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HomeMy WebLinkAbout0393 LAKESIDE DRIVE WEST - Health r393 Lakeside ®rive West \ Centerville ' P A - 232 021 -ti 4 No. Fee THE COMMONWEALTH OF SXATTS Entered in 'o titer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Zipplitation for Mispo8a1 6pAtem Construction Permit Application for a Permit to Construct( ) Repair(4 Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. , wner's Name,Address,and Tel.No. .393 � �, . , � �6�-ter,e,,s Assessor's Map/Parcel aka QJkrul" ,- .-3 , F DoYm�� Installer' Name, ddress,and Tel.No. 5A-exn o/o��r Designer's Name,Address,and Tel.No. v. Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) i +. �:,v Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental a not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date f(o Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued No. Fee t- THE COMMONWEALTH OF SfACHUSETTS Entered inco4uter: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 4pfication for Disposal 6pstent Construction Verntit Application for a Permit to Construct( ) Repair(/) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components r Location Address or Lot No-9Q3 ���,�� - > ST Owner's Name,Address,and Tel.No. / - &4a,-ehe4*,s "Assessor's Map/Parcel a39 a/ Oen kruj 114— m 3 Installer's Name,�ddress and Tel.No. Ji*•y.2a- ego 4_ Designer's Name,Address,and Tel.No. !„�aOX:,Z& 6_",54;C;AI�•,�7rC / Ux N/4 Je4VerCy'v Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd , Plan Date Number of sheets Revision Date Title - Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) / / 4e/ �� ��, Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code—a—Code-a-M not to place the systenoperation,until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date Application Disapproved by _ Date for the following reasons " Permit No. V Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ,) Upgraded( ) Abandoned( )by &Y at e 11p 5� �+Lr, /�b_ac�°"' has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer l f feJ , q t` ,�; Designer 6ejaer #bedrooms Approved design flo,A gpd The issuance of this p rmit shall not be construed as a guarantee that the system will f ction!as designe . Date f a h Inspector 1 J h ) S T -—�J 'a------->-- -�'=------------------------------------------------------------------------------ No. � �C � Fee _ < 7 `s"'.---- ttt//J THE COMMONWEALTH OF MASSACHUSETTS /�- - - PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS M1sposal 6pstem Construction pertnit Permission is hereby granted to Construct( ) Repair( ) // Upgrade( ) Abandon( ) System located at / ��/����i v ,//� 11 S l" pkwj me and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Constru ion mGa be °o p ed within three years of the date of this permit. _ Date Approved by / J / I/ I DATE :_ 10127(03 -- PROPERTY ADORE SS: 393 Lakeside Drive West -- -Centerville Mass 02632 -- - - - ------------------- On tree above date, I inspected the Septic syslerrt-at the above address. Tnls system Consists Of the following: 1. 1- 1500 ya.Q.Qon 6.e/�t.ic .tank. RECEIVE.� Z. 1-[�.i�ta.igut.ion fox. 3. I-Leaching taench. (40'X14 'X9 ' 1 3 2003 Baseo on my inspection, I certify the lollowing condltlons: [NOV, WN OFBARNSTABLE 4. 7hi-6 ih a t.it ee live .6eptic .6yhtem. (78 Code) HEALTHUEPT. 5. The zept.ic .6y6tem .i.s .in 121topea woak.iny oadea at the paezent time. 6. [move aod,6 .into the stone of the ieach.ing;rie.edStone,:i�aae day and clean. ( No Bio /7at) ( 3-Lateaaiz) SIGNATUR �71 'a/. Name - - - - P_ _Macomber_ Jr . MAP o m a n PARCEL ; Q 2 P Y ,14�t~Rh � M�S4m�2t`�d_ Son, Inc . LOT _ � �oress - _ ------ ,Yt.UP-- :1a _ _22.632- 0066 � ?^ one 508 . 775_ 33 )8 _ _ _ _ _ _-- TmIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. Tanks-Cesspools.l.eachllelds Pumped & Installed Town Sewer Connections P 0 Box 66 Centerville. MA 02632.0066 775.3338 775.6412 COMMONWEALTH OF MASSACHUSETTS = EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:393 Lakeside Drive West Centerville Owner's NameTerrance Deluca Owner's Address: Same Date of Inspection: Name of Inspector: (please print) J.P. macomber Jr. Company Name:Joseph P. macomber & son Inc Mailing AddressBox 66 Centerville Telephone Number: S 0 A_7 7 S_3 3-3 R CERTIFICATION STATEMENT 1 certify that 1 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. 1 am a DEP approved system inspector pursuant toSection 15.340 of Title 5(310 CMR 15.000). The system: �d/Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: /�-�7 l JV The system inspector shall bmit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ' CERTIFICATION (continued) Property Address: 393 Lakeside Drive West Centerville OWner:TP as . Deluca_ Date of Inspection: 1 0/2 7/0 3 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A Syste 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: The .sef?Y_ic 6u,6tem �i, in /22o/2e2 wo2king oade2 at .the onv.tnit.t .time B. System Conditionally Passes: lfll1L One or more system components as described in the"Conditional Pass" ass 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. Vd 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: �8 Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: l 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: I 2 Orrycl A�j y N S -I-"r T 0 p PL a-, I " NOT FOR VOLUTNTA-RY ASSFSS."LN"rS ' CL DISPOSAL SYSTEM INSPECTION FORM PAR TA C ER T!F'j"--'A—FI 0 N (continued) Propert)- Address; 393 Lakeside Drive West,-- Carite.4- i- 0woer: Terrarice Djeluca D 2 i e of Ir spectian:1-(�) 2 T77(0- C. Further F-valuation is Required by the Board of Hellth: Conditions exist which requue fiLl-1her evaluation b.y the Board of Health in order to determine if(he System is laililic, to protect public hclWl' 5al"w), or the envilonniclit. 1 SX5(em will 'rass uniess Board of Health determines in accordance with 310 CMR 15.303(l)(b) that the system is no! functioning in a manner which will Protect public health, safet., and the envirotiment, 14Q' Cess:9001 or privy : , —j7 's ',i(hin 50 feet -of'a surface water e�-'e)c�-Sslpool or P is NVI(hill 50 feel of a bordering vegetated wetland or a salt mars), .2. Systen, ty; 11 fail unitss the Board of litaith (and Public Water Supplier, if any; deterr-nines that the system is functioning in a manner Hhat protects (lie public 11"Ith, safety and environment; The system his " SePtiC and sc"I 3bs0rPti0iI system (SAS) and the SAS is within surface n-n too feet ol,,,. water SuPpi), or tributary to a surface wa[cr supply. P5-1 ILL(2 The system, has a scPt',- tanJk and.SAS and the SAS is Within a Zone I or a public water i he system Bras a septic lank and SAS and the SAS is wilhin 50 Cc',( of a private water supply Well. The s%,sjejji h n as a septic tang and SAS and the SAS is less than .100 fee! �ut 50 feet or more t'rotl 5"P P ell Method used to determine, distance "This S'Vsie rn pa 5se 5 11'tile :veil water analysis, performed at a DEP certified laboratory, for col i forn, bacteria and volatile orp.aMC cor.n pownds indicates that the well is tree fxOm pollution .cc ora,nn,on�, n the p;c5cil irlogen. and nitrate nitrogen i 5-orll that facilicy arl", S CQUal to. or less marl 5 pp,,.,, poyide-d that no'ouher failure criteria are triggered. A copy of the analysis Must b4! Hivched to this form, Other: i Page 4ofIP OFFICUL INSPECTION FOIE v j\r0'< 1 0 VOL '`-,TAJ. Y• ASSESSMENTS SUBSURFACE SEWAGE DISPOSA SYS7 EM INSPECTION Ia OIZM i�11• A >• CI✓I2,Ti7'lCf�"("IU'�'. (continucd) Property Add ress:393 I_akegide,.Drive west. OWeer:Terrancie 15 1uC,-j t.. Dote o! Ius�cctionl ® ,7�p — D: System Failure Criterla ap slica!)