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HomeMy WebLinkAbout0128 COTUIT COVE ROAD - Health 128 Cotuit Cove Road C-,luit -- - - A006 050 I r. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 128 Cotuit Cove Rd., Property Address OCONNELL, PATRICIA D Owner Owner's Name information is Cotuit MA 02635 2/28/14 required for every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When A. General Information filling out forms r on the computer, I �� use only the tab 1. Inspector: key to move your cursor-do not Robert Paolini use the return key. Name of Inspector Robert Paolini Septic Service Company Name 17 Playground Lane Company Address r Yarmouthport MA 02675 City/Town State Zip Code 508 362-3555 S14454 Telephone Number License Number i 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: r 2 Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further E all tion by the Local Approving Authority 2/28/14 Inspector 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. t5ins-3/13 Title 5 OjInspVorm: bsurface Sewage Disposal System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635 2/28/14 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑x I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. ' A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y N ❑ ND (Explain below): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments s° °v 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA. 02635 2/28/14 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 r Commonwealth of Massachusetts Title 5 Official Inspection Form R Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635 2/28/14 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 . -, ❑ z 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 ❑ 0 Liquid depth in cesspool is less than 6 below invert or available volume is less than'/z day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is Cotuit MA 02635 2/28/14 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) E Yes No ❑ 0 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. ❑ O Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ❑x Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ Z 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. • ❑ ❑x 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is Cotuit MA 02635 2/28/14 required for every 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 ❑x ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ Z Were any of the system components pumped out in the previous two weeks? ❑ ❑x Has the system received normal flows in the previous two week period? ❑ 0 Have large volumes of water been introduced to the system recently or as part of this inspection? ElWere as built plans of the system obtained and examined? (If they were not available note as N/A) ❑x ❑ Was the facility or dwelling inspected for signs of sewage back up? ❑x ❑ Was the site inspected for signs of break out? a t ❑x ❑ Were all system components, excluding the SAS, located on site? ❑x ❑ 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? ❑x ❑' 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: ❑x ❑ Existing information. For example, a plan at the Board of Health. EJ 0 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): 550 t5in3.3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a' 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635' 2/28/14 i page. City/Town State Zip Code Date of Inspection D. System Information. Description: Numberof current residents: 2 Does residence have a garbage grinder?, ❑ Yes ❑x No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes Fx_1 No information in this report.) G Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑x No Water meter readings, if available last 2 ears usage d na 9 ( Y 9 (gP ))� Detail Sump pump? ❑ Yes 0 No Last date of occupancy: Date 4 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3113 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 sa`'¢ 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635 