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Home My WebLink About0420 BAY LANE - Health 420�Bay Lane Centerville A= 186-015 -001 fog I UPC 12534 No.2,,,,_1531_.ORs NAYTINGS,ON.. Commonwealth of Massachusetts 01 =oaf 'N Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 420 Bay Lane Property Address Dan &Lisa Gorin W_ Owner Owner's Name information is required for every Centerville MA 02632 7/11/20175 page. City/Town State Zip Code Date of InsV lion �1 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 A. General Information filling out forms Lf / on the computer, vv o7 f (�tp use only the tab 1. Inspector: key to move your cursor-do not James Ford use the return Name of Inspector key. Ford Septic Services, LLC Company Name P.O. Box 49 Company Address Osterville MA 02655 City/Town State Zip Code 508-862-9400 S12482 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails Needs Further a ation by the Local Approving Authority 7111/17 Inspect s Signature Date The s em inspector shall submit a copy of this inspection report to the Approving Authority(Board of Hea h 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. 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 0�i Commonwealth of Massachusetts H Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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): 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 l Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. 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 15ins-M3 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 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/1.1/2017 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 due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 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 obstructed pipe(s). Number of times pumped.- El ® 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 ifthe 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. l5ins•3/13 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M e 420 Bay Lane Property Address Dan & Lisa Gonn Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The 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): 4 Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. Cityfrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: unavailable Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts N Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: unavailable 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): l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: system installed - 12/17/2007 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 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: 14" feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 - H-10 Sludge depth: 2 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts H _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. Cityrrown 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 24 Scum thickness 1 Distance from top of scum to top of outlet tee or baffle 5 Distance from bottom of scum to bottom of outlet tee or baffle 12 How were dimensions determined? measure stick Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tees were present. There was no sign of leakage. Grease Trap (locate on site plan): Depth below grade: n/a 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 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): N/a 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 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert even 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.): The D-box is in the driveway and is H-20. A steel cover was to grade. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 1 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 4-flowdiffussors 12'x40'x2' ❑ 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.): The Flows were dry and clean and in new condition A steel cover was to grade. 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 (Sins-3/13 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 r 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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.): N/a 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments r 420 Bay Lane 4„M Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 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 GArA5_L FA A f3 3 oil � yy F /S6 3S O. j I 3 as ' c yy 33 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts F Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 page. Cityrrown State Zip Code Date of Inspection D. System Information (Cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 13 +/. 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: Topo and water contours map. ❑ Checked with local excavators, installers -(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: see above Before filing this Inspection Report, please see Report Completeness Checklist on next page. l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a 420 Bay Lane Property Address Dan & Lisa Gorin Owner Owner's Name information is required for every Centerville MA 02632 7/11/2017 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 ry- Town of Barnstable Barnstable ti IU" MA Board of Health �edcaCly ,0�` � 111A 200 Main Street, Hyannis MA 02601 I.F 2007 Office: 508-862-4644 FAX: 5087790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi August 31, 2007 Mr. Stephen Wilson, P.E. Baxter Nye Engineering and Surveying 78 North Street Hyannis, MA 02601 RE: 420 Bay Lane, Centerville. Dear Mr. Wilson, You are granted variances on behalf of your clients Daniel and Lisa Gorin, to construct an onsite sewage disposal system at 420 Bay Lane, Centerville. The variances granted are as follows: 310 CMR 15.211: To place the soil absorption system five (5) feet away from the property line, in lieu of the ten (10) feet minimum setback required. Section 3601-1 of the Town of Barnstable Code: To place a soil absorption system 82 feet away from a wetland; in lieu of the one-hundred feet minimum separation distance required. These variances are granted with the following conditions: (1) No more than four (4) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) The engineered plans shall be revised to show two feed lines into the soil absorption system (every twenty feet). (3) The septic system shall be installed in substantial conformance with the revised engineered plans. Q:\VvTFILES\WilsonSteveGofin2OO7.doc (4) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the revised plans. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to it's close proximity to wetlands. Sincer ly yours, Wa ne filler, M.D. Chairman Q:\WPFILES\WilsonSteveGorin2007.doc e , iy pFTNE I DATE: 6(P 2- i'. . . FEE: l� � twtxsres�. y MASS. 1639. REC. BY _ Town of Barnstable.D. DATE: 6 Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORM LOCATION Property Address: y20 t3ey Lana , -4c4jw, ,//c Assessor's Map and Parcel Number: P►4 19,6� P,&I 15-601 Size of Lot:_ ti 3,5 Q eyes V.tetlands Within 300 Ft. Yes X Busi.ness.Name: No Subdivision Name: APPLICANT'S NAME: _p&&i,cl Phone Did the owner of the property authorize you to represent him or.her? Yes PROPERTY OWNER'S NAME CONTACT PERSON Name: Da.,,o1 R s L i4a N Go r�,n Name:6kyhan A. IA;ism, P.E 13aXim- Nye Address: qZ0 a3 j e G�.y/eid.%/e� MA Address: 7tB I�for1+., St. Nyavtvits 014 Phone: Phone:(508)7 7 t 7 50,z a kt I3 VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) G.t-6CL�a11 a NATURE OF WORK: House Addition ❑ House Renovation Repair of Failed Septic S stem Ln -ems Checklist(to be completed by office staff-person receiving variance request application) r _ Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) W Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) r— _(� Signed letter stating that the property owner authorized you to represent him/her for this request �`- Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applican s expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) /Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,R.S.,Chairmac) NOT APPROVED Sumner Kaufman,M.S.P.H� 4 REASON FOR DISAPPROVAL Wayne A.Millep,;PNR C:\Documents and Settings\decolIik\Local Settings\ emporary Internet Files\OLKFB\ I Q.DOC 1 �� MAIL-IN REQUESTS Please mail the completed variance application form to the address below. Also include four copies of engineering plans, house plans, authorization letter, etc (see check-list below). In addition, please include the required fee amount (see fees at bottom of this page). Make $85.00 check payable to: Town of Barnstable. Our mailing address is: Town of.Barnstable Public Health Division 200 Main Street Hyannis, MA 02601 Checklist _ Four(4)copies of the completed variance request form _ Four(4)'copies of engineered plan submitted(e.g.septic system plans) Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen.plans) Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) $85.00 variance request application fee (no fee for lifeguard modification renewals, grease trap variance renewals [same cwnerneasec only],outside dining variance renewals[same ownerleasee only],and variances to repair-failed sewage'disposal systems [only if no expansion.to the building proposed]) Variance request submitted at least 15 days prior to meeting date . FOR FAXED REQUESTS Our fax number is (508) 790-6304. Please fax a completed application form. Also, you must mail the required $85.00 fee. Please make the check payable to: Town of Barnstable. The check must be mailed to the address listed above. 