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0087 LIAM LANE - Health
87 Liam Lane Centerville P A = 167 016007 I ' Commonwealth of Massachusetts 9(y7 zj07 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments •'' 87 Liam Lane ' Property Address Susan Gaugham Owner Owners Name information is � t required for every Centerville Ma. 02632 10/28/2015 0 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms on the computer, J use only the tab 1. Inspector: // Z 7 key to move your cursor-do not Michael T Bisienere use the return Inspector Name of Ins key. P Cape Septic Inspections —ICI Company Name 624 Old Barnstable Road Company Address > Mashpee Ma. 02649 Cltylrown State Zip Code 508-280-3356 S13938 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 Evaluation by the Local Approving Authority 10/28/2015 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design'flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ***`This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. d(/ /t'/ �S t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System9 Page 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Liam Lane Property Address Susan Gaugham Owner Owner's Name information is Centerville required for every Ma. 02632 10/28/2015 page. Cltylro in State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: This home has a H-10 1500 gallon septic tank a H-10 D-Box and ( 5) 500 gallon leaching chambers 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Liam Lane Property Address Susan Gaugham Owner Owner's Name information is Centerville required for every Ma. 02632 10/28/2015 page. City/Town 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Liam Lane Property Address Susan Gau ham Owner Owners Name information is required for every Centerville Ma. 02632 10/28/2015 page. City/Town 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 '/2 day flow t5ins•3113 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 87 Liam Lane Property Address Susan Gaugham Owner Owners Name information is required for every Centerville Ma. 02632 10/28/2015 page. Cltyrrown 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: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts a Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 87 Liam Lane Property Address Susan Gaugham Owner Owners Name information is Centerville required for every Ma. 02632 10/28/2015 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ 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): 5 Number of bedrooms (actual): 5 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 568.32 GPD t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 87 Liam Lane Property Address Susan Gaugham Owner Owners Name information is Centerville required for every Ma. 02632 10/28/2015 page. Cltyrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available(last 2 years usage(gpd)): Detail: in 2014 155,000 gallons were used and in 2013 143,000 gallons were used Sump pump? ❑ Yes ® No Last date of occupancy: occupied Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(9Pd) 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 Lt5inaWater meter readings, if available: Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments SV• 87 Liam Lane Property Address Susan Gaugham Owner information is Owners Name required for every Centerville Ma. 02632 10/28/2015 page. Cltyfrown 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: 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): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts _ W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Liam Lane Property Address Susan Gaughham Owner Owners Name information is required for every Centerville Ma. 02632 10/28/2015 page. Cltylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 10/23/2003 plans from Barnstable Health Dept Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1 T' 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.): There is a additional sewer pipe in the front of the home but it is capped off inside the home Septic Tank(locate on site plan): Depth below grade:. 12" 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: standard 1500 gallon Sludge depth:. 311 t5ins-3/13 Title 5 Official Inspection Form:Subsurface sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Liam Lane Property Address Susan Gau ham Owner Owner's Name information is required for every Centerville Ma. 02632 10/28/2015 page. City/Town 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 apx. 35" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle apx. 5" Distance from bottom of scum to bottom of outlet tee or baffle apx. 12" How were dimensions determined? sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I would recommend the new owner put the tank on a maint. plan with a local septic pumping co. based on the future use of the home.The Barnstable Health Dept has a list of local pumping co Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•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 M •'' 87 Liam Lane Property Address Susan Gaugham Owner Owners Name information is required for every Centerville Ma. 02632 10/28/2015 page. Cltyrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 87 Liam Lane Property Address Susan Gaugham Owner Owners Name information is required for every Centerville Ma. 02632 10/28/2015 page. Cityrrown 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 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): At the time of the inspection there no signs of solids carryover or evidence of hydraulic failure 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-3H 3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments y 87 Liam Lane Property Address Susan Gaugham Owner Owners Name information is required for every Centerville Ma. 02632 10/28/2015 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: (5 )500 gallon ❑ 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.): At the time of the inspection there were no signs of hydraulic failure 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 Lt5in. 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 87 Liam Lane Property Address Susan Gaugham Owner Owner's Name information is Centerville required for every Ma. 02632 10/28/2015 page. City/Town 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.): t5ins-3113 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 87 Liam Lane Property Address Susan Gaugham Owner Owner's Name information is required for every Centerville Ma. 02632 10/28/2015 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 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 TOWN OF BARNSTABLE LOCATION c'fi��yiC:�n+ �Gh� SEWAGE # o'1QQ 7— 3Z)Q VILLAG G ASSESSOR'S MAP & LOT I INSTALLER'S NAME&PHONE NO. MIT V) It SEPTIC TANK CAPACITY 0 LEACHING FACILITY: (type) Cyr vp r (size) %Z X y)� O M.OF BEDROOS , BUILDER OWNER PERMIT DATE: !d /D D3 COMPLIANCE DATE: D `Z 3L)3 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist too,It 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 V\ to g' G O �G a 0 I i i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 87 Liam Lane Property Address Susan Gaugham Owner Owners Name information is required for every Centerville Ma. 02632 10/28/2015 page. Cityfrown 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: 10 plus feet feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: I augered a hole at a lower elevation and shot it with a transit Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-M 3 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 16 of 17 Commonwealth of Massachusetts uM Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 87 Liam Lane Property Address Susan Gaugham Owner Owner's Name information is Centerville for every Ma. 02632 10/28/2015 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 r e_ — .