2/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes 0 No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑x 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635 2/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes 0 No Building Sewer(locate on site plan): Depth below grade: 21 feet Material of construction: ❑ cast iron 0 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10i+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the building vents. Septic Tank(locate on site plan): 31 Depth below grade: feet. Material of construction: 0 concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions:_ 1500 gl. 311 Sludge depth: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 usetts Commonwealth of Massach Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635. 2/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) 3311 Distance from top of sludge to bottom of outlet tee or baffle 5-1 Scum thickness - 6„ Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 12" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump tank every 2 years.Inlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound. r 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 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICWD Owner Owner's Name information is required for every Cotuit MA 02635 2/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: . ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635 2/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert No 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.): Box is Ievel.Box has two outlet Iateral.No evidence of solids carryover.No evidence of leakage. • i Pump Chamber(locate on site plan): Y, Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments (note condition of pump chamber; condition of pumps and appurtenances, etc.): y ' *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 128 Cotuit Cove Rd. Property Address ' OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635 2/28/14 , page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits ' - number: leaching chambers number: 4 ❑ 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.): Sandy soil.No signs of hydraulic failure.Leaching chambers were dry at time of inspection. Cesspools (cesspool must be pumped as part'of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 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 M 128 Cotuit Cove Rd. Property Address , OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635 2/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) 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 Tithe b 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 128 Cotuit Cove Rd. Property Address OCONNELL PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635 2/28/14 page. CityfTown State. Zip Code Date of Inspection D. System Information (cont.) Provide a view of the sewage disposal system, including Sketch Of Sewage Disposal System: Prov g p y 9 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. O drawing attached separately' i At.3a1 ' is q 63:iff ID A Tay I t= JI t F t' I t5ins-3113 Title 5 Official Inspection Form:subsurface Sewage Disposal Sys`en•F"e 1s 0f 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635 2/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑x Check Slope 0 Surface water ❑ Check cellar ❑ Shallow wells t Estimated depth to high ground water: Bottom of leaching 21' feet Please indicate all methods used to determine the high ground water elevation: ❑x Obtained from system design plans on record If checked, date of design plan reviewed: 2006 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) x❑ Checked with local Board of Health-explain: As-Built ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS observation well data.USED:Technical bulletin 92-0001 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 128 Cotuit Cove Rd. Property Address OCONNELL, PATRICIA D Owner Owner's Name information is required for every Cotuit MA 02635 2/28/14 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist . FE Inspection Summary: A, B, C, D,�or E checked ❑x Inspection Summary D (System Failure Criteria Applicable to All Systems) completed System Information—Estimated depth to high groundwater 0 Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file ii t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OP BARNSTABLE LOCATION Q'i C up+ Coue.rJ• SEWAGE#ZdC4-3Z3 1] VILLAGECj�-� ASSESSOR'S MAP&PARCEL 0-1-406 �d INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY 1536 oc,� LEACHING FACILITY: (type) 'I-Sep q dq am'ncc5 (size)�-12`X 13°�12i NO. OF BEDROOMS t OWNER ��.