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HomeMy WebLinkAbout0008 REDBERRY LANE - Health �f 8 Redberry Lane . 71 Marstons Mills P A = 047 096011 I T -r �( Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 8 Redberry Lane n A-1 • p gi • �� l Property Address Ricardo Fernandes LM�g Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City'/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. . Important:When filling out A. General Information forms on the computer,use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC Company Name Q P.O.Box 763 Company Address Centerville Ma. -02632 fawn City/Town State Zip Code (508)428-4028 S 14454 Telephone Number License Number B. Certification 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 the inspection. The inspection_ was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails t' ❑ Needs Further Evaluation by the Local Approving Authority r=` -., LZ, 4/10/2008 Insp cto S' nat r - Date The system inspector shall submit a copy of this inspection report to the Approving Authority (hoard of Health or DEP)within 30 days of completing this inspection. If the system is aI shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner hall 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 Y the same,or different conditions of use. 8 Redberry lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 15 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City/Town 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 CIVIR 15.304 exist. Any failure criteria not evaluated are . indicated,below. Comments: The septic system is in proper working order at the present time. 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. Answer yes, no or not determined (Y, N, ND) in the ❑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. ND Explain: ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed 8 Redberry lane•03108 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: ❑ 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 ❑ obstruction is removed ND Explain: 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 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 8 Redberry lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form Not for Voluntary Assessments 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached.to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No".to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow ❑ ® 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. 8 Redberry lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less-than 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 gpd to 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 ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone 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 threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 8 Redberry lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ 0 Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any.of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® El available 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 size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 8 Redberry lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts H F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter.readin s, if available last 2 ears usage 2006:127,000 9 ( Y g (gpd)): 2007:132,000 Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow (based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc:): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): 8 Redberry lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: ti 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 I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: new leaching installed 2001 Were sewage odors detected when arriving at the site? ❑ Yes ® No 8 Redberry lane.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 2'feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): t Distance from private water supply well or suction line: 10'+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank (locate on site plan): Depth below grade: 2'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 gallon Sludge depth: 6,1 Distance from top of sludge to bottom of outlet tee or baffle 26" Scum thickness 6'f Distance from top of scum to top of outlet tee or baffle 6„ Distance from bottom of scum to bottom of outlet tee or baffle 811 How were dimensions determined? Measured 8 Redberry lane-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City[Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump septic tank every 2 years.lnlet and outlet tees are in place.No evidence of Ieakage.Tank appears to be structurally sound. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date 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): 8 Redberry lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official. Inspection Form Subsurface Sewage Disposal System.Form -Not for Voluntary Assessments 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank (cont.) 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 Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert No 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.): Box is Ievel.Box has three outlet laterals with equal distribution.No evidence of solids carryover.No evidence of leakage into or out of box. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 8 Redberry lane-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,M 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is required for Marstons Mills Ma. 02648 4/10/2008 - every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1-1000 ® leaching chambers number: 2-500 ❑ 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.): Sandy dry soil.No signs of hydraulic failure.Leaching was dry at time of inspection 8 Redberry lane•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 8 Redberry Lane Property Address Ricardo Fernandes Owner wn r'0 e s Name information is required for Marstons Mills Ma. 02648 4/10/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 J ' Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site ( e plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 8 Redberry lane-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 Commonwealth of Massachusetts -Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is Marstons Mills Ma. 02648 required for 4/10/2008 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch 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. 8 Redberry lane-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 Map Page 1 of 2 Town of Barnstable Geographic Information System P Map Size zoom Out J g j E, J J�J Parcel Viewer Custom Ma Abutters u d a In — y h( R r .r i�c!•n•� r � _ 1 ; � "I y n F `^ Z f nP x� r _ { 0 K ,. 20 Feet 4♦ III.^ Set Scale 1" =.20 '.I Aerial Photos r n^—rinhf 7nn6;-7n07 Tn,.,n of P—nefnhin nna All rinhfe roca— http:Hwww.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=047096011&... 4/11/2008 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 8 Redberry Lane Property Address Ricardo Fernandes Owner Owner's Name information is Marstons Mills Ma. 02648 4/10/2008 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of leaching 60'feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed. 2001 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: As-Built Card. ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-000-01 plate#2Annual ranges of groundwater elevations. 8 Redberry lane-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 Town of Barnstable �pP THE Tpk Regulatory Services ,Sj,,B Thomas F. Geiler,Director 019. Public Health .Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified by the State of Massachusetts,Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future not does this Division agree with any technical observation s and interpretations contained within this report. In addition, by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the"Disposal Work Construction Permit". If you should have any questions regarding this report, please contact the certified Septic System Inspector who conducted the inspection. COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION 0 4� MAPn PARCEL, , LOT TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: /�2v�er� L-.aine, RECEIVED Owner's Name: n AGA ee NOV 19 2003 Owner's Address: 47 094 44' TOWN OF BARNSTABLE Date of Inspection: !0 HEALTH DEPT. Name of Inspector: (please print) Company Name: je5/ ,,4.0— Tcc Mailing Address: v x •L�.f *!: Telephone Number:f Sor) 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 the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails / Inspector's Signature: — Date: The system inspector shall sub t 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. Notes and Comments ****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. Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A- -lCERTIFICATION(continued) Property Address: �E C,/2&, Owner: q 4 � e Date of Inspection: p Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. S y Passes: L �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: B. System Conditionally Passes: 21"e or more stem components as described in th system Po a 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. Answer yes,no or not determined(Y,N,ND)in the 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 ears old is available . e. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: 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 obstruction is removed ND explain: Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM -PART A- C RTIFICATION(continued) Property Address: Owner: _ Ge �el Date of Inspection: /o Z 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 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. _ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**.Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory,for 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 pimp,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Addr ess: &r Owner: ,P 5~Z Date of Inspection: to 0 D. System Failure Criteria applicable to all systems: You must indicate`yes"or"no"to each of the following for all inspections: Yes No 2Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool &I"bischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or /clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _f Liquid depth in cesspool is less than 6"below invert or available volume is less than%day flow _Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number �of times pumped . _ �y 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. T,Any portion of a cesspool or privy is within 50 feet of a private water supply well. _r/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 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,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] " (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: following criteria apply to large systems in addition to the criteria above) ye no the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area—IWPA)or a mapped Zone H of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should contact the appropriate regional office of the Department. Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B / CHECKLIST Property Address: cja ee , Z---v 117s Owner: . Date of Inspection: Check if the following have-been done.You most indicate`Yes,,or"no as to each of the following Y ' /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. T -- Have large volumes of water been introduced to the system recently or as.part of this inspection r/ Were as built plans of the system obtained and ems?(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 1z Were all system components,excluding the SAS,located on site _ Were the septic tank manholes uncov Bred;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 mauateuance of subsurface sewage disposal systems The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes no Existing information.For example,a plan at the Board of Health. C/ 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(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - - PART.0 -_ S TEM INFORMATION Property Address: Owner: Date of Inspection: FLOW ONDTTIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CUR 15.203(for example. 110 gpd x#of bedrooms): Number of current residents:_Y Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(yes or no):;0 [if yes separate inspection required] Laundry system inspected(yes or no):_ Seasonal use: (yes or no):AD Water meter readings,if available(last 2 years usage(gpd)): Sump pump(yes or no): 1W Last date of occupancy: L4 COMMERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 CUR 15.203): and Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no):_ Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system(yes or no):_ Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: /�f — Was system pumped as part of the inspection(yes or no): /lam If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYP P 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✓Altemative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach a copy of the DEP approval _Other(describe): Approximate age of all components,date installed(if known)and source of info o : /Iek/ S•�S dS' o/ �So Were sewage odors detected when arriving at the site(yes or no): lso-v Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - - PART_C_ SYS E IM INFORMATION(continued) Property Address: �j Owner. G<� 2F.f s/ �'7 Date of Inspection: /� D BUILDING SEWER(locate on site plan) Depth below grade: ( �?s Materials of construction: iron �/PVC—other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:—�logte on site plan) Depth below grade: /<2 // Material of construction: concrete—metal—fiberglass___polyethylene . —other(explain) If tank is metal list age:— Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions: r g Sludge depth: 177 Distance from top of sludge to bottom of outlet tee or baffle: J�2 Scum.thickness: / '" /I Distance from top.of scum to top of outlet tee or baffle: Distance from bottom of scum to bottotit tee-or How were dimensions determined 1101 eke vi c C (on pumping recommendations,inlet and outlet or baffle condition, structural integrity,liquid levels as to outlet invert,evidence of lFak�ge,etc.): ti ^ $n v70y� 17 C-'GJ vl 4-' 74-11,t Q,� es ih moo Coy. ,• , a,. L...e.�1�1'_ GREASE TRAP:k(locate on site plan) Depth below grade:— Material of construction:—concrete____Metal— fiberglass—polyethylene—other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART_C . - SY M INFORMATION(continued) � Property Address.. eW v / '�// Owner. 16G 6Gr 2 Date of Inspection: lWoua 07 TIGHT or HOLDING 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: eallons Design Flow:. galloiWday Alarm present(yes or no): . Alarm level: Alarm in working order(yes or no): Date of last pumping Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: (cif if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:!i��� G• Comments(note if box is level and distribution to outlets an evidence of i equal, y solids carryover,any evidence of leakage.' or out of box,dtc.): PUMP CHAMBER/v locate on site lati ( plan) Pumps in worldng order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART C - Q gSYSINFORMAT,I/ON(continued) Property Address• U l� Z' 106 Owner. Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type j,Zleaching pits,number: l x leaching chambers,number: leaching galleries,number: - 490 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.): � �, Gr - L—. �n Q f ". CESSPOOLS: /y (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: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: o to 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.): Page 10 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C- _ - SYSTEM INFORMATION(contim,4 Property Address: f'��✓�✓ /(/ Owner. rr P� Date of Inspection: /D 0 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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.. /4�+ T r i r © �t� 3 Ir �o - 3, 9c� �7 7 -3Y Page It of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM -- PART-C_ . SY - ORMATIUN(continued)Property Address: � Own 1 �( I"r• Date of inspection: .o SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water �Sfeet Please indicate(cheek).all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed- Observed site(abutting property/observation hole:within.150 feet of SAS) Checked with local Board of Health-explam: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: �Q You mustt scnbe hove you established the high,groundwater elevation: % c.... c� /7,� /r/� /� 1(v►cl Iry O or i A0 �'A v►tom► / 2 r` TOWN OF BARNSTABLE S II LCK'ATION 8 '2e 6o` r-t-" ljv fiar-t- _�� SEWAGE # r2661 L/3 VILLAGE D"(At-TFO. .s ►l Is ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.�B rs ce ho—wd[,, l Lim-5,ln SEPTIC TANK CAPACITY /5-00 t;AI LEACHING FACILITY: (type) 00 6,tl Coz) (size) a/o a DCo1S-r NO. OF BEDROOMS 3 BUILDER OR OWNER ��-�c � �lC. C� <<•S i c� PERMITDATE: a 0 0 k COMPLIANCE DATE: Separation Distance Between the:.. Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 1 7 3f' C.J 3T ti a S No. t� � THE COMMONWEALTH OF-MASSACHUSETTS FEE ` BOARD,/) OF HEALTH OF APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT Application for a Permit to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) - ❑Complete System Xndividual Components Moc /// anon �p ®� �wners a _X Map/Parcel# O Addry Iye. Z-- y 11�- ;G 0 4 7; Lot 4# Telephone# cv.Csz VkRUA�1"SLFQ \ �oy� �5ow Installer's Name Designer's Name, Sx, Address Address Telephone# Telephone# Type of Building: Lot Size G Sq.feet Dwelling—No.of Bedrooms ..3 Garbage Grinder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) �PI-15-0"gpQ Calculated design flow 3 gpd Design flow provided gpd Plan: Date Number of sheets _� Revision Date Title %L� , /D y6V/),9i51f /fee -Ali le 4VII &J-L.J r7 Description of Soil(s) 64 g^3 r. j2WAV 4dAm ? "����d�/a'J�� � 6 9—/92'*ax 1/4 t, 6lgxr&j-,Wv Soil Evaluator Form Noll)41 d/>C , Name of Soil Evaluator -Nr/ Date of Evaluation `D/ DESCRIPTION OF REPAIRS OR ALTERATIONS 77a L&AA4&0,�— 5004-S f4-'2 ra/✓ _ 7 /c. ;044r. The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE S and further agrees not to place th system in operation until a Certificate of Compliance has been issued by the Board of Health. Signed Date S btl r o FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 I U No. . - THE COMMO:NWEAr-T-H O-�FOMASSACHUSETTS FEE BOARD OF HEALTH rOF f APPLICATION FOR DISPOSAL SYSTEM CONSTRUCTION PERMIT _ , .t Application for a Permit to Construct (' ) Repair (�) Upgrade (..! ) Abandon ( t) - ❑Complete System 'Individual Components Location Owncr's a Ag/° � ARC 26 8`. �o.B I� ��ie ysT Map/Parcel# Add re j Lo7 lt/o, ZZ S"Od'- 76Q -4777 p Lot# Telephone# LE . ,&s n,�-r�s Installer's Name Designer's Name Address /99ress Telephone# 'telephone# Type of Building: Lot Size lied Sq.feet Dwelling—No.of Bedrooms .3 Garbage Gr nder ( ) Other—Type of Building No.of persons Showers ( ), Cafeteria ( ) Other fixtures Design Flow(min.required) /�"gpd Calculated design flow5jQ gpd Design flow provided gpd Plan: Date 9'//- D/ Number of sheets Revision Date Title ,&JNn0d zyz GA/Ur7-6 2- Description of Soil(s) Q 1-J" _fly AIW Soil Evalba Form No/�U�/C , Name of Soil Evaluator .b0 Date of Evaluation -/O/ DESCRIPTION OF REPAIRS OR ALTERATIONS -77) !- SD/LS M,'5- SON The undersigned agrees to install the above described Individual Sewage Disposal System in accordance with the provisions of TITLE 5 and further agrees not to place the system in operation until a Certificate of Compliance has been issued by the Board of Health. n ;a. Signed r I': i� Date 5r/7' .-26- 96oi - o Ins eeti is ' (UU C] (, o A o.. i' C tV - - I FORM 1 - APPLICATION FOR DSCP DEP APPROVED FORM 5/96 —— No. cJC ,""'��'1� THE COMMONWEALTH OF MASSACHUSETTS FEE ��J BOARD OF HEALTH CERTIFICATE OF COMPLIANCE Description of Work: ❑ Individual Component(s) ❑Complete System The undersigned hereby certify that the Sewage Disposal System;Constructed( ),Repaired(Vf Upgraded( ),Abandoned.( ) by: �-k(-c r at ((Z5 �c�e:��]crc^�r lrlaxlLr �lrae ,�ons il.l[�, has been installed in accordance with the provisions of 310 CMR 15.00 (Title 5) and the approved design plans/as-built plans relating to application No.00:A-VVjjlated 9- 210- Q 1 Approved Design Flow (gpd) Installer Bruce h0.CR\,, r A r( i Designer:Xn4X n �ca v e Inspector r o C 'Y l�C!\ Date The issuance of this certificate shall not be construed as a guarantee that the system will function as designed. FORM 3 - CERTIFICATE OF COMPLIANCE DEP APPROVED FORM 5/96 No. THE THE COMMONWEALTH OF MASSACHUSETTS FEE ►= N3`Af)� BOARD OF HEALTH DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is hereby granted to Construct ( ) Repair (Upgrade ( ) Abandon ( ) an individual sewage disposal system at 8 J V D'b c rr4 L A r t H a n S':L- I as described in the application for Disposal System Construction Permit No. r ���- Z dated Provided: Construction shall be completed within three years of the date of this permit.All local conditions must be met..,e Date �'/ /a�D /E�) Board of Health -'&._ f FORM 2 - DSCP DEP APPROVED FORM 5/96 r t FORM 1255 (REV 5/96) H&W HOBBS&WARREN TM PUBLISHERS- BOSTON r (� = 1 -.:� -!