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0370 MISTIC DRIVE - Health
370 MISTIC DRIVE, MARSTONS MILLS --- - A= 080 007 -- - - - -- y `II � N Commonwealth of Massachusetts u TitI6 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments i wM 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is required for Marstons Mills MA 02648 September 14, 2012 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. Please see completeness checklist at the end of the form. Important: When filling out A. General Information forms on the n I computer,use 1. Inspector. J, only the tab key to move your Patrick M. O'Connell cursor-do not use the return Name of Inspector key. Septic Inspection Services Co. Company Name r� 189 Cammett Road Company Address Marstons Mills MA 02648 City/Town State Zip Code 508-428-1779 SI 12855 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 SQtfon 15.34of Title 5(310 CMR 15.000).The system: IK ® Passes El Conditionally Passes ElFailtsy `"' Q 17-73 � e. ❑ Needs Further Evaluation by the Local Approving Authority zz 0 , ,KAO Septermber 14, 2012 `Job# 12-q-36 ~� In or's Sign re Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is required for Marstons Mills MA 02648 September 14, 2012 every page. Cdy/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: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: Tank was not in need of pumping at time of inspection, leaching system showed no signs of surcharge or saturation. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined"(Y, N, ND)for the following statements. If"not determined,"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND(Explain below): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is p required for Marstons Mills MA 02648 September 14, 2012 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will;pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh l5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name required fo is Marstons Mills MA 02648 September 14, 2012 required for p every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters El ® '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_day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 J �\ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name requiratifo is Marstons Mills MA 02648 September 14, 2012 required for every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No Required pumping more than 4 times in the last year NOT due to clogged or E] ® obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 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. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is Marstons Mills MA 02648 September 14, 2012 required for State Zip Code Date of Inspection every page. City/Town C. Checklist Check if the following have been done.You must indicate"yes"or"no"as to each of the following: t Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of ❑ ® this inspection? ® 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)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 5 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550 f t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 v� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Omer Owner's Name information is required for Marstons Mills MA 02648 September 14, 2012 every page. City/town State Zip Code Date of Inspection D. System Information Description: 2 Number of current residents: 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 N/A Well Water Water meter readings, if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Currently Last date of occupancy: Occupied. 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: t5ins•11A 0 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is MA 02648 September 14 2012 required for Marstons Mills State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Last date of occupancy/user Date Other(describe below): General Information Pumping Records: Unknown Source of information: 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): Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 t5ins-11110 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is P required for Marstons Mills MA 02648 September 14, 2012 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: System installed in 1987 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 2' Depth below grade: feet Material of construction: ®cast iron ❑40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 16"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: 2000 gal. Sludge depth: 2" t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is required for Marstons Mills MA 02648 September 14, 2012 - every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 30" 2„ Scum thickness 6" Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Liquid level was found at bottom of outlet invert and tees were intact and clear. Tank was not in need of pumping 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 �J Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is p required for Marstons Mills MA 02648 September 14, 2012 every page. Cityrrown 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.