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HomeMy WebLinkAbout0169 KEVENEY LANE - Health 169 Keveney Lane77W Ift Barnstable A= 351 —057 a TOWN OF BARNSTABLE LOCATION 6 9 )L6V15N&>-' L�� SEWAGE# 2012'60'7 VILLAGE ASSESSOR'S MAP&PARCEL .3SI/S7 INSTALLERS NAME&PHONE NO. /Vo e�i»+'^� �A✓�^L S�c9 3 98`��r7y� SEPTIC TANK CAPACITY / ASV v ��-�d-�► LEACHING FACILITY:(type) (size) 4 7 � '� � o •E� � NO.OF BEDROOMS S— OWNER QA-oJZr4Y t PERMIT DATE: ( �,t t Z-- 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 /' �I = r i � 7 a I r r N I w :y No ®®� c~•. ,=u Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZippliLation for Misposal *pstem Construction 3pPrmit Application for a Permit to Construct( ) Repair( ) Upgrade(* Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. i611 k-s(ru-j v'y N Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 3 J S7 c S).rX,-Y Z �A c�+�N9 �gc,i.i Inst�alle�r's Name,Address,and Tel.No.LS >3 3 9 ' �!'�+ Designer's Name,Address,and Tel.No. o w.j C9d-'t O 94" Jr �r....— Type of Building: -� Dwelling No.of Bedrooms S Lot Size 6i' d sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) S'Sd gpd Design flow provided SSZ ( gpd Plan Date /O/'`, 2-o t I Number of sheets Revision Date Title Jcr-6 ? _4_j Size of Septic Tank /�y c7 mac. {.j 10 Type of S.A.S. V[' S� y GA«•-� Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. t, e w . Date 3 / �— Application Approved by Date Application Disapproved by Date for the following reasons Permit No. /� D Date Issued i No Fee /✓ THE COMMONWEAL'-T;H-O ,, MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOW"! F--BARNSTABLE, MASSACHUSETTS Yes 9pplication for Distl'osal Opstr tt Construction 3pPrmit Application for a Permit to Construct( ) Repair( ) ;Upgrade Oh Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. /6% k:z:vc A+ f G ti Owner's Name'�Address,and Tel.No. Assessor's Map/Parcel Ste 04��'/ ,A�7n CT4s�.a Install is Name,Address,and Tel No. Svu 3 SS - 571f-_7 4 Designer's Name,Address,and Tel.No. Yp Type of Building: Dwelling No.of Bedrooms Lot Size 6/T v d sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) S5 o gpd Design flow provided SL I gpd Plan Date w/ ,/z o . I Number of sheets Revision Date Title Ji T r ?"A A .y Size of Septic Tank /,t o 0 G,,,- 1-1)u Type of S.A.S. U Gam' -+ Description of Soil r t q Nature of Repairs or Alterations(Answer when applicable) j` Date last inspected: Agreement: - -The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. /, 1 r-"Signe Date i Application Approved by Date `•� Application Disapproved by Date for the following reasons Permit No. �/ Date Issued _ =------------------ --------------------- - -----------------------•------_ ---------------------------- THE COMMONWEALTH OF MASSACHUSETTS i BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(al) If Abandoned( )by /y/0 ^T i C J ��/� c C �- at /(O 9 kz V c C has been constructed in accordance / / with the provisions of Title 5 and the for Disposal System Construction Permit .o��dated / Installer �iC).• C�-�'� Designer (7nT #bedrooms s Approved design flow r\ .5 -1 Z • 1 gpd The issuance of this permit shalll'not be construed as a guarantee that the systewwill fu�nat ri as destgned. Date \ \ 1 73 Inspector ----------------------- -------------------------------------------------------------------- -- - ---------------- - - - No. 007 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS j Misposal 6pstem Construction permit Permission is hereby granted to Construct( ) Repair( ) Upgrade(K) Abandon( ) System located at / 6 `� ��✓ C v Z ^ �` and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date /4 J Approved by ROM :down cape .engineering inc FAX NO: :15083629880 Feb.', 14 2013 03:35PM P1 V1i0 aPP r7 , [� s:i` tba1F T1' eL; n " \aaFr. lqe iva11� LAA: Rea li bllvTisi-a J •; :'1'� - :o$ lid IL`r�iN;T:��n, �9yllII'4'n dd4Ti" ^ 9Q➢Ill71 �, rV66b`-J�i[aanJ� '•�dll'�'rt, I-�I,�;.4llpLlli5i�.��;�•�n(�@� '�`C " " - . 8. 54A•iflr,�: liG'> d(4-1 t^M r U �i)2 7t'U1(i:31J @ s , &ITst elLllmi�ti ,.LPh`3D anm.L ��rrlf'1LD•�a�'llu71.t-D➢i 6a�]CDni( /a UG7 �.9'�KbP�UTr 'R 1��Ar o11� Daata i r 11.Ta;�n�,irn�:lr• :��� e :.G�/✓1R�h-:a nAn�It,�nllIl�,1C ••lT/!/�'--N -- `� ..r kdd a^ba, r ✓ �.- - - 4 CJ ZZ 6 3 g y OTT [ 11 L-. !!. •"i�•T? f/�-.. ��y 7V�1� l�bl7P.f��i l)l I m1, L() L[15�9►I 7.' 0713 'L�ll1Cr) sc lfi[, $Lri u'te� J,Gl a`ri�,l�ri ih;wJ7 by /chted" , (d gen f CI:.It;lfy Ll1i�t thr Sr'•[)tiL SYStelll.`rr:ll lcJ ce(1 �tbCwP iivzj 71,'str�ll(c I lih�,a�trlLi lJy rtr cuJ d 'n to - the clrs).L?n..,"i hick Loyiizc•lr:;tle:minur a �hlwr:rLGLa:Il�ess SbCli a5 1atei-a Tt-loc;Aioi, of z itntti riv box f r oa ify 'ihat the. si Pt7� .�.y`�t�m.ref(ar.ii�ed abuvr was iustal lerJ wlth nialul I?rrater Lhi�u lU' l�fe(�I,x(1uCatirn uf,tlIc `;A'•, u7 a6y ve"Fa.r-o:I le ;,tirin �:f(it(y rnmp()u( iTL of`Llie °cSyS`rer i) blit'in �1, c;r�J:d2nr c:.with. Sl�a�r. 1v: 1 CC�tl.Rr �1T]'�Liuu�. :)''l�t�i rrvrnr!il o➢ , c i r,C:JfiFIff.d i buill- by d ,;ic,0.61 to 1611ovr. Vo S L� p f)1�N1E A s i- y (just7.11(-;I's �T})T alllTB) CIVILO (1?esi �ltP1 „ Ji; ��tl1Tr:) (f1(ii; L)�s71..lvi'sSLtni> -1it'rr°)p a R��al�Ta.L'1 fTYtN _ i 1➢ 1t�E��l'�'Ll9 rraT i� f°YLII(�A,lf� dh71'Ar l;V'1W silty 1`�lQ DLL d d:'QDl�ros�-1 1dC'7�._l i 1?1p3, inn, i:3:iN�!:iD t1I'd'f11,_?r(D'6 IL 1D7, �f�.k_1Vlt .ARV+$_'A:A I91�.i(' U!�1ffJlZI�Ji9/1 ➢�9!—A°><_71FsII9 1AB!:.e�@ TI$, 1L9 flt�s�a�T�T bf_1f41`UUo_D>!T 1. .T.:..1-1/..:-.1: MIr-r n vt!Mil CA?inn htlla,3-) '''',;VUC- ; - kn It v rz E� 1p r - ,lk s. . i17, '7 fir' • • � �.� down cape engineering, inc. SIEVE SOILS ANALYSIS 169 KEVENEY LANE BARNSTABLE, MA J DATE OF REPORT:101*/1.1 JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 169 KEVENEY LANE BARNSTABLE, MA LOCATION: DCE Testhole l+2. 12.3' depth SIEVE ANALYSIS Weight Sample(Grams): 202.8 SIZE :WEIGHT RETAINED % RETAINED % PASSED (sum) ' 1° 0.0: 0.0%; 100.0% 3/4-----------I.............:......... 0.0�:---------- ___-____1......................�...A 1/2" 10.5 5.2%: - 94.8% ---}-•------------------------= ----- 3/8" 11.9;--------------5 o r---------------o- -------------' S.9/o: 94.1/o 16 2' 8.0%� 92.0% #10 118' - #20 44.8: 22.1%: 77.9% •______-_-__ _;..........................A---------------------}.................. #40 106.4: 52.5%: 47.5% ------- ..........................Y-_--___--___-_-______f.................. #50 140.6' ------ 30.7% #80 -----178.8:— -------- - -88 2% - -- -11:8% #100 1919' 94.6%: - •-___--_---_ 1........................ A----------___--__------------------ ------ #200 198.4: 97.8%: 2.2% -------------}-.-.---.------------ .....}---------------_-----r----_------------- PAN: 202.8; 100.0%: 0.0% .