Assessor's Iv1ap/Parcel Installer's Na Address,and Tel.No. _11W3aLL_10r _, De"ig2ter's Nam ,Address,and Tel.No. Z62 `t 2 S�,v� Co•..� aNt�tr\ �e�wS YY�c1 .�,v' �— ��� Type of Building: /f\,Dwelling• No.of Bedrooms " Lot Size sq.ft. Garbage Grinder 4; Qther j_-'Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design"Flo w(min.reuired) V f lv (' gpd Design flow provided 45 t ` gpd r Plan Date, `� �1 J ;Dumber of sheets Revision DateV V L9` M.. _ Title Size of Septic Tank Type of S.A.S. Description of Soil . Nature of Repairs or Alterations(Answer when applicable) � �lve. �a4 q(__4_ k_VQ_ ' Date last inspected: a Agreement: !I •}` r The undersigned agrees to ensure the const Gtio ind y6imenahte,6Sth6 afore described on-site sewage disposal system in � accordance with the provisions of Title 5 of t vtr entalz Ityli M ;ode and not to place the system in operation until a Certificate of .a .:Sf,w Compliance has been issued by this Board of e i d, Date Application Approved by t. Date -- J, 3 ' Application Disapproved by Date for the following reasons F Permit No. /,9 ^C) Date Issued 3 f THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Com Aiance THIS IS TO ARTIFY, hat t On-site Disposal system Constructed ) Repaired(f�) Upgraded Y ( ) Abandoned b f` "+'ln ` ( ) at 3 UtJ\�q � a( , has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No 4`"`p^00 Ited 1 h-3 �� a Installer r1T%S G�YfQrd1/besigner C. Af #bedrooms Approved desi flow �ct.cl gpd The issuance Jof thissperr�mit shall 't be construed as a guarantee that the system will fungi fig esigned. Date / // Inspector \ No. go/ 9 ^d Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Bisposal 6p7)M "' Construction Vermit Permission is hereby granted to Construct( -)- Repair Upgrade( ) Abandon( ) System located at 3 c? o, �'��rvj� rr7 a 9.1 U and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this Qb Date � �, Approved r Town of Barnstable " '� .� Regulatory Services Thomas F. Geiler, Director 1(``IiARNBf'ABLL. X Public Health Division Thomas McKean, Director 200 Main Street,Hyannis, MA 02601 Office: 503-362-4644 Fa:c 508-790-6304 Installer & Designer Certification Form Date: 3 Sewage Per / G� - �ssessor•s INIap\Parcel Desio,ner: L b Installer: e.y, .Sim, add:ess: D 1 / Address: Z ! a 14o j���J i+c On was issued a permit to install a (date) (installer) septic system at V" f vl DA 01/1 s d ona-design drawn bv -. address) V i) Lt. ✓ / i dated (designer) l certify that the septic system referenced above was installed substantially according to the design. which may include m;nor.aprroved charges sueli as lateral allocation o-tne distribution box ands'or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. c,reater than 10' lateral relocation of the SAS or an verilcall rellocatlion of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. OF MqS o D E �s9cJ+ (Installer's ivnature) 1140 . RfGISIE�� 2l0 esigner's Signature) Gaffs Designer's Stamp Here) ' PLEASE RETURN TO BAR`1STABLE PUBLIC HEALTH. DIVISION. CERTIFICATE OF CONIPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORA AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q: Health/Septic/Designer Certification Form 3-26-04t cloc 5 -- Brk 17752 Ps70 6115836 10-03-2003 a 02216P DEED. RESTR ICTION WHEREAS,D G� ,� e/SIY�� of (owner's name) e e tW "'LNG (address) is the owner of ,,SA/�� RID t.� located (address) at ,Sl'✓J C'� /�' � MA (hereinafter referred to as and being shown on a plan entitled "Subdivision of Land In � R ��e 1�1 � MA, Property of et at duly recorded in Barnstable County Registry. Of Deeds in Plan Book J , Page r= ; Or on Land Court Plan Number WHEREAS, ti as the owner of said lot has (awriers name) agreed with the Town of Barnstable Board-of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Env ronrrtental.Code,.Title V, Minimurp Requirements for the Subsurface Disposal of sahiia'y sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for a septic system in compiance vAtl tJ0,9MR 15.200, State Environmental Code, Title V,.Minimum ...Reau'p'merts for the Subsurface Disposal of Sanitary;bewage, and authorizing the i `,uanda of a building permit for the construction of a single family home on this 0,9perty, is requiring*that the agreement for the restriction on the number of b' drooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, deedr 1 Bk 17752 Pg 71 #115836 NOW, THEREFORE, 9�' � A _f�,��, -&I hereby place the (owner's name) following restriction on his above-referenced land in accordance with his -agreement with the Town of Barnstable Board of Health,which restriction shall run with the land and be binding upon all successors in title: 1. 3d, C,;Try ,��I- _ -�JA _ may have constructed (address) pon the lot a house containing no more than Mff., (jW) bedrooms. agrees that this shall be permanent deed (owner's nam®) n 2 jd� Mq�a restriction affecting 1 , located on +6 ` ��� nd being shown on the pl n recorded in Plan Book lyl�fj , Paged 3qq Or on Land Court Plan L le of 3a cx)- 6 f60i see the following deed: Book, Page --.'Or Land Court Certlfcate of Title Number ' Executed a al d Inst ument _ day of 4her Ignature s s' tune Owner's signature COMMONWEALTH OF MASSACHUSETTS 1�Gu gs �Qr ,20_ Then pe onally appeared the above•named `��� known tome to be the pe n who executed the foregoing instrument and acknowled ed the same to be .-_free act and dee efore me, lic ar ; . 7TRUE BLE COUNTY My commission expires: ��! Y OF DEEDS � a a OPY,ATTEST 5LV MAR NJ9TTyj?jPu , ADE,REGISTER COfAMnwedlAo/ �'--� doadr \ QOIgpllMlpll NOIG 1$;200g BARNSTABLE REGISTRY OF DBED3 s � 4C f�v No. C1T1 U�(,Q �,/1 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: e Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pprication for Diopogal 6potem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. /P ce ) f jJ �1� (A� ; '170s Assessor's 5 o'r'^�' ,�� t�Ca Lj h fi� e 2 0 Installer's Name,Address,and Tel.No. t Designer's Name,Address and Tel.No. k-0 l RO All.I c V CIA U ekA { wS [) ►'� 2 n eA e ty�e 2 ' Type of Building: � ���,z�,'��s u^ �Q., ca►� Dwelling No.of Bedrooms �' Lot Size p � sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow L gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil N,,ato a of Repairs or Alterations(An wer when applicable) ��S '� �e 1.5�� Pcj," C_k)q k hC/,q lZ ,SoO 6r 4 11 uAU LAP 0-e.Ga C A(4 /-..t p Le Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b t ' Boaro<V Health. C+ Signed_4� ' Date a o Application Approved by Date Application Disapproved fo the following reasons Permit No. ;zoo q— Date Issued 7LJ L THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY that the On-site Sewage tspos�l System Constructed ( —I Repaired ( )Upgraded( ) Abandoned( )by w t C at C.j w S a+ 0 h i has been cons tled i accordance with the provisions of Title 5 and the for Dis osalSystem Construction PermitNo. U ,S/ dated U Installer Q bpi� ( �SL c AU �� i o'' I Designer DQ �C. h e The issua'}ce oft is permit shall not be construed as a guarantee that a system i u cti n as designed. Date / �� Inspecto No. �U/le Fee THE COMMONWEALTH OF MASSACHUkTTS� Entered in computer. V, �y�,. Yes �1 PUBLIC HEAL" DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Application for,Migaar *p!5tem Construction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ' ❑Complete System ❑Individual Components Location Address or Lot No. ( / �'n�^f [��. Owner's Name,Address and Tel.No. p '"0(✓'S'�' (� czb ,Pn-4 w � 1foo Assessor's M 7 ?