+7 F s. J t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 i TOWN OF BARNSTABLE LOCATION Lam 014h e. SEWAGE # awl-- 3-06 VII...LAGE Cog,T erv,��G ASSESSOR'S MAP & LOT l INSTALLER'S NAME&PHONE NO. c Qm Vr 77t V) Zt SEPTIC TANK CAPACITY 70 d LEACHING FACILITY: (type) C✓r su .S' (size) %,Z X y)r No. OF BEDROOMS BUILDER OWNE R PERMIT DATE: to to D3 COMPLIANCE DATE: ® Z 3 D 3 Separation Distance Between the: - Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within'300 feet of leaching facility) \\� Feet Furnished by C—�?S y\ �r S � �o� 58 ,S& 28o c> _No. 203 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: A Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 21pprication for ;Dtopood bpgtetn Cong4ruction Permit Application for a Permit to Construct( )Repair( )Upgrade(x)Abandon( ) O Complete System El Individual Components Location Address or Lot No. $7 LI b M L A N t= Owner's Name,Address and Tel.No. CaAfTjFRVILLL InA55 St.ISAN C-AvC•14AN Assessor's Map/Parcel 0-1 L-1 AM LANC In /67 P / &- 7 CS/VTtR{e'ILLE 1n/4S,5_ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.6-0 fi- Z$ 3 3 4 I{ SOLLIVAN L:.NG-INSEIZIN,jZ�C. AD 09r45 ZVl L.L� MASS . Type of Buildin Dwelling No.of Bedrooms ) Lot Size O,L6' At Garbage Grinder(Na Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow -5_-6'Q gallons per day. Calculated daily flow 6_69 gallons. Plan Date SE PT. 3,0g 003 Number of sheets I Revision Date Title o.S S SE FITi G 1_16RAD67 Size of Septic Tank 16-00 6r,4LLO/ys Type of S.A.S.1"LIX4S' L-c-'qc t{ k AmBgX Description of Soil _ �— I rs L o i9M 4_ro PSO I L. , 1 V- 120�l M E D. S OIVD Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b Board of Health. Signed Date Application Approved by Date /v -/J—01 Application Disapproved f the following reasons Permit No. Uo — J Date Issued u �l ./' a. fFee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes 2pplication for Piopont *pgtem Cottgtructiou Permit Application for a Permit to Construct( . )Repair( _)Upgrade(X)Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 07 L I A M I_A IV L Owner's Name,Address and Tel.No. C[:f��RVILI.I: /YfAss StuS19NGG/a4IG.VIA N Assessor's Map/Parcel 8"1 t—t A M I-A N d /n /10 P l G^7 CEA' e-2VILLE Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.Sa f- Z S-3 3 4 4 SULLIVAN L'-N�-ilv6t:RINy� C -7 P9RKER VZpAD G e 097' Z VI LLE 10,9.5 S . Type of Buildin : Dwelling No.of Bedrooms J� Lot Size U.L5 Ac Garbage Grinder(NO Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow .'�(� gallons. Plan Date SE PT. 30. 2003 Number of sheets ( Revision Date Title P Po S E D SE PYi G L16lZA D E Size of Septic Tank /.500 GtiLL.o Ns Type of S.A.S.1.2�X 4 5- �CRcR� Alyl13ER Description of Soil 0— I fS�t L r,,4M 41-P50I L Icb"- 12a'l SAIVD t Nature of Repairsor Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by�this Board of Hea lth. , Signed Date 10Application Approved Approved by Date /u /J-u T Application Disapproved fdl the following reasons Permit No.._Q U Date Issued /o - 7 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded(x) Abandoned( at '9_7 hl Am L-A ,E (f&/V7C2VI L LE 1,V,4SS has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 100 -K—DO—dated ')-3 Installer Designer S IJ LI V QA,, =1Y641W Ef4i 11/o I/VG.. The issuance of this pe6t shall not be construed as a guarantee that the system bfuncti --as d si ned? c-+ Date .�12 3103 g Inspector y !��l✓( , .� g .J . --------------------------------------- No. 2.00 3- S-V V Fee — THE COMMONWEALTH OF MASSACHUSET i S PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSET t°S MiZposSar *pgtem Corgi.5truction Permit Permission is hereby granted to Construct( )Repair( )Upgrade(X)Abandon( ) Systemlocatedat el LI AM L_AyE CEn/T-miALLE- 1, M45S. and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of ermi Date: /U- 13 Approved by fl// . . - S- TOWN OF BARNSTABLE I i LOCATION SEWAGE # �b?s VILLAGE 1��n7 ✓vim ASSESSOR'S MAP & LOT 'fit✓/ INSTALLER'S NAME&PHONE NO. 9,&%e 012 Al 12' 7-7t 'V) t SEPTIC.TANK CAPACITY >>//-- LEACHING,FACILrrY: (type) 00 d."�� . (size) ( y NO.OF BEDROOMS � BUILDER OWNER PERMTTDATE: r 0 /D 03 , COMPLIANCE DATE: 3 D Separation Distance Between Maximum Adjusted Groundwater table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist ' on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet i Furnished by I i • � rr �l G �A% © © o a ® I :b `� a, Q s " . TOWN OF BARNSTABLE Lr-:A"TION 1�� 1 W d SEWAGE # VILLAGE �) \�� ASSESSOR'S MAP & LOT (®l ® QG INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY i()00 Ot,W 1 LEACHING FACILITY: (type) = � (size) ��4 uQ NO.OF BEDROOMS i BUMDER OR OWNER d aQ 0,, DATE: `' S, i. COMPLLANCE DATE: Separation Distance Between the: ? Maximum Adjusted Groundwater Table t J I Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 f et of leaching facility)_ Feet Furnished by_� ilk'31' �Z, A' 4�, 63:37' s-6 a -� • CO` NIONWEALTH OF MASSACH SETTS . _ 07% FAECL'T1VE OFFICE OF ENNIRON'�4E�TAL AFFAIRS DEPARTMENT OF ENE-IRONNIE�TAL PROTECTION Ems ' ONE WINTER STREET.BOSTON. MA 02106 611-29:-`:00 S TRL'D%*CO?= V�TLLIA .^�LL 1 1' .. ... J J .1• .. ..L .. .. . '\'�V� Jr.�.G"'. DAN'ID B STRL:1 ARGEO PALL CEL1L'CCI „- •; - _ -_ • LLGovi=i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .... PART A 1 . .. ' . - I -•1 �f��.� �/�� - CERTIFICATION . ..- V �•�+tw. ± Ad dress of Owner. Property Addres- 'D`7-low t4y Date of Inspection: �.g`c► pf difierentl Name of Inspector. 1`4. ..�o I! E��:C�� 411 1 am a DEP approved system inspector pursuant to Section 13.340 of Title S 010 CMR 13`000) ' y Company Name: �l o$14u'a �^ a"H a`'e -/� /r7. 0 2E• I t� �. Mailing Address: V� /30x P 37� - 195 /OPSL 4-5 �si.r;� ' Telephone Number: �- MAY 2 2 CERTIFICATION STATEMENT rows I cenif that I have pe•sonall% inspected the sewage d:s-,csal system at this address and tha: the information re�aoned afJo"W Is truk'accu and tomole!e as of the time of inspec-on. The inspe::o-i %as pe-iormer base=' on my training and experience in the proper funcicr, a^*/ maintenance of on-site sewage disposa: s)sterns. The m;em: ' Pas:es _ Concit-o^aiN Passes Nesc_ Funhe• E.