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HomeMy WebLinkAbout0130 TERN LANE - Health 3 Tern Lane Centerville A = 212 012 I r i i No. 42101/3 ORA QD FssELTE 14% (a 0 O 0 0 rree s -- No. V i r Fee j ;o �— THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes _ PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zipplitatlon for ;Disposal 6pstem Construction permit Application for a Permit to Construct(W Repair( ) Upgrade( Abandon( ) ❑Complete System ndividual Components Location Address or Lot No. 00 Te rA LN Owner's Name,Address,and Tel.No. C�n-fe r✓.7/e ^.4 0202- .+v44c� ,l-Sushi,.w,^lSo� Assessor's Map/Parcel -2.12 012 1 kAr-t!f ~ Installer's Name,Address,an Tel.No.(5'Z$'—?c2 7 0?6in02 Designer's Name,Address,and Tel.No. Sub/,'vita Gn�,n«r�7� Z 0krk,e✓' /!o( of-f-o Mit Po o C s sos3-4 Type of Building: 060 -S Dwelling No.of Bedrooms Lot Size �Z ZOO sq.ft. Garbage Grinder( ) —� Other Type of Building g e—.Si(,1,e y e.141 No.of Persons Showers( ) Cafeteria( ) Other Fixtures �y Design Flow(min.required) g 3 d gpd Design flow provided -3 S T•7 gpd Plan Date ;-/9�/-3 Number of sheets Revision Date Title enje.os--1 T^Arc ¢S Size of Septic Tank 15''0 6-1 74*t K Type of S.A.S. 9- Z/r 4%E444.0/' S Description of Soil tA I Pao^,* Nature of Repairs or Alterations(Answer when applicable) xz _ /..�.`C 1+"'E fr�7 k r!Oi 3'Y Ink'G/` 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 n place the system in operation until a Certificate of Compliance has been issued by this Board f He t Sighted_- t'' Date Tay YVTY�Application Approved by (Uay`- Date r J/ Application Disapproved by Date for the following reasons Permit No. � � �� Date Issued 61 TOWN OF BARNSTABLE LOCATION 2 3 0 rF2lA/ SEWAGE# ,R p/3 -o`Z l-2 VILLAGE C',�gJ� 6�I/!LGgr ASSESSOR'S MAP&PARCEL 21 o_`Z INSTALLER'S NAME&PHONE NO. O G aZZA6 d'a SEPTIC TANK CAPACITY /5-60 H - 0 v LEACHING FACILITY: (type)J.r , o �ize) NO.OF BEDROOMS OWNER ndq J 5 U S PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) I C�C)t . Feet FURNISHED BY = oLJ � l 11 ��` i `► �. A4 J / �a 19 , •TJ ; b. t M Fee _"—� h= No U Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS Yes J; PUBLIC HEALTH DIVISION =-TOWN OF:BARNSTABLE, MASSACHUSETTS 2ppYILatIOn for -MIspDBaY 6- psteitt COnBtCULtIOn permit ' Application for a Permit to Construct '' Repair( ) U rade Abandon Com lete S stem N �nldividual Components Location Address or Lot No. 19 U T e r"n L N Owner's Name,Address,and Tel.No. C-eA4--e vIle iA 0202. 44-i a t fL,Son.w:lS0A- Assessor's Map/Parcel 2 2 GI Z I P& �i n�rtr lU Installer's Name,Address,an Tel.No.,Sz)$ -9r,2 7-02S­o02 Designer's Name,Address,and Tel.No. su/�✓on G-.y,n«+.;7 7 Pkrkoel- led AA - i rV 1P0 0 5-9 s' - 2 Type of Building: Dwelling No.of Bedrooms Lot Size -O, ZOO sq.ft. Garbage Grinder( ) Other Type of Building 9&-S,'r1 e h e,`G I No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 3 3 C7 gpd Design flow provided —3 S L?.7 gpd Number of sheets / Revision Date / Title 0rv1240SIl/ � o!/Y,&,I �S ` • -- Size of Septic Tank 1 1,; Type of S.A.S. S14000 Description of Soil Ga 1 Pvn. / N } • Nature of Repairs or Alterations(Answer when applicable) li tgti�{�mOY`f Date last inspected: Agreemeni: 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 no (fl lace the system in operation until a Certificate of Compliance has been issued by this Board of Helt ,Signed4 / , . Date Application Approved by '�1yy� /( ��t. Date 1 Application Disapproved by Date for the following reasons g Permit No. a.D j' Date Issued --------------------------------------------------------------------------------------------------------------------------------------- TH E COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(X) Repaired( ) Upgraded y ( ) Abandoned( )by y7(T�S at 13 a ?"Q!t 1 L IV has been constructed in/accordance All with the prrl i o s of Title 5 and the 1 for Disposal System Construction Permit No. �— f dated Installer �. � Ar Designer t— — _ _ i #bedrooms 3 Approved design flow-- 357, 7 / gpd The issuance oft s pe it shall not be construed as a guarantee that the systemJ�dc�ti �s deigned.Date 7 Inspector ! ✓fi�/'I ///Ii ------___--------------------__-__-_--_-_--_-________.___________1__--_- ----------------------------------------------- ----------------- No. o�� o�-�'� Fee (50 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal *pstent Construction permit li Permission is hereby granted to Construct(X ) Repair( ) Upgrade( ) Abandon( ) System located at 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 permit. Date ( 4 ( Approved by Vy\� InN-L (LG 2 L--!!�, 4 i M 15• P 1.. Town of Barnstable Regulatory services- . . . Thomas F.Geiler,Director . Public Health`Division'. E Thomas McKean,Director 200 Maio Street,Hyannis,MA 02b01 . Fax:508 790-6304. Off ce:508462-4644 -- _:3dstall �&�9esig�ner Certification Fo _ . Assessor's Ma \Parcel Date. l� 2d �Sewabe Perms P Designer-: �t4-A wa.1 6 oo egethk&stafer u+lLr� 5 Address. `7 ddress 23 .