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HomeMy WebLinkAbout0088 WILD WAY - Health 88 WIL, ` r f 027-139,- :C'D COTUI or j-F COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS John Graci DEPARTMENT OF ENVIRONMENTAL PROTECTION DEP Title V Septic Inspector ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119 TeaTicket,Ma. (508)564-6813 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Govemor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ! ` PART A CERTIFICATION Property Address: 88 WILDWAY COTUIT Name of Owner LAURIE AND ROBERT COONEY �� Address of Owner: SAME x to Ike - Date of Inspection: 6/21/99 oF�9q �`99 Name of Inspector: Please Print JOHN GRACI � 'fs P ( ) r O 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) �0T 4r Company Name: nla j Mailing Address: n/a 9 i Telephone Number: n/a CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.The system: X Passes The inpection is based on criteria defined in Title V Conditionally Passes code 310 CMR 15.303.My findings are of how the system is Needs Furtheiubmit ua on By the Local Approving Authority performing at the time of the inspection.My inspection does Fails not imply any warranty or guarantee of the longgevity of the septic system and any of its components useful life. Inspector's Signature: Date:5/22/99 The System Inspector shall a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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 Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. NOTES AND COMMENTS THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. revised 9/2/98 Page 1 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:5/21/99 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: _ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. COMMENTS: System passes Title V inspection B. SYSTEM CONDITIONALLY PASSES: nLa 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. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not. nLa The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed witWn twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. nLa Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health). broken pipe(s)are replaced obstruction is removed _ distribution box is levelled or replaced nLa The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed revised 9/2/98 Page 2 of 11 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:5/21/99 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 the public health,safety and 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 ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER.IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,Method used to determine distance n(a_ (approximation not valid). 3) OTHER nLa revised 9/2/98 Page 3 of 11 1. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:6/21/99 D. SYSTEM FAILS: You must indicate either"Yes'or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day flow, X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped nLa. A X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well, X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic ompounds, ammonia nitrogen and nitrate nitrogen. X The liquid level in the SAS is over the invert pipe,is in Hydraulic Failure. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: - The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well) I The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. �I revised 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:5/21/99 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X Pumping information was provided by the owner,occupant,or Board of Health. X None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. X As built plans have been obtained and examined.Note if they are not available with N/A, X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. X The site was inspected for signs of breakout, X All system components,excluding the Soil Absorption System,have been located on the site. X The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site has been determined based on: X Existing information,For example,Plan at B4O,H, X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) (1 5.302(3)(b)] X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. I I , revised 9/2/98 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:5121/99 FLOW CONDITIONS RESIDENTIAL: Design flow:-44Q g.p.d./bedroom Number of bedrooms(design): 4 Number of bedrooms(actual):4 Total DESIGN flow: 4411 Number of current residents:4 Garbage grinder(yes or no):NQ Laundry(separate system)(yes or ono): NQ If yes,separate inspection required Laundry system inspected(yes or no):M Seasonal use(yes or no):M Water meter readings,if