•2tuarar1 Ev th cal Ap;mving Authcrm ' Inspector's Signature. Date: r T:re Svste^ Insze o• sha" submit a copy of this inspec.,an reoc.: to the Approving Authority within thin- (301 days of completing this inspection. It the s\-stem is a sha►ec' s\•stem o• has a des-gn now of 10.000 god or greater, the tnspe=or and the syster. owner sFbtl submit the repon to the aabropriate regional o +ce of the De;;..me of Envircnmenta' Frotecior.. The arigma! thould be sent to the systern o-ne and copies i"tt to the buy-e!, it applicable. and the approving authority INSPECTION SUMMARY: Check A, S, C, or D Al SY TE.'M PASSES: . I Have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure.crneria not evaluated are indicate: below. . COMMENT5: 61 SYSTEM CONDITIONALLY PASSES: One or more system components as described in the 'Conditional Pass' section need to be replaced or repaired. The systern, upc 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 wiry not. The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attachedi indicating that the tank was installed within twenty (20) years prior to the date of the inspection; 1 the septic tank, whether or not metal, is cracked: structurally unsound, shows substantial infiltration or exfiltration, or tan failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank -, as approved by the Board of Health, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A _ ,•. .-_ . ,, CERTIFICATION (continued) _ Property Address: id, ,.t. Owner: _ Date of Inspection: BJ SYSTEM CONDITIONALLY PA55E5 tcontinjr-d- _ _ Sewage backup or'breakout or high static water level observed in the distribution box is due to broken or obstructed or uneven distribution box. The system will pass inspection if(with pipets) or due to a broken, settled of the Board of Health). Describe observations: broken"pipes) are 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(s1..The system will-pass inspection if(with approval of the Board of Health): �. broken pipetsi are replaced obstructor is removed " -- : .. • -.... ... _---_-- - . ;.- _ �... : .__ ..feet _... ... . . , _ .. CJ FURTHER EVALUATION 15 REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require iurthe•evaluation by the Board of.Health in order to determine if the system is failing to prole the public health, saieti and the environment. U SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYM44 15 NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFME AND THE ENVIRONMENT: _ Cesspool or prl%ti is within 50 fee:of a surface water - Cesspoo! or prn-.• is within 50 iee: of a bordenng 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 15 FUNCT1O-I1G'Ili A MANNER THAT PROTECTS THE PUBLIC HE,kLTH AND SAFriY AND THE ENVIRONMENT: _ The systern has a septic tank and soil absorption system (S1S'j And the SAS is within 100 fee:to a surface water supply cr tributary to a surface water supoh•. _ The system has a septic tank and sail absorption systern and the SAS is within a Zone I of a public water supaty we!1. _ The syste-n has a septic tank and sail absorption system and the SAS is within 50 fee: of a private water supply well. _ The syste•n has a:septic tank and soil absorption system and the SAS is less thar. 100 fee: but So feet or more from a private water supply we!I, uniess a we!l water analysis for coliform bacteria and volatile organic compounds indicates th- the we!I is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to 01 less than 5 ppm. Method used to determine distance (approximation not valid). 3) _ OTHER (revised 04/1s/!') page 3 o1 10 / SL!BSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIO% FORM PART A CERTIFICATION (continued) Property Addross: Owner: Date of Inspection: DJ SYSTEM FAILS: You must indicate either "Yes` or 'No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. - 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 thie surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. Stanc liquid level in the distribution boa above outlet invert due to an overloaded or clogged 545 or cesspool. Licuid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day tlov. Required pumping more char. 4 times in the last year NOT due to clogged or obstructea pipes . Number of times pumped_ Any ponion of the Soil Adsorption System, cesspool or privy is below the high groundw•ate• eleyatior. Anv por:on o:a cesspool or privy is within. 100 feet of a surface wafer supply or tributar• to a surface water supply. Any porton of a cesspoo! or.pri�ti is within a Zone I of a public well." An. pc^tio- o,a cesspool or prt%ti• is within 50 feet of a private water supply well Anv por•-or. of a cesspool or pri%-%• is less than 100 feet but greater than 50 feet from a private*water suppl• well with no acceptable Ovate+ qualir� analsis. li the well has been analyzed to be acceptable. attach cop%- of well water analysis for coltiorm bacteria volatile organic compounds, ammonia nitrogen and nitrate nitrogen. E] LARGE SYSTEM FAILS: _ 1•ou must indicate either `Yes` or "No" as to each of the following; The ioliow:ng criteria app;% to large systems in addition to the criteria above: The system serves a facilin with a design flow of 10,000 gpd or greater (Large System; and the system is a significant threat to public hea!th and safer 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 bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/2S/97) pikom 3 of 10, 1 , SUBSURFACE SEWAGE'DISPOSAL SYSTEM INSPECTION FORM PART B •,:., CHECKLIST Property Addt:ess: 8l CA I tr L w Owner: t°y 0ei— Date of Inspection:'`\9� Check if the following have been done: You must indicate either "Yes"or'No`as to each of the following: YK No _ Pumping information was provided by the owner, occupant, or Board of Health.f 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 pan of this inspection. X _ As bull; plans have been obtained and examined. Note if they are not available with NIA. _ The fac:ltn or d%%elling was inspected for signs o°sewage back-up., _ The s%-stern does not receive non-sanitary or industrial waste flow. _ The site Mas inspected for signs of breakout. y K _ All systeT components, excluding the Sod Aosorption System, have been located on the site. _ The septic tank manholes Mere uncovered, opened. and the interior of the septic tank was inspected for condition of baffies or tees. materta; o' 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 The fac,lln o%%ne• nano occupants. tf dirteren: from owneri were provided with information on the proper maintenance of Sub-Surface Disposal Svsterr.. I4 Existing information. Ea. Plan at B.O.H. _ C�e;ermined to the field ur am of the failure criteria related to Part C is at issue, approximation of distance is unacceptabie (15.302.31;b1? (revised 04/25/57) Page 4 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM 1!�FORMATION (continued) Property Address: 0? L ii wl Owner: Cs tAd y Date of Inspection: 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 Ire Diameter Comments: (condition of joints, venting, evidence of leakage. etc.! _ r SEPTIC TANK: tlocate on site p an Depth below grade-* Material of construction.: ,�concre:e _meta _Fioerglass _Polvethylene _ othertexplam If tank !s metal. Iis: age _ Is age con:irmec o% Cen;fica:e of Compliance —('res.