�,pOt�to � Iv4 On ��\9 l3 was issued a permit to install a (date) (installer s tic stem at .hjb � S �� ' based on a design drawn by eP sy (address) L96-o. S LAv styIG �a�.L dared (designer) _ I certify that the septic:system referenced.above was installed substantially according to the desgn;;which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank I certify that the septic-system referenced-above-was=installed-with major changes (i.e.greater than`10.' lateral relocation of the SAS or any vertical relocation of any ' component of the septic system)but in accordance with State&Local �� awz y r s- - _. .. keguladons. Plaxi r poi or��,r° �a 01=-0 r c�y� �r �u-.���� . (Installer's Sl e (iO 29733. �,p V9'Y'Ol. K m (Designer's Signature) (Affix.Design s 5 amp.Here) -- 7 HFAI TR nTvISION.CERTIFICAIM OF PLL ? E-ItET -T g4BI�C COMPLIANCE L NOT BRISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.THANK YOU.. Q:Health/septic/Desipa certification'Farm 3-26-04.dac A.5 APW "�p1� AN1tl00 k AgUM I �p� I CL D5 YNIW1 T4 IY ' - - FlWIW45 P"pMA° - ��b . a Am. ATTA04 rrmmliow-: ' py Amsu h°IIWIN F AwtlOM rrm�MM�I aywi��i i�jn 9 P -- ------' •----- --- Zo tR� �a tie= a I I ��„ �-•p b b i i �� � zcm� AaNaem r——— a A'"S W ap�R R i • r I N a�a+A 6CA. pI��WD6M u'mI4Na a I pA61LLL M. °.pl M AlAJ6°TP!° .�g_ib{��Y° VYN- --- RV -- �6 �-•N n I Yw °e AucN 5 n.Y CC mce a. '-----------------' a6a d QQ�InIl } a F a Z W rL „ O❑ -d A.9 F NxwS , W l � o R�"r`,"o`Noa� 1K1K1K Z F a .�d�. N u 3 NOTE. z 77tl11 ALL WINDOWS ARE TO BE ANDERSEN A SERIES6 W/APPLIED GRILLES INSIDE AND OUTSIDE }, T1Atsu1 AeoVS {I'�. �ofi °� 7 a•b - Auwro Awlmee nuoN rvN A,9 Y'ClluYa --- - --------------- - ERE - -------------- ------------- ------------- Elm" ® .,�. z o"dam' OY�aiuYa �� rLaoe aoe � 8 h i a33e �ro�i�� F ytl Atnw 9 L----r ,l$ C�.5 e �� iuiuw � dME� aiB B'd�Mi B M/Ty Rmm muo uu Yvs+de r i 6 a, LUp A.9 AfCAe � A.9 �_________ ________� r✓ N Q J �Z� LL w 3 Cry/ BTr UDlO! dnraeas - Sa tf d.9 ; 6'dtle yp� A.6 e 8 drn °_ (`1 ` Q O F A,9 / s ____� I A.B wxcaere ro°rine I I I 1. I :Lutiswu•.•uvu i I ;�� ¢£Skg I 4.0 A.e I r , r , I •I � 0 --------- 1 _ _ Ngg=BB 1,8 rr— — ------Ir ----.------------------- — -- — __ w>.�-e• 1 1 �r ____________ 1J/ ca"cane on �r I______i I raxr�xuws n•,�o• I III ve•Axcwoa eocrs a 9s•o.c. en. 1. I concaere ro°rnc III 4 III win,9.v. ruAr wnswea rav' III �.a.°r r°ne NI I �p z Z I III III nie: •er,em III a ex°rmr I I F l o I i III III III ep L.�i 4.wu x° Cwxacncr PParCu i me v.rrn an.aoea II r I Id .____ I I —I I I I--J. L `e.a.ere ux°ca � � I -1 �J -1, — I �zl ......•..III - III .. os.+... ..... ..... . fa• �16---- ==r ' �v��n•.uvu F J===L =L�=J 1__J_ J__—LJ11 �s I " 1— ===rTio III —� `__� `—IIH'Jv; %MflS¢ III i ill III III �a volt. -e• III -- 4—B ---- J ` 4 y'bte�d££8aps®i6Q� en 111 �8 Vyll ca+caerc w.L.on a 16L�+iy uv..�III iJIL1 .xi. III ,C----.e --- °e ia'or xQ�1 1 I �____ I-I III / IIL ___ __ - --- e�"«coce�c°R *____ ________ A. s��exeno rxun+ III / ' 1 e Q V 4 j L� __________ Jll, I I G a a l ggonc crc yue� .ti � W se-a m-o x a 6• N h i9 wr ccnrixuwa Ee 4.�11 Q K F Z < n.Z a. TYPICAL N�O�??TES N mm jw,.0 nAM-1.erea ean4lw` raioa ro exa°euae e.ixrea�a O 1 1 1 1 3 BASEMENT NOTES: b rmrixc eoveuce GARAGE SLAB µ(r,Ao 1 I n w w � aC T. I ru�rrowse,¢aruae°raa. .�rec r'uu. y b E • 1 wxcaere ro°rwc uP".°rrM°r«i.°LM`w G rmr.cr n e° u.x I. 1 a.0 o.cx 1 I A.e «r iecvvri-e�°e�"+eee'ca;v 4`°R"eec"ro�m e��or":w crwia.."cro:`"raw - n nm. o e o f �,.•,.� °mow :. . /1 L ____c2Eugvreec_ ___ Jam_____________________ TOWN OF BARNSTABLE LOCATION SEWAGE# `oZ0/ -c`l l7 VILLAGE 1, E ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. CU G fly d�a SEPTIC TANK CAPACITY I cSGt7/�- - Cd v LEACHING FACILITY: (type)'( lr a Vize) NO. OF BEDROOMS OWNER Q q J 5 PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) 1 t Feet FURNISHED BY ------------ � 3= a� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner Owner's Name information is required for every Centerville MA 02832 12-27-12 page. CityfTown state Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection farms may not be altered in any way.Please see completeness checklist at the end of the form. important:out forms A. General Information fitting computer,on the fo s `\ \\``1�tttuannkn u e on t1 he ab `���t1;.....OF gss,,�i�' 1. Inspector. q key to move your -A = �y cursor-do not use the return James D. Sears JAMES key. Name of Inspector ❑ IRS C_ apewide Enterpdses,LLC Company Name :� TTFt�Vic? {$3 Commercial St. I N sps Co llrmu� L11 many Address Mash e MA 02645 City/Town State Zap Code 508-477-8877 S1623 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address ancf%at toe) information reported below is true, accurate and complete as of the time of the nspectioh*..'The inlipectton was performed based on my training and experience in the proper function andmaintenalme of"on site sewage disposal systems. I am a DEP approved system inspector pursuantyto Section 15.34 of Title 5(310 GMR 15.000).The system: y Co .ram ® Passes ❑ Conditionally Passes ❑ ails zn Needs Further Evaluation by the Local Approving Authority (7) I. 12-27-12 spectoes 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. 