available(last two year's usage(gpd): nLa Sump Pump(yes or no): NQ Last date of occupancy: nLa COM MERCIALIINDLISTRIAL Type of establishment: nta Design flow: nLa gpd(Based on 15.203) Basis of design flow: nLa Grease trap present:(yes or no):�LQ Industrial Waste Holding Tank present:(yes or no): NQ Non-sanitary waste discharged to the Title 5 system: (yes or no):NQ Water meter readings.if available:nLa Last date of occupancy: nLa OTHER: (Describe) nLa Last date of occupancy: nLa GENERAL INFORMATION PUMPING RECORDS and source of information: APRIL 99 BY BORTOLOTTI System pumped as part of inspection:(yes or no):NO If yes,volume pumped nLa_ gallons Reason for pumping: nLa TYPE OF SYSTEM X 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) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other: nLa APPROXIMATE AGE of all components,date installed(if known)and source of information: SYSTEM WAS INSTALLED IN 87 PERMIT#87-541 Sewage odors detected when arriving at the site:(yes or no) NQ revised 9/2/98 Page 6 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:5/21/99 BUILDING SEWER: (Locate on site plan) Depth below grade: i:C Material of construction:_ cast iron X 40 PVC _ other(explain), Distance from private water supply well or suction line: TOWN Diameter: nta Comments: (condition of joints,venting,evidence of leakage,etc.) nLa SEPTIC TANK: X (locate on site plan) Depth below grade: V Material of construction:X concrete_ metal_ Fiberglass Polyethylene _ other(explain) nLa If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NQ nLa Dimensions: L 8'6"H 5'7"W 4'10" Sludge depth: L Distance from top of sludge to bottom of outlet tee or baffle: 3 Scum thickness:Q Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: -Q How dimensions were determined: MEASURED Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND,RECOMMEND PUMPING SYSTEM EVERY TWO YEARS GREASE TRAP: (locate on site plan) Depth below grade: Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain) nLa Dimensions: Wa Scum thickness: nta Distance from top of scum to top of outlet tee or baffle:j3& Distance from bottom of scum to bottom of outlet tee or baffle nLa Date of last pumping: nLa Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) Iva revised 9/2/98 Page 7 of 11 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:6/21/99 TIGHT OR HOLDING TANK: NQ (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: nLa Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain) nLa Dimensions: nla Capacity: nLa gallons Design flow: nLa gallons/day Alarm present: MQ Alarm level:jiLa- Alarm in working order:Yes_No—: NQ Date of previous pumping: nLa Comments: (condition of inlet tee,condition of alarm and float switches,etc.) nLa i DISTRIBUTION BOX: X (locate on site plan) Depth of liquid level above outlet invert:LIQUID LEVEL WITH BOTTOM OF PIPE Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) DISTRIBUTION BOX IS STRUCTURALLY SOUND SYSTEM IS FUNCTIONING PROPERLY PUMP CHAMBER: MQ (locate on site plan) Pumps in working order:(Yes or No): NQ Alarms in working order(Yes or No): NQ Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) nta i i i i e, r revised 9/2/98 Page 8 of 11 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:6/21/99 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: nLa Type: leaching pits,number: TWO 1000 GALLON LEACH PITS leaching chambers,number: j leaching galleries,number: _nLa leaching trenches,number,length: nLa leaching fields,number,dimensions: nLa overflow cesspool,number: nLa Alternative system: n& Name of Technology: j3& Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PITS APPEARS TO BE FUNCTIONING PROPERLY,PROBE WAS DRY,NO SIGNS OF FAILURE,SAS IS WORKING PROPERLY. CESSPOOLS: _ (locate on site plan) Number and configuration: n& Depth-top of liquid to inlet invert: n& Depth of solids layer: nLa Depth of scum layer. nLa Dimensions of cesspool: nLa Materials of construction: nLa Indication of groundwater: nLa inflow(cesspool must be pumped as part of inspection)nLa Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) nLa - PRIVY: _ (locate on site plan) Materials of construction:nLa Dimensions:nLa Depth of solids: nLa Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) nLa revised 9/2/98 Page 9 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:5/21/99 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) n/a A—E-o"'—� — A � C AA 33 Ac� � n BC a� revised 9/2/98 Page 10 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:5/21/99 NRCS Report name: nLa Soil Type: n/A Typical depth to groundwater: nta USGS Date website visited: nLa Observation Wells checked: NQ Groundwater depth:Shallow _ Moderate _ Deep _ SITE EXAM _ Slope _ Surface water _ Check Cellar Shallow wells Estimated Depth to Groundwater 12 Feet Please indicate all the methods used to determine High Groundwater Elevation: r _ Obtained from Design Plans on record X Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions Checked with local Board of health _ Checked FEMA Maps Checked pumping records Checked local excavators,installers X Used USGS Data Describe hopv you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS=12+FEET revised 9/2/98 Page 11 of 11 r t 9 f � a DON 'IAY 2 51ftOF COMMONWEALTH OF MA USETTSEXECUTIVE OFFICE OF ENVI John Grad DEPARTMENT OF ENVIRONMENTAL DEP Title V Septic Inspector ONE WINTER STREET BOSTON MA 02108(617)292-3500 P.O.Box 2119 TeaTicket,Ma. (508)564-6813 TRUDY COXE Secretary ARGEO PAUL CELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 88 WILDWAY COTUIT Name of Owner LAURIE AND ROBERT COONEY Address of Owner: SAME Date of Inspection: 6/21/99 Name of Inspector:(Please Print)JOHN GRACI 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: n/a Mailing Address: n/a Telephone Number: n/a CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems.The system: X Passes The inpection is based on criteria defined in Title V Conditionally Passes code 310 CMR 15.303.My findings are of how the system is _ Needs Further Eva ua on By the Local Approving Authority performing at the time of the inspection.My inspection does _ Fails not imply any warranty or guarantee of the longgevity of the septic system and any of its components useful life. Inspector's Signature: Date:6/22/99 The System Inspector shall ubmit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(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 Department of Environmental Protection.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. NOTES AND COMMENTS THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING SYSTEM EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. revised 9/2/98 Page 1 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:6/21/99 INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: 1 have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist.Any failure criteria not evaluated are indicated below. COMMENTS: System passes Title V inspection B. SYSTEM CONDITIONALLY PASSES: n& 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. Indicate yes,no,or not determined(Y,N,or ND).Describe basis of determination in all instances.If"not determined",explain why not. n& The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent.The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. n& Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) or due to a broken,settled or uneven distribution box.The system will pass inspection if(with approval of the Board of Health). broken pipe(s)are replaced obstruction is removed distribution box is levelled or replaced n& The system required pumping more than four times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed revised 9/2/98 Page 2 of 11 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:6/21/99 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 the public health,safety and 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 ThE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER.IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well, The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,Method used to determine distance nLa_(approximation not valid). 3) OTHER nLa revised 9/2198 Page 3 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 88 WILDWAY C OTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:6/21/99 D. SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303.The basis for this determination is identified below.The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No X Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool: X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. X Liquid depth in cesspool is less than 6"below invert or available volume is less than 1/2 day Flow, X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped n[a. X Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. X Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion of a cesspool or privy is within a Zone I of a public well. X Any portion of a cesspool or privy is within 50 feet of a private water supply well, X Any portion of a cesspool or privy is less-than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis.If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic ompounds, ammonia nitrogen and nitrate nitrogen. X The liquid level in the SAS is over the invert pipe,is in Hydraulic Failure. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No"to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No X the system is within 400 feet of a surface drinking water supply X the system is within 200 feet of a tributary to a surface drinking water supply X the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well) The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.30412).Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:6/21/99 Check if the following have been done:You must indicate either"Yes"or"No"as to each of the following: Yes No X Pumping information was provided by the owner,occupant,or Board of Health. X None of the system components have been pumped for at least two weeks and-the system has been receiving normal flow rates during that period.Large volumes of water have not been introduced into the system recently or as part of this inspection. X As built plans have been obtained and examined.Note if they are not available with N/A, X The facility or dwelling was inspected for signs of sewage back-up. X The system does not receive non-sanitary or industrial waste flow. X The site was inspected for signs of breakout, X All system components,excluding the Soil Absorption System,have been located on the site. X The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum.The size and location of the Soil Absorption System on the site has been determined based on: X Existing information,For example,Plan at B4O,H, X Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) [1 5.302(3)(b)] X The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Subsurface Disposal Systems. I revised 9/2/98 Page 5 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:6/21/99 FLOW CONDITIONS RESIDENTIAL: Design flow:-440 g.p.d./bedroom Number of bedrooms(design): 4 Number of bedrooms(actual):4 Total DESIGN flow: 4411 Number of current residents:4 Garbage grinder(yes or no):MQ Laundry(separate system)(yes or no): N-0 If yes,separate inspection required Laundry system inspected(yes or no):M Seasonal use(yes or no):DLO Water meter readings,if available(last two year's usage(gpd): nta Sump Pump(yes or no): NO Last date of occupancy: nta COMMERCIAL/INDUSTRIAL Type of establishment: n& Design flow: n&gpd(Based on 15.203) Basis of design flow: nLa Grease trap present:(yes or no):�LQ Industrial Waste Holding Tank present:(yes or no): NJQ. Non-sanitary waste discharged to the Title 5 system:(yes or no):NO Water meter readings.if available:nta Last date of occupancy: nLa OTHER: (Describe) nla Last date of occupancy: Wa GENERAL INFORMATION PUMPING RECORDS and source of information: APRIL 99 BY BORTOLOTTI System pumped as part of inspection:(yes or no):NQ If yes,volume pumped nLa_ gallons Reason for pumping: nta TYPE OF SYSTEM XSeptic tank/distribution box/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no)(if yes.attach previous inspection records,if any) I/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other: Wa APPROXIMATE AGE of all components,date installed(if known)and source of information: SYSTEM WAS INSTALLED IN 87 PERMIT#87-541 Sewage odors detected when arriving at the site:(yes or no): MO revised 9/2/98 Page 6 of 11 I I I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:5/21/99 BUILDING SEWER: (Locate on site plan) Depth below grade: XE Material of construction:_ cast iron X 40 PVC _ other(explain) Distance from private water supply well or suction line: TOWN Diameter: nta Comments: (condition of joints,venting,evidence of leakage,etc.) nta SEPTIC TANK: X (locate on site plan) Depth below grade: V Material of construction:X concrete_ metal_ Fiberglass _ Polyethylene _ other(explain) n(a If tank is metal,list age Is age confirmed by Certificate of Compliance(Yes/No): NO Wa Dimensions: L 8'6"H 5'7"W 4'10" Sludge depth: 1"" Distance from top of sludge to bottom of outlet tee or baffle: Ar Scum thickness:Q Distance from top of scum to top of outlet tee or baffle:Q" Distance from bottom of scum to bottom of outlet tee or baffle: A How dimensions were determined: MEASURED Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) SEPTIC TANK AND ALL COMPONENTS ARE STRUCTURALLY SOUND RECOMMEND PUMPING SYSTEM EVERY TWO YEAR GREASE TRAP: (locate on site plan) Depth below grade: Material of construction:_concrete_ metal_ Fiberglass _ Polyethylene_other(explain) Wa Dimensions: Wa Scum thickness: Wa Distance from top of scum to top of outlet tee or baffle:_n/a Distance from bottom of scum to bottom of outlet tee or baffle Wit Date of last pumping: nta Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage, etc.) n& revised 9/2/98 Page 7 of t t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:5/21/99 TIGHT OR HOLDING TANK: NO (Tank must be pumped prior to,or at