------------- ----------=---------------------------------------------y---------- SAMPLE: 202.8' NOTE:TEST ON PASSING#4 ONLY, 7.4% RETAINED ON#4<45% O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-3(GRANULAR,COARSE SAND) (UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE : #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% OK #100 0%-20% OK , #200 0%-5% OK. SAMPLE MEETS TITLE 5 FILL SPECIFICATION >98%SAND _ OF kj RESULTS: PERMEABLE MATERIAL CLASS 1<2 MIN./IN. MATERIAL DANIEaLA. cyG� NONCOMPACTED OJALA SOIL DESCRIPTION: MEDIUM.COARSE SAND " CIVIL y No:46502 l 1 /q 6 i down cape engineering, inc. SIEVE SOILS ANALYSIS 169 KEVENEY LANE BARNSTABLE, MA(2) . I , DATE OF REPO RT:1011,18.411 .JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 169 KEVENEY LANE BARNSTABLE, MA LOCATION: DCE Testhole 3&4 12.3' depth r SIEVE ANALYSIS Weight Sample(Grams): 199.7 SIZE ;WEIGHT RETAINED % RETAINED % PASSED (sum) 0.0; 0.0%; 100.0% ------------- --------------------------»-------------------- I------------------ 3/4" off 0.0%: 100.0% --------------------------A__-__-__-_---_•_-----�__----_____---____ - ;l 1/2" 0.0: 0.0%: 100.0% ----_--------f--------..................Y---_------- 3/8" r------- ---------- #4 2.9' 1.5%: 98.5% d #10 5.8: 2.9%: 97.1%29.6 ........... i #40 90. . _•__•_--••_•_•__•_ #50 123.3 61.7%; #80 ; .166.3w_ _83.3%� 16.7% -------------• ----------- o ---------8-.,7-%------------------------- -- #100 182.4' 91.3/o' 8.7/o #200 194.5' 97.4%: 2.6% PAN: 199.7 100.0%; 0.00 SAMPLE: 199.7; -------------- NOTE:TEST ON PASSING#4 ONLY, 1.4% RETAINED ON#4<45%O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-3(GRANULAR,COARSE SAND)(UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE : #4 100% (TEST ONLY MATERIAL PASSING#4) OK - #5010%-100% OK #100 0%-20% OK #200 0%-5% OK SAMPLE MEETS TITLE 5 FILL SPECIFICATION >98%SAND RESULTS: PERMEABLE MATERIAL-CLASS 1 <2 MIN./IN. MATERIAL ����k°FMAssgOti NONCOMPACTED DANIELA. SOIL DESCRIPTION: MEDIUM COARSE:SAND o� OJALA CIVIL N ° No.46502 S S O i Nql E _ I i down cape engineering, inc. SIEVE SOILS ANALYSIS 169 KEVENEY LANE BARNSTABLE, MA(2) DATE OF REPORT:;Jvllt/11 .JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 169 KEVENEY LANE BARNSTABLE, MA LOCATION: DCE Testhole 3&4 12.3' .depth SIEVE ANALYSIS Weight Sample(Grams): 199.7 SIZE ;WEIGHT RETAINED % RETAINED % PASSED (sum ) --------------•--------------------------4--------------------------------------- 1" 0.0: 0.0%: 100.0% 3/4„---------- - ----------------0.0 ---------------0.0%: 100.0% 1/2" 0.0: 0.0%: 100.0% - ------------ i--------------------------r-------------- -------r------------------ 3/8" 0.0; 0.0%; 100.0% ------------------------------------------------------- #4 2.9: 1.5%: 98.5% -------------- ----------------------- #10 5.8; 2.9%: 97.1% -------------4..........................A---------------------•.......�---85 2 #20 --------------------29=6�-------------14 8%;-------- 85.2% #40---------;- 90.9: 45.5%; --54.5%0 •-------------,.......................--••Y---------------------l................... #50 123.3; 61.7% 38.3% #80---------�--------------------166-3;-------------83.3%:-----------16.7% - ------------•------------------------- --------------6i 182.4 91.3%: 8.7% #200 194.5: 97.4%: 2.6% --------------e------------:...._----------- ---------------------r------------------ PAN: 199.7: 100.0%: 0.0% -------------- ------------------------------------------------------------------- SAMPLE: 199.7; NOTE:TEST ON PASSING#4 ONLY, 1.4% RETAINED ON#4 <45% O.K. RESULTS: SOIL CLASSIFIED AS AASHTO A-3(GRANULAR, COARSE SAND) (UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE : #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% OK #100 0%-20% OK - #200 0%-5% OK SAMPLE MEETS TITLE 5 FILL SPECIFICATION >98%SAND RESULTS: PERMEABLE MATERIAL-CLASS 1 <2 MINJIN. MATERIAL ���ZNOFhfgsS4 NONCOMPACTED ��� DANIELA. cti� SOIL DESCRIPTION: MEDIUM COARSE SAND o OJALA CIVIL Cn q No.46502 S ANAL E down cape engineering, inc. SIEVE SOILS ANALYSIS 169 KEVENEY LANE BARNSTABLE, MA DATE OF REPORT�,1014�1.1 L JOB : GRAIN SIZE ANALYSIS-SIEVE TEST SITE: 169 KEVENEY LANE BARNSTABLE, MA LOCATION: DCE Testhole f4Z 12.3' depth SIEVE ANALYSIS Weight Sam ple(Grams):- 202.8 SIZE ;WEIGHT RETAINED % RETAINED % PASSED (sum ) ---.-----------•--------------------------4--------------------r------------------ 1 0.0; 0.0%: 100.0% --------------{------------------------------------------------I------------------ 0.0: 0.0%: 100.0% 1/2" 10.5: 5.2%: 94.8% #4 16.2: • 8.0%; 92.0% --------------•-- ----------------------b--------------------->------------------ #10 11.8; 5.8%� #20 M, `44.8 22.1%� 77.9% --------------{--------------------------"t---------------------ti----'------------- #40 106A: 52.5%: 47.5% •-------------r-------------------- ......Y---------------------r.................. #50 140.6; 69.3%; 30.7% #80 178.8: 88.2%: 11.8% #100 ------- ----ti---------------191-9�-------------94.6%s--------- --5.4% •-------------{------------------------. -------- #200 198.4: 97.8%: 2.2% -------------- --------------------------------------- PAN:--- -- --------= -------202_8r-,------------100 0% ------------0.0% SAMPLE:--r-- - - NOTE:TEST ON PASSING#4 ONLY;7.4% RETAINED ON#4 <45% O.K. RESULTS: _ SOIL CLASSIFIED AS AASHTO A-3(GRANULAR, COARSE SAND) (UNCOMPACTED) PERCENTAGE OF MATERIAL PASSING#4 SIEVE : #4 100% (TEST ONLY MATERIAL PASSING#4) OK #5010%-100% OK #100 0%-20% OK #200 0%-5% OK SAMPLE MEETS TITLE 5 FILL SPECIFICATION >98%SAND I"OF MgsS 'RESULTS: PERMEABLE MATERIAL-CLASS I <2 MINJIN.MATERIAL �o��pANIIiLA.�cy�N NONCOMPACTED o OJALA SOIL DESCRIPTION: MEDIUM COARSE SAND " CIVIL No,46502 Town of BamstaWe IKE ru, iDepactmG➢at of Regulatory Services L uAM917.tel.E; 4 Public �� al1��� ]�1lvASlloflll Date B+AB& � 200 Main Street, Hyanuis MA 02601 7 � A/A/w/ Date Scheduled_ . Time ff Fee Pd. Foil Siiitability Assessment for Se e DispONal Pcrronned Dy:__ Wlutessed By,; L.ocalion Address l / Ke ve Owner's Name -LA ✓Va �Lt! //(� Address Q Assessor's Map/Parcel: J / O� Cngincer's Namc (1(it�� (e NEW CONSTRUCTION REPAIR Telephone li Laud Use- Slopes(9'0) 1" Surface Stones Distance's Front: Open Water Body 7 40ro I1 Possible Wel.AreQ Drluking Water Well ' (t Dralna.ge Way Ft Property Line Ft Other ft SEE TC H, (SLTeet name,dimensions of lot,exact locations of lest boles 80 pert Le5ts,locnte weLlunds'I1)pro hin ily to holes) D t d) C=) �bo L , ' I Parent material(geologic)_�—LLu aq Yt. ✓4_ Depth tp 130ruck �Do Depth to Groundwater: Standing Walcr in Hole: a➢ Weeplpg I'lonl Pit pitce N'P� Estimated Seasonul High Otoundwater DETE I°dA7CRON FOR SEASONAL HIGH WATER TABLEMcthod Used: Depth Observed standing in obs.hole: Id, Depth lu 5QI1 Iki(111L53;- _ T Ili, Depth to weeping from side of obs.halt: I!l, c7ruuurJwuler.Ad�udlmen „gym„m .Ft. Index Well R Rcading Dalc: Index Well level _ Adl,ftwthP— A41.OvoundwaLe!'L. Ye.l JPICRCOLATION TEST [Lit Observation gg Flo1c# 4 Time tit 9'r _. (_ At �j tc Depth of Perc 1'I u'iF at 6" Start Pre-soak Time @ _ Time(V-6") End Presoak r Rate Min./inch Sitc Suilab111ly Assessment: Site Passed Silt-Failed: Additional Testing Necded(WN) Original: Public I-1callh Dlvision Observation I-Ioite Data To Be Completed on Back----------- Barnstable C'onseryntloll Div1Sio11 E➢t Yeast odic (1) Vveelc prior to Il➢2gdm.11tag. QASEPTlC\PERCPORrn.DOC ON F-TOLE, LOG Depth from so;I Irnrizon Hole # 0 Surface(in.) Soil Texture Soil ColorSoil. --- — (USDA). Other (Munsell) Mottlin t� g (Structure,Stones'; Boulders• tJ Con iste o ravel 70y „ DREP Depth Fram zon [�1V 7I'.1 ON HOL E LOG SoillTorizon Soil Texture Surface(in.) Soil Color ---- (USDA Soil (Mansell) Mottling (Structur Other Stories, Boulders. g' i Conss enc �0 9 .41 C auel 10 44L � DIE]EI1e 0-BS ERRVA -'—COAT-1110 LR ]L®C Depth from Soil I'lorizon ] ole �F 3 Surface(in). Soil Tex hire Soil Color. Soil —'—"— �— (USDA) (Munsell) MottlingOther (..structure.Stones,Boulders. ZL 3�^ Ice 3 :o siste cY 9aprsv tr 1-0.A. )D E]E13, Q�I�Lj[j]R TAl7CION TIOLE, Depth From �'®�Soil lloriZ�n I Hole � ~ Surface(in.) Soil Texture Soil Col or (USDA) ., 5'oil Other (Munsell) MOttlln g (Structure.Stones, Boulders, �ILI- CansistenpY %OrsyCll,' ][V®®d]nSaun•aance Rate Maas Above 500 year Iood boundary No Yes X (�/ithin 500 year boundary No ' Yes within 10a year flood boundary No YP5 _ IDle Itl>I o�P�clltanic�RBy cO1�ccu_ _fl _u Nog]gD ,VMous MaLtL!i l Does at feast four feet of naturally occurring pervious ma erial area proposed for the exist in all areas obsefved ttu'aughout the soil absorption system? {% l(d not, W110 is the depth of naturally occurring 1�ervio s maPal'Gal? _ � �erttllf--sc��ao�u C� I _ •. A ce.rti;f}, that on � 1L/ . 