'In addition, please mail four copies of engineered plans, house plans, authorization letter, etc. (see check-list below): Checklist -- Four(4)copies of engineered plan submitted(e.g.septic system plans) Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) $85.00 variance request application fee (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasce only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]). Variance request submitted at least 15 days prior to meeting date For further assistance,on any item above, call (508) 862-4644 V ' June 19t', 2007 Board of Health Town Offices 200 Main Street Hyannis,Massachusetts 02601 Re: 420 Bay Lane, Centerville Members of the Board, This letter is to inform you that I have authorized Stephen A. Wilson,P.E.to represent me for the variances being requested at the above noted location. Sincerel , C moi #2007-016 Goi inBOHLettendoc • ti 1 A /I ` 0401 M • \ 4 S�.tC. ,92 Iw�rlr s ysy.ylnr [s•L � 1 i�`J 3�LI.�e/aT ��` x•. J. 7 JG To G. .: 1 it \ e� Wtt I a �• � . 6 � I i tg-Z o ao�wtT tl . �,?e ..qo 4C, tov► i' c , ® we ,_ ✓ e 31. 1 Z4a io 3 / +. •tt is O i . I '1:21 Y �t►�' 54C. . aL r. J.6t 94. t pv. ------------ ABUTTORS MAP BAXTER NYE ENGINEERING & SURVEYING Abutters List Map Parcel Owner&Address 186 16 A.P. MacDonald P.O. Box 739 Centerville, MA 02632 186 15-002 R.R. Graham 430 Bay Lane Centerville, MA 02632 186 34 T.R. Lamminen 980 Main St. Centerville, MA 02632 186 29-002 I.M. Tolbert, Trs. 142 Bay Lane Centerville, MA 02632 2007-016 Transmittal Letter To: Board of Health 200 Main Street Hyannis,MA 02601 w p Attn: inn Mc-Kc4» From: Stephen A. Wilson, P.E. Subj ect: G c, -S,' L4.1.#_ Date: 7 - We are sending you E Attached ❑Under Separate Cover The following documents: 0 Prints❑Order of Conditions El Variance Approval❑Recording Slip ❑Septic System Permit ❑Notice of Intent.❑Other DATE QUANTITY DESCRIPTION 7-/1- O Aw Pmh c avert d!u 4 - See,4 /lc These items are transmitted as checked below: L Z!5 ® For Your Use ❑ As Requested ❑ For Your Files �? Co ❑ For Review and Comment ❑ For Recording ❑ As Required - Other: P7 4 n? G Q ZLE Additional Distribution File No. 2,0 0'7 -p!G Baxter Nye Engineering&Surveying Phone: 508-771-7502,ext.13 78 North Street,3rd Floor Fax: 508-771-7622 Hyannis,Massachusetts 02601 E-Mail:swilson@baiter-nye.com Transmitta1Lettff5.doc Town-of Barnstable �pF1HE 1p�� Regulatory Services Thomas F. Ceder, Director * $ARNSTABLE, ' 9$A 639• a�°� Public Health Division TFD Mp'l Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 22, 2007 Mr& Mrs Daniel Gorin 420 Bay Lane Centerville, MA 02632 The septic system located at 420 Bay Lane, Centerville, MA was last inspected on April 20`h9 20071)by James M. Ford, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995 TITLE 5 ( 310 CMR 15.00)due to the following: Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool. You have 60 days from the date of the system failure to bring the system into compliance. If there are any questions about this reminder, please feel free to contact the Barnstable Health Department. BARNSTABLE HEAL H DEPARTMENT Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health .{ ;. 1 TOWN OF BARNSTABLE LOCATION � .7c1L-- SEWAGE # `VILLAGE —p'�G�R� ASSESSOR'S MAP & LOT G—D/5=�V/ IN& r r WS NAart^ R HGN SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 6 (size) NO.OF BEDROOMS aO 'y BUILDER OR OWNER ;(C192969ti2 "�'''� PERMITDATE: A) COMPLIANCE DATE: Separation Distance Between Maximum Adjusted Groundwater able to the Bottom of Leaching Facility Feet''y 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 U.S. Postal Service-r. CERTIFIED MAILT. RECEIPT (Domestic Mail Only; O D' a Postage $ 0 Certified Fee ,L 02 Return Receipt Fee �C� Postm (Endorsement Required) ./ Here rn N (L ED Restricted Delivery Fee 2 }„ CO —D (Endorsement Required) 2 4 J Total Postage&Fees $ 1- 7 ti Ln Q S To ''--------------------- or PO Box No. cty A PS Form :00 June 2002 Certified Mail Provides: A mailing receipt (asianay)Z00Zeun( 008E�odSd ■ ■ A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Maile or Priority Maile. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE,IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Retum Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted-Delivery". ■If a postm on the Certified Mail receipt is desired,please present the arti- cle at the�ost office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. ., IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery,information is not available on mail addressed to APOs and FPOs. SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired: X ❑Agent ■ Print your name and address on the reverse - ❑Addressee so that we can return the card to you. . R eived by(Printed Name) C.Dat Del' ery ■ Attach this card to the back of the mailpiece, �� or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from Rem i? Yes If YES,enter delivery address below: ❑No INV,1=r''Bi Mrs Daniel Gorin 420 Bay Lane I Centerville, MA 02632 3. Service Type ❑Certified Mail ❑Express Mall ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. _J- = 4. Restricted Delivery?(Extra Fee) ❑Yes' 2. Article Number (Transfer from seMce label 7005 116 0 000010191; 0447 PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATESC�E?�ii1 t :. 7uy F� ass • Sender. Please print your name, address,�� ZIP+4 6this'6�6x• LP j PIBLIC HEALTH DEPARTMENT TOWN OF BARNSTABLE 200 MAIN STREET I i .HYANNIS, MA 02601 I I I I ifll1l!111111tf1111!!!1lllflf!F7►f!!�lffittlflll!!3!!f!tf�fll� Town of Barnstable GF tME Tp� Regulatory Services sActNsrABLE, Thomas F. Geiler, Director 9 : w Public Health Division Arfp�,�a, Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 22, 2007 Mr&Mrs Daniel Gorin 420 Bay Lane Centerville,MA 02632 The septic system located at 420 Bay Lane, Centerville, MA was last inspected on April 20th, 2007,by James M. Ford, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails"under the guidelines of 1995 TITLE 5 ( 310 CMR 15.00) due to the following: Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool. You have 60 days from the date of the system failure to bring the system into compliance. If there are any questions about this reminder, please feel free to contact the Barnstable Health Department. BARNSTABLE HEAL H DEPARTMENT Thomas A. McKean, R.S., C.H.O. Agent of the Board of Health COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONM.ENTAL-AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION J CX) Property Address: 420 Bay Lane Centerville, MA 02632 Owner's Name: Dan and Lisa Gorin Owner's Address: Date of Inspection: April 20,2007 Name of Inspector: (Please Print) James M. Ford. " Company Name: James M.Ford Mailing Address: P.O.Box 49 Osterville,MA 02655-0049 Telephone Number: (508)862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the'sewage disposal system at this address and that the information- port below is true,accurate and complete as of the time of the inspection. The inspection was performed based d ny training and experience in the proper function and maintenance of on site sewage disposal systettVl I am a,DEP c 03 approved system inspector pursuant'to Section 15.340 of Title 5(310 CMR 15.000). The sys , Passes .9 Conditionally Passes f,.. N ee s Further Evaluation by the Local Approving Autho ity ✓ ail Inspector's Signature: Date: May 3, 2007 The system inspector shall sub a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of complet' g this inspection. If the system,is a shared system or'has a design flow of.10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 420 Bay Lane Centerville, MA Owner: Dan and Lisa Date of Inspection: April 20, 2007 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the "Conditional Pass".section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if.a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or breakout or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 420 Bay Lane Centerville, MA Owner: Dan and Lisa Date of Inspection: April 20, 2007 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. The system has a septic tank and SAS and the,SAS is less than 100 feet but 50 feet or more from a private water supply well.**. Method used to determine distance **This system passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 420 BU Lane Centerville, MA Owner: Dan and Lisa Date of Inspection: April 20, 2007 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the-surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. ✓ Any portion of the SAS,cesspool or privy is below,high ground water elevation. ✓ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] Yes (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as . described in 310 CMR 15.303,therefore the system fails.. The°System owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) 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. 4 ,. Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 420 Bav Lane Centerville, MA Owner: Dan and Lisa Date of Inspection: April 20, 2007 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ _ Has the system received normal flows in the previous two week period? ✓ Have large volumes of water been introduced to the system recently or as part of this inspection? ✓ Were as built plans of the system obtained and examined?(If they were not available note as N/A) ✓ Was the facility or dwelling inspected for signs of sewage back up? ✓ _ Was the site inspected for signs of break out? ✓ _ Were all system components,excluding the SAS,located on site? ✓ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? ✓ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes No ✓ _ Existing.information. For example,a plan at the Board of Health. ✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)].. 