-No Dimensions Sludge depth a Distance from top o: s!udge to bonorn of outie: tee o• ba^-e Scum thickness- Distance from-'top of scum to top of outlet tee or ba-Ie _ Distance iron bottom of scurn to bo-o-n o,outre,.jet c• baf:.e .4 Mow dimensions were determined Comments. trecommendation for pumping. condition o� iniet and outlet tees or baffles. depth of liquid level in relation to o tie invert, structural 1 integruy, evidence of leakage. etc.i,,, d t_A E OW W J 0�1 GREASE TRAP:�(� (locate on site plan; Depth below grade: Material of construction: _concrete —metal Fiberglass _Polyethylene _other(expiain) 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.) y (revived 04/25:97) Page 6 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Propertt ddress: g 1, 7 lj -�yv Owner: Lu A-let tt Date of (hspection: s r FLOW CONDITION'S RESIDENTIAL: - Design floN Ball e.P.d.!bedroom for S.A'$ Number of bedrooms Number o?current residents•Q Garbage g g';`der (yes or noi:_tJ _ .. . . Laundry con-ected to system (yes or no). ._:_:_ _-- Seasonal use (yes or no!AJ 1 - --- Water meter readings, if available (last two (21 year usage tg'pd): i1J r1.0�► VSIk�-►'L� Sump Pump (ves or nor .• ._. ::; , .,. . ..... .._ .. Lai- date o-*occupanc-v 9,164, fb 11•�VtJ COMMERC;AL'INDL'STRIAL: Type of establishment Design fio%% _ltalionsida% Grease trap present Ives or no Industrial Taste Holding Tani; present. Ives or no ':on-sanitan Haste discnargec to the Title S system. ryes or no= %%ater meter readings. if availabie Las:pate o: o c6;;anc. OTHER. .De:cribe Last oate o►occuoanc% GENERAL INFORMATION PUMPING RECORDS and source of inform :nor. Q( r 1�P ►4-1— Iqcstt vow 1 oil-- System pumped as par, of inspection: (ves or no._ If yes, volume pumped- eallons• Reason for pumping �• TY�F SYSTEM ' Septic tank/distribution box'soil absorption system Single cesspool CNerflow cesspool Prno)' . - Shared system (yes or no) (if yes, attach previous inspection records, if any) VA Technologv etc. Copy of up to date contract? Other APPROXIMATE AGE of all components. date installed (if known) and source of information: I q pO 15 BN 9,f—j P( Ww--CVL-.0 Sewage odors detected when arriving at the site. (yes or no).-L=� (revised 04/25/91) Page 5 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C , SYSTEM INFORMATION (continued) Propert% Address: �� WWII. " Owner: l� Date of Inspectidn: g '9� TIGHT OR HOLDING TANK:_ -Tank must be pumped prior to, or at time, of inspections - (locate on site plan, Depth below Material of construction.--concrete -_metal _Fiberglass .-_Polyethylene _other(explain) --- - - • - Dimensions: Capacsn- galsons Design flov.• galsonsda. _._..__—__.._ - -• Alarm level Alarm in working order_Yes: _ No ~--- - - - Date of previous pu`nping - Comments (condition of inlet tee. condition o. a!a,m and float switches, etc.) - -- - DISTRIBUT10% BOX:kd( (locze on site plan Depth of liquid level aoove outie: m.e^ Comments' to level and distrsbu + ss ouz' evidence of solids rr}•over, evidence o'le kage into or out of box, etc.) I La, p - .. 21- t/-t PUMP CHAMBER:-" - (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.) - ---- "' ---- -"- ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Addr-ss: 87 Lft,W) Lo Owner:L)J0A J Date of Inspecu�n: SOIL ABSORPTION SYSTEM (SAS):144 (locate on site plan, if possible: exca anon not required, but may be approximated by non-Intrusive methods; ✓ If not determined to be present, explain: Type: _... Ieachrng..plts. number. leaching chambers, number:_ leaching galleries, number: _._____....._ __. . .._._..__. .. _... .. _ leaching trenches. number,length: leaching fields, number, dimensions overflow cesspool, number •- Alternative system Game of Technology Comments. In a condl 'on of soil, signs of hydraulic failure, [eve: of p ding, on tion of vegetation, etc.) - - - _._. _.._.._._. .__ .. . f --._ ,J w.._ . rT 3 IF CESSPOOLS: (locate on site plar. Number and configura:.on Depth-top of liquid to inlet Inver, Depth of solids lave Depth of scum layer. 'Dimensions of cesspool ' Materials of constructlor - Indication of groundwate inflow tcesspool must be pumper as par, of Inspection} 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.) fi (revised 04/25/97) Tag• 9 of 10 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM IN-FORMATION (continued; Propert,. Address: g�j In1 Owner: GILT I Date of In�pectio :SWI SKETCH OF SEWAGE DISPOSAL SYSTEM: _ - include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply-comes into house) b a3 y ►^guo 341 03- a0' �3� kz' n4' 37' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Propertv Addres-• £Y7 Lr►►w, Owner: 6-vi Date of Inspection: 1'ri . . • „ • Depth to Groundwater f3 feet Please indicate all the methods used to determine High Groundwater Elevation:—, Obtained irom Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Cneck with local Board o• nea!tr Check FE.MA maps Check purnping records Check local excavato•s installe•s (_se LKS Da:a r. 4 Describe in voi• o%%'. %,.oros ro•.% %o:: es:abhthed the High Groundwater Elevation. (Must be completed: 9,t213' J,d w-+cb-L t- 1-owe-yr n,f- ro� (rev--sad 04,2519'. Page 10 of 10 TOWN OF BARNSTABLE LOCATION SEWAGE # e VILLAGE ASSESSOR'S MAP & LOT 167 INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) 7 (,f (size) /0 NO. OF BEDROOMS PRIVATE WELL OR UBLIC WATER BUILDER O WN DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: -7 --2= )?- <;'3 VARIANCE GRANTED: Yes Now �ju3T (}'� j�,ts�. 1 � � � f� ,� � � �r ��+ �� - 1 � - � J � r� w�a�-T l V V THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Ter#tf rate of Tontylia re THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed ( ) or Repaired (x ) by .......................................... _.._.� - C. TT7... ....._.0 ��r...`'J . ..... ...._.._..... s Insr.Jlcr at ................................................... . ................ .................. ...... . ...... .............. has been installed in accordance with the provisions of TITLE of The State Environmental Code as described in the application for Disposal Works Construction Permit No. .���-....3.-�F1..__...__--- dated .......................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...................._....7... ' _.�r......�f✓.. ..._. Inspector ......._................ .......-]„r�-------------------------------------......... ---------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS ` BOARD OF HEALTH /G7 -616 6a-;) TOWN OF BARNSTABLE No... -. � . FEE....:........ �t���a�tt1 irk$ �ua��t��#i�n hermit Permission is hereby granted.....................�r ..................._ !`-?s� .......................................... to Construct ( ) or Repair (54') an Individual Sewage Disposal System at No. C'. r�c'_. U.... t_� --•-----��-------C....J ?.. N Street as shown on the application for Disposal Works Construction Permit No.✓3-35./' ___ Dated...7-_.. ........ .......................... .... ... . ..•-------------------...