�ra c.c` 4n' CQnn cV PERMIT DATE: 1 ' 7 P 19/64 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY l� ,\Je9t1eG.�� 5"nigila;q+Also lclas Bi-ti9 i 2 (NZ-iCz_ .,. 0 0 r2-3� n , Y tE f P� No. X?3 Fee THE`COMMON4SVEALTH OF MASSACHUSETTS - Entered in computer: � s PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Rpplication for �Bi5pogal �§p5tem Cow5truction Vermtt Application for a Permit to Construct( ) Repair( ) Upgrade ' Abandon( ) OV `i� Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address, Tel.No. As essor's Map/Parcel D& D jb /ZO 407P/7- 014,16 X-P, (',O`7VAe- /"lid Installer's Name,Addrgsss,and Tel.No. Designer's Name,Address and Tel.No. 6d. Type of Building: Dwelling No.of Bedrooms Lot Size . Z/ sq. ft. Garbage Grinder (A/,p Other Type of Building L No.of Persons Showers( ) Cafeteria( ) Other Fixtures 1 Design Flow(min.required) g^�j) gpd Design flow provided m gp Plan Date -1�� ��0 Number of sheets �� Revision Date - p - YID , l y Title �€ Jew �!L- ,Ti� Size of Septic Tank Type of S.A.S. 1 ,K Z 15 NCl� P Description of Soil 5e_f sx R/ Fog-, *")CW 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 o it 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by t is B d o Signed Date -7 " l Ll -4>(-- =Application Approved by At,-" Date Application Disapproved by: - 'Date for the following easons ` ! e CIA, ermit No. DDODG 12 3 Date Issued .. .,F-,..,_ _ - i .^ .,. .. gygggp•_ ,4 . .. .-, ._ _ -.. .. -. 7. Fee r ' Entered in computer: , .. THE C�OMLMO.N.YJEALTH OF MASSACHUSETTS - „,. ( ash Yes PUBLIC HEALTH DIVISIO'I� TOWN' OF BARNS P-B E, MASSACHUSETTS ZippYication for Coin rution permit 'Application for a Permit to Construct( j Repair-( Upgrade O Abandon O - Complete System ❑Individual Components Location Address or Lot No. , Owner's Name,Address,and Tel.No. /z I �d� -9, '��vr7- � /�,4�i�i�lq &<7�dVi� GL Assessor's Map/Parcel 64 O,tjQ r �Z� �pTjj/F �rD✓ JZ�. ;67U/r r u Installers Name,Address,and Tel.No. Designer's Name,Address and Tel.No. dr�V W Type of Building: D-1/a/ 1 Dwelling No.of Bedrooms Lot Size 'ZJ , 9$0 sq.ft. Garbage Grinder (nl)) Other Type of Building �_F5m, s?aa2_ No.of Persons Showers( ) Cafeteria( ) Other Fixtures ytu CAA)6 Design Flow(min.required) gpd Design flow provided gpd F I n Plan Date --Itnq Jl, 2.OD4, Number of sheets Revision Date &/o Title S'j.0- ' �rk:-r1 49/4he- /i f'�.9 0'��5� Size of Septic Tank / ) (,°,qG / Type of S.A.S. Description of Soil J`r�it f' a✓ �� _ d r'S- r-0g­'W1)0"j 4 L ' 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,Vi%e 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of ..ealth.,``•....... t r „ Signed i l,q_ Date Application Approved by Date . Application Disapproved by: a N C Date —7..— for the following reasons /1- ?r 7JIPA AI qr, r` Q m` Permit No. a0f, Date Issued 7 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Comp iance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded Y) Abandoned( )by !'4111 "A l i at JQ" l'„4 . has been constructed in accordance !6 with the provisions of Tittle 5 and the f r Disposal System Co strut tion Permit No. 3 a dated 7! /7/Installer (., 1 r 'f� t I id r � Designer { #bedrooms a Approved design flow gpd The issuance of this permit shall f o/f_be construed as a guarantee that the system will funct'on as des gned. Date / 1 I/ t! Inspector ------------- ----- No. (A 3023 Fee / THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS _ J 111i!gpo!5a[ �&pgtem Construction Permit Permission is hereby granted to Construct ( ) Repair/( ) rUpjgrade (k) Abandon ( ) System located at /.?