'cia' •( re)T have passed the soil evaluator examination approved by the IDepartrrtent of Environmental.h�rotection and that the above analysis was performed by me consistent with Vhe Aegt�ired trai ing, eicpertise and e per' nee descriUed in CIO CMI2 15,017, Signature , Date Q!1S2PTlC\-T'HRC6'ORM.DOC r Commonwealth of Massachusetts - 7 = Title 5 Official Inspection Form- Subsurface Sewage Disposal:System Form -Not for Voluntary Assessments F 169 Keveney Lane, Cummaguid ' Property Address Diana Barjabedian Owner Owner's Name information is 266 Midpine Road Yarmouth Port. MA 02675 January 13,2009 required for every page. Citylrown State Zip Code Date of Inspection Inspection`results must be submitted on this form Inspection 3forms;may not be altered,in any way. Important:When tnf orm atio n A. Ge neral . fitling out forms r on the computer, O l] use only the tab 1. ...Inspector. ,O key to move your cursor-do not Troy Williams use the return Name of Inspector.. - Troy Williams Septic Inspections Company Name' 19 Hummel Drive Company Address South Dennis" MA 02660 City/Town State Zip Code (508) 385-1300 S.1682 Telephone Number License Number r .5" ` , B. Certification certify that I have personally inspected the.sewage:disposaI system at this addr�C s and that the ° , t information reported below is true,;accurate and complete.as of the time of the i ection.CFhe Inspection was performed based on my training and'experience in the proper function and intenar of M site sewage disposal systems. I am a DEP approved system inspector pursuant o Sectior15.3 of Title 5(310 CMR 15.0001.The system ® Passes ❑ Conditionally Passes ❑ Fa s ❑ Needs Further Evaluation by the Local Approving'Authority January 13 2009 Inspector's Sign ure Date" =.x 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'off ic.e of ttie 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 j at that time.This inspection does not address how the,system wiill perform in the future under ' t condition of use he4ame or different c, ` A O 169 Keveney Lane,Cummaquid-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for:Voluntary Assessments .�' 169 Keveney Lane, Cummaquid Property Address Diana Barjabedian Owner Owner's Name information is , ;y required for every 266 Midpine Road, Yarmouth Port MA 026T5 January.13;2009 page. City/Town State Zip Code Date of Inspection. B. Certification (cont.) Inspection Summary. Check A,B;C,,Q or E l always corn plete:all of Section U. A) System Passes: ® I have not found any information which indicates that any-of the�failure criteria described in 310 CMR 15.303 or in 310 CMR 15.3.04.exist..Any failure criteria not evaluated are indicated below.. Comments:: System meets minirrium standards set by Mass.DEP..at the time of_inspection only =This inspection is not a guarantee or warranty on the future working conditions of.le'aching pipes or components: 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'66mpieti6n of the replacement or repair, as approved by the Board of Health; will pass: s Answer yes, no or not determined,(Y N.,ND) in:the ❑;for the`following statements: If°not determined. lease explain.. p . P ElThe septic tank is metal and over20 years.old*or the septic tank(whether metal or not) is F ri structurally unsound, exhibits substantial-infiltration or'extiltration or tank failure`is imminenf: System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of;Health. , t *A metal.septic tank will pass inspection if it.is=structurally,sound`, not leaking and if;a:Certlficate of Compliance indicating that the tank Is less than 20 years oldr 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 pipes)or due to a.broken, settled or uneven distribution.tiox. System will, - pass inspection'if(with approval.of Board of Health) El pipe(s) are replaced ❑ obstruction is removed 169 Keveney Lane,Cummaqwd-03/08 „ Titie S.OSidal:InspecUon Form:,Subsurface Sewage Disposal System•Page 2 of 15 - Commonwealth of Massachusetts . I DR Title 5 Official Inspection Form Subsurface.Sewage Disposal System Form -Not for Voluntary Assessments 169 Keveney Lane,Cummaquid { Property Address Diana Barjabedian Owner Owner's Name . information is required for every 266 Midpine Road, Yarmouth Port MA 02675, January 13, 2009 page. Cityfrown State 'Zip Code', Date of Inspection B. Certification (conf.) B) Sy stem.Conditionally'Pass es (cont.): distribution bbx,is leveled or replaced ND Explain: N/A g. ❑ The system required pumpingy more than 4.times,a.year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the t3oard of Health) El broken pipe( are replaced .. El obstruction is:removed ND Explain: N/A C) -further Evaluation is Required by the Board of Health: ls ❑ Conditions exist which require further evaluation by the Board ofHealth in order to determine if the.system is failing t6protect public health,-safety or the environment.$ 1. System will pass unless,Board of Health determines in accordance with 310 CMR 15.303(l)(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 ,. . f Cesspool or privy is within'50 feet of a bordering.vegetated wetland or salt marsh 7 2. System"will-fail unlessahe Board of Health,(and Public Water Supplier,if any) determines that the system is functioning m a.mannerthat protects the public health, safety and environment ❑ The'system has aseptic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to asurface.water supply., ' The,system has a septictank and SAS and the SAS is Within"' Zone 1'of a public water supply. El The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply ff , su I well. r . i 169 Keveney Lane,,Cummaquid 03100` 'Title-5 Orfiaal Inspection Form:Subsurface.Sewage Disposal System Page 3.of 15 r . y Commonwealth of Massachusetts Title 5 Official Inspection. Form Subsurface Sewage Disposal System Form -Not for Voluntary.Assessments ti 169 Keveney Lane, Cummaquid Property Address Diana Barjabedian Owner Owner's Name information i's 2 e66 Mid the Road, Yarmouth.Poft MA 02675 Janua 2609 required for every p ry.13. page. Cityjown 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 feeto,r more from a private water supply well** Method used to determine distance: N/A: ' **This system passes if.the well water analysis; performed at a DEP certified laboratory, for coliform bacteria indicates absent,and the presence of ammonia riitrogen.and'nitrate nitro9en'IS equal to or less than 5 ppm, provided thatrci other:failure criteria are triggered: A copy of the analysis must be attached to this,form 3...Other:` N/A` D): System.Failure Criteria Applicable to'All Systems: You must indicate"Yes" or"No"to each of the following for all' nspecfions:: 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 oe clogged:SAS or cesspool Static liquid level in'the distribution box above outlet invert due-to an overloaded El M or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" Below invert or available volume is less than Y day flow Required pumping more than 4 times in the last year,NOTdue:to clogged or ' El obstructed pipe(s),Number of times pumped: Any.portion of the`SA5,.cesspool or privy Is below high ground water elevation. ' Any portion of cesspool or.pnvy is withjn 100 feet of a surface water supply or El ® Inbutary to a surface water supply. 