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0030 NICKERSON DRIVE - Health
30 Nickerson Drive { Cottit A - .035 = 061. ;� - - - --- - - — - - - - - G 1 No. ao 6 Fee Q V ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: YesPUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 4pliLAtlon for Mispo80.Y *pstrm Construction Permit Application for a Permit to Construct( ) Repair�14upgrade( ) Abandon( ) . ❑Complete System ❑Individual Components Location Address or Lot No. 3o (\i( e rjvr) ADrtv2 Owner's Name,Address,and Tel.No. 5l -7710- S 73 Ma2altneQ�+iolsTt a/o A.%-i✓n4erprises Assessors Map/Parcel 3S (�/ C P.O. 4 do5z. Q I c f >^A 14, oav3 S- Installer's Name,Address,and Tel.No. 60$-YP8-.Vi.)(o Designer's Name,Address,and Tel.No.5'U8 a-U S-// ' cJpc�o(o-�Conglctx�'i c7�,inc.. .LIS yx�ustr {� `�w��(?ck rtt,c�y3 14 oacotl8 � �i n�eecri�;!x+t 43 i min St. cur 9 Type of Building: �� ` Cre-S Dwelling No.of Bedrooms Lot Size Y' sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 6(,D gpd Design flow provided 649 gpd Plan Date OC'66, I?\,ao i Cn Number of sheets Revision Date Title ZZ t 1 5 I,L ga-",-_ -130 L n S�rv,,t 00�c.e J r Size of Septic Tank f (5 �(-�_1C� Type of S.A.S 65)f4-ao Svc,�3.1 ely,mtL. f n jz•,�X /243 Description of Soil o p Nature of Repairs or Alterations(Answer when applicable)-1 14- 6 o 4 I S kL0% 1 eJ t�-�' S I C ZSckhAAtim"lnv 56M-4 in 5).SXl •k3 PA 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 C deland not place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed — Date Application Approved by Date a � Application Disapproved by Date for the following reasons Permit No. ?c)(U - 3-7-3 Date Issued if .. No. O(Kl L s f `',.x , ,... �•, Fee (7 r THE COMMONkVE LTH OF MASSACHUSETTS Entered in computer:_ Yes PUBLIC HEALTH DIVISION - TOWN`OF BARNSTABLE, MASSACHUSETTS 2ppliLatlon for MIStloBal *Pstpm construction loerinit r Application for a Permit to Construct(r) Repair(.Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.3p N jG�e�5 an r�r<<r e Owner's Name,Address,and Tel.No. U v),' sTx ci-/6 A,-! i✓n4er(�r i5E5 Assessor's Map/Parcel 35/G/ P o 105C, Installer's Name,Address,and Tel.No. 6-08-41P8- $9�Co �Designer's Name,Address,and Tel.No.��S- 3�a-c/ �Jor�o(o CvnS{r��t c>N,inc . �fS dus4r�Rai Kv�IW , Erigi r,eeu'r ;►��c 3� Main St. jvt Us 6-.x6 S Type of Building: � � re 5 Dwelling No.of Bedrooms (e Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) (p(a U gpd Design flow provided 66? gpd U< y , (� y it-,Date Number of sheets Revision Date Title 4 �= Size of Septic Tank !' }G -I[� Type of S.A.S(._),N-a v ScK,an.0 C.�r�n,t��an i n 5Z5.J'X /a•83 Description of Soil 6u Nature of Repairs or Alterations(Answer when applicable) Jjicj,,cp � � 14-1l) sc.nA4,(,."1"4 5 t A tr In 5 U•S X /� •S3 Date last inspected:` �^ Agreement: _• / The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal systerr►iin— accordance with the provisions of Title 5 of the EnvironmentalCode an'd no o place the system in opera ion until a Certificate of Compliance has been issued by this Board of Health. Signed - Date Application Approved by TN-, 'y--L Date (a 1 1_41(LO Application Disapproved by Date _ for the following reasons 4 s a Permit No. 7((Q 3 7_3 Date Issued loy (6, ----------------------—---------------------------------------------- --------------------------•-------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( ) Abandoned( )by Cw,-,Er ) �yr,\ arc - at 30 `n i L��pv 5 e�r� I)F U � has been construct d in co ce with the provisions of Title 5 and the for Disposal System Construction Permit No.�i �O Ited Installer f:n)y v v` ti �c,riS ct;C I()1 C Designer .x k.,5�,'1 �c� ,ve �,��r�� e f t l^S #bedrooms Approved design flow �.(,'� and The issuance of this permit hall notbe construed as a guarantee that the system will nc�'on designed. Date V� f / Inspector }n, --------------------- -----'-(-'----------------------/--------------------------------------------------------------------------------- - No. C7 " Fee ��01, THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS ]Disposal *pstem Construction Permit Permission is hereby granted to 'Construct( ) Repair(X) Upgrade( ) Abandon( ) i System located at (� N 1 C ram-, f 1, U-41 �c� 4, 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 - Approved by �I Town ®f Barnstable e� swe,��o Regulatory Services Thomas F. Geiler,Director * saaxsrast� « 9�A 1639 ®� Public Health Division i rEnwa'�°, Thomas McKean,Director 201 Main Street,Hyannis,I%a 02601 Office: 508-862-4644 Fax: 508-790-6304 i Installer&Designer Certification Form Date: / /7 Sewage Permit# Zo lk' 3 2\ Assessor's Map\Parcel Designer: 0 r1 � Installer: '60 Ale l/1 Address: / la V Address: P 0 ' jdox� 17 7 On 4fr 4,yas issued a permit to install a (date) (installer) I septic system at based on a design drawn by (address) 'r,V 0- 4-f dated d 1 (designer) j I certify that the septic system referenced above was installed substantially. according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I-certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component. of the septic system)but in accordance with State & Local Regulations. Plan revision or, ! certifie 4s-br' t by.designer to follow. OF Nis9cy �o DANIELA. {� o OJALA (Installer's Signature) CIV I j No 46502 1 AL (Designer's Signature) (Affix Designer's Stamp-Here)' PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. ! i - - j Q:Health/Septic/Designer Certification Form 3-26-04.doc I "NICKERSON DRIVE EXISTING 12' ROW TO MAIN STREET -- — — S87°1600"W \ 1 18.00 I GRAVEL IDRIVE � J 4, ° O 23. c9 I i � x I PORCH W \ O �, x O N \ O 10.3 w EXISTING w DWELLING - X C 0o f TOF = 39.1 —27.6' x J SLAB X I I I I I _ MAP 35 I PARCEL 61 j (A 0.39+ AC. 1 SEPTIC AS BUILT 6-249 PREPARED EXCLUSIVELY FOR THE PURPOSE OF OBTAINING A SEPTIC CERTIFICATION, NOT FOR ANY OTHER USE j. LOCATION 30 NICKERSON DRIVE PREPARED FOR: �v SCALE 1° = 20' JANUARY. 25, 2017. ®R'�'OL s 0N►7Te� c j REFERENCE NL4LP35 PCL 61 MC off 505352-4111 - C-)O OJALA N fox 50:362-9880 N0.40980 downcape.com m '� P 4 WN.CdAe e/J8%l/eer%A18,OAC, civil engineers land surveyors I 939 Main Street (Rte 6A) YARMOU7HPORT MA 02675 DATE REG. LAND SURVEYOR } i i i TOWN OF BARNSTABLE LOCATION �� �cX. -�z�c�rit tz'Jr SEWAGE#�c tom- VILLAGE l �i Lk i ASSESSOR'S MAP&PARCEL 03T-OC,,F INSTALLER'S NAME&PHONE NO. C. ��'•-1`7(—'1 3g47 SEPTIC TANK CAPACITY i .�E�_ LEACHING FACILITY-(type) '—ItZ4-�14-- (size) . •� K� NO.OF BEDROOMS �o OWNER C-6, 20 PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility d•— Feet Private Water Supply Well-and Leaching Facility(If any wells exist on site or within 200'feet of leaching facility) N e — Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Aj 417 r c-(-on-T, ✓� � L .� 430 gl.�.off: 0 3 5" D l �y.z 33 . ®c? . :j , s M�CQenatrown of Barnstable >P# /�111oo I��epa>rtment;�of Health,Safety,and�Envtr:o.nmen:tti'1 Ser',vecesr � , 1,MD1110VU-lealth D'><vdis��ion Date, •-. .• i 367 Main`S • P treet,Hytianis MAt026 " e a 5 ®AMffrADM i P Date Scheduled Time G A'A. Fee Pd. �D ' r Mr Soil Scitabli flssessa ®ent �° e ae � Disposal , • °� •�•• Performed By: t'C rut c, 2 Y-rq-t l'r Witnessed B�:.�_�!1 ul�/�l VV• &�� 12 Location Address �O n C � Owner's Name Assessor's Map/Parcel: 3J 6I Engineei''s'Name - Y Telephone# Od4 6 NEW CONSTRUCTION /` REPAIR p // Land Use Slopes(%) a ` 9 Surface-Stones N O/7 e Distances from: Open Water Body rOG ft Possible Wet Area 7(ZG ft Drinking Water Well 7 ft Drainage Way l ft Property Line U ft Other ft - SKETCH:(Street name,dimensions of tot,exact locations of test hoes&pert tests,locate wetlands in proximity to holes) 0 'Q) -_ . ,' P \ r4y 18' � z0� • Parent material(geologic) i,:ItiC�a ;(/ol�W�S.