�K rJu.4 r.,-y- 2 DJ , 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 ethis permit. Date 7I1,oxk TM Approved by fr s Town of Barnstable Regulatory Services Thomas F. Geiler,Director enar,srne,E, i634• �� Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: Sewage Permit# ;5004 -3 Z 3 Assessor's Map\Parcel Designer: NDbAg4 �VaJ1p1Y, Installer: ,®, SSG P Address�a Address: ug vST2 4V, �S7o t,JS ILL A.A . On %9 ©6 ZV was issued a permit to install a (d e) (installer) septic system at 4.7y/r 6 X/F_ based on a design drawn by (address) C-OTLJ/T A P-A dated . '7— 11 v s (designer) 1/ I certify,that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State&Local Regulations. Plan revision or certified as-built by designer to follow. BRUCE R w"u 5 p. (Installer's-Signature) MURPHY i E Jr,, No. 749 �a Ale, (Designer's Sig;`at e) (Affix Designer's"Stamp Hee) T� PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE'S OF° COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD-.,,ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. 1 Q:Health/Septic/Designer Certi$cation Form 3-26-04.doc i "cS COR. BLHD= J 1 " OAK 34.52 o o NEW 1500 GALLON O p TANK 0QP �co. . h � #128 �L o 10, AK , SAD, T.O.F.=35.70' � APPROX. G.I.S. 1 OA DATUM BREEZE 6'2 o �`�' 2—CAR GARAGE J (SLAB) EXISTING LEACH PIT, TO BE PUMPED AND FILLED F� "� � 1P#2 W/ CLEAN SAND. SS92� cF° �� RF o rl, PER 31"0 CMR 15`.255 30 \p S 11.4' F ^� 10" OAK A.M. 006 PAR. 067 HOUSE #112 \ / (TOWN WATER) w I ,40 P.V.C. 3" PER'FOOT 2' LAYER OF 1/8' — 1/2' WASHED STONE EXIST. EL=--35.5' OR FILTER FABRIC PROP. EL= 34:;1 .............................:�:::::::6' a EL 33.2 CONC. INVERT CLEAN SAND. .FILL • RISER & EL= 30.3' " COVER LEVEL, �'wQ` PER 310 CMR 15.255 9 FOR 2 LONGEST RUN ��� MIN 19.0' S=0.01 EL= 31.1 INVERT 6 SUMP INVERT o0 o O O O O O — O O o°mom o. EL 30.75_ EL 30:5 24" o_ m 6" BASE OF CRUSHED STONE OR c 0 e um EL= 28.3' MECHANICALLY COMPACTED PROPOSED 4.o s.5'_ 4.0'_ DISTRIBUTION 42.0' — - — BOX 4-500 GAL. DRY WELLS (4'-10" X 8'-6" X 2'-9") _E OF WASHED STONE SOIL ABSORBTION (TRENCH FORMATION) u 'OSAL SYSTEM SYSTEM (S.A.S.) 12.83' X 42.00' SCALE) BOTTOM- OF TEST HOLE ELEV.= 22.7' i (NO GROUND WATER) HOLE #1 EL.=33.2 TEST PIT RESULTS: TEXTURE COLOR IMOTTLING OTHER MY LOAM- l&R-3 .2 ------- :1.0�.EOBBLES SOIL-TEST DATE: 06 26 __06 . AMY SAND 10YR4 6 —————— FRIABLE B.O.H. AGENT: DONNA MIORANDI, R.S. JE SAND 10YR6 6------- NO GRAVEEL SOIL EVALUATOR: STEPHEN J. DOYLE, R.L.S. Town of Barnstable P# ) 3 _ Department of Regulatory Services BARNBiABIZ : Public Health Division Date �� bi- A, MASS. �p i67♦t• 16� 200 Main Street,Hyannis MA 02601 rFD MJ�� Date Scheduled � Time Fee Pd. Soil Suitability Assessment for Sewage Dis osal DU OAAA Performed By; `! t = — Witnessed By - the LOCATION& GENERAL INFORMATION ' P\J i,)! Location Address Owner's Name Y'4,T'i %) UrLl��itJ L Address Assessor's Map/Parcel: Engineer's Name /V/ qgc�p F �L S;�O_y i/✓� NEW CONSTRUCTIO REPAIR Telephone# �Q 4l Land Use p �.�ems, �6 :�- Slopes Surface Stones Y, �,o Distances from: Open Water Body T 1 5/i� ft Possible Wet Area 1 5 i ft Drinking Water Well I n O . ft Drainage Way. ',/D ft Property Line 1 C ft Other ft SKETCH:(Street narr wetlands 4n proximity to holes) r . AR. 050 ti y qR006 3 0 W ) '��61 FAmyr 380* 1lI' / Ce,a m �� W �''?