5 Page 6 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 420 Bay Lane Centerville, MA Owner: Dan and Lisa Date of Inspection: April 20, 2007' FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example:.110 gpd x#of bedrooms): 594-per design plan Number of current residents: 5 Does residence have a garbage grinder(yes or no): Yes Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): epd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or-no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Pumped after inspection Was system pumped as part of the inspection(yes or no): Yes 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) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: approximately 1994 Were sewage odors detected when arriving at the site(yes or no): No 6 f Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 420 Bay Lane Centerville, AM Owner: Dan and Lisa Date of Inspection: April 20, 2007 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 12" Material of construction: ✓ concrete _metal _fiberglass polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1500 a� 1. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: -- Scum thickness: 3" Distance from top of scum.to top of outlet tee or baffle: -- Distance from bottom of scum to.bottom of outlet tee or baffle: -- How were dimensions determined: Measurin z stick Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.). The tees were present The liquid level was above the outlet tee and backing up from the leach pit. Water was running constantly into the tank and no one was home Told owner about the leak. GREASE TRAP:. None (locate on site plan) Depth below grade: Material of construction: _concrete '_metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffler Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 420 Bav Lane Centerville, MA Owner: Dan and Lisa Date of Inspection: April 20, 2007 TIGHT or HOLDING TANK: None (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/day Alarm present(yes or no): Alarm level: Alarm in.working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) 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.): The.D-box was not dup up it is under the driveway PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms.in working order(yes or no) Comments(note condition of pump chamber, condition of pumps and appurtenances,etc.): 8 f Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 420 Bay Lane Centerville, MA Owner: Dan and Lisa Date of Inspection: April 20, 2007 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 4'x 6'(600 zaL)H-20 with 4'stone per designplan leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative.system Type/name of technology:. Cormnents(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): The liquid level was above the inlet Pipe and up to the cover. The pit is in failure. The bottom to grade was 6.5' CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to,inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no):. Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Cormnents(note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 420 Be Lane Centerville, MA Owner: Dan and Lisa Date of Inspection: April 20. 2007 ------ 3i��£114 Provide a sketch of the sewage disposal system including ties to at least two permanent referenc e landmarks or benchmarks. Loca e all wells within 100 feet. Locate where public water supply enters the bui ding. vno y jai y5 Aa.- 3s as - s3 A3' a$, Ua Ay ' aa, cm� 10 i Y Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C • SYSTEM INFORMATION(continued) Property Address: 420 Bay Lane . Centerville. MA Owner: Dan and Lisa Date of Inspection: April 20 2007 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 15 +/- feet Please indicate(check)all methods used to determine the high ground water.elevation: ✓ Obtained from system design plans on record-If checked,date of design plan reviewed: 1983 Observed site(abutting property/observation hole within 150 feet of SAS): ✓ Checked with local Board of Health-explain: topographic and water contours maps Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic and water contours maps the maps were showing approximately 15'+/-to groundwater at this site. This report has been prepared only for the septic system and components described herein. This septic system has been inspected and failed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed,written or implied, relating to the septic system, the inspection, this report and/or any components of the septic system which have not been located and inspected. 11 Commonwealth of Massachusetts * a Executive Office of Environmental Affairs ' Department f Environmental Protection ��p t o 1✓ C F �� One Winter Street, Boston MA 02108 (61 n 29 :p00 TQ < O a-I da � TRUDY CORE Secretary e ARGEO PAUL CELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: 420 Bay Lane, Centerville, MA Name of Owner: Mike MacDonald Address of Owner:25 Lewis Farm Road Date of Inspection: December 13, 1999 Duxbury, MA 02332 Name of Inspector: (Please Print) James M. Ford I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: James M. Ford Mailing Address: P.O. Box 49, Osterville, MA 02655-0049 Map: Telephone Number: (508)862-9400 Parcel: 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 Eval ion By the Local Approving Authority ils Inspector's Signature: 1 . Date: December 15, 1999 0 The System Inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. N=AND COMMENTS i. revised 9/2/98 Page Iof11 Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 420 Bay Lane, Centerville, MA Owner: Mike MacDonald Date of Inspection: December 13, 1999 k INSPECTION SUMMARY: Check A, B, C, or D: A. SYSTEM PASSES: ✓ I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure criteria not evaluated are indicated below. COMMENTS: 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. 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, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection; or the septic tank,whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health.. Sewage backup or breakout or.high static water level,observed in the distribution box is due-to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health) _ broken pipe(s)are replaced ; _ obstruction is removed distribution x i 1 r 1 box s evened o 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 revised 9/2/98 Page 2of11 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) ' roperty Address: 420 Bay Lane, Centerville, MA ` caner: Mike MacDonald , r Date of Inspection: December 13, 1999 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR 15.303(1)(b) THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system.(W.and.the SAS is:within 100 feet to a_.surface water supply or `r:tributary to'a surface water supply: The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public'water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approximation not valid). 3) OTHER revised 9/2/98 Page 3of11 t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 420 Bay Lane, Centerville, MA Owner: Mike MacDonald Date of Inspection: December 13, 1999 D. SYSTEM FAILS: You must indicate either"Yes" or"No" as to each of the following: I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No 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 overloaded or clogged SAS or cesspool. Static liquid level in the.distribution-box above outlet,invert due to.aq.overloaded or clogged.SAS or cesspool. Liquid depth in cesspool is less than 6" below invert or available volume is less than 1h day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped_. Any portion of the 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. 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria, volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No 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 upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 420 Bay Lane, (enterville, MA Owner: Mike MacDonald t Date of Inspection: December 13, 1999 e:. Check if the following have been done::You must indicate'either"Yes" or,"No"as to each'of the following: Yes No ✓ _ Pumping information was provided by the owner,occupant,or 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. (*The house was vacant.) ✓ _ As built plans have been obtained and examined. Note if they are not available with N/A.� r , ✓ 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. ✓ _ All 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 conditions of baffles or tees, material of construction,dimensions; depth of liquid;depth of sludge,depth of scum:_, The size and location of the Soil Absorption System on the site has been determined based on: ✓ _ Existing information. For example,Plan at B.O.H. ✓ _ Determined in the field(if any of the.failure criteria related to Part C is at,issue,approximation of distance is unacceptable) [15.302(3)(b)). ✓ _ The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. _ t revised 9/2/98 Page 5of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 420 Bay Lane, Centerville, MA Owner: Mike MacDonald Date of Inspection: December 13, 1999 FLOW CONDITIONS - RESIDENTIAL: Design flow: 110 g.p.d./bedroom. Number of bedrooms(design): n/a Number of bedrooms(actual): 4 Total DESIGN flow n/a Number of current residents: 0 Garbage grinder(yes or no): n/a Laundry(separate system)(yes or no): No; If yes, separate inspection required Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last two year's usage(gpd): 1998-145,000 Rals.: 1997-144.000 Qals. Sump Pump(yes or no): No Last date of occupancy: Approximately November 1, 1999 COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: gt)d(Based on 15.203) Basis of design flow 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: Punwed in 1998 -per owner System pumped as part of inspection(yes or no): Yes If yes,volume pumped: gallons Reason for pumping: Maintenance 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) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other APPROXIMATE AGE of all components,date installed(if known)and source of-information: -S years ago-per owner Sewage odors detected when arriving at the site: (yes or no) No revised 9/2/98 Page 6of11 II 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 420 Bay Lane, Centerville, MA Owner: Mike MacDonald Date of Inspection: December 13, 1999 BUILDING SEWER: _ (Locate on site plan) Depth below grade: Material of construction: _cast iron _40 PVC _other(explain) Distance from private water supply well or suction line Diameter ; Comments: (condition of joints, venting,evidence of leakage,etc.) SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 12" Material of construction: ✓concrete _metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age_ Is age confirmed by Certificate of Compliance_(Yes/No) Dimensions: (1500 gall Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 2" Distance-from top of scum to top of outlet tee or baffle: 9" Distance from bottom of scum to bottom of outlet tee or baffle: 14" How dimensions were determined: Measuring stick Y; 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.) 