� Depth:to Bedrock Depth to Groundwater: Standing Water,in Hole: N// �.. ti_ _ -Weeping-from Pit.Face 1v - Estimated Seasonal.High Groundwater.. /V <.;•:,>;:.:a:•;;::o::.::a:n:_;_•.::._...:.,.:.:.....;:• .:'.:•<:.:.:....,.':.:,.,...;�.1.�..�:,:�.,.+ ..:•�.•:�:,'?::•:::`;';";',";y�`�'%''c�<c£cs`�•:'<�:yiy�:y.•.�,;,q..�..,t,�;p.�'r.�;.y.;�•:y;��. •f:<i:.:<•.•` <si>:: ::::%:i::•,`:;t ;i t;[i: 'IVtethod Used: ��:;�:•:;�;;:•:�::•:........,............... ,' in. Depth Observed standing in obs.hole: in. Depth.to�sd&mottles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well#___._._ Reading Date:_,___ Index Weli level,_' A(lI!tfactor " " Adj:;Groundw,ater LNil evel__ sepl , ` Dnt@ :::::•::•:::•:::;»::•;:............................................................................. Observation I Time,at Hole#' Y. . _. • . �— Depth of Pero Time a4`6"`: Start Pre-soak Time Q Timet(9"-6") End-Pee-soak Rate Min./Inch �+ .ti a, e 4.. ,.�.,,r• 1 =' '.33:v: .. - .fir•` ,�/-?: Site'Suitability Assessment: "Site Passed•• Site F.ailed:� Addition�alTesting Needed y ,' �:, ;,4• • '� �` Original: Public Health Division Ohser'vtrtion Hole Data`TO Be'6moleted on`Back > Copy: Applicant '` ,. V ' R oI . . .. ... . . ... :. .:r.w•...:.��]C, �.,ill.�..........:.:.::::: : >.............. Depth from Soil Horizon S'oilTexlure 't �IiElSoil;Color','' Soil Other Surface(in.) (USDA), (Munsell) . Mottling' (Structure,Stones,Boulderes. g :3 S J�Xk6/0 6 r0 C /vl � /� d , •grvr e Depth from Soil Horizon Soil Texture Soil Color Soil Other Saiface(in:) (in:) , (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. n oaGravel) G-12 A L '5 1 0YA3311 loykyl_ - 132, C ,y I ON/RW . .. ............- ..... ...... . .. .... ... .... ..... ................... D'eplh from Soil Horizon Soil Texture Soil or Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure;Stones,Boulderes. o si nc °o Gravel) y BOA• :YP.? >'< > <>.....s><»>�» s ><»r'• .:::.�.;:.;:.:;;:;.;;:.::.:::::.:.;:>.;:: . �: ;::..•.: C��F�(�:I,��,(�.:�.�:.;:. :.;:.;;;:::.;:.;:;:.::.;:T...�. Depth from Soil Horizon Soil Texture Sod Color Soil Other ( ) USDA (Munsell) Mottling (Structure,Stones,Boulderes. Surface(in.) onsi en °o r e iMftdAnsuta cep afe Mfa � - J lt# Above 500 year floodrbounda y,No Yes 1V Within--.560=year.-boundary ..Nov Yes Wiihin;,Iao yeaf-floodt6ouudary`No¢. :�fYes Dipth of Nhturally Occurring Pervious 1VPaterial Does at least four feet of naturally occurring pervious aterial exist in all areas observed throughout the area proposed for the soil absorption system? Y I;f,not,what is the depth of alaturally occurring pervious material? GertiHeation �certify that oti 5~ _(datie)I Have passed the soil evaluator examination approved by the D'epartmet t;of E6Vironit elital7,Protection_and.thatthe=above analysis was performed.by�me.consistent.w:ith Attie required.trai ng,expertise y b perience,described in 310 CMR 15.017. Date Signature �—�� as Town of Barnstable Barnstable Regulatory Services Department + 1AMSPABM ' q�� Public Health Division m 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL#7015 1520 0001 2273 2657 February 18, 2016 Madeline M. Daniels Estate of %Madeline M. Daniels Revocable Trust 30 Nickerson Drive Cotuit, MA 02635 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE TITLE 5 The septic system located at 30 Nickerson Drive, Cotuit,MA was inspected on December 11,2015 by James D.Sears, certified Title,V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system"failed" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following:' • A single cesspool automatically fails in the.Town of Barnstable. You are ordered to repair or replace the septic system within two (2)years from the date of this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH ean,R.S., CHO Agent of the Board of Health r7j,0� QASEPTIC\Letters Septic Inspection Failures or Future Evl\30 Nickerson Drive Cot Feb 2016 2016.doc .Ostal Service' CERTIFIED MAI.WiRECEIPT r` Domestic nj m 0 F I r'- Certified Mail fee n.Jru $ S`t Extra Services&Fees(abeckbox,add fee as appropnatal !.S ❑Return Receipt(hardcopy $ C ❑Return Receipt(electronic) .$ _ -i �Postrill ❑Certified Mail Restricted Delivery $ Here C ❑Adult Signature Required $ t (FEBEB 23 06 ark ❑Adult Signature Restricted Dellvery$ t CV o C3 Postage ` ru $ � Total Postage and Fees s p s $ _ _ 73 Madeline M. Daniels,iEstate ofI „y r % Madeline M. Daniels Revocable Trust m r 30 Nickerson Drive i Cotuit, MA 02635 Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attemptedreturn receipt for no additional fee,present this delivery. U'PS@-postmarked Certified Mail receipt to the ■A record of delivery(including the recipients rs13ii associate. signature)that is retained by the Postal Service"' Restricted delivery service,which provides for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent Important Reminders. Adult signature service,which requires the ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mail®,First-Class Package Senfice®, 'available at retaiq. or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavailable for requires the signee to be at least 21 years of age International mail. and provides delivery to the addressee specified. ■Insurance coverage Is notavailable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retaiq. of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. USPS postmark If you would like a postmark on ■For an additional fee,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office'"for the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply ,f You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece.r ' electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Retum Receipt;attach PS Form 3811 to your mailpiece; IMPORTARf:Save this receipt for your records. Ps Form 3800,April 2o15(Reverse)PSN 7530.02-Oea9047 f • VERY e • • e • ■ Complete:items 1;2;and 3. A. Sin r ■ Print;ytiurname; nd address on the reverse X Agent so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. D to We very or on the front if space permits. `rr t�ke_�c3� �y�t- 1.-Article-Addressed to D.Is delivery address different from item 1? Madeline M. Daniels, Estate of 'f, If YES,enter delivery address below: ❑No Madeline M. Daniels Revocable Tror§t': 30 Nickerson Drive Cotuit; MA 02635 - II I'III'I I'll I'I I I I I l I'l Ill I II I ll lI l l I II'I I'll 3. Service Type ❑Priority Mail Express® 1 ❑Adult Signature ❑Registered MaiIT^' ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted 9590 9403 0521 5173 2836 68 ❑Certified Mail® Delivery ❑Certified Mail Restricted Delivery ❑Return Receipt for ❑Collect on Delivery Merchandise r2. icle Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature ConfinnationT ❑InsuredMail ❑Signature Confirmation 1520 j`0 0 01, 12 Z 7 3' 2 6 5 7 ❑Insured Mail Restricted DeliveryRestricted Delivery (over$500) PS Form 3811,April 2015 PSN 7530-02-000-9053 Domestic Return Receipt UNITED STATE%:PWAfjS First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • 53 r, Sender: Please print your name, address, and ZIP+4®in this box* Town of Barnstable Public Health Division 200 Main Street Hyannis, AL4 02601 t. USPS TRACKING# qJ1111-111-i-11.11-11111-11*1'ill� - --------------------- Town of Barnstable Barnstable Regulatory Services Department sARN9TASLE, s , 039. Public Health Division m 200 Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Richard V.Scali,Director FAX: 508-790-6304 w Thomas A.McKean,CH0 CERTIFIED MAIL# 7015.1520 0001 2273 2657 February 18, 2016 Madeline M. Daniels Estate of ' %Madeline M. Daniels Revocable Trust -30 Nickerson Drive Cotuit, MA 02635 ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE,TITLE 5 The septic system.located at 30 Nickerson Drive, Cotuit, MA was inspected on December 11,' 20,15 by fames D. Sears, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "failed" under the guidelines of 1995 TITLE V (310 CMR 15.00) due to the following: • A single cesspool'automatically fails in the Town of Barnstable. -You are ordered to,repair or replace the septic system within two (2)years from the date of this notification. . Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF,THE BOARD OF HEALTH , v cKean, R.S., CHO Agent of the Board of Health Q:\SEPTIC\Letters Septic Inspection Failures or Future Ev1\30 Nickerson Drive Cot Feb 2016 2016.doc 1HE 111 Town of Barnstable gr�BLF, �r� Regulatory Services Department D FAA - Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A McKean,CHO Feb 6,-2007 ' Rev. 7/6/15 DEADLINES TO REPAIRFAMED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x'marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑Discharge or ponding of effluent to the surface of the ground ❑Pumping more than 4 times during the last year not due to clogged or obstructed .pipe ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE (1)YEAR DEADLINE CRITERIA ❑ Static liquid level in distribution box above outlet invert due to an overloaded or clogged SAS or�cesspool ❑Any portion'of the SAS, cesspool, or privy, below high groundwater elevation ❑Ariy portion of the cesspool within'a Zone 1 to a public welI ❑Any.portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). - O 2 YEAR DEADLINE CRITERIA Single Cesspool ❑Any"conditionally passed systems" (broken cover,relocation of a pipe,relocation of a driveway due to H-10 components, etc) ❑.Leaching pit or cesspool with high liquid level, <12"below inlet(per Town Code §360-9.1) OTHER Repair deadline: Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc Commonwealth of Massachusetts : Tie 5fil inscton Fcrm ............ ,y p .... Subsurface Sewage Dtsposat'Systerrt Form ,Not#o ............... r VoCuntary Assessments .................................. 3Q Nickerson:Drive, - _. .. 2 Property Atld`ress GG Madeline nn' Daniels Estate Owner - Owner's Name Informattaxs s regdQfor every Cotuit ✓ MA_ 02635 12 11; 16 _. pa9g CltytTown State Zlp'COd.a Date of,Inspection .. _. pow $: GO:.... .. Cnspectton'results must be submitted ten th s form inspection#arms;may not be altered`in any :Way.Piease see;compieteness checkCtst at;the end of tiSe farm. Important When A G8t1@ral Inf©C"matio.n filling out forms /# II 3 2 ��utttunUf�p�l� On the computer' ��0� tiiN 4F M,q$ ��i�, use.onI the tab --.: .• ` ;:' •. . Y 1. Inspector key to move your cy cursor ;do not DAMES t N James t� Sears m use thereturn key Name af�inspector s,c� r,,;. Capewide Enterrises� L C.0 r , far m company Name ,�! TL 153 Commercial S#rest I �r� . Company Address. ttlltt _ Maslapee MA.. 02fi49.. CItyJTown State Zlp Code. 5Q8 477 8877 51623 Telephone Number Llcense,Nurnber .;Certficafion !certify that{ have personal{y irspectetl the sewage disposaC system at this address and that the rnfo rnation reported below ts,true, accurate,and complete as of the time of the r spectiort The inspec lop vvas performed based on my traCnmg and expenencein the proper function and maintenance of an site sewage.disposalcs stern . i am'a DEi='a y pproved s stem its actor ursuant to Section 15.340 of :.: Y p p Tine,5 t31;0 CMR` 15:00).The system; [] Passes ❑ Conditionally Passes ® Fails ❑ N,eeds Further Evaluation b r"ffi e7 ocal Apprciving,Aathority � ..._........ ... _ 12 1� 1 spector s-Signature Date The system inspector shall submit a copyof#his Inspection report to the Approving Authority{Board of Health or QEP within 3Q'da s of coin etin this Ins ectron s Cf the s, stem is a shared s stern } Y p g p Y y has a designfCow of 1Q,QQfl gpd or greater, the inspector and:the system owner shaiC subnitthe ;report to the:appropi7ate reg�ona#office of;the CQEP Ttie:original should be sent to the system owrie"r.'.: . - and copies sent#©ttie buyer, if applicable; and ills approving authority 'report ohly descr>bes,conditions at the time o#;inspection and under the cond�fons of:tase at that time'This inspection doss not address hov+rthe system wiCi perform m the future under ttte..same.crr.different conditions,of use». t5ms 3n3 Title 5 O.NiGai Inspection Form 5ubs�rface Sewage:Disposal System Page 1 of 17 I 1J t t e� ' .. _. ... _. Commonwealth of Massachusetts .. Title 5 Off c`1 lr * toc . Fdrm Subsurface Sewage E7sposat System Fgr>tt .Not for Voluntary Assessments . 3 Nickerson Drve _ . Property Address . Madeline`Lynn' Daniels Estate owner' owner s Narrie, information is I. I. r006i d for every Cotuit MA 62635 12 11-15 page - CitylTown, State Zip Gocie, Date of inspection. 1. B. 4t't1Ceti.4t1 (font.) lnspectron Summary Check A,B,C,D ar J. /a/ways complete all of section D A} ,System Passes: . .. . ❑ ( have not gun .any information which indicates that any of the failure criteria described in .10 CMk 15 303 or in:310 CMR 1'5.304 exist Any failure cnteria not'evaluated are iidicated``below: :Comrrients, Faded system darn Reg; Single unit ,;The system is a single c;pool House w/single:c, pool for. sand;' . :: .:: B} ,$' 0m Gdn, 1 iPnaliy Passes; 0 t)ne or rhore.system components as described in ttie"Conditional Pass"section need to be replaced or repaired The.system, uPori completion of thereplacement or repair,as apprnyed:by th Board of Health,Wi11 pass:: Gheck the box far"yeI. su "no°'or"riot determined (Y, N, ND}tar the following statements I. "not :' detle ined,"'piease?explain The septic tank is metal and 6ver20 years o(tl'::or the septic tank I. (whether rrietal oc not} is struc#urallyr unsound, exhibits substant al infilfeation or exfltration or tank failure is eniMj , t System wilt pass: inspection if the existing tank is replaced with a°complyi potit tA k-as approved'by the Board of Health. *A metal septic tank will pass inspection if it,is structurally sound, not;leaking and if:.a.Certificate of : " comp{iance indicating that the tsrik is less than`20 years ald'is available : : ..... ❑ Y Q N ❑ NC? (Explain be1. low} f5in� 3J13 :. Title;,,ff ciii insp,,,Potts SubsuRaCe,"$ 4be OiOo0l.SysWn Pabei,, f 17;. :�:.-:.::.:..:'.:.--*.:.::...:..:I:.*..-:.:.::.....::.*:.-..,.-::�-:..1-'.!:::..-'.:-...,:---....-:1.:�:.*..:.:p:F.*.:-.'1i.*.:....��.,-..:%��.:.-�.::.�-::.-.I.-.1-ii..,:::::1,--..,.. 1—..d..I,:-:-:..�1-'�.'I...:.:.I..::.:.:-:..I..:..:.�..1'....1�..1...1......:...-.. Commonwealth of;Massachusetts ... ..... .-. Title 5 fJf. i la Inspection Form . > S�aEasurface Sewage Q%sposalSystem Poem Notfor Val'untary:Assessments -:-::::::::::::::::::::::.:.::::'::::::::::.:::::::':.:::::*':::::::::.:::::.:::*:::.:::::'.:::::'::.::.�::::';.::::.:::::::::.:.:::::::::'.:::::::::.::�':::�:'.::*:::::::.:::*::::::.—::::*:::*:::.::::::::::.::::::::::�:-::::::::::::::*:.:*::::-:::*:.:*::::::::*:—.:::!:::::*:.::::::::::.::::::::::::;::::':::::::::::::.:::::::::.::::'::::.::: 30 Nickerson ©rive _,�_ _._II W.. �...- .. r ,.n�o . . Pro d Address ... ::: pY =:.... Madeline. ,pW Daniels Estate { Owner ... .