0 lv t5ins•11/10 'ft5ffl"h%Wt10nF0=-Su bsintac6 Sewage Disposal System•Pape 1 of 17 Dec 28 12 01:26a p.2 Cornmonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner Owner s Name information is required for every Centerville MA 02632 12-27-12 page. Citylrown 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 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 b thePPBoard of H Y 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 eAltration 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•i in o The 5 Official Inspection Ftxrrc Subsurface Sewage avassi system•Page 2 of 17 Dec 28 12 01:27a p.3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner Owner's Name information is required for every Centerville MA 02632 12-27-12 page. City/Town state Zip Code Date of Inspection B. certification (cont.) B System y stem Conditionally Passes(Cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box, System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below).- distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below); ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below); C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. system will pass unless Board of Health determines in accordance with 310 CMR 15-303(1)(b)that the system is not functioning In a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or"a salt marsh Gins•MID TftW 5 oftlrJel lnapedon FOrrr Subsurfeoe Sewage DLSMS d System•Pa"3 of 17 Dec 28 12 01:27a p.4 Commonwealth of Massachusetts Title 5 Official Inspection Form P Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner Owner's Name Information is required for every Centerville MA 02632 12-27-12 page. Cityrrown State Zip Code Date of Inspection B. Certification (cunt.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply, ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in INININ is less than 6"below invert or available volume is less than Y day flow,L E',¢cljrvG 15ins•11110 Me 5 Offrcu Inspection Form:Subsurface sewage oisposel System•Page 4 of 17 L sic 28 12 01:27a p.5 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Ownerowners Name information is required for every Centerville MA 02632 12_27-12 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. (This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 6 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached.to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 16,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone 11 of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-11Ito Title 5 ofidal Irtspeden Fort SLbsurface sewage Disposal system•Pape 5 of 17 Dec 2812 01:28a p.6 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner Owners Name information is required for every Centerville MA 02632 12-27-12 page. Cityfrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any'of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined?(If they were not available note as NIA) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® Ll 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)1 D. System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins-11110 Tiffs 5 Official Inspedion Form:Suhsufwa Sewage Disposal System•Page 6 of 17 Dec 28 12 01:28a p.7 Commonwealth of Massachusetts Title 5 Official Inspection Form 9 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner Owner's Name information is Centerville MA 02632 12-27-12 required for every — _ _ page. Cityfrown State Zip Code Date of Inspection D. System Information Description: The system is a 1500 Gal precast tank pump chamber D Box and five infiltrators Number of current residents: D Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2D11-1,000Ga1s 9 y 9 �9p »' 2012-1,000Gal's Detail: Sump pump? ❑ Yes 0 No _ Last date of occupancy: NADate Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft,etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: J 95irm-11110 Title 5 Official Inspection Form:Subsurfe w Sewage Disposal System-Page 7 of 17 r Dec 28 12 01:28a p.8 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tern Lane Property Address Anna Bamhart Owner _ Owner's Name information is required for every Centerville MA 02632 12-27-12 page. CitylTown State Zip Code Date of Impemon D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: NA 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) ❑ InnovativelAlternative 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): tsk,-I ill Tice 5 OfTdal Inspection Form_Subsurface sewage ois� g posal system•Page 8 of 17 Dec 28 12 01:29a P.9 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner Owner's Name information is' required for every Centerville MA 02632 12-27-12 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: 2003 Permit # 2003 -613 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑cast iron 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Pipeing is 4" PVC SCH 40 Septic Tank(locate on site plan): Depth below grade: 26"feet Material of construction: concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Gal Precast Sludge depth: lit 15 ns•11/10 Tale 5 official Inspection Fo"m SubsuMeoe Sewega Disposal System•Page a of 17 Dec 28 12 01:29a p.10 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner 6u ner's Nam. information is required for every Centerville MA 02632 12-27-12 page. cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle 29' 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 18 How were dimensions determined? Asbuilt-Plan Tape Sludge Judge 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 at working level w!in and outlet tee's, Tank and outlet cover at 26"wlinlet cover at 4" below grade. No sign of leakage or overloading. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass 9 ❑ 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 (sins-lvia Title 5 Official Inspection Form:Subsurface Sewaga Disposal Sysiem-Page 10 of 17 Dec 28 12 01:29a p.11 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner Owner's Name information is Centerville MA 02632 12-27-12 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.): t Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): Attach copy of current pumping contract(required), Is copy attached? ❑ Yes ❑ No t5ins•11110 - TWe 5 OtBcial Inspection Fa n:Subsurface Sewage Oisposai System-Page 11 o117 Dec 28 12 01:30a p.12 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments `• 130 Tern Lane Property Address Anna Barnhart Owner Owners Name information is required for every Centerville _ _ MA 02632 12-27-12 page. City/Town State Tip Code Date of Inspection D. System. Information (cost.) 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 is 16"x16"-10"Below grade w/one line out. 2" inlet w/tee.Box is clean and solid , No sign of over loading or solid carry over. 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.): Pump Chamber is a 1000 Gal Precast Tank at 30"w/outlet cover 32"cement at 14", Chamber is clean, No sign of solid cant'over. One pump-working, No one there, could not test alarm or check alarm box. Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: [Sins•11110 Title 5 Official hspec60n Forrrc Subsurface Sewage Disposal system•Page t 2 of 17 Dec 28 12 01:30a p.13 Commonwealth of Massachusetts Title 5 Official ,Inspection Form r Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner Ownees Name information required for every Centerville MA D2632 12-27-12 page. Cityrrown State Zip Code. Date of inspetlion D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 5 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number,dimensions: ❑ overflow cesspool number. ❑ innovative/alternative system Type/name of technology. Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is Five infiltrators, Standard chambers w/inspection port. Chambers are 28" below grade, Dry and clean. Leaching is 11'x37'. Cesspools (cesspool must be pumped as part of inspection)tlocate 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 15ins-11110 Title 5 offidel Inspection Form:Subsurface Sewage Disposal Systam•Page 13 of 17 Dec 28 12 01:30a p.14 Commonwealth of Massachusetts 1WTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner Owner's Name information is required for every Centerville MA 02632 12-27-12 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan). Materials of construction: Dimensions Depth of solids Comments(note condition of soil,signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5sa•11I70 Tille 5 Official Inspection Form:Subsurface Sewage Disposal Systern•Page 14 of 17 Dec 2812 01:31 a p.15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner Owner's Name irlformation is required for every Centerville MA 02632 12-27-12 page. Citylrown State Zip Code Date of Inspection D. System Information (cunt.) 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 � � O Eo 1 13 -i_ ig=6 I -a-, /G J3 13•-2- ' 3` -3; Sa. t5ins•11110 TWe 5 Ofbda!Inspection Form:Subsurtsoe Sewage Disposal System-Page 15 of 17 Dec 28 12 01:31 a p.16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tern Lane Property Address Anna Barnhart Owner' Owner's Name information is required for every Centerville MA 02632 12-27-12 page Ctty/Town state Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Nc 10, Estimated depth to high ground water feet Please indicate all methods used to determine the high ground water elevation- 0 Obtained.from system design plans on record If checked,date of design plan reviewed: 9-23-03 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: T.H. on Design plan 9-23-03' No G.W. at 10' Bottom of Leaching at43". Bottom of Leaching over 6' above T.H. Depth. Before filing this inspection Report,please see Report Completeness Checklist on next page. t51ns-I IRO TIM 5 oRdal Inspection Form:Stowdece Sewage Disposal System-Page 16 or 17 Dec 28 12 01:31 a p.17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 130 Tem Lane Property Address Anna Barnhart Owner Owner's Name information is Centerville MA 02632 12 27-12 page. cftyFrown _ required far every - -- State Zip Code Date of Inspection E. Report Completeness Checklist . 21 Inspection Summary:A. B. C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file 15ins•$1r1 D Title 5 Official Inspadion Form:Subsurface Sewage Disposal System Page 17 of 17 �2 n TOWN OF BARNSTABLE LOrATION 13,7 SEWAGE # -;-2C 3-- 612 VILLAGE �.m� o%��� ASSESSOR'S MAP&LOT 212`01 °Z INSTALLER'S NAME&PHONE NO. /nilOi �`c�a1�/.' Zo-mPZ--­'1i_r•d 5%;22YL, SEPTIC TANK CAPACITY is'ov G�l t ErL 10i'li 45;04)""' LEACHING FACILITY: (type) SSlet 1ru (size) // X 3>..ZLA G NO. OF BEDROOMS 3 BUILDER O OWNER `%meµ PERMIT DATE: i��s� COMPLIANCE DATE: I 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 ¢ Feet within 300 feet of leaching facility) Furnished by D Zzi 6o e-t 04 0 to 0 f No. — 3 % P Fee / THE COMMONWEALTH OF MASSACHUS07S Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pplication for Mi.5paal bp5tem Construction Vertu Application for a Permit to Construct( . )Repair Upgrade( )Abandon( ) U'Complete System O Individual Components Location Address or Lot No. 13® eve Owner's Name,Address and Tel.No. Assessor aarce �YJ��A�j/G� Installer's Name,Address,and Tel.No. / / C� Designer's Name,Address and Tel.No. cIV,? 