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BP-11388-99Lot 8-2 c +� n/f Kenneth W. g Anne Allen is'� BAKERVILLE ROAD n�f A�'• R- ohn George, Jr. 8= a S^ q q ILL vopy RE- P. copy G1 I II's Endorsed Plan Must Dv rept On Site DurmQy4yW Late rt 1y i r wk��7as:t ram _.. . � T { �' d- � t '= Y ..� " � �` P � � �� .1 � .� , r � � x r �fr ,� ' , k; �.. � ,� L � i., . � '"Y � . �^ iW i�i el. ��T R'k��s�9�}�#i�s��' �r� �:Y��'i �C��TiS '' S 4 `F d s .. +,' ., �?.r .�' ... _t,' Y _ .¢. � _P.. �=r. '�.. Asp?: k�,€. �... �..a. .�� M..... r xin jy. f r MI a ram; 1 1 � M R, x � . y xr YO F ` � l� i R x 3y j d7 nowN mom�t s1 F l F 'C S 1 Yf 14 K FINISHED GARAGE FLOOR 70.8 FINISHED FIRST FLOOR 79.9- TOP OF FOUNDATION ' 78.8. FINISHED BASEMENT FLOOR 70.8 INVERT AT FOUNDATION 75.81 INVERT INTO SEPTIC TANK 75.59 INVERT OUT OF SEPTIC TANK 75.34 INVERT INTO D-BOX 74.86 INVERT OUT OF D-BOX . 74.64 INVERT AT INLET OF FIELD 74.59 INVERT AT END OF FIELD 74.4 ELEVATION OF SOT. OF SYSTEN 73.9 ELEVATION OF G.W.T. A 69.9 LOT 8-2 Test Pit #101 (perc depth 110" 16 min/inch) - 13" Ap, SANDY LOAM, IOYR 4/3 FRIABLE 3 - 38" Bw, SANDY LOAM, IOYR 5/6 FRIABLE 16 106" CI, SANDY LOAM, 2.5Y 7/3, FINE, FIRM, COBBLES 06"-154" C2, SANDY LOAM, 2.5Y 7/4. FIRM, COBBLES Test Pit #102 (perc depth 69" 7 min/inch) „ I I" Ap, SANDY LOAM, IOYR 4/3 FRIABLE I - 38' Bw, SANDY LOAM, IOYR 5/6 FRIABLE S" - 71" Cl, SANDY LOAM, 2.5Y 7/3 FINE, FIRM, COBBLES T' -130" C2, SANDY LOAM, 2.5Y 7/4. FIRM, COBBLES MOTTLING: TP 101 AT 47 TP 102 AT 48" 7.5Y 5/8 SEEPAGE: NONE 'ERFORMED BY: LEN POTTER R.S. ON 9-3-97 WTNESSED BY: CHRIS MICHAUD PERCENTAGE OF LOT COVERAGE =11.6% UP -0- 29/63 :.I FINISHED G 75.59 SEPTIC TANK 77.6 .� / - 12"t � 74.64 Le 49' S= 0.01 D-BO -8- '.� 75.34 = A n 74.66 L_ 4" SCH 40 PVC SOLID PIPE-� OR APPROVED EQUAL SYSTEM PROFILE NOT TO SCALE LOT 8-1 . Test Pit IOISE 0 - 10" Ap, SANDY LOAM, IOYR 3/4. FRIABLE 10" - 26" Bw, SANDY LOAM, IOYR 6/8. FRIABLE 28" - 58" B2, SILT LOAM, IOYR 7/8, FIRM 58" - 94" Cl. SANDY LOAM, 2.5Y 6/4, FIRM W/COBBLES 94" -140" C2. SANDY LOAM, 2.5Y 7/3. FIRM W/COBBLES Test Pit # 102 SE 0 - 10" Ap, SANDY LOAM, IOYR 4/3. FRIABLE 10 - 30" Bw, SANDY LOAM, IOYR 6/8. FRIABLE 30 - 65" Cl. SANDY LOAM. 2.5Y 7/3. FIRM W/COBBLES 85 - 129" C2, SANDY LOAM, 2.5Y 7/4, FIRM W/COBBLES MOTTLING: TP IOISE AT 45", TP 1025E AT 50" 7.5YR 5/8 PERFORMED BY: LEN POTTER R.S. ON 9-3-97 WITNESSED BY: CHRIS MICHAUD / Tcp TP JO2 -�- [' PERF. PVC 74.59 4' ALTERNATIVE POLYETHYLENE UNITS MAY BE USED. OVCRALL FIELD SIZE RCMAINS THE SAME. LOT 8-1 Test Pit #101 (perc depth 96",7 min/inch) 0 -10" LOAM 10" - 34" SUBSOIL 34" - 96" FINE SAND, SOME SILT, STONES 96" - 150" MED-COARSE SAND, SOME SILT, STONES WATER AT 144" Test Pit #102 (perc depth 104 14 min/inch) 0-10"LOAM 10" - 24" SUBSOIL 24" 62" FINE SAND, SOME SILT, STONES 62" -154" MED-COARSE SAND, SOME SILT, STONES WATER AT 144" PERFORMED BY: RS. FENNESSY ON 6-25-91 WITNESSED BY: SUSAN GRIFFIN 'S 63 �� • 64 -- - 65 LOT 8-2 loo' 43,560 s.f. LOT 8-1 43,560 s f. 74.4 �..-IZ"GLEAN I„ �» '•.i 1'�ib .i�'�•'�'�i �+•:i•`:+►+a►.i!`s~�� q 8 -2 76.5 :?' 1. The sanitary sewage disposal system :shown hereon shall be CONSTRUCTED IN bVASHEn STONE---PEASTONE IIAV _ i :: 3 ' t 12" MIN6- r-o" M ACCORDANCE with the requirements of 1995 310 CAlft 15 (TITLE NJ of the State DOUBLE Environmental Code and local Board of Health regulations. Any MODIFICATION 'r - . s•�, L74,9 '� 1met 0 �4 lot TO --STAINLESS TO THIS DESIGN must be approved in writing by the engineer and the local Board MIN CLAMPS t' 6:_4" of Health prior to implementation. EL 74.4 4'-6" �;a T� 4'-3" STAINLESS 1 t '.:• 10'-0" GAS BAFFLE 2. Contractor shall verify and check the BENCHMARK as shown on this plan prior to END x • '' OR EQUIVALENT construction of the proposed system. CAP 1 Q x • °:; EL73.9 EXIST. ORD. 73.0 3. Notify the local Board of Health when the system is ready for INSPECTION, prior to ISAND Ov RDIG i �- II = 1 10'-6' 11 I, I1 E I - any backfilling. If CONFIRMATION OF CONSTRUCTION is required by an 4' 1 engineer, notify this office 3 days prior to any'backfilling. 