�� �,4•rim � �� . . • �.' A M a oos Ate) -• ti �?,, �, ' � G CIO N� �MAS Parent material(geologic) Rm V Depth to Bedrock. Depth to Groundwater: Standing Water in Hole: �' , Weeping from Pit Nce Estimated Seasonal High Groundwater L IS` t= F-<V F DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: [-VIP,Phi 7 Depth Observed standing in obs.hole: in. Depth to soil mottles: in, Depth to weeping from side of obs.hole: in, Groundwater Adjustment f[. Index Well# Reading Date: Index Well level Adj,factor Adj.Groundwater Level PERCOLATION TEST ime to 1 z(. Time iL,,Lo Observation Hole# Z 4- Time at 9". Depth of Perc 4 I Time at 6" Start Pre-soak Time @ Time(9"-G") End Pre-soak Rate Min./Inch f Site Suitability Assessment: Site Passed V_ Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division r Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the, Barnstable Conservation Division at least one(1) week prior to beginning. y Q:\SEPTIC\PERCFORM.DOC DEEP.OBSERVATION HOLE LOG Hole# F-L om Soil Horizon Soil Texture Soil Color in.) (USDA) S01I Other (Munselq Mottling (Structure,Stones,Boulders. on ten % ravel L d/Cr l� rZ��t7t t t Depth from DEEP OBSERVATION HOLE LOG Hole#Soil Horizon Soil Texture Surface(in.) Soil Color Soil �-Other (USDA) (Munsell) Mottling (Structure,Stones,Boulders. 1 C nsis[enc % ravel L S 1 O'(>L A . rc.\A Z - 4 Z`° C— s-V'attr� DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Surface(in.) Soil Color Soil Other (USDA) (Munsell Mottling (Structure,Stones,Boulders. C nsistenc o Gravel 1LrG�A r3L "D DEEP OBSERVATION HOLE LOG Hole# (�Depth from Soil Horizon Soil Texture Soil Color Soil Surface(in.) (USDA) Other (Munsell) Mottling (Structure,Stones,ra Boulders. 0— (O 1t Consi ten 1 )')�{TZ �v '� it �lL�� ��,t.: � C,.t't•l�a,� Z4� 1z5 G Flood Insurance Rate Man• Above 500 year flood boundary No_ Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes e Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? � t-_ If not, what is the depth of naturally occurring pervious material? Certification I certify that on 315L' (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CUR 15.017. Signature Date D(o� Z� �p6 QASEPTICIPERCFOR M.DOC Barnstable Assessing Search Results Page 1 of 2 INN �� M $ p9l { A`/i 'f ✓ %yAR!b 6V' �: ..... I. E L3��gg o's yy,,, g Aud� NVOS Ki/v Home: Departments. Assessors Division. Property Assessment Search Results <<back to search 128 COTUIT C Owner: OCONNELL, PATRICIA D Property Sketch Legend Map/Parcel/Parcel Extension 006 /050/ T ' Mailing Addressa OCONNELL, PATRICIA D 128 COTUIT COVE ROAD a COTUIT, MA. 02635 Y 3 ' Assessed Values: Appraised Value Assessed Value Building Value: $ 134,500 $ 134,500 Extra Features: $2,600 $2,600 Outbuildings: $0 $0 Land Value: $ 122,400 $ 122,400 Interactive Property Map: Ma re11, wires Ply in: Totals:$259,500 $259,500 1 have visited the maps before Show Me The Mao April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: OCONNELL, PATRICIA D 8/15/1995 9813/060 $ 100,000 BLUESTONE ENTERPRISES INC 3/15/1992 7899/ 187 $ 100,000 HIRST, PATRICIA OCONNELL 6/15/1991 7577/226 $ 1 HIRST,JONATHAN W 2800/71 $0 Tax Information: Tax Rates: (per$1,000 of valuation) Town Tax $2,439.30 Town Fire District Rates Other Rates 9.40 Barnstable 2.88 Land Bank 3%of Town Tax Cotuit FD Tax $487.86 C.O.M.M. 1.54 Cotuit 1.88 Land Bank Tax $73.18 Hyannis 2.89 http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/... 3/28/2003 Barnstable Assessing Search Results Page 2 of 2 West Barnstable 1.96 Total: $3,000.34 Due to rounding differences these values may vary Land and Building Information Land Building Lot Size(Acres) 0.53 Year Built 1978 Appraised Value $ 122,400 Living Area 1982 Assessed Value $ 122,400 Replacement Cost$ 154,616 Depreciation 13 Building Value 134,500 Construction Details Style Cape Cod Interior Floors Pine/Soft WoodVinyl/Asphalt Model Residential Interior Walls Drywall Grade Average Grade Heat Fuel Gas Stories 1 1/2 Stories Heat Type Hot Water Exterior Walls Wood ShingleVinyl Siding AC Type None Roof Structure Gable/Hip Bedrooms 4 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 2 Bathrooms Total Rooms 7 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL2 Fireplace 1 $2,600 $2,600 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story (Unfinished) CAN Canopy FUS Second Story Living Area (Finished) UST Utility Area(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK,Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http:Hwww.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessing/.... 