77te baffles were present. The liquid level was even with the outlet invert. The tank was pumped the next day for maintenance. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments: (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.).. revised 9/2/98 Page 7of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 420 Bay Lane, Centerville, MA Owner: Mike MacDonald '•' Date of Inspection: December 13, 1999 :_{ TIGHT OR HOLDING TANK: None (Tank must be pumped prior to,or 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/day Alarm present: Alarm level: Alarm in working order: Yes_ No_ Date of previous pumping: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: ✓ -- (locate on site plan) Depth of liquid level above outlet invert: -- ;.i Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) The D-box was under the asphalt driveway and not du-o up. PUMP CHAMBER: None (locate on site plan) Pumps in working order: (Yes or No) Alarms in working order: (Yes or No) Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) revised 9/2/98 Page 8of11 I SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 420 Bay Lane, Centerville, MA Owner: Mike MacDonald _ Date of Inspection: December 13, 1999 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan, if possible;excavation not required, location may be approximated by non-intrusive methods) 7 If not located,explain: Type: leaching pits,number: I-4'z 6' (H-20) leaching chambers,number: leaching galleries,number: leaching trenches, number,length: leaching fields,number,dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.) The pit is under the driveway and was dry. The bottom of the pit to grade was 6'6". CESSPOOLS: None (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.) PRIVY: None (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.) revised 9/2/98 Page 9of11 r , SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 420 Bay Lane, Centerville, MA Owner: Mike MacDonald Date of Inspection: December 13, 1999 Map. -, Parcel: SKETCH OF SEWAGE DISPOSAL SYSTEM: - include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) i 3 A y 3� y5 rya- 3s U. - 53 A3' a$ �33- U a Ati ' a°� [34 - q o revised 9/2/98 Page 10of 11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 420 Bay Lane, Centerville, MA Owner: Mike MacDonald Date of Inspection: December 13, 1999 NRCS Report name Soil Type Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: ✓ Obtained from Design Plans on record ✓ Observed Site(Abutting property,observation hole,basement sump etc.) Determined from local conditions Checked with local Board of Health Checked FEMA Maps Checked pumping records Check local excavators, installers ✓ Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) A perc test was done on the next door lot, and no water was observed at 12'. The high groundwater adjustment for this site (MIW 29, Zone A, 11199)was 2.5'. The system is in the front yard at a higher elevation. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. 77tere have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. revised 9/2/98 Page 11of11 Town of`Barnstable P t, IMM of THE Tp� o• Department of Regulatory Services RARMS ABuB • Public Health Division Hate y MAM. c� sesp. 200 Main Street,Hyannis MA 02601 p�FO MA'S� Date Scheduled V 11mo. At" Zeo:7 Time in 1 dog Fee Pd. Lorin.CJ'O Soil Suitability Assessment for Sewage Disposal Performed By: SftVt W'I`tee Witnessed By: 2�"nna Mer4rcO(; LOCATION & GENERAL INFORMATION Location Address �a Owner's Name Pa ijal R. Goan . y S/to Bed t,4..s G�e-*A.-,vf Ar ` Address CaKitro,/(4, OLL92- Assessor's Map/Parcel: /• a/��OC2 , Engineer's Name Sfrgt�aw A• LDi I s", P,d'. f3a K1t.-N' NEW CONSTRUCTION REPAIR X Telephone# Z ekAIJ Land Use Re-a.edtamk Slopes(%) Surface Stones Distances from: .Open Water Body �'Sk70� ft Possible Wet Area Drinking Water Well 8 Drainage Way It Property Line 11 Other tt SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Ak a e-24 J 'A BRUSH llf 0-20 / , te I• 3-19 To FN VM NEW 57EP5' ^ 4- �o UNK �.o d \ o< _ Ds i'. pip u� K �2 pglpl 1 � Y MAILBOX \\ NDERGROD/NP _ BE RF10 A) 8-9 ,1` •0 1^ p y 3 22 3': N ___� .. - Br LEACH Rf Parent material(geologic) a i ac%d 1 0%, $b Depth to Bedrock r: Depth to Groundwater: Standing Water in Hole: (-9S Weeping from Pit Face <1t Estimated Seasonal High Groundwater C.^ DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: ii. mt Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ PERCOLATION TEST Date 7 Time 10,%5 Observation �� _ Hole# _ _ —' -Time at 9' Depth of Pere (o�I I Time at 6" /0:,�G Start Pre-soakTime u /0-27 Time(9"-6") End Pre-soak. /0.32 - Rate MinJlnclt 2 N1L1 "tJ. Site Suitability Assessment: Site Passed X Site Failed: Additional Testing Needed(Y/N) Original: Public 1-lealth Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1) week prior to beginning. Q:HEALTH/WWPERCFORM ��.Z 007-of 6 DEEP OBSERVATION HOLE LOG Hole#_ Depth from Soil Horizon Soil Texture. Soil Color Soil Other Surface(in.) (USDA) (Mansell) Mottling. (Structure,Stones,Boulders. Consistency.%Gravel) EF- DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture. Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravell :DEEP OBSERVATION HOLE LOG Hole# Depth fromil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Oravel) DEEP OBSERVATION HOLE LOG Hole# Other Depth from Soil Horizon- Soil Texture Soil Color Soil. ( USDA) (Munsell) Mottling (Structure,Stones,Boulders. Surface(in.) Consistency %Oravell Flood Insurance Rate Map: Above 500 year flood boundary. No X Yes Within 500 year boundary No_ Yes k Within 100 year flood boundary No_ .Yes k_ Depth of Naturally Occurring Pervious Material y Does at least four feet of naturally occurring pervious m ial exist in all areas observed throughout the ater area proposed for the soil absorption system? Y�s If not,what is the depth of naturally occurring pervious material? Certification I certify that on H / 19.51 (date)1 have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15,017. Signature Date !� 2S e 7 Q:H EA.LTH/W P/PE RCFORM TOWN OF BARNSTAB,LE LOCATION I' 6. L SEWAGE VILLAGE CP.� f/i l ASSESSOR'S MAP & LOT INSTALLER'S NAME PHONE NO. SEPTIC TANK CAPACITY i D LEACHING FACILITY:(type) / (size) /0 .� NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: � — s DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No y Q � � go TOWN OF BARNSTABLE LOCATION ��® ,�,�y l.A.yc —��v/ SEWAGE VILLAGE �c�„f,�s/�� ASSEASOR' �MAP & LOT�- dj�dd 1 j 1\ c oS INSTALLER'S NAME & PHONE NO. c�A, S C�Cre�vad�l 4�156 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) (size) NO. OF BEDROOMS _PRIVATE WELL OR PUBLIC WATERC BUILDER OR OWNER ,�/� DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 35 / s s u A C U: 0-3 J 6 - j THE COMMONWEALTH OF MASSACHUSETTS SUBJECT TO APPROVAL OF BOAR® F !-1 BARNSTABLE CONSERVATION _ COMMISSION �----...-.OF.....k5.. ,gyp iration for Disposal Warks Tnnitrn.rtinn ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System-at: Location-Address -- or Lot No. . ..... -� cam _ .......................................•-.........._ Ow e'r Address a ` ........................... Installer Address d Type of Building Size Lot_am__ 7____ C_Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder (` 114 Other—T e of Building No. of persons____________________________ Showers — Cafeteria Other fixtures -------------------------------- - - - •- -- -- ,a W Design Flow......_..._�5'_.....................gallons per person per day. Total daily floyv--_07__��__-®____________._______._____ �ons. WSeptic Tank—Liquid capacityl5 I.allons Length./iO. ...-�Vidth5.--_._S.-_ Diameter________________ Depth., . x Disposal Trench—No_ ____________________ Width.................... Total Length.........__.__.____ Total leaching area_-..................sq. ft. Seepage Pit No..........i--------- Diameter....�.•� 1_._• Depth below inlet____ _........... Total leaching area.3, 0..sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by. 5 __ -_1�. ._r____________________ Date._ _ ,4 Test Pit No. 1___._.�----minutes per inch Depth of Test Pit....1'�__ _____ Depth to ground water_- (4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ---•-----------•-------------------- ...................................................................................................... O w DESIGNING-- (�INEER--MUST--SUPERVISE------ x •-•-----------------------------•••---•--------------•------------------•--•-----••--------------------------tNSTALLA'TION-AND--eE4RTIFY"IN--VVRIT S----- V Nature of Repairs or Alterations—Answer when applicable------Tge-SYSTEM--SAS__INSTALLED-_IWSTRICT----- --•---••--------------------------------•-----•-•--------•------------•--.._.