� ceb /j 4c M a W P 10 In.,Wler's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 5 ta'a ' a�ja•Z K0A) Euccau �-� 1wS „�y .L) A (ZR ��u h, eY�2 PC, l I /n /a S ) p�.� !°n oa GY5 , �3 t- .w e s T 7 X f3 Ry f f Ty U���Type of Building: ,,+ °'�.''�, :f e. r`A ch Dwelling No.of Bedrooms Lot Size'�. 3$ sq.ft. Garbage Grinder( ) Other Type of Building No.of'Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow V Z�IU gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title t Size of Septic Tank Type of S.A.S. Description of Soil i � ryatur of Re airs or Alterations(An wer when apphicable) I" l � So� �o I /wU/u '`Lte A c.G i.�� C A id wt i en.t G +2 Cr.IU a-� e Date last inspected: ` Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been isss edVby, ,*s Boar o ealth. Signed "i Date 7 Q . _ _ �/a7 �t./ - Application Approved by ;. .� - _ -F Date. . ./. , 1 Application Disapproved for the following reasons _ I , Permit No. j UO q` qg Date Issued W2 7/d 1` THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS f. Certificate of Compliance THIS 1S TO CERTIFT, that the On-site Sewage Disposal System Constructed( '') Repaired ( ).;Upgraded( ) Abandg}�ed( )by U Aj S K C W u ' t N at S �' ^' S ` n U_e has been const cted in acc rdance with the provisions of TitlS,5 and the for Dis osal System Construction Permit No. �b s� dated 7/(,c Installer K ON { �c/a U IV* I r- I . Designer A Me 'e h r The issua ce of t 'rs�permit shall not be construed as a guarantee that e system 1fu cti n as designed. Date �� 7 f Inspector ^---�"-`�� No.—�U0LI ' NS( -----------,------- Fee Jot/— THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS �i9;po!6al *p!gtem Construction Permit Permission is hereby granted to Construct( )Repair(V)Upgrade( )Abandon( ) System located at S a w n yv,, f�P Q r�f� ,b and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction/must be completed within three years of the date of this p rrn11 i Date:_ V f a 7I ! , Approved by V TOWN OF BARNSTABLE LOCATION 4 SEWAGE VILLAGE f' f ®ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.&A S C-X670,2��K Se l? y27 G 7? SEPTIC TANK CAPACITY fd90 LEACHING FACILITY: (typt)'s Ste 't � `S(size) 13 X 33.t NO.OF BEDROOMS Lur BUILDER OR OWNER i" r / �� e �S PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist > '; within 300 feet of leaching facility) g Feet Furnished by c 6 �S 146 as- ' 4j;tF^` TOWN OF BARNSTABLE LOCATION SEWAGE# VILLAGE A' J51a61f ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO./1 df'1S �XL°�r:�4 5416 y�7 Q17� -� SEPTIC TANK CAPACITY _A/M LEACHING FACILITY: (type) 13 SCO .� (size) 13 1C 3-K:1— - ' NO.OF BEDROOMS i x T BUILDER OR OWNER / .. :_ PERMITDAT ,� E: COMPLIANCE DATE: Separation Distance Between the: " Feet - Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist y on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist .. ' within 300 feet of leaching facility) >¥ Feet Furnished by, :. 4� O �is2�' o A 3 C D i 0 !q 311 On3� 93 , Town of Barnstable Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,RS. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. August 29, 2003 Mr. Darren M. Meyer, R.S. 43 Vine Street Duxbury, MA 02332 RE 32 Wlrgfoot Drive, Curmaquid A 349 07$ Dear Mr. Meyer, You are granted conditional variances on behalf of your clients, Robert and Linda Wilson, to construct an onsite sewage disposal system at 32 Wingfoot Drive, Cummaquid. The variances granted are as follows: PART VIII, SECTION 1.00: The pump chamber will be located seventy-eight (78) feet away from a wetland, in lieu of the 100 feet minimum separation distance;required. 310 CMR 15.405 and 15.211: The soil absorption system will be located ten feet away from the foundation wall of the home, in lieu of the twenty feet minimum separation distance required. These variances are granted with the following conditions: (1) No more than four (4) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) The applicant shall record'a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to four (4) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. MeyerWilson . C . > rTown of Barnstable 5 , Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. August 29, 2003 Mr. Darren M. Meyer, R.S. 43 Vine Street Duxbury, MA 02332 , q RE 32 Wingfoot Drive,.Cumma uid A=349-078 Dear Mr. Meyer, You are granted conditional variances on behalf of your clients, Robert and Linda Wilson, to construct an onsite sewage disposal system,'at 32 Wingfoot 'Drive, Cummaquid: The variances granted.are as follows: PART Vill, SECTION 1.00: The pump chamber will be located seventy-eight (78) r feet away from a wetland, in lieu of the-100 feet minimum separation distance required. 310 CMR 15.405 and 15.211: The soil absorption system will be located ten feet away from the foundation wall of the home, in lieu of the twenty feet - minimum separation distance required. These variances are granted with the following conditions: (1) No more than four (4) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms according to the MA Department of Environmental Protection. (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstabl&County-Registry of Deeds restricting the property to four (4) bed rooms'maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent .prior to obtaining a disposal works construction permit. (3) The existing Leaching pits shall be pumped, crushed'and pilled with clean sand. . (4) The septic system shall be installed in strict" accordance ith the 00 engineered plans dated revised July 21, 2003, signed by the 4'_ n 1,, S`'`'"��°'� ereer In red ink-dated July 2 v 0�� „�,,,ne� ;��e� ��r— (,,_��k (5) A 40 ml polyethylene liner shall be installed adjacent to the leaching facility as shown on the approved plans dated revised July 21, 2003, signed by the desl n .in red" inpk dated July 25, 2003. (6) The designing engineer shall supervise the construction of the dnsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliaDce with the ubmitted plans dated revised July 21, 2003, signed by the design sneer in red ink dated July 25, 2003. u �o This variance is granted because tfie p`h`1y'Zal constraints at the site severely restrict the location of the soil absorption system due.to the proximity of a wetland on the property. It is the opinion of this Board that the proposed new septic system is designed to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sincer y