3/28/2003 No.. .................... .................. THE COMMONWEALTH OF MASSACHUSETTS BOARD F H EA H .................OF......� ..... .. .......... Appliration for Disposal Works Tonstrurtinn rruti# Application is hereby made for a Permit to Construct (`,/) or Repair ( ) an Individual Sewage Disposal System at: ( y ............. �._...: :..K�.. ..........1 .rl LI =5-1 �' _.lK,'...... ....`��j / ... -...... • _ •- y --•Loation- dress i ✓ G ...... :1. ''�6'L+i1��. .. �P.�.'.-:'..-P�r.Ts --- -6.� ..---- -1�_ ..fir.:----- -dA .3yfr.---- Owner- ddress Installer Address d Type of Building Size Lot:. . ,. :7 __._..Sq. f t U Dwelling—No. of Bedrooms...........�................._..........Expansion-Attic (�o) Garbage Grinder j) Other—Type T e of Building pa yp g .____._�-.................. No. of persons.......11.................. Showers Cafeteria Pa Other fixtures -------------•--••......•-•-••--•-•-... • •-- .5 rb .n L, Ions. W Design Flow.a+ ._ .: _.'. _.__...__..gallons per person per day. Total daily flow................ gal W Septic Tank—Liquid capacityJ0.00—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 (ve) Dosing tank ( ) Q Percolation Test Resul Performed by... _A��A.ve.A_Yl.j............. .�... .._---_......_ . 1 ' .-.--_-..-.----- _. Date.._. Test Pit No. 1..Z`- ;!-....minutes per inch Depth of Test"Pit....1. _....... Depth to ground water.....'--________________ (s, Test Pit No. 2........-A_..minutes per inch Depth of Test Pit.....j.a....... Depth to ground water------............... W Description of Soil........ �_._....!v¢ :. rrt ......._ /fie..._ •---•---•-------------------••...................... ..........•---- •• .. ••-.••••• ---._----• - W UNature of Repairs or Alterations—Answer when applicable............................................................................................... • -----------••-•-----------------------------------•--•....--•---••-•- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TL I1,LE K 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. Sign d- ----" � .. Date Application Approved B �,.— ..... % . .._Y....................... Date Application Disapproved for the following reasons------------------•-- ........•..........•--•-••-••••••••-••••-•••••••-•-•--••••-•......--•-•---•••-•------•-- � .............................................••-•---••----.....------------••----•--....-•-•---------•---...---•--..•._...........................--� ~ .^. ......-• ......----....._. ' •------- L S Permit No......................................................... Issued--- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD F H A H 40 a, -- OF..... --------------•-------..---_--.---.- Appliration for Bigposal lVarkii Tonatrnrttun ramit Application is,,hereby made°-:;for a Permit to Construct ( ) or Repair ( ) an Individual Sewage; Disposal System at: •...............__....---......:.,.......................................•---..........._.---•-- .......---__-•----_•-•---.............._...... • ......._........... Location-Address or Lot No. ......................—^.....................................•--_•-...........•_•_.............. ...........--•---_--.....•---...........................---------•----............:....:....-•--•- Owner Address W �i Type ....g............... Installer .... :....... ^..... 'Size ess - ..... T e of Building .........Sq. f et aDwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder J aOther—Type of Building ............................ No. of persons...............................Showers ( ) — Cafeteria (* ) Otherfixtures .----•----------•-------•-------------••-•-••-•-------.•-••--------•------•---•.--•---------•---•-......_•. = W Design Flow..................................."-------gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity............gallons Length.__....t........ Width................ Diameter................ Depth.............V, 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 0-4 Percolation Test Res96 Performed by---•=•=-------•---._.....