!e to all s;stems; You rnus IlldiCFst�°`ye5°°or 01(1011 td t!Ch Uf t}!z fo11o'14'irlg IUr ±il irls.pections: Yes No /J `� ackup of sewage into facility oe system component dwc to overloaded or clogged SAS or cesspool u_ ��`DischLrga or poo&hg or cm uent to the s�dace of';l,e ent to the s�dace of';l,eround or surface waters due to an overloaded or 110,syged SAS or cn�sspool -,L, Static liquid level its the distribution box above ouliei invert due to 'V overloaded or ciagged SAS or cesspool 7. iY0 Jty!quid deptll iu s�l,�l l; less Shan. � beln.�. i'"1 or a tillbic Volume is less than 'A day flow �I, :,vq'uered pwnDingr 1.,o e- }.- . ti!;ie_ t!'; in(. !apt yea, N_Q. dk'C 'to Jr obstructed dogged r !rutted pipe(s). Number of tinle5 pi!n7pCC1 i% . any portion of d e SAS, cesspc.,:i or privy i5 be Vv iil)i t,ow)d water elevation. Any portion of ce,sspgol or pri`.^/ is within 100 feet of a sud'acc water supply or tributary to a surface /water supply. r' G/ Any portion of a Cesspool cr privy is v,lttiin a Zone 1 of p p• �' public ';yell. _ ,ny portion of a cesspool or privy is wi?hin, 50 feet of a private water supply well. _ r1nypUr2!on of.f ccsSpool or priY;' is 1Kty"ri?d? ':Qti le.t '>St g-eater than 50 feet (Tom a pflyate Wate( supply Well will, no eccvnzblc Wa pr uuallty analysis i1 his 3),stem pas3es 1t 11!e s,'cil water IT,.A!}'SI.s, terl�lr!liGCl sit td iii l i,mified iar:ormor:,', for coliform bacteria and 1'olatile organic compounds lad"Catcs that the Veil is free from poilu'don from that fgcjiit) and the presence of ammonia nitrogen and tlitrate nitrogen is eoual !a or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the iinalysis roust be alti:ched to this form.'I Cam' �YeS,�lo�The systel'n fliilS• 1 ii `.' de;cr ii'n�d that Qne Cyr rnoii of the above failul: criteria eXISi aS described in 3!0(,IiR I`.!;)j. !,n1ernrr the sys?ern fails. The system owner should contact the Board of rlealt}! to cici rhnine whiff! will be npcessar.y io Co;-.Cct the fajiUre. Largen„ To be cc`risiderect a large sysieni (he sysitril must serYC a facility "'ith s design flow of 10,000, gpd to 15,000 gpd• You lust indicate cithtr 1 yesY1 Or 01nU" !v t aC.1i of l};c i- 110w[+';�' The 4;o1loWi cri?;rl'c apply to large S1'stems im addition to the criteria aboyc) e.5 di0� �. the Systern is Within 40o fret ofn s,!rfarF drinking 1i'atr supply __.. ��he systc°rn is `ft'i!l in :1Gr �f o a surfs i leaf � ii•.i.lar„i Ce d;ink:ing wafer supply the sy ster"n is lo<-ated in a nitrogen sensi6 e area (Inlcrim Wellhead Proteciion Area— IWpA) or a mapped Zone 1! of a pu lir water suppiy well It ) 1h31'e P.S`.,':'f .d ")'eS" ii) :1?}'gUeSl!Or? 1n " Section b. the system is considered. a significant thleat, or answered yes in Scclicn above the I t o system has failed. The OWner or operator of any larg,r system considered a si;niflcant tetras! under Section: E or failed under Section D sl)ali upgrade the system in accordance with 310 CMR 15.30"'. "the s,'s?em owner should coniac, the appropriate regional )ruler of the Department. .l Page s or.I I OFFICIAL, INSPECTION POM -NOT FOR VOLUNTARY SUBSURFACE SEWAGE DISPOS;.L,SIYSTEfv �3�'SI? CI''10:N c_�;;. •; PART B CHECKLIST Property Address:393 Lakeside Drive West Owner:Terrance D 1 ,a. Date of 1030eciloo:1 0 27 03 Check if the foliowtn have been done.You must Indicate'yts1°or'°no'°Es 10 eicil Yes No ® rPumping information was provided by,the owner,occupant,or BaErd of Pc ltt. ® Were anyofthe system components pumpedout in the previous Has the system recelved normal flows in the prevlous two w,c;: Have lame volumes of water been lnt8odueed to the sywro �cCcntly o; _t Were as built plans of the system obtained and exzmLned7(I r the/•„.�, t ® Was the fae ill ry or dwelling Inspected for suns of sew&ge back un �® Was the site inspected for signs of break out? , Were all system eomponents,.eluding the SAS, located on site? Were the septic tastk manholes uncovered,opened,and tine ill;ri of th�e'baffles or tees,material of eonsnction,dimensior-is,d4pth ut d! Was the facility owner(and occupants if diMrent from mainte.nanee of subsurfa6e sewage disposal systerns The size and location of the Soll Absorptlon Sys trin (SAS) tl:c ;;tc Ycs n�/Existing information. For ex&rnplc, a plan at tlra 4 Determined In the field(if arty of the rdl0_ cr;z.ri is unacceptable)(310 CMR 15.302(3)o)-1 v i Page 6.or 11. i OFFICIAL INSPECTION FORM —NOT FOR VOL-UNTARY ASSESSMENT) SUBSURFACE.SEWAGE DISPOSAL, SYSTEM INSPECTION YORM- PART C SYSTEM INFORMATION Property Address: 393 Lakeside Drive West Centerville Owner: Terrance Delucaa. Date of Inspectlon:1 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design):---� , Number of bedrooms(actual): a% 9 DESIGN flow biscd on 310 C1v(R 15.203.(for example: 1.10 gpd x M of bc&oains Number of current residents: ) ""�---` Does residence have a garbage &vsder(yes or no): XIbI Is laundry on a sepuatc sewage system tycs or no):ZO (if yes separate Inspection required) Laundry system inspected es or no): Seasonal use: (yes or no): � Water meter readings, if available(last 2 years usage(gpd)):2001:20, 000 9a(. e0n.z-5 r, 0 iPD Sump pump(yes or no):a1J8 Last date of occupancy: 2002=13, 000 ga.2L)on. s 3 5. 52 r?D COMM ERCIALANDUSTRIAL Type of establishment: Design flow(based on 310 C1vM 15.203): d Basis of design now(sests/persons/sgfZ,ete.): Grease trap present(yes or no): & - Industrial waste holding tank present(yes or no):X Non•sanit.ary waste discharged to the Title 5 system(yes or no):/ Water meter readings, if available: l- Last date of occupAscylust: ___ a!! - OTHER(describe): GENERAL INfORAIATION Pumping Records Sourc•c of information:None ava.i2agie Wu system pumpcd.as pads of the inspection(yes or no). If yes, volume pumped:—�O aons Flow wos qu"Ilty pumped determirIcri7 Rerson for pumping: 7P.