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HomeMy WebLinkAbout0140 THANKFUL LANE - Health a 4 ThankLful Lane Gonlit -- ------ A= 03 9 -035 No. l- C/ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS- Application for Migpogal 6pgtem Construction Permit Application for a Permit to Construct( ) Repair(,No Upgrade( ) Abandon( ) ❑ Complete System Individual Components Location Address or Lot No. i `T o 'Tl+o40Kru(, (-4)t Owner's Name,Address,and Tel.No. (jdiL)iT Pr--TM '� Zo1640 121'R0OQlLL0 Assessor's Map/Parcel d 3c O S Po U, 13 V4 (No S u,Epj3 OeJj MA o u7 Z Installer's Name,Address,and Tel.No. S09 417- :9 S-77 Designer's Name,Address and Tel.No. WA Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) WCrt),- ;5dA4Q cZ1r_ 4n PfPG 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 Certificate of Compliance has been issued by this Board ealth. Signed Date Application Approved byej�� Date f� Application Disapproved by: Date for the following reasons Permit No. d d d Date Issued IN i No. -) Fee U THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: er ( '. PUBLIC HEALTH DIVISION -'TOWN OF BARNSTABLE, MASSACHUSETTS I 2pplication for Dtgpogal 6p tem Cowaruction Permit Application for a Permit to Construct Repair(� Upgrade Abandon( ) El Complete System X Individual Components Location Address or Lot No. 140 —f F+A PKrLA- CAINt . Owner's Name,Address,and Tel.No. (juT.>rT ELT E, -X o t4 tV �Fz0 oGr I L-L0" f \, Assessor's Map/Parcel o3q d35 P��• 4U�e 13h S514ERJ3t W MA OL'71 Installer's Name,Address,and Tel.No. 5A8 -417- :9�s-77 Designer's Name,Address and Tel.No. NfA Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder ( ) 1 Other Ty pe of Buildin No.of Persons Showers YP g S o ers Cafeteria Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date ! Title. 1 .s Size of Septic Tank Type of S.A.S. Description of Soil �> /•` Nature of Repairs or Alterations(Answer when applicable) t PG-Pt aCz; D'-PO< AVD A&-PjA<,C �5_�Ebacg A0 Zel v&M Date,las nspected: ti 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 Certificateof Compliance has been issued by this Board gf-14calth. - - Signed Date t Application Approved by Date 'Application Disapproved by: Date for the following reasons 7 v PermitNo. s2 o j t 1 d J Date Issued (py - f V p u I� THE COMMONWEALTH OF MASSACHUSETTS o BARNSTABLE, MASSACHUSETTS - Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired (x) Upgraded ( ) Abandoned( )by C A?Gw i DG iE-l_�f 6f65 u c at i qJ 'TwianuL L4kVr_ <—lOTt J I T has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. o�y y — , � dated Installer Designer lUA #bedrooms Approved design flow lk/{,/I jg gpd t% The issuance of this permit shall not fie c nstryd as as ^guarantee that the system will functionct as/desi/gped.;� Date . {� % Inspectors't CUB i 1. �V _ - /O(, �{ r Lt `,� Fee No. u I. THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION — BARNSTABLE, MASSACHUSETTS Migogal *pgtem Congtruction Permit Permission is hereby granted to Construct ( ) Repair (X ) Upgrade ( ) Abandon ( ) System located at (L�{] "'I'4aw Kl:--c (Ay _) <2 O-c 0 r r- and as described in the above Application for Disposal System Construction Permit.The a plicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction trust be completed within three years of the date of this ermi . Date i {t' Approved by ( y� J u123 1410:34p V p.1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo Owner Owner's Name information is Cotuit required for every MA 02635 7-22-14 page_ Citylrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way.Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information ttIp111fItIrU // on the computer, N pFMri7 use only the tab 1. Inspector: A9� V key to move your � 2:' •y cursor-do not James D.Sears JAMES .u,use ,' key,the return Name of Inspector .y_r CapewideEnterprises,LLC !Company Name * ' �'.� o � � 153 Commercial Street _ /'%�,F 5 IN spE��``���`�— CompanyAddress U H'"TMit Mashpee_ __._...,— MA 02649 Cityfrown State Zip Code 508-477-8877 S 1623 Telephone Number License Number B. Certification 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the 6me of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 7-22-14 spector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared,system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority., **'"This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform In the future under the same or different conditions of use. ko I m t5ins•U13 Title 5 OlEval Inspection Farm:Subsurface Sewage Disposal System•Page 1 of 17 4 Jul 23 1410:34p p.2 I Commonwealth of Massachuseft Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo Owner Owner's Name information is required for every Cotuit MA 02635 7-22-14 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: f - B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. . Check the box for"yes", "no"'or"not determined"(Y, N, ND)for the following statements. If`not determined," please explain.' The septic tank is metal and over 20 years old"or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. "A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ NO (Explain below): t5ins•3M 3 + ,�,.