time of,inspection) (locate on site plan) Depth below grade: nta Material of construction:_ concrete_ metal_ Fiberglass _Polyethylene_ other(explain) Wa Dimensions: n& Capacity: nta gallons Design flow: Wa gallons/day Alarm present: NO Alarm level:jiLa- Alarm in working order:Yes_No_: NO Date of previous pumping: n(a Comments: (condition of inlet tee,condition of alarm and Float switches,etc.) n& DISTRIBUTION BOX: X (locate on site plan) Depth of liquid level above outlet invert:LIQUID LEVEL WITH BOTTOM OF PIPE Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) DISTRIBUTION BOX IS STRUCTURALLY SOUND SYSTEM IS FUNCTIONING PROPERLY PUMP CHAMBER: NO (locate on site plan) Pumps in working order:(Yes or No): NQ Alarms in working order(Yes or No): NO Comments: (note condition of pump chamber,condition of pumps and appurtenances.etc.) n& revised 9/2/98 Page 8 of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:6/21/99 SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,if possible;excavation not required,location may be approximated by non-intrusive methods) If not located,explain: n/a Type: leaching pits,number: TWO 1000 GALLON LEACH PITS •1 leaching chambers,number: _nLa leaching galleries,number: jVa leaching trenches,number,length: n& leaching fields,number,dimensions: nLa overflow cesspool,number: Wa Alternative system: nLa Name of Technology: jiLa Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.) THE LEACH PITS APPEARS TO BE FUNCTIONING PROPERLY,PROBE WAS DRY.NO SIGNS OF FAILURE,SAS IS WORKING PROPERLY. CESSPOOLS: _ (locate on site plan) Number and configuration: nta Depth-top of liquid to inlet invert: n& Depth of solids layer: n& Depth of scum layer. n& Dimensions of cesspool: nta Materials of construction: Wa Indication of groundwater: n/a inflow(cesspool must be pumped as part of inspection)Wa Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n& PRIVY: _ (locate on site plan) Materials of construction:Wa Dimensions:Wa Depth of solids: nta Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) n/a revised 9/2/98 Page 9 of 11 L r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:5/21/99 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes into house) n/a c Ag � Qq 33 A&4� Ac 5� Cp 17 17 BC 2a revised 9/2/98 Page 10 of 11 l r v SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 88 WILDWAY COTUIT Owner: LAURIE AND ROBERT COONEY Date of Inspection:6/21199 NRCSReportname: n(a Soil Type: nLa Typical depth to groundwater: n& USGS Date website visited: n& Observation Wells checked: NO Groundwater depth:Shallow _ Moderate _ Deep _ SITE EXAM _ Slope _ Surface water _ Check Cellar Shallow wells Estimated Depth to Groundwater 12 Feet Please indicate all the methods used to determine High Groundwater Elevation: _ Obtained from Design Plans on record X Observed Site(Abutting property,observation hole,basement sump etc.) _ Determined from local conditions _ Checked with local Board of health _ Checked FEMA Maps Checked pumping records _ Checked local excavators,installers X Used USGS Data Describe how you established the High Groundwater Elevation.(Must be completed) USGS MAPS AND CHARTS=12+FEET revised 9/2/98 Page 11 of 11 y _ rower/Client Ball, Timothy 8( Mar�r — ~X -ilildress •88 Wild Way County Bartstable`_ _ State MA Zip Code 02635_ Lrn eder/Client Boston.Harbor Mortgage_._Corp.- i I 1. S r. L�tict I-">Oa Avl t� �RM') Jjt,�-��� l �� L..l✓!1/Q � l OU»t i N G RNC1 , ' . S Loa A� t CQ 3. It MA S'TCA. Vl P4 E - f IY FROM BALL BROTHERS ADJUSTMENT CO FAX NO. 508-426-4434 Sep. 03 2004 10:45AM P1 DEED RESTRICTION WMREAS, Timothy M. Ball and Mary J. Ball of 88 'Wild Way, ,;,otuit', Massachusetts 02635 are the owners of 88 Wild Way, Cotuit, Mktssachuse:ts (hereinafter "the property") and said property being shown as Lot i on a plan enti'1ed, "Wildwood Subdivision Plan of Land in Barnstable,Mass.,prepared for Hilary-Lauren Real Estate:Trust Scale 1" = 40'dated July 22, 1996" recorded with Barnstable Registry of Dceds is Plan Book 433, Page' 3; and WHEREAS, Timothy M. Ball and Mary J. Ball as the owners of said property have v agreed with the To-,m of Barnstable Board of health to a restriction as to the number of 0 bedrooms which can be included in any home constructed on said lot as a pre-condition to [ obtaining a disposal works construction permit in compliance with 310 CM'R 15.000 State Environmental Code, Title V, Minimum kcquircmcnts for the Subsurface?Disposal of Sanitary Z Sewerage; and WHEREAS, the Town of Barnstable Board of Health, as a.pre-condition to granting 'a disposal-works constructiou permit for a septic systern in compliance with 310 CMR 15.200, `M State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building perndt for the construction of an addition on the home on this property, is requiring.that the agreement for the restriction on the number of bedroorns in the home on the property be a put on record With the Barnstable County Registry of Deeds by recording this document, b NOW THEREFORE,Timothy M. Bali and Mary J. Ball do NTCI)y place the . following restriction on their above-referenced property in'accordance with their agreement with the Town of Barnstable Board of Health, which restriction;shall run with the land and be binding upon all successors in title: 1. 