8.3' V MAX( GROUNDWATER 'EL69.9 96" PRECAST 1500 GAL, SEPTIC TANK 4. DEEP TEST HOLE INFORMATION indicates soil condition, percolation rate, and EL65.0 water table elevation at the time and location of actual testing and should be verified -- at the time of construction. The contractor shall notify the local Board of Health if. 100' BUFFER LINE 130' 68 SEE NOTE # 12 EXCAVATE ALL UNSUITABLE MATERIAL WITHIN 5' HORIZONTALLY OF THE LEACHING AREA ca FROM THE PEA STONE COVER DOWN TO h EL. 65.0 (100" t BELOW EXIST. GRADE) N EXCAVATION MAY BE REQUIRED TO EXTEND DEEPER IF UNIFORM SUITABLE MATERIAL IS NOT ENCOUNTERED AT EL. 65.0 APPROXIMATE LOCATION O-EXISTING S,A,S, BAKERVILLE W- WGI SUP 29/62 HYD?'?- NN' SITE PLAID SCALE: I" = 30' W -t- - -1 - 69 DECK I s' 70 - 2' �. 6g• te' PROPOSED ISE , 3 BDRM. - 101 f DWELLING --- 71 _ 4' 1 r - 2 s 'a( 77.6 �. 72 T ~ PROP. 02SE 1500 GAL Fne TANK N TP 1201SE \ 73 RESERVE 167.13' - 74 U 11P 29/61 BENCHMARK: -O- P 29/60 -C�- NAIL SET IN 20' TREE ELEV.= 76.53 N.G.V.D. GROUT U WATER or PERCHED WATER is encountered at a higher elevation than w . indicated on this design plan. BASIS OF SANITARY DESIGN 5. TOP OF FOUNDATION, BASEMENT and FIRST FLOOR elevations may be raised BUILDING USAGE: 3 BDRM. DWELLING but NOT LOWERED withoutthe consent of the engineer: SIZE OF TANK: 1500 GAL, 6. Unless specified in the Basis of Sanitary Design, this system is NOT designed for the FROM GARBAGE GRINDER: NO use of a garbage grinder or other high water usage devices. SEPTIC TANK CLOTHES WASHER: YES ESTIMATED SEWAGE FLOW: 330 GAL/DAY 7. Where the building selVer pipe exits the foundation ABOVE the basement floor, an- LOT 8-2:TP 10114 MIN/INCH, TP 102 7 MIN/INCH,TP201SEp=22 min/inch PERCOLATION RATE: effluent or grinder pump conforming to 310 CAIR 15.229 may used to discharge A LOT 8-1: TP 10116 MIN/INCH, TP 102 7 MIN/INCH7P202SEp-22 min/inch VOLUME OF LESS THAN 25% OF THE DESIGN FLOW from any basement I DESIGN PERC. RATE: 25 MIN/INCH, CLASS II facilities to the septic tank. I 3 SETS OF 6 CONTACTOR 75 UNITS W/4" PERF. PIPE LEACHING AREA: 8. - If any components of the proposed system are specified as HEAVY DUTY, those I I 8 END CAPS 16.5 WIDTH X 52 LENGTH= 858 S.F. components shall conform to all state & local requirements for ASSHTO H-20 loading. t I 9. The SEPTIC TANK shall be 1500 gallons minimum, unless otherwise specified on this SYSTEM CAPACITY: design plan, and Fitted with PVC schedule 40 INLET.TEE and OUTLET TEE WITH I 4 - 2 CLEAN WASHED STONE 858 S.F. X 0.40 GAL/SF/DAY= 343 GAL/DAY GAS BAFFLE of proper length. Septic tank construction shall conform to 310 LAIR 15.226. The SEPTIC TANK OUTLET COVER is to built up to within 6" of the I W/PEA STONE COVER finished grade unless otherwise specified on this design plan. I I DEEP TEST PIT INFO` ATI ON 10. SEPTIC TANK and DLSTRIBUTION BOX shall be placed On a 6" `minimum I compacted GRAVEL BASE to prevent heaving or settling. ALL JOINTS AIUST BE PVC END CAP PERFORMED BY: KEVIN SILVA WATERTIGHT, sealed with asphalt cement or other cement suitable for that specific WITNESSED BY: SUE GRIFFIN 8 CHRIS MICHAUD (TP IOISE 8 102SE) component. 1.5' 6' 6' 1.5' DATE: 4-7-98, •9-3-98 8 9-4-98 11. SOIL PREPARATION PROCEDURE FOR TH E LEACHING FACILITY AREA shall I conform to 310 CMR 15.246 & 15.247. Test Pit #200SE (EL. 73.0) 16.5' 12. An EXCAVATION OF UNSUITABLE MATERIAL designated on the tan shall' 0 - 12' Ap, SANDY LOAM, 5YR 3/2, FRIABLE Y � p 12" - 31" Bw, SANDY LOAM, IOYR 5/8, FRIABLE conform to Construction in Fill requirements as outlined'in 310 CNTR 15.255 LEACHING 31" - 75" Cl. SANDY LOAM, IOYR 5/3, FIRM, STONES, COBBLES, BOULDERS, l3. No HEAVY EQUIPMENT shall be run over -the. components or the prepared leaching AREA DETAIL POCKETS OF SILT LOAM (IOYR 6/2) W/VARIEGATED MOTTLING area during installation. RUBBER TIRE MACHINERY are not to be driven over the NOT rO SCALE 75" - 132" C2, SANDY LOAM/LOAMY SAND STRATIFIED prepared natural soil base or sand/stone bed during system installation. STONES 8 COBBLES W/POCKETS OF SAND 14. For proper performance, the septic tank should be INSPECTED annually and when SEEPAGE AT 48"(EL. 69.0) PERC DEPTH'AT 96" (EL. 65.0) - the solids and scum depth exceeds 1\3 of the liquid depth, or three years has elapsed MOTTLES AT 46" (EL. 69.17) STANDING WATER AT 103" since the last pumping, the tank and the leaching pit (if any) should be pumped. Test Pit # 201 (EL. 73.4) 15. No wells were found to be within 200' of the proposed leaching area. 0 - 12" Ap, SANDY LOAM, 5YR 3/2, FRIABLE 12" - 40" Bw, SANDY LOAM, IOYR 5/8. FRIABLE 40" - 100" Cl. SANDY LOAM, IOYR 5/3. FIRM, STONES, COBBLES, BOULDERS, - POCKETS OF SILT LOAM (IOYR 6/2) W/VARIEGATED MOTTLING 100" - 150" C2, SANDY LOAM/LOAMY SAND STRATIFIED STONES a COBBLES W/POCKETS OF