{- f�Ki4 r R `' i��'_F _-'S'•' - " '°'' 'tN" }' Yr� q�....,.-5,.. �f'1 sn, ,�Zs34�''ir,Seg._.a,' ^M 01 111 - � OF BARNSTABLE t �� a .. VII LADE �A S Ll �s ASSESSOR'S.MAP INSTALLER'S NAME&PHONE NO.� SEPTIC"TANK CAPACITY /v Oo Gar/ LEACHING FACILITY: (type) 5 O o Gft/ (size) J,2/d Y XLRS7 r NO. OF BEDS ROOMS .3 ' BUILDER OR OWNER _ CG I l cr ATE. CQMPLIANCE Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet. Private Water Supply Well and Leaching Facility (If any wells exist on Site or wtthin.200 feet of leaching facility) Feet Edge;of Wetland-and_ .Leaching.Facility..(if any wetlands east r within 300.feet of leaching_ facility) 771 Feet i Fur ushed by . - I j - Y i ... $ 6 1 6-101„ Copyright and Prohibited Use Statement This design was created and authorized by Shawn M:Byrne("Byrne"). Byrne exclusively owns all rights to this design, r.5ubwuof%d and the copyright laws of the United States protect this design. Any use or 4'-3" reproduction of this design without the express written consent of Byrne is _ __ strictly prohibited. Civil damages for unauthorized use of this design may equal I.-�" or exceed the fee normal of Sound 9 Advice and/or Byme from creating, 1 2 I implementing and installing all work contemplated by this design. All unauthorized users of this design will be i liable for all civil and criminal IF2 /1/L��j C',' I penalties permitted by law. I7 2 3��4" 3'-1 l " g _ Shawn M.Byrne,www.soundadviceht.com —I I - Job Title I —1 Caldwell Theater 2" g_1 Client Initials 4' 'V.V Don Caldwell Drawn Date - �3 61,E � Byrne 08/31/2010 Element Acoustical Analysis 1F- _. .I:. — -- -- — -- 1.Install Quest Perfsorber along the top 1 foot of the back wall. Use Quest �-15 Q-Sorber below that to the chair rail. i 2. Install 2" of Owens Corning.705 Revision scale faces with aluminum foil backing N/A N/A below the chair rail to the top of the Project Number baseboard. Caldwell-MA-0810-2 _ 1 TOWN OF BARNSTABIX L I�1CiiTION �p/ L SEWAGE 'u1 VILLAGE / rS,4sµ, 117•/Is ASSESSOR'S MAP & LOTId� -�,Z INSTALLER'S NAME & PHONE NO.)y,-c � Con,T A0 �r e SEPTIC TANK CAPACITY LEACHING FACILITY:(type) Pfe C4 Sl— R� (size) /we 4-(;".r NO. OF BEDROOMS _PRIVATE WELL. OR PUBLIC WATER BUILDER OR OWNER -,7 CIA, DATE PERMIT ISSUED: . DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No T3 f li ,YF No..l1.®... Fizs...--7 ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for B44pntittl Works Tonstrnr#'tun ramit Application is hereby made for a Permit to Construct ( ✓�or Repair ( ) an Individual Sewage Disposal System at: s �) i s .... ::. .T....... ......-. -e•••-- • r �'`........... : �• M � '2 ... ........ ........... Location-Address C— or Lot No. ....s a._`�.�_...�.�.. ./..�u �,4..--------------- ..........: .vu.L.ems.. ..._....T ...... .. .. �Qwner l ddress Wl e _ ....�—�.�. .......✓t ............................................... ............................................. Installer Address PQ Type of Building 4,3 .3 Size Lot. f. �.. Sq. feet Dwelling—No. of Bedrooms.......................... ..........Expansion Attic Garbage Grinder a Other—T e yp of Building .._f Q— No. of persons....... ............... Showers (� Cafeteria..... .._. a Other fixtures ---._. ................................ Design Flow.................... ...........gallons per person psr day. Total daily flow............. V.._.._.._.._gallons. WSeptic Tank—Liquid capacity.l gallons Length_ ... Width. ....I...._ Diameter................ Depth..5.r..Qi x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. JI Seepage Pit No.......... ......... Diameter.......a..._.._.. Depth below inlet......<.......... Total leaching area..._Z.'..Lsq. ft. Z Other Distribution box ( ✓S Dosing tam)" Percolation Test Results Performed by....... .....^_�.... ................................�............ Date............ .. .. ?}.7 4 `} ,.1 Test Pit No. l...... ..Z-minutes per inch Depth ofr Test Pit.../& .4--- Depth to ground water....... 1.�`—'. f— f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a ------------------- - ----......-•-------•----------•-••-•-•......... -• ---------•-- O M - �o c1 r-s < `� L. Description of Soil------••---• ..... ---------------------•-------....--------------•-------•- --------....-•-•---••--------------•-•--••--•••..........••-- W V ---------- ------------------ •------ ..._..-------------- .................................. --.-.------------ ------------------- •-------------------------- -.......... . -------------- W •--------•------------••---•-----------•••-•---•---------•-----•-•••----•-------•---•--....-••••-...-------•--••--------•----------•---••----------•.......••-•--•----•--------•---•----......••-----•-- UNature of Repairs or Alterations—Answer when applicable............................................................................................... ---------------••---- --•-- �.. ------------------......••----. Agreement: The undersigned a o install the aforedescribed Individual Sewage Disposal System.in accordance with the provisions of ilTLL 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. Signed,x 1!1 &'5'.. ...��-----.-- ....._..._ Application Approved By. ..... ••. .. ..'