88 Wild Way, Cotuit, Massachusetts may have constructed upon the lot a house containing no more than four(4)bedrooms. Timothy M.Ball and Mary J. Ball agree that this shall be permanent deed restriction of&ding said property. , For our title see deed to us dated August 18, 1999 recorded with Barnstable.Registry of ?eeds in Book12485, Page 234. Sal!Timothy Deed Restr`.ctlo—doc k FROM BALL BROTHERS ADJUSTMENT CO FRX NO. 508-426-4434 . Sep. 03 2004 10:46AII P2 Executed as a sealed instrument this day of ,2004. G lmothy M.I3 • Mary J.B 11 _ COMMONWEALTH OF MASSACHUSETTS C_ ,ss, 200-4 me :he usidersi red notary public, . 2 beforeS da ofY P n this 1 c{ , � Y i�ersonally appeared Timothy M. 13 1 and Mary 7. all,proved to me through satisfactory evidence of identification,whICh were_MVt to be the persons whose names are signed on the precedin8 or attached document, and acknowledgei to arse that they signed it voluntarily for its stated purpose. o y Public My omtniWon Expires: Le MAR1'HANotaryP blic � f;cmmortw�'th of iNasgachus . My Cam�niee�on Expires ' . 1B E009 s ` MARGINTAL REFERENCE: See Book 12485,'Page 234 EWI TiWhy Deed ResUicdaus.doc No. �....� _ F$s_... TkE COMMONWEALTH OF MASSACHUSETTS y: BOARD QF HEALTH o...Ge�.:. :of........ JU. V7T&L .......:..:.... Appl ration for Disposal Works Tonstrnr#inn Prrmit Application is hereby made for a Permit to Construct" (L-�`or Repair ( ) an Individual Sewage Disposal C ysteai at• -Location- dr or t -- - �.. , � _... v cps. . . ... � ... ._ Owner Address 1�. .- -�:�.--------------------- ---------------------------------------•-- Installer Address Type of Building Size Lot.�� _ _.Sq. feet Dwelling—No. of Bedrooms.........`_�:...............................Expansion Attic ( ) Garbage Grinder ( ) Other—Type e of Building No. of ersons...._•......__.. .... Showers — Cafeteria G4 YP g ........................ P ( ) ( ) a' Ot�er fixtures .........................:...:............................ d -------•---••---•--••--•............/.. n..................................... Design Flow.....-.t-J 0jo----------------------•gallons per person per day. Total daily flow.._..�f... .L...........................gallons. Septic Tank-Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ Disposal Trench—No: ............... Width................. Total Length....... Total leachingarea-__. ...._..._..... ft. 3 Seepage Pit No._ ._...__._._. Diameter.-_��?.�........ Depth below inlet...�t ` Total leaching area 1:2s 7Pd -- 6 Z Other Distribution box (b Dosing nk ( ) I r� `, ``.. II 6 Percolation Test Result ��77 Performed by..___. Gt�.. LX11v L�.1../�. �. �Date.....7.f.�. a Test Pit No. 1....�.L,_..minutes per inch Depth of Test Pit....f. __.. Depth to ound vt�ater•_ .Q�Eck ` � P P eP gr Li. Test Pit No. 2..:.............minutes per inch Depth of Test Pit.................... Depth to ground water........................ x .........................................................:......•--------------------..._........--•--•---------•----•------......•----•••--•......-•-•-- • 0 Description of Soil------------------------------------------------- -------------•----------------------- ...... �- a.. _.... .....................................................................----------- 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 pr visions of iI'l U 5 oft State Sanitary Code—The undersigned,further agrees t to place the stem in era ' til a pliance has been iss oa o heal Signed. --_.. .. ..................... •• . ....i � at A lira on Approved B :�=----------------------- �.. ...: .: Application Disapproved for the f oll g easons:.........................................................................................................._.._ --------------------------•.............--------•------•--------------------......------------------......-•-------------•-----•-----------..:------------•---------------------......................._ . PermitNo...... .J..l:.r..._......-.•....._...... Issued-........................................... ........ Date _ .��.r.+<<�s-...tvwv�+.w...-�..-.f�..... ..