- Owr 6e Name mfo.n.apon ms Cotuit , MX Q2635 12-.11 1,5 requUed for every Aa98 . _, p,Code Dateof lnspect9an .. . City/Town• State Zi a.,.; er#i ication {Copt . Pump Chamber pumps,aiarms not operatio.11 nal System will pass wath Board ofi Health approval-if pumps/alarms:are repaired. B}, Syatem_Condit onoily;Passes (cant:} I ❑ 4k nervation of sewage... ckup or break out or high static water level in the d►sft*tj *''box due 1. .. to°broken or otstructed pipe(s}or due to a,broken;,settled;or uneven distnbuti6 box System will ... .. . .: pass inspection';if(wath approval of Board of:Health) :: _�' broken. pe(s}:are rep aced :.Y N ;p NQ'{Explain.below}! obstruction is i,emoved Q Y 0 N .: ND(Explain below} . [] distribution box�s leue[ed.or feplaced (Q Y Q N ❑ ND;(Explain below} . . :: ❑ Tt e system required pumping more than jimes a year d'ue to broken or obstructed pipes} The system will.pass.inspection !f(with approval iof the,Bo1.ard of Health} : �.610 broken pipes}are repla1.ced,16 0 Y [] N `� Nb;(Explain below} 0 obstruction �s rernaved 16. [] Y ( N; ND (Explain below} ::' vatiF i B C} .FurtherEaluons . qured by the oard.ofkealth: ❑ Cond ': : exist which require further evaluation by the Board of Health in order to detern me if - the system as'falmg to protect public>health:safety'or the envrror'ment : 1 System will,pass:c ales Board;of He aith.dete 61 rmines in i3ccordance:with 310:.o : `15 303('!')(b},that the systemic not#urictionrng i:n a manner whrch gill,ll protect public health, s9.a#ety anci.tlie enviro'Mont _..... ❑ Cesspool or privy Es v+nthin 5Q feet of a sur€ace,water : :: Cesspool or,privy is within 50 feet of a bocdenng vegetated wetland or a salt marsh . . !sins :3/93 ::: Title 5 Offc al Inspection Form,Subsurface Sewage DtsposatSysl6 ' Page 3:ot;17 n - .::.-.:::::II:.:::-::..:�::::I.:::::..:::::i.:::::::...:::::I.:::::1..::�::::I.:: I:�.::,:.,::�:.':�..:1..�-.,T..�'..&..::.';I�":-:::::6'�,fI: .:'.-.I,i.�I1.:.:..-.�:-...:q..-1,::.....:,:1 1-::....:...:..:::,::,.:,.I:,:: :::.::I-::qI.:-:.1 -i .. i ::.,�.::..-.:*.:*..::-..4.:...:.-.:....--,:.:......1:....:q..*.I...-.:........:.':..�......I:..:�-. : ...... : '1.:--:..i.�...:�-..:.:*...4:��-� ..:.-:.�.�,pI.:...----....P:..-:-1:.:.-�:1..:1!�::�I"�:.-:;.-.:.-�-:....::.l-.:.:..i.�...I- .!. :.:: -::.. .:i .1-,:::�::::I�:.:.:::::I.:,.-::.��:�:::1-:: :-.:.::::1::::.-::..:::1--:::,:.�::1:.::::�:�J..::-.::..1 i�:.,.:..::�I �'�::.:.::�,::.::..:.::::.Ip:.:�:::..:i.i:.�f�:.:�..::::.-I..:::::.�.�,�.I.::::. .t:.-%....::...c�I...,...,:1.."..-.i....:�:"....,.,.-: �:.�I:�.........��.;...:!'....::v,....::,..,�,.,: .:: ._....... .:::::.... ... ._......._..................... _..:.. __....... .....::. - _.......:: :. ...........:'. :i :-:: ,,::::l-:�..::::::!:.:::-::�:.::::::,::::::::::.�.:::::::.* ::::.;i:::::::: :::i .'- :�...1:::.:.::1.:-.i:..::1...:1.I.::,,:.:...::..:...:.:::..:.::...:.::.� ::I.:..::..::::..::I.:.::::::'.::.::.:::::'.:..,.:::::..:.:..:::,.I.:::.:p:..:::..:::::1..:.::::::::...::-:::::::::.. -:::::::::-: .. Q6m i 'nwrealth of Massachusetts . " tl tffil Ins ctc n Form: Subsurface Sewa a Ds osai S stern Form Nat-#or.lalunta Assessments` g p :::.:::::,::.*:::�::,: :::I:..::::.::-::.-.: ::;::�:.:: Y__ _ rY ::.::::::::::-:.::.::::-:::::::.:::::.::::::.:::::::::,:::.:::::.::i:::::.:::::�::::.::.::::,:-:::.::.::-::-:::.:,:..-:,.:.:::::::;:::.::::::*:::.::p:,:::.::::::::::::::.:::::::::-::::.:�:-::::::i�.::::p:::::::::*-:!::p::::::*:-::::::::::':::::::-:-::::::::::..::::.:: II 30`NIckersan Lrive Property Aduress : Madeline'1 ny_n'_,D nieI ,Estate Owner Owner's Name lnforrriaUon is required for every COtuit .. MA 02635 12-1-1-.9 S CI :: page rylrawn State Zlp Code ©A:.:: lnspectlon B Certification ib, 2. Sjtstern will fait 1. unless ttae Board of Health{and 1.m." :.. Suppl:er if anyj'. ... determines that the.system�s functioning In a manner that protects the pubic health, safety and and .T... -.-.I h,... e system;has a septic tank and soil absorption system {SAS}and'the SAS is within 1;40 feet.. a surface water supply ortributary to a surface:water supply:; . Q The system:has a septic tank and$A$and the=SAS is within a Zone 1 M a;public water supply. The systerri'has;a septic tank°and SAS`and the:SAS�s with�rt'50 feet of a p iyate water supply ,well. ❑ The system has a septic tank and SAS and the SAS is less than':100 feet but 50 feet or nOM from a private water supply well** .._.. .. . (Viethod used to deterrnme distance' .::::: is system asses�f the weI water anal sis„ erforrned at a DEP cert"fied labocato, for fecal p Y p rY� . colifoi nri bacterEa intficates absent;and the presence of ammonia nitrogen and nitrate nitrogen is equal, to or less than 5*pp.: , provided that no other failure crj,ri are triggered ,A copy of the:anafysEs must be.attached to this form. 3. .Other. E Dy 1.System Failure Cr terra Applicable to All Systems : You must ind-eate"Yes" or"No"to each of the f+�llowing`for ail:inspections: Yes. No. i. 0 Sacku .of sewage:nto facility ar system:componen#due to overloaded or P clogged SAS or cesspool D .ischarge or ponding of effluent fa the surface of the ground or surface waters due: pn overloaded ar clogged SAS or:'cesspool.. Q Static ti uidlevel �n the distribution box.above outlet inert dtreto an ouerloatled q . or clogged SAS or-cesspool .:. . liquid depth m cesspool is less than 6"below inverf o�available volume rsless t than a day flow t, s 3J3 .. I. Trt b 5 Qff aal inspect an Porm.$ubsurtara Sewage Disposal System, Page.4 of 17 -......_, .:... ....... .... . . __._ .. _. __. :. '_ I....._:....._-__...... . _ . . ::::. ........ _..... _....... ..... .. ... . .. . _ .. _ __. _ _..::::::: _..._. .... ... _ ... ........ . . ....... __.:. ....... . ... ... _ _........... .. __... .... _. ........ _._. . ..... _. ..... __. ._.. __.. ...... _.. ..... : .... ......... .... ..... ......... .__._. ... ....... .. ....... ... .... ..__.. .__. ......... __._..._ ......... ....... .._........ __ __. _.. __.. _ . ._ _ _ - --._. _...._::: :._. ......... _.._. _._ _._.. _..__._..._ __.... ..._._..... ........___..... ._.......... .._._ _ . __....... .. .._...._.. .. _. _........... Gommgnwaalfih of Massachusetts .: 1 71 Mta� 11S tG1C� Chi Ft �'1"1'1 Subsurface Sewage ftspos:al System Farm Not.for VoluntaryAssessments 3Q'Nickerson ©rive . - . Property AdOr M.adeline;�nri Daniels IwsWe. .I1I:,... —b a. pwnee Owner s Name information rs required for every Catuit _ I MA 02635 12 11 15 Ctk (t State Zip Cotle Datexiof inspection : pa9a:: y own : B C ltifjc tan {cons.) Yes Re1.quired 11 pumping:more than 4 times in the fast year 11tC3Tdte fo clogged or obstructed pipe(s)!Numper of times pumped ( Any portion of the SAS cesspooI. l or puny is Below high ground water elevation ` 0 Any portion;of cesspool or 11 privy is.11 within 100 feet of a surface water;;supply or : tributary to;a surface water supply :... : .. . Any.portion of a cesspooLor privy is.withm a Zone 1 of a public well: :i Any.portion,of a cesspool or privy is within 50 feet of a private water supply;well CJ Any portiori;of a cesspool or privy is less than 100 feet bu#greater than 50 feet - : from.1 private water supply well with no accep#'able water quality analysis jThts system passes, the well water analysis, erformed,at a;1 E certified;;. : p. Eaboratory,:for fecal coliform bacteria indicates absent and the�presence .. ... of arhmania nitrogen anti.nitrate r rogen sis.gqual to or less than 5 ppm, provided that no other failure _. ..iala -tr'iggered..A copy of the analysis ... and,'chain f custody must be,attached,to tM form.j Q The system'is a cesspool emng a facility with Ya design ffow-of 2000gpd .... 