---- �•--. -•----................... �--- Date Application Disapproved for the following real s:--•••••••--•----•••-•-•-•••...--••--•••----•-----•••••••--•-•-•-------••--•-••••---•--•-•....................._ (�((jj Date PermitNo....-�1---5�.. . iT- ----------------•-. Issued----........-----------•---•------.....----_.-...---- Date ...............A -------------------------- ----------------------------- i-- Not1.0..... f Fzs..7 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... a....'nfl...OF...... �... .."..Z.rV- s 7.,qZ3 4 J_— .............. .... ....... Appliratiun for Disposal Works Toustrurtiutt rrrmit i Application is hereby made for a Permit to Construct (k"')' or Repair ( ) an Individual Sewage Disposal System at: p Location-Address or Lot N. ... ................ ` - -- -•. !; !'--D»t;-_ T r-/- »»�d Z/%•�t ner jAddreS3 40 - ..... ............................... - .----- .... .._........ ...._....---•--._.... Installer Address Type of Building Size LotA_�,e. G..�_'_.Sq. feet Dwelling—No. of Bedrooms.......................:....................Expansion Attic�(-�7— Garbage Grinder (''`) '04 4 Other—T e of Building l c_ "..... No. of persons._..._.I�R................ Showers , — Cafeteria "" 04 Other fixtures ..._ W Design Flow...................` ............gallons per person per day. Total daily flow..._.........'-._.. .............:......g�allons.� WSeptic Tank—Liquid*capacitye�29qgallons Lengtha'__...�:...... WidthA_..L F . Diameter................ Depth ..... a. x Disposal Trench—No..................... Width.....1............... Total Length............. Total leaching area...................sq. ft. Seepage Pit No.........5.......... Diameter...... __........ Depth below inlet.... ........... Total leaching area..................sq. ft. Z Other Distribution box (✓) Dosing tatsk•(—r , ►-+ .... � car" `-2 f 0.4 Percolation Test Results Performed by .._..�. .................................................� „ Date.--•------.'.....- --- •- ,�,,, � a Test Pit No. 1....�. .minutes per inch Depth Test Pit...ZN- .... Depth to ground water......................... ' (z, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ F�l a .................... ......_.. _ ,...._...... -. _..�. .............. O Description of Soil............° ` �� " �- = --�' t ----•...................`..............---------------- �.L ='_. ...... - --•---- - -----......................../.------... w -----------------------------•-...._._..---•----•---•--....---------------------------•-•--•-•....••••---._._...--------------------.......------------•-•--=--......---....-•--•--•--•--------=•--••--- V Nature of Repairs or Alterations—Answer when applicable.........................................................:..:.................................. C........... 0 ... f ....... Agreement: 1: 11 The undersigned o install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT11 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. Signed:X�.... ............................. -•............................. .......................... ® Date Application Approved By.. ..... ------ ------- ...::. .::�............ . .............................Date Application Disapproved for the following re s:............................................................. ..._........_.._ ..--•-•--•-•------•-••-•------•-•----•--....-•--•----------------•-•--•---....__.........------..__...._..-•------------•-----------....-----•--------------.......--•----.......---••••------....-- . _=Ll� ...............Permit No.. -- - --.... .. Issued--------------------------•---•---........Date ..... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ffrrtifirate of faumplittnrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by---•--•�jP c:-6 i�---- ............................................................._....................................... ._».._ Installer ---------•.................•--------------•••-•-•---.......------••--•-- has been installed in accordance with the provisions of T LE 5&.�. State Sanitary Code s dg&cr' m the application for Disposal Works Construction Permit No.- .'' ..... dated----.�(,?.. .i�3_.�. .........._ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GU RANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................•••--•-.... :,� .......................... Inspector................. ... .................................................. t THE COMMONWEALTH OF MASSACHUSETTS "/BOARD OF HEALTH U..` 1.....�.:'.:�"`. .......OF... :."'�... —. ! .f-. . No .. Fs$ ........ Disposal Norks Tutttourtiun frrmit Permission is ereby granted......! ` =' to Construct ( ) or Repair ( ) Indite d al S ewage Disposal ystem at No.... -.4?..."�' -� Z _ . � . .................... Street t as shown on the app icatio� Disposal Works Construction Mnit N '�s� Dated4. ?.... .......... ............ �• ...:; •I"*t-`� •.--• . .................. - -.... Board of Health DATE--- •-- _I - .............•--------•--•-•--_--•:_ FORM 1255 A. M. SULKIN, INC., BOSTON i ( 2N,t"STUD WALL .. "O.C.(TYPICAL) 7'x4"STUD WALL R-13 INSULATION W • (TYPICAL) EXTERIOR GRADE PLYWOOD 4Y•TYPE"X"GYPSUMBOARD - SHEATHING w)TYVEK HOUSE WRAP h 1"E'XOTERIOR GRADE PLYUIOOO ----- --- _ --._-_�. WITH PLATER FINISH.