yours, W ne M er, D. Chairma r MeyerWilson (3) The existing leaching pits shall be pumped, crushed and pilled with clean sand. (4) The septic system shall be installed in strict accordance with the engineered plans dated revised July 21, 2003, signed by the designing engineer in red ink dated July 25, 2003. (5) A 40 ml polyethylene liner shall be installed adjacent to the leaching facility as shown on the approved plans dated revised July 21, 2003, signed by the designing engineer in red ink dated July 25, 2003. (6) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the submitted plans dated revised July 21, 2003, signed by the designing engineer in red ink dated July 25, 2003. This variance is granted because the physical constraints at the site severely restrict the location of the soil absorption system due to the proximity of a wetland on the property. It is the opinion of this Board that the proposed new septic system is designed to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sincer y yours, W ne MVer, WD. Chairma J Meyeffilson °```"�' t• DATE: RECEIVED �n FEE* r At' A , •.lARN3Ti1131E, ► —AUG �-20 MABS Town of BarnstableL HEALTH DEPT. CHEH-. DATE Board of Health a 200 Main Street,Hyannis MA 02601 14 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-63Q4 Sumner Kaufman,M.S.P.H.. Wayne A.Miller,M.D. VARIANCE RE VEST FORM LOCATION W 1�4 y�iT DRI U CUMA4L�V IIQ Property Address: ,�i ��(},Cf Q � s �j Assessor's Map and Parcel Number: /� 079 Size of Ld -3 "e-slo,6 70 Wetlands Within 300 Ft. Yes X Business Name: No Subdivision Name: APPLICANT'S NAME: Phonpe �63J 367,"'21 Z2,,, Did the owner of the property authorize you to represent him or her? Yes No PROPErR�TY!QMER'S NAME 1 , CONTACT PERSON pp �� Name: & C��N19A :UJ!L,50 M Name: J)FBI R-614 t4 . �y Q� f.S., Address:32, W 1 Wi F 1 P.., M, 1A. V) ddress:43 V 1 of, Sr- D U� p���ll , .gyp Phone: SOS 3-7 S--' Oo q('7 �33�' Phone: 6 J�G'' �� �✓ ARIANCE FROM REGULATION(List Rog.) REASON FQ ^,RO -VARIANCE(May attach if more space.needed) 1 SCE. BOO teo ZI c,Oc, IJAIJ 0`. er y/a,41i 2°1 3Vd 64 !r-2// 164Cff,N fly Z J Al- eAe.,r lice-'hol °bar I-eatl��n�` M a c h �t r�i ®-f�te�.►'�'t�accGk J NATURE OF WORK: House Addition ❑ House Renovation El Repair of Failed Septic System Check[`(to he completed by.office staff-person receiving variance request application) Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Fora(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) — Signed letter stating that the property owner authorized.you to represent him/her for this request — Applicant understands that the.abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISgPROVAL Wayne A.Miller,M.D. n C:\Documents and Settings\decollik\Local Settings\Temporary Internet Fi1es\0LKF13\VARIRFsQ.D0C } �1NE DATE: FEE: " BARNSTABLF. MARS 619•��� REC. BY ` Town. of Barnstable,,,... -DATE Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-630f4 Sumner Kaufman,.M.S.P:H.. Wayne A.Miller,M.D. VARUNCE`REOUEST FORM LOCATION PropertyAddress: 3Ol WIN/ V URl M t 6UmA4,kV/l Q �j Assessor's Map and Parcel Number: ) , 3�1,' /� ` ®79 Size of Lot:!•3'i A"e-.S153°00 64'4' Wetlands Within 300 Ft. Yes X Business Name: No Subdivision Name: APPLICANT'S NAME:Jl� � /"�° , R•S Phone 70�j 362—21 2,2.,, Did the owner of the property authorize you to represent him her? Yes No PROPERTY QWNER'S NAME CONTACT PERSON Name: 20 5OX bt P 0A UJ I L,50 M Name: k USE i"1 . tA6\ 9 9-� �.S Address: W 1 P—..W M1li/1 V 9 Address:43 V I N e S-r- D o g u PW M& g �p q v2�3 Phone: I 0JR ��S 00 4L1 Phone:(5a j J�z- 1�7✓ ARIANCE FROM REGULATION(Ua Rcg) REASON FOR VARIANCE(May attach if more space needed) i 560 I00E183 01tlsc4-- Vtable 1uC4P2 Pvn4P 2�1 /O 451*4 /T-211 LEAD IJ102-5 /Vo dAe.+r I-acXhivi Fvr Bea,(,�L•� NATURE OF FORK: House Addition 0 House Renovation 0 Repair of Failed Septic System Checklist(to be completed by office staff person receiving variance request application) Four(4)copies of the completed variance request form - Four(4)copies of engineered plan submitted(e.g.septic system plans) Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the.abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISgPROVAL Wayne A.Miller,M.D. C:\Documents and Settings\decollik\Local Settings\Temporary Internet Fi1es\0LKFB\VARIREQ.D0C 64 �4 X P if l z x zo �LOO V-- FCA�N IAJ I AJe-7 r } t � � r Y .. 4 -0 1 �- .r* u �- �_ LoFT- ADD i I ABUTTOR'S LIST FOR 32 WINGFQ-or DRIVE, CUIVIIVIAQUID (MAP 349/LOT 078) MAP 349 LOT 104 DONALD H. LEBER 54 WINGFOOT DRIVE 64 WINGFOOT DRIVE YARMOUTHPORT, MA 02675 MAP 350 LOT 001 CUMMAQUID GOLF CLUB 35 MARSTQNS LANE P.O. BOX 182 YARMOUTHPORT, MA 02675 MAP 349 LOT 077 PATRICIA M. CONNOR 277 MARSTONS LANE P.O. BOX 15, 277 MARSTONS LANE CUMVIAQUID,NIA 0263"7 MAP 349 LOT 075 ROBERT T. & ALICE STEPHENS 23 WINGFOOT DRIVE 83 UNION STREET NEW ROCB.ELLE,'NY 10805 MAP 349 LOT 074 JEFFREY& CONSTANCE SHAW 35 WINGFOOT DRIVE 35 WINGFOOT DRIVE CUMMAQUID, MA 02637 MAP 349 LOT 073 CLYDE K. & CATHERINE M. HAYDEN 53 WINGFQOT DRIVE 53 WINGFOOT DRIVE YARMOUTHPORT, MA 02675 • July 29, 2003 Clyde & Catherine Hayden 53 Wingfoot Drive Yarmouthport, MA 02675 CERTIFIED MAIL Receipt 7003 0500 0005 5793 4606 RE: Septic System Upgrade—Variance Request Wilson Residence, 32 Wingfoot Drive, Cummaquid, MA Dear Mr. & Mrs. Hayden: • This letter is to notify you of a hearing before the Barnstable Board of Health scheduled on Tuesday August 19, 2003, at 7 pm in the Barnstable Town Hall Hearing Room to present the proposed septic system upgrade plan and the variance requested for the above referenced site. The proposed system design has taken into account requirements set forth in 310 CMR 15.000 (Title V) and the Town of Barnstable Board of Health Regulations. The following variances are requested: 1) Per 310 CMR 15.405 1(b),. variance from 310 CMR 15.211 to allow proposed leaching to be 10 feet from foundation vs. required 20 feet. 2) Per Barnstable Board of Health. Regulations variance to allow septic component (pump chamber) to be 78 feet from wetlands vs. required 100 feet. As an abutter of the property in question, state regulations require that you be notified of the hearing a minimum of ten (10) days prior to the hearing date. If you have any further questions regarding this request please feel free to contact me at (508) 362 2922 or attend the hearing on the scheduled date. Sincerely, Darren M. Meyer Registered Sanitarian 43 Vine Street Duxbury, MA 781-585-0293 July 29, 2003 Jeffrey & Constance Shaw 35 Wingfoot Drive Cummaquid, MA 02637 CERTIFIED MAIL Receipt 7003 0500 0005 5793 4590 RE: Septic System Upgrade—Variance Request Wilson Residence, 32 Wingfoot Drive, Cummaquid, MA Dear Mr. & Mrs. Shaw: This letter is to notify you of a hearing before the Barnstable Board of Health scheduled on Tuesday August 19, 2003, at 7 pm in the Barnstable Town Hall Hearing Room to present the proposed septic system upgrade plan and the variance