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No l5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is required for Marstons Mills MA 02648 September 14, 2012 every page. City/Town State - Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): il Depth of liquid level above outlet invert 0 Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): No solids or high stains present. Liquid level was at bottom of outlet pipes. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10' Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is reeuired.for Marstons Mills MA 02648 September 14, 2012 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 8 Flowdifussors. ❑ 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.): Area of SAS was probed with no signs of saturation found. Soils were dry and vegetation was normal. 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 Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-1 V 0 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is Marstons Mills MA 02648 September 14 2012 required for State Zip Code Date of Inspection every page. City/Town D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): ` Sewage Disposal S Title 5 Official Inspection Form:Subsurface S stem-Page 14 of 17 g p Y 15ins•11110 i r Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh _ Owner Owner's Name reformat on is fo required for Marstons Mills MA 02648 September 14, 2012 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached_.separately r r r r r r r r r r r r • . . r r r r r r , r r r r r r r r r r r r r r r r s r r • r r • r r r r r r r r r • r r • r • • • r r r r r r r r r r r r �r♦r♦r,r,r,r,r♦r♦r,r, r r r r r r r r r r r r r r r r r r r r r r r r r r r r r r Wall 8 1 28 52 t J N u!'`�J.�� a �YyT r7,i..,s��:.✓. S e �• r aa } ..,tJ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is required for Marstons Mills MA 02648 September 14, 2012 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells 12+ Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Elevation of pond at rear of property is 12+' lower than SAS. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i N� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 370 Mistic Drive Property Address Kevin Kavanagh Owner Owner's Name information is p required for Marstons Mills MA 02648 September 14, 2012 every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file l5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 ZONE:RF Area(min.)41560 SF' :;.....� �' �tie'�a# �k.• Pronto a(min) 150' Setbacks. Hush Front 30' o S'pe d Side 15' Rear 15' y, Mystic Lake v r + 7 In " B I^ram f LOCATION MAP: 0= ,� 1'-z000f' ASSESSORS REF.: Map 080,Parcel 007 OVERLAY DISTRICT: AP-Aquifer Protection District FLOOD ZONE: Icb X(0.2X Annual Chance) a and I I 1 / I i 1 P k X(Min.Flood Hazard) r r `/ ' C 1t05"1nJ No. �50001 y 76, 2014 REFRENCES: Deed Book 27253 Page 167 Plan Book 482 Page 15 Book 203 Page 53 Subdldsfon Plan Indian Lakes Estates' at Town or Bamstobfe town hall. ma o od sty Dwalns I / a o g y�v� Buadfn .n 1 / 100.00 Imo/ I j r ( 11 /w to /�~ / B.J• r/ !ee'w 61.J1 �� To Be D--Wed/ / w �. f'A T '� bra igq 2 LEGEND: pCDT C.dor Tres 0 HT Halt'T— Q DT Deeidmue T S79•�,�� R Cr Coniferous Tree 17&fi 'a,utility vas -E- Electric 370 Mistic Drive TFnd PIP, 0. Co. � wmeae nee # ught Peat 0 ®/OH -CHW— Ovarhood Wres —25— ElewUm Cwtw TITLE. site Phan PREPARED FOR., PREPARED BY. & m Proposed Improvements Edmund A. & Carolyn Gaither Sullivan Cn0nsul{+I1'ng"InCie At 370 Mist)c DriveMarstons Mtllsr MA 02648 370 Mistic Drive '` t aed •P0•�tW.'n• �r 1a M1t aadlbarle�inca .tvtrawllMna�ln.00m q Bamstable wa►stws Mi1is) Mass. j Draft CTR Field: CTR/JOD a to >o rb an Cam CTR Review: CTR P� DATE OMWr24,2017 SCALE t. N Prof. P 370027 1 Prol• N Gaither I r CERTIFICATE OF ANALYSIS • ��� �tia,; Page: 1 of 1 Barnstable Count Health Laboratory M-MA009 rM Y rY � ) ssA�I '' Report Prepared For: Report Dated: 8/1/2016 Kevin Kavanagh Order No.: G1695148 P O Box 182- 370 Mistic Dr 66 V Marstons Mills, MA 02648 Q Laboratory ID#: 1695148-01 Description: Water-Drinking Water Iti Sample#: Sample Location: 370 Mistic Dr. Marstons Mills, MA Collected: 0&25/2016 Collected by: KV Received: 07/25/2016 Routine ITEM RESULT? UNITS RL MCL METHOD# ANALYST TESTED NOTE *. Nitrate as Nitrogen 0.112 mg/L 0.10 10 EPA 300.0 LAP 7/26/2016 ts: x . Copper ND mg/L 0.10 1.3 SM 3111E LAP 7/29/2016 Iron ND mg/L 0.10 0.3 SM 3111E LAP 7/29/2016 pH 6.7 PH AT 25C NA 6.5-8.5 SM 4500-H-B DCB 7/25/2016 Sodium 10 mg/L 2.5 20 SM 3111E LAP 7/29/2016 Total Coliform Absent P/A 0 0 SM 9223 RG 7/25/2016 Conductance 90 umohs/cm 2.0 EPA 120.1 DCB 7/25/2016 Water sample meets the-recommended limits for drinking water of all the above tested parameters. Attached please find the laboratory certified parameter list. Approved By: (Lab Director) a' ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level 3195 Main Street, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Page: 1 CERTIFICATE OF ANALYSIS 3 Barnstable County Health Laboratory Report Dated: 9/8/2005 Report Prepared For: Order No.: G0532954 Lee Kavanagh P U Box 980 Marstons Mills, MA 02648 Laboratory ID#: 0532954-01 Description: Water-Drii"ig Water Sample#: 32954 sampling Location.t370 lVlistie Dry Marstons Mills,MA � Collected: 9/1/2005 Collected by: L.K. Received: 9/1/2005 Routine ITEM RESULT UNITS RL MCL Method# Tested LAB' Inorganics Nitrate as Nitrogen BRL mg/L 0.10 10 EPA300.0 9/l/2005 LAB. Metals Copper BRL mg/L 0.10 1.3 SM 3111B 9/8/2005 Iron BRL mg/L 0.10 0.3 SM3111B 9/8/2005 .Sodium 8.0 mg/L 1.0 20 SM 311113 9/8/2005 LAB: Microbiology Total Coliform Absent P/A 0 0 309 9/l/2005 LAB: Physical Chemistry Conductance 56 umohs/cm 1.0 EPA 120.1 9/1/2005 pH 6.3 pH-units 0 EPA 150.1 9/l/2005 Water sample meets the recommended limits for drinking water of all the above tested parameters. _ Approved By• (La rector) s �a mT ,1 o Z I Qo RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph: 508-375-6605 SUBSURFACE DEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 3 70 /�/S�i re v e J ma rj 9L0/7 S Owner: Date of Inspection: q 5 SKETCH OF SEWAGE DISOSAL SYSTEM: V 0 T TO S include ties to at least two permanent references;landmarks or benchmarks locate all wells within 100' .0 s� jjedrooryl Ho vs e clean-ou� / I N D $cX I2000 Gallon ASA 12 __ \ -� V TS%'% RECEIVED °p NOV 1 4 1995— �+e****�e*******�►e*fie**�+e�e�tr�e�+e**�te�e�te*fie****��e*�►e* � �um�vc 19 This Subsurface Sewage Disposal System Inspection Has Been Performed In Accordance With The State Environmental Code " TITLE V " 310 CMR 15.300 thru 15.303 March 1995 Revised August 15, 1995 By : so uth hore uruey Consultants, Inc. Registered Land Surveyors & Civil Engineers 167 R Summer Street • Kingston, MA 02364 (617) 934-7553 (617) 582-2185 FAX (617) 582-2239 O S O ° 007 �. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address:3 70 /!7/sy'/G OR/✓E,10A1'SMi Addreea of Owner: Date of Inspection:A Io,.e,"5er. /o ig95' (if different) Name of Inspector: Gary �ul�S e// Name of Owner: /(a0ana9 h , Ale✓in A, Company Name,Address and Telephone Number:, SOUTH SHORE SURVEY CONSULTANTS,INC. 167 R Summer Street,Kingston,MA 02364 (617)582-2185 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: Passes Conditionally Passes Needs Further Evaluation By The Local Approving Authority Fails Inspector's Signature: Date: //-/O - 9,5 0 The System Inspector shall submit a copy of this inspection report to the Approving Authority 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. INSPECTION SUMMARY: Chec A, ,C,D,or E: A) SYSTEM PASSES: Ve I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. B) SYSTEM CONDITIONALLY PASSES: . One or more system components need to be replaced or repaired. The system,upon completion of the replacement or repair,passes inspection. (revised 8/15/95) 1 f v SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 370 J MP,-s 4o n s /ni11s Owner: Arp u,1 n a9 h,, A-e vi„ Date of Inspection: //- /o_q B) SYSTEM CONDITIONALLY PASSES(continued) Indicate yes,no,or not determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined",explain why not. The septic tank is metal,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 conforming septic tank as approved by the Board of Health. Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(#)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 leveled or replaced 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 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 WELL PASS UNLESS BOARD OF HEALTH DETERMINES 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 a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or salt marsh. (revised 8/15/95) 2 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 370 IZ60'S 4l n S Owner: /�a a nag h/ ote vtij : f. Date of Inspection: //- /o -95" C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH(continued): 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER, IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 feet to a surface water supply,or tributary to a surface water supply. The system has a septic tank and soil absorption system and is within a Zone I of a public water supply well The system has a septic tank and soil absorption system and is within 50 feet of a private water supply well The system has a septic tank and soil absorption system and 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 tree from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D) SYSTEM FAE S: I have determined that the system violates one or more of the following failure criteria as defined 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. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overload or clogged SAS or cesspool Static liquid level In the distribution boa 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 1/2 day now. 