� ,. TNe 5 O`Gclal Inspection Forth Suhsurtaoo Sewage Disposal System•Page 2 of 17 Jul 23 1410:34p p,3 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo Owner owners Name information is required for every Cotuit MA 02635 7-22-14 page. Cityrrown State Zip Code Date of Inspection B. Certification (cons.) ❑ Pump Chamber pumpstalarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cunt.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of,Board of Health): Elbroken pipes)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y . ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ 'broken pipe(s) are replaced _ ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1.. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water �] Cesspool.or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3113 Tille 5 Off.ciel Inspectlon Form:Subsurface Sewage Disposal system•Page 3 of 17 i Jul 23 1410:34p p.4 Commonwealth of Massachusetts ` Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments - 140 Thankful Lane Property Address Peter Frongillo Owner Owner's Name information is required for every Cotuit MA 62635 7-22-14 page Citylrown State Zip Code Date of inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Suppliers 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: t • **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: Youmust 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 0 ® Discharge or ponding of effluent to the surface of the ground or surface waters due town 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 0 ® Liquid depth in a is less than 6" below invert or available volume is less than %.day flow P17--r ° 151ns•3l13 Title 5 Official Inspection PornG Subsurface Sewage Disposal Sys tern-Page 4 cf 17 f — Jul 23 1410:35p p.5 Commonwealth of Massachusetts Title-5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 140 Thankful Lanelu- Property Address Peter Frongillo Owner Owners Name information is required for every Cotuit MA 02635 7-22-14 - page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® 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. El ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis,performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is.equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to.correct the failure.. . E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpdto 15,000'gpd. For large systems, you must indicate either'yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply 6 ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ 0 the system is Iodated in a nitrogen sensitive area (interim Wellhead Protection Area,-IWPA)or,a mapped Zone II of a public water supply well If you have answered`'yes",to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above;the large system has failed. The owner or operator of any large system considered a significant threats 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-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 I' Jul 23 1410:35p p.6 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal.System Form-Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo Owner Owner's Name information is required for every Cotuit ` MA 02635 7-22-14 page. Citylrown State Zip Code Date of Inspection C. Checklist . Check if the following have been done.You must indicate"yes" or"no"as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? El ® Have large volumes of water been introduced to the system recently or as part of this inspection? M' ❑ Were as built plans'of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or,dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected,for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The slie 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 i Residential Flow Conditions: Number of bedrooms(design): ' 4 --- — Number of bedrooms (actual): 4 DESIGN 440 flow based.on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): t5irs•Y13 Title 5 Offidal Inspecticn Form:Subsurface Sewaga Disposal System-Page 6 of v Jul 23 1410:35p p,7 Commonwealth of Massachusetts Titl e 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo vz5j P Owner owner's Name information is required for every Cotuit MA 02635 7-22-14 page. City/Town State Zip Code Date of Inspection D. System Information Description: The system is a 1500 Gal.tank D Box and two pits. Number of cur rent r i 4 e t es dents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection [] Yes ® No information in this report.) Laundry system inspected?- ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2012-72,000Gals 9 f Y 9 (gP ))= 2013-69-00OGal's Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Present Commerciallindustrial 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 I Water meter readings, if available: t5lns•3M 3 Title 5 OR:.ei inspection Form Subsurface Sewage Disposal System-Page 7 of 17 f Jul 23 1410:36p p.8 Commonwealth of Massachusetts Z . Title 5 Official Inspection Form Subsurface Sewage Disposal'System Form-Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo Owner Owner's Name information is Cotuit MA 02635 7-22-14 required for every page. City/Town State Zip Code Dale of Inspection D. System Information (cont.) Last date of occupancyluse: 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) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the IlA system by system operator under contract ❑ Tight-tank. Attach a copy,of the DEP approval_ ❑ Other(describe): t51ns-3/13 Tllle 5 Official Inspection form:Subsurface Sewage Disposal System•Page a or 17 r Jul23 1410:36p p.9 Commonwealth of Massachusetts Title 5 Official- Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo Owner Owner's Name information is required for every Cotuit MA 02635 7-22-14 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: 1982 Permit#82-304/7-14 New D Box and Lines to pits. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site'plan): 28" Depth below grade: f V feet i. 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 17"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 4 f. Sludge depth: 211 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Jul23 1410:36p p.10 commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo _ Owner Owner's Name reformation required for every Cotuit MA 02635 7-22-14 page. Cityfrown State Zip Code Date of Inspection D. System Information (cunt.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 28 Scum thickness 1' Distance from top of scum to top of outlet tee or baffle 12" Distance from bottom of scum to bottom of outlet tee or baffle 17" How were dimensions determined? Asbuilt-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.Tank and cover's at 17" below grade_ In and outlet tee's. No sign of leakage or over loading. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑ fiberglass ❑ polyethylene_ El 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 M Date of last pumping: Date i5lns•3/13 Title 5 Official Ins pection Form:SuDsurtaoe Sewage Disposal System•Pege 10 of 17 .. t r Jul 23 1410:37p p.11 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments - 140 Thankful Lane Property Address Peter Frongillo Owner Ownei's Name information is required for every Cotuit MA 02635 7-22-14- page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): •Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 15im.313 Title 5 Official Inspection Form:Subsunace Sewage oisposai System•Page 11 of 17 Jul 23 14 10:37p p.12 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo Owner Owner's Name information is required for every Cotuit MA 02635 7-22-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont_) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): i D Box is 16"x21"-33"below grade wlcover at 6". Box is new 7-14 w/two lines out. 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.): *If pumps or alarms are not.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: Wins•3113 Title 5 Official Inspection Fora,Subsurface Sewage Dispose'System•Page 12 of 17 r Jul 23 1410:37p p.13 Commonwealth of Massachusetts Title 5 Official Inspection Form -- bl Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo Owner Owners Name ione Cotuit MA 02635 7-22-14 required for every page. City/Town State Tip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number. 2 ❑ 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.): Leaching is two 1000 Gal.Precast pits w11' stone. Pit's at 3'below grade . Pit#1 Cover at 20" w/1'water, no higher stain line. Pit#2 Cover at 1', Dry wall's are clean in both pit's w/ no sign of over loading or solid carry over Cesspools(cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer r; Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No tslns.3113 - Title 5 Orridal Inspe0on Form.Subsuffaw Sewage Disposal System•Page 13 all 17 Jul23 1410:38p p.14 Commonwealth of Massachusetts. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongilio Owner Owner's Name Information is required for every Cotuit MA 02635 7-22-14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): r . Privy (locate on site plan): Materials of construction: — Dimensions _ Depth of solids -- Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): j t5ins•3113 Title 5 Omdai Inspection Forrrc Subsurface Sewage Disposal System•Papa 14 or 17 Jul23 1410:38p p.15 Commonwealth of Massachusetts Title 5 official Inspection Form y _ Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo Owner Owner's Name information is required for every Cotuit MA 02635 7-22-14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal'system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet_ Locate where public water supply enters the building. Check one of the boxes below: hand-sketch in the area below drawing attached separately r s A clr B 13- � i O 3 [Sins•3113 TRIe 5 O`ficial Inspection Forth Subsurface Sewage Disposal System•Page 15 or 17 Jul23 14 10:38p p.16 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal,System Form-Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo Owner Owner's Name information is required for every Cotuit MA 02635 7-22-14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) . Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells 00 12' Estimated depth to high ground water. feet Please indicate all methods used to determine the high ground water elevation: ' ® Obtained from system design plans on record 6-1-82 If checked, date of design plan reviewed: Date ;q Date , ❑ Observed site (abutting propertylobservation 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 6-1-82; no G.W:at 12'. Bottom of pit's at 9' below grade. Bottom of pits at 3' above T.H. depth. Before filing this Inspection Report,please see Report Completeness Checklist on next page. ISIns 3113 Title 5 OfTdal Inspection Form:Subsurface Sewage Dispoaa System-Page 16 of 17 Jul23 1410:39p p.17 i. Commonwealth of Massachusetts _- Title 5 Official. Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 140 Thankful Lane Property Address Peter Frongillo Owner Owner's Name information is required for every Cotuit MA 02635 7-22-14 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file f i t5ins•:3113 Title 5 Official Inspection Fo¢n;Subsuftoo Sewage Disposal System•Page 17 of?7 53 36Y LOCATION SEWAGE V ITT 0- C ll 11 y-v Pro J9,ic c 'VI LLAGE I N S T A L,LE.R'S . NAME 1< ADDRESS 4, BUILDER OR OWNER DATE PERMIT ISSUED OAT E COMPLIANCE ISSUED i i e5f 6ol THE COMMONWEALTH OF MASSACHUSETTS b BOAR® OF HEALTH ............ ..........-------------------- OF.......................................................................................... Appliratiou for Dispnoal Work,5 onstrnrfiun Vrrutit Application is hereby made for a Permit to Construct (V<Or Repair ( ) an Individual Sewage Disposal System at (� �y cation•Iress or Lot N�o.o� ............ ... 3�✓����_-�c-...Lo.A-X ��..1. .................................. ic Owner t�..._..-•-----•-••---._...----••------- ..... - - r� a�Ti----- s.!................. Installer ddress �j� /A��� d Type of Building Size Lot 4t&L_...k�.t_,...Sq. feet U Dwelling—No. of Bedrooms 101Un+........................Expansion Attic (1Jo Garbage Grinder per, Other—Type of Buildin "09-10L_._.. No. of persons__;C .......... Showers Q) — Cafeteria ( ) a' Other fixtures ----------------------------------- W Design Flow...........1.1__.....................gallons per person peer day. -Total daily flow.:._.��0______.____.____.__.._.__ Ions. W Septic Tank—Liquid uid ca acit 5P allons Len h_t�'4a ._ Width�°'_a_ _._ Diameter________________ De th_ -------- Disposal q P Y�------•----g � P x Disposal Trench—:i�o_ .................... Width.__.__.__._._.__. Total Length..__-_._____... Total leaching area....................sq. ft. Seepage Pit No------a,.......... Diameter._�__.'-0.... Depth below inlet......G___b._. Total leaching,area_q+P?A.....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by------------------------- --••-------___......................... Date........................................ Test Pit No. 1..��---:Z-_---minutes per inch Depth of Test Pit__.: -�__.__._.Depth to.ground water..N®__W!�TP.R (i Test Pit No. 2.._.-z-__minutes per inch Depth of Test Pit_._._.0?.______ Depth to ground water_."................. a ----•--------------------•-------•--_._...-----------------------------_---- -----•••._...---•--•-........-----•--------------•-•---------- Description of Soil Q -QSaP'--...--•----------------------------•--------•-------• --•--------- x ....................................................--•-------------•---•---------..-•------=------ V Nature of Repairs or Alterations-Answer when applicable. Agreement: The undersigned agrees to install the aforedescribed Individu 1 Sewage Disposal System in accordance with the provisions of iIT?!: ' 5 of the State Sanit r C de— he der ned further agrees not to place t system in operation until a Certificate of Compliance has e n I tied th alth. Signed-------- � t 0?fpt o Application Approved B ...........