169 Keveney Lane,Cummaquid•03/08 Title 5 Official Inspection Form:Subsurface.Sewage Disposal System•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official- Inspection Form Subsurface Sewage'Disposal System Form Not for Voluntary"Assessments` 169 Keveney Lane, Cummaquid Property Address Diana Barjabedian Owner Owner's Name information is 266 Midpine Road,Yarmouth Port > ` `"MA 02675 January 13; 2009 .required for every page. City/Town r State . Zip Code Date,of Inspection B. Certification (cont;) 5 D) System Failure Criteria Applicable to All Systems (cont). F Yes No " Any portion of a cesspool or pr'iuy is within a Zone 1 of a public well: ® Any portion of a cesspool or privy is within 50 feet of a_prlvate water supply well.' EJ Z Any portion of ace sspool'or privy.is less than 100 feet but greater than 50 feet from`a private water supply welt with no'acceptable water quality analysis. [This system passes if the well water analysis, performed at'a DE certified laboratory,for fecal coliforrii.bacteria indicates absent and the presence of ammonia nitrogen.and nitrate nitrogen is equal to or;less than 5 ppm, gg py provided that no other failure criteria are tri ered.A co"' of the analysis. and chain of custody must be attached to:this form.] The system is a cesspool serving'a facility with a design flowof 2000gpd- 10j000gpd. 0 ® . The system.fails. I have determined that one or more'of the:above failure . criteria exist as described-in 310.CMR,1`5.303,therefore the system fails. The system owner should contact the Board'of Health to determine what will,be necessary to correct the failure. s 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 s - stems you, mu st indica e'e�t it er ' es' r'' _ q h o no to each of the followin 9 systems, Y Y .. � 9, in addition to the , questions in Section D. Yes N' 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.11�of a public water supply:well If you have answeied '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 , r 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 169 Keveney Lane,Cummaquid•03/08 Title"5 Official Inspedion Form:subsurface Sewage Disposal System•Page 5 of 15. Commonwealth of Massachusetts Title 5 Official Inspection, Form Subsurface Sewage Qisposa. System:Form -Not for Voluntary Assessments.: M rr 169 Keveney Lane, Cummaguid V Property Address Diana Barjabedian Owner Owners Name. information is 266 Midpine Road, Yarmouth MA 02675 Janus 13;2009_.' required for every rY. page. Cityrrown State Zip Code Date of Inspection',. C. Checklist , Check if the following have beerrdone.,You must indicate"yes".or"no'as to each of the following. Yes No Pumping information was provided by the owner; occupant or Board of Health Were any of the system components pumped in the previous two weeks? ❑ ® Has the s•stem rece• d normal flows in the previous two week period Y ive Have large,volumes'of_water been introduced to`the system recently or as part of El Nthis inspection? ® El Were as built plans of the system obtained.and examined? (if they were not available.note'as N/A) I ❑ 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? b. ® ❑ ` Were the septic tankymanholes uncovered, opened, and the interior of the tank dimensions,',depth,of'liqui, ected4or the coition of the:baffles or.tees material of construction, eptli`of sludge and.depth of.scum? Was the facility owner(and occupants if different from owner) provided with ® Ell information�on the.proper main tenance.of subsurface sewage disposal systems? The size and`.location of the Soil Absorption*.System(SAS)on the.site has been,determined based on ® Q Existing information-For example;'a,plah'at the Board of.Health 0 " Determined in the field (if any of the failure criteria related to PartC is at issue approximation of distance is unacceptable) [310,CMR 15.302(5)] • 2 189 Keveney Lane,Cummaquid•03/08 t Tltle 5 Official Inspection Form:Subsurface SeWege Dleposel Syglem•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments. M 169 Keveney Lane, Cummaquid Property,Address Diana Barjabedian Owner Owner's Name information is 266 Midpine Road, Yarmouth Port MA , -'02675 January 13;2009 required for every page. City/Town State Zip Code Date'oftnspectlon 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 gpd i 0( 1 prior Number of current residents: ). v e rinder.Does residenceha e a arba � Yes No I ® a Is laundry on a separate sewage systerti? [if yes separate inspection required] ❑ -Yes ® No. Laundry.system'inspected? ® Yes ❑ No Seasonal,use? ❑ .Yes ® No 'Water meter readings, if available last 2,., ears usa e d 08=40,000dals`. 9 ( Y 9 (9P )) ; 07=40,000gals Sump pump? . ❑ Yes No 1 Last date of occupancy: Vacant 3.weeks Date Commerciallindustrial Flow Conditions Type of Establishment: 5 Design flow(based.on 310 CM 15 203)` Gauons.per day(ypd) Basis of.design flow(seatslpersons/scift,Jetc):`, N/A Grease trap present? Yes ® No Industrial waste holding tank present? A ❑,'Yes ® No, Non-sanitary waste.discharged to the Title 5 system? ❑ -Yes JM No -Water meter readings, if available:, N/A' N/A Last`date.'of occupancy/use. . Date Other(describe): N/A 'r 7 e Lane, u ma uid•03/08 TiUe.5 Official Ins action Form:Subsurface.Sewe a Dis osal 5 stem Pa e 7 of 15 169 Keven y La ,C m q P,, 9 P isle Pq9. Commonwealth of Massachusetts Title 5 Official inspection Form o Subsurface Sewage.Disposal System Form Not for Voluntary Assessments y 169 Keveney Lane, Cummaquid Property Address Diana Barjabedian Owner Owner's Name information is 266 Midpine Road, Yarmouth Port MA 02675 Janua 13; 2009 . required for every rY page. City/Town State : Zip Code Date:,ofanspection D. System Information (cont.) General Information Pumping Records: Source of information: No pumping info was available Was system pumped as part.of the inspection?: �` Yes .No If yes; volume pumped .` N/A gallons How was quantity um"P ed-determined? j N/A .. . q . Y. p,.; Reason for pumping N/A Type of System: ® Septic tank, distribution box, soil absorption system Single cesspool Overflow cesspool Privy El Shared system (yes or no) (If"yes, attach previous inspection records,.if any) F Innovative7Aiternattve technology "Attach a"copy of the current operation and maintenance Contract(to be obtained from system Owner)an d a copy of latest inspection of the l/A.system by s'stem operator under contract El -Tight tank,-Attach a"copy of the'DEP approval ❑' Other.