SAND SEEPAGE AT 42" (EL. 69.9) PERC DEPTH AT 94" (EL. 65.57) MOTTLES AT 42" (EL. 69.9) STANDING WATER AT 103" BOARD OF HEALTH STAMPS OMIT CNUINEERS AS- .; . PLAN & CERTIFICATION STATEMENT REQUIRED This System Is Not Designed CONSTRUCTION OF THIS SEPTIC SYSTEM For Garbage Grinder, -Whirlpool MUST DE COMPLETED WITH THREE (3) EARS OF THE Ot�TF OF APPR0\1AL Or Other High Water Use Devices. Y BOARD OF HEALTH STAMPS BOARD OF HEALTH INSPECTION 0 o D REQUIRED WHEN EXCAVATED ... c MAR 17 1999 �� APPROVAIB`f [HISOt;ftCE GuaRANtE� 3ttE ELEVATIONS IMF , ooEscto� CH iUGED ST �OT a BY: � � �EFFEc�tv�Ntrss of atrr - TOWN OE D R ' AOUTH trash +eta v "at H � I�IITHOUT 3011PI I BOARD 0 HEALTH aARtn�outw Bo Rt3 o OF HEA LTh , =t, p� p , P.E. STAMP SUBSURFACE SEWAGE DISPOSAL SYSTEM L�GE1 o�� OF � OWNER: CHRISTOPHER O'NEIL EXISTING PROPOSED KENNErHR. CIVIL ASSESSORS MAP & LOT: MAP 29, LOT, 8-1 No. 3 Ipo----- CONTOURS. - lo0 9 ALA STREET LOCATION: 'BAKERVILLE , 91 x 9 SPOT ELEVATION 91.1 ENGINEERING FIRM: --- PROPERTY LINE KENNETH R.` FERREIRA "FEB2 2 Ep• EDGE OF PAVEMENT E.P. P.L.S. STAMP ENGINEERING, INC. r STONEWALL �iNOFMgs WELLG ti KENNETH m DATE: 4-21-98 SCALE: 1" ; 3.0'.. O DEEP TEST HOLE R FERREIRA' LEACHING TRENCH 90.2871s ° 9FGISTEPCONTACT PERSON: KEVIN SILVA PLUMBING PIPE ADDRESS:`46 FOSTER ST., NEW BEDFORD, MA. O274 , REVISED ON 2-19-99 CHANGED HOUSE FOOTPRINT BY K.J.S. TEL: 508 992-0020 FAX: 992-3374 REVISED ON 6-22-993 ADJUSTED FIELD LOCATION. ADDED TP RESULTS BY K.J.S. a SE 9162 J� �� - iu- A\ r R _ �. M J� 1611 ` • ( V 41 ,f, III .% •ssaa e N � LOCUS MAP - NOT TO SCALE FINISHED GARAGE FLOOR 70.8 FINISHED FIRST FLOOR 79.9- TOP:�OF FOUNDATION' 78,8 . FINISHED BASEMENT FLOOR, 70.8 INVERT AT FOUNDATION 75.81 INVERT INTO SEPTIC TANK 75.59 INVERT OUT OF SEPTIC TANK 75.34 INVERT INTO D-BOX 74.66 INVERT OUT OF D-BOX . 74.64 INVERT AT INLET OF FIELD 74.59 INVERT AT END OF FIELD 74.4 ELEVATION OF SOT. OF SYSTEN 73.9 ELEVATION OF G.W.T. 69.9 FINISHED GRADE 77.6 c- PERF. PVC PIR12"+ / // 74.59 74.4 74.64 SLei ' Se La 49' Se 0.01 D-BO = ge e o e o 0 0 0 0 o e o 0 75.5'.� 75.34 :: _ A m o 0 0 0 • a o o 9 - _ �' 'SEPTIC 74.86 <,�.�•.' TANK 4. ALTERNATIVE POLYETHYLENE UNITS MAY BE USED. 4" SCH 40 PVC SOLID PIPE OVERALL FIELD SIZE RCMAINS THE SAME. OR APPROVED EQUAL SYSTEM PROFILE NOT TO SCALE LOT 8-1 NO Pit #101 (perc depth 96",7 min/inch) LOT 8-2 LOT 8-1 0 -10" LOAM Test Pit #101 (pert depth 110" 16 min/inch) Test Pit IOISE 10" - 34" SUBSOIL 0 - 10" Ap, SANDY LOAM, IOYR 3/4, FRIABLE 34" - 96" FINE SAND, SOME SILT, STONES 0 - 13" Ap, SANDY LOAM, IOYR 4/3 FRIABLE 13 - 38" Bw, SANDY LOAM, IOYR 5/6 FRIABLE IO" _ 28" Bw, SANDY LOAM, IOYR 6/8, FRIABLE 96" _ 150" MED-COARSE SAND, SOME SILT, STONES 28" - 58" 62, SILT LOAM, IOYR 7/8, FIRM WATER AT 144" 38 -106" CI, SANDY LOAM, 2.5Y 7/3, FINE, FIRM, COBBLES 58" - 94" Cl. SANDY LOAM, 2.5Y 6/4. FIRM W/COBBLES 106% 154" C2, SANDY LOAM, 2.5Y 7/4. FIRM, COBBLES 94" -140" C2, SANDY LOAM, 2.5Y 7/3, FIRM W/COBBLES Test Pit #102 (perc depth 102; 14 min/inch) Test Pit #102 (perc depth 89" 7 min/inch) 0 - 10 LOAM Test Pit # 102 SE -I I" Ap, SANDY LOAM, IOYR 4/3 FRIABLE 10" - 24" SUBSOIL 11" - 38" Bw, SANDY LOAM, IOYR 5/6 FRIABLE 0 - 10" Ap, SANDY LOAM, IOYR 4/3, FRIABLE 24" - 62" FINE SAND, SOME SILT, STONES 10 - 30' Bw, SANDY LOAM, IOYR 6/8, FRIABLE 38" - 71" CI, SANDY LOAM, 2.5Y 7/3 FINE, FIRM, COBBLES 62" - 154" MED-COARSE SAND, SOME SILT, STONES 71" -130" C2, SANDY LOAM, 2.5Y 7/4, 30 - 85',.CI, SANDY LOAM, 2.5Y 7/3, FIRM W/COBBLES „ FIRM, COBBLES WATER AT 144 85 - (29 C2, SANDY LOAM, 2.5Y -7/4, FIRM W/COBBLES MOTTLING: TP 101 AT 47 TP 102 AT 48" 7.5Y 5/6 MOTTLING: TP IOISE AT 45", TP 102SE AT 50" 7.5YR 5/8 PERFORMED BY: IRS. FENNESSY ON 6-25-91 SEEPAGE: NONE PERFORMED BY: LEN POTTER R.S. ON 9-3-97 WITNESSED BY: SUSAN GRIFFIN PERFORMED BY: LEN POTTER R.S. ON 9-3-97 WITNESSED BY: CHRIS MICHAUD WITNESSED BY: CHRIS MICHAUD PERCENTAGE OF LOT COVERAGE =11.6% 3 63 64 63- i -Q 29/63 BAKERVILLE W- WGIi �Bp 29/62 SITE PLAN. SCALE: I" = 30' SUP 29/60 a.•_Iz.• CLEAN IT 1 I i END CAP ; �e SAND i 66 67 s8 50' '- 9"-2" PEASTONE 16.5' FROM SEPTIC TANK GENERAL NOTES: 76,5 1. The sanitary sewage disposal systemshown hereon shall be CONSTRUCTED IN 12-MIN. ilc -r-o- SIN ACCORDANCE with the requirements of 1995 310 CNIR 15 (TITLE V) of the State L?4.9 DOUBLE -STAINLESS Em ironmental Code and local Board of Health regulations. Any MODIFICATION , p� CLAMPS TO THIS DESIGiN must be approved in writing by the engineer and the local Board t 5'-4" of Health prior to implementation. TEE �' ItEL.74.4 4'_6.. •` 4'-3" - � STAINLESS GAS BAFFLE 2. Contractor shall verify and check the BENCHMARK as shown on this plan prior to OR EQUIVALENT construction of the proposed system. EL73.9 EXIST. ORD.73.0 ' '=•i::r ::ta;!,:�,::...