—................................. . . .......................... Y"'' PP PP Y ` Date Application Disapproved for the following reasons:-------•-----------------------•--------••--------------------•-----•--•-----------------------•------•----••••- ...........................................................-------•--•-.....--•----------------------------••-------------------------•-------------------------------------------------•-----......•._ Date PermitNo.......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS • BOARD OF HEALTH ........ .. ..........................OF......................................----- Appliratiun for Disposal Works Tonstrnrtinn Vrrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .........................._...................................................................... Location,A&Wress or Lot No. : ._.AM. -..2� ...- s%.Lo..-•---.... � .... Z.A".Q..- .1_................................. Owner d e ....V,.� �+�'�.......ls%A 2-I�.,�1.x,:�:?�.. ------------------------- ...... 1�.�. ���.................................... Address /�� d Type of Building Size Lot.+!��-.�.---- .,__Sq. feet aDwelling—No. of Bedrooms..N. 2 ......................Expansion Attic (1,:zio Garbage Grinder WOther—Type of BuildingN'1 •Q. .... No. of persons_R !? , --------- Showers ( Z — Cafeteria ( ) dOther fixtures ----•-----------------=-------------•----.....----•----•--••••-••--•-----••-•--•--•--•--••-•••••---••-•-•--•••-------•-•.....--•-•----•.............. W Design Flow............I.A0.....................gallons per person per day. Total daily flow......��0........................ long. WSeptic Tank—Liquid capacitylSO allons Length__V�+_.. Width' `_.'. ..... Diameter________________ Depth_.+ ........... x Disposal Trench—No. .................... Width' Total._...._. Total Length.................... Total'leaching area.....................sq. ft. s S °' _.. Depth below inlet.._...( Total leaching area.__. Seepage Pit No------- Diameter.._. ...... p g ..-sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........................................................................... Date........................................ Test Pit No. I...< _'L___minutes per inch Depth of Test Pit..... ...... Depth to ground water_.: In:.1! bars 2 LL, Test Pit No. 2--__<1 .minutes per inch Depth of Test Pit------- n ...... Depth to ground water........................ P4 -------•--------------------------•---------------•---......----------.....---------•----•---.............................................................. Description of Soil...._Q_?t.-t..... :&L."- ... ...... -•--•------------- V ....•--•-•-•-•---•--------------••--••--------..........•-•••--....................--------•-•-•------------------------•----------•.----------------------------------------------------•......_..-•-- W VNature of Repairs or Alterations—Answer when applicable_______________________________................................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITA LE 5 of the State Sanita y Co e— e u ders g ed further agrees not to place th system in operation until a Certificate of Compliance has he i ued th lth. Signed ------ -------------- ....................................... A .� 8�� g - D to Application Approved BY .. - -- ---------------•--------•-•-•--- ------ ,+_ V ...................... Application Disapproved for the following reasons------------------•--------------------------------------------------------------------------------......._------ ---••---•••---••-••-•-•-••----•---------------------••--••-•-•--------------------•-.....----•••-•---------••-••----•--•---------------......------•...-------•--••-••--••------• ...................... Date PermitNo------ -------------- Issued_....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF..................................................................................... Trrtifiratr of TunipliFanrr THIS IS TO C RTIFY, t the d:vidual Sewage Disposal System constructed ( ) or Repaired ( ) by ,� .__....... .. !._..--P elk ....::� � ................................................. Installer at..................................----------------•----•---•-------------••-•-•---•--•••---•--------•--------•-•---•--•-----•--------------•---•••. ................................................ has been installed in accordance with the provisions of TI�I'r; 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No..�;4_,�.V------------ dated................................................. THE ISSUA CE OF THIS CERTIFICATE SMALL NOT BE CONSTR E AS A GUARANTEE THAT THE SYSTEM WILL. U CTION SATISFACTORY. DATE................7.... J2................................................. Inspector. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH " .....................................OF..................................................................................... No.--- FEE---3 ... Disposal Works TDunutr ion frrutit Permissionis ereby granted.............................................................................................................................................. to Construct r Repair ( an Individual Sewa Disposal Sy tem .-� .. . .. at No.................... ::� :..... treet as shown on the application for Disposal Works Construction Permit No...................� D ted.......................................... = ,--.._ 0-_I--------- --------------------------------------- ' oard of Health - - DATE. -----, -= ------------------ F01' MBS & WARREN, INC., PUBLISHERS �.- - r Ivo..r �l� ...... a FEso c i`........�..5 r- -*'l ............................ THE COMMONWEALTH OF MASSACHUSETTS `A—q0 BOARD OF HIRALTH l-O- -!-.--� .......OF....� ��` '�� ''` C ........................ J'jA_JA:pVfiration f,arhui nrk nnrrinn erani Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal Zk Sys em at: i I r"k�12Tr U L '4< " - -- �-jam.. Y. ? .t.ea�,��� y Location-Address _r or Lot No. � A ,t� -G _i .� �'.......-•---------((��. --`- .....f-�.l-•---•-•27.............. .. ..... dd t a ,t..�... -�_..... 7.,�--- -------------------------------------- Installer . Address U Type of Building �-- Size Lot..-,�-• `•��-� Sq. feet 0-4 Dwelling !—�No. of Bedrooms.... ..............Expansion Attic ( ) Garbage Grinder ( ) '404 Other—T e of Building No. of persons............................ Showers Cafeteria dOther fixtures -----------X, A 4Y-AjA.IL/.----•-•---.--------------------------------------------------•--•--------------.......................... W Design Flow..................... .........__gallons per person per day. Total dais flow------------- WSeptic Tank—Liquid capacity_y#00Q_gallons Length.......--... Width....-�- �-__ Diameter................ Depth_.......... x Disposal Trench—No. .................... Width f........l---------- Total Length......... _ _ Total leaching area ----- ----------sq. ft. Seepage Pit No.' �._-__-- Diameters___ .."' pth below inlet-. `.�.......... Total leaching area l-_ z Other Distribution box (14 a�Ac;iing� an Percolation Test Results Performed by.......�� t....�_. N �__1� �_,'�p ep._... Date___..2�--�� �A7� ------------- ------•--- ,aa Test Pit No. 1Z_2".._..minutes per inch Depth of Test Pit.......�! Depth to ground water....... -4-at- fi, Test Pit No. 2.4::�..2._minutes per inch Depth of Test Pit......�a ._ Depth to ground water------�� O Description of Soil -------------------------------•-•----•------------.._............-----------•--------------------�----- -------------------.................---------...........----- V .....••••-•-•--•-••••---•--••-•••--••••......----•••....•----••-•---......••-•••-•••-•--••-•••-•-•-••---••---•-----------•--_---. - ---—� '------. W ------------------------------------------------------------------ 1 ' .�5�- ---......................................... UNature of Repairs or Alterations—Answer when applicable.____________________0 Z__: .......................... -----------------------------------------•--•------------------------------------•---•-•---•----•-----------------------------------------------••-....: 74 Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by he 3arli\of health. Sie - ....... a --------- Date................ Application Approved By..... AO... X,971. Date Application Disapproved for the following reasons------------------ ---•.................•-------•---•-••-------•----------------------------------------------•-----•----•--••------------••--••••••---•-------•---•---------•---•-•-•-------•-----•••.................... Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF ALTH ......OF................... .... . .................................. �rrtgfiratr a ompHaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ) Repaired ( ) by ---- ---------- --- - -------- ---- ------ w I taller has been installed in accordance with the provisions of TIT 5 of T)e State Sanitary Code as described in the application for Disposal Works Construction Permit No._ �l"/............... dated__-. 7..04._._._. THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................. Inspector.....---•--•-----------=`= THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH':, 7, 7�t/ . ......L..:Lt✓(......OF......... ... .Ia.-.—"-->............................:........-_.... �� No.................1..... FEE..------.--._........... Disposal Vorkg Tomitrudion trntit Permission is ereby granted ..................