requested for the above referenced site. The proposed system design has taken into account requirements set forth in 310 CMR 15.000 (Title V) and the Town of Barnstable Board of Health Regulations. The following variances are requested: 1) Per 310 CMR 15.405 1(b), variance from 310 CMR 15.211 to allow proposed leaching to be 10 feet from foundation vs. required 20 feet. 2) Per Barnstable Board of Health Regulations variance to allow septic component (pump chamber) to be 78 feet from wetlands vs. required 100 feet. As an abutter of the property in question, state regulations require that you be notified of the hearing a minimum of ten (10) days prior to the hearing date. If you have any further questions regarding this request please feel free to contact me at (508) 362-2922 or attend the hearing on the scheduled date. Sincerely, �a11J1,�G't� Darren M. Meyer Registered Sanitarian 43 Vine Street Duxbury, AM 781-585-0293 July 29, 2003 Robert &Alice Stephens 83 Union Street New Rochelle, NY 10805 CERTIFIED MAIL Receipt 7003 0500 0005 5793 4583 RE: Septic System Upgrade —Variance Request Wilson Residence, 32 Wingfoot Drive, Cummaquid, MA Dear Mr. & Mrs. Stephens: This letter is to notify you of a hearing before the Barnstable Board of Health-. scheduled on Tuesday August 19, 2003, at 7 pm in the Barnstable Town Hall Hearing Room to present the proposed septic system upgrade plan and the variance requested for the above referenced site. The proposed system design has taken into account requirements set forth in 310 CMR 15.000 (Title V) and the Town of Barnstable Board of Health Regulations. The following variances are requested: - 1) Per 310 CMR 15.405 1(b), variance from 310 CMR 15.211 to allow proposed leaching to be 10 feet from foundation vs. required 20 feet. 2) Per Barnstable Board of Health Regulations variance to allow septic component (pump chamber) to be 78 feet from wetlands vs. required 100 feet. As an abutter of the property in question, state regulations require that you be notified of the hearing a minimum of ten (10) days prior to the hearing date. If you have any further questions regarding this request please feel free to contact me at (508) 362 2922 or attend the hearing on the scheduled date. Sincerely, Darren M. Meyer Registered Sanitarian : 43 Vine Street Duxbury, MA 781-585-0293 July 29, 2003 Patricia M. Connor PO Box 15 227 Marstons Lane Cummaquid, MA 02637 CERTIFIED MAIL Receipt 7003 0500 0005 5793 4576 RE: Septic System Upgrade—Variance Request Wilson Residence, 32 Wingfoot Drive, Cummaquid, MA Dear Ms. Connor: This letter is to notify you of a hearing before the Barnstable Board of Health scheduled on Tuesday August 19, 2003, at 7 pm in the Barnstable Town Hall Hearing Room to present the proposed septic system upgrade plan and the variance requested for the above referenced site. The proposed system design has taken into account requirements set forth in 310 CMR 15.000 (Title V) and the Town of Barnstable Board of Health Regulations. The following variances are requested: 1) Per 310 CMR 15.405 1(b), variance from 310 CMR 15.211 to allow proposed leaching to be 10 feet from foundation vs. required 20 feet. 2) Per Barnstable Board of Health Regulations 'variance .to allow septic component (pump chamber.) to be 78 feet from wetlands vs. required 100 feet. As an abutter of the property in question, state regulations require that you be notified of the hearing a minimum of ten (10) days prior to the hearing date. If you have any further questions regarding this request please feel free to contact me at (508) 362-2922 or attend the hearing on the scheduled date. Sincerely, �VAUt M kill— Darren M. Meyer Registered Sanitarian 43 Vine Street Duxbury, MA 781-585-0293 July 29, 2003 Cummaquid Golf Club PO Box 182 Yarmouthport, MA 02675 CERTIFIED MAIL Receipt 7003 0500 0005 5793 4569 RE: Septic System Wgrade—Variance Request Wilson Residence, 32 Wingfoot Drive, Cummaquid, MA To Whom It May Concern: This letter is to notify you of a hearing before the Barnstable Board of Health scheduled on Tuesday August 19, 2003, at 7 pm in the Barnstable Town Hall Hearing Room to present the proposed septic system upgrade plan and the variance requested for the above referenced site. The proposed system design has taken into account requirements set forth in 310 CMR 15.000 (Title V) and the Town of Barnstable Board of Health Regulations. Thefollowing variances are requested: g q 1) Per 310 CMR 15.405 1(b), variance from 310 CMR 15.211 to allow proposed leaching to be 10 feet from foundation vs. required 20 feet. 2) Per Barnstable Board of Health Regulations variance to allow septic component (pump chamber) to be 78 feet from wetlands vs. required 100 feet. As an abutter of the property in question, state regulations require that you be notified of the hearing a minimum of ten (10) days prior to the hearing date. If you have any further questions regarding this request please feel free to contact me at (508) 362-2922 or attend the hearing on the scheduled date. Sincerely, Darren M. Meyer Registered Sanitarian 43 Vine Street Duxbury, AM 781-585-0293 July 29, 2003 Donald H. Leber 64 Wingfood Drive Yarmouthport, MA 02675 CERTIFIED MAIL Receipt 7003 0500 0005 5793 4552 RE: Septic System Upgrade—Variance Request Wilson Residence, 32 Wingfoot Drive, Cummaquid, MA Dear Mr. Leber: This letter is to notify you of a hearing before the Barnstable Board of Health scheduled on.Tuesday August 19, 2003, at 7 pm in the Barnstable Town Hall Hearing Room to present the proposed septic system upgrade plan and the variance requested for the above referenced site. The proposed system design has taken into account requirements set forth in 310 CMR 15.000 (Title V) and the Town of Barnstable Board of Health Regulations. The following variances are requested: 1) Per 310 CMR 15,405 1(b), variance from 310 CMR 15.211 to allow proposed leaching to be 10 feet from foundation vs. required 20 feet. 2) Per Barnstable Board of Health Regulations variance to allow septic component (pump chamber) to be 78 feet from wetlands vs. required 100 feet. As an abutter of the property in question, state regulations require that you be notified of the hearing a minimum of ten (10) days prior to the hearing date. If you have any further questions regarding this request please feel free to. contact me at (508) 362-2922 or attend the hearing on the scheduled date. Sincerely, Darren M. Meyer Registered Sanitarian 43 Vine Street Duxbury, MA 781-585-0293 } � ® IDom• D . ru - I= � • Im •� Ph I -In .. .> � Postage $ ��-®-----.�. U7l L six i u 1 -n Postage $ I O Certified Fee 1 IMC3 ' / 7\ j Certified Fee QL. 1 p Return Reclept Fee synark { Return Retie ( i(Endorsement Required) ( �FW ! (Endorsement Required) a`c- ; Restricted Delivery Fee �/J6 i! 7 Restricted Delivery Fee HeretJ, � (Endorsement Required) _`, ©>y P (Endorsement Required) O Total Postage&Fees $ `4 L a V `=3 Total Postage&Fees $ �L a m I C3 ent To "IO .