� .:• ..r;;:t..-, a.,.. 3. Notifythe local Board of Health when the system is ready for INSPECTION, prior to any backfilling. If CONFIRn1ATION OF CONSTRUCTION is required by an I engineer, notify this office 3 days prior to any backfillina �ELs9.9 96" g Y Y p 3 �. I PRECAST 1500 GAL, SEPTIC TANK 4• DEEP TEST HOLE INFORMATION indicates soil condition, percolation rate, and I IEL.65.0 water table elevation at the time and location of actual testing and should be verified at the time of construction. The contractor shall notify the local Board of Health if GROUNDWATER or PERCHED WATER is encountered at a higher elevation than indicated on this design plan. BASIS OF SANITARY DESIGN 5. TOP OF FOUNDATION, BASE11iENT and FIRST FLOOR elevations may be raised BUILDING USAGE: 3 BDRM. DWELLING but NOT LOWERED without the consent of the engineer. SIZE OF TANK: 1500 GAL. 6. Unless specified in the Basis of Sanitary Design, this system is NOT designed for the GARBAGE GRINDER: NO use of a garbage grinder or other high water usage devices. CLOTHES WASHER: YES ESTIMATED SEWAGE FLOW 330 GAL/DAY 7• Where the building sewer pipe exits the foundation ABOVE the basement floor, an LOT 8-27P 10114 MIN/INCH, TP 102 7 MIN/INCH,TP201SEp=22 min/inch PERCOLATION RATE: effluent or grinder pump conforming to 310 CNIR 15.229 may be used to discharge A LOT 8-1: TP 10116 MIN/INCH, TP 102 7 MIN/INCH7P202SEp=22 DESIGN PERC. RATE: min/'tnch VOLUME OF LESS THAN 25% OF THE DESIGN FLOW from any basement 25 MIN/INCH, CLASS II facilities to the septic tank. 3 SETS OF 6 CONTACTOR 75 UNITS W/4" PERF. PIPE 8 END CAPS LEACHING AREA: 8. If any components of the proposed system are specified as HEAVY DUTY, those 16.5' WIDTH X 52' ' LENGTH= 858 S.F. components shall conform to all state & local requirements for ASSHTO II-20 loading, p SYSTEM CAPACITY: 9. The SEPTIC TANK shall be 1500 gallons minimum, unless othernise specified on this design plan, and fitted with PVC schedule 40 INLET TEE and OUTLET TEE WITH 4 - 2 CLEAN WASHED STONE 858 S.F. X 0.40 GAL/SF/DAY- 343 GAL/DAY GAS BAFFLE, of proper length. Septic tank construction shall conform to 310 CNIR w/PEA STONE COVER 15.226. The SEPTIC TANK OUTLET COVER is to built tip to within 6" of the finished grade unless otherwise specified on this design plan. DEEP TEST PIT INFORMATION 10. SEPTIC TANK and DISTRIBUTION BOX shall be placed on a 6" minimum compacted GRAVEL BASE to prevent heaving or settling. ALL JOINTS MUST BE -PVC END CAP PERFORMED BY: KEVIN SILVA WATERTIGHT, sealed with asphalt cement or other cement suitable for that specific WITNESSED BY: SUE GRIFFIN 8 CHRIS MICHAUD (TP IOISE 8 102SE) component. DATE: 4-7-98, a-3-98 8 9-4-98 11. SOIL PREPARATION PROCEDURE FORTHE LEACHING FACILITY AREA shall Test Pit #2005E (EL. 73.0) conform to 310 CINIR 15.246 & 15.247. 0 - 12" Ap, SANDY LOAM, 5YR 3/2, FRIABLE 12. Any EXCAVATION OF UNSUITABLE N[ATERIAL designated on the plan shall 12" - 31" Bw, SANDY LOAM, IOYR 5/8, FRIABLE conform to Construction in Fill requirements as outlined in 310 CNIR 15.255 (1-6). LEACHING AREA DETAIL 31 - 75 Cl. SANDY LOAM, IOYR 5/3. FIRM, STONES, COBBLES, BOULDERS, 13. No HEAVY EQUIPMENT shall be run over the components or the prepared leaching POCKETS OF SILT LOAM (IOYR 6/2) W/VARIEGATED MOTTLING „ area during installation. RUBBER TIRE MACHINERY are not to be driven over the NOT TO SCALE 75 - 132 C2, SANDY LOAM/LOAMY SAND STRATIFIED prepared natural soil Fins d/ b REVISED ON 2-19-99 CHAh�ED HC:JSE FOOTPRINT BY K.J.S. REVISED ON 6-22-91A ADJUSTED FIELD LOCATION, ADDED TP RESULTS BY K.J.S. e or san stone ed during system tnstallatton. STONES 8 COBBLES W/POCKETS OF SAND SEEPAGE AT 481EL. 69.0) PERC DEPTH AT 96" (EL. 65.0) 14. For proper performance, the septic tank should be INSPECTED annually and when MOTTLES AT 46" (EL. 69.17) STANDING WATER AT 103" the solids and scum depth exceeds 113 of the liquid depth, or three years has elapsed since the last pumping, the tank and the leaching pit (if any) should be pumped. Test Pit # 201 (EL. 73.4) 15• No wells were found to be within 200' of the proposed leaching area. 0 - 12" Ap, SANDY LOAM, 5YR 3/2, FRIABLE 12" - 40" Bw, SANDY LOAM, IOYR 5/6, FRIABLE 40" - 100" Cl, SANDY LOAM, IOYR 5/3. FIRM, STONES, COBBLES, BOULDERS, POCKETS OF SILT LOAM (IOYR 6/2) W/VARIEGATED MOTTLING 100" - 150" C2, SANDY LOAM/LOAMY SAND STRATIFIED STONES 8 COBBLES W/POCKETS OF SAND SEEPAGE AT 42" (EL. 69.9) PERC DEPTH AT 94" (EL. 65.57) MOTTLES AT 42" (EL. 69.9) STANDING WATER AT 103" LEGEND EXISTING PROPOSED IQO -' - - - CONTOURS 100 91 x 9 SPOT ELEVATION •ti9u -- PROPERTY LINE EP• EDGE OF PAVEMENT-E.P. STONE WALL _ t.'