•-•--• ................. = ;......_ ........ .... to Construc or�Rep ( ) an Individu ewag D spo S at No.. Street e.... as shown on the application for Disposal Works Construction Per lJo._�._�j . Dated_.._ ''.................. ........ Board of Health DATE............................................................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS } Fiz N .. ... . { S THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH ..............OF... . ?)`. ,+�`.. .��..zL� ......... ..._........ Appliration for UiapnaFal .arkZor Tonatrnrtinn Fermi# PP A lication is hereby made for a Permit to Construct (i Repair ( ) an Individual Sewage Disposal 11 System at: t ""Tt'a�N 6'G•V-•U t. it 7 tit}hid �v ' c€ �3�� �( ' .. A� t'.y ..............L ................_�. .... ............................... --------•-........... ---------------- ... ------------------ �✓i „,�" Location Address .M `' � n ^� /.,� ,�§,/,,p•yA} �---�� or L�sot 01 . .... 3Z.`»�'t..1 ._. ",," .,.';'."'�--' -�................. d ..T'.:1(./L-�'...... ,�?-'_�!f_Y�1.....a2......�-.....-. 7.'`.�'.............. X --...._.... --------- -••--- •.............••-. •-- •...........---•.............---••--- In.taller y. Address Type of Buildi Size LoIt....................... -_Sq. feet V Dwelling No.-of Bedrooms--- k� ...............Expansion Attic ( ) Garbage Grinder ( ) 4 Other—T e'of Building No. of persons........................ Showers — Cafeteria a yP g P ( ) ( ) IZV III Design Flow----•---•--•--- ...:5�- .............g gallons per per-o Other fixtures .........._. �?!� ..!.!Vla W a arson per,day. Total daily flow.__..._... _ ......................gallons. WSeptic Tank—Liquid capacity`eW,gallons Length................ Width.....a�......I Diameter________________ Depth__-....__.. Disposal Trench No. ............ Width .. .-. >....... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.'T9)J_...__.. Diameter � Depth below inlet.A.l�...._.. Total leaching area'' .`7._-sq"'ft �t-/ z Other Distribution box (Vy' 6'F4;"*6osing tank ( )r _ 'u ��/ '-' Percolation Test Results Performed by, .. i' .._. ....!�:....�...`_ ��� ._.... Date__..�..............................L5 ` 7-9 ,`� Test Pit No. la!..a'-_-minutes per inch ,Depth. of Test Pit...... Depth to ground water---_-/r f=1 Test Pit No. 2.�,'`..?—_...minutes per inch Depth of Test Pit----- Depth to ground c� water------ :-------------------------------------•---------------------------------------- ---- •� ..� 00 Description of Soil................................................................................................. •• ............- -...................................------- "4 /'-- 4-' !�/J -----------------------•---•-------•-•--...-----•--...---------•--•--------------------------------------•-------------------------•------------------------••--------••---...---•---••-•--•-----••---.0 W _. ------------•--•---•--------------•---------•-----------,-•-•----------------•-------------•---... UNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned'agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of:ITT is 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has:,been issued by the board of health. w S' -n' ' ..............••......•----•• •----•---•• .........-• ............. .................. Date. g Application Approved'By 1 ................... Date Application Disapproved for the following reasons:................. ............................... ........----------------______ ----......_... -Y. --•--•--------------•---------------•-------•-----•-------•-------------------------'i:-----•--------....------•.....--------------------- Date . m � r Permit No.--•............... .......... - Issued-------•------------------ �. ------ ^•-- ----- Date THE COMMONWEALTH OF MASSACHUSETTS e . BOARD OkF �\LTH ........ ......OF................ ........ F T.eriifirFa#r n441 tFanrp S THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ) or Repaired ( ) .................-•--_.. • �rX all 7.at has been.installed in accordance with the provisions of TI 5 of pe State Sanitary Code as described in the application for Disposal Works Qbnstruction Permit No.*- __` 7...............I da.ted--. ...... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE.CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION' SATISFACTORY. DATE .............................................................................. Instor-----------------------------------•............................................... P7 THE COMMONWEALTH OF MASSACHUSETTS BOARD F. HEALTH �' �-* : ..........OF.......: si ......................................... No......._ � :... FEEld._ "":'......... Dispont Workii TwOna#rndian rrmi# Permission is. ereby granted ---------------•--------------------- --------- ...... j ----•-. ...... to Construc or Rep ( ) an Individ eivag spo¢a1 S em f j at No.