--•-•-••-• ......... Board of Health DATEg- 3-------------------------------- FORM 36508 HOBBS♦!WARREN.INC..PUBLISHERS No... °, .9, . Fas.............................. THE COMMONWEALTH OF MASSACHUSETTS APPROVED BOARD OF HEALTH Barnstable Conservation Department d�-_�--F TOWN OF BARNSTABLE �' ned �Vltr�' u`r li����t at Wurkii Tuatitrurtiun lirrmit Application is hereby made for a Permit to Construct ( ) or Repair (�). an Individual Sewage Disposal System at: T7 L_//)7" L_9NF C-Z.rr0Lu/c L6 ....................•-----............-•---••--------.......-----------•-------•-•••-----•-••----- ••-----••---•-•------------------•-•--•---....--••---•-•-....-----•------...................------ � v Locat 7 L l/-1�✓l LA ns� ......................_............-----------------...------------------------------••---------- --...---------•--------C---••---••••T-•--�--•/-Lo•-r•J-L-i-o-t-c-•�N-�-o-.---•----•----•--•-•--------------...------ W G/ U w7n'j OwnerC . si 7( � ddress . .. � L�►-� y r�J /1!14.l S Installer Address Type of Building Size Lot............................Sq. feet �.. Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) 04 Other—Type of Building ............................ No. of persons.-.------------------------. Showers ( ) — Cafeteria ( ) Qt Other fixtures ............................... . . WDesign Flow.....................f ...........gallons per person per day. Total daily flow...............3..--......................gallons. WSeptic Tank—Liquid capacity........--..gallons Length---------------- Width---............. Diameter----- .......... Depth................ x Disposal Trench--No- -------------------- Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter...............--... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. I................minutes per inch Depth of Test Pit....--.............. Depth to ground water........ f%4 Test Pit No. 2................minutes per inch Depth of Test Pit--.-----..-.-------. Depth to ground water........................ a ----------------------------••----.......-----•-----...-----------...........................------------------...---...........-----..............---------- 0 Description of Soil........................................................................................................................................................................ W V ....----•••------------------•--•-•-----•--•----•---------------••------••-•••••------------•--------------•----••----•--•-••-----••---••-----------------•--•--•-•------------•--..............-•...---- W ------------------------------------------------••-----------------------------------•----- .-------------------- ----------------------- --------------- J UNature of Repairs or Alterations—Answer when applicable.-.-.---....- ----------���..-�`C�L...1�- .. �i CS� -! -----------------------------•-------------------.................-...---------..--.----------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has e iss e y t board of health. Signed ------------- ................ . .. ...�/g ?_ ... - ,.a.. .,� Dace Application Approved BY o c1... ................................................................................ ... .gi g..".�.3.... Dare Application Disapproved for the following reasons: ... ..................... .. ...... . . ....... . --....................... ................................ ............................................. ..................................... ................................... --- . . . . ........................................ qq 2�y Date Permit No. ._.L..3...`.✓Y/........ ................... Issued ........----7.-`-D-g---�7�.................. Daze J� 1 No....F3-,319'l_- Fps.....�2.... ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 6G7 TOWN OF BARNSTABLE Allp iration for Di ivatiu1 Worlas Tutuitrnrtinn Famit Application is hereby made for a Permit to Construct ( ) or Repair (x) an Individual Sewage Disposal System at: I '�-7 L 147" A Yt--S;,7 CU/LL � ..............................................................------------------------------•---- -•••-••-••--•-•••--•------....•-----•-----•-••----••----•..__.._..-----•-•--•••-_•.....-••-•----•- Locst' n_-Address or Lot No. - ------------- ••-••••••-----•--•--••••-----•--•-••........-••--•....••••---•-•••....----•-•••--•---•••••-•....__ Owner Address a OG/c r G t U� 5 / n �l ..-_...--------------- -•----------------------•-------....---`'• �l9 ,��1!1•,/YI/I•[5... ._._...----••--•••----•-.....•-••---•.....................•----- - . ..-------•- 04 Installer Address Q Type of Building Size Lot............................Sq. feet UDwelling— No. of Bedrooms------------------- 3_.-.-.--_..___._-.Expansion Attic ( ) Garbage Grinder ( ) p" Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures ...................•.-----------•---- . W Design Flow.....................cam............gallons per person per day. Total daily flow..--.-..--_.- ..................gallons. 04 ic pth sp Tank—Liquid capacity. .. gallons Lengthidth... .---. Diameterarea De .DiPosal Tench No ... .- idth - ---- -rotal Length ..... _ Tal leaching -- ..__.....s . ft. I Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by........................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water......................... 0 Description of Soil-------------•-------------------•---•-------------------------------------------------------------------------•-----•--•-------------•--•---......._...._._._.._...---- j V W ....................................................--................................................................................................................................. ............. UNature of Repairs or Alterations—Answer when applicable.............- 4.0---------AQ... ..................•-•-------------...----------------------------•--•----------------------------------------..._...------. .............................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with . the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee issued y the,board of health. Signed ...............%1.(�(....... t�-G- �4�. ......�/........�.f .......�.- - � �-........ �� .mil"-�..... Dace ApplicationApproved By ............... a ..: ................................•... . .................................... --7 g.".%..?.... Date Application Disapproved for the following reasons: ...................................... ................................_.......---....... . ........................... .... ............. ..--.............................................. .................................................. ..--.... ......_........_.................................. ........................................ qq 2 G Dare Permit No. --..1...3...-. .J./../ Issued .. .��.....4_-D ................ Dace LAC—A 10N 4 ?-7 SEWAGE PERMIT NO. ILAGE C tf 4,� F2�2 4e-,e 4zeL, INS LlE 'S NAM ADDRESS 9 B U It D R OR OWNER 5 DATE PERMIT ISSUED .� - DATE COMPLIANCE ISSUED Y .1; •r . t LOCATION U:si I �--�1 M_ NO. �.. V I LLAG E_ C�.TE W We: . ------- ---�....