(TYPIC.AL)�i:" CEDAR SHINGLES OR CLAPBOARD SHEATHING Ix)TYVEK HOUSE ILRAP . i.V- TO MATCH EXISTING HOUSE(TYP) 2'x4'P.T.SILL WITH SILL SEALER CEDAR SHINGLES OR CLAPBOARD s0'TKG PLYWOOD SUBFLOOR TO MATCH EXISTING HGVBE(TYP) !FINISH TO BE DETERMINED) :.�'2.4•P.T.SILL u✓SILL SEALER 4'CCNC.SLAB WITH FIBER REIIF. �__-� WI.ANCHOR BOLTS 4'OL.a .', WIT ANCHOR BOLTS• E S WITHIN 17'OF ALL CORNERS PLACED• MID DEPTH OVER 8"COMP. - WITHIN 12'OF ALL CORNERS • � `EXISTRYs CONCRETE -_- GRAVEL WITH VAPOR RETARDER FCUNDATION WALL a R-30 INSULATION CONCRETE FOOTINGS .. - FIN[ 0 GRADE ll I U 7"xl0'P.T.FL JOISTS 16'OL. FINISH D GRAD CJ :6TO: I U DRILL A GROUT 8-LONG 2"R-10 RIGID INSULATION L I. S DOWELLS•12,OL. �9 CRALLI SPACE L 1 D"i170'FOOTING lW 0• ' •. 1 `� !4"INTO PI�OPOBED J OPTIONAL o' WTHC2G75.FOUNDATION�PL-ACED FOUNDATION 4'INTO •i I EXI8ITNG FONDATION 3 = 2x4 CONT.FTC.KEY TOP.BOTTOM OF WALL(TYP) I 4'CONC.BLAB WITH FIBER R£INF. 10'CONC.FOWDATION WALL r3)-S RE-D.ARB CONT. PLACED• MID DEPTH OVER S"COFIP. WITH 2-S RE-BARB PLACED 9 I L— ----- -� L] GRAVEL WITH VAPOR RETARDER jf Y - TOP(BOTTOM OF WALL(TYP) _ Z W TYP. FOUNDATION WALL 's GARAGE V.20'FOOTING w/ I . 2x4 CCNT.FTG.KEY - SCALE: 3i I i 9 (31-S RE-BARS CONT. + DRILL.GROUT 8"LONG TYf=, FOUNDATION WALL MUD ROOM Z S DOLLELLS•12-OL. !( (4'INTO PROPOSED SCALE: 7 I O FOUNDATION.4"INTO 1 I I I EXISITNG FOlPU3ATION a7a'x11'STEEL BASE RATE 33'.STD.STEEL PIPE BOLTED TO FO PIVATION WALL WTH(4)14'0 ANCHOR BOLTS (tm"LOW WITH 3"HOCK TYP) sl! I I ................ a'xa"xh'STEEL BABE RATE WELDED I { ........... ............. ... ........_.. Skalds"STEEL BASE PLATE NGN-eHRINt WeCUT To STEEL GOLIlN r�1"WIE U LD rYPICA I I BOLTED TO F ION WALL .. ...ry. ............................................. WITHANCHO TH(4)- . BOLTS L-------J I .� (IO'LQ1C WITH 9'HOOK Ti'PJ . 33'.STD.STEEL PIPE �_- ----- ------ --- ---- -- ll WALL LEGEND Ex1BTddG OR PROPOSED FOWDAT CN WALL FOlNDATION WALL" FOIU D4 „", --- ---- ----=--- . PROPOSED 8"FOUNDATION WALLS NOTES 8kakl1•STEEL 15AW PLATE UELDED I WITH 20"xl'J"CONC.FOOTING(TYP) I.WINDOWS 1 DOORS STYLE.COLOR TO STEEL COLUMN OV WELD TYPICAL) 1./ PER OIFY AL CHOICE. EJECTION PLAN VIEW 44 I OUT EXISTING FOUNDATION WALLS 2-VERIFY ALL ROUGH OPENINGS WITH .._.............. WITH LONG.FOOTINGS(TYP) 'SUPPLIER PRIOR TO FABRICATION 3.FLOOR LAYOUT SWOU14 MAY BE COLUMN TO FOUNDATION DETAIL MODIFIED PER OLLNER'8 CHOICE. - I4.ALL STYLE'S.COLOR'&OF FINISHES ,I IN EACH ROOT PER OILNER'B CHOICE .1 S.PROPOSED MUD ROOM FINISHED 8'-0" FLOOR TO MATCH EXISTING DUELLING FINISH FLOOR } © DOOR SCHEDULE NO. QTY UNIT DIMENSION TYPE B CI I I6-0 >1-0" OVERHEAD 8{OPED/ REq m Z D2 I 3-0 x 6'-8" STEEL EXT. A J 03 I 2'-8' r 6-8- STEEL EXT. J J 3 p1 1 2-8'i 6'-8" IN.FRENCH 3 I" U fCLOBET Dr, a'8"r 1b 8" 51-FOLDUND - O � iSTA RS y'�j � LANDING p erAlRe WQ ® N WINDOW SCHEDULE �Y t NO. QTY UNIT DIMENSION TYPE jt w }4 _ ;N EXISTING'RE-USE) DBL- UNG DUA W y- 6._ yxj U LLf' 30"'56, =EL-uUNG - I I U 17 2 W y r' SECOND BOOR STORAGE 7I u w3 3C"^^_O.' -RANSOM I �9 R UP MUD ROOM F� WALL LEGEND LIN ING E OF 9'CEIL ABOVE 1 .. .. ....... .._.. .;\ LANDING PROPOSED 2•x4'LUMBER WALLS m ---_ EX18T LINE OF 6'WALL 1' _ RNG LUMBER WALLS TO REMAIN 'I 0 --- - ---____L FINISHED SCHEDULE O ROOM NAME FLOOR CEILINGS IUALLB9LOP$�J ARE/✓' 1 1 ECC.I-- °_OCR 3 5 A _c_NG.0 573 PAYOUT A JR J PROPOSED SECOND FLOOR LAYOUT !; SCALE: 1/4"-1'-0" 34 Isrur Date:724/09 Prujen Number:W-269 16 THESE DRAWINGS ARE THE SOLE Prepared For: Revisions Scaly:AS SHOWN PROPERTY OF CHOUDAH ENGINEERING �t Sheet Title: 1 GROUP,AND ARE NOT TO DE USED IN WHOLE . e rip Dy:I.E.S. WRITTEN CONSENT OF ' I)NS DONNIE&DENISE CALDWELL No Date Dtion Drawn PROPOSED FOUNDATION OR IN PART WITHOUT , N REDBERRY LANE Designed By:LES. CTtekrd By:H.C'. C'HOUBAH ENGINEERING GROUP. FIRST FLOOR&SECOND MARSTON MILLS,MA CONTRACTOR TO CHECK AND VERIFY FLOOR LAYOUTS 1;, EXISTING DIMENSIONS&CONDITIONS IN - rU FIELD DEFORE STARTING CONSTRUCTION 1 ANDTO NOTIFYCHOUBAH ENGINEERING " CROUP OF ANY MATERIAL OR DETAIL CHANGES Sheet Numhe a> s' 1 BENCH MARK TEST HOLE RESULTS P#67o� D A T E : ©� 9�a 7 W I T N E S S E D BY , '.T c/z fZ �- TEST HOLE . . 48. Q TEST HOLE' -qzV� 3 ?° 00, (' 4 � f j 112 DR - - I f/° GROUND WATER GROUND WATER f•, , A_i ENCOUNTERED ENCOUNTERED ��nc 49 MANHOLES AND COVER TO BE BUILT TO 3 ` �'"� :? ELEV• TOP OF WITHtN 12+ OF FINISHED GRADE FOUNDATION a. FINISHED GRADE MIN, 2% SLOPE 4" D I A. - ++ 12"M 1 2++ LAYER OF o.:' _ ..;;��,✓. - _. 4 D I A. PIPE �FI RS r.. ----• MIN . \ . .7/ , , 1�8'-"V2+ PEASTONE t , PIPE — -;..�„v. MIN. PITCH I FT._ 2 LEVE • ' ,ry --2 Nt�N MIN. PITCH �.a-.v+ .� ►¢" �- � r p I/4` F T. DOO MAN. �O _ : , Q t- '•• . f I N' "suMP INVERT - �� INVERT - �7 GALLONZ ,— a �"'� �✓4� I %2 / DIST, DIA. SEPTIC TAN �� INVERT B .. `• (d W 'J •.. i R FOOTING TO BE PLACED ' � INVERT OK p WASHED STONE r �.. - ON A MINIMUM OF 18" OF iN .r �.. ALL AROUND , Y , � , � f �_ P L,ACE O N . ! , II .,r , � � '� � • �,_p /� ' < _•, .� -_ Let._ ►. ; ra..._ ..r-� a• _l T`, ^,# A ,• G l F VIRGIN OR COMPACTED � % , --►� FIRM BA5 �; . _- r r171- _ - SAND O' MIN ) ' . ., .. .. _• O GARBAGE ,! ) : .- GRIN DER ii .&<77'.-' QF T, ! 1 '�' ELEV. , 07 PR 0 F I` L E OF GROUND WATER TABLE ,Z3e4t7v✓ SANITARY DISPOSAL. SYSTEM ( NOT TO SCALE ) D E S I G N D ATA CONSTRUCTION OF SANITARY I) I S P O SA L 3 BEDROOMS ,z SYSTEM SHALL CONFORM TO THE MASS. DESIGN FLOW 33o GAL./lDAY ENVIRONMENTAL CODE ' TITLE 3Z• Z REVISED 7- 1-77 ) AND THE ' TOWN LEACH RATE MIN.