� OF SYSTEM eptic LuOc.distribution box, soil absorption system l.'L`? Single cesspool Overflow cesspool "v Pri vy ;7 Sh;red system(yes or no)(if yes, attach previous inspection words, iC anv) >f Innovative/Alternative technology. An. copy of tips G �7.6?t Gy'L(atiJil ar':C lbii?i4naP.Cf COn:r3c( f!o be obtained bom system owner) ,�Ti at t�it `(j1D Attach a copy of u?c DEP approval -Loother(describe): Approximate age of all eompoents,date installed (li knr,wn) and 50Urcc of ir,;or7?,ctiG Wcrc sewage odors detected when t rrivin;° ai ti?c ;its (ycs hr no 6 Page 7 of i l OFFICIAL INSPECTYQN FORM NOT FOR VOLUNTARY SOSURFAOE`SEWA:CZ DISPOSAL SYSTEM-Ym? EC1"ION ad'o,"-;fit PART SYSTEM INS'® .'ii'I©>`d(eontt:t!cd) PropertyAddress::39 :.._La P-sldp- F1-rivie West . Qwp..c► Terrance De ca Date of inspection: 10��,� BUILDING.SEWER(locate on site plan) Depth below Vade: Xe Materials of construction:ekcut(ron X_40 PVC 40 �� other explabi) Dist�nee from private hater Supply W611 or suction lirse: l� CornmentsAon condition of jobtts,venting,evidence of IC-4tge,ete.Ji o.int 3 " a ea/t I- ht> No evidence o v�ak4.peo S��� vented aoug a 200 ven i5o SEPTIC TANS{:,(locate on alto plan)✓* ``�` Depth below 4-n— Material of eons� ncrete' mctalA I. or�las olycih.ylcilc If tk is metal Ils ago 6onfb-msd by a Ceaddf cote SCois!yii :�c ( s yr sad)e �r_�ei .drs e Ce)v GI cenific�cc). ',1 r N� l�ir»enatogs [� --�✓�✓ � . � �1 Sludgc dept Distance fromalop of sludge to bottom Rootlet tee or b3Nle: SC�tbt ChICk.AC$s:7 Dist r�c�tom top of$ca:it_to top of outlet tee or bade 'yam Disu tce 4•om bottom of setlrn to bottom f outizt ice or Wilt: Now wire dimensions determined: � _ Comments(on pumping recommendations, trtlel and outlet lc,; or l3Eti1:C'J;iCI!14tt; STuC!Lta; iCtJ I.j i.j�!� ,C ::3 zi related to outlet i,tvert,evidoce o.f•ld�dgc,tle•): Rump--zep�ic .ta,'nk__evelcu 2--3 qea&.3. In-gc�.t X ou,'_C ! t. t �; l c c r, 7 ' f r7 lY tl( .••_.•""._% iiquid vzvev at ihe`• out vet �aue��F tip' � ;„ CREASE TRA. .�'i� locate on site Depth below grade:�� i�{mtedlal tlfCOraSfrUCtltl41 60n6r66e intG3l tDbLr,lat5 �s 01 CGs;lr, ,rf, 4pi1tK? S.ctart tlil61Ui6sd . Disncz from tdp of scum to top of ouli�t fey sir hwtle up° Dlsujice [0ni botiol"t)t36i18rd tl bCttz0il5�iti7Jtltt rt?tJr , ;`! qua of I t pumpb, Coffumonts(Oil pure ib� rccorrrtiateitdatio.sas, laic:uif�t ct!l !{{c: :r�aaC�;c c��ndi!ic�r, s!rvcnarol utitKrity, liquid rck(i l to outlel L,tiveft, �vi&u? F Pages of I.1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY A.SSESSM1 N-TFS SUBSURFACE SEWAGE (DISPOSAL SYSTEM YN'SPEC','yQ 1z k PART C SYSTEM INFORMATION(continued! Property Address: 393 Lakeside Drive West Centerville Owner: Terrance Deluca Date of Inspection; 10 2 7 0 3 TIGHT or HOLDING TAN( 1'(tank must be pumped at time of inspcction)(locaic on site pii�';) Depth below grade: y , Material of construction: } 'concrete 4M metal dA fiberglass col; OUR r Dimensions: Capacity: allons Design Flow: XW 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.): 7aht- na hn-Pdj n q tankb ate DISTRIBUTION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert:AY Comments(note if box is level and distribution to outlets equal,any evidence F;olig.' .c- ,; v ,v; leakage into or out of box,etc.): uiion Sox hays thaee iateaa 0z, No 2v.z <cr.cc o/ o 1'-/{. nt�va. No P �a-r/ try�/ ace o-1 .eeaka�2 1n: o._o%c_c,u7.�u j_"__.�;` 0.oA •:_--------_� PUMP CHAMBER4�(locate on site plan) Pumps in working order(yes or no): I si Alarms in working order(yes or no): / Comments(note condition of pump chamber,condition of pumps alid ,appurtenances, etc.): Pump cham ea t no �)e"zen T. ` a V Page 9 of l OFFICIAL INSPECTION FORM-.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPI C'11"T01 P C)Rir1 PART C SYSTEM INFORMATION(contutued) Property Address393 Lakeside Drive West Centarvi 1 1 A Owner:Terrance Del ica Date of Inspection: 10/27/0 3 Zlocate SOIL ABSORPTION SYSTEM (SAS): on site plan,ekcavailoii i o; 1-40'114' -2eachZie�d If SAS not located explain why: Located see Page 10 T Xleaching pits,number: O leaching chambers,number: ey'D leaching galleries,number: 6 ,Vb leaching trenches,number, length: 13 leaching fields,number,dimensions: .42-1) overflow cesspool,number: , innovative/alternative system Type/name of technology: _ Comments(note condition of soil,signs of hydraulic failure,level of pondinc darn;, !, r-unditi:,n c•� F: cict etc.): Loamy .band medium nand to line zando No .6-yn,� h (; ,-ec/ - 4a.i.zaaa oa. nond.i-ng. DIZQZ)P. a- d.s into the z nn_;>__r: - .i6 d2y and no zigns oZ l.io mats. Ston.ez aze Sn.r:./'s veggetat.iorrr�� .s no2ma$. C SSPOOLSJ)4&�(cesspool must be pumped as part of inspection)(loca:f, on s !c elan j Number and configuration: t Depth--top of liquid to Het invert: °>> _ Depth of solids layer: Depth of scum laver: WhA 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., ccnJidon or vt,acL'ition, cic.) reLLb,Q[1[Li�h---rin_v_ n_nf- ,ygnnf ," Y__ ______.,_-•---- --_-----.---.__..._ _--- ----- PRIVYQ&-&(locate on site plan) Materials of construction: Z;4 Dirnens*ions: ()/ Depth of solids: Comments (note condition of soil, signs of hydraulic failurc, lvvcl of ponjina, cond1:ion of v j,etaiion, 2.l-vy -i,3 not Rn.e•5eni_ 9 Page 10 of I I. OFFICIAL INSPECTION FORM —NOT FOR-VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSs''C�'Ir?i� PART C SYSTEM INFORMATION(continued) Property Address:393 Lakeside Drive West Centerville Owner. Terrance Deluca Date of laspection:10127/03 ` SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including tics to at bast t�/ro P: >�vn r,lcrcr:: !�n�r;arks rr benchmarks. Locate all wells within 100 feet, Locate where public w:ter a� p ly c,:z•5 i, L, o /4. U _-a - I !n ;i0i: 001 A ?% t.� COMMONWEALTFi OF MASS? C#iUk" '>'S NAME OF OWNER Mr. and Mrs. Martin Urr,z nt5 . ADDRE,9S.- 10 Judith Road -'antre Mass. 02159 ct• -ot !� rvo� 1'ovatl or City Statzp Cod PROJECT .F,OCATTON 427 Lakeside -"ruly 3, 3_979 r st is: hereby cert .f ies stated in a r. 0, zr as�c D1a 17t.._1978:. _.._. - ___•-��__g I',y t(-'e BARN,S`.;.'r,k'.I..,A_ COINI St,R'Jl' TION L^.omv,. `)ave been satisfactorily complet,A. s' ,n ...a. n x :).n the a'.egistry of D,�cds f ca i_strlct Xn which the .la-rd s' 1 u c a, c l T ae Order was originally recorded 0rl july 21, 3.97F3 � 1 #r'20845 (date) _... ....• .....•.., _._ __....,�_ ..�_ u_ r� � �r��g e I' ., 1 OF IS SU;>_NC, Ai.1 TH0P.I ..v ..�... ...._ ._ ._........-.,_ ........-L---..�.. .� �..e._- - ./mil ....V. .� i.��-Lt.. 011 L-A'a I. 1 % Cpe e d a" of �\ 19 U to "1t? } 71U�+?t tc, b(;+ iJicl �et rsc,n .btCIL iTl i:trid who executed the. f"J] 1_S1S+:XliP.E7i•'. ctllli Llix�l. 1„ a. C XL., L--ed the same as his. free ac ?TlC_ died. Pa} Commission e;� Page I 1 of l l OFFICIAL INSPECTION FORM - NOT FOR -""I SUBSURFACE SEWAGE DISPOSAL SYSTEM YNTS)?EC-'T` ,' FOFI =i PART C d SYSTEM INFORMATION(continued) Property Address: 393 Lakeside Drive West Centerville Owner: Tprrance-DejUpat Date of Inspection:a 0/2Z103 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water id feet - e Please indicate(check)all methods used to determine the hi&h ground water eicti a:ion: 4149 Obtained from system design plans on record • Ifcheckcd,date ofdcsirt Man reviewed: Observed site(abutting property/observation hole within-l50 feet of SAS.) -' d. Checked with local Board of Health-explain: Checked with local excavators, installers •(attach docusngntation) Accessed USGS database-explain: r You must describe how you established the higgh ground watef clevatlon: !sedt Gafz (7i22ea f'lode2. 