�11f.' /` 7 Sent To I Sheet,Apt NA; - �- --- — ] 3`treet,APr o.; or PO Box No. .�.�_-`!!� _._ -- orPO -- _ City,State P+¢ /, Itat Ln �Ln e. o • ,�' 1 m "I Er •� M . I I USE ul Postage $ V�h Ln �1 Postage $ Sri 0 Certified Feet 3/ ark t p Certified Fee n? Return Reciept Fee I re/ O /I (Endorsement Required) 'a Return Redept Fee 1 4•{/ �a i III Restricted Delivery Fee CA �6/ �k i ��rsement Required) 4�y j rep j O (Endorsement Required) �� / )C3 Restricted DeCrvery Fee �•/ (Endorsement Required) 0,Vill fro C3 Total Postage&Fees $ ��� gip - --® i Total Postage&Fees $ J m0 Sent To I t/� {/ i mnt To n, or PO Box Na- -- •-- :S r _ ..... _ .... I N Streeg ApC Aro; .�. ...... or PO Box No. QQ 1- -- - - (� City,State,ZI =------- ----- ks���.�"v''4.:�1! .._..._... i City,State ZI --..� - / ¢ ....... ....... A rn Er =r3 F' C I A L U � Postage $ Ln a'I Postage $ I O Certified Fee �4j - ) i c" 0 ` aril !C3 Certified Fee p Return Redept Fee A i Here�t, I p 1 ��, (Endorsement Required) N.. ';� ! Return Reciept Fee C� ark Gr\ (Endorsement Required) '" _ M Restricted 9el'nrery Fee (Endorsement Reqund) 1' ;,— �/ � Restricted Delivery Fee c6( u-I '`�i..i 1" M (Endorsement Required) AN, j Total Postage&Fees $ [ 0 m Total Postage&Fees $ \y p Sent To . .Y C�t. -....... ...... 0 Sent To -- F` $treat dpt S ...-....»......••--••-•- O �-_--- - f� N94 or PO Box No. .1 _.... 4 APL --_-- _--- -_- . ------»•--- or PO Box No. - ------- ldi1. .....fit_..... City,Ste ZIPa4 Va ----....�-�__�._,.City,State P+4 ` ,r �� UNITED STATES POSTAL SM � �� Glass -Mail _ t GL7 `�•� �... S�: 0A Fees 1�7,d Cr10�- `a- L ° Sender: Please print ygpr name, address, and-ZIP+4 In=tfiis boX• Via St b fikA 0953A 1 j III fill fit 1111111111111111 fill 11 lilt If 1111l!l�ll!llil ffl lilt if SENDER: COMPLETE THIS SECTION COMPLETE THI&SECTION ON DEHVERV ■ Complete items 1,2,and 3.Also complete Sig ature" item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the revers X ❑Addressee so that we can return the card to you. TVDate of Delivery ■ Attach this card to the back of the mailpiece, 9 or on the front if space permits. r�f�-Mra(5`03 D. Is delivery address erent from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No 3. Service Type 0 Certified Mail ❑Express Mail Y�u ❑Registered ❑Return Receipt for Merchandise D /� ❑ Insured Mail C.O.D. �IL��� ❑4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 2 n` 57g3 qS-�Q (Transfer from service label) —71-v) J W PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVI � _ _ first-Class Mail Gu� Pottage&Fees Paid - _. -1PeftlfNo;-G- -10 USPS w p M ° Sender: Please print yout>ngf e, address, and ZIP+4 in this box CI G I J I >-13 V i ku--Du�bL49 Sfi r'� itittill�tlli3ltEtiiiltt3�it.��1111ii.{itt itit{�i�it�f il�illt.fli I f 3 w1A1 F-Aoz- . DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sign ture ❑Agent ■ Print your name and address on the reverse ❑Addressee item 4 if Restricted Delivery is desired. X so that we can return the card to you. B. Rec ved by(Printe Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, MA- or on the front if space permits. D. Is delivery ad s different -m it lYes 1. Article Addressed to: If YES,enter delivery add low: .� 3.� �'� �'� �� (✓� Service Type 5 VVV Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise v` w� ❑ Insured Mail ❑C.O.D. � 75 4. Restricted Delivery?(Extra Fee) ❑Yes.- 2. Article Number `0O5 OS-06) 00S— 5743 (transfer from service labe {/ U (� PS Form 3811,August 2001 Domestic Return Receipt 10259e-02-M-1540 UNITED STATES POSTAL$ERVICC ""` First-Class Mail v ' Postage&Fees Paid USPS I Permit No.G-10 ° Sender: Please print your name, address, and ZIP+4 in this box° fI ll�.>:�C�r�.:..�'t�W a'i"? I+�rlrrt�r�rlllt�r�ttrrlrirrl�rrittr��t�l�atrir�ir�rr�irirrr�l 1 32- laity 1�v6T SENDER: DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. B. R ed by(Printed Name) C. D� elivery ■ eiv Attach this card to the back of the mailpiece, <D1 ' or on the front if space permits. D. Is delivery address different from item 11 ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No &04--Drl 3. Service Type KCertified Mail ❑Express Mail d d' //j A ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 0 219,57 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number �-7 05(�,E„a O�� �jg2> () qs— (Transfer from service label) ! PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SE -Fi►�st-Class,Mail- �, stage 8�Fees.Paid �� `t PS Per y — USmit No.G10_ ° Sender: Please pri` yo .n 6 address,.and ZIP+4 r)Oh s box° . A-JV1 Kt #tl:,==,l=lt;#� SENDER: COMPLETE THIS SECTION COMPLETE . . . ■ Complete items 1,2,and 3.Also complete A. Signature I item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X ❑Addressee I so that we Can return the card to you. B.'Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, I or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No I 3. Service Type )!�Certified Mail ❑Express Mail 2-7-7 7 ❑Registered ❑Return Receipt for Merchandise /�� 4. ❑ Insured Mail ❑C.O.D. (/v V J Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (Transfer from service laben3 PS Form 3811,August 2001 Domestic Return Receipt - 102595-02-M-1540 I• UNITED STATES-POSTAL SERVIC O\ w n� cn� t. . a... ertiidTNo:�-10:...• v tuc g �. • Sender: Please pri ycgr , address;and ZIP+4 in this box• -Dwt&L AL er /j 2 T Ij V1 " PtA 09339 }j i s d i i id i i idi i = 4 3 ii _ 1'11!iiddldidd�fi:dd�fid3d�d.l3dfifiddfidlddddififi�d:fialddldd��=.fid?'.I� r—a SENDER: DELIVERY ■ Complete items 1,2,and 3.Also complete A. Sig a item 4 if Restricted Delivery is desired. ❑Agent ■ Print your name and address on the reverse X Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. ni � D. Is deliveryem 1? ❑Yes 1. Article Addressed to: If YES,aow: ❑ No r Glob I V Ook l 3. Service Type Certified Mail ❑Express Mail / ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. p�J 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number /�S0o �73 (Transfer from service label) 3 11 PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 I 1 Town of Barnstable P# 1>10, — ME Tgk�o Department of Regulatory Services • Public Health Division Date �63 BARNSTABLE, v� i� ,0$ 200 Main Street,Hyannis MA 02601 Date Scheduled �'2( Io 3 Time 10 Fee Pd. p Soil Suitability Assessment for Sewage Disposal I/1/' Witnessed By: Performed By:D—A. "�'� i ocation Address 102 C�,wKrvlR1 vt Ct Address L W I ti4 1 Q Engineer's Name. � Assessor's Map/Parcel: •3e t 1p v 0 r7 2 NEW CONSTRUCTION REPAIR Telephone# SVR 36[— Land Use ��e-'sIy C-�I/i2 Slopes 0/0 Surface Stones -� Distances from: Open Water Body �10p ft PossiblejWetArea �� '''� ft Drinking Water Well Drainage Way ft Property Line ?/0 ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) "� i ` 1 Parent material(geologic) / l �t��j Depth to Bedrock N $ 1 f Depth to Groundwater: Standing Water in Hole: �/�" ' Weeping from Pit Face Estimated Seasonal High GroundwaterAN � ,. .'