7i-- Type of Building: Dwelling No.of Bedrooms 3 Lot Size f�Wef sq.ft. Garbage Grinder(-1�10 Other Type of Building �i e*d e No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 13�32y) gallons. Plan Date A9Z umber of sheets Revision Date Title r.0?Je a w,9' 0 !i/`/jA4, G Size of Septic Tank / G7 6`' 04D 26W pe of S.A.S. Description of Soil 3 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued y ' B d f Health. Sig Date IZ— �-D Application Approved by - Date !L-3' /5�� Application Disapproved for the following reasons Permit No. Date Issued a' S Ir — No. 77 Fee� - .?� , v THE COMMONWEALTH OF MASSACHUS&TS w. e'�nte;-ed in computer: ✓ r, j Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Zipplication for Zi!5poga[ *potem (fou truction Permit Application for a Permit to Construct( . )Repair( V)Upgrade( )Abandon( ) LP/Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. r l� Assessor's M /Parcel 3&4 / we % CG ek wl j/e �i Jt� / Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 77/ 3 Lid-�/5� / r r Type of Building: Dwelling No.of Bedrooms Lot Size �� � ZOO sq.ft. Garbage Grinder(40 Other 'Type of Building /t&S �°W"-e_ No.of Persons Showers( ) Cafeteria( ) � Other Fixtures Design Flow l/J gallons per day. Calculated daily flow 530 gallons. Plan Date 112 7 14 :5 Number of sheets Revision Date Title T- ) 90 7:- ZA Size of Septic Tank /5�d/:' laey ��Type of S.A.S. "2--e Description of Soil 3 1 Z 5'X/or�✓�� / Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board pf Health. / Sig�ed"" Date Application Approved by--,,-. - Date Application Disapproved for the following reasons Permit No. ;a '� —6/ Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal Svstem Constructed ( )Ren- aired ( Plo�Tpgn A.A. ( ) Abandoned( )by at /3(�' �/�I'!i! sa has been constructed in accordance accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 9lu,Z -A/3 dated I a f l s 3 Installer Designer r The issuance of this permit shall not be construed as a guarantee that the system will functi n as deli .ned. Date 1 I l:I ItL Inspector 0w,Y l�.ai1� --------------------------------------- No. Q00 3 (j /� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Zi5pogar *pgtem Construction Permit Permission is hereby granted to Construct( )Re air(V)Upgrade( )Abandon(/ ) System located at / .3� ? 7r/4-C/ l • 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 this peq Date: I c Approved by TOWN OF BARNSTABLE LOCATION SEWAGE # ASSESSOR'S MAP &LOT 2-01 °L INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY. is'ov 1•9 r ����' 'r. ' LEACHING FACIUN: (type) SS of Lrz<,�ft•�r -� (size) X 3>.,1s- 'Y NO.OF BEDROOMS BUILDER O OWNER PERMIT7DATE: _COMPLIANCE DATE: / L Separation Distance Between the: j- Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by P FY 4 I ,7 - , �- 77 ti • /3J r� Y- . � y 6Y 6 , Joe, � r � o A.5 I. 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VA— A--Ij ACCE55 -{qr II _______CChTER 1.'INJDCy1;-'RiDGE'------ m O N 0 z ZZ 0 o u / IL-C• CTR_/4D:.E :EQUAL Z I�[ TSaC1` 7S<C22 Ii Z I � AiS-0.AI/- ATrAO -FAO,a -�/A TSAO:< O m Iy AD-A05A AD-40SA A?-<O]< A?�<O]< i Vr \ _ 5 p Z ♦T FAo11 7 AD-05A 1401A �/ REIGN TRANS R 2 / 1155 AS 5-10"N PROPOSED rn A d01 T F4 a SUNROOM j DW,LpSA;a R'-L F�5'-L-b ATFa01d a n _ ADnaOSA p _ VAULT \ 16'CEILING VAUL A'-D' S'-O' BLUE570NE PATIO ATFd01A 7'-2' 12'-L• T-7• FWTBII< ADWdOSd m�y'g8i�u'6 I ...- F-03.115 r C TWERnATRU INSULATED z vI C¢ TRANSOM ABOVE - _ - .. _ o I- ADN2D50 DH?D / rWHID]ILD � fWTD-I-LO2Aa /. __ O ATF1111 AT1201d TAT7,5;� AT"1 pH2cl4 ADW?O]A4DH1 VOV�T'Y;AUL? i o L Q ory (� FW Cllla PW�l11< I FWTlIIa �' 7 ADW2DS0 I DW 1 WHIDlILIIrNHIp]144 fWHlDl16115i D '' F 1 �•7 ATr2Dl d•_0• IADH1 Q F FWHID51411 F ,- rA CD PROPOSED PR`OcPOSED ROOMPROPOSED BATH _ A I�Aw2Dso _ b BEQRQQM I ?-0,y-L CONTRACTOR S 4Ll CNSURE !� TWAT rIRCPLACL/L'I It CY VJ !o]o u 4 5TRUCTION cor,rueD r✓Au Z Q Q 5 I I ".e 5N A siriNTD�ooeonAL • o I I I DIVING ROOM i ]0]0 ...._... .... ................. ....__......--......__......_......_.-..-..........-....._.....................__. .-..---'---•]'-<• T-II' 20'-Y I a A,S I -_ - D' SQINRE COL j 40'eM;�p D'SQUARE LOL. Ov D' .DC ! /11'CEILING -_ ( PROPOSED 14]O r0(ryEEwALL ol CTYP.\ KNCCwALL TYP. STWE VCNCCR g`a�D(p�i�•ni �gYZ REr I PANTRY _ OPEN TO ABOVE PROVIDE L•MIN.To O DL _ TI [! 9- e` _ gBnn --- - ----- - GLG. LINE RITLINZLINCO IN CODE <D'CO. .AV qAoi" d2=.