90;"O"i I fihe system fails I have deter rn oed that orie or more of the:above failure criteria exist as described in 31:0,GMR 1'5 303,;`therefore_thesysteni';fails " he system owrtier should contact the Soard of Health to:d..etermtne 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 flowof 10,000 .. gpd to 1 A00 gpd. For large.systems,.you must indic1-1 Iate either"yes"or`no"to.each of tie foflowrng,,tn addition to the :: quest ons.:In Seaton"D. Yes Na .. I 1- 0: E the system is within 40Q feet of a.surface dunking water supply ❑' ❑ the systern',is within 200 feet of a tributary to a surface;dnnkir g water supply ,. the system is iacafed in a nitrogen sensitive area p iteiim Wellhead Protection Area f-1WPA)or amapped Zone 11 of a publie avatar supply well !f you have answered'I.`yes"to any question in" ectton E the system is considered a significant fftreat, , or answered"yes" it Section D above the large<system has failed Tl 'e owner or operator pf any aarge system considered a significant"threat under Section Ear failed under Section D shelf upgrabc ihe systei it in accordance with 310 CMR 15:304 The system owner should contact the.appropriate 'regio'ral office of th`e Department . :.I!�qs .3113 Title S,O iiaar fnsp�cUon Fenn Subs i*Sasvag8.0isposar System P,aga$Of!7, . _. ., i N Commonwealth of Massachusetts iiTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments j 30 Nickerson Drive Property Address Madeline'L nn' Daniels Estate Owner Owner's Name Information is required for every Cotuit MA 02635 12-11-15 page. City/Town state Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ED 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 N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the manholes uncovered, opened,and the interior inspected for the condition of the 19ffbmw tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 6 Number of bedrooms(actual): 6 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 660 t5ins•3113 r'dle 5 Official Inspecdon Forth:Subsurface Sewage Disposal System•Pape 6 of 17 ..,.._ .. .... ... ...._.. .__..._....... ..... .......__ _ _. ..._... . _ _ _ ...... _ _ _ .. ..... ....... .. _. _.. ..._...._ ... _... _....... .__. ..........__.... _ _.. . .._ .... ........ ...__ . ._ ..._. .. ._ . .._.._.... ._....... _.._.. ..._....._..... ... _..._... _..._ ....._.... __..._.... _. __ . _ ..... ....._ _ .... ..... _... - _. ...__....... .. _.__.. ._ _. ___.._ ....__. . __....... ......... _..... .... ........ . .. _.. ......_..._..... .. ._ .. _ _ _.. . ........_. ...._ __ _ __....... __ .. "1.-...�-::1.I:-'.�I'1.-.-.:.:1-..:':ll1-.�1..::.:..:....:1.:::.:...�:.11I.�.11..::1.:...:.'.1-1.::-.:..:.:l..�-.��.1w:�.:...,'l.....m;:-.::..1.:.:��..1-�..:- Ccimmonwealth af,Massachusetts, :.'-.�..I...:.i:::.1....'-.::-::.1-.,-.::::...I,I1 q.i..-.i 1'.,I1.�:':..:..�:.:..."..:I..:...-.�:.....d::.�'.�...z..,,..,l,I.v,�.I k.�.,.'....-.m.....,. ..:��-l::.::�::: ::..::'::.:,.' , . Tine C f i' Ire pecfi Form:,:.1,.�::-:.::.I:::::::.::::.*::::.:::::� u .. A Subsurface Sewage ©sposal System Form Not for Voluntary Assessments : ... .... . . :::::—::::':.:..::::::::::.:::..::::::::::'::::..:::::.:::::.:::..::::::::::.:::�.::::.:::::..:..:::::::*::.:.::�.:::::::::::::.:.:...: :.:.w:::::::..:::.::::::.:::..::.::p:::::.::..::*:::::::r::!..:::*:::,:.:p:..:::*:::::.::'..::::::::.:::..:.,:::*:::::::-..:::*-:::::::::..::::::*:::::::..*:�:::::::::::::..::: ... 30'Nlckerson..nrve Property Address Madeline"Lynn' k7amels Estate owner owner s Name Information is Coturt MA: Q2635 12 1:I-15 required for every II page City'l own State 2ip Gode Date=of I!i pe ron �i I y In: arr natrc n 0I. Ttiesysterri rs a sncie c. pool. House wlsinl c pool for1.1.Laundry _. .. . . .. . 1. . Number of current residents.. 0 :: Does residence have a garb" a rrnder2 _..__ _ . g 9 Yes No .. Is laundry on a separate sewage system? (Include iaurttlry system rnspectron ® Yes ❑ No . rnforrnatlon ire this report.) - :. -:... .: Laundry system Inspected? ® Y.es:❑ :;No Seasonal uI. t?? ❑ Yes M N Water`meter readin s.11; rf avarla6le last;2 ears usa e d 2Q13 35,QOOGais 9 { Y 9 (9p )) z ::.::. : 2Q1.4-34,QQGai s .. . Detail; Sump;;pump? 1. ❑ Yes No. . Last date of occupancy. NA . .. Date :' Cor»trjerciatllrtdusfrlai.Flow-CandtI *ns, Type of Establishment: Design flow{based on 31QCMR 15 203); Gallons per daY(9Pd). - Basis of design flow(seatspersans/sq ft etc . Grease trap present:?. ! ❑..Yes ❑` No . indusfrrai waste tio11 iding tar;k present? ❑ Yes ❑ :No Non-sanitary.wastp.e discharged totha Title 5 system? ❑ Yes ❑ No Water;meterreadings, if available: t5ma.3/13 . Title 1 4 cia1 lnspec6on Farm:.$ubsurtase...' ge l i80 ai System Fagg 7 W 7 :. Go ponwealth € Massachusetts: Title 5 Official insp ction Firm Subsurface Sewage E3isposal System Form Not:for Voluntary Assessments 30 Nickerson Drive. _ Property Address, Madeline`Lynn'Daniels Estate Owner; Owner's Name ' Enforrnation is required for.every Cot" _ MA,� 02635 12-11-15 page: CityrNwn State• Zip Code: Date of inspection Q System l;nformativn (cant.;) Last ate 0f'OCCUp4nCy/U54 __: Date: C)ther{describe below):.. r.. _..... ...................... ..... eeral`In€ormation Pumping Records; Source�of information: Was system:pumped as part of the Inspection? No if yes;volume pumped..; ::gallons:... How vas quantity pumped determined?' - — .. ... Reason for pumping: ........ ..... ... .............. .... Type<Of System; Se"ptic tank, distribution-box;soil absorptio.n system: 'ngfe cesspool, C] Overflow cesspooil D, Privy (❑ Shared system{yes:or ro} {if jes, attach previous inspection recoeds, if any), nnovativefAltemative technology Attach a�copy of:the current operatlon;ang maintenance contract(to be obtained from system owner)and a cgp.y of latest. iispec"tior of the l!A system by:systern operator under contract:: 0 Tight tank.Attach a copy of the DEP approval> �' Otter(descnbe} sin le c: ool Laund;. (S na•3113:. Tkw 5&iiollnr pp Farm:§4 r6c:6 SewagabispOfo Syatem P8ge 8:at:1T 11 _ ._._. , Commo-11 nwealth of�IaSB1Ct,usetks �1....-...1...�..1.....�..--......�:.........�".I........1 L.�-.....1�..-.111...1.I!11...-..1:..I:1.�..L Y �..11'.;1-1..'1.,� 11' � " t.1--..1�.l 5 Offici .in p tonI.::::I:':l...l.I:. For: SusurFace.Sewage t3isposaI1Il!'System 1=arn -Not for Voluntary As"sess.: m::::::i.:,':�ent:..p:.-sI,._!,.:-.:-p-.,:.::::-:,.::�:..:.*.:::...:.:::..:::,::..::::..:::::.i--.:::*:::::::::.:::!:.::::..:!i:.:::..:::.::.:.::.:.:.:::�::.::.:�:i::.:,:::--:.:,:::.::.::::1,:.::,:::..�.I:::�..:.::::....:.:::�...:.:.�::l...:.:,::'...:.::.:.,:I.:.:..::�.-.:: .;:.:.I.-:.:::.�::_-::: -:.:::::.:.:::.:.:..,:::.:..:::.:.:..:::::.:.::.:.:..:::::.:..::::.:.:.:::.:...:'::.:..:::.:...:'::.:..:I�.::.:.:':�::...:l:..�::.:l:.,::..:'.�::.:.: .. .::..:...:...::.::..:_..::.�.:..:�:.:..::..::_. .. 3© N'rckersdn ©rive - --_ _ __ _'__ . Property Ad1. dress Mad llne__LYnn_ -aniels'Estate , Owner: t�wnt's Name tnformattan.,4 Cc tui# MA 02635' 12 11-15" requ€red for every u .._ - a e C4!T'pwn : State Z€ Cade Date af.tns ectton ..: P 9 P, p. :;v�4'St+EC1 �11ft?t't't1a�Itt1 (Con#. Approx rnate.;age of all components,date installed {if known}and source of inf©rmation ( A1.1. 1. 1.1. 