(describe): Approximate age of all components, date Installed (if known):and"source of information. Tank, d-box&leaching were installed on 5/4/75per compliance Were sewage odors detected when arriving at4 he Site?" ❑ Y@S No 4 i 169 Keveney Lane,Cummaquid•03108 w Title 5 Official Inspection Form:Subsurface"Sewagebisposal 8ystem Page 8 of 15 a m`4 e - Commonwealth of Massachusetts.,• e t Title 5 Official Inspect Forml y - Subsurface Sewage Disposal System Form -,Not for Voluntary Assessments 169 Keveney Lane, Cummaquid Property Address Diana Barjabedian Owner Owner's Name information is 266 Mid me Road Yarmouth Port MA 02675 anus 13 `2009 required for every p .1 ry r page. City/TOwn State ZV Code pate;of Inspection.' ^F( I D SystemAnformat ion�(cont:) Building Sewei(locate on site plan) Depth below grade: 18"+ k feet' Material of construction: r x ® cast iron E1.40 PVC ®'other(explain) Orangeburg r Y, Distance from private water,supplywell or suction line: N/A. feet -Comments (on condition of joints :venting; evidence of leakage, Flushed lines and406rid clear at the time of inspection. Note: Orangeburg pipe is prone to root= growth, blockages and other problems.that maV be of concern in the#uture. Line is under lar a tree. '- fi Septic Tank(locate on site plan) w s } k Depthbelow:grade 18" « feet, 'Mate[ial of construction. i ® concrete ❑ metal ❑.fiberglass' ❑ polyethylene ❑other(explain) If tank is metal Mist age N/A Is age confirmed by a Certificate of Compliance? (attach a copy of ceitificate) ❑ Yes. ❑ No x• R 5'X 9' X 6' 1000 gallon - Dimensions;.;.. Sludge depth. r " Distance from to'p.of sludge to bottom of outlet tee or baffle 2 8 , r, Scum thickness, Fnone Distance from'top,of'scurn o top of outlet tee or baffle" 41, Distance from bottom of scum to bottom df outlet tee or baffle: 14' How were dimensions determined? Probe/Measured 169 Keveney Lane,Cummaquid•03106 Tdle 5 Official Inspection Fonn Subsurface Sewage Disposal System Page 9 of 15 - Commonwealth of Massachusetts Title 5 Official Inspection Form f Subsurface Sewage Disposal System Form -.Not for Voluntary Assessments " 169 Keveney Lane, Cummaquid Property Address . - Diana Barjabedian Owner Owner's Name information is 266 Midpine Road Yarmouth Port MA, 02675 January'13, 2009 required for every , page. Cityfrown' 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.): Concrete inlet and outlet tee's were present. No evidence ofaeakage or damage was found. Tank was not in need of pumping at this time. Grease Trap (locate on site plan): NIA Depth below grade: feet Material of construction: concrete ❑ metal ❑fiberglass ❑ polyethylene ❑;other(explain):. N/A' r Dimensions:' N/A scum thickness N/A Distance from top of scum to top of outlet tee or baffle, NIA ; Distance from bottom of scum to bottom of outlet tee or,baffle N/A Date of last pumping: N/A 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) N/A Tight or Holding Tank(tank must be.pumped---at time Hof.inspection) (locate'on site plan): . Depth below grade: NIA Material of constrtaction. ❑ concrete ❑ metal r ❑fiberglass ❑ polyethylene ❑ other(explain)' N/A 169 Keveney Lane,Cummaquid-03108 Title 5 Ofriaal in Form:Subsurface Sewage DispoSaLSyslem•Page10 of 15 Commonwealth of Massachusetts kipTitle 5 Official Inspection Form Subsurface Sewage Disposal System form.-Not for.Voluntary Assessments 169 Keveney Lane, Cummaquid Property Address Diana Barjabedian Owner Owner's Name information is required for every 266 Midpine Road,Yarmouth Port. MA 02675 January 13, 2009' page. City/Town State F,Zip Code Date of Inspection D. System Information (cont.)" Tight or Holding Tank(cont.) N/A Dimensions: , .. Capacity:. N/A r gallons N/A Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm, level:' Alarm in working order i:' "❑ Yes ❑ No Date oflast pumping: N/A Date Comments (condition of alarm and'float switches etc,): . N/A *Attach Copyof current pumping-contract(required). 1s co attached? p p 9 PY '❑ Yes ❑ No . E Distribution Box('if present must be opened) (locate on site plan): .' s .Level with' Depth of liquid level above'outlet invert 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.): D-box was found level and in working'order w6g66d flow through to leach pit. Pump Chamber(locate on site plan). Pumps in working order:, ❑.`Yes , ❑ No Alarms in working order:" . ❑ Yes ❑ No- 169 KeveneY Lane C mma9 ia 03ioe Title 5 Official Inspection ioo For m. surface.Sewage.Dispo sal System-Pagei1 0 15 Commonwealth of Massachusetts .r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 169 Keveney Lane, Cummaquid Property Address . Diana Barjabedian Owner Owner's Name information is 266 Midpine Road, Yarmouth Port {".MA 02675 January 13 2009 required for every ry , 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.): , . N/A. , Soil Absorption System(SAS) (locate on site plan, excavation not require If SAS not located, explain why: N/A' u i Type. . 1-8'x6`pit `® leaching it s .' number: w/1'stone ❑ leaching,chambers number: ❑ leaching galleries;,:: number: leaching trenches ,number, length: ❑ leaching fields ;: number,dimensions. El overf low cesspoot r 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.):. Leach pit was found with 4' of water present with a visible stain line"approx, 18"below inlet invert. No evidence of hydraulic1ailure or problems in the past were found at the time of inspection: •169 Kevene Lane,Cumma uid"•03/08 "" Y „ q Title 5 Official Inspection Fonn Subsurface Sewage Disposal System Page 2 of 15 a � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .�y 169 Keveney Lane, Cummaquid Property Address Diana Barjabedian Owner Owner's Name information is required for every 266 MidP ine Road, Yarmouth Port MA 02675 January 13, 2009 page. City/Town State Zipi Code Date of Inspection D. System Information (coat:) Cesspools (cesspool must be pumped as part of inspection),(locate on site plan): Number and configuration N/A Depth-top of liquid to.inlet Rinvert N/A Depth of solids layer N%A Depth of scum—layer, N/A Dimensions of cesspool N/A Materials of construction N/A Indication of.groundwater inflow Ej Yes ® No. Comments (note condition of soil, signs of hydraulic failure, level of'ponding, condition of vegetation, etc.): - N/A a. Privy (locate on plan): Materials of construction: N/A N/A Dime nsions''a Depth of solids N/A Comments(note condition of soil;sigfd f ponding, condition of vegetation, etc.): N/A M, :... 169 Keveney Lane,Cummaquid•03I08 Title 6 Official Inspec ion Form:Subsurface Sewage Disposal System,Page 13'of 15 .� Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form-Not for Voluntary'Assessments y 169 Keveney Lane, Cummaguid Property Address Y Diana Barjabedian Owner Owner's Name information is 266 Mid pine Road r�mouth Port MA 02675. Janua 13, 2009 required for every p ry page. City/Town state Zip Gode' Date of Inspection D. System Information 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. A . c 2 10'6'� 3 y v`•fir g' C y Z 'y?, r 169 Keveney Lane,Cummaquid-03/06 Title 5 Official lnspedion Fomi:Subsurface Sewage Disposal System'Page t4 of 15 r� Commonwealth of Massachusetts . Title 5 Official Inspection - Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments • M 169 Keveney Lane, Cummaquid #. Property Address _ Diana Barjabedian Owner Owner's Name information is 266 Mid me Road, Yarmouth Port MA 02675 Janua 13,'2009 required for every p rY page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water _„ Check cellar he a lar ❑ Shallow wells.,. { Estimated depth to high ground water: 20'+ feet' Please indicate all methods used to determine the high:ground water elevation::; ® Obtained from system design plans on record i If checked, date of design plan reviewed: 6/3/74 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 = • . SDW 252 Zone A .t 47:4'. 1.5'adjustment You must describe how:you established the high groundwater elevation: Soil was sandy. Hand augered 2' below bottom of leaching with no water found at 15.0'. Groundwater adjustment in.area at the time of inspection was 1.5' Bottom of leaching at 140'was found.not to be Located in the.high groundwater elevation at the time of inspection.Home is located on hill with a minimum drop in grade to water below of 20+'. USGS groundwater maps also show groundwater at approx: 20'. Test hole on permit also showed no groundwater found.. f t 169 Keveney Lane,Cummaquid•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 15 of 15 . .x, } N�FNenrY Keve�e N/ '1 old sYo„v f,dd s• o - � 1 , A. ISI tk - g 9 P � - ➢j �, �Ac 0 , 0 `- Cs� ,_ T QI - Z P D'" 3. A 33 cp to � '_ 1 fig. - • _ —_ PLAN OF LAND IN = to 3Cv (` Ll CVMMAQVID 8n<tNsnoa�E MASS. ro G E R TRUpE (�/1 P C),R E y - _ - ' CT f .'J UNDER SCALE Jim,4�')fi- NOV.9. - ,0 L L.'-W.- NEB•o...Se�.ascR,4wno�.cw���gyeronc 0 NO AOY 1 fi 191➢ `' _. 6asa u F . r .�T" C7� t LOCQ,TION , SEWaC,E PERMIT UO. o� INSTALLER 5 W MF- ADDRESS BUILDERS 1.1 MF- ADDRESS Dt-\TE PERKAIT ISSUED = 7 `f — _L D ATE COKAPLI WlCE ISSUED ; = y '�`' ��� . r, r �� � . n --� � . -a _.. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .........OF........ .. .... .... ..... ................. Appliration Ink Uiqnmal Viarkii Cnons rurtion Vrruift Application is hereby made for a Permit to Construct ( J or Repair ( ) an Individual Sewage Disposal System at: catio dd e or L t ...... . ys 46" -"p1�.OeR.....Y� .2�A4,d ----_---------------- ice. 1`1_ ,�r....�&r-a`""'IWAG, Owner Ad ress Installer Address � d Type of Building Size Lot//r;� ..__Sq. feet U Dwelling—No. of Bedrooms._-__---�-j:........................Expansion Attic ( ) Garbage Grinder (V Other—Type of Building -__________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures`- -------------------------- -- W Desi n Flow_•................... �_.._.___._gallons per person per day. Total daily flow-_----•�:P J--=�--.......gallons. g g P P P Y Y Septic Tat;k t—Liquid capacity . '.gallons Length................ Width ._._.._...... Diameter...........----- Depth.___.._____._.. x Disposal Trench—N� ____________________ Width.......... T�ota z_ .._. �._- Total leaching area-------------.------sq. ft. Seepage Pit No_________ ___________ Diameter_ ...__ Depth e�K low in e _________ _____- otal lea h trea�../.. ._---.-.___-sq. ft. z Other Distribution box ( ) Dosing tank ( ) 0 �� �/'Y/7; - aPercolation Test Results Performed by......_-----------........................................................ Date---------------------------------------- Test Pit No. 1................minutes per inch Depth of Test Pit..-------........... Depth to ground water...---._----.-._...._. (i Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_. ............!---•------g -------------•----- - /--------••-------------- Description of Soil �'�� y ��y -A U -----------�/' W U Nature of Repairs or Alterations—Answer when applicable..----------------------------------------------------------------------------------------------- ----------------------------------------------Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with .the provisions of Article NI 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 th bo r of heal a Sign d._ • --- ------••-•••------------------ ------ --- - ------------ -----------=---------------- - --- ate Application Approved BY . ,- f - 1 Date Application Disapproved for the following reasons------------------------------------------- '------------------------------------------------------------------------ --•-•-.-•--...---•--------•----•••------------------------••••-_.._..-----••-----------------•-------- Date PermitNo........................................................... Issued........................................................ Date ad THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH /41 _ Appliration -for ` Y'tA anal Works Cnonotrur$ion Vrrmft Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal System at catio I d e s or Iot No. Owner Address Installer Address d Type of Building _ Size Lot;l -....Sq. feet Dwelling—No.t-of'Bedrooms---------- ......... _Expansion Attic ( ) Garbage Grinder (� aOther—`T e of Building ___...__._ No. of persons ......................... Showers — Cafeteria ( ) a f YP g ••-; P ( ) Q '" Other fixtures`_ --_... ..... _ ...... - - --------------------------------------------------------------------------------------- W Desi n Flow...................... J allons per person per day. Total daily flow_______�._�J_.�.T,___"'_"`-- gallons. .g �------------------g� P P P Y• Y g� Septic Tank Liquid calacityl __gallons Length---------------- Widtl-_:__---_-.--_.. Diameter----------------- Depth-______....... . xT Disposal Trench—N�_____________________ Width___________ :: __ Tota t _ _ _ �__- Total leaching area--------------.-----Sq. ft. /.� . �Seepage Pit No_____________________ Diameter .__.__..._._..:._ ept Xelow in le _.._:.___ _. ___JTotal leachiu area...__-____-_:__._sq. It. z Other Distribution box ( ) Dosing tank ( ) r�C"''��" �/ �7 Percolation Test Results Performed by ------------------------------------------- Date_._.. Test Pit No. 1_______________minutes per inch Depth of Test Pit.................... Depth to ground water_...__-_____-__-__-_-_-. ,a fX, Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water_. O 1 — -------• s �. .._ /. i Description of, Soil-----`_""-------�~--------�---- �-''�---'`•'�=�---�►-=�'--------- ------------------� -----='=---------1---...------- ---�'e�- U •----------------------=------------------------------------------..................................... ••---•-•--•-•--•-:-----•=•--•-•-•--..........--•-----•--- •-----.°------------ ----- -- - - -- --- �xj _,_Nature of Repairs-,or-Atterati9ns Answer when'apphcable _ ;. -------- -------------------------- --- -------------------------------=-------•------•-------- -----------;-- --------••......•-----... -----. ------;:. -:. Agreement: ` The undersigned agreesito install the aforedescribed Individual Sewage Disposal System in acc2rdance with the provisions of Article X•I/of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued bb t boa of heal . Signid.. ------- ---------•----- ............. rv.