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 Soil Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. (revised 8/15/95) 3 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: .3 70 ��S�io D•-ii✓�� /77c+�s Td'�s�i��s Owner: Date of Inspection: ��_ p_ 95 D) SYSTEM FAILS(continued): Any portion of a cesspool or privy is within a Zone I 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. If the well has been Analyzed to be acceptable,attach copy of well water analysis for colitorm bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above: The design flow of system is 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: 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. The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 8/15/95) 4 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 3 70 /;21 s}i c Drl ve' 104 rS Torts 10P�7111S Owner: ltla v ar7 a.3 h., Date of Inspection: Check if the following have been done: ✓Pumping information was requested of the owner,occupant,and Board of Health. ✓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. ✓ As built plans have been obtained and examined. Note if they are not available with N/A. ✓The facility or dwelling was inspected for signs of sewage back-up. ✓The system does not receive non-sanitary or industrial waste flow. The site was inspected for signs of breakout. ,_e Ali system components,excluding the Soil Absorption System,have.been located on the site. 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. Y The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. ✓The facility owner(and occupants,U different from owner)were provided with information on the proper maintenance of Subsurface Disposal System. (revised 8/15/95) 5 i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 370 /�js�i o �r/v G me+ S �o h S 172xl S Owner: --' Q u a n a 3 h J e v� F• Date of Inspection: f_ - 5 FLOW CONDITIONS RESIDENTIAL: Design flow: 550 gallons Number of bedrooms: _5 Number of current residents: _0 Garbage grinder(yes or no): t�0 Laundry connected to system(yes or no): .S Seasonal use(yes or no): ,�VO / Water meter readings,if available: ors a we Last date of occupancy: /9 9 2 x 70 A;yi e 114j� 3 yr�s we eh ends, COMMMERCLAS./!NDUSTRI_Ai: Type of establishment: Design flow: gallons/day 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: OTHER: (Describe): Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: 12e✓e r- eD_"dld /!? 8 G j e-4rd ao�.f/n ow»G System pumped as part of inspection(yes.or no): A10 If yes,volume pumped: gallons Reason for pumping: (revised 8/15/95) 6 SUBSURFACE SEWAGE DISPOSAL"SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 370 Mis tic Drwe�' /tears Tun s /rli//s Owner: �a� anacJh ��evin , Date of Inspection: /�_ p_ 95- TYPE OF SYSTEM _J�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) Other(explain) APPROXIMATE AGE of all components,date installed(if known)and source of information: _ Lf,eQrS ssued 10- 27--87 Sewage odors detected when arriving at the site(yes or no): /✓o SEPTIC TANK: S (Locate on site plan) Depth below grade: Material of construction: concrete metal FRP other(explain) Dimensions: 2 00 0 a o/%n z X 6 X 5- Sludge depth: 3" Distance from top of sludge to bottom of outlet tee or baffle: R_ Z" Scum thickness: O" Distance from top of scum to top of outlet tee or baffle: /✓/� Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural late grit ,evidence of leakage,etc.) ,r a is e a GG e 3 S C G Y e-S A lvi'7�� i✓n G " o �ii-�is� 4 ra4e (revised 8/15/95) 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 3 7O /7'713�ic �r/ic /na s Tans /�i�� Owner: /tea ra a n a 3 A Date of Inspection: �/- /O_ 9� GREASE TRAP: (locate on site plan) Depth below grade: Material of construction: concrete ,,__metal FRP 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: 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.) TIGHT OR HOLDING TANK: (locate on site plan) Depth below grade: Material of construction: —concrete metal FRP other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm level: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) y (revised 8/15/95) 8 i ,d SUBSURFACE DEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 3 70 /nljhi- ' D,^li'e /7'larsJ��ns mi��s Owner: J Date of Inspection: DISTRIBUTION BOX:. ALES (locate on site plan) Depth of liquid level above inlet invert: O - Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box, etc.) /S�2 '' X /> ax i:s qQ " Jelew q rod t jrar,d no ewidenca o-P /eV-A et PUMP CHAMBE& (locate on site plan) Pumps in working order(yes or no): Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) SOIL ABSORPTION SYSTEM(SAS): S (locate on site plan,if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present,explain: (revised 8/15/95) 9 w i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 370 M%,3 beG .�rl v e Owner: Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): continued Type: leaching pits,number: leaching chambers,number: �T"' 9 mar g .�'/o�✓ c/e IOUs e Y S leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) Abwn report P1okeS 2" e {' 59or»e ctroynar p�e7v,Sers� v� o� Co»crel�c c��TuSer• t-!y" 6t�ow Arede CESSPOOLS: (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(cesspool must be pumped as part of inspection): Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) (revised 8/15/95) 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 370 /'j')/s}i ��S Owner: Date of Inspection: PRIVY: 1= " (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments: (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.) DEPTH TO GROUNDWATER Depth to groundwater: /2 feetro.-, g►^ale Method of determination or approximation: 8aen s aZle G onSe#,ya Ao'r7 �rni 1l /ace e/ae� /a.•Z Z- 86 �o tyel�er o.Eaftrvt 1 (revised 8/15/95) 11 SUBSURFACE DEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 3 70 /22i S 1i c !