12/16/94 .GaouncL r�¢ e2.� e.e !a e d r US Q d a t a° u n !e ed • US(7 T __ - -- - � �000- I %zat� LeAching 9 Groundwater. Feet Below Bottom of Pit . High Gi0Ui1CI1Vc ter Therefore, the, vtrdca! scji bra;- jiS!anr. 1N t • < .cn Of t}SC Icachin", P}. foci. E• RG`•+9,c ',LOi;. :S ,�.' G',`F!'r . II , .•wwnr+.�n:r�.�.w�a.wrwwv.�nr�+w►.nrwnw+nw►nn.wwnw�s�x.�•�.r�nwm .- ,,�. _.... . .' TOWN OF BARNSTABLE WARD Oir )fe°t1UNI SUBSURFACE SEWM)E DISPOSAL SYSTEM INSPECTJO?j a 0ii,{ d a'r wr' 1) '.-•vn�••.-::.—�.,,a•awrnwanw•w+„n e�w'+�rnwwnr.�a��vrwrn erww�rv�r�revrt r«+.. v.t�w,^rrr.�:yai�.,•s.�r,.r-•w°ar,•xx ert'r�r�w.::.r,+-n.� Y ' -TYPE OA t'AINY C rAU"i,'i- PROPERTY INSPECTED STREET ADDRESS 393 Lakeside Drive West ASSESSORS MAP, BLOCK AND PARCEL ._ 232-021 OWNER' s NAME Terrance Deluca •,� ,• -•- •xbr+i'-mr,+•Ler.e:.nOax +^M.vuw*skC'®e"ue^asRc+:wt+ti:'o•dwaRaslyy:ys-Y•—`.—•_`•._•_�_.� FART D o C �d ?'avC,,7I�rl, NAME OF INSPECTOR Joseph P.Macomber a7 T`. COMPANY NAME q._P.Macomber & Son Inca. COMPANY ADDRESSBox 66 Centerville,Mass. 02632 Strove lcttl s•cvSly _. _- ,._ a 5tta C!f' COMPANY TELEPHONE ( 508 ) 775 3338 F,,.X ( 5Q8 -»r;, ; [,fin, CERTIFICATION STATEMENT I certify that I have personally inspect <cl :kthis address and that- the inrormation r port .c; is t,ttay , c,�;.z, �xt $ ^ompiete as of the tiriie of -ins 'ihe ijjjpe�: taar� wasJ pi' fe�r�,ed and j� 1 � recoinrnendatLoris regarding upgrade , dnaintenance. and rf. ' ' Pttl : i�r� cc, s , aCe;, t with my training and experience in t}acs pro; �;tnctiori nn�i rnainr: en:;rlcp , ,r site sewage disposal systems , Check one , System: PASSED PASSED V' p The inspection which I have conducted 1 noi.nf'crmaiion which indicates that the system fai. is t _: ade ;;�atl,l� pzotf,ct , , heal Eli or the envirotl cat its deri"d K Puy- i.c { + !� r i ;� 10 C •i!�c 1 ., , "}U:i , Any i a! ?•.i cri teria not evalu,,t6 d al-e tag :�tdLc,'.r i ;{ the FAILURE c this form. �Lr? rzr�. ?ieC' tlo„ or System FAILED � The inspection which I have; con �rct ;l ti�a :s rL+.in d th+Ii, s;rstem „ ils tc protect the j,ttblic health and ti+Q C-tivi ".on.t+en { r ,�c{;crdanc;,. + r,r1 'lit l 5 , 310 CMR 15 : 303� and as ` 1 :spec_ f i-ca. ' ,: ni}tart j; PAFR' - i f U:R. k CRITERIA of this inspection fcq-f;I , , R. Inspector Si nature . , ;,..'�✓'�% r ��, ::ace;Frs eacaw tsr5v�-.�uuuy� _..:+orc:�vey+�a+•:cacc�.aas.w.a;•�.}•.r.:: s-v.ry.:.:.. �-cx_,-. ,.a....a _""_•.• vxx�rssc z:...:m.�aa�x.r�r:,ra gin® copy .of this certification t{lust b;: i : cv; c:ic=d t.cl the C�''{ '(� ( whury G1)p11o4b1Q ) 4nd thv I:Oh,ar1 tltll'%Q f the inspection VAIL90, th*-,: us;r:+3r c.,1 {oanr �tor ahul ? up ' t e.n, «ithin one year of tlici tiara of Lh� +.r; a :C,c *.i 11 un} ess :tl. ' a:-.ad �,x• ,.��, L �� otherwise as provided in 3.10 CC:Ffit ,. , 3o pcic•td : dor_, SEWAGE INSPECTIONS L ATTON _393 Lake-bide DAive Nett DATE �U/27/U3 VIl AGE Cente2vii ee' Na,3a. ASSESSOR'S MAP & LOT 232-021 .IN PBCTOR aohe�z l. Nacorn e2 aa. IT i 1 SEPTIC TANK CAPACY 1500 ua eiona 9-Box LEACHING FACILITY; (type) 401X14' fieid (size) NO. OF BEDROOMS BkDER OR OWNER 7e22ance [fie euca OWNER MAILING ADDRESS Same . yo ,_ 3 po� cvesT I { !t ! t�7s�v'1NwYkrll �k31 (AUj(,BORTOLOTTI CONSTRUCTION, INC. 45 INDUSTRY ROAD,MARSTONS MILLS, MA 0264508-771-9399 508-428-8926 FAX: SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ., . _ , ,,,w. , CERTIFICATION Property Address: js „ - W ()0 ,QdiA,0,qdJ,01 Date Of Inspection 7 Inspector's Name: Ow er's Name and Address:e J AIIA CERTIFICATION STATEMENT: I Certify that ay!personally':Inspected4lie:Sewage Disposal System at this address and that theanforma tion reported'below l true;accurate and`complete as of the timer of Inspection. The Inspectioin.was perform- ed based on my Training and Experience in the Proper Function and Maintenance'of.On-Site Sewage Dis- posal Systems.T system � ! `Passes,', VY,1, Cond1tionall sses s Needs Fu Ev ati y the Local Approving Authority p Fadur . • 22 Ins ector's Si nature _ llate: �� o�14 TheSystem Inspector shall submit a copy of this Inspection Report to the Approving Authority with Thirty (30)Days of compieting'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 Offie of the Department of Environmental Protection. The Original should be sent to the System Owner and copies sent to the Buyer,if4aapplicable and the Approving Authority. INSPECTION'SUMMARY: A) SXSTE PASSES; ! I have not found any Information which i ndicates that the System violates any of the fail- ure criteria as defined in 310 CMR 15.303. Any Failure Criteria not evaluated,are indi- r y .. ;.sated beSow e + B) SYSTEM COND.ITIONALLYTASSES: „ .,, One or.more System,Components need to be Replaced or Repaired. The.System,upon : .' completion.of,the Replacement or Repair,Passes Inspection Indicate yes,'nor,or.,not.determined,(Y,N,OR ND). Describe bases of,determination in all instances. If"not determined",explain why not. ' -,^FThe`Septic.;Tank;is=Metal,Cracked,Structurally Unsound,shows Substantial Infiltration or exfil- tration,or Tank Failure is timminent. The System will Pass Inspection if,Existing Septic Tank eviisiReplaced with a,conforming Septic Tank as Approved by the Board Of Health. Sewage Backup or Breakout or High Static Water Level observed in the Distribution Box is due to f =,w 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):. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM { PART A CERTIFICATION(continued) Broken'pipe(s)replaced Obstruction is removed Distribution Box is levelled or replaced The System required pumping more than four times a year due to broken or obstructed pipe(s). The system will.pass inspection if(with approval of The Board of Health): Broken pipes)are replaced <� �. j r moved �y rr:� ..� ':.Obstruction, s e , ! C4 .�+,}:9¢�� ".adtir'+•u e.x�y:�.{�. - 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 Me system is failing to protect the public health,safety and the environment: `ual1)'SYSTEM.WRJ4ASS`UNLES&B.OARD;OF HEALTH DETERMINES T- HAT THE .•714`''""°v°"ISYSTEM3`IS NOT°FUNCTIONING IIN AIMANNER WHICH WILL PROTECT�THZ,,. ";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 APPROPRIATE)DETERMINES•THAT,.THE SYSTEM IS FUNCTION- ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND;SAFETY AND THE ENVIRONMENT. qr. The system has aseptic tank and soil absorption system and is within 100 Feet toa surface 3 t:f is,,water supply or.tributary to a surface water supply. r.. E ,,s .'# 'The system has a septic tank and soil absorption system and is with a Zone I of.a.pubhc 1T :3 water.,supply well. The system has aseptic tank and soil absorption system and is within 50 Feet;of;a;private, water supply well. „,a The system has a septic tank and soil absorption system and is less than 100 Feet but 50 Feet or more from a private water supply well,unless a well water analysis for,coliformq,r{, bacteria and volatile organic compounds indicates that the well is free fromrpollutton frott►` the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal`to or less .fir;;.tl' t '•+'{' "�'S pP� , . .. . . + a 4, . v.. 