�......-..._._.... ... DATE APPLICANT CEEWBQ.IF3�, �V Q�P►�. FEE' . I ADDRESS � r..�'�0✓1 �, TELEPHONE NO. _on -refundable ENGINEER C—LOPeoGe EL1Q1ueeQ,kk Z� TELEPHO NO '111 DATE . SCHEDULED Il..1Ati( ?bI17 19�'�► S.e�-Z+ ANT pplicant' s signature SOIL LOG SUB-DIVISION NAME :DATE "A-4 "_7 `$1 TIME EXPANSION AREA: YES ✓NO ELr&P_ ENGINEER TOWN WATER_�/PRIVATE WELL IGL7tJ 6 t�L7�D BOARD OF HEALTH Am Dp�,SCO u__ EXCAVATOR SKETCII: (Street naine,etc. ,dimensions of lot, exact location of test holes and percolation tests, locate wetlands in proximity to test holes ) �„�• NOTES: _ N to n i LOT PERCOLATION RATE: t 'l 0 . M I►,,j /I TEST HOLE NO: ELEVATION: TEST HOLE NO: ELEVATION: 1 2 -e4`CrD Pscz 1 L— 2 3 3 4 4 5 5 6 6 7 7 9 9 10 10 .12 12 �I 13 it, t - 13 14 14 15 15 ' 16 ` 1.6 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PIT LEACHING TRENCHES -- UNSUITABLE FOR SUB-SURFACE SEWAGE. REASONS NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION i ORIGINAL: COMPLETED IN ENTIRETY BY P . 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I..l.I.�..1�I;I'I9 IIl.._:I._�9�,..9�I.�.:;1���.9-I�;.-..9.4_I I�.,._..�I�9..I�I.I.�.i�1...�1.��.I..Q 1�DI I�III�I...-�-.I�I'11-.9I.%..��.� ___.-�_ _- _._-.-- '___-_ -- '�1 ------- J ._ EXISTING TREE ROUGH PLLM5 2 -/y j' _ .� G TO REMAIN BATHROOM ONLY - �- r `- =/: - '� - - .BATH'; O :0:�. 'W . ' - - _ . .: I ._ ..-. _ - ' - _ - , - - ----- a a . 1� - `y w \\ p. '" >, - "PATIO AREA _ - i : t - - - . I I �. '. ': . _ :,n A4' -' -- _ _ BEDROOH i .4, .<C I FMAHOGA.Y DECKING - _ WALL KNEE 'LANDING 1 STEPS ` ! ! EXISTING POOL q'-0 I/2' _ _ 1':- 1i-.. -_._- I yt 1 S?(o i - -----'--------- _ 5 - - _ - i - ,. _ ,.. s€AK�AST- --- - . �" _ _ E - 'TLE L i PRE-TAB GAS 10 1CLOT _ :"5 O - I - SETBAC -- ..yy `'• - I'" %, ".0 F:USH TILE - FIPEPL A:CE - L :S - HEhRTH - - .. -, I' CcNTe RED ON-WA:L I �/- G.ANT R D _� '., -..,`. - - _ i - GABLE P -- .0,. 1.. 'KI,TCHEN., SITTING " .. Ij 1 ' I�' TLE s--- NE OF :AREA 07 G . . . : ,�-_-_ CARPET - CARPET �� 2ND OO -- . L , . . Y �}s I EXISTING WINDOW - 1 - j' - �i _ ..-__-____-_- TO REtt AIN . : - - 5)NK.CAB NETS.AND- '% I M' - 91<B.VE T$ ... DAQ �CTS . COUNTER_TOP TO . . . BRAI .. : - .,_ nAINTAIN EXISTING . ,' - - - - ____ - t PROVIDE $EP ARATE PRICE FOR THE FOLLOWING"2.d FLOOR GARAGE - I WOOD FIOOR� -P _ _ . . - - _.__ ..________-. .__- --_.--___._...-'' OF ;. `. RICAL( RD ON DAP NDANT>O40 . w.,.,.. ... " ..,� __- __ __ -_ AL J L_ LI S ;�'E TRI lO�T STS GHI"NG A SHOWN ON E.' . . :f ___ _______ -______,. ._ _-. '- - ..'tea' __ 3.NSUL.ATIION.WITH VAPOR BARRIER O 11 / 1� _ - 4.Gv.P::FINiSH W/]COA iS FAINT _ I o',. !"I /` i 5.TILE FLOOR n BATH k "THRESHO!D - -% <.CAR?EF.'BEDROOM.STTING AREA.I STAIRS I _ .EXISTING PANTRY yW� .. _ - //I� 1 BATH (.. alll q4, ^45'Dj I - '1i.L ORK IDOJR�t TRIM)1NST AILED AND PAINTED - . NO GRANGE .. I OPENING .. r-rrl-J .-I`- -j - d FINI$ PLJIIBING t _ EXISTING DEN - } - - - ., ;, _ NO IRANGE 1 ,�.. I. � ' 6_G. ' - - i.. .1 _` .. :_ .S i`,I \„_'N.. S .) i �E OEYIO,_OI SH EXISTING GARAGE.BRcE2EJ!PY f.DECK'CONFLETLEY- I. „ a, -=C O'` - - GARAGE � ___ INCLUDING FOUNDATION _ 9 GE . , ._.__- -�. J-_�-T_- •�'O� l\ .CONCRETE - 2 ]. PROv,DE,e/C a NEW ADDITION 1ST F�.00R I � �RE-U5E AS MANY / I _ I ' .I .. .3_ .cAaINET5 A5 - - _ Q -P,OSSIBLE:PROn �.-� Y. :1�� - - 3:ALL INTERIOR iERIOR'tR! nATC:i EXISTING MOUSE 512E1 STYLE'.. (/(+ryy \\ ,'EXISTING KITCHEN ri - D.. '+' Y i �+ '/ ENTRY_-FOYER "� I T-RF-RE LL1-H -___ _--_--� I; � -'-.TO.NEW:P,N T Y- • MI ,a .9.REMOVE FENCING$ ):GARAGE TAAT WILL N c E --' - � �-. -, I- .' ; '. ` 1I11 - CONSTRUCTIONS1 STOOKPILE AWAY FROM WORC AREA.'" �I -. - i,__._._- ____--.- -.-_-- ,-,i - TILE - /v :F �n - RE-INSTALL FE!ICe.TO'COKNCCT WTH NEW GARAGE.': . ------ -- /, ISl d 2Nq. . ry I' ='. DI EL00. :P:LAN ,:< .. J,... .: . - II WINDOW SEAT W - :.: .:. 1 - t..�F=l FLIP uP iOP ,.. i .EXISTING ---' - -- - 7 + DINING'.ROOM _ .I @;. @: �.. EXISTING LIVING. f - -` - . - NO-CHANGE ; !: - 2 �6.-1/8" ... I1 _ - _ - - _ DATE: I.� AN.-:10173 -I - . . 9 ! - _ _ _ � _ SGAL'E V9 I_--0 Al,_ _ .'I .I, �,I .(, ` FILE: 021P_AN. _.... ,l J BRICK LAN ING _ X STEPS ��. I�� ..' .. .. __� f .__ --_.__ _ ,_=1 L__ �_.J'__� 1.6' 'tl'-O '-6v I\ _ .: _ .: _ BRIC<.WALKW Y _ '__ _______-_ _ _vEW A✓� _rvr CFRAyE ___-__.._ __ _ _ - a� A �. 2L' 0" 1 �\ II \ I I IST FLOOR PLAN A2 SCALE:'1/4', I'-0- \\ I - A ■ - ---- I ,.-- ,-- :,.Aa,_. -__<�:. �:,.. >...._-. '...-,-. �,...�.'.:.,..:'__.__.. .._,...•-- ..--_::.:.:, .:,.-..-- y;�.::.,�_ �.�r,-�=..�-.,.:..,.r�.�,....:>.___.-._, -.y,�.,�_._.._-`__ „�._.... ...4 _.__...,_�__ ...._.,.._...._--_.._,. „s_-.,-. i-....... �_ -_..-._ _..3, - y�..,_ :_, ._� _,... .,.._......._u,.�.._, . . ___,,.-" .- - _ __..w.., - ..,_ - ._.. .. ... :.n!• ::: -...., .'.�..: �. :. :' 77777 , - •yKINGS°Ffl.N�.MA.O]3<4 i . 4 lfll$B5.D280 � ' '- CDNT.RIDG ✓ENT.RCH SHINGLES: Y E MATC01-1 ER:(IST.. A _O .. H E• L , TIPICAL EA VE 1 .. ALU!"' RAINWATER LEADER RREAD CEDAR. EDAR CLAI?BOAROS .. - -. .. - . .. - Y 70PIn tH Ex[STIN'.HDUSE'. �. - �.^ - .. :. .. _ .:.. ARCHITECTURPL 1 I/2' :=.RDWN.Y1GU_DWG.CAP - - . .. - -. SHINGLES S L 1'4ACOL EXIST. - �.--•+ SHING °TOP 1 1• ctO45E STYLE f C..10 � W/�WyI.E ¢lA, :�- t..; - -: _TYPICAL RAKE TYPICAL EPVE � �. � :�.� � � �-- �f--- ---- ri � 1.4 a2.P.tNE CORNER-BOARDS TO HATCH EXISTING HOUSE - --- ---J� - N- _ - LLJ 'n ��y - 4. •.}. 'XI- 1 Ix6 PRIM?GARAGE GOORS v/ �I FLUSH PANEL^.GARAGE DOOR$ .a�.d ALUM.RAINWATER LEADER -.pi -- --- I -a2 PINE CORNER BOARDS l 1 xt - : .. _ - - EXIST.1ST FLOOR FINISH EY.ST:1ST FLOUR'.N!SH _ Llj (J) GARAGE31AB=LEv r. w al .. FRONT ELEVATION., Z } 2 LEFT ELEVATION 3 ' I .SCALE: i'-O" = I/9° .. \� A3' SCALE: 1'-0- WINDOW SCHEDULE .I MFR, TYPE RGUGH t OPENING -'Li c REMARKS A AtdDER50N DOUBLE HUN$,.'5 9 9'-5 Ili. TW2692-2 F�j' T- W i �S B DOUBLE HUNG l 6 I1.2. x'4 5.1/9 - - '.TW3642-3 V0). J �t DOUBLE HUNG '2• 6 1/8"!x 9'-S-I/9" TW2692 - ':;, D CASEMENT 3%6' - CASEMENT �2'-9.: /8">i'3:-S 3/6' CW135 - . " - TW24<2 I F .. OJUBLE HUNG:'-• �. ' TRANSOM O x 4�-G .. �BRi�IDl:11/i.EW ✓ H . DOUBLE HUNG X !/9 TW2942-2 - AR'C.:HiT EC TSi 'J DOUBLE HUNG ;8'-2:I/4'Y. 3'-5 3/6- CIi7135 / P3 35/ C1U135 T I �>2 CONT. RIOCE VENT-_--- \ AIR;=L:TEC TUR AL 41T. 101 $HISTYLE ':7 MnTCH cx,IST HOJSE COLOR - -._I _ - - -- L U IQHITE CEDAR SHINGLES.G ARAGE� ND FL. nuB �- FLvGR ��•1-�,'.I,_' i -1L A TY PI�.=AL.RAKE' _ ^ ALUM !NlIIP. RATER LEADER I � _ I aa :. � :. -.-_- :-- f. -�'y- :.�-• �-: { "ems Fc"i. .`�{°� �€YI __ GaRnGE 2n•D FL.�$NBFLOOR - _ JAN 3 CCEDAF '! .__ -,.- _�____. ., -,.�:•_�-_�--_ _-,L:•I !¢ -: - r�Y�- ___ �' � DATE: 0 ���200 --�' WHITE CECAR - --- -- ----i; SCALE.- /9f O'- .. . _ ____ __-__-____ .; -__..- _.I'•-i. �� } ....:151' FLOOR FINI5HEC SI+nGLeS -- .--==c FILE:. 021.P4:AN: IS_- -- _- -- -- '1 r -- I-:5 v2 PINE CORNER B�AROS Y - . - . -•\ RECESSED nDO PANELS IST FL FINISHH=D .�\ PAINTED,: `- BASE CAPMOULDING ARAG SLAB .:3 < PiNc SUR ROI;,ND?ING BACK .ELEVATION PAnE s RIGHT `ELEVATION SCALE: SCALE 05' t:. r 1 , !I _ W ' TYPICAL ROOF CONSTRUCTION 2A6 RAFTERS�-IWO.C. 12 12 �.. :._. W co TYPIGAL EAVE.' .. "�........'