1.1.1. I Were.sewage odorsdetected w1.hen arriving at the site7' ©... es No Building$ewer(locate on site pi'an): . Depth'below.graI.deII : : 3 ... feet: .: :: : Materia{of construction 0 cast.iron ❑40'PVC �11 other(explain) C?istance from private water supply w11 ell dr sucI. tion line: Beet ;Comments 1(.on 1.c11 ondition of;joints,;' ting evidence of leakage, etc.j: Pw eng isranurge. Septic Tank(Iodate', on site plan) bepth below;gr de: ' feet ...:Material of construction1.: ❑concrete ❑ MelI tal I. ❑fibers lass: ❑ pofjrethylene ❑other(explain) if tank',is me#al, l�st,age: years is<age confirmed by a Certificate cf G6mplia11 ncel. (attach a copy IIIof certificate} ❑ Yes ❑ Na Dimensions: Sludge depth': tI.- 3113 F#ta 5 affual tr specban farm'.Subsurtace Sewage D�spasai System Page.B;af f7 Commonweal#h of Massachusetts .;.:.�1':.�.1'��:.!�...�.:1:..1�....-1:.'..�1..I.:.-..:m1�.-:.1..:.1'�...,'.I�I..I-._.I..�:..-...�:..-.1.:.:.'1-.:.j.'-I:.,i-,1.-�....I-1...:..1I.1:..:..I::...11:..:.I..:,:I.:1...,:..:1�.::...:.::.-.:-:.I.::..�..:.::..:.:::.::.�.:::-1..:'::.:11�.::.."-.i-.-:,.si:.::.o:.:,.t-:..::.=...:,-.:.��:-,.:;�I::I,-.:::-.,.::.�...:::...':�,.1.�..1p:..-.1::.:..;.:.:.�1::I. .::...:..1p��.:.:�:..: :..:..:.1 :...:.:1 .. .. ... . , :*:p:I.:.:i 1'il::.1-:-.-:..::ii�::1:-�!-::-*:�i:.::'ll:.:1-:�ii:�.:.-::.ii:::.,:...ii::.::.ii:.I.:*:*.:.::.ii:...:....mp:..::.::.�:...::..:-.:.::.l:.,�:::.*:I I.'—I.-1:.'.1m:'. . I ---d...—...,...:�I'..I.I..�:.,'..'...:.::.::...�:..::'.:..:::I...-..I.�:...'....�...-.:....:1..,....-1 Q-1-!'I� :...p:.-.:-rP...:":.:- ... :.:.:-::.I.::.::.::.I:�.:':::..:..::.',-.....-.:..:I::..:�.::..:.:..::.:.�:..:�.::..:::�::..::�-.':1::.::�..*�::.:.:::-..:::::1:.:..=:;�:-:..:::..::;�..::..::�..�::..::.1:..::�-.::...:�.:.::...�:.:.::i:..:1.:.:.:::�..1:::...:::i...::.:...:::�I:..:..:::�::::-.:...:::�::.:...:::::.:�.:..::-.�:,..::..:i..:::...::::..:::...::,:..1::..::::...::...::::..1: :..;:.::..:::-:..::.:.:::.:..::.:::�:.:..F:.:..:.:.:..::.:*:1:.:�:..::.:.::�:I.:.::*-:..:..::.:::...�:-:.:.F::..:b:�..:::::..:..:._.::::':1...:.. .::.::::,.:...::-:.::...:..:;:=....:..::.:I,-..:..:..:�. ft _ .1::I.:-..'.,.::..."..:.:.l.1�.:':....1�':.....1:::......::...:I:...,:::."..1.I:....1:.:....:.:-,...:.-::......:.:-:.,.'.1: T l 5 tffii tr�san� orm Sutisurfiaee Sewage arsposal Systei Form Not r Voluntary Assessments .I..:::...:.'.:.::1...:.l.'�-::...:. l�:..:I:I.......1:...:. ,�..-.�-:I1.:�...-:....:..:..::.,..o. - : .- ... ::...::.:..:*.- **::.:...:.: ... :: .. .1..::...::..:'.1..:-:....:.p.�.::1-:..:.:. ....:.I::-I.......: 30:Nickerson Drwe Prope€ty:Address Madehne'Lynn' Qaniels-1 scat _. . I... Qwner:' w Qwner s Name mforma�pn 1s i s required for every Cotuit MA' 02635 12 11 15 page _i' CMtyRown.. W State Z+p Code Date of Enspacfion D System rfarmattn (cunt:) Septtc Tank(cunt:) . Istan'ce firom top 0f sludge to bottom of out.. 1 t1.1 ee or baffle. SI I....a..'.'- I I thickness Distance from tap of scram fo tap of outiettee or:baffle- Distance from bottom of:1-1 scum to bottom of outlet tee or;baffle;; ": How were dirriens11 ions determined : ` Comments ('on pumping recommedat�arls, inlet and outlet tee or baffle contlition, structural�ntegnty, :. I�quiii leueis as related to outlet invert, a ttlencep lea,jags, ete) . .. . . : _ _ . : . : _ _ _.__ .. Grease T'rall p,;(locate on site plan):; Depth:below grade,. feet Material of coast""ruction: .. : ❑concrete ;; ❑ metal ❑ftterglass I.-.:::.:-:::::':::':.❑.polyethylepe ❑other(explain) Difndnsions. Scum<thickness : Qistartce from top of scu:11m:to,top of outlet tee or baffle D3starce from bottom of scum.to-bol.lttom of outlet tee.or"baffle. Date of lastllI pumping: . Date,. isins.:3H 3 . ;: TNie 5 of al inspection Forms;Subsurfacg$swage QisposeP:Syalein Page;-1 qq O'17 . . . Sy ......:: :::u.... ........................ ......................:::: ....---... --......-----... .. ......... ......... .............................................. ........ .....................:::::........... ............ .......... ..i...... ...... ...................................... ........................................................... .............................................................. .... ..... ...................................... ......... ................. :::::::. .:::::... ........... .......................... ................. -...... .....::::::.....,.... .......... ..... ......... .......... ......... ............... ........::: ........... .......... ................ .-....................................................... ::::::::::: .......::::::. ....... .............. ........... ....... ..... ......I... ..........................: .......... .......................... .............. ......... ......... ............ ............. ......... -............................................ ...................... .. ........... .......................... .............- ..1......... -.......... ............. ......... ................. .......... ............. .......... ..- ....... ...... .. .. ....... .. ..... ... ...... ....... .,.. .... ............................................................ Commonwealth afMassachusetts Tine 5 tff : ia1 inctian Farm y SU- 14ace Sewage p sposai;System Form Not;far�oi'untary Assessments : 30 Nickerson Drive ,. _ - -� ---- -_ Prue Address _..:p rhr..... , .. Madelinenn� C}arnels;Estate'. Owner:: Owner's Name tnforrriattort is required for every Cgtuit MA; 02635: 12 1.1 5 _W ._ cit !Town page ..: Y State Zlp code: Date.:of tnspecflon D, System Information (ant.) . _ . : -:::......... .......... Comments{on pumping recommendations, inletand outlet teeor baffle condition,.structural integrity, liquid;i,"evils aS`related to outlet triuert, &iderice:of leakage, etc.) . : . : .. .. . : _.. .. .. : :: Trght er Holding TanK{tank mtast be I.pumped at time.of inspection) (locate on site plan). Dept11 h 5elbw grade 1.;;; Ma11 terial of construction. II ❑ concrete ❑.rrietal ❑fiberglass: : polyethylene ❑ other{explain} D(mensions :: Capacity: gatlons Design Flow: gallons per day Alarm pres,11 ent ❑I 1Ces. ❑ :No Alarm level. . AII laI. rrn in working orde11 r ❑,~Yes ❑.,0 ;Date of I.last pumping; T Date . . : Comments(conditidn of alarm andlIfioat switchel.s; etcI1-1 ). r Attach copy. current pumping;contract{required) Is;capji attached? ❑ Yes ❑,.No t5ms 3/13 Tdle`5 OiriClai Inspection Form Subsurface Sewage Disposal System: Pa9ekli or17 Commonwea'Ith of Massachusetts Title Off iCi i sp �t o arm SuEssiirtace S.euvage Dtspasal Syatm Form Not:°for Voluntary Assessments ... ....... 30 Nickerson DdVo .............. Rroperty Address Ntadeline't_ynn"Danieis:Estate Owner: ,._�.. ... _ Owners;Name inform�t�on is required for every Catui.t mm MA 02,635` 12 1;.1 15 page..: CitylTowri State Zip Code. Date of Inspection: _. .. ....... ...... -- . ..... ......... D. Systialm tnfc r atEon (cont.) , Distribution Box(if present.must be opened} (locate on sete plan): Depth of liquid level above outlets invert NC}IBOX Camnlents(note jf;box is level;and'distri'butidh to outlets equal; any;:e-dense of solid carryover,;any evidence,of leakage'rnto or;out gf box,etc.):------------------- ............. . ........ ... ........ ._.. .................................................. Purt�p:Chamber(Ideate onsite plan:} Pumps in working order: 1'es ❑ No* Alarms in working;order Q Yes: Q No* Comments(note conditian;of pump chamber;condition of pumps and:opptarfenances etc} * if pumps or alarms:are.nat in working order,system is a conditional pass: soil Absorption System (SAS);(locate on site plan,:excavation.not required); if SAS not located,explain why: :............................. i51ns_•,3tt3 Yt�e<$:offictsl Enapec%3ein Farms'Subsuifaca:;Sat�ege!Disposal:5jrst®m.