�ri v e J /�7a.-� �vh s 1121,115 Owner: A-aa v a n Q l A Date of Inspection: /,/_ /0_ 9 5. SKETCH OF SEWAGE DISOSAL SYSTEM: No T' TO S C,9L LC include ties to at least two permanent references;landmarks or benchmarks locate all wells within 100' ' 6 Ho vs e clean-O \— .� 8�'e�s dust/�^- 90•S� ' I � I I \ N D Sox II 2000 6 12 i TOWN OF'B.ARNSTABLE; ✓, LOCATION 7`� 'C �''"'�' SEWAGE # + ��J / VILLAGE /�'b ��`"�'�s �� /SASSESSOR'S MAP & LOT - `7 If, INSTALLER'S NAME & PHONE NO.�•�L'�r+ J���e�wo, 1 SEPTIC TANK CAPACITY O O LEACHING FACILITY:(type) 6r- /T/o �@ f (size)���1� er ..�1 ' NO. OF BEDROOMS PRIVATE WELIPOR PUBLIC WATER OWNER /4hS AZ 'v-t'A��.-�.:2 � t/.�'n ov d DATE PERMIT ISSUED: DATE .COUPLIANCE ISSUED: z112, 7 VARIANCE GRANTED: Yes ✓Wo!I No /41/7—/ / p�u X ' �V 7No.=- --B_-- Fee- -�--�-�- BOARD OF HEALTH TOWN OF BARNSTABLE ZippYitation-*rVerr Con0tructionpermit Application-is hereby made for a permit to onstruct ( ), Alter ( ), or Repair (-"')an individual Well at: ---------------------------------- Location — Address _ Assessors Map and Parcel �wner Address Installer — Drillel Address _ Type of Building Dwelling - --- - ------------- - - Other - Type of Building No. of Persons------------------------------------------------ Type of Well-y Ca acit ---------------------------------------------------- Purpose of Well----DAI- 6 T%C- -- -- — - -- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certific to of C mpliance has been issued by the Board of Health. I Signed- - - -- - ----------------------- -f1�'_/h3----------------- date Application Approved By--------- - ------------ - + '-�' ="�1 - _ date Application Disapproved for the following reasons:-____---__________--_--____________________________________________________'____________ ---------------------------------------------------------------------- ----------------------------------------------------------------------- q date — —— PermitNo. ----�-----9�--�-�--__------------------- Issued------------------------------------------------------- -- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate (Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired b /�_h_S ti�e #—I- ll------DI" //.-' -- ----—- -------- ---------------------- - ---------------------------- Installer I S Tic /116LA TottiS_ /k iL�L-------------------------------------------------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No�/--2—n�-7----Dated--------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------------------------------------------------------------------------------- Inspector------------------------------------------- -------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE lVeir Con5truct ion Permit No _23=°7----- Fee--- Permission is hereby granted -- - t ---------------------------------------------------------------------------------- to Construct ( ), Alter ( ), or Repair ��,) an Individual Well at: No.------ e J ---—-- --______-- -- - -------------------------- ----------------------------------- Street as shown on the application for a Well Construction Permit No.- - - -- ----- ----- __ -_ -- Dated--------------7 ^-Z' "l—------------------------ ------------ ---------- -- - --------------------------------------------- Board of Health DATE------------------------------------------------------------------------- No. Fee----1---:5:-- y i BOARD OF HEALTH TOWN OF BARNSTABLE 2ppritation-forlDerr Con5tructionpermit Application pis hereby made for a permit to Construct ( ), Alter ( ), or Repair (�an individual Well at: 37o nd�sl.c D( ' -M4rS/orJS M, /i �k �'► 0C - - - - --------------------------------------------------- Location/— Address !Assessors Map and Parcel 1PJiaJ IG�Gr u • ` U. v Uu v/V /lwa CJ ',?,?/ t " Owner Address 10A J GG6'�r C 1 y f t! �✓�/i /a , 1 rs r ., d�.dJ r�G p r- �Xx.+ I d.^�_iQ.I } ---— — —t= — — ---------------d------------- Installer — Driller Address Type of Building Dwelling ------------------------------------------ Other - Type of Building-------------------------------------- No. of Persons--------------------------------------------------------- Typeof Well_-y r, — — --- ------ - ------------ Capacity -------------------------------------- © " n=Purpose of Well-- O--- ---( -- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certific to of C mpliance has been issued by the Board of Health. Signed—� _ ---L 116------------------------------------------ - --t�J h`�------------------ date p Application Approved By-------- - "r �f Application Disapproved for the following reasons:------------]--------------------------------------__--- -- : _____________________________________ ---------------------------------------------------- ------------------------------------- date Permit No.- - ------- ----------3 ------------------------- Issued------------------------------------------------------------------------------------ ----------------- - date. BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO,CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( �`) -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer 37a A, tS 7 /4 has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No�-- �4 ---Dated---------------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------------------------------------------------- ---------------------- Inspector—----------------------------------------------------------------------------- A- BOARD OF HEALTH TOWN OF BARNSTABLE Yell Con5tructionPermit w - �- No.