`..��...��...��.��,....��....,✓.. ._.��-- - _--__ __ __�C., _J� _l.. _-- —__ - �J�:, .�J.�.i✓�. �az 4� Ii r i \ I i t 1 KITCHEN .. .. _ .W ENTRY WINDOW 1"'_- __.:_. --- —..-c_ -._. _I _ _ .. !. _ TYPICAL.WALL CONSTRUCTION.. 1 I, FL F OOR FINISH :. _ ._ - 1 3.• fir ( BR/1(DEf'f1LfE ARE;HYTEC TYP. FOUNDATION WALL - SECTION A T SECTION --ALE 1/ = I-O P Ro�F' -JE I`! . IPTAL DRIP EDG = \ . +I+ I( 'DATE O jA4. 7003 :{ SCALE 1/2 5OPPIT W/'WONT PERir- ne TAL VENT-- /: n'.1. FILE: 02iIPLAN . SEED nIULDING TYPICAL EAVE A< SCALE: O" ■ � �-.'-.'" ,1'i:I.,1-I-�,-!' 7 � , ' . .� ' : ��....�..;..�. ..� ,I..� .. ..zz. -.- - .0-- , . ' 1 - ' 11.- :. . ' . ' : .1� . ,� i "4 - � , I- -,� _:: I - :: : � . � ,. ..7 ..".:I � . � � .. . �. 1 6 'o�w1� -, 1 9"II. --l.:, ,---- � '- '-k �9 � ,--' .l'- -. . .�. - g',� .� I. I " I 1. I I ,�.i . .'.... � I . .I.. L-'-I' K",.,I' N,., ."G C...:�.II S T o W�� DRIB -IZ J,-.1B:� l. ' ...- .L ", Il- .".1- �.�i.'. �!.i .- ,�. k :i , -. !� ... 'L I.... g - -�.-� L i - .--,- '1I ;l , _ . i � 'W - —�- � . - .. . .. - . . - kI i .. - I -4� . -- z2 �- " . � � .., � - .--- I - TYPICAL P T . , �: .. . l- " 1 L'.%.--I- , , %- I L �l1 " �o I I," '.-". I � '� � .- , LI -,L �.L 'L ,LL - ' : .. ' ,-- � � ,...L i . . --4 . . .. .I - "'-f I � . - .. I . , ' -"- .. . . .. . . TYPICAL EAVE DEJA . ,. 7 ';�- . . .I �. :� ..�:'�.' .: .7 -�1. : . .. ..- � -- N , .. . I. . ..:7�I �"� % I - . I I. ?," . . �. . . - -. ., I� SITING AREA I t . O� I - - . I . . . .: B , .. .L BASEOARD HrA7 W ( .. -- — , . �t 'L' -T '- I. , TYPICAL WALL CONSTRUtT16b , . .. .. YPIC OOF CONSTRUCTION . .. . I 1, I " f ai ,CONTINUOUS RIDGE VENT 11. 'ARCHITECTURAL AS-ALT SINGLES RK'IS FELT PAPER — - i 5/8_COX PLYWOOD -- \ .. ' . PICAL POUNDATN ;2XIO RAFTERS 61'"D.C. � . — T Z -.- -- '` . , ICE I OAT p S IELD LOWER 51 0 s. ,1, ,2 . I. AND VALLEYS ALL pFPI'IES ,. A - -II . I ,1� ,. I . U" � TO'PLATE-DORMER - i. -- IL , — .I � ' -- — . I , U f— I r I 2X8 CEILING TIES C 0�' I I ; I i, "�- : . .. i R-30 F.G.INSULA]ONL -- ' . I 4 ! GYP..0..1 S F�& i 4 -- a I GOI." SECT ON L .MlrVAPOR B,Rk-e CALE� 1/2I 1 61B 1 _I2 S BRAlR MVlffW " . . . \\ : I - L TO.5UBF10OR?GARAGE 2,dFLOOR :. ! I I 1 - ' v TYPICAL F�V�EfJ61L I" _ " " - . I t , ; . METAL.DRIF EDGE ,I/ '--0 10I5T5 W.O.C. . : ALUM,GUTTER , ' --.-- -.--- - -------- fkB PASClA..PAINTED ---.,-L------- -- "TTIE-FTvE-7wTEOl --- . IX SOFFIT W/CONT;NUOU5 i L GYP. 50:0'STPAF11., / - . . SOFFIT VENT STEEL BEAM � . � X6 FRIEZE BO..PAINTED I3 GARAGE . 11 - -' ,- � '...., . .L II -... . ..1:. . , ....- ...�.� I. :.- - . I .;''..- I 1 . % TYPIC AL WALL CONSTRUCTION' . I, W 4-4 CEDAR S-CLE5ON FELT P-F.--sue ! V2'COX PLYWOOD SHEATHING. . . L . ; . .. � 2X4 STU06-14-O.C. I � Qa15 F.G.INSULATION " . i -3 112 CONC S— ,MOOT. i.5� � . : TYPICAL FOUNDATION ---- GRAVEL 'ILL. ---- ---- - - % . ECHANIC ALLY C-MP ACTED ; � C Z ': II I I.TO 15%COIPACTiCN I r0'E0f/�.L*"L:0 'NSTALNc.oR CQ'09S I L,i i b. . . ; I to.COIC.FOUNDATION WALL - :qMui DAMPPR0opl.G I : 2-s REB.P Col T. L L .L TOP BCTTOM - CON CONC FOOTING 0 MN BELOW GRADE -- I ON UNDISTUZBED �� , SECTION AS SCALE: !*-0' = /:' I �,. . L I I . I I . � I --i'----".�'.� �--it"---�' I.�z-- - .---- -l-- :-'-',. -..�.11--- - .1 - - - -,%1-,,:-.. � l , rm,,, I � -�;N, 1�,-! �l%, , "� 1 � . m� � . . �. � - .. . ., , .F 4I tfF ,', �,, - � f � I .� ,� - .� I �, 4- - I - .. ��; p �::,I - ;.� �, . 1. 1,�,B; � . -: . �, . .� - — .. rl� - .� .. : , . �., I . �� � ,-� - .. . �: ., :, "—R I - . . , I� - . , I� ,. .-z- - I.:t. 7 . . .1 1 . . G � I I � : 1 ,, 1 ' - ,, , . 1 .. . .. .. . ;. -- . , .. - . . , - . �� .. . � . .1 .. '-,:,� . ..1 , .. ' ,.--,. . . . . .. ___ : . -- --. .. I • I�— t � .. � I . ;,�... . ,� 1.� ". - ,.. .�..,......-!-� : -� , ,1 f 1 ,: .,A.-. ., . .. .I , , .. i. .....I:, I.,,. ., 7 I ," I. �-%, .. ...I t ., I . ,. . .� I : . � I , . ,. , Co .. " . ;I . 1. . ..1 - . . I, . . - I . . " .. : .. . %. �- - . P - ., � : ems:.. . .1.11 I i -; . . -' - � i t,. 1I, 1 .. :- { ; l !.. I . 1 !,; ! .,,, 6 � . . . . . llt ... I .%1 . . .— ,-- . � 2N b FLOOR FRAMING p,4N, . —W , .; . s I 1 I� f- , I; .i��.%. .. % Ir. �i I �,- , .- .,.-. .. � - - � � .: -- I — . , :. st — .. �: .sCA E:1/8 -i,-o, 1 I ... iST FLOORFRAIN,G PLAN . .;,... . . . 5 SCALE 118'.= r-o I ., - - t . � I,- ... � > , II . . .. — wI . a U n : '} I . I . . , Ajzbi ifec is- 1.- - . I— - . 6 T�I 1 . . . � - ,'� I OOQORnEqIE.DSS . 1 %. G . . 1 � ,.:!.•., . . . . � I O"VER^'�AE I uI,. T l -1 : - - � I - .. . RIDGE _ I . iL 9 I . . - -. FRAr1IN G' 2 10 ITi. — ' I I . I ., . .DATE: 10 jAN..2003 —TER Hal0 LOWER 3C .. OF A IROOF IK.S A.0ENTIRE i1 . LENGTH OF VALLEYS — — . 1 PAN o — StALE ROOF PLA N . ROOF FRAMING PLAN .- SI SCALE:1/8' =V-o: . I 3 _ I I I �' SCALE; 1/4- =1-0. . . . I I . : , , .1 - ..I.�, , -- .- .�I.. .. .Ik.- I I. I.� . .� I . p . . : I I � . �. .� %- ...... I � - - - <' F.G. 27.7 • B1 24, \ ice i'� Q" v ;� •� 23.0 ' 24.3 1500 Gallon s • •ts, '••' "A \ \ Septic Tank 24.05 Top EI.24.0 e...y �' g •a•` I 7 �r'> Bot.El. 21.0 ) -; �� `;�D I ,•�/!' zy, �-� 1 �\ ; \ 23.65 23.40 / \ \ Bedding Y` �n OT '�Rg� , 1 Per Title 5 Bot.T.H. EI. 15.0 _ 1 �., - _. Bay A, No Groundwater OG� DELVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM evr�, \ \ Not to Scale DESIGN DATA NOTES •' •`•• �� �� _ p• t� /, Single Family-5 Bedroom ,� • I. Water Supply For This Lot is Municipal Water. 1' \ / Gar bage a Grinder 2.Location of Utilities Shown on This Plan Are Approx.Daily Flow: I10 x 5 = 550 gpd LOCUS PLAN At Least 72 Hours Prior to An Excavation For This Septic Tank: 550 gpd x 200%= 1100 d y 9P Project The Contractor Shall Make The Required SCALE I 2000 1 F1p0` 1 / �,, Use a 1500•Gallon Septic Tank. Notification to DIG SAFE-1-888-344-7233. ASSESSORS MAP 167 LEACHING AREA 3.The Contractor is Required to Secure Appropriate PARCEL 16-7 / ! j 550 gpd/0.74= 744 s.f.Required Permits From Town Agencies For Construction ZONING RD-I / j r Sidewalk 2(12 +45 )2=228 s.f. Defined by This Plan.�B SETBACKS FRONT 30' i Bottom Area:12.x 45 = 540 s.f. f \ 4.Install Risers as Required to Within 12"of Finished SIDE 10 768 s.f.Total Provided. Grade. , Exts� '--_! mac' LEACHING CHAMBER DESIGNEAR 10 5.AlAll Structures Buried Four Feet (4�) or More or EL Li h tr ► �� AI I Pipes to be Schedule 40 PVC. Use 5 Subject to Vehicular to be H-20 Loading. _ -500 Gallon Leaching Chambers in 6.Septic System to be Installed in Accordance With tZ, 12 x 45 Washed Stone Field as Shown. 310 CMR 15.00 Latest Revision And The Town of Barnstable Board of Health Regulations. t 2 a•' ! All �� Finish 7. All Piping tobe Sch.40 PVC. (iAOC) AO Grade looO "` Gx l s / i 1 a�,. a+/ �.,q N CAL. 5 s T. /SE Ti SOO L / oN w Fobric, Ccmpocted Fill h ;\ T41J1� L / a �1 CET 4 Pea Stone k l3 Leaching Chamber _ 3/4"-11/2"Double 9 drF\�� Washed 12'_0 \ c CROSS SECTION OF CHAMBER PM n9 NOT TO SCALE t» N AN 7�33q{ CIVIC. 0 `\ MEO. SAND L�q� 3Y 1v0 C;ROU1V0\^/ATeR PG_RC. Ni a. : P— 12.03 on-ram'. s-/as/8? wtTNE35 . RON GIFp-°RD.-r.0•13.0.0. 