-..�1w..,,,....r..r"._.-w...'.r++-�+...j-^7,...._ ..-•....^_+.e.,.-_..+.rs©+.-^E.�..+ao-...-...�'*'y..;rti^.....� a:�-r,r r^..2,,... h-a...):�«-�i�S.s i'6i(..�....`.sir. .i.--..+' .r .✓ '' �✓ 7����5 is �._1,.� �l' ��`�� r- - No. �...+r S1 F$s....1_ 'THE COMMONWEALTHOF MASSACHUSETTS 8OtkRD F' HEALTH x` Appliratiun for Disposal Works Tonstrwtion Prrmi# 1 Application is.hereby made for a Permit to Construct (Vj or Repair ( ) an Individual Sewage Disposal system at: 4 i�:�....... lv� ...................... •-- ..................... ./.. .I/Yl 11 ............ �•�� Location- •dre s -- -�-- �� 17 or Lot No. ..• -��. ....... ....... ..!:!. " C.. .......„......`: .1.. V,6 V '7 •Y V_ p .. .«._._ r r._.......... l Owner Address a . ............... ..- ..... -------------............... ......-•-••-••-•-•--••-•......-•••••...... Installer Address Type of Building Size feet aDwelling—No. of Bedrooms......... T...............................Expansion Attic ( ) Garbage Grinder ( ) aM Other—Type lof Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Q Other; fixtures ... .......................................I.......................................... '-Design Flow.....24 ......................gallons per person per day:•"Total daily flow..... ........................gallons. Septic Tank—Liquid capacity_._._,_. .gallons Length................ Width................ Diameter................ Depth................ Disposal Trench'No:___:................ Width.................... Total Length.................... Total leaching area...................-sq. ft. Seepage Pit No.__ .......__... Diameter.../-_-.-1........ Depth below inlet....(q.�......... Total leaching area_. 9, .�ft. �A Imo. z Other Distribution box O Dosing tank ( ) �- } : q 6 r- 1� 1 _Percolation Test Results Performed by_..._._.�U I� ....._ 7. �1...-.. ..1. (. :� 1 .._ �'JCDate....-... ..�........-....... ,.a Test Pit No. L___.._... -.minutes per inch Depth of Test Pit.... ....... Depth to ground 4ater_.1� !)sV :.fG61��f ' Test Pit No. 2....... .......minutes per inch Depth of Test Pit.................... Depth to ground water........................ x -� >*-----------------------------------------------------------------•-•---------------.........:-.......••-----•----=----------.................---•-•----•---- `O "Description of Soil......... - ------------- - V ..........................•-•-•-------..-------•---------•-----------------•--= ..._.__..�.�..���. ......... �.. ----------------- :----.------•-----•----..........---------......----------------------•--..:- - ,,..•r .0 Nature of Repairs or Alterations—Answer when applicable..............:......:..:::�....•...........•.............................................. --.....-•---......---•.................::............................•--------------•----------.....----.........--••------•----..........--•--------..........----........-•-•------•-..............-- Agreement: M The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the pr visions of TITL S 5 of thA.State Sanitary Code—The undersigned further agrees not to place the s in ratien ntil a C ifi :� ' pliance l as been issued by>th -board o health. / SignedC -.. r- /ystem �_ �. _..C. APPlica on Approved By_..... s^ ! --:w1 ....------•.............•----.-. .. ��,�" 1• .. .� � Date Application Disapproved for the follounng reasons: ...................•--•-•--.'- --.-.--------___ j� .............................................^----...----•-------•---------.-.... .........-------------•-•-----.....----•------------------.......----------------...---•-.....Due.------------ PermitNo..... ..! -- ( -................... Issued-..........................................._.......... Date < -1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ; �.1; A % �._ OF......... ................ (Irrfifirair of Tomplianrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) Installer - ..................................................... has been installed in accordance with the provisions of TITLE 5 of-Thy State Sanitary Code as described in the application for Disposal Works Construction Permit No...... _ . _..-` ..t_..__.___. dated__....... ..-::J.. ............ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................./ :�...........�9 :"_ SC )....... ...... Inspector...--•- ........................ .. ._...................... ------------- — --------------------------------------------------- "` * THE COMMONWEALTH OF MASSACHUSETTS ! BOARD Ofp HEALTH 1 L dV . :....OF..........!`,•.'. .................a;...... No..�!............it F=...... ............... Disposal Works Ton#rur#ion f rrmif Permission Is:hereby granted... •.. ..�...ll....��_e, !: `....