�INCH• REQUIRED LEACHING CAPACITY • �I27� HEALTH DEPARTMENT REGULATIONS (,T • SEPTIC TANK, DISTRIBUTION BOX AND . EACH - PROPOSED " 4 2'7 GAL/DAY LNG UNIT TO BE OF REINFORCED CONCRETE : . * �� s ! ''`"� �000 MIN. CONCRETE STRENGTH 3000PS.1. REQUIRED SEPTIC TANK : / GAL. MIN. STEEL STRENGTH 20,000 PS. I. MIN. DESIGN LOADING : 0 PROPOSED SEPTIC TANK : /000GAL. 0 DRIVEWAYS NOT TO BE LOCATED OVER SYSTEM UNLESS H2O DESIGN LOADING IS USED e ALL PIPES AND FITTINGS TO BE WATERTIGHT AND TO BE OF CAST IRON OR APPROVED P.V.C. HEALTH AGENT APPROVAL DATE SITE PLANS H O WING PROPOSED CONSTRUCTION ZONING DATA LEG EN D LOCATION ,Q��'GI� STi�� L. zF �/Y�A�Z.ST©n/S /Yl� �.ts)� /�'��`sS. FOR : LEBEL- SOLLOWS OEV. CORP. DATE ZONE � � TEST HOLE LOCATION REFERENCE -. LOT � 2- AS SHOWN ON ,REV_-I_SIONS : — — -- — — REQUIRED AREA _. 43,, SG04� EXISTING SPOT ELEVATION I7.6 �t� Uf a Pi.AA/ 8,,.v RQZ3'//I W. W14CO>( .;�..;S• /�"O EXISTING CONTOUR — 16 0 'G ti� b zG7 REQUIRED. FRONTAGE :- -. REQUIRED FRONT SETBACK : 30 PROPOSED CONTOUR 16 CAVIL y 27483 SCALE Mo. REQUIRED SIDE SETBACK / ` PROPOSED WATER SERVICE W REQUI RED REAR SETBACKo� '�FctSSER �`� : .5" PROPOSED GAS SERVICE G sroaaLE� PROPOSED ELEC. a TELE E a T 3/ � CRAIG R . SHORT , P. E . =�G�'r� PRO FESSIONAL CIVIL EN G I N E E R BUILDING INSPECTOR APPROVAL DATE A 131 _ OLD ROUTE 132 HYANN IS , MA. 02601 FILE NO. / - 66"6 ( TELE. (617 ) 362 - 9411 ) SHEET OF - __ - BENCH MARK : TEST HOLE RESULTS P#�� DATE : / 0,/ 9//8 7 WITNESSED BY �T' 1Z /Z y v�/•✓i r1/ G: . C:J, hr. 0 TEST HOLE . ._-I 48, 0 TEST HOLE 1 7c) , 1 14— ' DR " GROUND WATER GROUND WATER �x �2 ENCOUNTERED ENCOUNTERED D r, 42 4 9 �- 0 38 8nx MANHOLES AND COVER TO - BE BUILT TO nj o r<'27 ,. ` f ELEV. TOP OF WITHIN 12" OF FINISHED GRADE FOUNDATION FIN ISHED GRADE MIN, 2% SLOPE - 1 ��T � / 4 DIA. .; r . 4 DIA. PIPE FIRS 12MIr• �_=_ C nn�N. MIN. 2 LAYER OF ` r y� P1 P E _ "M�Nv MIN FT• - 2 LEVE _ r _ I�8'.,.I 2' PEASTONE MIN. PITCH i�'n�w. 14- �D . • • / 4, I/4'`/F T. /DOO n�nv: ti I N�$..SO G•'svrip I Nµ V T ' d F- .� w DIA _.. ` � `� J . ___-.--•� . / INVERT :. - GALLON �Z ,.t •D`I S T '' � N ���� 4 �2 'J SEPTIC -TAiiK • a + FOOTING TO BE PLACED INVERT =-S - :; - INV RT _ gpX ��-� �• � �t� gip.• WASHED STONE _ r - T - .�. q ON A MINIMUM OF 18" OF a: _ INNER �• ;p . � w d ALL AROUND ^� , � -�� I P L A 1. E 0�- �_ :} . ` irr+' T� VIRGIN OR COMPACTEQ � > /2� FI RM BASE �---� i7' •.�`' --, ,p' MIN•) f � c � • BOTTOM AT ELEV. /• SAND �� GARBAGE ( 2 O' MI N.) (� , GRIN DER ' &407- CIF T,, t&" ELEV. 3 5, C7 PR O F I L, E OF GROUND WATER TABLE ,�3ELbv� SANITARY DISPOSAL SYSTEM ( NOT TO SCALE ) DESIGN DATA o CONSTRUCTION OF SANITARY DISPOSAL 3 BEDROOMS SYSTEM SHALL CONFORM TO THE MASS. DESIGN FLOW 33o GAL./DAY ENVIRONMENTAL CODE TITLE SC LEACH RATE 2- MIN. INCH ` t (REVISED 7- 1-77 ) AND THE TOWN 27 REQUIRED LEACHING CAPACITY : HEALTH DEPARTMENT REGULATIONS • SEPTIC TANK, DISTRIBUTION BOX AND . EACH PROPOSED " 427 GAL/DAY ING UNIT TO BE OF REINFORCED CONCRETE , C77"'(4 MIN. CONCRETE STRENGTH 3000PS.1. REQUIRED SEPTIC TANK / 000 GAL. MIN. STEEL STRENGTH = 202000 PS. I. MIN. DESIGN LOADING : i000 PROPOSED SEPTIC. TANK GAL. • DRIVEWAYS NOT TO BE LOCATED OVER SYSTEM -- UNLESS H2O DESIGN LOADING IS USED ALL PIPES AND FITTINGS TO BE WATERTIGHT AND TO BE OF CAST IRON OR APPROVED P.V.C. HEALTH AGENT APPROVAL DATE PLAN SITE SHOWING PROPOSED CONSTRUCTION G Z0 I N N DATA L E G E N D LOCATION : �3�r2N S7T�� L � (/�A�zs ro es �• « s) /I'��'S S, FOR : LEgEL— SOLL4WS OEV. CORP. DATE : ZONE _ — TEST HOLE LOCATION REFERENCE -- LOT ;�E2- AS SHOWN ON REVISIONS : �3, SGOs EXISTING SPOT ELEVATION 17.6 REQUIRED AREA ' — — — or ' PL A/V Z3,r ..T2c713//V W. K//t!. CO)< <'Z,4.pS, . REQUIRED FRONTAGE 0I3o EXISTING CONTOUR — 16 8/)06/)87 REQUIRED FRONT SETBACK : 30 PROPOSED CONTOUR 16 cry y SCALE / "�-- c�4 ' REQUIRED SIDE SETBACK � � PROPOSED WATER SERVICE W \ Il � �or Fc»R REQUIRED . REAR SETBACK /•� PROPOSED GAS SERVICE G �s�K1NALEN�'� PROPOSED ELEC. a TELE E a T— CRAIG R . SHORT , P. E . PRO FESS10NAL CIVIL EN G I N E E R BUILDING INSPECTOR APPROVAL DATE 131 OLD ROUTE 132 , HYANNIS , MA. 02601 FILENO. / - G,S� ( TELE. (617 ) 362 - 9411 ) SHEET / OF I, 00X EL, 103 L 7 sEWA6 E SYST�M PJe4F/L F x SOILS 7"EST RESl1LTS FIN, G,2.9DE M/N• .SCOPE OF 2 T . d 19•' COVER IAA: •T.9<L M45*10/57,BDX C MAX W/ G '' _4/MP /INII N '¢ 9340"MMAx, „_ 7=/ EL.103,4 3 Z„ CDV£�2 OF �9- I�2 STONE,o scy/ 4O P✓c L��dio G� Cf �¢D VC 9✓�G 40 P/C A LogM /N✓ /)NVVI f� /¢" /NV, /NI/ / /00.8 5" /00.73 4W,S6 N 3 42 :_ DOUBLE y » n o a o /Z • - - - 7 5 Y/� �¢ L oAMY B W9sNt"p C2) wr0 LEAcd ePAMWS DOIJSLlr ' 2 EFF. AEPTN � STONE :, o SToNF •SToNF• , CONCR-e7lf SEPTIC TANS I z 0 -f .79 ' 6Rg1/ELL y (7-0 REMAIN, SO/�s A85oRPT/Ow sysT�M BOTTOM Oe TEST i SAND S W_4aL sy3CM DES/GN C4LWLA rIONS 2 5* 3y Bt:DRooMS -( //0 6P UmM, = 330 6-Po. ' .INASHE.b, STONE. '�- 2. RE4?4/RED AEORPT/O/V AREA GiPDU/VDINit?�� /VD? E/✓GOZINTERE.d 330 6Pd O, 74 Glsrl D4Y = 4 6 5,F, So&_5 7�s7 ATE - - ,Z� 9- 7 Zook - 8 9 3" USL� TWO 500 GRr. 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' p DOYLE,III No.g � BA�NST9BLE /CIA• sl 10, �'G9L E /// FEET a ✓. 4 0 YI-C ASSOC 1.47E:Sr TEL: SC8 S- 1994 , ry r c _- I