{ Date Application Approved BY ---4C . •=-• . -• ---�-- to 7 ! Date Application Disapproved for tli,e following reasons: -----•-----------------------------------------------------•------------------••-•--•-•-••---•-•-- i W Date Permit No................-........................................ Issued: Date THE COMMONWEALTH'OF MASSACHUSETTS BOARD OF HEALTH ' Tler$ifiratr of f 'lampliaurr -, I I C E R Y, That the Individual Sewage Disposal System constructed:( or `Repaired ( ) by --- -•••------------••--------••-•-•-•----••••-----•-•--------•-- -- InstallZc, ea has been installed incordance"with the provisions Of!Article XI of The Sta Sanitary Code as described in the application for Disposal Works.,Gonstruction Permit No............A-X.,57-------------- dated_-. ,t;:T1_YY ................. THE LSSUAN�E 0' THIS CERTIFICATE SHALL. NOT BE CONST UEDk.A4 ARANTEE THAT THE SYSTEM y. L FU CTION`SATISFACTORY. ., DATE....:. y/ • -•:.... ....... Inspector.-•.. ........... . = ............. S THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .......... ....... oF.-........5... r :h:.. -- . -,/l .P-+I A-0.................. No..........2--�::. FEE-./ ......-•-....... VNiaat �rruti$Permission i hereb ranted ...Y g �•--- •---• --_-.�1�-.._.----- - ...............................................--............ to Co or or Repair ( ) an Indivi y4w-144-11,L4 ewage Disposal System . at No..�- 9! yt r� ----- '-------- <,d:d c ......... 4--a_ Street / Dated....(W—T- ••-7 � =:--- as shown on the application for Disposal Works Construction it N _.__ --- ; .4. -. /� /�� r. Board of Hea h DATE................................................... FORM ,1255 HOBBS & WARREN. INC..'PU,�BLISHERS T 40-I'+ Z (EXISTING) W y (EXISTING) T1NG) li] R Q, 7-5'3 5'-8' &-4' - 5 2'-' z , C.t] Q UNE of ROOF NEW (—ovERHANG ABOVE DECK 4 Z z -- -------- -- - NOTE: (o?UVINDOW5 AND DOORS THIS WALL q�p TO FIT `�, N� NOTE: x INTO M5TING OPENING W)OTHS,VHi1Fr IN IIE(D - N ^i w 47 SMStRUCTURAR DRAWING5 FOR Lo N MOMENT FRAME AT THI5 WALL © M ❑M TRANSOM ©ABOVE �M -J• !w D29ANDMAN F WX 61 1 5 µFWHiE 6061 I PAIR )5 K - E- U N --- NEW SUNROOM I H 00 o r --(SEE FitAMING F'I/W)- ABOVE NI z ,1. 2'-4• 3'3' 3 3' I1'rF 3-3• 3'-3• 5'i' 3'-1' 3-I' T-2' w 8'-(Y 4 - REMODELED F G F F G F E C] 00 b D =--- ---�----=---a---=�I� D LIVING ROOM 3K 21 21 3K 3K 21 2.1 3K K 2.1 2J SK N v O 2K \ 1 N _ CL y E I I y EXIST. I DQST. REMODELED 4 d N w NEW K BEDROOM I BEDROOM PORCH N z d "rC O EXIST. I TFER zl E " ¢ �O W N DECK KITCHEN I WWAus5A OCCODFUD0E AND x O _ I _B8'_C.O. EXIST. .I'� 12'-0. NOTE: .BU MG COUNTERS CA51NE75 TO REMAIN i i I - ppST. I LL__7P EXIST. = O 0 O I HALL Ef1Ao 5T. U Z, REF. 7.9'� i5 I f FA .MST. N NDED� i�pp DIO EXIST. u4, M5T.i BATH I BEDROOM m� I I = Eas�-rM TE ^ W G7 BATH v) S a I LL I NEW o+ �1(1/.I� t I ) IN15T. .� 8 a ILN JL- I 2K 2K 2K •� �] Z ' T -r�rr B ------ c c z ¢ ? Ed- L L L 1_I_IJ J J J JJ 4'-T s'� L T EXE T. z cn N I — NEW I g § 5: � a Z B NEW 2s' NEW RC I I e I' PORCH I a v W m �- STORAGE MUDROOM I I a AREA \ II I D E- 4,_I, ----- 1':,- II I COW-APRON ARE 2 II I q, cy_r 4'-a' ICOURAN5 W G' NEW N COS I I Ca I DI I O'•8'2 � a NEW ❑ (ADDITION) �-• p! 4T-9`t 24-3•t `�� WOSTING) (DXISTING) Qom„ ww -� 06 0 � WE � A' —o A IL FIRST FLOOR PLAN GENERAL NOTEs: 1.)CONTRACTOR 15 TO VERIFY EXISTINGRJEW CONDITIONS AND 1L ------ --- ----------- _ EXIST.FIRST FLOOR 2859±S.F. DIMENSIONS IN THE FIELD PRIOR TO THE START OF WORK XE= SCALE ' UNE or 5ECON� NEW FIRST FLOOR = 622+'5:F. 2•) CONTRACTOR TO REMOVE EXISTING DOORS,WINDOWS. Fr, ftDOR ABOVE ® _ REMODELED NEW SECOND FLOOR = I I823 5•F. WALLS,d ROOFING AS REQUIRED FOR NEW CONSTRUCTION. 1/8„— I I-Ou GARAGE - a NEW COVERED PORCH = !44 S.F. 3•) ALL NEW CONSTRUCTION TO MATCH EXISTING IN MATERIAL, �- �, ' LEGEND DETAIL,AND F]N15h.(UNIE55 NOTED OTHERWISE) r u DATE f� EX15TING WALL CONSTRUCTION TO REMAIN 4.) ALL E BUILRK DING CODE (LATORMEST ST THE ON)AND OTHFTT5ER - / � STATE BUILDING CODE(LATEST EDITION)AND ALL OTHER � `� 1 2/27/2(OD I 1 ® NEW WALL CONSTRUCTION APPLICABLE LOCAL CODES cm EXISTING WALL CONSTRUCTION TO BE REMOVED 5.)ANY DISCREPANCIES.ERRORS AND/OR OMISSIONS IN THE NOTES, ' g ® NEW 6MOKVCAR50N MONOXIDE DETECTOR DIMENSIONS,.AND/OR DRAWINGS CONTAINED ON THESE DOCUMENTS /� PROJ. N O. ® NEW HEAT DETECTOR SHALL BE BROUGHT TO THE ATTENTION OF THE DESIGNER PRIOR TO 1u C. 201 1-072 COMMENCEMENT OF CONSTRUCTION.PROCEEDING WITH CONSTRUCTION O 5' 10 15 20 CONSTITUTES ACCEPTANCE OP THESE DOCUMENTS AND ANY STAMP DWG. NO. DISCREPANCIES,ERROR5 AND/OR OMISSIONS BECOME THE t' RESPON5IBILTY OF THE BUILDING CONTRACTOR_ 6J CONTRACTOR TO VERIFY ALL EXISTING DOOR AND WINDOW ROUGH 3K 3K OPENINGS IN THE FIELD AND MAKE ADJUSTMENTS TO WINDOW ORDER AS NECESSARY. O-.'kIGHT 201 1 10-51/Xi A 3'-Y A 10-5 1/2'f ' . HAl "OMAS A. MOORE DESIGN CO. 24'a" (EQSTING) 24'-6.2 3 1'9•S =15T1NG) (DR5TING) i (0015TING) z ^yQ 7- o w UZ ¢ N a oo °N EWDECK UJ O c S 4'-D•± B'-r V-2' 4'd7'f �- W W N MTKAN50M p ANDMEN ABWI:ANDSMEN p + [,t� (/w7 I� F"2961 1 5 FM G=1 I FALK fwH 29G)1 5 I. 4 K 3K 21 2.1 3K Q O ti cq U co4. z w cQ NEW O O 0000 MASTER o BEDROOM � � Ln - O m ¢ I� 4Vr 13'-1'2 6-7 4'•(P r d N W y 3 m 3 GIla d O w � � 0 E-'21 o NE1N I Ey MASTER INEW NEW p c/)N rsi s BATH jW 05ET BALL U z M I C � ON l m E I 7-4•- - 'Zi �i E^N to Z co K)r LEDGEI O L_--- J {. n 91N1C ————————------------ T -H_ W z as w BOOK SHELVES �U a ------------ --- N—E OF LAW b W CCIIJNG B C5 4T-9 t K � 4 (E!(15T(NG) (DtlSTING) G� 2' SECOND; FLOOR PLAN o �" NEW - TV ROOM Z, m WINDOW SCHEDULE TYPE MANUFACTURER'S UNIT ROUGH OPENING GRILLS REMARK5 K H A ANDER5EN TW 210410 3'-0 1/8'x 5'-0 7/8' G/1 DOUBLEHUNG O Q O 0 3 N F 13 C 155/P 5055/C 155 1 O-0i- ' 'x 5'-5 5/8' 10/30/10 MULLED UNTT5 +� A All " A m C TW 2442 2'-6 IV x W-4 7/5' 6/1 DOUBLEHUNG - K D ° ' C 155/F 4055/C 155 1 O'-O'-�-'x 5'-5 5/8' 10/20/10 MULLED UNIT5 z W� Q a K 2K 2K ° . `s_.c:�.y E CX 155 2'-8"x 5'-5 3/8' 1 LTTE CASEMENT _ W T ss T F ' CW 1 55 2'-4 7/8°x S'-5 3/8' 1 LITE CASEMENT w!EGRE55 HARDWARE ,'�Cu A-v: x , G P 3555 3'-5 5/8"x 5'-5 3/8' 1 LITE PICTURE WINDOW :✓/y''� `'� H C 255 4-0 I/2"x 5'-5 3/8' I LITE DOUBLE CASEMENT , K A �] J A41 4'-0 1/2"x 2'-0 5/8' 1 O LITE FIXED AWNING TRANSOM f X t IN ATTIC F ,rt' Q K PICTURE 8'-0"x 5'-5 5/8' 1 UTE CUSTOM PICTURE WINDOW L A 41-2 &-a:t x 2,-0 5/8" 10 UTE FIXED AWNING TRANSOM 1 SCALE : M " A 31-4 12'-0'i x 0-0 5/8' 8 LITE FIXED AWNING TRAN50M m UNFINISHED I'-011 ATTIC IN CXW 155 3'-0 1/2"x 5'-5 5/8' I LITE CASEMENT 'o <` sc 4, P TW 3452 3'-6 1/8"x 5'-4 7/8' 1/1 DOUBLEHUNG s 0r ST '� � ;' DATE Q TW 21046 3'-0 1/8"x W-8 7/5' G/I DOUBLEHUNG /O.NAI- `� J K CN 145 1'-9"x W-5 5/8' 5HOKT FRACTIONAL CASEMENT w/TEMPERED GLA55 i "—' h 12/27/20 I I 5 P 3545 3'-5 5/8"x W-5 5/8' SHORT FRACTIONAL FIXED PICTURE w/TEMPERED GLA55 PROJ. N0. T " TW 2431 O I 2'-6 I/8°x 4'-0 7/8' Gil DOUBLEHUNG 201 1-072 U TW 210310 3'-0 11&x 41-0 7/8' 6/I DOUBLEHUNG v W R 2431 O 2'-4 7/8°x 2'4 7/8' 4 UTE CIRCLE WINDOW STAMP : DWG. NO. NOTE#l:CONTRACTOR TO VERIFY ALL QUANTITIE5 AND 5M OF WINDOWS WITH.OWNER AND I z'1 ur 12'1 1/2' ROUGH OPENINGS WITH WINDOW MANUFACTURER PRIOR TO ORDERING OF.WINDOWS NOTE#2:CONTRACTOK TO VERIFY ALL EXISTING WINDOW ROUGH OPENING 51ZE5 IN THE FIELD 'OPYRIGHT 201 I PRIORTO.ORDERING OF WINDOWS A2 24'3 t Y THOMAS A. MOORS DESIGN CO. (D(ISTING) NOTE#3:ALL NEW WINDOW5 AND DOORS SHALL HAVE APPROVED PRE-CUT PLYWOOD PANEL5,NUMBERED AND STORED IN BA5EMENT.PROVIDE PRESET APPROVED SCREW FASTENERS WITH EACH PANEL. SYSTEM PROFILE ALL SYSTEM COMPONENTS OMPON NTT BE MARKEDAPE OR PROVIDE MIN. 20" OIAM. WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. ACCESS COVERS TO WITHIN 6" OF FIN. GRADE 2" PEASTONE OR GEOTEXTILE CONCRETE COVERS TO WITHIN 3" GRADE PROP. VENT \ TOP FOUND. EL. 34.1' FILTER FABRIC OVER STONE o 34.0' MINIMUM .75 OF COVER OVER PRECAST 2% SLOPE REQUIRED OVER SYSTEM 35.0' j ocu c� Cb PRECAST H-10 BLOCKS OR RISERS (TYP.) PRECAST RISERS 4•SCHao P� 2'0 4"OSCH40 PVC MORTAR ALL H-10 PIPES LEVEL 1ST 2' COMPONENTS E ENDS (TYP-) INV'S EL. 29.17' 3' SIDES 30.17' 10• PROPOSED 14" �00000000' °. °• o°•o°°o°.o°° ;�. 