.t WELL O DEEP TEST HOLE LEACHING TRENCH PLUMBING PIPE BOARD OF HEALTH STAMPS ENGINEERS AS -BUILT PLAN & CERTIFICATION STATEMENT REQUIRED This System Is Not Designed For Garbage Grinder, Whirlpool CONSTRUCTION OF THIS SEPTIC SYSTEU,'Or Other High Water Use Dievices. MUST BE COMPLETED k1ITH THPEE r3 BOARD OF HEALTH STAMPS BOARD OF HEALTH INSPECTION REQUIRED j Q ED WHEN EXCAVATED APPROVAL 8Y THIS OFFICE MAR I ! 1999 DOES NOT f,UARANTEETHE EffECTNENESSOf ANY ELEVATIONS MUST NO BE BY: � INSTAu.AT10N ARTh90UTH BOARD OE HEALTH CHANGED WITHOUT EO RD i0/)f OF DAR KITH D OF HEALTH APP RR P.E. STAMP SUBSURFACE SEWAGE DISPOSAL SYSTEM � -ilk OF OWNER: CHRISTOPHER O'NEIL OZ. KENN R. ASSESSORS MAP & LOT: MAP 29, LOT 8-1 IFERNo. 3 • o STREET LOCATION: BAKERVILLE ROAD AL ENGINEERING FIRM: t� O KENNETH R. FERREIRA P.L.S. STAMP 2 ENGINEERING, INC. H OF Mq rea��•01� 81 1 . s • KENNETHDATE: 4-21-98 SCALE: I" = 3-0' f R. -- No.287116 FERREIRA y CONTACT PERSON: KEVIN SILVA 9FGISTEADDRESS:46 FOSTER ST., NEW BEDFORD, MA. 0274 AL LAND TEL: 508 992-0020 FAX: 992-3374 SE 9162 FINISHED GARAGE FL60R 70,8 FINISHED FIRST FLOOR 79,9 TOP OF FOUNDATION 78.8. FINISHED BASEMENT FLOOR.*' 70.8 INVERT AT FOUNDATION 75.61 INVERT INTO SEPTIC TANK 75.59 INVERT OUT OF SEPTIC TANK 75.34 INVERT INTO.D-BOX 74.86 INVERT OUT OF D-BOX . 74.64 INVERT AT INLET OF FIELD 74.59 I INVERT AT END OF FIELD 74.4 ELEVATION OF BOT. OF SYSTEN 73.9 ELEVATION OF G.W.T. .0 69.9 ;,. FINISHED GRADE 77.6 8 Lef • Se Le ' 75.59 : SEPTIC TANK` 49' S= 0.01 75.34 , 74.66 40 . SCH 40 PVC SOLID PIPE-1 OR APPROVED EQUAL SYSTEM PROFILE NOT TO SCALE 4' PERF. PVC 74.59 4' ALTERNATIVE POLYETHYLENE UNITS MAY BE USED. OVERALL FIELD SIZE RCMAINS THE SAME. LOT 8-1 Test Pit #101 (perc depth 96",7 min/inch) 74.4 GENERAL NOTES: ,a`�"_11- CLEAN 1- '~ � - •`� 1, The sanitary sewage disposal system shown hereon shall be CONSTRUCTED IN e '2 wAs►tEn STONE-- PEAS10NE lu,,rl. 76� 3- • r-o' 6- �' ACCORDANCE with the requirements of 1995 310 CM12 15 TITLE V f h iZ-MIN• G.IQ=LEVM q ( ) o the State DOUBLE Environmental Code and local Board of Health regulations. Any MODIFICATION 10" -STAINLESS • •! 10" -STAINLESS TO THIS DESIGN must be approved in writing by the engineer and the local Board CLAMPS of Health prior to implementation. I I EL. 74.4 4'-6.. TEE '; -3.. 4' STAINLESS GAS BAFFLE 2. Contractor shall verify and check the BENCIIN[ARK as shown on this plan prior to END is '-OREQUIVALENT construction of the proposed system. CAP 1 �Q 1EL3.9 EXIST. GRD. 73.0 ''�' �3. Notify the local Board of Health when the system is read for INSPECTION, prior to i ►'D OVCRDfG t II - r c�-ir �► I ` I y y' Y , L I- 10'-6' any backfilling, if CONFIRMATION OF CONSTRUCTION is required by an / i , J 8.3' MAX. GROUNDWATER 4 I 96" engineer, notify this office 3 days prior to any backfilling. _ G I EL69.9 PRfECAST 1500 GAL. SEPTIC TANK 4. DEEP TEST HOLE INFORIAIATION indicates soil condition, percolation rate, and water table elevation at the time and location of actual testing and should be verified LOT 8-2 LOT 8-1 0 - 10" LOAM Test Pit #101 (perc depth 110" 16 min/inch) . Test Pit IOISE 10" - 34" SUBSOIL 0 -13" Ap, SANDY LOAM, IOYR 4/3 FRIABLE 0 - 10" Ap, SANDY LOAM, IOYR 3/4, FRIABLE 34" - 96" FINE SAND, SOME SILT, STONES 13 - 38" Bw, SANDY LOAM, IOYR 5/6 FRIABLE 10" - 28" Bw, SANDY LOAM, IOYR 6/8. FRIABLE 96" - 150" MED-COARSE SAND, SOME SILT, STONES 38 -106" Cl. SANDY LOAM, 2.5Y 7/3, FINE, FIRM, COBBLES 28" - 58" B2, SILT LOAM, IOYR 7/8, FIRM WATER AT 144" 58" - 94" Cl. SANDY LOAM, 2.5Y 6/4, FIRM W/COBBLES 106"-154 C2, SANDY LOAM, 2.5Y 7/4, FIRM, COBBLES 94" - 140" C2, SANDY LOAM, 2.5Y 7/3, FIRM W/COBBLES Test Pit #102 (perc depth 89" 7 min/inch) Test Pit #102 (perc depth 102; 14 min/inch) Test Pit # 102 SE 0 - 10 LOAM 11- Ap, SANDY LOAM, IOYR 4/3 FRIABLE 10" - 24" SUBSOIL .11' - 36 Bw, SANDY LOAM, IOYR 5/6 