--L--�-= - ------ Fee—2t_s :-------- Permission is hereby granted -- ---------- ---------------------------------------- --------------------------- ------------------------- to Construct ( ), Alter ( ), or Repair (y) an Individual Well at: -a�= 5, ------------------------------------------------------------------------------------------------------- NO. ------ - 4,4� --------------------------------------------Street as shown on the application for a Well Construction Permit No.------------------------------------------------------ --------------------- Dated --- ��' - ;� - - ---------- ----- ------'-- ----------------------------------------- d Board of Health DATE-------------------------------------------------------------------------- h � a D'epartnnentbf Environmental Management/Division of Water Resources i WELL:COMPLETION REPORT G� WELL LOCATION GEOGRAPHIC DESCRIPTION Address �?�n .ado N S~'lf)W of rC J r i (feet) (circle) lF; u City/Town + 1�.. /\.4\/ST/C Q (road) ?Ad owner �ryv ��� r;1C"^Ea�� ` ress �o)r $ = - �. (�'$ E" W Of M r Il /4i lmi.;n tenths! klydel iOlJle intersect. w%M rd of Health permit obtained: yes ©" no ❑ - (road) LL USE WELL DATA Domestic ®_P_ublic❑ Industrial Q Total well depth / ft. �• Monitoring 0 Other Depth to bedrock ft. Water-bearing rock/unconsolidated material: { Method drilledCr 1 1�J Description^r cl e66 rS e sue-rt Date drilled ' ,15 Water-bearing zones: CASING t 1 From To— Type �Lft/1� Ad C Length/D It Dia(.LD.) —in. 2) From—To From To Length into bedrock ft. Gravel pack well: dia. Protective well seal: Screen: Via. Grout_©' Other bot'`l�length iI r from ` to1 STATIC WATER LEVEL(all wells) Static water level below land surface rV ft., Date WELL TEST(p'roduction wells) Drawdowil —2 It. _ after pumping_f' lit min,at 16. gpm How measured T19r' Recovery' 0 ft., after_hr.'r _min. o. LOG of FORMATIONS COMMENTS ` Materials Froni To, - �- Driller Firm DA Address A.Z.,9./ r.l f City/Town /ii a Supervising,DrillerReg.# - � Si nature.of supervis;ng.registered Well driller Bleese print r;retry .: BOARD.�-OF ,HEALTH .COP-Y. - u�. ��.i✓��+�+ Epp J��•J�i ct�'��� ! ��t5 t�i u: p1 f ae+!!'R(.,� � - •• - ��--ter' r y y4��i9 Jam•.�I fit'' ':f I1�FI�rH'1 - ��I I-- I�.. �_ I I // WINNOW �I w 0gj HIM {r',, Will Wal Lli'4.[I r Offu�ti mti i�.0 ' � ' 9 � ,S � x,1 n I{N t1!mod` 'idl '1 i '�. •/ • } •a:; '�. �{'Iy' „� ` 9V 7- r►t Fpir t �; S�srIIisi �ir�inft I,�ilEtl<�G H'>,t y°Yiuft Ik�x�i Efm�?4"w�c , � • i' do 9Et ,�R•;. - .ti x - - , � e�'3ao'uw� ® i I1i1 y�Y vt, t:i� ! 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"t■■,n4 �.� �:.., 1 it `��;1°� aµ 'i.Ca +�� --- tr•1 «a i t' —,. 4•=_�g,E/ r,�ll. ®'� t �I■ — -., ?..: •.�r :✓.tu�iyr r:.'::,lsD - 'fs.■,. .I Illhm 1-J_� •-• ��.a :� 1,4;los..— • ®1 .1 �?dir,'rtla'•:I��t:���-" r eT�•.� �j '"t.l��h's_�I h�s l�i�.�l�m.�le�l1'�._ IL`�11 �IIiIrIA`�1i1 ®I■.��.•sul.� �E!■I �I�IL r•,It:•j�r,•1��� [aaaaaaw IICit ,e•r L=r.� nal r•a�n,��l ,�-`�'=,■t.■..�mrr�■eo-�'1®'I��1ik1®�.�� ��-lt.� ��11..:_'��A�u� i—��-.��i�a�-'"»..J `i�oi� ��i' ATM`\ `�r 4 4 } - � , t l ■L yyyy ),..! errS W *J'I T "P •�S[.l iti•a-..1�r ����' S ¢¢ y Jr ;�Cft�'c �� �.ar' •r L /t I 'a t {_ 3�1 /' 1 -,j t .,��F'jF''�il��i2�`rF� �►.y+t '.�■:11 ~p� a,, i +r�, � kM i i 1 t r r � r',�k�y�!� ( ■�i\F�1w T4 �r-•6� �5r�.��r �'1.2''�v r Yid�.�� 'i'• f�W,+�, ��/ /♦ .�'� IZ oyya�"b�e/% T'it+�"*�� ».�iC�+it�' r �f ,�t1� IIP 4 ^• !`jar~i' `�,%n `.. ("y ��t T It!f r► �r t� /Jry�9 —arR,�/�Q� � v /!t g�!1 ILVL � �`+, i ���'1^{,��Ir�hi�j•rr��fihTj�tt*r�t,�t'>li►,,`Ft��'��k � '!Q1 1 1 1 � GENERAL NOTES EXTERIOR WINDOWS/DOORS FINAL ENGINEERING WILL BE NECESSARY FOR ANY FRAMING. ASSUME ANDERSEN 400 AS FOLLOWS(SEE ELEVATIONS FOR QUANTITIES) Jr THESE DOCUMENTS MAKE ASSUMPTIONS ABOUT FRAMING AND T U C K E R CONCRETE REINFORCEMENT WHICH MUST BE VERIFIED BY AN DOOR 1 FWH31611AL(SEE ELEVATIONS FOR GRILLE PATTERN) Architecture & Landscape ENGINEER PRIOR TO ANY CONSTRUCTION. DOOR 2 FWH27611AL(SEE ELEVATIONS FOR GRILLE PATTERN) DOOR 3 FWH27611AR(SEE ELEVATIONS FOR GRILLE PATTERN) 59 Atlantic Avenue, rch.co head,MA PRICING ASSUMPTIONS: DOOR 4 FWG5080R(SEE ELEVATIONS FOR GRILLE PATTERN) ww(781)631-3 46 (781)631-3546 DOOR 5 FWG12080-4(SEE ELEVATIONS FOR GRILLE PATTERN) Tucker Architecture and Landscape LLC FOUNDATION:ASSUME 1OX20 STRIP FOOTING WITH 3:#4 REBAR AT DOOR 6 FWG5080L(SEE ELEVATIONS FOR GRILLE PATTERN) BASE.FOUNDATION WALL TO BE 8"CIP REINFORCED CONCRETE WALL W/2:#5 BARS TOP AND BOTTOM AND#4 BARS @ 48"OC VERT. WINDOW A TW 3046(MUST MEET EGRESS)(SEE ELEVATIONS FOR GRILLE PATTERN) WINDOW B AW 281 (SEE ELEVATIONS FOR GRILLE PATTERN) SLAB TO BE FIBER REINFORCED 4"CONCRETE SLAB OVER 6 MIL WINDOW C CX 135(SEE ELEVATIONS FOR GRILLE PATTERN) VAPOR BARRIER. ALL WINDOWS TO RECEIVE FULL SCREENS.ALL DOORS TO RECEIVE FULL SCREEN DOORS. FIRST FLOOR FRAME:ASSUME 2X10 @ 16"OC ON 2X6 PT SILL PLATE. ASSUME PAINTED INTERIOR FINISH,WHITE CLAD EXTERIOR. FRAME SPANS FROM