� '.- y. •� � � Method Used: Depth Observed standing in obs.hole: t in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well le{vel Adj.factor Adj.Groundwater LevelEll SUL _ Observation � j 3"S,se- Hole # i. T Time at 9" _ Depth of Perc — Time at 6" �As bu �. Start Pre-soak Time @ i Time(9"-6') End Pre-soak Rate Min./inch � � Site Suitability Assessment: Site Passed. Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back Q:HEALTH/WP/PERCFORM y t v: s� > >,: I. k 4T flab 1 K ! !, u' .. f�.. •,:�."?y''I`" '� Is n u °A v N Y 'f' f i t 'SaFf:iiP b tu ::,... ?@:v'SS.S .u.:G , .,,.:...�!3 �.e Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel �#-3 '' , Il ���— �Jvll Jt�nc� �•� �l .' 1 w ..,. .. SPIN ; S 'M. �•5;,y�'}um.��pI..wLi.,,4.I��,AW,"Yyy rt!.'i A:i�i,u:?IiJ.x,!;.kM,'.!>Ei',',�Y6Ukk'i�':{.'..I:�'.I,f x ,a51;'e6'f�k:.���,A:aim,x:"wl Tv°'1F;5 I:�F1 i:T 1.J„�:4J;�l';;I;C�;i:d:�..;_ni4!ay:a„&".In:'i:`�M JI' .... ..Ir!. ".. „,i'.,..i.. ii t kiy `... ..�^ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel ,.;,' 0 '� t•a�" i}� !!1'A•Ay:.!:�,I'r: x 'x. �1$�� ? i �� �!? •,!i ii!13' awl �1'IM, I rat ira r o.:'i� °F kl tiRe ;, �, .' :r!. �ati� { w.' i'ixl7';n'"y' �Iri!M t'; ku v A y tiRB .< ?_ .. :Nw t,�7w�}i....tM :' Y.n.a;.. Depth from Soil Horizon ? Soil Texture Soil Color , Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel t LL TdA IAt �'! E Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling Structure,Stones,Boulders. Consistent %Gravel Flood Insurance Rate Map: 9� Above 500 year flood boundary No_ Yes. Within 500 year boundary No Y Yes Within 100 year flood boundary No X' Yes DeptWof Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the ' area proposed for the soil absorption system? e-S. If not,what is the depth of naturally occurring pervious.material? Certification. I certify. n (date)I have passed the soil evaluator examination approved by the Department of En ironmental Protection and that the above analysis was performed by me consistent with the require ' in ,expertise and experience described in 310 CMR 15.017. Signature / �. f9y A�A Date Q:HEALTH/WP/PERCFORM No...... .....:... ....... THE COMMONWEALTH OF MASSACHUSETTS n) BOARD HEAL' (� �S ; Appliratinn -fur Uftipnuttl Worko Cnun,itriartiun PPrntit Application is hereby made for a P7rnut to Const ct ( ) or Repair ( ) an Individual Sewage Disposal System at , 2,- - ' -i7c to, ,) — & n.................. -cation-Address or Lot No. e� .... .,�-•- z --- - -------- ------------ ------- _------- -----.... --•-------•------------ ----. .------------------------------------ Owner re s Installer Address QType of Building Size Lot----------------------------Sq. feet U Dwelling No. of Bedrooms______________ ...__......____.______-Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No, of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtur s ______ __________________ Design Flow.................... Mons er erson per day. Total daily flow........._ _.____--_._..gallons. W g - g P P P Y Y g� WSeptic Tank Liquid capacity �s� gallons Length................ Width ___-..�...... Diameter---------------- Depth-__.---_----__. x Disposal Trench—No_____________________ Wid li•_..�:_____ ot 101 t _ Total leaching area--------------------sq. ft. Seepage Pit No.______ ______ Diameter �___®�D``e�pt'i ow m et____.:__.___°__._.__ Total leaching area------------------sq. ft. z Other Distribution box ( ) Dosing tank ( ) a Percolation Test Results Performed bY-------------------------------------------------------------------------- Date.-------------------------------------.. Test Pit No. 1................minutes per inch Depth of "lest Pit-------------------- Depth to ground water...-___.___-__-__.__..-. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ -- ----------------------------- .............. -------------- Description of Soil------------------------------••---••------ - ! � -- ----_ -------- --------- - ..r� W ----------------------------------------------------------------------------- � � - U Nature of Repairs or Alterations—Answer when applicable._._________ ��r_ __-_ -.. _.. ----------------------------------------------------------------------------------------------------------------------------------------------------------------- _ ------- .... - Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee 's e the card f 'e h. Signed- - ------------------------------------ _ Date Application Approved By...-----T� --- . - - --- -- ••---• - ate Application Disapproved for the following reasons---------------------------------------- --------------------- ------- -------- -------------------------------------------------------------------------------------•-----------------------------------------------------------------------•------------------------------------------ / Date PermitNo......................................................... Issued....... _�_ 1- --............ Date� No.•••-1.../. Fiz ...................... THE COMMONWEALTH OF MASSACHUSETTS BOa4RD �HEALT �1 .. ------ .OF...... App iration -for Uiopoottl Marko Towitrurtion Vrxutit Application is hereby made for a P mit to Cons uct ( ) or Repair ( ) an Individual Sewage Disposal System.a • 0 ocation_Address or Lot No. ... Owner 2e__"UZ W . 1 Installer Ads Type of Build in / �/ Size Lot____________________________Sq. feet ., Dwelling No.'of Bedrooms -----------------------E�pansion Attic ( ) Garbage Grinder ( ) aq Other—Type of Building ____________________ No. �ofr'�pe sons ____________-__ Showers ( ) Cafeteria ( ) P`' Other fixtur s 1 d -- -------- - -_-- ------------------- .. W Design Flow ________________ gallons per person per day. Total daily flow............................................____---.-....gallons. r4 Septic Tank-Liquid capacitygallons Length-------------- Width _.... ------- Diameter-..------------- Depth_-_____-_-... x Disposal Trench=No. .................... Wi _1 ________.__ 0 1 t - Total leaching area--------------------sq. ft. --- Seepage Pit No-,____ _______ Diameter G De th ow in et__ ______-__. Total leachin area_____--__________sc it. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results " Performed by-------------------------------------------------------------------------- Date----------------------------------- Test Pit No. 1................ininutes per inch Depth of Test Pit.................... Depth to ground water________-__- __-_-____. (1 Test Pit No. 2....._..........minutes per inch Depth -of Test Pit-------------------- Depth to ground water................:___-__. P; `" • --- ----- DDescription of Soil---------,.......:.,..,... •-••--•-------- t� . ----~ ------------------------------ ----------- - - -------- ' "� - ------ - ---- V Nature of Repa rS,-or''Afiterations—Answer when apphcabl ._-____ ---- ___r ••-------------- -- ----- -- --- ---- -----••---•-----•- •-----------•-------- -------- ---- V Agreement: ,.. The undersigned agrees to install the,.aforedescribed Individual,Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be is e the oar f e h. I . . Signed •• --•----------•-----•--- - -a-t- e- - at Application Approved BY-....._ _____________Application Disapproved for he following reasons______________________ == = = ---------------------------------------------------------------------------------------------=----'-----"_--------------=----------------------------------- = '----------------------------------- ?1F Date Permit No------------------ ------------------•--------------• Issued - '+ .............. Date 1.. THE COMMONWEALTH OF MASSACHUSETTS f` BOARD OF EALTH • OF 4 �rrtif irtttr of 61 mpiiaurr THIS110TO Rl, , Th the I tvi Sew ge Disposal System constructed ( ) or Repaired Y `­6 at j�-�- ( � --_ � • „ has been installed in accordance with the pr isi s of Article I o r e.,.State Sanitary d s descri ed in the application for Disposal Works Construction Pe mit No________________......"... 1(AV....... dated_ - A_: 3 ��_..__ TIHE ISSUANCE OF THIS (CERTIFICATE;-`SHALL NOT BE CONST EQ bS A A ,'i E THAT THE SYSTEM. W NCT1 N SATISFACTORY. t DATE-�- -•- �-�-- .....ZsX.................................. Inspector___ _ --- -- -- -- `- .... THE COMMONWEALTH OF MASSACFJUSE+T_TS F l BOARD O -HEALT.H , 1 r" itr .. ... i7... .........OF.-:. .... ?. . .. •-- -•--- No { FEE;%................. Binvo 1 grkii an rur ' at rrmif Permission is hereby.,granted._ " x_-_- -- _ ......... " -----._ ___ ___ ___......................... � . to Constr ( e air ) apt Individ S e Di- Sa] ,system f at i Street _ .•' as shown on the application for Disposal Irks Construction e t No____ __ __ _____ ted_ -:_ DATE-- -- ,'�:.�".±. ---�;,� ------ --------------------- _ f a to - •• - Board o He • FORM 1255 HOBBS .& WARRIkN. INC.::- PUBLISHERS I �' No.--�- �QyOQTNETO�yO OFFICE OF THE BOARD OF HEALTH 6 OF THE S BAaBSTABLF, o TOWN OF BARNSTABLE, MASS. MASS. 9ppA 1639. lf0 MAY�- ----- -� ----------------- 19 _ SEWAGE DISPOSAL PERMIT Permission is granted to ---1---- =---Alt�`- to construct��.—�—��- -- - --- Upon the Premises of Sketch Ma In the village of -------------- ---------- - - - - 100 or more feet fro any source of water supply �C� �, o (9n 20 feet from building 1 10 feet from property line 'k IT -_ --- v e th Officer.. T" WL O z w U 20'[Tx pgj�Fo (FXI9TING) - i!- (EXISTING) 0 Nadz� tu�Wyip - z"J' N 0�K� s w °000�w ~ W W W V p W F-R1Q I-U TO REMAIRNAILINGS - - i1 O (� EXIST. z W DECK, O oa EXIST. Q o ANDERSEN ANDEI25 N ANDEPSEN DECK [� FWG 1206&4 RVG 12�68-4 MVG 1206&4 F— —� •�� �" -� HUTCH 1.1' O Q� T. LL REMODELED fi Q N A N rTl BEDROOM i q„ c D 5U'ILt-N NEW DINING ROOM � E� EXPANDEDI =1 N� ® LIVING ROOM ABovE(SIZEOBIOTHERs) EXIST. sr o —GLQ. p r I I 11 1 1 1 I l i NEw I I I H I ® EXISTING ®__=__� �________ , r. 15I --u I i i — § it COUNTP,11 I N r Q DRESSING Nx HE �� — �y KITCHEN Il MAGI D AREA _ ————— LAMMeitMff cg OWN 9'-8' r aL; —IT—— CAgCDKEYSOTONEI jG LAVOIIT w!d�A'NI BATIi— T-4* ::j. II ® o. rli �1rr.t�, ABOVE(51ZED VY OTHERS) q q BOOK BOOK BOOK _.�1 �LI�OP S.P.ABOVEI- _ N �g "mvm WASH I I '- _ ( rpYy-1 { NEW y NEW ReF I ►®' 41 B /1 yr I I FOYER 5'-T T-6' 4'-I 1• NEW e. --'LlI: v�-.._J I I(OPEN ABOVE) ♦I c LAUN RY r STa `Y I I ROOM F—+ OW < 'C'■ 'C 1��1 O L ' NEW c �••( PORCH q_I•x I E 4'-!' O 4' 7`2•x ---i-r' --- 12'dY V ( T-2'x ^ C ! DRION) A cn cn 23'-B•x 18'-(Yx __J• 26'-4'x 20-0'x (F.'Try (EXISTING) (EXISTING) 1 (EXISTING) (EXISTING) SCALE WINDOW 5CH EDU LE FI R5T FLOOR. PLAN GENERAL NOTES: 11_OII 1.)CONTRACTOR 15 TO VERIFY EXISTING/NEW CONDITIONS AND CJ DIMENSIONS IN THE FIELD PRIOR TO THE START OF WORK TYPE MANUFACTURERS UNIT ROUGH OPENING REMARKS EXIST.FIRST FLOOR vj = 2356±S.F. 2,) CONTRACTOR TO REMOVE EXISTING DOORS,WINDOWS, DATE A ANDERSEN TW 24310 2'-6 118•x 4'-O 7/8' DOUBLEHUNG EXIST.SECOND FLOOR = 1132±S.F. WALLS,4 ROOFING AS REQUIRED FOR NEW CONSTRUCTION. B TW 2432 2'-G 118"x 3'-4 7/8' DOUBLEHUNG EXIST.BASEMENT LEVEL = 1474±S.F. 3•) ALL NEW CONSTRUCTION TO MATCH EXISTING IN MATERIAL, 1 2/29/20 I 1 C TW 2442 2'-6 I/8"x 4'4 7/8• DOUBLEHUNG LEGEND DETAIL,AND FINISH.(UNLE55 NOTED OTHERWISE) . 4.) ALL WORK SHALL CONFORM TO THE MASSACHUSETTS D TW 24310-2 5'-01±x 41-0 7/8" DOUBLEHUNG O EXISTING WALL CONSTRU "ION TO REMAIN STATE BUILDING CODE(LATEST EDITION)AND ALL OTHER P ROJ. NO. E TW 2432-3 7'-G'±x 3'-4 7/8" DOUBLEHUNG WINDOWS MULLED ® NEW WALL ON5TRUCTIC+i APPLICABLE LOCAL CODES F CN 335 5'-1 1/2'X 3'-5 3/8' CASEMENT C EXISTING WALL CON5TRUC:(ION TO BE REMOVED 5.)ANY DISCREPANCIES,ERRORS AND/OR OMISSIONS IN THE NOTES, 201 I -rJ 4 I O NOTE#I:CONTRACTOR TO VERIFY ALL QUANTITIES AND SIZES OF WINDOWS WITH OWNER AND ® NEW SMOKfJC.AR80N MONOXIDE DETECTOR SHALL BE BROUGHTT TO DRAWINGS HE ATTENTION OF THE DE51GNEP MOP TO S ROUGH OPENINGS WITH WINDOW MANUR.ACTUREK PRIOR TO ORDERING OF WINDOW5 O 5 1 O I 15 20 CON STITUTES ACC�F CONSANCE OF THOSE DOCUMENTS AND ANY ING WITH CONSTRUCTION DWG. NO. :. NOTE#2:CONTRACTOR TO VERIFY ALL EXISTING WINDOW ROUGH OPENING SIZES IN THE FIELD DISCREPANCIES,ERRORS AND/OR OMISSIONS BECOME THE PRIOR TO ORDERING OF WINDOWS ( RESPONSIBILTY OF THE BUILDING CONTRACTOR. 0"COPYRIGHT 201 ! ' BY THOMAS A. MOORE DESIGN CO. Al w S o CHIMNEY TO REMAIN o[p w c J FACNEW ING STONE ) - 09 N d z p N Q w¢ OS M SHINGLE CAP W w w w p w O L L L ua Z L u STIG BRICK - z r r r m¢r U CHIMNEY TO REMAIN yq FACING,STONE O u NEW ASPHALT NEW ASPHALT NV IXSAT NG ~ ROOF SHINGLES ROOF SHINGLES 00 12 NEW ASPHALT 0 _ • �12 ROOF SMINGLES O�- 00 Fi-d 1� O W � EXI5TING FA5CAZ D5. SECOND BE REPAIRED 9U OR. O :. TOP OF PLATE - 0 Hill- Ta5TIG CORN ® ® ® � ® ® - Q (� ro BE Rtra �0 Q' FFH [y� N NEW WHITE DING [J] O 51:tTO SIDINGTH f s•_roweamER 4W WM III Jill S�.OLOOR W O O ell yal Q FRONT ELEVATION z47- (EX15TING) (EX15TING) H B E H E Z I� O NOTE: F phi EXIST. rGRI55 MNVO VERIFY S EGRESS WINDOW EXIST. BUILDING wr BATH, BUILDING INSPECTOR EX(ST. DREARE55IN6 ® e BEDROOM MOWER r. EXIST. BEDROOM (� {-•--a G c oast. EXIST. EXIST. O O ATTIC I HALL i Fiz �Er EXIST. KITCHEN�.-————1 BATH O BELOW N r ►[ O 2 e• ` N ��LCONY --- — ——— ,-- -- —————— --MMo—DD—EE— - iv § STORAGE I — OPEN 5TORAGFD C N cn —�� TO FOYER,R . J c N it It -1 4-- L------- SCALE . 1/81I= 11_0 II �� i=I DATE ---I� 1 2/29/201 1 PKOJ. NO. 201 1 -5410 231-&± ,B�-D• 26'-41x 2Q�= DWG. N O. (EX15TING) =115TING) (FJ09TING) (EXISTING) SECOND FLOOR PLAN 0 5 10 15 20 Q COPYRIGHT 201 1 NEW 5MOKE/CARBON MONOXIDE DETECTOR MEN BY THOMA5 A. MOORS DE51GN CO. A2 �r z:U. :rl 3 F- 2D-as: N IL Z O Fis) O (EWTING) - (D45TING) OIm w w w w O w In $' M co Z W E-- r� Li u u u ILI u . w O D(I5T. E)(15T. Q go PATIO' PATIO a W ._ • srEr sTEF Q N F r""vicD I �Sbe a [77- NOW wer.Alt (/�EXIST.