-•--•-------------------------- Agreement: ACCORDANCE-TO-PI•:A*:-------------------------------•--•---•---- The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. c/ i Signed ... -.................................................... JQ] . ./..� _ � Date Application Approved By........ +.-.... ----�.D........................................................ ..._ ------ '✓ _ Date Application Disapproved for the following reasons--------------------------------------------------------------------------------•----------......-------•••---•- --------------------------•••._...-••-----•••---._...---------------------•--••-----------•••••---------•.. c� Date Permit No........ - S ----....- �------•--•---......... Issued_.--------••---•• --•------------------------------- a—� .5"L i 710f1•�L V Date ems;, THE COMMONWEALTH OF MASSACHUSETTS BOARD QS, EA .._7. .. ..L............OF.......5 ... .... ..................... Appliration for Disposal Works Tonstrurfivia 1hrmit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: 4/t I 4to 7t e*v L V:��-j P, ................................................................�L........................... ..........................LOT....................................................... 0 0 S or Lot No. % CL: ....... ....Vi. E............................... .................................................................................................. owner Address Installer Address C) Type of Building Size Lot.a.A.14C.Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder P4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria P4Other fixtures ..................................................................................................................................................... Design Flow...........87.5 .....................gallons per person per day. Total daily flo)v----3Z..O.........................gall"onsW . Septic Tank—Liquid capacityIS-O.Qallons Length./O.�-6.'Width,5."—.'9."Diameter................ Depth-. —. ...'S Disposal Trench—No..................... Width....._......._...... Total Length.............._..... Total leaching area....................sq. f t. Seepage Pit No..........I......... Diameter.-_. Depth below inlet.......__......... Total leaching area.3-3.0-.sq. ft. Z Other Distribution box Dosing tank ( ) E19 ..... ...... Percolation Test Results Performed by._b&4_-T ................... Date.. aTest Pit No. 1.......Z ....minutes per inch Depth of Test' Pit.....1.2........ Depth to ground water.- Test Pit No. 2................minutes per inch Depth of Test Pit____.__........._... Depth to ground water._._..._._......._.._.._ .................................... ....................................................................................................... ........................kA 2----------- 0 Description of Soil — ... ........ J�...................... �4 t , "'" -----<iJ1Z.11R.VJF1.1 .................................................................................................. ..................................................................................................................................................... ................................................... U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ..............................................................I......................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLIT11 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. I I ) I R I ej- Signed..... ........_)Z�.' . ................................................................ ............................... Date Application Approved By......... ... ............................................ ------------------..Da -Date .............. Application Disapproved for the following reasons:..............................................................................................................- ......................................................................................................................................................................................................... Date PermitNo..........i�.2....... ................ IssuedL..................................................... Date THE COMMONWEALTH OF MASSACHUSETTS I BOARD OF HEALTH .......... 7.............OF.......... ................................... Tntifirair of Toutplitturr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (�) or Repaired by---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Installer at.............J,.'_T....Z............ ...... ..................................................................................................... has been installed in accordance with the pro i§ions of TITLE 5 of The State Sanitary Code as described in the. application for Disposal Works Construction Permit No.._._ ......... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................... . ............................. Inspector.................... .................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH C . ............OF........ &...................................... FEE... .7 .......... ------ Disposal Works Tonstrudion "unfit Permission is hereby granted........Z-,,:.Z...Z.............../ oe - N .X....... ---------4 ..................... to Construct Qk) or ..Repair C-11P...... � ... an Individual Sewage Disposal System _ ................Pr_ ................................................................................................. at No............................. . .. c Street as shown on the application for Disposal Works Construction Permit No.2.2-._k ._ Dated.......................................... ....................................................................................................... U Board of Health DATE..--•----- = ----..--.................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS (E%ISTINGI (EXISnNG) (EX,STWG) (J B.s z7 )-ocl— ///111 S2 Q z o N � < Lo ON. 0 m �UNLLJ OO� zs r-v zs AS F' 00-00 O E_- CL MSEAT --------r ------------------- ------- ---- -------; w -------------- -------------------- ------------ REM CD. n5 NEW as ----5-� DECK ENLARGED SCREENED NEw4x4P.T.POSTWI DECK e ^ PORCH "�1xBDAGING b - - U �i 6- : ,'-10' a'-7 z-to 2.10' z3' zS a'•z z-iP z-,P z-t0' r-4' 1 ----- a I •x68' ZB'xs B B B B I B b � 5' 4 NABOVE t NOT TUB VFBIE��SRE;MFR d ' . C B e B�' B FVllt __ � � DErAIIS+wi gwNSRs ON. _ m r W- -ems --ti__—T R OD- Dil Tc zB.Ea, - v l PIITRY ''s. I I FULL L"c B B I r , EXIST. FxlsT. DINING F"�4 { OM - ,T BENCH i,, ICAp. F (VAULTED CFJUNG) L O EXPANDED FAMILY NEW II r—DNEOFSF ROOM zs:sJ eon MUDROOM"Eases --r---------- --------�� °� BHOUJ� - _j 5 ---C=mac- __ w STORAGE CUBBIES I I " ----I: NEWWIOx,BSEEL8E A8°VE EXIST. -__ ems= _-- _ - ----- BEDROOM#1 ss Ts a'-s: - sINX ,ryEw,lvErBAR (Yw B,B PosTS Wn INSTAL x 10 CASING r J LINE OF S.F I I r, I I \+UNDER W l�fl' �0 ABOVE I I I I INSTALL GAPa BASE b GE I ' I I =^ dREFN DETAX EXIST. N w IIER O L_ 1 ----- ON. l_-_J b= NEW- - - LINE OF I KITCHEN ITCHE SAY I I (VERIFY KITCHEN I I lyl LAYOVT W/OWNER) I I I j DESK I REMODELED I I EXIST. i LIVING U 11 EXIST- :O GARAGE - mnoowsEAr - ROOM II HALL EXIST. EXIST. ly BATH I W.I.C. N1 A b F II I I W 31 �tl H z z O B w U EXIST. EXIST, bF � b o EXIST. O EXIST. A I A I--I Q4 U A5 0 EXIST. EXIST. C H 4•a 4'.0• q5 ra Bar <4 (ADOfNON) t�-�t (EXISTING) (EXISTING) (EXISTNG) (EXISTWG) �J WINDOW SCHEDULE TYPE MANUFACTURER'S UNIT ROUGH OPENING REMARKS FIRST FLOOR PLAN A ANDERSEN C 345 F-0 1/2"x 4'-5 3/8" CASEMENT ~ B TW N52 2'-6 1/8"x 6-5 1/4" DOUBLEHUNG EXISTING FIRST FLOOR =1750 S.F. NOTES: F-1 C AW 251 2'-4 7/8"x 2'-4 Ire" AWNING EXISTING SECOND FLOOR =1303 S.F. EXISTING GARAGE =524 S.F. 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS SCALE �E D A 2 2842 2'-10 1/8•x 4'-5 8" AWNING NEW ADDITION =100 S.F. &DIMENSIONS IN THE FIELD J A E A 21 2'-6 5/8"x 4A2'-0 114' AWNING NEW SCREENED PORCH =147 S.F. 2.) CONTRACTOR TO VERIFY ALL INTERIOR&EXTERIOR MATERIALS, F TW 24310 2'-6 1/8"x 4'-1 114" DOUBLEHUNG G CN 13 1'-9"x 7-0 1/2" CASEMENT EXPANDED SECOND FLOOR =492 S.F. DETAILS,&FINISHES IN THE FIELD WITH OWNER �/4» H TW 28310 T-10 1/8"x 4'-1 1/4" DOUBLEHUNG 3.) ROUGH OPENING HEAD HEIGHT OF WINDOWS AT fi' DATE LEGEND: FIRST FLOOR TO BE -10"ABOVE SUBFLOOR J TW 2442-2 4'-11 15/16"x 4'-5 1!4" DOUBLEHUNG 4.) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS K TW 2436 2'-6 1/8"x V-9 1/4•- DOUBLEHUNG EXISTING WALLS STATE BUILDING CODE.SIXTH EDITION 8/1 7/2007 1.CONTRACTOR TO VERIFY ALL WINDOWS WITH OWNER AND ROUGH OPENINGS Lr.__� CONSTRUCTION TO BE REMOVED THE DESIGNER SNML ea NOT"'MT Nr WITH WINDOW MANUFACTURER PRIOR TO ORDERING OF WINDOWS NEW CONSTRUCTION .. THESEDRAv N6sP(DORTTOSTART ON OF D WG- N0. - 2.ANDERSEN 400 SERIES WINDOWS LOW-E4 GLAZING,WHITE EXTERIOR W/ CONSTRUCTION.THE BUILDING CONTRACTOR - CLEAR VIEW SCREENS ©SMOKE DETECTOR , WRL BE RESPON G$I FOR THE CONSTRUCTION INTHESEORFW EIF CONSTRUCTION COMMENCES WITHOUTNOTIFYWGTHE DHESE DR OF ANY ERRORS SOLELY OMISSIONS: Q CARBON MONOXIDE DETECTOR THESE OM R N ARE TED,—OTHER THE USE OF THE OWNER NOTED,ANY OTHER USE OF THESE DRAWINGS REQUIRES THE WRDTEN CONSENT OF THE DESIGNER UNDER THE ARCHITECTURAL COPYRIGHT PROTECRON ACTOF,. CONT.RIDGE VENT NEW RAKE 6 TRIM BOARDS To MATCH MST. NEW ASPHALT SWNGlES 2 12 12 TO MATCN OUSTING (V a ^^p !V < ++ NEW FASCIA 6 FRIEZE � TOP OF PATE BOARDS TO MATCH MST. NEW❑ N ❑ R ❑ ❑ TOMATCRHE%BOARDSNER V1 oo 3 L- D° 0 NEW MIDAMERICA r V wLl -RSORVIEW SOLID. L✓U) Emil[ III DINNERS�OR W/ O c Q T Q fcLr, 12 NEW SIDING TO J SECONDFLOOR EXIST. MATCH EXISTING SUBFLOOR TO_P OF GATE 13 ❑❑❑❑ ❑❑❑❑ El FIRST WEIEL R SUBFLOOR �EI�❑ DEE= ou ❑❑❑❑ ❑❑❑❑ FRONT ELEVATION O D D C AS AS A5 r: (EXISTING) (FXISTWG (MSTING) (EwSDNG) B ANEW PORCN W 8'-0' sd T-T: A5 ROOF BELOW EXISTING CHIMNEY -NEW ADDRION TO BE REMOVEDROOF BELOW f'-T`---�T--1 1za I ts- O EwST.z �EMT. w NEW I _ § BALCO Y 4 UNEEO�F ANDERSEk I - CLOS.