-•.........................•-•---.......................................... to Construct or Repair ( ) an Individual Sewage Disposal System . .. at No... --•• ----....(A.-1�.(5J- ....�, G 4 .....-----•........��{/1___rl�_C.�.!----........................................................................... Street QQ as shown on the application for Disposal Works Construction Permit No.!l. ".5��.. D'ated..-..v_.�_.f .J.!.................. //^ y I Board'of Health DATE -- ---- ---.. ...(............................. v . II / r _ Ap*m , ILI fo FTT I i I li I I I I I. I + 4 r -- l v __ : I -- -' -- — — : — — - r I � I �f I f t - / ✓/ may-\ 9 Y i I I Q -- COO it it li JaD� _ r I I t „ I I .�l I STI+k L 7 .r ` y I 1 rl I I 1 1 ; _ -41 r- I ��'/ .. - .. SCALE: f.PPBOVEOBY: 'ORIIWNBYGjz,y : DHNWIN O NUMBER A„I T � . II I4 I1�� .:I c c{-P _. ��.. 7 i 1 1 _11 1 t �4 Tc 11�Y,✓p Jar -13 u. c {� Ion PFvo..; _ .. ........_ -.. - " r !I LID .. - -� v _ I ✓nw� r F o rL ✓ r�rc v�1.1 t < _rs _ I': ! I I?..c ! c.._ ,.. n I F .v. t I , :E_ r _.�.rc. � a iax I �( �, ,�:.''�f y X 11 3 ����': -..� I' ;o `--�D �-,„... ! ��_✓�:'.E�.`--`c- � I I, �! i .,r I I ( I� All l - 1 ',,.�1`r�-�'--� 1 Jt'11°�_'� ,, ,-¢.P.J�ark: /'�'b j;9v� ���:�.::✓'--__-__ � .. {. !j iI. _ ��. I S � ILA, :fi ,.. . —>I I '- 1 � 1 � I•I ntz rt N v I \%V p C _ -�`. y� _,S E.r�M.:?z«•�--4_I>_r�o. I it toF nl � � ?i )' :4uI,.1zE � - I - I 1 I.i ,• {_N. it GVTavzu_- .. _ - HPIL ..- SSIrnsM .. e-._GAS_ E,z.. �r �C:cHni a f \ ,,,Ca IDnI I ' I •t/` 1y Nara JI. — .� + 77 rJ r.( G. ZF:.Y--F- 7-•I✓} 4�I``-�i.G.-.F�-`FW000 SuYi F rJ f> i 6J tom/ f�2•- ; N- i K G 1 I. 7� tiI w >V\ Al (GI} J L GGft j� L{ J S- �/✓ _ _ 30 .. 1-.. - - _ �. � -. � E FL.vL...,._ � � v:'E•�t.. r S.-.:f..,. : - � � � - !r2Y`.l �,�-i/ y'i.:.'!SE_c 1 ti, � _� ; ..,L. rtl; _.._. I .-..�l,Y,�. _ �++ � II I �' ,i '•I 1: - iif 1? 3� '�7�.-F._, Y ".:eA C/y mil I • I J --r-' .___..:._._ �_1w C�vl— .__._.._..xV._:-I •.;__3 O.y.h,�'—''_/ �!i. - _ %q L�/L, 1-fG-A1j! � +I u r � /y ✓r_- 1�JS.ps=.r fr , an l'- `.. c J :''•�Pr' i °,., - _- �Lt k_�,20"o _rk - - tam �a�i K -��h 1 G,prn1r nnr I L. it IH ' _. ..��-�`/q _.—_. .-------�------ I�.ji:=3�--_--^ - ---- — -...._ � .c%9 ..._..- --------- A . '\�L T'Y r 1 Z. � n�-�-! ` i L: _ I I+ >e ~tile. y E2 y � I a ! i;: I• ;.'._ _ _ � '- ;�ti-e � i _ _ _ .. ...... i _ •. � + : :: _..- � 1 ....i.. APPROVED BY.� SCALE: qS NO'TEO DRAWN BY Sf j • . A DATE: 8 26-'04 DRAWING NUMBER > II u ' IN, , - t__. .. ...... i I I , i I i. ,�. 7I-._ 't .--- _ �f9 sT✓g_ '�, v 4- � I ' -CII 7 I t I ------------ • i E f }4 I - i - •i i .—_.__ _... .__. .. .. ..a. I' 4� � '1-N G" h3 A L. 0 8 W� �n �1✓ ol ' I SCALE: DRAWN 9Y L`; . � } DATE n� - _- - � DRAWING NUMOER - I mot.`..,_._• ,.=...r.___. .-.. _- ____-___.. .._-__ __ _._.._ -7—op 0 roNf4r) 10N F�.VV I 90 87 OD - ---- � - 86 - — 8 - 82 8 1.50 81.o0 So 8 r 25 80.4o --- -78 7 5.50 84-9O 74-- _7 2 •70 I ti./D TE &XTE1,/D ALL /9PPL/CFi BLE - - -- - - - -- exis-7Li r, /-ounoI ro,ci/e MRNf-lOL t- CO l/E)2S TO G.I/TH/AJ ' -o—o—o—o— �roposed ground S C � VE /2T. SCf�I� : / /O� /2" O F 91:) F L o IAJ min. %4'Pe� ,''•f:� FLDW " SHHED. ¢D P. l/. 7. o,e Crninimum % Per ,�oof') �fe r��asfor�e. EQUI9L TO SEPTIC PIPE To 8E lj 3•r9,�.1 -/-+O"- —/,c/� LEVEL a I I D/ST B OX !� LEVEL r 6 314 -- 4vaS he& s>cone� ! r' TANS EACH PlT — a PZ, _ r — 30' 4 D E- SMG /�/ E DATA: 36 TEST eY= 1- OW + 1-141.LIP IM C.E D P Cno dispos�r� W/Tti/ESS : T KEEN� 8...�. ��_B9.OFf/�a. rN ?' ;n � /��t=- :2C. ,G�faTG- c... Z �.-I,•ti/.//.1/G N -r- c. , -rr ...._. _.._ 62,E I .. 1 C n I 4 -� � LEf7CH/NG F1,2Ef� : Ck I 1 s!!'7cc..�F3LL: /9e, 5X2 5 = 47/,7--5 G. P.D. -78-_5 x /,S" = 78.5o - S AnrD � 86 - - - � - - - - - - - - _ _ - - - - - - - - -- � TOTf1L -5�-9. 75 G.P•D.(xL= /o99.50) ,, I � `! �. _�- - - - - ;- -- - -- �- us �� : (2) 6X� LEAc:I-I P175 �,,/12 OF S ,' O T / uYN RF o s A N v I m rn' 2 / 0, 77 e- I 70.4 L 4-1-" I #� / G =,�T/FY THAT THE BU/LD/A/G No W�TF R LOT PF� �PO$ED ON THE G2oUN0 AS CnlCDuNT6RE17 I SH(',t,JAJ Oti/ TH/S PLAN/ DOES _ To THE 5U/LD/l,J6 5e-1= S/ T E - S E W 1gq (SE PL tzl- l J - �F' ._ h' �E QUI�EMEtiJTS OF THE i 88 7 0L,,JA/ OF ��R!y STAB L. _ _FOQ : 0 7- 1 /��, Pc� �qs /"I A R S T O N S M s r 88 j '�4+ c f PREPARED FOQ: .SOur,N CAP R ALTY '' O�ORCE OW. JR. , 8evl' ost-` SCALE: AS tiIOTE D OF Y /4- l 98 I ARD M q 47 PL%1 /V cscogLE: r - 30") V/ E 7-6 O. o o e x/s•f-! n c7 eleva-fion BL DG. SETBACK _ ssl�N L ProPos�c/ e /� vat/or� F�'EQU/!zEMENTS : FlPPA2C)1 ED ' ' fro n 3 L E �� Inc . - - - 5f Bo� ,2D f EALTf-l. 714 !"IA/N5T,2EET - ,oro�oSed co1-7 four-S 1 , MF-!SS• YPRr-07OUTH P02T, MASS . P�oFE55lONfIL ENG/!VEERS fr LAND SU2VEY'Gb25 �i S6-"O9