'D)SYSTEM FAH S: I have determined that the system violates one or more,of the following failure`criteria as defined:. in 310 CMR 15.303. The basis for this determination'is identified below The Board of Healthft �sh6uldbe�contacted'to determine what will be necessary to correct the failure: Backup of sewage into facility or'system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of efluent to the surface of the ground or surface waters due.to•ant, �4.te, overloaded or clogged SAS or cesspool: F'14 , Static liquid level`h the'distribution box above outlet invert`due to an overloaded or clogµ, go SAS`or cesspool,, :s Liquid depth in cesspool'is less than 6",below invert or available volume is less than 1/2 "aay°flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped -2- L . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) 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 I of a public well.' Any portion of a cesspool or privy is within 50 Feet of a private water supply well. Any portion of a cesspool or privy is less than 100 Feet but greater than 50 Feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: � ;The fotlgwiag criteria apply to a large system in addition to the criteria above: .. . t At°�.•• '#ni k_rd "' e`,;".,., i.':�., < ..td. ." : .wp.3 t •t The,design flow of a system is 10,000 gpd or greater(Large System)and the system is a significant. threat to public health and safety and the.environment because one or,more of the following :conditions exist: The system'"'within 400 Feet ' a surface'drinking:watersupply k a The_system is"within 200 Feet of a tributary'to a surface drinking water supply = The system isjocated in amitrogen sensitive area Interim'.Wellhead Protection Area (IWPA)or a mapped Zone I.J.of a public water supply well!, `i ,The owner or,operator_ofany such system shall bring the system and facility:into full compliance with.the pvundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Check;if the following have been done: 6 Pumping Information was requested of the owner,occupant,and Board of Health# <,,.� _._�..,. oneof the stem components have been um for atleast two weeks and, +'�N sY Po pumped 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. n _ ✓' As-built plans have been obtained and exanuned. Note if they are not available with;N/A. ` _ The facility or dwelling was inspected for signs of sewage back-up. The system does not receive,non-sanitary,or industrial waste flow,.:,, �_+I'he site was inspected for signs of breakout. Ali system components,excluding the Soil Absorption System,have.been ocated on site. _ Theseptic;tank manholes were:uncovered,opened,and the interiorof the septic"'was to , spected for condition of baffles or tees;material of.construction,dimensions,depth.of liquid,4r. th of sludge,depth of scum. r y size and location of the Soil Absorption System on the site has been determined based on t, existing information or approximated by non-intrusive methods. -3- 3� 4 y J " w. A ♦e ..1. e t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(continued) r .?tom,The.facility owneu(and occupants,if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM y , . PART C !-5 ;: p •; tSYSTEM INFORMATION FLOW CONDITIONS, a RESIDENTIAL: f Desigq Flow: ons Number of Bedrooms: a Number of Current Residents, _ Garbage Grinder: Laundry Connected To Syste Seasonal Use: F Water�Meter: it. ble: Last Date`of Occupancy. k COMMEiCiAIANDUST 7 pe of Establishment Design Flow:tL ^�gallondday?Grease Trap Present: (yes or no) ` Industrial Waste Holding Tank Present . ?Non-Samtary1Waste?ischarged=To The Title V System: - g Water Meter Readings,If Available' '- Last Date of Occu ` s panty: V. ;n, .;. OTHER: Describe) Last Date of Occupancy: ' GENERAL INFORMATION PUMPING RECORDS and source of information:� ,c�it I System-PumPed as part of inspection:{) If yes,volue pumped:' "'gallons Reason for pumpu►g , r m ,. TYPE STEMS TTanWistnbution Box/Soil Absorption System" Single Cesspool Overflow Cesspool t Privy Shared System(If yes,attach.previous inspection records,if any Other(explain): . �� �"nt�'G5,"f'),' `4"�h9'�.� "�' ,.� + Y j, ; .: ¢` " { 4�, 01 s ti a{s ,xs�: r •..... (sq:�';°<.. _ i s APPRO� TETAGE'of all'components,date installed(if known)and'source of=information:' Sewage 0#rs detected when arriving at the site: -4 i e SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART GENERAL INFORMATION (continued) SEPTIC TANK: v o\C Depth below:grade:T Material of Construction: ✓concrete metal FRP Other (explain)` ' ;•. .. . . .. — , Sludge Depth: " Scum Thickness: Distance from top of,sludge to bottom of outlet tee or baffle:. � . Distance from bottom of scum to.bottom of outlet tee or baffle: Comments:(recommendation for pumping,condition of inlet and outlet tees or battles,d.pth)of liquid level i relation'to_outleVirivert, cturaf integrity,evidence o le age, to; 57 V. r � a a GREASE,-TRAP: it Depth Below-Grade: ` Material of Constnuction: concrete metal FRP Other Dimensions:_ - Scum Thickness: Distance from top of scum to top of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,,depth of ligtud level in relation to_outlet invert,'strbctural integrity,evidence�of leakage,etc) ,F TIGHT'OR HOLDING TANK:_�10 DepthZelow Grade: Material of Construction:_concrete—metal—FRP—Other(explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm Level: r Comments: (condition of inlet tee,condition of alarm and float switches, etc.) DISTRIBUTION BOX: Depth of liquid level above outlet invert: Comments: (note if IKyel and distribution is equal,evidence of solids carryover,evidence of leakage 'nto or out of box,etc.) PUMP CHAMBER: . 'Pump is in"woilsing order: Comments: (note condition of pump chamber,condition of pumps a6d'app6rtenances,etc.) ,5- d ' ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r PART C SYSTEM INFORMATION(continued) SOIQ. ►BSO .1(1PTION SYSTEM(SAS): (L,ocate on site plan,`if possible;excavation not required,but may be approximated by non-intrusive ; methods).-If not determined to,.be present,explain: 1eaching'pits,murnber: Leaching chambers, number: . Leaching galleries,number. Leaching trenches,'number;length ' 'N"Leaching fields;"number,dimensions: Overflow cesspool,number " `y Commen (note`condition o 1�signs o ydrauli failure level of pond' ,condition of vegetation, 1 etc.) ,iC ,df2� l�� are+p Tf ��pZC �BiYlr . CESSPkOOLS• /001 ' €d"F`>f `t 4C..���r i k 7,.