FRIABLE 0 - 10" Ap, SANDY LOAM, IOYR 4/3. FRIABLE 24" - 62" FINE SAND SOME SILT STONES ' 38"- 71" Cl. SANDY LOAM, 2.5Y 7/3 FINE, FIRM, COBBLES 10 - 30" Bw, SANDY LOAM, IOYR 6/8, FRIABLE ' 62" - 154" MED-COARSE SAND, SOME SILT, STONES 71" -130" C2, SANDY LOAM, 2.5Y 7/4, FIRM, COBBLES 30 - 85" CI, SANDY LOAM, 2.5Y 7/3. FIRM W/COBBLES WATER AT 144" 85 -129" C2, SANDY LOAM, 2.5Y 7/4. FIRM W/COBBLES MOTTLING: TP 101 AT 47", TP 102 AT 48" 7.5Y 5/8 MOTTLING: TP IOISE AT 45", TP 102SE AT 50" 7.5YR 5/8 PERFORMED BY: R.S. FENNESSY ON 6-25-91 SEEPAGE: NONE PERFORMED BY: LEN POTTER R.S. ON 9-3-97 WITNESSED BY: SUSAN GRIFFIN PERFORMED BY: LEN POTTER R.S. ON 9-3-97 WITNESSED BY: CHRIS MICHAUD WITNESSED BY: CHRIS MICHAUD PERCENTAGE OF LOT COVERAGE = 11.6% . 3 63 64 65 LOT 8-2 LOT 8-1 loo' 43,560 S.f. 43,560 s f._ - _ - - 66 J- A_ - T_ 100 BUFFER LIN 130' - 68 69-- - - - o - 1 SEE NOTE # I? - EXCAVATE ALL UNSUITABLE MATERIAL WITHIN T2� 5' HORIZONTALLY OF THE LEACHING AREA FROM THE PEA STONE COVER DOWN TO h EL. 65.0 (100"! BELOW EXIST. GRADE) N EXCAVATION MAY BE REQUIRED TO EXTEND DEEPER IF UNIFORM SUITABLE MATERIAL IS NOT ENCOUNTERED AT EL. 65.0 APPROXIMATE LOCATION OF -EXISTING S,A,S, 13AKERVILLE W- LIP 29/63 wG-h LIP 29/62 HYD9'- 41 SITE PLAN SCALE: 1" = 30' W 16' DECK 69• 16, PROPOSED ME 3 BDRM. 101 i DWELLING r� T 1r as• PROP. •--/ 1500 GAL PTIC TANK �]z- 69 70 -71 72 O Ot�C�� 124.D' 19 1a 1'' O� Q� V 4�7 N165 T'SE -- 73 40' RESERVE 167.13' - 74 ROAD z 29/61 BENCHMARK: - CUUP 29/60 NAIL SET IN 20" TREE ELEV.= 76.53 N.G.V.D. at the time of construction. The contractor shall notify the local Board of Health if GROUNDWATER or PERCHED WATER is encountered at a higher elevation than indicated on this design plan. BASIS OF SANITARY DBSIGN 5. TOP OF FOUNDATION, BASEMENT and FIRST FLOOR elevations may be raised BUILDING USAGE: 3 BDRM. DWELLING but NOT LOWERED without the consent of the engineer. SIZE OF TANK: ° 1500 GAL. 6. Unless specified in the Basis of Sanitary Design, this system is NOT designed for the FROM GARBAGE GRINDER: NO use of a garbage grinder or other high water usage devices. SEPTIC CLOTHES WASHER: YES ESTIMATED SEWAGE FLOW 330 GAL/DAY 7• Where the building sewer pipe exits the foundation ABOVE the basement floor, an d_TANK LOT 8-2:TP 10114 MIN/INCH, TP 102 7 MIN/INCH,TP201SEp=22 min/inch PERCOLATION RATE: effluent or grinder pump conforming to 310 C;1IR 15.229 may be used to discharge A LOT 8-1: TP 10116 MIN/INCH, TP 102 7 MIN/INCHTP202SEp_22 min/inch VOLUME OF LESS THAN 25% OF THE DESIGN FLOW from any basement I DESIGN PERC, RATE: 2S MIN/INCH, CLASS II facilities to the septic tank. 3 SETS OF 6 CONTACTOR 75 I I UNITS W/4" PERF. PIPE LEACHING AREA: 8. If any components of the proposed system are specified as HEAVY DUTY, those I 6 END CAPS I I 16.5WIDTH X .52LENGTH= 858 S.F. components shall conform to all state & local requirements for ASSHTO 11-20 loading. 52' I I 9. The SEPTIC TANK shall be 1500 gallons minimum, unless otherwise specified on this 50' I SYSTEM CAPACITY: design plan, and fitted with PVC schedule 40 INLET TEE and OUTLET TEE WITH II - CLEAN WASHED STONE 8S8 S.F. X 0.40 GAL/SF/DAY= 343 GAL/DAY GAS BAFFLE of proper length. Septic tank construction shall conform to 310 C1\IR W/PEA STONE COVER 15.226. The SEPTIC TANK OUTLET COVER is to built up to within 6" of the I finished grade unless otherwise specified on this design plan. I I I DEEP TEST PIT INFORMATION. AT10 10. SEPTIC TANK and DISTRIBUTION BOX shall be placed on a 6" minimum I compacted GRAVEL BASE to prevent heaving or settling. ALL JOINTS INIUST BE PVC END CAP PERFORMED BY: KEVIN SILVA WATERTIGHT, sealed with asphalt cement or other cement suitable for that specific WITNESSED BY: SUE GRIFFIN e CHRIS MICHAUD (TP IOISE 8 102SE) component. 