�' o 6-I ac7o-S' - J4'-10' C yI ESV�•s�,. dd�Ex -0 d-0. n 5' Po 4 l 1qz, ADW?eso !a]a 70 ur ME oVE � -_ ___-__ _ ssbb wALLL :: _ _. T - - e:wt''u'" A'Y•S_� 6 Al I' ?D70 PROPOSED I 4TF2DI4 ATF?Dta PROPOSED LAV. I• ADW2D DD5 50 AH20 PROPOSE yI -�r3rr TF261 I I I I � L. __ II 5'-O' �� 9'-G' �� 5=6' I• . D 2•-L' Ir'-D' 1AAN261 TR u/RIDG A01421550 nE•L_L• 20'-O' Q 1W` PROPOSED 'T:IE�Y.ATAJ�r•iiu6ETE PROPOSED 4• - L'.L' P.T. POST o J v I,J I I ( FIBERGLASS DOOR u/LIGHTS 2-1 5.L 0'f ENTRY WRAPPED TO 10' _ _ W Q 1610 ..,ATE,5 OE 20 MIN.DOOR ADH?GdO F IL'TRANS •1 ABOVC BLUESTONE 5QlA4C TYP. _ Q Q AS �2•'O. 2D7o NOTE, Q_n Z m _I CONTRACTOR TO PROVIDE FALL PREVENTION ON ALL wINDW5 O lL W N rv) I R WITH SILLS ABOVE 72'ABOVE F_SH GRADE PER CODE.ALL K F WINDOWS SHALL WAVE FALL PRNCNTICN DEVICES AND SHALL d Z ASTM r WITH THE OW OPENING 0 OF I^ O m Q ASTM r10g0. WINDOW OPENING DEVICES SHALL FREE PAS ACTING VI AND PALL BE R,GiosPOSITIONED E PRO,4. THE FREE PASSAGE Of A 4'DIAMETER RIGID OPENING E ITINL �THE WrNDOW OPENING J ?�E-ATR T I WHEN TWE WINDOWWITH OPENING LIMITING DEVICE 15 -IO INSTALLED IN L _ f IBER4LA55 DOOR I ACCORDANCE WITH THE MANUFKTU4CR'S INSTRUCTIONS. - I c .:FLOOR IIVwG SO FT. 2!71 i ]-•e FLOOR SG A}'2D50 I TCTAL L VIw DLQ] GARAGE SO FT. ]52 O PROPOSED i I' -TRY R-SO FT. <!• O�Z.. GARAGE Lf' - �, RODO Ga4AGC DOOR � O TAL-DER TCDEQ ROOF A A I ^RGYIDr I LATER 52' A.S TYPE' rIRECCDE GnB ENTIPE GARAGE 1 CEILING r-.-.-.-.-.-.---.- J O c I APRON NOT=: ALL 'r:INDONS ARE TO �_ c - ANDER5EN A SERIES m$ I W/ APPLIED GRILLES 1 0 IN51DE AND OUTSIDE m I AD-'2D5G !2 EXTERIOR WALLS•i•'ALL Be^As a I - •N'LO.C.UNLE55 OTHER IEE NCTED. I p \ I gODO GARAGE DOOR 2.ALL INTERIOR YhALLS SJALL Be Z%t •O •Ib'O.C.VNLCSS OTHCRWISE NCT_O. L-------------'---- S.CONTRACTOR SHALL VERIFY ALL WINDOW ROUG•I OPENINGS PRIOR TO ORDERING WINDOWS. v p Oi d,CONTRACTOR SHALL VERIFY ALl DIMENSIONS vj N Z ADH2D50 ADH2D50 n PRrM TO CONSTRUCTION, CONTRACTOR _ ASSUMES RESPONSIBILITY FOR ANT n1551NG OR < W INCORRECT DIMENSIONS NOT BROUGHT TO v = Q HE ATTENTION OF THE DESIGNER. O VI � 6 z x U —10i ------- —� r T 0. I VI � 5 i A,b CONCRETE FOOTING I O I I I I I n I I I nl I o n i¢ I I 5)1y,,I14•LVL I I `'"�Da.w$ FLUSH am$ $�+R TEE A.b I I r oN / - PT_ - -------\--------------- I 1L J L I V zr I/ 10•THICK.A-e• \� ———— ——I�--—— —————--———————� G I W �'$ coNCRETE WALL ON V') I CONTINUOUS 7o x10 —J111 III 5/5" ANCHOR BOLTS o 56• O.C. Dn, lr A.b CONCRETE FOOTING III - III PIIN, 7' EnBEDn ENT PACT. w/9'x9•xl/A' PLATE WASHER EMEND TOOTING 17' .•��� j' III III III BEYOND F.P.Dln6. E_L7 O 5 g III III III 5)I y111 4•LVL cr7 v7 r ilt— JIL CRAWL SPACE r J�—OROPPCD 5'- ' O r z to > r 1 7•CONCRETE DUST DE IO nIL VAPOR RETARDER _ III I DOUBLE JO15T5 UNDER II I I A_L..L_....R._A—L.L_E—L.rP_A..RT-O N._rSI .==...._=_...._.—lo.•_J.-_o—•__T.1= L—i— I rILr=--.. J ] I c-51 c-A• c-r hIII 5)iL• L c ....._------- ILI' _ .�_—�IIIIIII.on II --- II IiI o__ ef•I REPLACE FOUNDATION[D Ggwdd¢cosTlELE — ARE WdY Iw GRAVE g�o �DDa<�yu�ia�_Y� -gsF�p=:';3 2! DIED, TYPICAL. L_ 5)11,.II 4•LVL — E[_——0=— - E'9 C I I� rwsH —(=RIII T T� —1— -=I———� I I I c4� Sze" n III L—{I--J L_ J L__J�� L—_J L�I_J / y A_A I' EARLY ENTRY 5 1/7-CONE.FILLED III ea gA jA ypyD{{[}pp``. VERIFY w/GRADE CONTRACTION JOINTS I1I III STL.LALL' COLunN III .�O III a I �EXY�F>+ bp(Q�Lj SO54AD i+GL I TYPICAL IL r DRIOPPIED•LVL III ��C`F500TINGD TIP. III Na III Dn. - "'l I, hI I �La�Y yQCS gggGG$e Cq� J r—III— III e)I'w1+4•LVL III �o III PACT. G I D 9� E�EplNe64 FwsH 10 THTOK.r-e' III A.B6Dsg I Ili I I Bn III G Ili J d�F:�a ._�Er4t CONCRETE WALL ON ——_— J \ L[NTINUCUS 70'.10'/ ——————————— ^ bLUSHII 4• LVL III L—aid-J PACT. III` A•'8 III CONCRETiFOOTINO I I 1 _—___�_� J r ________________ --- I III I1L 11 tl I� III � --____— —__— \� O CA CAD. LL OR TUBE STEEL BULKHEAD I` COLUnIN III / I [ \ - —————————— 75•-6• O 1 Dq�, g O 70'-0• Q U R L_ JI, PRT I RFTE 1_AD� .I� J Z 1L♦ 1n _—LT —__, I A.5 7'-o' I I �'- A.5 ( I Z O— O }}�------ttt PROVIDE PS REBARS 1� ry —l L 7'OC.VERT N-IN A.b A.5 I— W Z Q FOUNDATION WALLS TO TIE IN TO FROST WALLS. -YP. t O W F- CONNECTION wu ERE POUR E Q ((� _———— 5 NOT CONTINUOJS. f'Z / I TYPICAL NOTES: in a AlI STRUCTURAL ENGINEER/DESIGNER TO PERFOan FR ING INSPSECTI04 •" _ N�EN'FRAn ING 15 DOn'•Lr-AND PROR TO ENCLOS RE BY INTERIOR Q J I' EARLY EN'T4T _L PLASTER DOdRO/F1N15+N, C. NT4dCTION Jp NTS TPICAL PROP TOP O(WALL I / 17'AT DOOR OPENINGS I I 5ASEi`1ENT NOTES: GARAGE SLAB I +. IN FC;P:DATION WALLS To DE Io• OuaeD coc.w 71.5 B.45 TOP I .BG_T .REST FOUNDATICNI ON IO•x70•SIT—IOa7ING. CONTRACT DR SHALL I PITCH 1/e•P!R FCCT - I PROVIDE 5 :CQIZ.DABS CONTINUOUS IN STRIP FOOTING w/ AI Ae' nINInUn TOWARDS D00R5 K_EY Y PROVIDE ti VE4T.DOWEL51 7A•OC... z.EMENDED. - FOOT,NG COVERAGE I / I 5'-1'n1N.ABOVE TOP 6 FOOTING.PROVIDE 5/e•A.C O' <•CONCRETE SLAB I DO_T5 1 X'O.C.r.AA,nIN T En*ED ENT I.T/5"W5 A'PATE WASUER D$ z AOI Io nIL VAPOR RE.ARDER I t _i + • 7.ALL 5TTOC Y N STEEL TI u'^15 TO BE 5 I/7•GONC4ETE FILLED Tf u V. A I I O q 4 7".12 S TO BASE TO FOOTING B_OW.PROVIDE a•.a•.5/e•CAP PLATE <IA - j L u ___________________________________ a]'.IN45 T BE PLATE w 7 I5/A' DIA, TEBOLTS.WELD ALL CONNECTIONS i 3_u a- A.5 i I__________. I -t ♦ A.5 _ FOOTINGS TO DC%'.5A'x:i•SGLARE CONCRETE W 5 P5 OARS fAV 5. 000 LE FLOOR J0!5T5 UNDER ALL PARALLEL PART IT IONS* CONCRETE WA P I % A.CONCRrC DIETCAP TO BE 7•POURED CONIC.ON COTPACTED FILL. _ D C . GONTINu0_'S 70"•:0' I I C'JT JOINTS ALONG WALLS AND DEAn C0.UnN LINES. _ c u CONCRETE FOCTI\G 5. CONTRACTOR TO P OVIDE BASEI-IEN'T VENTILATION A5 m j 1 DROP TO!OP r..A': REOu:IRED BY CARE(WIN S OR 1.C ANICAL) T DOOR OPENINGS I I � i i.CONTRACTOR S+a L ENSURE TUAT ALL FOUNDATION WALLS nAINTATN I I i I R ..