\A I w FWN 6DBB gPLR I t—� b + b it Z6x6'B' EXPANDED L_ IST I BEDROOM#3 ;; W Y SKYLIGHT EXIST.Allow I (FORMER BEDROOMm") TA E-1 BATH Z <'t L----i r EXIST. " L DRY KITCHEN II E BELOW ;�7 w I ----- -'_------ ~� O I I x I - � ,.p¢a I I 11 EW BEDROOM#4 Pa=__ xB� NEW s-? I EXPANDED EXIST. FORMER BEDROOM bI WALKWAY svLaS HALL MST. BEDROOM#2 § ^ a toiE <•a +Ca - I--I zxcwau ;+ Q EXIST. R s' ;; HALL ;CLO ------------ II cusroM BELOW o n TOILET G 4 -1 I r , Q III W NEW COMPARTMENT W.I.C. e NEW A UZ d' BATH �—( C�2 Zs'x 6s tq m F' I I Z6x6s ; N rz FHIGN�F b F -- I P 4 RAILING SCALE p -+r---- ;I NEW: yy"**�� r UK A5 - H H H 1/4" = t'-0++ N AS �' zsxsa � A DATE 4 E I E b C z4 AS 8/17/2007 sa ea' s-v rs zos ss DWG. NO. (NEW SHED pORMER) zra- +<-vi ZB-(TS 16-0'z A (EwsTING) (EXISTINGI (EXSTING) (EXISTING) � (L^TI SECOND FLOOR PLAN (-,-/�/��1` oo�N U N � CD V NEW RARE 6 TRIM OOAROS ^ ^ 2 TO MATCH EXIST. } / �a V)Vc L7 NTOP OF PLATE 12 TOP OF PLATE EXIST. L�4 LLo E- X ❑ ❑❑ ❑ - L) C].L El Ll SECOND FLOOR 2 SECOND FLOOR l_J SUBFLOOR TOFF PLATE 8 SUBFLOOR TOP2FPL4 Fpqpp ® F FIRST FLOORIso S48FLOORflumus FIRST FLOOR -- SUBFLOOR NEW TRADEMARK -- "UNG SYBTEM r^. 00 El 13 O .......... NEW�T.8�6 POSTS W/ AZEK 1 x)/I x B CASING F�J REAR ELEVATION W � Q ® COW.RIDGE VENT /- 12 NEW A6PHALT SHINGLES (I/\ EX ST.r TO/MTCH EXISTING HEW FASCIA 6 FRIEZE 12 �Iq' 12 BOARDS TO MATCH fJUST. `+x� '� EXIST- r, TOP OF PLATE ` �•L••{ _ _ _ ______- ` TOP OF PLATE 7 ❑ ❑ ❑ _ �, W � NEW CORNER BOARDSiEl r TO MATCH EXIST. 1 r. L)IS i <W � IhFO��YY\ 2 F r Fi w SECOND FLOOR l2 NpN SUBFLOOR LIATCH EXISTING IST. S. SECOND FLOOR LE SUSFLOOR EW SI G TO TOP OF PLATE - TOP OF PIAIE FIRST SUBfI i SFl�UBF FLOORA-I O SUOFLOOR- Ei 13 SCALE LEFT SIDE ELEVATION DATE RIGHT SIDE ELEVATION 8/»/zoos D WG. N 0. A3 zoo U <N N 0��0 23'-Tx az-Se 150': U nl- (EXISTING) (E%IsnNO) (EXISTING) Ly Q^Q� �- (>;F i O) Q �- ti 7 V1 LL]N� B'-S ,2'O 2Zd 3 d 0 (ADOmop x c L? U) A-v U m�n=[¢L. NEW P.T.6 z 6 POSTS WJ C ,•TN z B CASING ON 1Z I1 A5 DIA CONO.SONOTLIBES I I I I I Wl 2B-DIA CONC.SIGFOOT FOOTINGSUNDERNEIATH a4 Ib I I I I UP TO BELOW GRADE USE SIMPSON ABU fib AP POST BASE 7V TO Z 6 BC 6 POST C z.vr.zawi ,.�,� L_T '\ Pr.z:,z P.T.2al0a 16'a.c. P.T.2x Ia.®t6'— �,DIJTUNE OF EXIST. b DECK 6 POSTS TO REMAIN / +go- I. SOLID LOCKING BO,LEDGE LOLTEDTO KBO BOLTS SOLID BLOCKING W/N ERS AT LOT BOLTS A u x ,6"o.c.WIJOISTS MANGERS AT BOTH ENDS T"I/ }PTLIA / ____ OUTLINE OF EXIST I w I B J P.T_2a LQaQ,6 o.c OECK6POSTSIO O REMAIN I - I EIGHT TO IN� I - b F VERIFYMNDOWSBEFOR LL _ THESE IMNDOWS BEFORE Z-ilT T'3 §F I t ORDERWG EXIST. UTIL. I o b EXlsr. r CLOS. EXIST. I I FAMILY XIST GAMEROOM =___�° EXIST. - BATH I Ily �-+ 1 I II" ROOM _ Q E%ISi.}2z 10 qRT �� EXIST_12a,0ORT w NEW 3 1?DIA STEEL _ LALLY COLUMN 830' EXIST. 'i r 30'a 1S DEEPCONCRETE b F I T ' F'•"( FOOTING DIRECTLY UNDER - NEW POST 6 STEEL BEAM r 1/ P.T.2 x 10 LEDGER BOARD LAG BOLTED TO ON THE FIRST FLOOR SOLID BLOCKING WI(2)LEDGERLOK BOLTS F.L( b F 16'a.c.WI JOISTS" ANGERS AT BOTH ENDS I——— r, g —— EXIST. Z ~Z•-I NEW P.T.2•BaQl6'o.c e® -- STORAGE r, �( W T. GARAGE .. 1 O } ato. I zk / 0 \ H F EXIST. J A5 U r 1 F a u N A A Q. ry s.4 a.v � I� , 1AD01T10N) C ✓�-1' --------- -------_— NEwuDu tort. AS "_;6 �4 SONOTUBES Oil2B'DIA V BK.FOOi FOOnNGs TO M 04 BELOW GRADE � FJ�{ O TA'OA 1<'4f 2H'tr,t I6A: ' (EJ(WT,NG) (EXIsnNG) (EXISTING) (EJ(IsTwG) SCALE BASEMENT/FOOTING PLAN SATE : 8/17/2007 THE DESIGNER SHALL BE NOTIFIED IF ANY D��' O- ERRORS OR OMISSKINS ARE FOUND ON THESE DRAWINGS PRIOR TO START GF CONSTRUCTION.THE BUILDING CONTRACTOR MLL BE RESPONSIBLE FORTHE CONTENT IN THESE oRAWONGS IF CONSTRUCTON HOUT THESCOMME CES DRAWINGS NO.FOR AA NG THE DESIGNEROFANYERRORS OROLOSEIGNS THESE OWNER N ARE SOLELY FOR THE USE OF THE OWNER NOTED.ANY OTHER USE N THESE DRAWINGS RE DESIGNER Es ND WRITTEN CONSENT OFTHE COPYRIGHT UNDER TNE CTI ' ARCHITECTURAL COPYRIGHT PROTECTION ACT OF tSsp. v NEW ROOF CONST-7-\ z o NEW ROOF CONST. CONT.RIDGE VENT COW.RIDGE VENT <cl" •2 z ROOF RAFTERS N -tz cox PLYWOOD ROOF s)(EATroNc � � C -ASPHALT ROOF SHINGLES(MCH WIND) c� / \ -15LB.FELT PAPER -W HI-R BATT INSULATION 1 6c Q X --- ---_-- 2z 6c®16'o.c ®SLOPED CEILINGS(RKM) 2 -S-BATr INSULATION - - < L— L7 0 FLATCEILINGS(R•Y) CD V)Ld N�-- / :2z 12 RIDGE BOARD I ICANE CUPS ALL RAFTER EN r =O TOP OF PUTS F / z Lac®16'o.c. \ Y -ICFJ WATER SHIEIDATSOTTOM TOP OF PLATE 1 m In . 3V OF ROOF < / •PROP-A VENT BETWEEN RAFTERS /f-� EW t?GYP.QOARO \ \ CONT.ALUMINUM / U ❑ U Q' �S.L•NEW ON 1 z 3ATWPING \ \ SOFFIT VENTS -- �1E Q.c./ \ \ WALL /�/ Y Tac / / \ \ NEW / / PLY WOOD SUB FLOOR. S; CONST. / .NEW NEW NEW \ \ 3 / /, 0 a GWEDa—LED WALLW.I.C. HALL BATH \\\\ f CONST. /�/WA K 2 m 12 / / 2z1 GYP0 S16-o.c. \ \ EXIST. M WI 1?GYP.BD. ..SECOND FLOOR WAY NEW STORAGE 121— / \ SLTBFLOOR SUBFLOOR Op OF NEW 2 x tan 16 TOP OF PLATE FJO$T.2 z 10 JOISTS®16-o.c. EXLST.2 z It)JOISTS @ IToc "o.c. NEW MULTI LW BEAMS NEW EXIST. KITCHEN GARAGE FIRST FLOOR FIRST FLOOR SUB_FLOOR SUSFLOOR EXIST.2.10%0167P.c. EXIST.2.lac @ 16b.c. EXIST.3 2,IOGIRT NEW}P.T.2zW.WI P.T.2 z B RAFTEFTE RS O tEo.c..USE 2Uno. EXIST. O OF Z RIGID WWLLTON S R-2B a P.r.PLTwooD BASEMENT rrTT SECTION @ NEW W.I.C./BATH A5 n BUILDING SECTION @ NEW KITCHEN AS EXIST.1� \ \ \ 12 w 12 \ \ EXIST. NEW ROOF CONST. I� TOP OF PLATE tOn@16'o. 2.Ia.@16'.c N 2,GYP.BD.oN \ NEW ROOF CONST. slMPsoN Lsra STRAP SAP MULTI LVL BEAM \ COW.ALUMINUM MULTI-LA 1 36T PING®1B o.c. \ \ SOFFIT VENTS RIDGBEAM 12/ // \ \ F, 1--� t ANEW NEW NEW Val\ �12 r F- /// STUDY HALL L'DRY CL Ste\ 12 — — zxen 1sP.n BOTTOM OF O ~ W / \ — — H C4 u NEW WC T a G PLYWOOD S. NEW WALL CONST. O erA SECOND FLOOR r \ SUBFLOOR 1 SUBFLOOR-GWED6 WULED r l ElUSTING2z tOs 16-ne. EXISTING 2a Lan®16'o.c 1.2zISTUDS�16'oc RIFT INTERIOR W TOP OF PLATE 2.1?PLYWOOD SIffAT10NG 3.3 1/Z(R-13)BATT.INSULATION TOP OF PUTE FINISH WJ OWNERS EW W 10z 19 STEEL BEAM I.VZ GYPSUM BOARD MULTI LVL BEAMS. r NEW W 10 x 65STEEL BEAM S.W.C.SHINGLE SIDING 8.TYVEK VAPOR BARRIER NEW '� VERIFY DECIDNG MATERIALS REMODELED EXPANDED BEDROOM#4 NEW TRAD NEwzXl�3J,EnP. 9 PORCH SCREENED WALL �� NEW WITH OWNERS ETnARK LIVING FAMILY SOLIDB OCWNcwB(P)AREDG�ELL K90iTs 4 i ROOM ROOM 1To.c.w/JCISTBNANGLE BOTHENDS CONST. v1?GYP.BD.ON o //—VERIFY DECXING MATERIALWWOWNERS FIRST FLOOR 1 z 3 STRAPPING O V.n bN NEW 32X lac SUBFLOOR ."J'VVC FIRST FLOOR EXISTING 2x Ia. SUBFLOOR P.T.2 x Bc l6'o.c ®6-o.c STING Ix lan�l6-o.c NEW P.T. 10n�16'o.c P.T.2x lac�t6'nc 3P.T.2z th .. 1Zc ' SIMPSONP$ON SG 6 FOR GIRT TO POST NEW T BATT NEW SIB PLYWOOD i NEW P.T.6a 6 POSTS M INSUATION SEAL ALL OPENINGS EXIST- ,z]Jl X B CASING ON 1Z (R-30 a BEAMS NEW FULL W 22W DIAG'c°ONc BBIGFOOT NEW P.T.6 16 POST$WI M U DROOM BASEMENT FOOTINGS UNDERNEATH ,x rll x 8 CASPIG ON 1Z NEW la CO NC. TO IV BELOW GAME DIA.CONO.SONOTUBES S C A L E FOUNDATION WALLS U$E SIMPSON ABU W POST BASE W12W DIA GONG.BIGFOOT a SC 6 POST CAP FOOTINGS UNDERNEATH TO IV BELOW GRADE USESIMPSONABU WPO5TBASE /,T" NEW IT.2lT CONC. a BC 6 POST CAP Y FOOTINGS L - DATE nBUILDING SECTION @ LIVING/FAMILY ROOMS ' 8/17/200�l 7 BALCONY DETAIL SECTION DWG. N0. A BUILDING SECTION @ NEW PORCH A5 :.J Ia-r I3s Tzd ad Z pv C_7 ¢N N ✓l Q O�"r NEW?AULTI LVL REAM Q (` v�c_7 Irl L3-1T0� p ca COO x D 1 ; D 8 m?<:. < _ F F R'd= f6dx (EXISTING) >r (EXISTING 1 3 (EXISTING) (EXISTING) B � AS I o 5 - J I j 1 / b I b I 6r NEW HEADER v b 7-1 — b r--- Fill I I O I I L---J F NEW 2z ILTO ER NEWSE uu,[L(q TO RM E ROOVER NEW SHED DORMER RODE GYGTEM 1 EXISTING RIDGE BOARD I 1 , m � � V_ _ _ EJJSTNG RIDGE BOARD_ ^ ¢ i NEW MULTI L HEADER I I W x 1 U III L b ( I I 2=fv 1S'o b I rFF I--I 8 U � I br b b W 1 ' b I I N INEWGAEEDORMER) (NEW SHED DORMER) 1Yd: Ifd= 2STIN (EXISTWG) (EIUSTiNG) (EXISTWG) (EIUSTtlJG) F' I ROOF FRAMING PLAN NOTES: c 1.)ALL ROOF RAFTERS TO BE 2 x 10's UNLESS OTHERWISE NOTED �1 2.) USE SIMPSON H 2.5 HURRICANE CLIPS AT ALL RAFTERS ENDS 3.)VERIFY GUTTER TYPE/I.AYOUT Z H W/OWNERS t--1 SCALE 1/4" = 1'—o" DATE 8/17/2007 DWG. NO. : ® 6L .� LEACHNG AIEA RECILFE EN rS v,�, �•,,,� � � �� NITROGEN LOADING LIMITATION: NA RESIDENTIAL: 4 BEDROOMS DXST>NG E d FINISH FLOOR - 19.1 x 110 GPD/BEDROOM sET AT i.Fasr ONE MANHOLE FRAi�E TOTAL DESIGN FLOW = 440 GPD r� � To WHIN A OF FINISFI GRADE GARBAGE GRINDER TO'BE REMOVED &r MANHOLE 0 GRADFRAIME � O PERC RATE = t5 MIN. f INCH (CLASS 1) RISERS & COVERS SHALL BE wATER=ff COVER O GRADE GRADE N RISERS a COVERS swot BE wAtERnGfrT - LiAR = 0.74 GPD/S.F. DaSTM.y w► , .-. . £ ': OVER TANK = 16.8 MIN. LEACHING AREA OF SAS. REQUIRED: F'N�iSHF.D GRADE OVER D. 90)( = 16.0 VENT 440 GPD/ 0.74 GPD/S.F. = 595 S.F. MIN. ; r MIN. FAD GRAW OVER SyM . PROPOSED SYSTEM: ,r tae-tee 26 tFM4. 9di 40 PVC OS-1.89X • ; �"` , * W OUT - 15.0 6 MN. OF li= ` DOUBtE 9' min Cover wITIMi a' OF FMSIi GRADE INSTML ONE 06PE!MM PORT TO 10` f �� r A W IN- 14.8 W OUT- 14.5 FIRST 2 (TO BE LEVEL.) , , , x xx = Mr►stlm FF�►s1ONE OR 36• (max; Cover PER c►AMe�rt SIDEWALL AREA: (40 + 12)2 x 2 DEPTH = 204 SF µ y se, "" k ` K_°� , #, >�' h t; Gr►s EV�FFl.F 2' 4' St i. 4o Pv�C wv IN- 13S �orornF FLIER FAeRIc WN BOTTOM AREA: (40' X 12') 480 o r 4.Y i' ,v, -t,}a.K „rbz z i' ' v'•.r +,, �"'x 'fOO SF r. "hsr i �1'44 ;• - _ ., 5 �2 �i'` ry $ _ sx �', a�µ7y,�+"a,. .#tt�x�i'�'. 14• t :.6• p TOTAL EFFECTIVE LEACHING AREA 684 SF ♦ MiV OUT-142 .< _' .�. -,.•x< � ;< RDNFORCFDi CONCREiE • o G O C o o f '^' ".•� ,.:•. ::. ._ SEPTIC TANK SIZING: 440 GPD x 200% = 880 GAL d s ., .,.N.,:-.P• ::'v!7f' _..,* .. .,..-,. - a ..,i L.:t : , ...::.