1.5' DATE: 4-7-98, .9-3-98 8 9-4-98 11. SOIL PREPARATION PROCEDURE FORTI I LEACHING FACILITY AREA shall conform to 310 CMR 15.246 & 15.247. Test Pit #2005E (EL. 73.0) 16.5' 0 - 12" Ap, SANDY LOAM, 5YR 3/2, FRIABLE 12. Any EXCAVATION OF UNSUITABLE A'IATERIAL designated on the plan shall 12" - 31" Bw, SANDY LOAM, IOYR 5/8, FRIABLE conform to Construction in Fill requirements as outlined in 310 CNIR 15.255 (1-6). LEACHING AREA DETAIL 31 - 75 CI, SANDY LOAM, IOYR 5/3, FIRM, STONES, COBBLES, BOULDERS, 13. No HEAVY EQUIPMENT shall be run over the components or the prepared leaching POCKETS OF SILT LOAM (IOYR 6/2) W/VARIEGATED MOTTLING area during installation. RUBBER TIRE MACHINERY are not to be driven over the NOT TO SCALE 75" - 132" C2, SANDY LOAM/LOAMY SAND STRATIFIED prepared natural soil base or sand/stone bed during system installation. STONES 8 COBBLES W/POCKETS OF SAND 14. For proper performance, the septic tank should be INSPECTED annually and when SEEPAGE AT 48"(EL. 69.0) PERC DEPTH AT 96" (EL. 65.0) the solids and scum depth exceeds 113 of the liquid depth, or three years has elapsed MOTTLES AT 46" (EL. 69.17) STANDING WATER AT 103" since the last pumping, the tank and the leaching pit (if any) should be pumped. Test Pit # 201 (EL. 73.4) 15. No wells were found to be within 200' of the proposed leaching area. 0 - 12" Ap, SANDY LOAM, 5YR 3/2, FRIABLE 12" - 40" Bw, SANDY LOAM, IOYR 5/8, FRIABLE 40*'- 100" Cl. SANDY LOAM, IOYR 5/3, FIRM, STONES, COBBLES, BOULDERS, POCKETS OF SILT LOAM (IOYR 6/2) W/VARIEGATED MOTTLING 100" - 150" C2, SANDY LOAM/LOAMY SAND STRATIFIED STONES 8 COBBLES W/POCKETS OF SAND SEEPAGE AT 42" (EL. 69.9) PERC DEPTH AT 94" (EL. 65.57) MOTTLES AT 42" (EL. 69.9) STANDING WATER AT 103" REVISED ON 2-19-99 CHANGED HOUSE FOOTPRINT BY K.J.S. REVISED ON 6-22-96 ADJUSTED FIELD LOCATION. ADDED TP RESULTS BY K.J.S. LEGEND. EXISTING PROPOSED 100 --- - CONTOURS loo 91 x 9 SPOT ELEVATION .•..91.1 PROPERTY LINE '-'- EP. EDGE OF PAVEMENT EP. STONE WALL WELL Q ❑ DEEP TEST HOLE LEACHING TRENCH PLUMBING PIPE BOARD OF HEALTH STAMPS ENGINEERS AS -BUILT PLAN & CERTIFICATION STATEMENT REQUIRED This System Is Not Designed For Garbage Grinder, Whirlpool CONSTRUCTION OF THIS SEPTIC SyS 0 r Other High Water Use Devices. MUST BE COMPLETED WITH THREE 9 YEARS OF THE DATE OF APPMIAL BOARD OF HEALTH STAMPS BOARD OF HEALTH INSPECTION CepCIS' REQUIRED WHEN EXCAVATED I,� } +� THE AT SOT GUARANTEE THEE ELEVATIONS M R 1 i 1999 oars Bnw4ESSOf NNY UST NO BE EFfEIt3STALLATION EAITVA CHANGED WITHOUT EOt D °& 7H DARTMOUTH BO€,RD OF H BY' i OW OF DAR UBSURFACE SEWAGE DISPOSAL SYSTEM OFA OWNER: CHRISTOPHER O'NEIL o� F�" R F ASSESSORS MAP & LOT: MAP 29 LOT 8-1 V CI No.35 5 STREET LOCATION: BAKERVILLE ROAD ENGINEERING FIRM.- v, I 4y� KENNETH R. FERREIRA P.L.S. STAMP ENGINEERING, INC.zI'"' SH OF MAss9 VAI n" KENNETH N DATE: 4-21-98 SCALE: 1' _ � R. 0 FERREIRA y No.28716 CONTACT PERSON: KEVIN SILVA e FGjSTEFE �O NA«aclo ADDRESS:46 FOSTER ST., NEW BEDFORD, MA. 0274 TEL: 508 992-0020 FAX: 992-3374 SE 9162 Residential 1999 Residential 1999 Contact Address Name (print) 3.1 Licensed Construction bupervisor: - -- - rr Licensed Construction Supervisor License Number Address Expiration Date Signature Telephone 1) o-------- A u,,..,o 1-nvPmPnt Contractor: Not Applicable ❑ Are you a Home Improvement Contractor subject to (780 CMR-6)? ❑ yes ❑ no If no, go to the next section! Are you claiming exemption from the requirement? ❑ yes ❑ no If yes, submit the required affidavit! Company Name Address Registration Number (if none, state "none") Signature Telephone I Expiration Date 3.3 For Residential Remodel Work Only Telephone PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO THE GUARANTY FUND: QUESTIONS OR COMPLAINTS call or write: j Home Improvement Contractors Registration, One Ashburton Place - Room 1301, Boston, MA 02108, (617) 727-8598 Owners Name (print) Signature by signing the above, the home owner acknowledges that there will be no eligibilty to the Guaranty Fund Date 3.4 Homeowner Exemption - One & Two Family Only FOR HOMEOWNERS WHO INTEND TO PERFORM AND BE RESPONSIBLE FOR THEIR OWN PROJECT 109.1.1 Licensing of Construction Supervisors: Except for those structures governed by Construction Control in Section 116.0, effective July 1, 1982, no individual shall be engaged in directly supervising persons engaged in construction, reconstruction, alteration, repair, removal or demolition involving the structural elements of buildings or structures, unless he or she is licensed in accordance with the rules and regulations promulgated by the BBRS entitled Rules and Regulations for Licensing Construction Supervisors. Exception: Any Homeowner performing work for which a Building Permit is required shall be exempt from the provisions of this section; provides that if a Homeowner engages a person(s) for hire to do such work, that such Homeowner shall act as supervisor. For the purposes of this section only, a "Homeowner" is defined as follows: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a Homeowner. If you are applying Signature: Your