-0'T:1NInY CODER m ' I I I 9ACKFILL O ].PRONTO[wED STIFFENING PLATS AT ENDS O E4 STCCL Bn5, TYP, GO•PACTED FI � n ILL L G D.SEE STTURAL DRAWINGS FOR LOCATIONS OF ALL STRUCTURAL CO_UnNS. Q \ I I RK AWI O G I A.8 P CONTRACTOR S A L NCT• LE DR INGS FOR DI EN51ON5. ANY n,1551NG• I O \ l r:CO4EECT OR OJEST IONABLE D-E'SIONS NOT BROUGHT TO THE A TENTION 11 IO I I A. I I Of THE DESIGNER BEC E T-E RE5P 51B1LITY OF TUE CONTRACTOR. e•x A•..75 - a TUBE STEEL / _ U w —————————7 A--o-————————— m O N MITIGATION CALCS: OVERLAY DISTRICT: Existing Built Area AP - A s ` ' 0-50' Buffer 1324 S.F. Aquifer Protection District 9 50-100' Buffer 3040.7 S.F ,• ,e � r �� 4y3 m Proposed Building & Drive - - 0-50' Buffer 633.8 S.F. 50-100' Buffer 3682.5 S.F. Net Change FLOOD ZONE: 0-50' Buffer Zone B & C (see plan) 690.2 S.F. Less Area Disturbed Community Panel No. � *Y J N #250001 0015 C 50-100' Buffer t t t ^ July 2, 1992 641.75 S.F. More Area Disturbed t•1 Top El 00 Overall Reduction ' • x 48.75 S.F. � • � � ' � �� 31.4' sn r-... r.o.. ".; #a;;.i, bps• , Location Map: -' To El 1"=2,000±' 32. 55 0� i 0 El a /1 4 1i lam. e 1� i' \ � 31.7 � F et l ' `•: `\ '' $ \. 31. � . e , \ REF ;i Tree Line" ...., ine ., o rap EI ` Map 212, Parcel 012 Typ \ 33.1'i � _ Lawn \ ••t r I f 1, CB/DH i � ,r i -............. \ Fnd i y l jj l 1 j1 \� BotEl ZONE: \ • rt iii _n i 1 1......,... O aw \ RD 1 f \l \ f Area min. 87,120 SF RPOD - `\ Top El (min.) ( ) J�) J /jf r / J / .' 64.8 .' i l ` Exisking 33.3' Frontage (min) 20 Width (min) 125 . L..... C : a t � Setbacks: SRevetment Fron30 ......... RemainsPro os Side 10' Septic System ! i Patio \ \ 'A as per BOH card J ' / / :p \ `� , Lawn r0 Dwelling v a \ Rear 1 0 Septic Permit -� f f \ \ \\ pas ing Top El #2003-613 #� 332 \ \ 3-p � S 2 ''Sty w/fxistin\ D'Welling, �` o :.k.......... f FF El e:v. 38.8' ,� ,g Pu Bat El DIRECTIONS: nt hdr)q r & s T k N. l \, From Hyannis: Take Bearses f 3 v J � �. f --- }•. \� '_ �ti �:�.••• � Way take aleft -onto Rt rap El 28. and take a right onto 0.88' \ �. - 11 33.3 01d Stage Rd. and aright o onto Shootflying Hill Rd. / 22 Turn onto Tern Ln on the O \`\ % / jo Right and the House will be on the left # 130. eat El O \. \ 32.0' j l \ Prop ed Re,o idn of \ \ She i \ Existin Septic k .r-- '- \ \ ,_---aC1d Pu p Cham Top El 33.2' � Parcel Area . -'` - / (To Water Line) I ... l 1 `l \ Existin ( .`f Air / o:\ 9 3 6 F 04 0 S Ven t t \I' rivesot E7 Lawn J1.6, i ,tb _- `.. v. r: Top El 32.7' Notes. - Dry Well•.for oof / \ \ Runoff and rive,4 re 1. The property line in motion shown was \.\Proposed _ n Drainage Ty /'` o Fe° P p y \Drive _ ;• compiled from availa /e record information. ----------- gd °r 1 0 2.) The topographic in rmation was obtained / Tree Line \ - 100000o�e°a from an on the group survey performed on __ ---`� _- x' '9 'e--- ... .. N6a� or between 08/JAN/13 nd 10/JAN/13. 3.) The datum used is mean ea level based on lV7g5 We ua uet Lake d um. r.j l 2po„ q q ' , w BOYANCY CALLS Legend: /' � � / Nor N mop ` ancy K ,tfcLea 1000 GALLON PUMP CHAMBER 5 Cedar Tree `�Stone Dive /// / stone n 4.83 X 9.0 BOTTOM AREA OF CHAMBER Drive / 2.4 OF WATER f co 4.83 X 9.0 X 2.4=104.4 C.F. Holly Tree \\ Z_I-- 0 104.4 X 62.4 LB/CF = (V,�� / 6510.1 LB OF BUOYANCY FORCE / WEIGHT OF TANK = 14,500 LB Deciduous Tree 1 f 7989.9 LB OF DOWNWARD FORCE I / CHAMBER SINKS Coniferous Tree / 1500 GALLON SEPTIC TANK 6.16 X 11.0 BOTTOM AREA OF TANK ® Catch Basin / Q� f Stone / ' OF WATER © Water .Gate (round) 2.1/ m � Drive © Gas Gate (round) / oc 6,16 X 11.0 X 2.1=142.3 C.F. -0 Guy � .--�- -- / 142.3X62.4 LB/CF= -& Utility Pole / 8879.3 LB OF BUOYANCY FORCE El ID o Ventt Pipe ; %/ WEIGHT OF TANK = 21,230 LB -OHW- Overhead Wires 12,350.7 LB OF DOWNWARD FORCE - -25-- - Elevation Contour / / / / TANK SINKS ......• S.....•.• Underground Utility Line j F.G. EL. 38.5t Approved Filter Pump to Existing Flow Equilizers D ^- -Box As Required AN�F / PROPOSED EL. 35.75 EL. 40.77EL. 36.25 P\- Mqs / Installer To 9 J� s90 Relocate Existing x/stin t,' Ide. �- i / ' / Confirm Prior EL. 36.0 1500 Gallon EL. 35.7 Relocate Existing To Be Installed On O rn �t - / D_Box r C. G oh//7 / / A To Any Work Septic Tank 1000 Gallon ab e om acted as EL. 40. �t -A m H-20 Pump Chamber PCD Waterproofed H-20 °`^-^Y cD Waterproofed FI .34.8' V ,i -- -- / Estimated High Groundwater Bedding,"T"s, & Baffels C.� cn W _-' / EL. 31.5 Per Perc Test# 10585 as Per Title 5 'a Q 2 ~- ._ J~-�af1W / / � � EL. 31,2 TERF' / e P FSS NAL ,,'Water �p DEVELOPED PROFILE OF SEPTIC SYSTEM s"k` 5c," / sL � �.' NOT TO SCALE cc' p�� w<'� Cle�'� CB/C a- Water Fnd o Meter Revision: Move Proposed Septic System 5-30-13 Revision: Move Proposed Driveway 5-13-13 Title: PREPARED FOR: PREPARED BY.- Proposed Improvements Plan of Land Anthony & Susan Wilson Sullivan Engineering," 11 Hearthstone Pl. Inc. CapeSury At 130 Tern Lane In PO Box 659 7 Parker Road Andover, MA 01810 Osterville, MA 02655 Osterville MA 02655 Bamstable (Centerville) Mass. (508)428-3344 (508)428-9617 fax (508)420-3994 420-3995 fax www.copesurv.com ' V 20 0 10 20 40 60 Date: May 9 2013 Scale:1 „ ,ZOr Field: WHK/MJD Review: RRL s Comp/Draft: WHK/RRL/CTR Drawing # 3300001-WILSON I I i ......_«,.:...-,w................w.