�• ., .. .. v :. ; h ,fin _rt. � �`" + § Numtier 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 soilk,signs of hydraulic failure, level of ponding,condition of vegetation, +L< Materials of construction: Dimensions: Depth.,of Solids: Comments:(note condition of soil,signs of hydraulic failure,level of ponding;condition of vegetation, etc.) zN£ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references,landmarks or benchmarks. Locate all wells within 100 Feet. t 1 3p . . . t o DEPTH TO GROUNDWATER: -Depth to groundwater:_-- '/ Feet Methoo of Detemiinationpr Oppro /O O� /Q G/i 5 d� -7 l r ...._ y�cl r, F�$.. 5.. .. ThIE COMMONWEALTH OF MASSACHUSETTS BOARD OF, HEALTH ..............7ju/A1...OF........134�CPTW L&71--------_------ 1 oration for Disposal .arks Towul"V"It �3IGVIS �! / dddt/ 01 �`��V Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual 5ewa63.bf�po%l System at: i',,,.,.., a,,. ,. . . ................•..4A-,EEC:ES!2?.f......2?JK.►.JeR---------------------- ................................. ............................................. Location-Address or Lot No. .,tii,.�t -----u r.1A4AYkS.........---•------------- ........-ta.,�-,c.��,. Rom.........v car �✓.... .F. r�e� I Owner Address'i a ............... 8l1t G�C/1�✓E..__.FC' VIC ,Q�.AseS�E'�`._..f��4'�/ ,tSl�l.�Sta✓o/l1..1` Installer Address d Type of Building Size Lot.._I.Z�Q�_-r..Sq. feet U Dwelling—No. of Bedrooms................S.......................Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ............................ No. of persons.-_--__.-___--_--___-__-____ Showers ( ) Cafeteria ( ) Pa Other fixtures -------------------------------- - W Design Flow......................SS* ............gallons per person per day. Total daily flow----.------ -A0....................gallons. WSeptic Tank—Liquid capacity/Sdfi..gallons Length_/_-Q-_L__- Width..!A—___ Diameter________________ Depth__;,: -J. x Disposal Trench—No.....................Width.................... Total Length.................... Total leaching area---- _'_._._sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet...._............... Total leaching area_..-V14 J...sq. ft. Z Other Distribution box (Y) Dosing Ata ( )Percolation Test Results Performed by-----. �.r.. . --------•-- Date------. ---- M Test Pit No. 1.......;L,...minutes per inch Depth of Test Pit----- .... Depth to ground water............ fs, Test Pit No. 2.......a...minutes per inch Depth of Test Pit----------S_--- Depth to ground water______..-_4K%r-.. a' -- ;V-------------------------------------------------------------- -•--------•----------------------- O Description of Soil___._p/ --- ......... ........�� /i_i�c .�c�b_l�_�. Y~"� `...L`�,,rlt7�- x C1w tt. .. .....P t t�U� ------ ---- ------ • W -- ,e7. . . ..... A� Prr a 1 UNature of Repairs or Alterations—Answer when applicable-------- ----- / ---- ,� ----- Agreement• �dI/1't�' f 7 � f�.1 91A P The undersigned agrees to i4n's'ta�ll� the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITi.. 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 Signed ,.. ---•------------•--•--•----------- ----------------------- Date S Application Approved By--.. yr .. -7---r,*---7 ------- Date Application Disapproved for the following reasons:...............................•----•--------------------------------------------------------------------------- .................................•--•-------•-----...----•--•------------•-•-----•------•--------•------•--•---------------------------------•----------------•----------------------------------_----•- Date .o[ 7• 7� PermitNo......................................................... Issued_....f-�---........................................ Date s T 'V No.------ ....... _ Fmc..2�,..._ THE COMMONWEALTH OF MASSACHUSETTS s BOARD. OF HEALTH ............. ...OF......... <' ? :-. SEL. ........................... Appliration for Uiiipniia1 Works Tontrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at.: # ~R ................. ..-_.Z.R_L. .Cn.-•................... ................................. .....-i •--•----------------.:....::`: ...__..... Location-Address or Lot No. . — -`B A.......................... ......... ........! �O°. ,+U/4�+C_•.- wyner _ �f Address W 1( ?�?_^���.....5.>:"w. ....:li���tffC,t....._ _.__..•...t.��.�rz"R S e.4. _/:���1�_!(/�w Installer Address UType of Building Size Lot....-_- .:..d ....._..Sq. feet Dwelling—No. of Bedrooms................_'_......................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures .................................. W Design Flow........................ .............gallons per person per day. Total daily flow..............:�2.6....................gallons. WSeptic Tank—Liquid capacityZSidt.gallons Length.6- ... Width__ _-16... Diameter................ Depth...... ��': x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area-___--_.--•__---_---sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area...-S./ ..sq. ft. Z Other Distribution box (y,.-) Dosing tank ( ) Percolation Test Results Performed by..... � ��-_._ Ml _ � ........... Date.......`....`!-7p. aTest Pit No. 1-------2,._._minutes per inch Depth of Test Pit...... Depth to ground water.............?' Test Pit No. 2........ ._.minutes per inch Depth of Test Pit------ 'S._.. Depth to ground water....................... ...... --•••-••-••••-- •-••-•-••---••........................................................................... O Description of Soil -'.' rl ? �'Y !:&t'rj{_�k t� � ��" � A.A.�� V ... e y��s ' `T 1 Irk 0tw ii'-�- a U Nature of Repairs or Alterations—Answer when applicable.-------------- �! - .......... •-•----•---------------•••••-••..................-•yt * ...... .......• . ........ Agreement: t ,.L 4 The undersigned agreesnstall the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI.; 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. Sigd ....................................................-- ----- - - Date Application Approved BY......... ,• F ''� 1� ..... " Date Application Disapproved for the following reasons: ---------------------------------.......................................................... -----------------•-----......----•------------------------------••-------...-----............-----------•-••.......• ... •----•-•-•---•-•-••-••--•.....-------•-•----••----------•......-•----......_ Permit No. Issued...... .�_Z f_ .., _..' ......ate_ Date THE COMMONWEALTH OF MASSACHUSETTS • BOARD F" HEA TH t' *00,'✓�''l..':........0F...... .... .. ..... ............. Cwrr#if iratr of Toutphaurr THA IS TO ClYRTIFY, That the Individual Sewage Disposal System constructed ( r Repaired ( ) b -------------•--------- --- ---------------•------------------ t1 Inst er --------------------------------------- has been installed in accordance with the provisions of 'r ._i 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No :__._------ -------------- dated_....' a�+ _" ._.`_._..._.. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS AGUANTEE THAT TIME SYSTEM WILL FUNCTION SATISFACTORY. DATE--••---.�.;�`.'... �.- 7 ------•.....................•-----....... Inspector.•---- . .,�.....�!! ...