EXTERIOR WALL TO CENTER CARRYING BEAM. INSTALL 3/4"T&G SUBFLOOR. ATTIC/LOFT FRAME:ASSUME 2X10 DF SS OR#1 @ 12"OC.INSTALL 3/4"T&G SUBFLOOR.ASSUMES NO MID-SPAN BEAM. ROOF FRAME:ASSUME 2X10 @ 16"OC W/5/8"ZIP ROOF SHEATHING, CATHEDRAL FRAME AND 5/8"DRYWALL. INSULATION:ASSUME CLOSED CELL FOAM IN THE ROOF, FIBERGLASS BATTS IN THE WALLS,FIBERGLASS BATTS IN THE FIRST FLOOR FRAME.PROVIDE SOUND BATT INSULATION IN BATHROOM WALLS. EXTERIOR FINISHES:ASSUME PRE-DIPPED CEDAR SHINGLES WITH WOVEN CORNERS.5/4 X5 PVC TRIM AT ALL OPENINGS.1X2 OVER 1X8 RAKE BOARDS.1X FASCIAS.INSTALL PVC BEADBOARD AT SOFFITS. DECKING:ASSUME 1X4 UNTREATED MAHOG DECKING W/SS SCREWS. INTERIOR FINISHES:ASSUME 1/2"DRYWALL FOR WALLS,5/8" DRYWALL FOR CEILINGS.1X5 BASEBOARDS,1X4 DOOR/WINDOW TRIM.ASSUME WOOD 4 PANEL INTERIOR DOORS.FLOORING TO BE 1X3 STRIP OAK STAINED PER OWNER SPEC.BATHROOMS TO RECEIVE 12X12 PORCELAIN TILE ON 1/2"DURROCK.SHOWERS TO BE WHITE SUBWAY TILE WALLS TO CEILING,2X2 NON-SLIP SHOWER TILE BASE.SHOWERS TO RECIEVE 1/2"CLEAR FRAMELESS SHOWER GLASS.PROVIDE ALLOWANCE FOR STOCK VANITIES.ASSUME KOHLER BATH FIXTURES.INCLUDE PANASONIC BATH LIGHT/FANS. ALL CABINETRY ASSUMED PAINTED.THE SECOND FLOOR FINISH WILL BE PAINTED SUBFLOOR. INCLUDE RECESSED LIGHTING ON FIRST FLOOR LEVEL.PROVIDE ALLOWANCE FOR DECORATIVE FIXTURES. REVISION DATE: 2017 1101 Permit Set ASSUME WOOD TREAD STAIR WITH OAK HANDRAIL AND PTD TAPERED BALLUSTERS. ISSUED FOR PERMIT Blueberry Bend Accessory Dwelling Unit 370 Mistic Drive Mars s Mills, MA 0Votes NOTE:ORIGINAL DRAWING SET TO 24X36 FULL SCALE PAGE NO. 0.1 0 1' 2' 3' T U C K E R Architecture & Landscape z Z 59 Atlantic Avenue,Marblehead,MA C-) ,6'tl 6 lOJI www.TuckerArch.com N (78I)63I-3546 � . Ik Uog0!00SSV Tucker Architecture and Landscape LLC �I 1 S 196mo 8}0�S3 U 1 sa>fQ7 uoipul f`j O d/u /56 j i J �0ap pagsi/o uaap / a8 01 oaay 6u IA!7 ;�� 11 qpm a a 600g 43'-6'' 67.7 J +62.j i t Pujl M o� ,RP .V2N 9 I 1 L FFE=69.0 / N ( 1 `uP qoi 00*oo i FF , / / J AIVG Grade=64'�6, Ana#S / ,Ridge-EIev=9j��odOad �N Idg HT=26.63'f � �t I � a1go4sujog ogdaS 6uigslx o4 .6f , +61.75 jo uMol 6ulpj1n8 6N ;oau oo ;J dojo ( i J/U REVISION DATE: 2017 1101 Permit Set 6Mrit a M t, t ISSUED FOR PERMIT / IS Z l OLD# I inup Janoa� �' t t 0 Blueberry Bend ' } ! I Accessory Dwelling Unit P Ui 370 Mistic Drive m Marstons Mills, MA qs r a(, u�o� � � a}off �Mo� , (/ ,1 Site Plan Diagram - Detail 1 Site Plan Dia ra ( NOTE:ORIGINAL DRAWING SET TO 24X36 FULL SCALE PAGE NO. " 111/// 1 Scale:l'=10'-0' I f'l, 1, ` 5 1 ` 0 V 2• 3• 1 1 T U C K E R 0 © © 8 6 0 Architecture & Landscape 50'10^ 59 Atlantic Avenue,Marblehead,MA 3'� 4' 14'-9" 14' 14'-9"^ www.TuckerArch.com (78I)63I-3546 I I I I I ! Tucker Architecture and Landscape LLC 43'-6" 8"Concrete Filled I Sonotube Foundation on Bigfoot_footing TYP---_ 60- Venting- - -,: -- ---------------------O Window (30"x12") Eil- Beam Pocket,TYP of 2 ;0 I j --------------u---------;----------- ------------',----------- -- ----------� 04 I UNFINISHED STORAGE 4"STL LALLY on 24"x24^ 2 o e 5 00 10" Reinf. Concrete Walls on 10"x20" Reinforced Reinforced Footing,TYP OF 3 N i or Footing. Provide 3" Fiber-reinforced Slab over vapor P barrier over gravel. ASSUME 3: 11 7/8"LVL a Equipment: Locate Hot Water Heater in this space. DROP BEAM ABOVE 6"Curb I ®- UNDER DECK STORAGE GRAVEL FLOOR SLOPED TO MATCH :�� w o ADJACENT GRADE. INSTALL 2X °° Cn ; FRAME BETWEEN PIERS CLAD WITH; 1X6 VERTICAL PTD CEDAR BOARDSi1Z O® --- - - - - ---- - -- - - - - - - - - - - - - --------- ----------------- REVISION ---------------- - - - - - 017 ermf Set t� I 4 2 11 01 P 8"x8"Concrete Pier on 30"x30"x12"Reinf.Footing I Cedar Porch Skirt on PT Frame " ISSUED FOR PERMIT 6"Deep Fieldstone Veneer , ---------------------------------------------- - Blueberry Bend Accessory Dwelling Unit ! 370 Mistic Drive U U U U U Marstons Mills, MA Foundation/Basement Plan 1 1 � NOTE',ORIGINAL DRAWING SE��24x36FULLSCAIE GE N0. FirstFloor Plan 2 Sca1e:3/B"=1'-0" 6 1' � 1 1 T U C K E R 8 6 Architecture & Landscape 50'-10„ 59 Atlantic Avenue,Marblehead,MA , WW m 3'4" 4' 14'-9" 14' 14'-9" 1 (7 I)631--3546 i Tucker Architecture and Landscape LLC I 43'-6" I I I I PT Frame wl Mahog(Decking. I I Step down 6"from Fiiiished Floor ]// ACCESSIBLE ENTRY 3 ;OUTDOOR 2'-8" ' 3' 8'3�2„ SHWR 5 2" UTILITIES/STG zORO-ENTRR� W/D 60x30 BATH ATTICS A R BELOW STAIR M ACCESSIBLE v LNDRY Tub ! ACCESSIBLE SHOWER + lJ CASEWORK BATH Pocket Door Ooen to AboveUP ---- 3�2 6'-6y2^O- - - rENTRY 8Pocket Door I3'-0"x6'-8"RO THRESHOLD `�' o a? 1 0 2'7" 4' V-3" 1 ao o N I Open to Above s = w BEDROOM s r Q N Q LIVING ROOM PT Framewl w Mahog D cking. `V o 51/2 l i 5/2' 1 Equal Equal � Equal Equal Equal Equal N O N O 3 3 8'Sliding,Door 12'Sliding Door 8'Sliding Door —.STD Pergola Above , S ORAGE RDECK DN PERGOLA COVERED PERGOLA 8„R PORCH 11"T N x6 PT Post wrapped in 3'High Guard Rail,TYP PTD PVC Trim,TYP ® --EPDM-Covered Roof Above. _ _ _ _ ® REVISION DATE 2017 1101 Permit Set �SLCFrame Grade 3'0%2^ ! 3'0%2" ISSUED FOR PERMIT I PTT Frame w/Mahog I Treads,PVC Riser loped Blueberry Bend Handrail/Guardrail. __ 14 11 i �. 