1500 GAL H-10 TEE ��®® 0 �00TEPEEP'Emn MM 0 -���0 ° 0-° ° �r o 29.90 TEE �29.659 ° 000 ° ° o ° SEPTIC TANK0 ` °o°o°o°o ®� 'o°o°o°o°0 00000000000 00 O >°o°o°o°o > o 0 0 04' LIQ. LEVEL 0 0 0 0 0 0 0 0 0 o ap®��p p�Qp®��® F-®Op q F Dp� o 0 0 00 0 0 0 0 0 0 0 0 0 0 00 0 0 0ACME OR EQUAL GAS BAf}1E o �o°ono°ono°o o� >°°o°o°o°°o oaaaao®o�oo 000a oo .00000000 ' °°°°°°°° °°°°°°°° 27.17' 29:53 29.36 °°°°°°°o . 00000000 :••. 6" MIN. SUMP01 0000000000000000000000( 12" MIN INT. DIM. H-20"500 GAL. LEACHING 'CHAMBER BY ACME PRECAST OR EQUAL. 00000^000^0000 0 0 0 o c 3/4"-1-1/2" DOUBLE WASHED STONE n n n n n. n�n�n�nOn�r (5) UNITS REQUIRED pNVERT,our of EXIST. sT `� ALL AROUND PRECAST STRUCTURES LOCUS MAP 6" CRUSHED STONE OR MECHANICAL OVERALL DIMENSIONS TO OUTSIDE OF STONE: 47.5' X 10.83' i COMPACTION. (15.221 (2]) 8.9' 18+' SCALE 1"=2000't ASSESSORS MAP 351 PARCEL 57 MIN. LOT LIES WITHIN FLOODZONES A11 EL 1 18.25' BOTTOM TH-1 & 2 11 AND C HOUSE IS IN C( 2 % SLOPE) ( 1 % SLOPE) ( % SLOPE) NO GROUNDWATER FOUND ( ) LEACHING GROUNDWATER EXPECTED AT EL. 9t FOUNDATION 28' SEPTIC TANK 12' D' BOX 21' FACILITY VARIANCE REQUESTED UNDER CMR Q 15.221 (7): SAS TO BE 4.8' NOTES , SYSTEM DESIGN: TEST HOLE LOGS BELOW FINISH GRADE (1.8' VARIANCE) 1. DATUM IS NGVD GARBAGE DISPOSER IS NOT ALLOWED 2. MUNICIPAL WATER IS EXISTING ENGINEER: ARNE H. OJALA, PE, SE DESIGN FLOW: 5 BEDROOMS ® 110 GPD = 550 GPD DONALD DESMARAIS, RS 3. MINIMUM PIPE PITCH TO BE 1/8" PER Fool. USE A 550 GPD DESIGN FLOW WITNESS: DATE: 10/14/11 4. DESIGN LOADING FOR SEPTIC TANK < 5 MIN/INCH TO BE AASHO H-1Q: CHAMBERS AND D-BOX TO BE H-20 SEPTIC TANK: 550 GPD (2) = 1100 GPD PERC. RATE _ 5. PIPE JOINTS TO BE MADE WATERTIGHT. USE A 1500 GAL. SEPTIC TANK CLASS I SOILS p# 13425 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH 310 CMR 15.000 (TITLE 5.) , _ , LEACHING: ELEV. ELEV. ELEV. ELEV. SIDES: 2 (47.5 + 10.8) 2 (.74) = 172.5 GPD Q Q Q Q 1 2 3 4 7. THIS PLAN IS FOUR PROPOSED WORK ONLY AND NOT TO p" 35.25' 0" 35.25' 0" 36.6' 0" 36.6' BE USED FOR LOT LINE STAKING OR ANY OTHER BOTTOM 47.5 x 10.8 (.74) = 379.6 GPD PURPOSE. A A A 0 A 8. PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. TOTAL: 746 S.F. 552.1 GPD F1O/YF SL UNSUIT. /SL IT. XA�SL UNSUIT. /SL UNSUIT. " 4/3 „ 1OYR 4/3 " 1OYR 4/3 „ 10YR 4/3 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED USE (5) 500 GAL. LEACHING CHAMBERS (ACME OR EQUAL) B /B �B B WITHOUT INSPECTION BY BOARD OF HEALTH AND WITH 2.5' STONE AT ENDS AND 3' AT SIDES PERMISSION OBTAINED FROM BOARD OF HEALTH. AM UNSUIT. LOAM UNSUIT. /LOAM LOAM 10. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING R 6/4 10YR 6/4 10YR 6/4 UNSUIT. 10YR 6/4 UNSUIT. DIGSAFE (1-888-344-7233) AND VERIFYING THE 36" 36" 36" 36" LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES C1 /C1 /C1 C1 PRIOR TO COMMENCEMENT OF WORK. SILT LOAM SILT LOAM , UNSUIT. SILT LOAM UNSUIT. SILT LOAM/ UNSUIT. 11. ANY UNSUITABLE MATERIAL ENCOUNTERED SHALL BE i i i UNSUIT. i i i i i i i i REMOVED 5' BENEATH AND AROUND THE PROPOSED 2.5Y 6/4 2.5Y 6/4 3 25' 120" 2.5Y 6/4 26 6' 120 2.5Y 6/4 26.6' LEACHING FACILITY. 144 3•25 144 12. EXISTING LEACHING FACILITY SHALL BE PUMPED AND REMOVED 13. WETLAND FLAGGED BY PAUL SHEA, PWS FROM C2 C2 C2 C2 INDEPENDENT ENVIRONMENTAL CONSULTANTS, INC. PERC PERC 0 1sa" 0 14a" MCS MCS MCS MCS 204" 2.5Y 6/6 18.25' 204" 2.5Y 6/6 18.25' 192" 2.5Y 6/6 20.6' 192" 2.5Y 6/6 20.6' .7 FLAG A-3 NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED FUG A�.�-E-� 9.39 �• ` .� 1 1 ��. .•32 LAND SUBJECT TO COASTAL 1 1 •�.. / 1 STORM FLOWAGE 1 O�5 'F�iRG A-4 X FLOODZONE EL. 11 X.04 X• , 1 .T1 °0 10. 4 \ �' +11.35 , 11 3 I ' X1 ��11.57 �11� �\ / 1+11 83 \ i �10.0\ i QY 11.11 +12.55 *12.49 \ . . A-5 �•' / 9.49 -1 .27'`• ` pp }12 78 10.6 8.94 4�. 9�. TRANSECT (TYP) � 12.74 'k.AG A-6 +11.96 PARCEL 2A 10.7 �9.23 1.5 ACRES +12.74 ( 11.65 1�20W8 \ 10.82 NO COASTAL BANK \ 9 71 (< 10%SLOPE THROUGH EL. } 13.35 \ •� 10.00 11) .93 � 11.00 10.96 $ 2 \ 1 92 FLOODZONE \� \54 =�COASTAL BANK) BOULDER'\ \ ss 11.82 +13.44 tl4.1 +15.40 .16 10.94 / 15.17 16.13 \ 0 �S \\ •• \ ••�•••�.FLAG A-8 M 11.19 +/�5.47 16.84 76 .79 /� \16.70 +\1 .51 11.78 \ 17 \ 16.09 PARCEL 2A / �8 °�� 1.5 ACf / 5 19. +16.75 v1` + 9 17.4 +1 /-K17.16 \ ' 18.82 \� 20 j \ 27 +\19.62 / 2 +/19 5 PROP •.` \:67 \+20 .87 -22 21.62 PROP. E �'r STAKED/TILE FENCE •``° 23 ZONING SUMMARY � . 3 . 2 POSED SUNROOM EXIST. STONEWALL 28. 'h4.71 �sr ZONING DISTRICT: RF-1 W/DECK ABOVE � +25.50 MIN. LOT SIZE 43,560 S.F. 6 •-Z9.49'.� 32.6' +25. s` MIN. LOT FRONTAGE 20' 24.0�' o + 28.97 MIN. LOT WIDTH 125' +27. _ _ N +26.35 26 EXISTING MIN. FRONT SETBACK 30' "c� + 9.82 a ^9.58 27 0 27.04 DWELLING MIN. SIDE SETBACK 15' °' y EXIST. DECK / 12. (REMOVE) •�.. +29.59 r2 �O +29. 28 SITE IS NOT LOCATED WITHIN RESOURCE ��� N PROP. �.. F` 0.08 DECK EXISTING PROTECTION OVERLAY DISTRICT A DWELLING \ ` �.. 29 TOP FNDN. 29.69 +31.26 5' REMOVAL OF UNSUITABLE SOIL REQUIRED p ELEV. = 34.1' 30 AROUND PERIMETER OF LEACHING FACILITY, `92 / +31.7 �3 99 84 DOWN TO SUITABLE SOIL LAYER. REPLACE 31 WITH CLEAN MED. SAND, TO MEET SPECIFICATIONS OF 310 CMR 15.255(3) OWNER OF RECORD 31.60 32.28 -32 SANJAY & KALPANA PALIT GARAGE �� , .50 32/18 FENCE 169 KEVENEY LANE PRO ORCH 9 ` _ a - .35 33 POSTS CUMMAQUID SLAB T EL. = 34.6' I STONE X fO ' DRIVE o +34 - +33.78 34 34.51 +34.48 4• 9CB \ 3-N'd I +35 25 I 35 5.13 ]I- 6 REFERENCES .�5 BENCHMARK: USE \ � 'ROCK 1 \99 I CONC. SLAB AT \ TH 2 05 ELEVATION 34.6' +3�7 - �� 5 /+ 6.76 DEED BOOK 24872 PAGE 311 ELEC. 3� - - - - BOOK 242 PAGE 139 i TH 3 1009- RESERVE�: 4- PLAN , 7, MET Tt1 4 G� -3 - - - - -k-3 5.7 4 \ 58--- \ .98 3 /1�37.31 Q +\36.25 \ ,, 37 OCK i .-36.62 37.18 37 O // 35. 4 +36.93 \ �� \ 17.97 \ \\ 8 PROP. VENT WITH CHARCOAL FILTER \ �8.42 AND BUGSCREEN (FINAL PLACEMENT BY +37.7737.79 ` 38 / CONTRACTOR WITH HOMEOWNER \ ti k /, CONSULTATION) 36.39 38.51 I 38.55 8. l FN 38.61 c V FND 9.0 �QGF 8.56 SITE PLAN i TO BE FILED WITH THE BOARD OF HEALTH +38.52 FOR 169 KEVENEY LANE CUMMAQUID PREPARED FOR SANJAY AND KALPANA PALIT off 508-362-4541 jN of y fax 508-362-9880 ��� qs. �jH OF Mqs OCTOBER 19, 2011 I downcape.com © �� DANIEL yes ��� Sly. NOVEMBER 7, 2011 (EFF. DEPTH) A. N Scale: = 20 �g � o oANI6LA. � „ , down cope eftgineefing, Inc. OJALA OJALA CIVIL N civil engineers P 465 0 10 20 30 40 50 FEET °F o� o land surveyors `°0 S` e ISTE 939 Main Street ( R to 6A) t' ZO`� Fs � C YARMOUTHPORT MA 02675 DATE DANIEL A. OJALA, . .L.S. � d � u o0 Cl PO i v l� �aN ��STR�c i J �50 331 `.. , Ab �I ���pe