+ ":.r:,t, "wK',�.c. _•�. ,y-,.r. :I^�,•i: b'. •.,: .a _ . :'' _ EXISTING SEPTIC TANK IS 1500 GNIM .. .. .. .. � NRWfAfI •c .. �I�'•r •A:••}'i .~. .�: .i,•� .}:11.`• �' ....-.i• . STONE EL 12.9 UNSUTTABIE 901LS. F BELOM► LOCUS MAP Scale: 1" = 2000' T10N D06T1�L11,900 GALLON ONE-<'�01iPAi�t1�1T 8EF'i1C TANG DIBTF�l110N 801(d�0 LOADirC� THE PF�►sTONE ELEV (TOP of SAS). � BE 6' MIN �`` - 1�IwSIIEv StDNE DEM i�E ROiONDO DB-9 OR EMK REMOVED TO THE 'iC HORIZON' AS REQUIRED TO INSTALLED ON A LEVEL STABLE BASE - SEE CONSTRUCTION NOTE J5 HEREON. 3.1 9 CURETS REQUIRED OONCRM RM DFAJM ° I CON87TIUC"NOTP 1. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH FIRST FLOOR ELEVATION (EXISTING) 19.1 TITLE V OF THE STATE SANITARY CODE DATED MARCH 31, 1995, AS AMENDED r THROUGH THE DATE OF THIS PLAN do ANY LOCAL RULES dt REGULATIONS SEWER INVERT OUT S FOUNDATION (EXISTING) 15.0 � / SEWER INVERT INTO SEPTIC TANK 14.8 j APPLICABLE. / SEWER INVERT OUT OF SEPTIC TANK 14.5 2. ANY CHANGE TO THiS PLAN MUST BE APPROVED IN WRITING BY THE B-21 ) I CP SEWER INVERT INTO DISTRIBUTION BOX 14.4 ENGINEER. ELEVATION INFORMATION MUST NOT BE CHANGED WITHOUT WRITTEN J / MANHOLE FRAME AND 3 SEWER INVERT OUT OF DISTRIBUTION BOX 14.2 PRIOR APPROVAL BY THE ENGINEER. ' / COVER GRADE �• - 1 S. / / 2" PEASTONE OR (IF UNDEE R PAVEMENT) WASHED STONE SEWER INVERT INTO LEACHING CHAMBER 13.9 / GEOTE)MLE FILTER BOTTOM OF LEACHING SYSTEM 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILUNG, NOTIFY THE !J / FABRIC GROUNDWATER OBSERVED AT ELEVATION 3.1 BOARD OF HEALTH AGENT FOR INSPECTION. / •{� ;�,•[tl pi{•�? J'';y�t�'�`..nN tir, ^.+.r O.•A TP 4. ALL SANITARY DISPOSAL. SYSTEM PIPING TO BE 4' SCHED 40 PVC. UNLESS / 24 12 ��Y;��=;��r�+ ;:r O C� •;cs��rs��o�r�z } EFFECTIVE .�;. ,-r��'; R'"� :.. •.,-.- ,,•.,, ;� / %l "'�'R'�`''S'�i•. vt?y�,•�t"s�:��:7 •kii� i',.i,{. •it:.. �i.��.aw.iy;�:{' OTHERWISE NOTED HEREIN. // DEPTH 12 ,+� �?' • Yk,_ s h*�,.F�,��"� w ,s• �S- •af^ x. . tom. + !t r. MATERIAL AS NOTED TO THE •C HORIZON" , FOR A - / H / i 4' 4. 4, 80L LOGl DAM:S/N/0�7 5. EXCAVATE UNSUITABLE B 20 / BRUSH S / HORIZ. DISTANCE OF 5' SURROUNDING THE LEACHING FIELD, AND REPLACE / / 12' M BARNSTABLE WITH CLEAN SAND PER 310 CMR 15.255 TO THE TOP ELEVATION OF THE SAS. SOIL EVALUATOR: BOARD OF HEALTH AGENT: yes �o ~�2 CONCRETE FLOC' DIFFUSER DETAIL STEVE W►LSON, P.E. DONNA MORANDI 6. INSULATE ALL PIPES AGAINST FREEZING AS REQUIRED WHEN LESS THAN 3 / I (H N2 LOADING)o OXF TEST PIT 1 Olp OF COVER. / �i � 7. THE EXISTING GARBAGE GRINDER IS TO BE REMOVED. / G.S.E. = 8.8 , , 8. EXISTING HOUSE HAS FIVE BEDROOMS. PROPOSED INTERIOR RENOVATIONS / ! // J3`' / G 4.0' 4.0' A 10YR 2/1 SANDY LOAM • WILL REDUCE THIS TO FOUR BEDROOMS. / ! / 0• 9. A GAS BAFFLE SHALL BE INSTALLED ON OUTLET TEE // J! / �o� // ` , , ''�" CONCRETE �4' / , / ! / � � _ B • 10YR 3 2 • SANDY LOAM A. = - • C ; IOYR 5/6 MED. SAND Av /4• ��3/4 -1 1/2 WASHED Si(VEl " �I ' - 1 ��- I<- �� -- - - 84 (ELEV 1.8) FH #370 32' EXISTING �� // P `�`- N �� \ PLAN OF 80L ABOW-1ION 89i M111 H _ '/ \ :fl PFECAST00 R. D ) WATER AT 68• (ELEV. 3.1 STEPS TO ) c� - No SCALE PERC O 60• (ELEV. 3.8) BE REMOVED R CLASS I SOIL/IN VARIANCES BEING RE UESTED: V Q DECI� TO BE i � 1. TITLE V. 310 'CMR 15.211(1) - TO ALLOW AN SAS. TO BE 5. ENLARGE 2 OFF , ' A PROPERTY LINE IN LIEU OF 10' WIT#i NEWS I � . ��-•-.� S�PS CP 2. BARNSTABLE BOARD OF HEALTH, CH. 360-1; SETBACKS - TO ALLOW AN SAS. TO BE 82' FROM A WETLAND IN LIEU OF 100' / �'� \ SiTE LOCATION: ExISTINc�� \ 420 BAY LANE I v N 4 PIPE \\ n I N V.=15.0� C CENTERVILLE, MA PROPOSED ' N XISTING PREPARED Fat ADDITION , Q EPTIC t 11 T N K DANIEL R. GORIN r,f 11 N J '� Y too � � � � � LISA F. GORIN CD -�N N1. r� TiiLE S0� � r D-Box Wetland Permit Plan � e e.�W� PROPOSEDo PORCH\ PROPOSED 2 . 1�), BAXTER NYE ENGINEERING & SURVEYING \ WINDOW SEAT \, .,. F` � I • �`' REMOVE PIPE °' '4 " Registered Professional Engineers and Land Surveyors cA AND PLUG OUTLET 78 North Street-3rd Floor,Hyannis, Massachusetts 02601 Cp REMOVE Phone (508) 771-7502 Fax - (508) 771-7622OF EXISTING D-BOX MAILBOX 10 0 10 20 PAO 'CPSCALE IN FEET 4ps .-- SCALE: 1 10' sir L I. { 6 f RELOCATE 7 UNDERGROUND \ G• \w ELECTRIC D.A. 07 \ \ P 8/BALL - -2- DATE. 6/18/07 -� \ \ �' HOOP VENTUP 2 2§", B-g \ 2` c� , �063 0 0, - ` ti 30.41 .0 d� �\ \\ s ��45, C> 12e35,44„ W _ f r _ ' -,,A 4 S 22°03'28" W � PROPOSED Q P02 S _ - \ - ~-- ' y r0� EXISTING S.A.S. NO. BY DATE REMARKS LEACH PIT ow►wN RY: MM DESIGNED CK Err: DRAWING NUUM BN-_$ _ - ..� \� - _ 10 (TO BE REMOVED) _ _ 0: 2007 2007 016 surve worksht 2007 016WPP2.dw 2007-016 a I i I V 27-Tf 42-'S't 194r* ~ (EXISTING) (EXISTING) (EXISTING) p N m DN. � WN� 2'-S. T-0' 2' r a 0(7 0 Lr � �� SEAT -----n -------il ' _ I -------4 i 11 -iI REMOD. NEW EN LARGED I ---- b DECK SCREENED I DECKS ___ __j PORCH N ------ � j GAS F.d W/ HOT TUB I �-----�ABO�iE _ 41 ►.. __ NEW BEAM ABOVE41 L -------,r--�-- Z H I--------------� I 2F � n I EXIST. PITRY I -1-- DI ING I 1 �� 04 �- OM ..�.a....L..-1-4'Ld I BEN ,,..�� O I I 1 I 1 I I I, 1 !�1 1 1�-�.. (VAULTED CEILING) I EXPANDED FAMILY NEW II I ROOM 1�1� - UDROOM yam= ,------------ ---------�, - I I i -1 LbSe STORAGE CUBBIES' I ` P� t- I p � ---------� ISLAND {I , _ ;; _ - - NEW BEAM ABOVE - - - - EXIST. -�- — — — — — — — — — -- � _ - - -�= - - - BEDROOM #1 I---� SINK I 1 I��M►t�� 1� I 0 I I 1 \��UNDER GE 1--- 1 i e J COUNTER EXIST. 0 1 oW 1 N yg 1 1 DN Y 1 * t a NEW t:_�JLINEAAKWAY I KITCHEN aeovE I W } I DESK REMODELED II EXIST. '� II 0 LIVING � EXIST. � f GARAGE - tDOW SEAT ROOM I { HALL EXIST. W.I.C.IST. -----___-- LI IL- BATH I IC i W EXIST. EXIST. ONO F !� dty mmmi EXIST. EXIST.T-W S'4F 74r O z F 2V-0't 14'4r:k 2IV4r:k 194rk (EXISTING) (EXISTING) (EXISTING) (E)fJSTING) F FIRST FLOOR PLAN W � O EXISTING FIRST FLOOR = 1750 S.F. EXISTING SECOND FLOOR = 1303 S.F. EXISTING GARAGE = 524 S.F. SCALE NEW ADDITION = 100 S.F. NEW SCREENED PORCH = 147 S.F. i 1 /4 LEGEND: . 0 EXISTING WALLS DATE : r CONSTRUCTION TO BE REMOVED --- 6 2 2 0 0 NEW CONSTRUCTION THE DESIGNER SHALL BE NOTIFIED IF ANY D��. A ,'v 0. ERRORS OR OMISSIONS ARE FOUND ON THESE DRAWINGS PRIOR TO START OF CONSTRUCTION.THE BUILDING CONTRACTOR WILL BE RESPONSIBLE FOR THE CONTENT IN THESE DRAWINGS IF CONSTRUCTION COMMENCES WITHOUT NOTIFYING THE DESIGNER OF ANY ERRORS OR OMISSIONS. PRELIMINARY DRAWING n p,A I w,G THESE DRAWINGS ARE SOLELY FOR THE USE c cREVIEW cj�/ycV�/V�"v OF THE OWNER NOTED.ANY OTHER USE OF FOR DESIGN 1\LV'L Y Y THESE DRAWINGS REQUIRES THE WRITTEN At CONSENT OF THE DESIGNER UNDER THE ARCHITECTURAL COPYRIGHT PROTECTION ACT OF I=. 12 12 12 Z A 4 � � 4 - 11 � � C) N C/) W N op A., oo IF F—E�w lr7 Lo JL-i BILL-- 1j, 12 _ EXIST. z aoElElEl / ElElEl Ell::]El IE:l j 00 EIE:]E:l❑aoao - _. - oaao 000a Fill FRONT ELEVATION. . . 27-V r; 23'-7"t (EXISTING) (EXISTING) (EXISTING) (EXISTING) EXISTING CHIMNEY . , TO BE REMOVED i I ♦ i I i f i ♦ I I EXIST. i I /� �� i I EXIST. NEW --§ (► LINE OF WALL I + CLOS. 4 or- BALCONY H1 BELOW I __� ----- - EXPANDED EXIST. BEDROOM #3 SKYLIGHT I I I I I I I I ( ABOVE I (FORMER BEDROOM*3&#F4) EXIST. [ i I 7AC BATH t it - -- J rSI�NEWo 11 L � L DRY I 1 I EXIST. 11 KITCHEN rn tI I F ( .0 L_-- _j II ; ; BELow I , - - - - - - - - - - - - - - - - p I1 1I- --- -- I aaxm 1 " 1 I I i EXPANDED EXIST. 416 NEW I I NEW I HALL EXIST. BEDROOM #2 II II WALKWAY I ��"� ,_ I BEDROOM #4 , , _ -- -+i— DN. Q I I (FORMER BEDROOM5) , If II I I I I EXIST Z . i 4'x S , ► - I ; HALL I cLos. I I CUSTOM t I " BELOW I SI`- - - - - - - NEW I ► 1t t I - — t + � - - - - STU bY TOILET I I NEW , I COMPARTMENT 4 I I I V 1 W.I.C. NEW I ' I I I BATH I ' - -_" ---- ----------- --------------- Nor_—F SCALE NEW I I I I b N 1 /4�, W.I.C4, I Q ' LIN. ivil ... .. DATE Ar 3'-9" 6 /12/2007 (NEW SHED DORMER) DWG. NO. 24'40"t 14'4r* 26 4ri 164)"t (EXISTING) (EXISTING) (EXISTING) (EXISTING) SECOND FLOOR PLAN PRELIMINARY DRAWING FOR DESIGN REVIEW U 12 > W � oo NT L—ALIJ r=l LJ Uum 3 - 12HH I — I � LJ }^ m 4 11 FE:1 E rim JL Fl:l L 3 � RM19 HH 010 13 C3 0 0 0101;0 O REAR ELEVATION � W � 12 EXIST. > Q O G; a (D a � i7EXIST. 12-12 CQ � � W SCALE 1 /4 09 = 1 )-off LEFT SIDE ELEVATION- SATE RIGHT SIDE ELEVATION s /iz /zoos DWG. N0. PRELIMINARY DRAWING A 3 FOR DESIGN REVIEW -�-----�----�'ll'.�.��-.-,--�-�---�----�---I-------11-1---�-'------, ---'-- , ---------- , , ---,--, --1-----111 ,-1 --..---I'- , - - � 1, I -'----------------1---------------,--'-- -- - ----,----,----------,--.-----,-----� , -- � . . /77-7�' �'�- -I" -- - -1--�------7------ -----------------,---- -----"------------,--------�--------------�---�,,�--,-,-------�-,�,,,,-----,,,---_�,----, -�"- -,--.�=-----ll- �-�-�- -------"�-�------ , -- -----'-----------�''-,----'--"'----'-'-'- --------------------------'."--- I I I � I , �. '- , , 1--�,-��,,��-""--�-- ,��.�,�, � I . I I I I I � I I ,� , I � I I I , � � , -'-.------'--�-.........-'-"-"---'--- I/'/�I I I I � I I I " I I I I I I � I 1,�" � I I I I I � � 1,-I. I I � . I 11 I . 11 I I) !�� I I " I I I . : . I I � I I . I v �� I ; I I I I I I � I I I I I � I I I I I I I I . . I I - I � I I � I I I I � � I I I I I I I i 11 � I I I � I I I I I I 11 � I I I I I I I . I I I I- I I I '-� I ' 'I � I I I I I I I � I '' I 1: �111 -� � I 4, I I I I I I I I 11 , I I I I I I I- I I I I I : I � � � � � I I . I I I I I I I I . I � I I 11 I � � - I 1, " � I I I I I I I I I � I I I I I I I i � I I I � I I I � I I I I I I I 11 . I I . � I I� I- I I � I � I I � I � ' , I I � I I I I � . I I 1� I I I : � I I I I , I � . I ; r � . � I 11 � � . � I I I . � I I I 11 I I 1, I I - 1. � I � I I I I ' 'I - I , I I . I I . I -11 I I I I I �� I I I I � , I ;, I � I I I I I I I I I I � � I I 7�� I I I I , I I I I I I � �' I I I� 1� I I I � I � I I I I I � rr"" I I I , I � I � I I I I . . - ir .. I I 1, I � � � I I I I I � I � I � I I I - -1 .1 GENERALNO S '' i � I I � I I I � I ' ll I I I I 1. I - I ' ' . � 11 � I ' ' I I I I I I � I t ! � � . I DwAx 07 1 VARUNCES BEING REQUESTED:.": , I 1� ' ' I I I I I I I 11 . 