`. `".ram 1'�' ./�t�t . ---- stJt ..•.•... D , as shown on the application for Disposal Works Construction Per o._ ..._ Dated.._jr ' _...........?. . 4!1 Board of Health:: DATE FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS " SGNEDVLE OF ELEVATIOPIS SEE GENEQALr !`IOTW,S .dND COIdSriZOCT10N _ SEQUEt�1GE FpfZ. PROPER II�ISTALL_,4T10N , ^— - - - -= TOP OF FOUNDATION T.C. R&R_TIGULAA1ZL.Y KAoTE Qo. BASEMENT FLOOR IN.C.F• _ '7l� • ,4t�lY ALTEQZ&�TtONS MUST BF_ APPROVED IN FII�IlSL1ED pE TNVERT OF PIPE AT FOUNDATION = gam ' W2ITIN6 >��! THE. bEStC,N EN�1IvEEtz. L' LAYEt2 % To I/2 INVERT AT SEPTIC TANK INLET = Q, FOW- PROPER. PERFORMANCE SEPTIC TANK sNI)uLD WAc5"rr_D STONE CLEA►v =NVER.T zT SEPTIC TL&N4C OUTLET '� �- PUMPED LLi.1NUaLL`t. AC4GFILL =NvERT AT DISTRIBUTION Box INLET - "7�� 5 2 00 o •O o•o YNVER.T AT DI6TV-12,U710t-1 F30X OUTLET = 10) . o -- - - ° ° o W/�SI'4EP °o ° 0 0 0 SNVE2rt AT LEAiCNINCa F'IT xxk STONE o °°° 0 —� Et_-EVAT 101-1 OF A 17- PBOTTO M Ao& X' V.C.6. � S P(PE t.x PLOT PLANWITH �Q" OPEN J20� to s.-- PROFILE OF SYSTEM /7P�J �I MANF(Ol-E GO�/ER - t.([Pt.DIA.= IZ I ,4 by (V" SQL OU<S"T UP TO WITHIN 12' OF FIN. GR'A,DF_ �[NISNED GLADE PRUDEMC E_ (LOC4AM 5E R R.Y) u t_"TR_-a I ]�( T tz.EQ"o 4'-r t,-."T Je) T PPE I i v O i 4 ? H/C 2" -T Sao i a Co -- ' \ r Ica"T Sot-AT �' �'-. " 14!111 Olt SA•u 1TiLQY TEE -# dBr o a 1 ti"L�I<T 4-o O Is+ PI�lG►.SaT 0I-�®I 4`c7 1501.11TARY W VEE0U [�� btSTK l8UT1D1�1 BCC l,EA.CNINGt 1��t a=Y) +�� x OUTLETS�} at OV"rLETS To PSE Go,° ��t• 2 ��• -[ 'PLUGGED FOR FUTURE EXPANSION � I / c�►J �� QU RPOSE5. SEE PLOT PLAN FOR I.AT I ALLOUTLkET PIPES SHALL BE LEVEL 9RFPTtG TANK GoR AT LEAST ONE PIPE LENGTH• �C� Q ALL OUT�_ET PIQiES To 3k AX T NE F_L.EVATtON. / � � t°iLLGi5..5-r RE(NF02 C ED GONGIZk'.T cr �� � ,�'� ,`� -3' �. �� C&F,,dc tTV Ok TAt�K I OOD�rr I GENERAL NOTES ��,� - "p ``, �� I • ALL CONSTR.UCT10M TO CONFORM TO TWE Fz.EQVIR.ENl1�T1TS OF T4 E "ASS. DEPT.Ot= PUB1. lG 4 c I Am:Al_T" SAmt'rA.R-! �t�col , TITLE FIVE ANo rNe TpWt l OF (3A�N;rAQ,LE 8aeR0 OF 1-�Fi�t..TH. ��y a J 2• PEQcOLA.T10N TESTS PER.FOV_MED IKI ACGOR.DA "CE WIT" THE INST2.UG'T ►O[vS of T"F_ 01 C K �( MASS- C7 p'C• OF PUr5L_tc T I T LE FIVE S E775T ED IMAY FLoW L 3 Bc.>< 1 ►DG/fi p I ^� Y � �.ID�I�q'�A S " � f• � � �`__. _ _ Q` �._ � 4- DESIGN P�'2.GOt..,dTlO1J RATE 2M.P.1 . � o n L41 0 Y� TeiP_ Q "T " x `� �-r x f� x 2• �G�SF s 3z Q r2l ' ` I �, �� - ~ i f Y C ^'T w J< I ! X L Z �. i r i ✓.L � � � I , �/ 401 ���• � 2 5. L�A.G�It�1G A��. PRovtD����� � 2 ;4 �Y.� ,� I � ,/: _i_�• rry 7 FINISH 6RADIN61 TO PJE DONt~ I" AC.GORDAlQCE WITH Pt_O-r Pt_•A<N. 0. "e:'dvY GR&PING MA-e-, "I"ez, 5"AAUL MOT F3E: FSeMITTED TO PASSOVEQ LEA.CtAIN4 FIELD. - oj. I4C'T APPUCA.BI,� �- j_jE'�.C_%4% AC- 'To Rr EXC�VA.T�DTO EI..E�I. ANd 13AGKFILLE� To R.EV, wITH A '50QE7Y 6►V-AVEL, FR.TE OF C(_A.`l, FIt.IES. LAjZ&Z 15001.DEQs, STUMPS , F¢.Oz�I FARTI-� ETC. t-L,�.VING A- PEQGOI. I�tION SATE IN [TS oR.1GINAl /\ U (r / LOLA.Ttot-1 Gtr- 2 M P=. OtZ SETTePZ i � ���✓\v a �` l0• ALL_ )LE:VAT►ONS R�F�R �o I N-rE 2 SEC--'1 oM St�t�.Q2or=I LC �ATuM = P>I '70 n �• oTZ T-QoI= NY 40 Iw v' ,D TEST PIT SOIL L_OG PROPOSED SEWAGE DISPOSAL SYSTEM.�� � 2- CY O >> i I Q� ,up �,,,,I ��• 0-4 7D L �'- ��J�,-- 1� LOCATION I � zitxI, " LET S TNa-NKFLIL 4 P1ZU NGE C1-IEGKE2PSGQ2�() 4 (Lc),cq& J ms:#cz f OT UITGOM OHS" BA_V_MGTABL.E , MA. SS - I 4D'w1v[s J�S,4- ( � WargR- We,TzR- APPLI CANT_ 4 /10 ��� ELTG901LT�E �5^^� CI�OIl �i I / ✓ r. / .T YV dT f,<;; R ''�'� `70 VJ�o I71.A.1JT7 ST2�HT _ ��.,,0 ►J C'��1 c.�i : 11 't C,-T I r ;� 1, -T ��L H E R PLO ►.J MA, t OT' 2• Q 0g°�1 ELEV. D WATEQ TA E8 X tl 'rt,_ F r � �'•"1'' Dr=:SI GNER I G° L� I PEF7C LA l0 TE T •' i x CDoISOrtsmD E "OL E ,J � K L_d.�.l I� M A. D(-7 21 lr- . ,1� ,GiT (G ¢ L 5• ^IO > PERC. iZA.'TE"= 2 ? PEeC•Q,4TE= i DATE : GAT- I -1 SCALF_f AS NOTED U4TF• o F P>c 2co1..,4T t o L1 : � . ' `� '1 '--' , I Try, F � ,q-�cr. - = '" ��"�'«,�i tb Cox r»Tt T -7 7,(,-7 t -7 7. O ON -7 t•c Isc nt 1 " _ ,._J' ( . llE3A0L I7 4 Icr V-o• T tv'—,� L+7A`..�'fbt ov`�LE`CS r J c AV,W- \' �-}� �C�?t M1,� _. 1;tom,' ALA. L. -NC)t- G .`� c �,c �o>a �C© a'�->W a. ��& t�A`a. eat. A `t 1Z LE V\vE A►,.� TONE— Tows -cA•t0iFA.ry. \+.(.��' f I � 1op ' ... .. #1 / _ ' r.��T; .. T��, I G�, , ,..' rz�A L. _ L l_ l ''� / �, �,. .'" i ! ? �, �AC t►_ ARC+A C 2c�v Its. , .�C�F = Z X 1 X �C. X ��. Y 2 ��'T\ 7E ? ,c`�`� r�R� I AL , Q to c� s+41 SAY 1 --' !, PP i f �. _ L t„To R LV b— 2.�i L Q,CATK N I �'` ,� "' , a►.,q � � � > CQTUIT COMMUNE R-ARNSTAB- E , MASS, ' f r MRS, AMRNC}0 FRONGILLO 0 �ti I DLAND ST L 7 �5 2 1 W- '804 s r; DES a ; I , ` V' V�; ,.tIGNER ) CORBETT CQRPCRATION P.0, BOX -tk. 147 ` _j