1 t_eSS T:--1AN ZM\lv,/INGN. " PLAN VIEW SITE PLAN Scale: 1"= 30' PROPOSED SEPTIC UPGRADE AT 87 LIAM LANE CENTERVILLE , MASS. FOR SUSAN GAUGHAN SCALE: AS SHOWN DATE SEPT 30,2003 SULLIVAN ENGINEERING INC. OSTERVILLE MASS. � -. F ti r m � ''' .- < "' , .. 77 - ,e•ti: tom..""?�,a F, . -L. .. ..I. , r,x', !'w• ,,,:i•r, 'its,. r, n,7 -•.n. „se. -r'v ,e,,: «�,. v... ,. r a -+e. ,,.,. II ,fit r .J•.. , , Y .. c ., ±:'3' .,.....,�,F..�.,,P..17"iFaw* •r. �' ,�.,, ,.. .. , w. 1 ..+.' : _. !.: ,Itcr: . ..N..",y4 ^91' .F: '4; 7i' w e.-. w.+.ra►a,+w...---wr,- - �7t fir,; ,fie r , --. 4e . t :.:. ... ,.Y ,. t. > .J.Y .. r _4 .•,, :" J � t + 't.d .. fr. t , '.: .. . .. ,. . ,-. 11 =v.. , , . „I, , -n. ".. , , „ 111 t 1 r DOOR• a•- . 14 . SCHEDULE . , BPAIDEN'v!FW A;<," . - '`,_ '' I -.1 iIAR;.N DRIVL� a .1.. : ) a KIN-,gT'�N, MA O ,, .� ( MATE0RIAL SIZE MANIJ> ACTURER - MODEL NARDWARE NOTES . ` ; ,.�� F a, ..� . . , , �81.585.0280 ," A WOOD t GLASS 3'-O"x' &'-8" w/2 SIDELIGHTS MORGAN MI00, (2)M-182 LOCK t DEAD BOLT -1 ' IY p �r ' B WOOD POCKET 2'-6"x L'-8" M-1051 LAWRENCE HEAVY DUTY POCKET DOOR FRAME1 . / " , J\/ \y ``, C GLASS FREN-CH (2)2'-O"x b'-8" M-3911 PA SAGE r llr. S . 5, q,l D WOOD BI-FOLD !2)3'-O"x 6'-8" M-2FD-1051 PULL KNOB . I I ,- ,. CENTERED ON ;�,�; • E WOOD t GLASS. 7i-8"x C-8" M-'1108 LOCK 5ET - KEYED i GABLE { .w ip j.t, F WOOD t GLASS 2'-8'x b'-8" M-3,912 LOCK SET - KEYED• 1 --T--f� - -, �i G 5TEEL 2'-G"x 6'-8" PERMAjDOOR BE-'10 PRIVACY SET -' KEYED 20 MIN. FIRE. RATED - i ' 1 .. p11 - . ' H GARAGE 9'-0"x 1'-6" OVERHEAD DOOR Co. SERIES 494 MOTORISED OPENCR I I I, I dI. ,1 I II , N , ... J WOOD 2'-6"x 6'-8" MORGAN M-1051 PASSAGE I 'r: { -� • K WOOD BI-FOLD (2)2'-6"x b'=8" M-2FD-1051 PULL KNOBS ! i r L WOOD 2'-6"x 4'-8" M-1051 PRIVACY I I _ - _ I ----?- 5"-O" KNEE WALL I � , • 1 I 1.0 � , I 1 7 1 .. 1 V I '-I I m I is , ' I I I i aI .e4 I I I I I I I - I1 I I I ,. °" PLYWOOD FINISH 1" ; I I r , , ! > ;': i i 'r I i .. ( ' I ; ! I., � ON STEPS ONLY , , DOWN I 1�I I o J I 9 ITTING . ��j ►n r 1; AREA ul "I,- . �l 1 1 1 I a I 1 i _ 1. ��c� - ----t ,I'I r("� J l I u v.,~- ---- ---_- _----_ _ - --- _____-- -- -- _ - A ��1. � 1\ -2- �(y �-- .,l 1. J r ROUGH PLUMB. , a l _ � EXISTING TREE / ,3r- TO REMAIN BATHROOM ONLY I ", O ."��.;i I ) "7 �J, Al wf BATH,, I __ . rr11 s (1) o . o_ i . I I � .J t ,I, - 1 � I I V / f,J` I I I C1� �D 1� . I 11., .1'.. . 1 -------- I I f ,1�', 'z `� I _11" Ili . . . . I I J, 0 I I = G� ( - ��p -y;l. I f T �'' �' f_ _ I I �� r'r PATIO AREA Q� ��I IL11, : j ;I L� Its - -. . I I I I �� , I " i N I . . -` i w { } " I s y r �'-,.,I , ! I . ( O .111d .J'� r 1 I I // 1 r , _- , I I I_ 41 O N , \K 6' �� , <� A4 _ „ I - 1 .-1 I -- . .. _ _ - ( # -_- 31'-O �� 10 -0` L • , I I cv I _ BEDROOM _ ,� '! f I MAHOGANY DECKING . I C-O" KNEE I I v_ <' ,w • - - I EXISTING POOL i 8 LANDING t STEPS WALL 1. I _ { • Ln __ " Il_q,. 31_IJr l'-il f/2" 3'-O" ; t 11 I - --- 1 r w I 1 I . I z I _ .� I I, i , I , l I 1 1" AI I IJ ,I ► � _. 6 2 4 1- i/8 0i I �� _ __ I < " 1 :tl� (I I i . I -- {, ,,, I IS�-r- I j I T - < /I ."'. I 11 1 I TTI i `� 1 �� I I :- . C - - L � _ -- --t -� �- _ I j , I a j I I mil/ f BUILT�1N I I 1 - - _' II ' . i c B NETs + I �_ I I 1 , p \ i I t 1 I ry • [1-1 trJ '_. aA +�l.C?� -- t(Q I rI �� 1 r f I TILE 2"v/ PRE-FAB. GAS 10' SIDELIOT ; 5 _�1 - ; �- , _ _ Q FLUSH TILE ( FiREF'LACE SETBACkt �_ \ ---- ' 1, CENTERED ON WALL . 1) __-__-__� I �� ' `�, I 1 I I ° 1i HEARTH 17 I I - _______ - tti I o � I ___,.,-- � � � j CENTER ►� - II H °p 1 . KITCHEN - I �' - - - -� - _ 1 0C.1 I 0 F4 .t� I. TILE SITTING j - �`'`� , t-----LINE OF AREA I s R l IT �] /� *I /''�GARAGE p .1.i - I CARPET CARPE. II I 1' FLOOR I- L A I V �...i A R /`'�t G E r. .�,�,k�� r I I- _ 21� 1l - -_�,,, _ - - SCALE: 1/4" = I'-O .:-,._n,_. *„,: A4 °:'.;+•,,rfa,:.,:, � - EXISTING WINDOW I � � -. ,..'8 ''` TO REMAIN -- -- ------ ,I I � _ x, - --- - a a I I I _ - __ _.__.__ _ - __ R X "" j i'. SINK, CABINETS, AND ! I iI BRAD\! l�D� #,I . - I COUNTER TOP TO I I I tSUILT-IN 1 '-* _ CABINETS Q_ 1. »e �a. # 6.".. ,* iII I REMAIN ; I I 2 /y ; �,� ,e� I . . ARCHITECT $fsl r. 1 I I I _ j jr( I 1\ i i1 I t: I . MAINTAIN EXISTING I i - - - I \/ \\ __ .. --l. __ � 1 .I �k PROVIDE SEPARATE PRICE--FOR THE FOLLOWING, s 2nd FLOOR GARAGE WOOD FLOOR - rS� '� _ I _ 11 ` [. - -)) I- I I. HEAT (BASEBCARQ ON INDI_PENDANT ZONE) -` - �i. y- I `"" "_` UP O I ( 2. ELECTRICAL {OUTLETS t LIGHTING A5 SHOWN ON Eh ``:I __-_.- :D 1 1 _ r`- 1 .1 II m , ; �\ i , j 3. INSULATION, WITH VAPOR BARRIER -...a , 1 t , I ° , _ _ ''� ' +! -_ _ _ _ _ - J �--_-- I-� ( I y r i ° \ 5. TILE FLIOOR W.'BATH *P i _ _ , n 2 COATS PAINT , I I I 11 I I { B •1 -" -- --- I EXISTING p i THRE5HOLD s 0. ---" �- `_� �I BATH I �'_A $ ! r y i - & CARPET BEDROO . SITTING AREA: t STAIRS I M A i l I NO CHANGE l CASED I I 1. MILLWORK (DOORS t TRIM) INSTALLED AND PAINTED -*;„ '� i r OPENING r i INI - it 1---- - 5 M /'� EXISTING DEN , - I �� 1 I � - ------ ----- r -- - - NO CHANGE I Ii I /'r 6 -� / I i I yt. .�, L BINf -. I �r 11 - CU I 81, - I GENERAL NOTE _ -I ( Ii I / \v 18 8,i I �� 5: �- � n ��� 1 I I, DEMOLISH EXISTING GARAGE. BREEZEWAY t DECK COMPLETLEY :\- ��- A�� L�..-,L �---•- - I 1 `V I l'-4'' �~ GARAGE INCLUDING FOUNDATION ,, x, . 4 i F �� ,\ , I I I 1 T CONCRETE Iry . I , RE-USE AS MANY ` I \'" I I1 - 2. PROVIDE A/C 9.NEW ADDITION IST FLOOR � "j i i I� I -3 CABINETS A5 I t I nn I " �' POSSIBLE FROM /�' ,. C, II -1 3. ALL INTERIOR -rkl MATCH EXISTING HOUSE SIZE t STYLE ,_. I. �- y� I'---� ! r EXISTING KITCHEN / ENTRY I=OYER G a `� ,,° - - I II RR __-�- ( TO NEW PANTRY I 7 �) O I IV A 4. REMOVE FENCING GARAGE THAT WILL INTERFI=RE WITH I } 7 f _.� , .b , TILE ✓- I �� / l/ i' 1 CONSTRUCTION t STOC PILE AWAY FROM WORK AREA. I . . , _ I F_ - ! ! ,/ O I �0 , . I 1� I I RE-INSTALL FENCE TO CONNECT WITH NEW GARAGE. { a ( NST L ,� i �- I / A + I � /- of IST � 2N D _ 4 I1 i ' D1. I ! I I L I ,I ` WINDOW SEAT W/ it in FLOOR PLAN , I _ _ -I FLIP UP TOP r I I ( EXISTING i ;;j _ _._ _� _ - _ - -- - - - - - - - - -- - _ _ _ - __ - -- - - � I j ' DINING ROOM I ` ! M 1 11 j I ' ) 'I *' EXISTING LIVING I __) 1' 3 -II 51�3,, i1 , }} � �0 ! 11 i NO CHANGE I11- 1 I 2'-b 1/8" t I . ! {111 ! N J , ~l t 1 l i II ' I I �, h 'i,� :y 1y DcALE:IO 4JAN, I2 y , �r, I' d 10 I I "' I F__� A5 II I - .tr I1110 ,:.. is•..".. PILE: b21IPLAN A I I BRICK LAN ING I 1.1 t ' s, t STEPSILZZZ� , . . L ____ - _ 1 I 1R- '' `6 II -O '1 - yy '{ h9 tt°If BRICK WALKWAY I 26'"O" i ,F, 'y w{ +j 1.311 NEW P MENT I" , AVE a GARAGE }{d 1ST FLOOR P1_ ,41� Y.r :, I - , I . ,: . , . �, _ za A2 SCALE: I/4 I'-O' , , • roes 1'`' 'r 1 , , a;, . . - td1.a5 , I , I � ". . I -I "I . I I � ! I , , .I � . 1 1. � I , . . - r � I I . I ,:, ' '. . � � I . . . j ''-'�"' ., , . II'll .-. 1 . I I . . . . . 1. I q I � � I o. ., , I I � I I 11 :1 ,11, I r_ I � I I . � I . . . .. - , I I , � . , , , I.1 , � � ,,, I '' - :. - . ., . � . I . � I I . , � � , . ,�.., �. . I . . . . . � , -1, , r .� L"' , '�I,' - , 4� . , . . I " 1, 1 {", I 1' . I , , I I 1. ,, 1_. .,. r - - , y. - 1 r: , , .. .. .. . , , r .�� 1 s` �3 , .,.� , " J Jr. wa