section sign below: r-vs drr T- e5),&w / certain responsibilities, including but not necessarily limited to, general liability NOTICE TO LICENSED CONTRACTORS: The Building Code provides in the Rules and Regulations section that any licensed Construction Supervisor, whether or not they have taken the permit are responsible for code compliance. (see Appendix of 780 CMR R5.2.15) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached: ❑ yes ❑ no NP-h'ew ❑ addition ❑ alteration ❑ repairs construction* ❑ chimney/fireplace ❑ deck ❑ pool ❑ accessory bldg. ❑ replacement window/door ❑ other (shed/garage) no. of windows_ doors_ (specify below) * If new construction, please complete the following: 3 Single Family: no. of bedrooms L'? no. of baths 11 Signature of Owner Date ❑ woodstove ❑ demolition (specify below): 1, 6 k' i5 (tVL.-,r :E . t,i ( , as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief. and penalties of perjury. Print N Signature of Owner/ Date c:\wpwin\forms\bldgapp.res Page 2 January 20, 1999 c:\wpwin\forms\bldgapp.res Page 3 January 20, 1999 Residential 1999 .......... ....... ............... ........... . ... ... .. .............. ... ................ X.: Ksm... . .. .............. X: . .... ............... Toy. Om ......... .1 C ................ ............. ........ ..... ...... .......... ..................................... ...... . .................. ................. ..................... 1. Date plan reviewed: 2. 30 days to review period expires- 3. OK to issue date: 4. OK to issue subject to requested submittals(see project review worksheet): Date: 5. DENIED (see project review worksheet): Date: MAYT 2 8 6. HOLD reason: AN Date 7. HOLD subject to Zoning Board of Appeals action:- 8. Comments: 9. Inspector's Signature: Date: ..................... -- ...... ....... .... ..... ....... .. ....... . . ........................ ....... .... .. ....... .......... ... JS —* ... ....... ............ .. ......... T. .................... -PPM. CANT: 0 I." T ......... X.- ...... ......... X-'X�X: X-:;.: ....................... . ...... .......... ....... ........... . ........ . .. .. . ......... - ......................... . . .... ..... . 9 q Applicant informed o above Date- Time: 7 Clerk - Comments: .............................. ................... ............................ X: 10 X 7S% , * *'.:.:--...............�.................................. 10N�i 0 CE INSPECT �R ................................................. .......... ............................... ........ .... . . . . . . . . . . . . . . . . . . . . . . . . ................ .... ................. ......... ........ .... .......... — .............. Total Permit Fee: $ . ........... .......... Less Application Fee: $ 25.00 I .............. Remaining Balance: $ 6z) I TOTAL FEE: Gross Area - New Construction total sq. ft. Gross Area - Alteration total sq. ft. Permit Issued To- ............ . ....... ...... ..... .. ............................ . .................... ......... S .................................. S, WPM 4. .. .. ..... .. ... .......... M 0 "A" L.- C �14.:": DDITI N S KETCHE ............. ................... ........... ...... .. ..... ............................ .. ... . .. .................. ........ ....... ... .. .............. .......... . . ...... . .......... ........... c:\wpwin\fon-ns\bldgapp.res Page 4 January 20, 1999 Residential o F0 UNDA TION ONLY 1999 DATE RECEIVED LJTH DARTMOUTH BUILDING DEPARTMENT 400 Slocum Road, P.O. Box 79399 Dartmouth, MA 02747 V 508-999-0720 FAX 508-999-0738 APPLICATION TO CONSTRUCT, REPAIR, RENOVATE OR DEMOLISH A ONE OR TWO FAMILY DWE� LING Zoning Review: Signature: Vl IJULt:- " Energy Report: Signature: __IDae. Fire Chief- f Signature:-- Dat/ Board of Health: Signature: Conservation Commission: Signature: Date: Other: Signature: Date: NUMBER OF PLANS SUBMITTED: 3 1.1 Property Address: 4-1 � ev hIpAle, 01 Nearest Cross Street: Subdivision Name: Total Land Area Sq. Ft.: 4!, Water1.4 Supply (MGL c 40 § 54): B'fAunicipalEl Private Well �r-i-4rt Name (print) SITE PLAN SUBMITTED: IR/yes 0 no 1.2 Assessors I & Lot Number: 4pce 5L P Pat G Lot f 1.3 Historical District 0 yes 0-110 Has application been submitted to the Historic Commission? 0 yes GKO Date: R 0 Municipal ID,6n Site Disposal System Contact Address 14 1 e r i i c k. �e A / 5P f,4 e,97 0 1, ?2 7S- phone number 1 o(�2� c:\wpwin\forms\bldgapp.res Page I January 20, 1999