>Ps9e;12.of:t:7: Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments "< 30 Nickerson Drive Property Address Madeline'Lynn' Daniels Estate Owner owner's Name information is required for every Cotuit MA 02635 12-11-15 page. citylTown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ 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.): Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 1 Depth—top of liquid to inlet invert 8' Depth of solids layer 4" Depth of scum layer 0 Dimensions of cesspool 8' Deep Materials of construction Indication of groundwater inflow ❑ Yes ® No thins-3113 Title 6 Official Inspection fomL Subsurface Sewage Disposal System•Page 13 of 17 I . .. r..; .. 11.1. :::::: ...... ... ..... .... .. -. ..... ........... ...... .. ....:. ... ..... ..: ::.. ........... 'I:.:.1:.1....11.:....-:..11-.I�:.:.1:.:..1.I:.,..:.1:..1..-:.:.1:..:..1.�::,..:...�:1.,.1:...1.-::.1.—I.�,'.:1..:.'i.1-'��..:-.!.1'-:.�-�..1�11-..�I:......I�::-.:'.,::.:...�.-..::sI.�"I II,",,M","7..,��", :,..:.-.911,-��11�:1.':-.::...:.:-�.i:-I:.�.:1.::—.. Commonvrrealth of Massacbsetts. r _ . t T` tI 5 + ffl i In i{t � a Subsurface.Sewage b spo$al Syste►n Form -Not for Voluntary Assessments .. - . ... __ Y:: . ... .... ___ . : _�30 Nickerson Drive .. I. . _.... ...." -,I ' . 4. _"__ - 11 Propert Address Madeline';L nri' Daniels:Estate: C}wner.: C7wnes Name information is, Cotuit MA.: {?2635 12-1'1..1;5 r. red for every Ctt lTown Stag _--- p"g, . Y Zip Code D3teof inspection II D. ,System Infon"t�er {writ:} C; whents{note condition of sail, signs of hydraulic11111..failure, #eve#of`panding, condition of yegetat:din, etc.}: Main Pool 8'deep black.W cover at 2 "below grade Cover at:23'"w14"sludge and water No outlet . . . line. Per gam Re :;;sin l nit.faild. Ndte: l.aund has 0 se arts single c. ool --- _ _ . . . . :: Privy(locate on sEteplan} : Materials of construction. DimII ensions .....—1.I� -.". : 11 D*h of1. solids .— -' .'.I-'. _,.._ Comments II(dote condition of so€#,signs of hydra"uirc"failure, level of ptsnd1ng, canditor of vegetatron, . etc}: t5i6s"..3i13 Title 6 Official inspectiO090 0-1 SuBsurface;,Se�wag8 pisposa!System:P,age.l* 1Z ,. _......... .. ._... ... .. ....... - .... _..... _....._ ......... ..... _ _ _. ....__ __ _ _ ._....... _....... _.... _....... .._..... .._.__. . ....._.. ..__.... _......_ .. .._.. __ ..___ ..... _._... ...... .. ....... ............ _.......... ... __ ......... _._..... ....__ .. _. ... __ _ ...... _ __ I ......__ __..... _ __ .. _ ........ ...... ._. . .. Commonwealth of Massachusetts ::-.::.1:.:.:.::'.1,:.:...::.1::.:1...::'.1::-:-...::*.1,:I::-1:::.:.*--.'1.�:,.:.:.�::-1.1:-.�.:-..�.:l..:I.::I.:.I:.:.., .I.- �-�—�,I,��,..��.�-".mI-:.�,.:.t:.:.-�I::..--.=:..�:-..-::..T l a.:--.-::-:*.�I ..:'e1:......:l:.::.:�:::�:.: m tat to e+ on ....I Fo I.I r.. .... .1:.::.1:.:�1:., .1:;.1: i;..i-:::::.-::::::::::*:::::l:::::*'::::::':::::.:::.::::*.::::w*.: .. .:-::*:*'m::: -..1.'1.--.. ::.::::m� :::�* Subsurface Sewage Drsposal'Sysfem Form Not for Voli ntary,Assessments :: :::::!-::::::::::::::::.:::,:::::�:p:::::l.:::::::.�:::::::.,,:::::.*:::::::.::::.:::::::.:::::::.:::::::.:::::!:.:::::::.:::::::::::::--.:::::.:::::::.:::::::.:*::::::-.::::*:::.::*-::::.::::::- :::p*:::::.:*:,:::-::::::::::-::�:::::*.::::,:.:::::w::. .::::::.:::::::;::=.:::;::::::::':::*:::-::::::: ::p;.::::::..:-::::-::-: 30.;Nickecson Drive . Property Address; Madeline Lynn" C►atiiels Estate! Owner:- WW owners Name mforma#ton Is Cotu�t MAI, 02&35 12 "11 15 requtre,tl for eery _. _ �. :.: .:: ps9e City�Town State: Zip.Coda Date of Inspection D System Infcarmation (calf.} $ketch Cif Sewage Disposal System Provlde.a view of`the sevrage disposal system; Ineluding tees to `at least twa permanent reference;landmarks or ben., -marks Locate all wells wlthlm! feet Locate,. where:public waters... _ entersers the building-Check ohs of the boxes below hand sketch in fhe area below' .. ® drawing.attached separately .. . .. - . -- -- _ . _ .. . .5K 319 . 7rtle 5 Offiraat Inspection Farm.S_,.race$swage Disposal System Page 1`v, l f 3 O /V lCk fRs ON dP 8 c I Ll--c Noes . �y3T, a [ILIa f� T sys .� rRa,vIr pvto is ........... ........ ........ .... . _... ..... Ct rnmonw"Ith of Massachusetts iciatinap .......... rt Sub, Ufface Sewage®tsposal System Eorm Nat for Voluntary Assessments 30 Nickerson Drive Pioperty Address Madelme'Lynn'Danii;els Estate Owner _.W. Owner s flame mforrnatton is regwred for every Cotu►t MA' 0�635 12 1;1 15 ON. Gity/1 awn State:Ztp Code Date.:of inspection D. System I'nforrnati.on (cunt.} Site Exam: ❑ Check Slope, ❑ Surface water .... ❑, Check cellar ❑ Slallaw wells Estimated de th to t h round water: p i 9 feef Please Indicate all methods used to determine the high ground waterelevataon ❑ Obtained from system.deslopr ans;on record If checked, date of design plan reviewed: Gate ® C7bserved site';(abutting property/observation h0 Orrwith i►,150 feet of SAS) .. ❑ Checked with local Board of Health=explain 0;. Checked with local excavators, installers ;attach"'d' erttation) j ❑ Accessed USGS database-explain: You must describe,tovu Yeu established the,high ground water elevation . CK area&abutting property, area drops 20'+ ;Before filing this lfispection Report;please see Report Cortpteteness Checklist on next,page.... t5ms 3l13 TUe S,OHiclai tnspechors Form Subsurface;Sewage Ij sposal system Page 16',of 1 T ._c . —. ..y ..... ...,... ...... ...... ........... .....I.. ........ ....... ....... ..... ........ ............ .:::�: :::::' .:::::: .:....... "........ Ce`tnrnQr�weal#- cif Massa1. chusettsI. - V :e 5 . ffictal M. ,:::::: fion orm... . 'A 1.Sub surEace.Sevicage Dspps2r System I=orm Not"for Voluritarjr Ass+rssments; 1. 30 Nickerson Drive ... u,: �.,w�. �..._.___.. Praperfy Address 1 . _fifladeune`L nrr Daniels!estate Owner Ownees Name tnfae , '' tis '' Ggtutt __._ �.�___ __ MA' 0283 :d 12-11-15 required for everX -- -- pgge; Caty7Town .: ... State Zip Code date v#InsjaeGklfln . : E. Repofi Cmperess Ghcklwst InspeII ction Summary; A, S, C, D, or E ch1,1Iecked ® Inspection Su....11 .. -1.1 stem Fa►lu:re Cnfena App ande to All System1. s)completed SyII stem►Information--Estimated depth to high.11groundwater ® Sketch cif Se iage Disposa System either drawn on page 15 or attachetl�n separate f!!e .. .. ... .....: ...... .. . . -.... 1. I. 1. Tstle504fpal#nspediart-* IM S+ibsuRaceS®wageDlsposalSysCetn' PagelT:ofii] u TOWN OF BARNSTABLE LOCt.TION :3 1) �. SEWAGE #c"� - i VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME &,PHONE NO,,'2& Z4A "Z I o3 SEPTIC TANK CAPACITY 'LEACHING FACILITY:(type) f (size) j( D NO. OF BEDROOMS 3 OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: - '— Y' ly� DATE COMPLIANCE ISSUED.: 3 ^l d VARIANCE GRANTED: 1W 1 brz) \ i a ('I AsBuilt Page 1 of 2 3 ti �u�.ckRs dN '070r r L . i C l upuS Sys EM 4. V .. a AWN'` sY`slf�' RO O t ,r a� 1 Ws 4. http://issgl2/intranet/propdata/prebuilt.aspx?mappar=035061&seq=1 3/31/2016 F replace wdw replan wdw replace wdw (wdw ab—) O O A A II O 'ii Q I L Z" - O �ogQ O T I e� --- Z y e END P-O' (nm � m L___ -- � O °REPLACE P-X15T -n w I 8 O n _0 E 0 II __ a f� F m - �a I i Z Q 0 E ao =8 Tom. o ® Lp I — ®® G) O O L— OeEucul O V \ v E repirs wdw replace wdw I replace wd replace wdw . I 9d sa SP II D� I $ 8 O�� � g 'QQ I g '-0' z/s _ t dr f---il �� L---0 m d 9- CN O� J E O .Z7 O M c J E. n zr� ' BENCYI --r2-- -- Q z O y wdw r e wdw r�i; Gt > 5'-4 n n G r 0 O �I II z ll o I I PROP.PORCH 6 SHWR ADDRIONS 7'-G'(+/-) (6-nate sloped ced;ng replays wdw replays wdw at st—,Vdl below) 4'-9' O O ew wdw replays wdw ---------- m C ' O m° 05 1= Ill O I m O I O o u �� I mP u m Q Z O Q I 3 0 I o -I 6 0 0 T 4 DS — �^ aN _ m I T1 I oA F� I V I 8 L9 Nam�\\ FQ N ------------- ---- r D I O al I PROPOSED ROCf BELOW I Z I R O CD uo N I I g ml O 8dIca = — -- 0 I � — I I E 0 0 0 O tv A ---------- m=O replays wdw replan wdw repave wdw replace wdw M D . o a O13 £ E - F E s �d \V"701 I replace wdw •1 � 7 IS$' 5 ^ g PROJECT: t (5W427)4279 om M > o MCCO CK ADDITIONS a FAX csoeoa29.729s z 930 NI DRIVE, COTUIT, MA � o m TITLE: FIRST INNOVATIONS FIRST A ND FLOOR PLANS Po. Ocartu a 1 II I I a 0 O II � IlE15TING 2Y6 FLO9 5T5 r T, C O o l 1 1 EXISTING M; FLOOR M15T5 $16'O.C. I I O° I b Z m Zsg I I @IG'O.C. Pa01 �a I I I 11 I I �'pj II I I I to II I I. nl = 0 oo� ` 11�-` KISS I Im II I I gl a G Zt- E�$'r1�3� g_ogy s° 1IIIIII1I • giQ N _ Nti '��I;11I�I I111III��' i _ F�>III Z. IV F�L--rn zxn L-_EDG-_ER-_BD---_-xNN -_m-_--_II---_- ------------- ---- D S$ ° ' i IN G8 � 'n D _ --- --- Z o0 F� lo ?l 2X P.T.