900 SF, Accessory Dwelling Unit 370 Mistic Drive 0 © © O U U Marstons Mills, MA First Floor Plan 1 1 O NOTE:ORIGINAL DRAWING SET TO lIX31 FULL SCALE PAGE NO. 7 8 5 1 First Floor Plan 7 Scale:3/8'=1'-0' - U - 3' 1 1 T U C K E R $ s 0 Architecture & Landscape r 50'-10" ' 59 Atlantic Avenue,Marblehead,MA www.TuckerArch.com -4- 4' 14'-9" 14' 14'-9" (7 I)631- m 3546 i I t I I Tucker Architecture and Landscape LLC 43'-6" I I i I I I I 11'J' 21' 11'-3" I I I I ! i 2'-4%2" 2"-6" 2'-s" 2'-6" 2'6" 2'-6" 2'6" 2'4�2" SLOPED ROOF SLOPED ROOF DN o BELOW igh H nd Gu rd il,TYP BELOW io r v 20'-1" 2X4 Kneewall w/Access PanelE1:2 OPEN TO BELOW 2X4 Kneewall w/Access Panels - - i - - 11'3 - - - - - - - - - - - 3'High Guardrail,TYP C I t Y I 1 o RIDGE ABOVE i M 0 CN o LOFT LOFT ' e 5 14'-3%2" OPEN TO BELOW 14'3%2" s a° i 2X4 Kneewall w/Access Panels o 2X4 Kneewall w/Access Panels r + I , - SLOPED ROOF o SLOPED ROOF o BELOW 14 BELOW I 2'-1" 2'-6" 2'6" 2'-6" 2'-6" 2'-1" 3" 3" 3" I 14'-11" I I I bo I FLAT ROOF BELOW I I I I REVISION DATE: T - _ .. _ r _ .. ._. _ _ - - _ i - - I 2017 1101 Permit Set ISSUED FOR PERMIT I Blueberry Bend Accessory Dwelling Unit 1 ! I I I I 370 Mistic Drive © © Marstons Mills,MA First Floor Plan 1 1 NOTE ORIGINAL DRAWING SET TO 2036 FULL SCALE PAGE NO. 7 8 5 or Plan 3 Assumed Roof Assembly:2x10 Rafters @ 16"OC w/Closed Cell Foam Insulation. Cathedral Ceiling with 5/8"Drywall.Assume ;f 5/8"Zip Sheathing,Asphalt Shingles. T U C K E R Architecture & Landscape Assumed Wall Assembly:2x6 KID Studs @ 16" � 59 Atlantic Avenue,Marblehead,MA OC w/Fiberglass Batt Insulation.1/2"Drywall. Assume 1/2"Zip Sheathing,Pre-dipped cedar WW(781)631- m 3S 6 shingles w/woven corners. Tucker Architecture and Landscape LLC 5/4 x 5 PVC Trim.2"PVC Sills l \ 1x8 w 1x2 PVC Rake Trim Porch Roof Assembly:2x10 Exposed Cedar Cedar Frame w/ — Rafters covered w/2x6 T&G Decking(exposed PTD Wood Brackets below).Install adhered tapered insulation @ 1/2"/ft and Asphalt Shingle - pitch covered with full EPDM membrane. Roof 6x10 Paralam Plus PSL(Treated Beam)wrapped with 1x PVC trim and LCC cap. -- 6x6 PT Post inside PVC PTD Columns ` 6x6 PT Post wrapped w/1x PVC Trim.Natural Mahog Cap Cable Railing System Deck Assembly:2x10 PT Frame on 6x6 PT Posts on Elevation sonotubes. 1/4 Mahogany Decking w/SS Screws -- -- - REVISION DATE: 2017 1101 Permit Set LEI Cable Railing System WWA ISSUED FOR PERMIT Blueberry Bend Accessory Dwelling Unit 370 Mi' I � stic Drive _ m s n i 1x6 Cedar Porch skirt Boards on PT Frame Marstons Mills, MA i 4"THK Stone Veneer on 10x10 Reinforced F 1 I i I Concrete Piers Elevations NOTE:ORIGINAL DRAWING SET TO 24X3fi FULL SCALE PAGE NO. 3,8 Elevation ; � � - i Asphalt Shinges T U C K E R Architecture & Landscape 59 Atlantic Avenue,Marblehead,MA www.TuckerArch.com FU7 Cedar Shingles w/Woven Corners (781)631-3546 mm� PVC Trim Tucker Architecture and Landscape LLC uI / 44 PT Outdoor Shower Frame clad w/1x6 T&GVG Cedar - - -Groove ear \ Cedar Shingles w/Woven Corners _ _ . Elevation FT \ ` A Vill 4x4 PT Outdoor Shower Frame clad w/1 x6 T&G V-Groove Cedar REVISION DATE: 2017 1101 Permit Set ISSUED FOR PERMIT Exposed Concrete Foundation Blueberry Bend 1x6 Cedar Porch.Skirt Boards on PT Framp Accessory Dwelling Unit 370 Mistic Drive Marstons Mills, MA 4"THK Stone Veneer on 10x10 Reinforced Elevations Concrete Piers NOTE:ORIGINAL DRAWING SET TO 24X36 FULL SCALE PAGE NO. 2 El1tion 6 T U C K E R Architecture & Landscape 59 Atlantic Avenue,Marblehead,MA LVL Ridge Beam www.TuckerArch.com (78I)63I-3546 Tucker Architecture and Landscape LLC 12112 Pitch 2x8 Fir Rafter Ties \\ 8 a 8 a REVISION DATE: 2017 1101 Permit Set ISSUED FOR PERMIT Blueberry Bend Accessory Dwelling Unit 370 Mistic Drive Marstons Mills, MA Building Section NOTE:ORIGINAL DRAWING SET T024X36 FULL SCALE PAGE NO. Section 7 3/8'=1'-0' 0 1' 2' 3' T U C K E R Architecture & Landscape 59 Atlantic Avenue,Marblehead,MA LVL Ridge Beam www.TuckerArch.com (78I)63I-3546 Assumed Roof Assembly:2x10 Rafters @ 16"OC W/ Tucker Architecture and Landscape LLC Closed Cell Foam Insulation.Cathedral Ceiling with 5/8" Drywall.Assume 5/8"Zip Sheathing,Asphalt Shingles. 12/12 Pitch 4/12 Pitch 2x8 Fir Rafter Ties LVL Beam 4/12 Pitch 1x3 over 1x8 Fascia 0 _ 8 EPDM Membrane C; Tapered Rigid Insul(1/2"/12") - 2x6 T&G Fir Decking 2x10 Fir Joists 2' 410 Fir Beam Assumed Wall Assembly:2x6 KD Studs @ 16" OC w/Fiberglass Batt Insulation.112"Drywall. - PT 6x6 Post wrapped— Assume 1/2"Zip Sheathing,Pre-dipped cedar with 1x PVC o shingles w/woven comers. - - Note Capital and Base L Guardrail 1x3 over 1x10 Fascia Stone Veneer over 8x8 Concrete Pier Porch Skirt-1x6 Cedar over PT framing REVISION DATE: 2017 1101 Permit Set ISSUED FOR PERMIT Blueberry Bend Accessory Dwelling Unit 370 Mistic Drive Marstons Mills, MA Building Section NOTE:ORIGINAL DRAWING SET T024x3�IULLSCALE pAGE NO. � Section 8 - -- I _'�-�=�_tom � �• ginII a �,"` ��"" Y;~ Cxi giR�'f � yppy?Wp?�y���pypy������ �■a; � 5�l, i I ��p/Y�_■�����u ,. � ape ..Y4•I � 4f�� x � i f �mimv �P.+1M�k .1�� i � �'. ��,� '� 'a-��-a-+■��m�-`---_.�� -��'' «, .. .{� n !• �I�4 ���` �,� I. �■.! ���` a ��- �R ���� ni.e ur+w•�� r � • e . _ mod �� a .� 'sl® in _ - <.�.-'',.+r^-�. �---�� I .,- ':� a,'t� ;,`:R - x ` ..�..�^�e Y - ■IRI ■a-S�,I.B �� JI � r � 41n� .. 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