•PATIOiEX15T. L E-� a. cc BEDROOM ---------------- +F- 003TING O.H.DOORS TO -. T.BEAMSBE REMOVED AND REPLACEDAND P05T9 TO REMAMNEW DOORSEX15T.EX15T. FAMILY 0-1 cy P T.GARAGE ® I AITH. p FIE ----- ------ ----- --- --- FL I I EXIafX-5• ALLue b - _ EXIST. ® o Tu x HALL ®R� WALL EX15T.To AIN m STORAGE41 - WnuT =DRILL.PIN NEWFOtAiDAnON' a ?O E'XIsT.FOUNDATION llOP4BOTTOM(Nrww'LLbkl d•_ _ G.F90TINGclq MSCQALE7 2•1 12'-O• 7-2•a 1/8°= I I-0(ADDRION) _2(y-at DATE (DGSnNG) (DpsnNG) -, - RV5TING) _ (DU5nNG) 12/29/201 1 BASEMENT FLOOK PLAN PRO-1. NO. o 5 !O 15 20 201 1 -5410 DWG. NO. . SM01WCAR9ON MONOXIDE DETECTORS . NEW.HEAT DETECTOR QCOPYRIGHT 201 I BY THOMA5 A. MOORE DESIGN CO. 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N ASSESSORS MAP: TEST H C L E LOGS 5��� h PARCEL: U7% NOTES: FLOOD ZONE:C 01). SOIL EVALUATOR: D.I McTa R��'S� 1. VERTICAL DATUM: A5SVPW-Q M �p WITNESS: �AM WHITE . gAD. REFERENCE: $v.-• 'L3S 2. MUNICIPAL WATER AVAILABLE. --� � DATE: MA 21,ZUo3 p�• Qj Qj Li 3, SCHEDULE 40 PVC PIPE TO BE USED THROUGHOUT SYSTEM UNLESS o��-�wkK Q o Cj_ Cl- Q- PERCOLATION RATE: 2 INcN OTHERWISE NOTED. � Cl-,FSS 2 Soll, = (,n4-/2; 0,7�( 9P��Y 4. ALL PRECAST UNITS T❑ CONF❑RM WITH AASHTO: I"�� HZO RI ('n Cy) �' TH-1 'O/,0/ TH-2 5. PIPE PITCH - 1/4' PER FOOT UNLESS OTHERWISE NOTED 6. ALL CONSTRUCTION DETAILS TO BE IN CONFORMANCE WITH MA, ENVIRONMENTAL LOCATION MAP[wT'S 0q � Z„ w 9g 3y CODE (TITLE V) AND LOCAL REGULATIONS. VAV 3 A S � 7. CONTRACTOR TO VERIFY LOCATI❑NS OF ALL UTILITIES PRI❑R TO CONSTRUCTI❑N. , LOAM 10 , EKISTiNC LeN{k NC1 7b 13E �VM�Et� C2USlft��. 1-ILi.Ef� P6)e- I1TZ-E 1//�EMfrJ J� PEe- 310 CM�R1S.qos I(b) via-�A�Ncx �� 3 n� 10 CM�15.211 - � rl Cl- 41 �7.55 A ) --�- --r- s q- No "ownl PR4uA-Tr=: wirr.L..S W/rn ISU' v F tEPrGt1-rn14. -to k'LLo1Q LC-AaWp Tb 13E ID r-gbJ1 k CIjLLA-9 hJ AL VS- S" �, � jy to IN5-r.4L�_ L omi Poi4e*ye�cBa�el� l�Sstivwr✓ o t'tzt�l�+T' INFlLTR�iIo►�l .._.. -- -- '-`A%jI� l• LvA-w 11. wwvg, ML_ U0SVlT4PJ(,9 SOIL S' A-"UND 1,� fiIhl TO EL, gS•9jq AJD 9-4r=P ACF_ � �1ZE uLA�'cf�Ns \ C SR D 2.Sy Y 4fL,6AtQ M Cr-piv•M sPraD. ��'1 1�. klf-r• ep-,Se a-yic,E TC) BE 9.E-u0u�Teo. N1gIN i�9�a ►O� F�Mb E. GE LEA-C4-/n1 -iv r3�. �f�r r=1r..v� wt�o '', ` ) � 100 ; Na G") o�Ss ) 131 Sc��Ins L1Nt_ ro r3E �EE�It --�1 !o �ErT S o T- WArCk _ S&LU c.E. VS. (IqvrR��O SEPTIC SYSTEM DESIGN 1'� ��M� CA4M?,eiL-7o Be H20 Lvgioo, _— FLOW ESTIMATE BEDROOMS AT 110 GAL/DAY/BEDROOM = U GAL/DAY SEPTIC TANK rode' w g,y S Lots 59,667os F IF T7v GAL/DAY x 2 DAYS = gg� � f'�L � ,rs 1s51 AC. GAL 2 d+q u � 64a9 y�l� USE GALLON SEPTIC TANK-Ele'STiN4�9EPLA<.6 W/ 7o RLA� ` '� ,. ?59.63 /S.vv G'ilz. S.T' ►+= 1�i1-rlc� owF�' 3.7o SOIL ABS❑RPTION SYSTEM � undvs�2eo ' _ (an \ flu f '�C!rx� "a�rd /z 6' Chy9 S60 g44,LO/J PRC-64 S7 L_ 4Ct1! M&t/,Z o � � N �s• i)PUMP GSA#46E2 To 13L FAGTO�Z VJATEj2_PRCOF6fl 6 Sp A- vJ w/14 L.. S i,��s. �3 5'` xl3 wx z 7Nvr�-s�A� ar_ee?vg,.--,- q•� 6426 / 2)ALA"5 TO 13E AunlWLJ'5URL> 01� �6> - �9 �s E�►E b SIDE AREA. (_33.5�2t63)?]x 2 k o,l� l 37 �vq A5PPkn"9 u&wir FeuM PUMP db 3) P u M P TO be: ZOE.u.Fst."214 QvAL dk0:•� "�— 1-/►nI, — BOTTOM AREA: 33.Sx 13 X O, 32z,27. /4. 5 v s E �(kRJki McRGv 4 I,EUF.��vnme�t.S -ramass, - E Eov V51, l � P� � TLRErSE L _�PrTE4� I� /!� ®89.43 /" —� - SEPTIC SYSTEM SECTI❑N '4 yPD /-<?_/ x 90.10 Ir plant x 9LO J. x ,N11 S,�T b 4T'y ..ii .:.. �` dt,�F4::: 'X9943. L! l;L.l 1 9r37 1 _ _ ` rT d-6�X I �_ K.................... .. -y�.... 7! �0�1N�F M 07B NA r , Dud boX n � r . DA N �, 7� .._ ELEV 6'St �,, ELEV D-BOX �S. 3/y -I Dcvl.le n �>' 9 �� 10D �� ,"MFiYER GAL 17 �k -kd ELEV Washed s7are- J No. 1140 SEPTIC TANK EL Itvtl�ess, Z.Si x 5.32 c�.$ 10�03 �c 9020 � ��G I S T EO LX/S�/✓ �f-��1 r 3 InJ • /V x SJMTAR\PN G3 _ �OTIU�I OF JCSTiyoLE ; �.= l�• OF QP p tN OFM�, TERRY SITE AND SEWAGE PLAN Benchmark set 1 - M� gQ,c 0 WARNER ANNY � �y No.38721 WARNER Pk nail set � '��, 1 38721 No. � Ei.=100.00 5 REtiw✓At, 7o t L . 9S Sy L❑C A T I.❑N: 3 2 W/N y FooT Pz/ 141E (Assumed) WRF1 � i 9��6�• j4 3 0- Toe o S�.R�JIGE �ozm � iota S �� PREPARED FOR: �,0P_>6YZr WIL56ON) sL Esau 4O M l Scale: 1�'=30' ��� K PfQOM &1..98 7� Qo;- or Fivo. SI I sol�-INli7Ei2 E/T, a SCALE: 0' 30' 60' 90, Li NE' DARREN MEYER, R.S. GTR,IL �j 43 VINE ST, DATE. �dP w7uncs Ta B9 DATE HEALTH AGENT DUXBURY_ MA 02332 re'v. �u y Z<,2�3 (508)362 2922 i ASSESSORS W1 TEST C L E LOGS S h PARCEL, D7� � E S NOTES: p� SOIL EVALUATOR: D. Mew, R.S. Op- FLOOD ZONE:C, d. 0� � ��0 1. VERTICAL DATUMS A55uNt� Cr) `p WITNESS. CAM WRITE - g� 'I3p• F HEw,4 J ` . REFERENCE.' 51�-- 'L35 DATES MA 21�Zoo3 2. MUNICIPAL WATER I� AVAILABLE. Qj � � - 3. SCHEDULE 40 PVC PIPE TO BE USED THROUGHOUT SYSTEM UNLESS opts-W K DR. o Cl- 4, PERCOLATION RATEi 4,ZV �N�N ❑THERWISE NOTED. i' C0515 2 SOIL, = Pd tf6-A. 0,7y9 ��y 4, ALL PRECAST UNITS TO CONFORM WITH AASHT❑: 14 LHZOoo - T M ,M TH-1 '0/.01 TH-2 5. PIPE PITCH - 1/4' PER FOOT UNLESS ❑THERWISE NOTED, 6. ALL C❑NSTRUCTI❑N DETAILS TO BE IN CONFORMANCE WITH MA, ENVIRONMENTAL �I.1-S ,C „ CODE (TITLE V) AND LOCAL REGULATI❑NS. LOCATINN MAP( ) � Aq � 3Z 9B.3y U A Sow 7. CONTRACTOR TO VERIFY LOCATIONS OF ALL UTILITIES PRI❑R TO C❑NSTRUCTION. \J �AkT �1 J Logs 0 ' ,I EXrStYN I EhtHIN f� 3.E ►�VM►°E� CRUS/tt� F/Lr.Et� P 1 r7ZE �/ Ur�ME . M�1S. as' I b VAR.}ANcx >=ieoM 31U C -iS-Ztl �l k 41 �7.55 �) 4__._._._.� t----, PEA. 3 0 c � ), � lvAmoy Ioy�s/, q. NO Iwow►J PR4 Un-Tr- w>rus w/►>1 iSv' oF tE,+6trrN4. "Cp pcl.l,ouJ I,CRuktNcj Tb T3e IaI fi-R>rrJA, C G iLA-12-hJ4l. VS- 62r SAID �5•�y Io• (N5-r.4 - Y0mI Pe-6J"t U 01 D Zo LVA`l/ II� �MwE PL,%- U05y1r►-P,,I,f Soles 5' A-"U►NA L�AC.I+INC��O-EC,, gS_�4 AND RC-Pc.&E SRtJD 2.Sy / c �15.3� SrWeLg (3D.o� K` 4ul.�"IDNs ti C Y (L4-- J M�.gry sl�a . . ._.. . ---..---- nl '�' ,g�� Tv f�E, �$I Fr.�1� Wt�,.�-►�0 1ti1o+•r>;r-Spa-Vr� To � �.E-t,oc.rt-�0. (nn�lN�►-ra lo.._.Fw.�M��..0_F !-E��++-r,�4� PU-tAPC H-A� 131 sot,tbs LINE To 13e- st-ezvE1.� o.+v to' Er Sl�E, 67- WArCk- SE .4 _..._ SEPTIC SYSTEM DESIGN l )��mp C#4mwL-7o Be- H2O FLOW ESTIMATE BEDROOMS AT t10 GAL/DAY/BEDROOM = U GAL/DAY J SEPTIC TANK I,Soc)� �0MP CHA14mk n9IL- Lots 166 3 169L �! i ir19 5 58.6703 S.F �.. GAL/DAY x 2 DAYS SgU I Z,�Cw a 1.35* AC GAL ~�•ya USE I GALLON SEPTIC TANK-eZ1STrN4�IZE�c.�CbW� 7 a9 ,�1yS.9o3 e.aii /Svu 6*1 t. 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C. 87 07 f3AFFU r �� , d =1�O r : �-r 1 ���w ,� o� DAp N •- ELEV 6 Stw< q8�° 3/y''_I '' Povble n ELEV D-BOX 9a as \ti ° 14MffYER 0 /00 GAL 8,i7 �k'�tsl ELEV blushed S'tane ' s �No. 114O � Q SEPTIC TANK EV \ EL k�tl+�ss f.�12.s% x 13 W S'32 > -4 GISTS�r, _ S $arlu�r csF C-STiyU&E ; c4. NrrAa v� J: AIV x TARRY ANN cti SITE AND SEWAGE PLAN WARNER ANNCA TERRY Goa Benchmark set , .. No.38721 $ WARNER `� # Pk nod set Sy No.38721 I El.=100.00 . ' 5 RE A.0V*t, T O -L . 9 L 0 C A T I.0 N. 3 2 T(it��NC� e o D/Z (Assumed) SrrR�l ioe roam i h _ /y/l�/�3 1�rj �l PREPARED FOR: P�aYLT L,�tiJDA' 1/1/�LSO/J P R 7L 6 s�E sou� :. �m l «.y��y���. Scale- 1"=30' r-)WM &L,78 7-0 Qor 0/� FivD. 51.9 o r-vdi4Mi2. crr, SCALE: � ' 30 0' 30' 60' 90, U DARREN MEYER, R.S. DATE: ddP 3�Z E.Lfl�.fRIL 4� 43 VINE ST. DUXBURY, MA 02332 orb y 21,2003 07u-nas -1a BE M".Q DATE HEALTH AGENT (508)362-2922