` a m Oo m+S - Z I P r° zo O z +9-a 1- ° +'a 1 -1 _ IA 2 D _�-J�.•II III I ti oI 2X6 P.T. IDECK JSTS~ 1 0 m F; °� AI I -----I fez ------ 2X LEDGER W. I . � a � 2X6 DECK JSTS _�S'c O1 b 8 1 �16°O.C. i 2/2x P.T. 1. S �, s�-a uz• �, s�-0• �, a o p0 0 fa .Nd NEW EXPANDED GABLE ROOF qqO 2 ------------------ (r k I 1 I I I N�, 11 / I -n 0 r 0 I I I D Q I Q I I u I I I �. 'fl I I I n ------------------ ,� I j r I o I D I I I I I I .......... I ---------- I / I I / T I I I --- 1 I I I L---J 1 1 I I I I I I I I -------- - -------------------------=------------------ I I I I I I 1 I I I I I I _ I t I I I I I I i I I I - I I --------- ---------- I I I I j PROJECT: REVISIONS: McCORMACK ADDITIONS 1 `FAX'�°�," �5 a z 030 NICKERSON DRIVE, COTUIT, MA o ARCHITECTURAL INNOVATIONS TITLE: Ul FOUNDATION AND ATTIC FLOORPLANS .0.B072OMCEMPRPRA026 IC P.O.BOX 2058.CCRLR,MA02895 ALL SYSTE SHALL SYSTEM PROFILE MARKED WITHCMAGNETICTTAPE OR BE NOTES PROVIDE MIN. 20" DIAM. WATERTIGHT PRECAST H-20 (NOT TO SCALE COMPARABLE MEANS FOR FUTURE LOCATION. ) 1. DATUM IS ASSUMED o. ACCESS COVERS TO WITHIN 6" OF FIN. GRADE RISER TO GRADE 2" PEASTONE OR GEOTEXTILE PRECAST H-20 RISER TO GRADE j 2. MUNICIPAL WATER IS EXISTING TOP FOUND. EL. 39.1' FILTER FABRIC OVER STONE 36.5' MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 37 -38 3. MINIMUM PIPE PITCH TO BE 1/8" PER FOOT. o� NOTE: 2" MIN. WALL 4. DESIGN LOADING FOR ALL PROPOSED PRECAST PRECAST H-10 BLOCKS OR RISERS (TYP. THICKNESS REQUIRED UNITS TO BE AASHO H-2Q (H-10 TANK) 2'0 1E 4"OSCH40 PVC PRECAST RISERS y: MORTAR ALL Locus �o :.,,..,,. s" MIN. SUMP PIPES LEVEL 1ST 2' COMPONENTS H-10 5. PIPE JOINTS TO BE MADE WATERTIGHT. o 12" MIN. INT. DIM 4' (TYP.) 4 q: ENDS SIDES 35.0' *35.58 10" 1500 GAL H-10 14" .1 ➢00000000; °o° °°o°°o°° 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE Do��o® ���o Do ®00 00© ��Do WITH 310 CMR 15.000 TITLE 5. 35.12' TEE SEPTIC TANK TEE 34.87' ( ) 4 Schoo/ °o°o°o°o°o°o WATERTEST D'BOX 'o°o°o°°o° ®�®®®®®®®0 ®®�®�0®®�®® >o�oao�o� 0 0 0 0 0 0 '°°°°°°°° o 0 0 0 0 0 0 0 0 0 0 0 o o '°°°°°°°° 7. THIS PLAN IS FOR PROPOSED WORK ONLY AND St. •//, GAS BAFFLE.." o 0 0 0 0 o FOR LEVELNESS cv '°°°°°° ®0�0�0��®0 �O�®00�0�00 °°°°°°°° Cotuil +_o°o°c ono_ > o 0 0 0 ®0®0®0®0�� oa®❑®ooa®�® o 0 0 0 , NOT TO BE USED FOR LOT LINE STAKING OR ANY �� ° ° ° ° o 0 0 000 0o n o00 ° ° ° ° 32.0 34.36' 34.19' °°°°°°°° °°°°°°°° °°°°°°°° OTHER PURPOSE. Bay 4' LIQ. LEVEL (ACME OR EQUAL) l7 •c o°o00000000000000000000000000000000000000000000L 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. 0000000�00000�0�000000000�0�00000 0go°00000. - H-20 500 GAL. LEACHING CHAMBER BY ACME PRECAST OR EQUAL. 3/4"-1-1/2" DOUBLE WASHED STONE 4 MIN. (5) UNITS REQUIRED 9. COMPONENTS NOT TO BE BACKFILLED OR ALL AROUND PRECAST STRUCTURES She// 6/uff 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 50.50, X 12.83' CONCEALED WITHOUT INSPECTION BY BOARD OF ��pt COMPACTION. (15.221 (2)) ;n HEALTH AND PERMISSION OBTAINED FROM BOARD OF HEALTH. 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING DIGSAFE (1-888-344-7233) AND 24.5' BOTTOM TH-1 VERIFYING THE LOCATION OF ALL UNDERGROUND & ( 2 % SLOPE MIN.) ( 1 % SLOPE) ( 1 % SLOPE) NO GROUNDWATER FOUND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. LOCUS MAP FOUNDATION- D BOX 21 23' SEPTIC TANK 51 ' ' LEACHING 11. ANY UNSUITABLE MATERIAL ENCOUNTERED NOT TO SCALE FACILITY SHALL BE REMOVED 5' BENEATH AND AROUND THE *THE INSTALLER SHALL VERIFY THE LOCATIONS OF ALL PROPOSED LEACHING FACILITY. ASSESSORS MAP 35 PARCEL 61 UTILITIES AND ALL BUILDING SEWER OUTLETS AND ELEVATIONS /2. EXISTING LEACHING FACILITY SHALL BE PUMPED App ZoNF C N 2oME�� PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM AND REMOVED OR PUMPED AND FILLED WITH CLEAN4T .S��Z ESTV � - L E G E N D *PLUMBING TO BE RE-ROUTED AND CONNECTED TO SAND. AR�NEZoNE CEX\S1 C. EXIT ONE LOCATION AS SHOWN, INSTALLER TO ZONING SUMMARY 99- EXISTING CONTOUR CONFIRM FEASIBILITY PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM X 99.1 EXIST. SPOT ELEV. "NICKERSON DRIVE" ZONING DISTRICT: RF RESIDENTIAL DISTRICT -[991- PROPOSED CONTOUR _ _ - - - - SYSTEM DESIGN. 198.4 EXISTING 12' ROW TO MAIN STREET MIN. LOT SIZE 43,560 S.F. MIN. LOT FRONTAGE 150' ] PROPOSED sPor EL. - - - - GARBAGE DISPOSER IS NOT ALLOWED TH1 -Sg7°18 00"W MIN. FRONT SETBACK 30 MIN. SIDE SETBACK 15' TEST HOLE 118.00' �� ' / EXISTING 6 BEDROOM DWELLING � � MIN. REAR SETBACK 15' J DESIGN FLOW: 6 BEDROOMS @ 110 GPD = 660 GPD MAX. BUILDING HEIGHT 30' 2� SLOPE OF GROUND GRAVEL _ / / USE A 660 GPD DESIGN FLOW C-OL) UTILITY POLE I DRIVE PROP. VENT WITH CHARCOAL FILTER Vn FIRE HYDRANT AND BUGSCREEN (FINAL PLACEMENT BY 24.5' _� / " SEPTIC TANK: 660 GPD (2) = 1320 CONTRACTOR WITH HOMEOWNER - - NOTE: NOT ALL SYMBOLS MAY APPEAR IN IDRAVfltLGj CONSULTATION) s ,/ / USE A 1500 GAL. SEPTIC TANK � .0' �d' " LEACHING: TEST HOLE LOGS SIDES: 2(50.5 + 12.83) 2 (.74) = 187 GPD J� � (0 co Aso zo BOTTOM 50.5 x 12.83 (.74) = 479 GPD ENGINEER: CRAIG J. FERRARI, SE #13871 X TOTAL: 901 S.F. 667 GPD DAVID W. STANTON RS EXISTIN PORCH WITNESS: BENCHMARK: c"! USE (5) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) 8 5 2016 CONCRETE BOUNDDECKS o �so � DATE: ELEVATION =34.6 TO BE 0 X WITH 4' STONE ALL AROUND PERC. RATE _ < 2 MIN/INCH rH1 REMOVED Cf, TH 2 W CLASS I SOILS P# 15116 T EXISTING 4- DWELLING - X ELEV. �,� ELEV. TOF = 39.1 �/� ' „ `��' -7 0 0 O - ----27.6 APPROVED DATE BOARD OF HEALTH MA 0 36 0 36.5 / rn O A A � O j j X LS LS �0 /0 28.7' �� 10YR 3/1 10YR 3/1 � 38.1' 12 12" SLAB X B B ,� PROPOSED TITLE 5 SITE PLAN LS LS PATIO OF 10YR 6/6 ' 10YR 6/6 I �s PROPDECDK 3g 35 3� PROPOSED 33.6 24„ 34.5' PARCEL PORCHX #30 NIC OKERS N DRIVE -� COTUIT MA 0.39f AC. J � w _ C C _ PREPARED FOR PERC ---- MS MS EXISTING 12' ROW TO MAIN STREET JOHN McCORMACK CNo� c.o N S��crFD> N 86°46'52"E 118.00, l CD - DATE: OCTOBER 19, 2016 1OYR 7/4 1OYR 7/4 �/ r� DANIEL A S �H OF M (H OF MgsS9 \ ��(H of MgSp� '� off 508-362-4541 0DA{�EEI_ � r� DANIELfax 508-362-9880 A `' DANIELA. cy� gA. A.' �A downcape.comOJALA OJ-LA 9�: 0A A U) 138" 24.5' 132" 25.5' Po �� 61E o IVIL ��o.409 0 16 No 40980 own cape eagineefing� //!c No.46502 A • IFS a�srtiR `` � . ° �w �q FSSS 0. � ;S civil engineers NO GROUNDWATER ENCOUNTERED Scale: l = 20 f A N Fs� T �� °sulz� land surveyors 939 Main Street ( Rte 6A) ' Vc-���DC�' 0 10 20 30 40 50 FEET DATE DANIEL A. OJALA, P.E., P.L.S. YARMOUTHPORT MA 02675 # 16-249