-..++..+...-..�.:.••.«+-.�•...wti's..a va ssaenmmw:e<.+rt:,w..:.xs...:ww,sarnw f,! ! LEGEND SEPTIC DESIGN: (GARBAGE DISPOSER IS NOT ALLOWED ) TOP FNDN. EL. 40.0' SYSTEM PROFI11 TEST HOLE LOGS DESIGN FLOW: 3 BEDROOM:; 110 GPD = 330 GPD ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) 100.0 PROPOSED SPOT ELEVATION ) r (WATERTIGHT) ENGINEER: ARNE: H. OJALA, PE USE A 330 GPD DESIGN FLOW ACC`:3a COVER WATERTIGHT TO MINIMUM .75' OF COVER OVER PRECAST J` WITH{Il 6" OF FIN. GRADE SAM WHITE, RS k SEPTIC TANK: 330 GPD 2% SLOPE REQUIRED. OVER SYSTEM WITNESS: ._. � # 100x0 EXISTING SPOT ELEVATION (g. = 1485 '" - - 44.0 MAX. I_ I 1 1 100 USE A 1500 GALLON SEPTIC '"A�:K RUN PIPE LEVEL DATE: 9✓�3✓0 ' IR t PROPOSED CONTOUR 38.0't* r� FOR FIRST 2' 2" DOUBLE WASHED PEASTONE a IV6v 1 , < 2 MIN/INCH LEACHING: PR 150o L / PERC. RATE _ _. = LOCUS ' I 2(37.25 + 10.83 _(.71 _ GALLON SEPTIC ' 41.0' I �, ` I 100 ---- EXISTING CONTOUR SIDES: ",a) 41.2 y /.40 / 37.15 Q� ,TEE CLASS SOILS P 10585 r TANK (H 20 ) GAS 37.25 x 10,83 (.74) = 298.5 WATERPROOF BAFFLE aQ 40.77' �'� `�'60 a 40.58' 4' AT SIDES $ BOTTOM: --.._.._ MIN 3' AT ENDS N TOTAL: 459 S.F. 3: 9.7 GPD ( 2 % SLOPE) �6" CRUSHED STONE OR MECHANICAL 0.58 40.0, ELEV. USE 5 STANDARD INFILTRATORS W TH 4 STONE AT opt ✓" l I ' COMPACTION. (15.221 [2]) 39,g0 '\ SIDES AND 3' AT ENDS DEPTH of Flow = 4 (.�_% SLOPE) ( 1 % TEE SIZES: 0 BUOYANCY CALC (1000 GAL H-10 PUMP CHAMBER) " 3 4" TO 1 1 2" DOUBLE .WASHED STONE 2,4' x 8,5 x 4.8 x 62.4 = 6110 LBS UP INLET DEPTH = 10 ✓ ✓ 2 WEIGHT OF PC = 8240 LBS (OK) OUTLET DEPTH = 14' E LOCATION MAP NTS 5, j Fs I FOUNDATION 30' SEPTIC TANK 7' PUMP 50r D' BOX 4 t LEACHING 5' 10YR 7/1 ASSESSORS MAP 212 PARCEL 12 FACILIT CHAMBEF, BOARD OF HEALTH B - MA I_S APPROVED DATE *THE INSTALLER ' HALL VERIFY THE USE HIGH WATER AT EL. 35.0' 7.5YIR 4/6 I LOCATIONS OF AI UTILITIES AND ALL (LAKE INFLUENCED) 16" 38.4' j BUILDING SEWER ;.')LITLETS AND ELEVATIONS I I +,35,33 `PRIOR TO INSTAL] ING ANY PORTION OF C [ SEPTIC SYSTEM PERC ALARM AND CONTROL PANEL ® \�� w CS TO RE INSTO LLE" INSIDE ,mac 9 ' 33,82 ua��>,: c's W,ATEa 33.6' 131 IT{. T!•jG, r,` I{j tiE 0;,; LUI �� SEP, FATE CIRCUIT FROM PUMP INV. IN 37.08' 1000 GAL, H-20 S/ 2" PRESSURE LINE \ 74 ALARM ON 700 GAL.+ SLOPE TO DRAIN BACK TO PC FLOAT SWITCH RESERVE WEEP HOLE \ \`� 1,�YR 5/6 -; SETTINGS, PUMP ON CHECK VALVE U.5 4' WORKING RANGE \ ZOELLER 'WASTEMATE' \� G� CONCRETE 4' SUBMERSIBLE MODEL M282 1/2 HP P'JMP ` ���, _ RET. WALL 120" 29.80' PUMP OFF 8' SYSTEM (OR EQUAL o�000 `�0000 0000 0000 � 2,97 ' PUMP C HA MBER \ �° (NOT TO SCALE) CO <� < 33,90G, � +4 .26 40, 1. WEQUAQUET LAKE I WATERPROOF ' 39, e 0,4 40,35 NOTES: ,�40J8 77 ` 33,91 1 . DATUM IS WEQUAQUET LAKE DATUM SYSTEM '*39, � 2. MUNICIPAL WATER IS EXISTING ,5 APPROX. LOC 39,87 �� 5.26 41.8 CESSPOOL 3. MINIMUM PIPE PITCH TO BE 1/8 PER FOOT. ER OWNER EXIST. CONC. ��� 92 4, DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 20 0 DWELL PATIO �� �, 7 • � � TF=40.0' `� `�, 5. PIPE JOINTS TO BE MADE WATERTIGHT. 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. 39, 5 \, ENVIRONMENTAL CODE TITLE V. 4 .-)6 - 41,7 .\ \ O APPROX. 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE INV OUT USED FOR LOT LINE STAKING. Y ELEC EL=38.15 SCH. 40-4-" VC. 4P�A METCR 8. PIPE FOR SEPTIC' SYSTEM TO F' i GYM ` CID 39478 9. COMPONENTS NOT TQ BE BAGKFILI_FD (�R C.'ONCFr. n 'W:T'by:!IHG'_' a J\\„ •. \ u - i�r'.:..: - ,i :✓ . J.J .it �.c 'til il._V x 40,39 I 1 ,-�39.69 '�`` ,., ,17 ��. �, _, , '., FROM BOARD OF HEALTH. 4 I a4 �1 I ,r 39, 7 '\ s-.39,ao ' : 9.�3- _ 10. CONTRACTC�R SHF;LL BE RESPONSIBLE FOR VERIFYING T HL SPECIMEN HOLLY - SAVE �� ' � TH � LOCATION OF ALL UNDERGROUND 8t OVERHEAD UTILITIES PRIOR � 40.58 ' i I 33,85 MARK TO COMMENCEMENT OF WORK. I / BENCH , / 40,95 ! COR STEP . :, I EL= ' 1 39.79 -,-- EDGE OF WATER 40.19 STONE LOT 48 5, ! DRIVE 30,200 SFt TI TL E' S SI TE l "L AN 40,7 9 Q ' ---I�3 ,23 � f39,41 �'r1 +3 5 ` PROPOSED VENT (FINAL PLACEMENT BY ti /' -k39,14 `� J 1 130 TERN LANE CONTRACTOR WITH HOMEOWNER CONSULTATION � 38,99 , 5 �\ +3''.67 r 33,87 ) •,�-39.21 ; 1' 'I-�39,12 \\ IN THE TOWN OF: BUGSCREEN AND CHARCOAL FILTER RECOMMEND=D " RED APLE �-�38,87 �38,94 33'88 ( CENTERVILLE) B A R N S TA B LE I,38.893 4Loo O/ ,1 388g ,�+39.82 �, \ \'+34.76 PUMP AND REMOVE (OR FILL WITH CLEAN - --} 71 38,46 G� SAND) EXISTING CESSPOOL(S) PREPARED FOR: A N N A M A R I E B AR N H A R T 38,92 i x +4 .30 38.q+�3877 - ---- I-38*15----- _'137.90 20 0 20 40 60 36,13 / `}-38,50 lb�/ �/ SCALE: 1" = 20' DATE: OCTOBER 2, 2003 / W** J 00' �'` �r ?8 REV 1/5/04 (MOVE SAS) l �38.53 I 1 H OF MAl?. �1N OF MASS E }38.39 37,80 �o� ARNE y°Nyfi� ��yG H. o ARNE H. y OJALA H OJALA No,26346 CD CIVIL o. !q0'� 95�b pQ- t THE INSTALLER IS TO CONFIRM ADEQUACY OF ELECTRICAL --- U - IorrnL **WATERLINE ONLY MARKED TO METER PIT' - PRIVATE T(l' SYSTEMS FOR PUMP INSTALLATION AR NE H. OJALA, P. .L.S. DATE DWELLING (REQUIRES PRIVATE MARK-OUT) ELECTRICAL WORK BY OTHERS o")` PLUMBING W'IRK BY OTHERS (1F NECESSARY) SLEEVE SEWER LINE IF WIITHiN '10' OF WATERLINE 4� } mac- �<"� I k ! t off 508-362-4541 fox 508 362-9880 R I I U - down cape engineering, inc. f CIVIL ENGINEERS I .LAND SURVEYORS 939 main st. yarmouth, ma 02675 I 03-254 i ! i i k.