•• •-- .... ...... � THE COMMONWEALTH OF MASSACHUSETTS BOARD OP HEALTH No.- ' � FEE..... ............ or on action rrmit i Permission is hereby granted..:•:_ ,;..:._:_. ...................... to Construfefj 'Re it ( ) an Indlvi alS/ewage D tlp al Sy at No�-•- _. ,r tier°oQ i •---• A......J ---------------------------------- Street ^,� as shown on the application for Disposal Works Construction Per XNo., Dated-__ ;" ........ 4 Board of Health „s DATE......L............................................I.......-•................ >L FORM 1255 HOBBS & WARREN, INC.. PUBLISHERS , r r r NORMAN GROSSMAN REGISTERED LAND SURVEYOR/REGISTERED PROFESSIONAL ENGINEER 226 HOLLY POINT ROAD CENTERVILLE,MASS. 771-0362 DATE December 22, 1978 TO Town of Barnstable Board of Health In accordance with Barnstable Board of Health regulations re : variances , I hereby certify that the sewer disposal system on Lot 6, Lakeside Drive, Centerville, , Mass . was installed in accordance with plans dated April 10 , 1978 and the variance dated April 27, 1978 . Sincerely, `�� " 7* Norman Grossman, P .E. NG:mm _.. 3 LOC&.TIOt,I 393 5EWQG,E PERMIT UO. VILLAGE IWST LL U E FA.DDRESS BUILDER 5 1J &ME. ADDRESS DIaTE PERNA T ISSUED --l�arlIX174 — — — D QTE COt%APLI &11,aCE ISSUED ; '�-__._� ( - .�,r2- g `' 1 � ,� � �. .. ti w � f �, �j . . s� .� j . ��.� -Assessing As-Built Cards Page 1 of 2 LOCATION 393 Lakeeide D4iye UP.6t v DATE 10/27/03 VILLAGE Cen-.teaviP@e1/7aaa. ,ASSESSOR'S MAP 6c LOT 232-021 -INSPECTOR JozeP4 P.lldc0m9.e4 aa. SEPTIC TANK•CAPACM.1500 ga2PoRe 1-Box LEACHING FACILITY:(") 40'X14' field (size) NO.OF BEDROOMS BUILDER OR OWNER 7e44ance Deluca c OWNER MAILING ADDRESS Same I L L _ _ yo'� 373 I-Akeside DR wesr r http://www.townofbarnstable.us/Assessing/HMdisplay.asp?mappar=232021&seq=1 2/24/2016 f i f , I Existing Deck 20'-1"x 1 T-8" 2'-9 7/16" 3'-5 1/2"2'-2 9/16". -I—.- 9'-2 9/1b" �� 21:'-10 5/16" 14'-9 1/2" 11' 1'-1 11/16" q 5/161, 1'-5 11/16" 9 1/2" 2'5 9/16-1/2"1 1/16" 2" 2 5/16" 1'-2 1/2" 2" 3 1/4", 2", 2'-3 3/4"B 5/16" 5/161, 2'-8" 5' 5' 4'-6 15/16" -2'8" 2 8' 2 8"- 2-8 �— - 2' emp I z=ovH z�aovH I I I 7'-1'x 4—Ji�JDH vH zs ovH zbmcH z3JcvH z3 ovH iV - - - - - I I— — - - - w -- --- -- Lr � - gJ� G (V o I I I I I Gloset I J o'er - �I New Bedroom I I I 1°x 9'- I i Existing Kitcheh-Dinning-Living R 'w 'i t� 10'2°x 14'2° I� I I I I 1 j antra , I � \ o I I I I 36'2 v` ! "x26' 1" w FamilyRoom 1 "x 4 ` r v I I � Bedroom#1 I - �" / �1 -- ---- - - - — - -- --" - - s N -t�LI - o L 3"x 24'0" `l oeB xe. 13' F J � f � � 3ElD `� N 4^1436R W2J96R W1436R `-- I 41. WB2JR I B]R I B24R Bath#.1 10105e 0 6'-1 1 x 5'-4° ® "9Q 2'9"xl: Llv, — — New Bath New Closet BCW1J36R W�J_bR-W]iBR W165R --.J Q- i; _ f 5 1 4"x 5'2"x 9'2" 2 Q O � O � I — -- -- '-- --- --- _ - - -a -. ' ]lJvOH e34JOH GH ]9JOOH J' / , ]j4JOH ]9400H ]3JJBH 3LJv�H �1400H i990 .—__ - .._..._.— ..._ —. ...._t\ �r — — _ __- _ - 3'-5" 2'-8'- 2'-8"0 4'-10 T16" s�; \ 2'-8' - 2'-L ,-2'-8 - 2-8 2'- 2" 35/le. 2" 2'-l'l,,2 5/8' 8 4'-9 11/16" 2'8" - 5'-2 13/16" 13'-99/161,— \ 20'-5" o+ i" / 20'-91/2" 12-81/2" b' lb'4" a JF// \ I i! /'o� 14 2nd Level Floor Plan LIVING AREA 190"I sq ft Y I 1 i , 4 ti 1 ' - j 14'-9" 51F �1 3/16", '3/16", -8"- -8" 2'-8"T2'- 2-5" 2'4"1 1.40DH �]b40DH 3940DH I 2l400H _— — —]tl400H _ — D3400H _— -- - I Living Connecting to Existing Living Room �.mi �I 114'-3"x q4'-0" ; o i o Bedroom I 10'-2"x 14'-0" i QI .D N ! •� t" t LI ct1�406' LU B- X BD4R� I Bath i — i 12'-3"x 9'-2" I Closet I °- r 1 I 5'-1"x 9'-2" Connecting to Existing Living RoomFd� 1 i 9 3/83'-8 15. t 2'-8" 6'-2 1/16" J I !16" 2'-8"- LIVING AREA 631 sq R New Addition—2nd Floor Layout I i f , I t . ( Centerville, y nn� MA 5h� wEQU p,QU ET LAKE �U 1 = (A Great Pond) Wcquaquet Q�c .- MITIGATION CALCULATION TABLE � Ike Lakeside PROP05EO HARD5CAFE IN 0-50'BUFFER: 3 Dnve East 28' � ss inke side t" KAYAK PACK I O S.F. Dr-West PROP05ED ADDITION +260 S.F. / TOTAL 270 S.F. ad . - s \moJ"Fp PROPOSED IN 50-100'BUFFER: _.EdOe of WctlznA `ear �6' 20fa LOCUS °ce PP.OP05ED ADDITION 270 5.F. 1 U KAYAK RACK +10 5.F. TOTAL 2505.F. / N NOT TO SCALE ,N� { CONSERVATION NOTES: o HARD5CAPE(DRIVEWAY)TO BE REMOVED IN 0-50'BUFFER: - / (, I UP / O ) 1.)LIMIT LIMIT o_ LAND COURT PLAN 20239-C SHALL BE AS SHOWN. A SILT FENCE SHALL BE CONSTRUCTED TOTAL 361 S.F. ALONG THE LIMIT OF WORK LINE PRIOR TO THE COMMENCEMENT OF ANY WORK 0 CERTIFICATE N 171320 ASSESSORS MAP 232 PARCEL 21 - / LOT G 2.)ROOF RUN-OFF FROM DWELLING 5HALL BE CONTROLLED BY GUTTERS,DOWN5POUT5 J' HARD5CAPE(DRIVEWAY)TO BE REMOVED IN 50-100 BUFFER: I Awrea=0.3�Acres AND DKYWELLS OR STONE TRENCHE5 UNDER DRIP LINE5. TOTAL 347 5.F. / \/ I \ 3.)CONTRACTOR BUILDER-AND OWNER 5HALL REVIEW THE ORDER OF CONDITIONS PRO, LEGEND TO AND DURING CON5TRUCTION. 42 EXISTING CONTOUR PROP05ED CHANGE IN HARD5CAPE IN 0-50 BUFFER: /— uF O ' O 42 PROPOSED CONTOUR so'Bvffer oRa, xizs, EXISTING SPOT GRADE PROPOSED 270 s.F. Zone ago ".� 24x5 PROPOSED SPOT GRADE EXISTING -31 5.F. TOTAL CHANGE -91 S.F. ,� —w— APPROX.WATER SERVICE LINE / �1 `Sx —oh— OVERHEAD UTILITY SERVICE PPOP05ED CHANGE IN HARD5CAFE IN 50-I00 BUFFER: AG —D— UNDERGROUND UTILITY SERVICE o / za� �\ _ e.�snng Kayak R.ackz To Remain —G— APPROX.GAS SERVICE LINE PROPOSED 280 5.F. / ��a,A p TEST HOLE/BOPING LOCATION /�P ,\ f j 44 EXI5TMG _347 5.F. Q l Do � s d TOTAL CHANGE -675.F. / UL Gaj �� _,tj� / A•L 5T SEPTIC TANK S� Y ,to� ti<� /O Pato Below Deck DIDDISTRIBUTION BOX SA5 SOIL ABSORPTION SYSTEM „DB 9�"�/ � � � � ao Resen-e RESERVED FOR FUTURE BENCHMARK: e r0, UTILITY POLE To f PK Nail in Pavement �' `(N ' i 6 ELP (1988 NAVD) P \`: Op Q LIMIT OF WORK � CATCH BASIN v A FIRE HYDRANT - � f 3 � ov. �yoR� ., h� O (. WELL DRAINAGE MANHOLE PLAN CONCRETE BOUND,FOUND y 6L ,y1 - (3)PRpO�PO5ED RED Emstingnvewa DyTo Be �9• �--\ q p.. ��-' 2.� \ 5 I TOLIMIT F WORK Of 13ANK IN Resurfaced / � APPROX.LOCATION SCALE I"=20' —'—'— T/I2' (2)BLUEBERRY 5HRUB FENCE �F% EDGE OF CLEARING UP N6-T 'n 2i \ x{"� tc �0 EXISTING GARDEN AREA TO BE REMOVED a o� a = �� --_ '�— Bnck Walkway(To Remain) WETLAND FLAG,SET AND AREA TO BE U5ED FOR BOAT STORAGE " TREE KEY Existing Floaong Dock © 0/10" 10"OAK TREE 5/12" 1 2"BEECH TREE 100'Buffer P' - u T/I 4" 14"TUPELO TREE PROPOSED RED MAPLE(3)TOTAL (iN v BLUEBERRY SHRUB sse Approx.Location of Existing Shed Walls .1 J O` �20' sN ROP05ED(5)HIGHBL911 Sewage Disposal System <Roof to Be Removed ' a `3 Per Assors'AsBudt Card , O O 36 _u ! Zone Soc T/14° f r APPROX.LOCATION �Cl I j j I _III \F/I O' y` / (I)BLUEBERRY SHRUB + +I +I + 18 / V Dca i I 34 '- _ F ..--- ----- -I---- --------- --- ------ -- - —- ---j 34 \ ft lD W EXISTING DOCK PLAN VIEW I EXISTING FLOATING DOCK 1 Edg of Wetland I Top of Bank HORIZONTAL SCALE I"=10' 32 '� — ----- - -------- --- - ' 32 REVISED 1 2-1-1 5:ADDITON FOOTPRINT CHANGED I I Bottom of Bank (At Edge of Pond) REVISED 1 1-5-1 5:CHANGES MADE PER PRIOR ENFORCEMENT ORDER �n eoctm +' i I Peter Chencg I I� c 30 ----------—� —'-- -- -._--_._—--_--_ ----'-- 3 Lake Slde Drive West,Centerville.MA 39 PROPOSED SITE PLAN EL=32.4±WATER LEVEL IN POND DN 9/2/I5 393 Lake 51de Drive West, Centerville, MA 28 L------' ---— ------ -- —-- — -- ------ ----- -- 26 J.M. O'REILLY & ASSOCIATES, INC. 0+00 0+05 0+10 O+IS 0+20 0+25 0+30 0+35 0+40 Professional Engineering & Land Surveying Services EXISTING DOCK PROFI LE 0 20 40 GO 1573 MaiinOStreet Box1773Route SA P.