11 1- 1111 - I � I , � I I � I � ; � I . I � 11 I I . I I � I I i I 'EA'A � � 11 I I 11 I - 11 ' ' ''�- ' 'I I � � � I I � 11 I r , 11 I I 11 �' I I 1, I I I I I 11 I f i I I I I � I I . : , I ' 'I 11 I I I I � 11 I 1, I I I 11 I I � � I � I I � I 1. I iI 1 . I I I I � . I � : I I I I I I . 1.) THE INTENT' OF THIS PLAN IS70 DETAJL EXISTING SITE CONDITIONS AT LOCUS I : 1. TITLE V, 310 CMR 15.211(l) '-[TO ALLOW AN SAS. TO BE 5' OFF I I I I � I I I I I I I I I : I i . I I � � r I I I I I I � � I I I '! I I I I � I I 11 I I - � I � I I I ! i � I � 1. A PROPERTY LINE IN LIEU OF 10' � I I I I I I I I � � I I � I i11 ...� I 1. � " I - I I I ,. I 11 I I I � ; I , I I I � I i " I � I I I I I I I I I 11 I � I I � : I . I I I I i ! r� I :11 I I -----"- - I � I I I � I I I I I I � I � I 1 2.) LOCUS AREA IS COMPRISED OF : � I I : I . .. I I I � I I I � I I L- I I I I , I I - � I I . I I � I I I � I � I ''I - : � I I . 1 2. BARNSTABLE BOARD OF HEALTH; CH. 360-1; SEIBACKS - TO ALLOW AN �I � -, � I 1 -1 I I I I I � � I I" - I I I I I 1, : � , I I � I I I � � I I I I � I I I BARNSTABLE ASSESSORS MAP 186 PARCEL 015-001 1 1 1 .�- "!, 4.k� -A%-1 1, � S.A.S. TO BE 82' FROM A WEILAND IN LIEU OF 100", � 1, I I 1. I I I I I 11 "I � I I r I I 11 � I I I I I � : " I I I - 156,065 LOT I LC.PL 39143A f � . � I I � I I I I I . I I I I � I I I I I CERTIFICATE OF TITLE: I I I I � ��t'��' .I --11� 1w I '%�� I I 1, I i � I I I I I - I . I I � I I . � I - I I I 1� . 11 I I I I - I I I I I I I I I I I I I I . I I I � i - ."14, 1 1 1 I I I I I I . I , I - I - DANI I � � 000��"�-�' �" �� I I � I I I I I I : - I � ; I I I I I I OWNER. EL R. GORIN I I . I I I . I I I IL 11 � 0 �' - I I I I I I I 1, � I L' I I " I ,� I � I � I I I I I � . I I I I I I SA F. GORIN I I I I I I I I . I T- I I I I � I � I I I I � I � , I'll , 1 �222 , � I I I I I � � I I I � i L I I I U. � � I I �' 41 I i . I I I I I "L'I , ,I . I I 11 I I I r I - I � �' I I I I I I 11,', 4i I 11 I I I I � I I � I I I I I I I � � I � . � - . . � I I � I I - I I I I I I ,I- � . I �� I � I 11 I � � I I I I . I I 1, 420 BAY LANE I � I I S" 0� .. 11-- I I I � . I I I I I I I I; � I I I I ''I I I I I I I I I I I . CENTERVILLE, ", 02632 1 � 1, I I I I I I I I I I I � - 11 I I I . I I � �" I I 1, I I I I'll, I 11 I ,� I I I I I I I I � . � I � I . I I I I I I I I " I I 11 I L I 11 I I I I I I I I I I I I i I I I � I I I � I I I - I � I I I � I ,� I I � . ' I I 11;. I I I I I I I .� I I I 11 I � I� I I I I � I I I I I - I I I I I I I I � .� I I I I I ' ' I I I I � I � I ': "I... � � I I I . I 11�1 I I I I �' I I I I . 11 11 I I I I I I I I I I 1 3.) PROJECT BENCHMARK : M28 QS ELEV. 27.416 (NGVD29) - CONCRETE BOUND�WITH DISK I I I I I I I I I - I I I - I I I I I � 6 I I I . 11 I � � � I � I I � , I I � �. I . . � I I I'll, I I I � I I � I I � I I I I � 1, I � � I 11 �; I 'll �' I I I 1 I � I I I I I I I SOUTH SIDE OF SOUTH COUNTY ROAD, EAST OF BAY LANE, CENTERVILLE � 1� I I I I I 1 � I I . I I.. % I 11 I I I I 11 � I � I . I � I I I I 11 I I I I I I I I I � I I I . � I ! 1". ;;; I I � i .' I I . I I I . I I 1 4. 1 . I � I � ; - � - I I 11 � ", I I I I I L � ) ZONING INFORMA710M . I ,� I I � I I I i �i : I I I � '� : I I I I . I I I � � 11 I I I I I � . I I � I � � I 11 � � - I I I � 11 I � � i . I � ��117X-Jw 1 1 1 1 1 1 1 - I I 11 I � � ,I ZONING DISTRICT : RD-1 (Residerftil) I I I - I I I I I - I I I L I I I I I � I I . i � ; I I � I I I 11 I � � I I � I I I I � I I I I I � 1. I 11 � I I � 1� I I I I I I . I I I I .� 11 I I . I I I I � I MIME. . I I � , I I I � I � I I - I I I I I � I r I ;' I I I I I I I I I AP Aquifer Protection Oveft Distrid I I I I � I I I I I I I �' I I ' I � � I � I I I � I � I I I I I : I � I I I I � . I I I I � I I I I I 11 I I I I I I I I ,I I RPOD Resource Protection Overlay DW,ct � I " I I I I I I 11 I I . � I . I I I I I I � I I I I � I I I I I I . I � I I I I I ' 'I I I I I I I I I I � I I 1, I 11, I I I I L I I I I I � I I I . . � I � I " I I I I I r I r I I � � I I I .r 11 I 11 i I 1 I 1. I I I I 11 : - : I I I I I I I � " I I I I � � I . . CURRENT MINIMUM ZONING REQUIREMENTS. . ,r I I I I � I � I I I I I I � I I I I I . I I I � I � I . I I � I I I I I I I � I I I I I I I I I I I I . I I I I I I � , � - I I I I I MIN. LOT AREA = 2ACRES I I I I I I I � I I I I I LOCUS MAP Scale: In = 2OW I ; � I I . I . ,1. I I I I . � . I I I I I : I I I � I I I I I 11 I I I - 11 I � � I : I ' 'I I I � � I I I I . 11 I . I 1 . �I I I MIN. LOT FRONTAGE = 20' ,,' 11 I I � I 1�1 .1 I I I I ''I' ll, I i I I I I I I I � � I � i I 11 I . I I ' 'I I I I I I r 11 11 I I I'll I I � I I I � I I � I I I I � . ' I � I I I I � 1 I I � I I -1 I I I I . I I , I I � I I I I � I I I I I I � , I I I I � MIN. LOT WIDTH = 125' 1 1 " I : I I I I I I I I � I � I I 1� I ' 'I � � . ''I I , I ' 'I ,� I'll 1, I I I 'll �11 I . I I . , I 1. I I � I I I ,I I I '' I I .1 I � I I I � I I I � � I I I I I I � I I I I I �. I I I I 11 I I I I � 1� - . I . I I I I I FRONT' YARD = 20' 1 1 � I I .. I I I I I I I I I I -� I I 11 I I � 11 I ., I I I I I � I I I � I � 11 I . I I I I I I I I I I I I ! r I I I I I I I I I I I I I � i I I I I I I I I I r I � I I I I I I I - � I I � I I I � ; I I I I I � . I I � I . � � 1 I SIDE & REAR YARD = 10' / 10' L ,r I 11 I I I I 11 I - I - I I : I I I I I I I I I I � . 11 11 I � I I I I . I I I I 11 - � I " I I � � I I I I I i � I 11 : I I � I I L I I I I I I � L I . I I I � I I I � � , , � I I I . I 1, � � I I I I � I I I ' ' I I I I I I I I 11 � I 1. � I I � I I I � - I I I I I I I I � I I 11 I I I I I I I � I I . - I I � I I I I � I � - I i I 11 I I I I � , I I I 11 I I I I I I I I I I I I I I . I I I I I I r I � I I I I I I � I I I � I � , � I I . I I I I I I I I � I I � I I I I ; I I I I I 'll I I � � I I 11 I I I � I I I I I r I � I I . � I I I I I I I I I I I I I I � 11 I I � I I I- I I I I � I 11 I 11 " 11 I . I I 1� I � 5 TIT HA IT IF DETERMINED I I I I I I I I I I � I I 1, � I : � I I I I I I 11, 11 I I i I I � I I � I I 11 � I . 11 I I I I I I I I - '' I 11 � I"I" I � I I 11 I I I I 1: 1 I I I I I I I I ' 'I I I TO BE NECESSARY A TITLE SEARCH SHALL BE PERFORMED BY OTHERS. . I I 11 I I I � � I I � I '� I I I � I I I I I . I 11 I � � I I I I . � I I � i I I I I I � I I I I I I 11 I I I i I 1 � I - I . �� I I- '' . 1; I 11 I I I � I 11 I � I %, I 11:. I � I 11 - I � I "I 1, � 11 I " . � 11 I I I I i I � r I I .11 I I L I I � - I I � I I I � I 11 . I � I I I I I . I - I I I I : I I I � I I I I I I I i I I I I � I 11 'k 1 , '' I I I'll , I � 6.) THE PROPM LINE INFORMATION SIM IS BW ON CURRENT AVAILABLE'RECORD ,, � - I I I I I I I I I � I . 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I� I I � I ' 'I I MAM 21 AND MARCH 27, 2007. ��, I ,� L I I I � I � I � I I I : , I I I I I I I I '' I I 11 I I 1, I : I 11 � I I I �, 11 I ' ll, - I I I � , I , 11 I i� I I �' � I I I � I 11 I I I � : I I B-38 I : 11 I I I � I I I I �I I I � I I I � I � � I I 11 I I � 1 I, ,�I I I I 11 I I I I � I I I� I I I I I I . I L L - ;I I � I I 11 -I I I .1� I I I I ' 'I 11 I I 1�I I 11 I I "I I I - I I - 11 I I I I I .1 : I � I I I � r I I I I . , , , , I � 11, � I I -Jk I � I I I I I I � I I - � I I: I I I I I I � - � I � � I I - I I I I' � � I � I I - I I I I I I I 1 17. 1 -:250001 0016 0 ', , � I � I I . I � .--'��. I 11 I � I � I I I ''I I 11 I I I I I 1, I I I .1 - ,� ,� I � I I I I I I I - � 1 - I % I I ) COMMUNITY PANEL: NUMBER. ' I I I I I I I . I . I I � . - � I I I I 11 I I 11 � I 11 I 1. 11 L I I I � % ..I I I I I . I � I � I � I I- I ' 'I I I I I I I I 'll I I 11, I I I I . I I I I I I I I I ,;" I I I . I I I " THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONES AIO (EL I 1). 8 AND C. I � I . . . 1 '�*-�B�-39 -40 8-4'2 \ I I I I I � I I 11 I I I I 11� I I . � I I 11 I I � - I . � I I I I� I I I I 11 11 I I I I I I I I I I � , I I I 1� I I I'll I I I I I I I . I � I I I I I I I � I I � I I � I 11 � I I I � AM OF MINIMAL FLOODING. I I . I I I I L .�� I I � I I I I I I I I I . I I � � I I'll, .1 I I 11 I I - .'', I I I I I I L I . � 11 I :1 �� I I I � I I I � . : I "I I . I I � 11 11 I I I I I I I 11 I 11 I I L. I I 1. I I ,� I I I 11 I I I I I I I I I I - I � I I � I � I I I � I 11 , - I I � I .I -, I I I � I � 11 -� I I - � I I � I � I I I I I I I I I' ll ,r I I I � I I , I I - I - , I I I � I I I 1. I - 11 I 11 I I , I I � � - 1� L � ,� I I I - I I I 11 I I . � I I I I I I I 11 V I I � I - i I � 11111 � - 11 1, - '' I , I I ' '� I I I I �11 I I � I I I I 11 - I - I I I 11 I I I o " I I � 11 . ' 'I I I I I � I I I r 1 : I I I . I 11 � I I I I 11 .1 I I � .1 - - 1. 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"I I I I I I I '' I 11 11 I 11 I I i I I I I "I , I , It , 1, I I 11 I I , I I I I I � 0 WETLAND OWNEA71ON BY JIM GASS, MSR/AECOM, MARCH 23, 2007. , , , � I I I � I ) - , I 11 � I I I I I I . I I 11 � I . 16.) � ' I � I , . I I I I I � I � I � 'mm � It 11'�'. , I I 11 I I I I : 11 I 'I I I I I . I I I I I col/.'�' I '*MAIN DITCHO per LC C. P1. 35762 A I I "*�-�:I ' 11 � � � � I EWE OF WATER , I I Ak I 11 ?/ ""', / � .;�* I I . � I I I , ' I I �' L ' I � L � � ' - I I ,� I I � 1 B-25 "I - / ' TP i - ' � - I . I � i - U - , I FIELD LOCATION DATE' MARCH 27, 2007 1 1 1 1 - ' e I ,- ' I I / ' I r I I �� I I . , I �� I I . � : I 11 � I � I � ' I I I I I I FIELD LOCATION BY BAXTER I W ENGINM?ING & SURVEWNG. - ARCH 26, 2007 � I I I I 1 �\/ / Ak I � I Ak : , I � . 11 I �"" . I I I I , I � � 11 I I 11 I I I I I I I � � I . I I : 1 1 1 1 � L I I I I I . � I I I � I r, // , " * I I , I I � I I I .11 � ' 1, 11 , : . � I 11 . 1. I I I I I I 11� I I I I I � I . 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