(508)896-6601 Office Brewster, MA 02631 (508)896-6602 Fax HORIZONTAL SCALE I°=S' SCALE I"=2O' DATE: SCALE: BY: CHECK: JOB NUMBER: VERTICAL SCALE I"=2' • G:WAlobs\Cher�g8042�dwg�8042PROPO5ED51TE(12-1-15).dwg 10/13/15 As Noted KEF/JFM KEF JMO-5042 1 14' 11' c� 14' 11' \ N 804006 404ODC a � Ir .n � ryJI� S l0 m � � Connecting to Existing Living Room 2 m Ln Ln , m ' Bedroo '-2" x 14' 1" M LIVING E 1 Y-b" x 14'-1" Ln 3 1/2" Pull-Down Stairway to Attic Ln 4068 N .x LU 3168 2668 0 v m \ Bath 12' 6" x 11'-5" 9 � CIO 5et m cn Remove Existing Exterior Wall with Window 5'-5" x 11 Sr n Connecting to Existing Living Room B24R —' r - --r - - ,— T - --}' - - m 524R 524R B24R 524R 824R B24Rcn M436R W2436R 1M2436R V42436R W2436R AM 3020AW CN T_ m iv New Addition — 2nd Floor Layout LIVIN - , REA Scale: /" = 1' 393 I �� Y O� j Existing Deck 22'-3"x 16'-1" 76'-4" 2'-9 7/16" 8'-2 11/16" 2'-9 7/16 3'-5 1/2" 2'-2 9/16"-13'-4 1/8" 18'-6" 14'-0 1/4" 11' :n 3'-b 1/2 2'-5 3/4" 11/16" 1541/8" 18'-6" 8' —11' zt ry O aanbuc iy awooc a iV (V (V �'I 19oae a Oit q"�77�"tl'I Z ry N I l f`Y Gloset J m New Bedroom �4 1.1 x T-f, antrg Existing Kitchen-Dinning-Living Roorr * p 10'-2"x 14'-o" m V 11 28'-a"x 25'-11" bun w Family Room UP _ a o 5edroom#1 - \ 1 °x 14'-0° c�v m 13'-3"x 24'-0" Ej v ) Pull-Down Stairway to Attic c Llobe xi 33ba lbbB X Lu $ $ RL 3 L $ Bath#1 Close b'-11"X 5'-4" � ® 2_q x New OSet m Etti����� BLvlld36 I'1N96R WI9R w1a3R 1� 5'-2"x 1 a 5' Demolish Existing Wall New Bath#2 s 124"x 11'-5' A a 3oM'vl e p FW>a RTe RT<Tle 96lONv 30f0uv w]a36ft YW36R wla3aR wla3aR wle3a 4, .mob � I 3wbaV I 3ala'w 9> ♦ .., m e•, 2'-8 3/84 2'2'-5 114 52'-7.1�5'-3 15/16"-8 516, 3,_3 3/81, 5'-10 1/4" 9' 3'-10 1/4" 3' 2'-10" 4'-8 9/161, �" 2'-10 - 77/16" , A + 20'-81/2" p b 16'-b" �E 4'— �f�- 12'-81/2" 6' S �0 b ««-_—_Existing House- >>>> ««---New Addition-- >>>> LIVING AREA 2ndievel Floor Plan[Old and New Structures 19b0 sq ft 5cale:1/4"=2' I 22'-3" x 16'-1" -2 11/16" _2'-9 '7/16" 3'-5 1/2" 2'-2 9/16 154 1/5" 18'-b" 14'-0 1/4" 11'- -2 13'-4 11b" 18'-b" 3'-6 1/2" 8, 2-5 3/4" 11'— Ln N 6940Dr, (V 60400G 4040DH 9268 cn (VO 13068 m � Of � r}, O 111 O Oin v N I m m ' New Bedre ,GI xset , a Existing Kitchen-Dinning-Living Roo L10'-2" x 14'- antr I to 11 1 - — _ uF 25'-4" x 25'-11" �, w Family Room 13'- " x 14'-0" J :droom#1 Full-Down 5tairws '-3" x 24'-0" v m v m 4068 2668 rc a N 3368 26, D.- I x W c4 —� - - � I m � Im Bath#1 R ® B9R Close Net 6'-11" x 5'-4" m OO i „ Fr 2 -9 x • BGVV2436R W2436R Y4215R W165R Demolish Existing Wall jin New Bath#2 -4" x 11'-5"12'NOR � m T TL - - R W W B24R B24R I 3020AYV 3020A 3020A B24 B24R I B28 3020A 4 W2436R W2436R W2436R VV2436R W2836 3040AW 3020AW 6 2'-b 3/6►� 27-5 114 52-1 11/16"'? „_8 5/8" 3 3/8" 5'-10 1/4" 3' 3'-10 1/4" 2'-10" 4'-5 9/161, �Fo� o�o�+ 2-10 - F - - , - - I - 5 -3 151,16 - 3 — - , 2-1 T 16" + a D� 9/161, 20'-b 1/2' 16'-6" 4' 12'-6 1/2" ' b '1614" ,0 i 406E U482490 U482490 BGU212490R cv N � 7 Connecting to Existing Garage = 0 IQ n < Remove Existing Garage Door (b M _ N n N. Garage `C%4 1 S'-8" x 21'-0" QL F- - - - - - - - - - N � Cb N Connecting to Existing Garage _ o `_N I I o U3 o Remove Existing Garage Door be I I ' o �o 9080 W b' 9' 41-6„ Z 0 b, 19'-6" 25'-b° LIVING AREA New Addition Only — Ground Floor Layout Scale: %" = 1' _ C 76'4„- Existing Storage Shed to be demolished 12 10" 14'-9 5/16" 20'-7 13/16 b' 19'-6" m 12'-10" T-1 1/b" 6'-6" 8 3/16" r ewe Break Existing Exterior Wall fV , ,nee ,aee S weawo 8 Nos Break Existing Interior Wa Remove Existing Garage Door a s Library m DEN [Old Garage converted] 26'-3"x 9'-9" s a 14'-5"x 16'-10" in Bedroom#3 � - 12'-4"x 14'-2" a it ,tee a New Garage N 3 iv [Existing Supporting Posts and Beam] nwe3�o we�o o w�� we m 15'-b"x 21'-0" o athroom#3 a 9'-0" .-0" s m yy [Old Garage Converted) UV 5torage Room g 25-2"x 10'-11" Remove Existing Garage Door r+ Main Sewage Line s m in Utility $ DehumidiRer2x2x2 'r 9'-3"x b'-9" `s "Portable Dehumidifier weo,na " .,o we�.4o I I m Halhuay si m 3 3 Washing Machine&Dryer 90°0 Rekigeretorti2 m b' 9' 9'-911/161, 6-15/16" 10'-03/4" 0 � a�4 c«<--------Existing House------»» ««-----,New Addition-----»» Existing Septic Tank System L J LIVING AREA 16round Level Floor Plan Old&New Structures 11564 sq ft Scale:1/4"=2' L- I U I-+--`1 7/ I b_- LU-- I I Z1l 110 12'-10" / // \\ Break Existing Exterior Wall 404006 6668 / 12668 \\ 4068 U482490 U"152490 O c� m O < m 0 0 N 0 Break Existing Interior Wall 0 o L _ Remove Existing Garage Door DEN cold Garage Converted Library [ ] 26'-3" x 9'All broom#3 14'-5" x 16'-10" .4" x 14'-2" U482490 U482490 U482490 U462490 U482490 U152490 4068 0 v v ry New Garage r 9 in o i Posts and Beam [Exist g 5upp rt ng os ] Q U463690 U483690 U483b90 U483b90 U483690 1 V'-b" x 21'-0" athroom#3 r 2168 C1'-0" 1-0" r [Old Garage Converted] 6B m I I _ Storage Room 25'-2" x 10'-11 Remove Existing Garage Door Main Sewage Line Dehumidifier 2x2x2 t I 5 ty a .. "Portable Dehumidifier U362490 U362490 U482490 Hallway Washing Machine & Dryer 9080 Refrigerator#2 b' 9' 116" b'-7 5/16" 10'-0 3/4" N�° 30'-4 1/4"1 `� �\tK ««________ New Addition----- - Existing House ««-_____ »» o. Existing Septic Tank System i Ivl N(-7 ARF,4 (:,Fri vFi irocl �.� y '� \l pa ADD ' � ....'�—.—,.7�+rr�����✓'.�ir' 'y'°° /�f�'�—/' ,`. �j. �-(4"' `�"_.3�'�'_'r� '�"`^`'` /wiA CAC'F'YGL / j { i ��1•- s/d' w>v s N-Z) GRvsNED,S'rA*dr I S-fS 1 .s�r�r� jv (. 3 OR WASAfEtx 6 R.4 r E 4 STo.v Af ® 6 O c G i G O gyp, ! G -�..!.._�' .Y_-�- J .r r�•.,�.i T, 3 r dW 40o o j l j I.313TT61W bF 434=1> -v / LaNG/7 U 0/*14 S-C-C /C) A/ 'T`YP/CA L. ,,5 rA nr EC NoT -r2s jCGALE i t � .t 1 r .afl { , % ��--�-- '�f� _ .v,�T Trs SCENE D 'Tvp. fOV A/V, . Ld T Tify C A.i F �.ti.3'a►= ,, \ u_c v> 4� i F '�s�► 4 S+CS /N/•5�,� G9PA�UL�:44 xo Fi'*v1.5H G+�i4�r� ���t✓�.S/v G P�9t>r" I buy�L�t vG - Ov R 774,, O✓Eif' /SL Q d x f wl At .410 - AD AD f\ E J' 4,0 PJZa`t? Ca�.'Tov F�, 4ox o PQo F? ,S`Ra T- --i Etl 1 _o Ez v ='¢ iV/tJ;w DER OF Lie-:V.E'a S 3 c5zj.E-�t✓i�T-irrJ Rll:�SSG;N.S R 49 E7?Rc o M _ i? f � SAND i .407- /9 Pf q T> 446� T o f A,44?d # 7W G i'AC.4/NG A zeA pea v/vEz;, 460 � 1 1 OF cew+�si j s��va I �� /CR. yy.gT..r'IE T/1 QLL " 6fwac,•lE- _ _. S .�, >E'C• P.gTE: Z MlNfiN' o NOt2MA _ i �,�'`'"• � �� c��E�Pr.>9Tia>s+S ,?y; ,� Gri^��"llA1V v, �r .+'.fs�64►r't?_ia' C ".'T�'�� .1,°r�'?�'� '' cQi �2J05 1.OT (, LAXa�lS'lTJE Ta.+2 !</0�.4 fd7i,�T ' ., / � � NO,a4'sHgrt!�'�OSS/�f•'J,�' r'E 'A --.-._ .._..._ _-__ .—___ ._..___.,� __._ �_.-----��tl��?f%L.L,�-- / /0,1976 970 itA1 C t�iGGl 1/.t'tccL: 1Ys:1P.��4�Y - c'•, C .cV'"/Y../, •