-- 4 = Date ,.a Test Pit No. L ....._......minutes per inch' Depth of Test Pit.................... Depth to ground water........................ �T4 Test Pit No. 2................minutes per inch.; Depth of Test Pit ............ Depth to ground 'water........................ Rr' Descriptionof Soil :--------.........:................•--_--..........--•-------_-•-•----_--=----------•-----:••----------•-------_.......----_--_•.....-----__......-_-•--_---- -- V T:... W Nature of Repairs or Alterations -'== ..--------•••-•-_--_•......_. U P rations—Answer when applicable .........................._ ----------•--------- AgreeTent: f Th`` <<tifidersigned agree- to install the aforedescribed Individual Sewage Disposal System in accordance with I the promi�s oils of Tl"= 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. / Sign r Date Applications;Approved By......._. � •-••-••--- Date ......._.._ Application°Disapproved'for the following reasons:.................... .. ................................................................................................._..............................._....__........_......---.............__...........__.............................. e i Date Permit No..........................`::. •+' Issued_....................................................... Date 1,. THE COMMONWEALTH OF MASSACHUSETTS fe BOARD HEALTH .... r .OF. .. .............................................. &rrt ffi'atr of. Tift fianrr .r`THI I TO CE I That the Individual Sewage Disposal System constructed ( or Repaired ( ) Jen -.-..- nshas installed in accordance with the provisions of T The State Sanitary Code as describ d in the application for-Disposal Works Construction 'Permit No: ................ da.ted:_..'/r _"' .f�# +___..... THE.-ISSUANCE OF THIV,CERTI,FICATE SHALT. NOT BE CONST SAG ARAIVTEE THAT THE "SYSTEM. WILLS C .. : TIO�SATISF T Y. L DATE.. •••••.----- .--- Inspector:...._ THE COMMONWEALTH OF MASSACHUSETTS BOARD HEALTWa r r N � ...... ....., tl ..... . .OF......... ...:. ................... FEE.....::......,...,.,.,.r.... Maps or WEJ5 an rrmtt Permissio s reby grante - t Cons'tr �t Repa`' �anidual $evcrage'`Disposal System ' y a No.- -- ( eet as shown on the application for Disposal Works Construction e iAN— Dated.._./� ""caBoard of DALE...................... - tr l , FORM 1255 HOBBS & WARREN'. INC.. PUBLISHERS - , co 33C> SFET"IC- T LK = 330.r 1�7Ci % • 4-956.P.o. O�''��-�`.• - S. . {v� r. � �r USA- looti CAL. 5P054L PIT - uSt= Iboo GAL. k Bt�TTo�K Aet=A TOTA L 'D G616.1 r 425 Ml oTAt_ c tzc�I.�,TIou tZeTE "tu 2ml u orz �� , , ' I .� .i, P.e�� ( _ .. —� V 4 � ,,•w� ;' _ 5 WHARD BALK �rUYAI te> 0 t. ol S'•,rr-ST a/8J18 Top F'wo sloo ft %; /i i T J .4 r a: 1000 tMppl ' a S�so1V 4 PIPS GIST. Iw• GAL. ' Iuv t '$Ox 9� Sc-Qnc; ' ; ' I oao 94 G t TANK i t Ny,' t►LV ..� , y ' �,; � t ,' GAL._. - -�9�$ °�q�o -r :.• t !j . h I ! JAaO r WAS4lED t: STowF-- /•a 6.0' S C.SZTI SD pl..IC>T toc.ATlot-4 -UVATE IT Go��S 40 , � s ?. 1 G6tzTlt;14 THAT TI4a 'Dw`Y°:Gt��1[� Staawl.l P�.Afi.1 RL—.i=C2eV.jC- . NF:Qt=o��l CCarV�PL�(S W 1'Y'K Th1�. �j1Dti:_t.l►-•1� I ,: , , .- :, r. Af.LD SETt3ACIG WE-: QUIIZEAA&WTs OF 'ro W W ; DATE i, fi 6,4XTCIZ Gr. W eF_- IQc.' tZE6l5it.iZ�D LAI.ID 5U2VcYotZS ' ' TI-41.5 VLAW 1'S UoT t3ASCvl1r(ASS/ , F•. NDT' Ic,L- WSC-ta 5 , 51.1G>t�JLD AP PL-I GA.t`,.1 TGeeML�JI= -r r c ✓r F LOCAY 'ON � � SEW'. 0 PER 4T %0, N 'VILLAGE ._, _. A34 �� J1,11 T L-ti!S' %lp A0DRE-SS mac^, 0 y 0`W N E R.. Ai - yu R DATE PERMIT ISSUEDAo } �Dy `A T E COMPLIANCE TOWN OF 1BARNS'TABLE t LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACIL=: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: - COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by r t 4 g COTUIT / � oop \o "" � ° A.M. 006 CO �% LOCUS EXISTING 1000 GAL PAR. 050 f TANK (TO BE REMOVED) 1 / J AREA=21 ,380f S.F. �O ;t o do N o 43.9' A.M. 006 i t cow / o. - PROPOSED of :PAR. 051 ,��b �,, ADDITIONS \o` LOCUS MAP HOUSE #23 (TOWN WATER) \ / PLAN REF: 134/41 c> DEED REF: 9813/060 COR. BLI-I / J ZONING: "RF" 30'-15'-15' 34.52 / —\ / ASSESSORS MAP: 006 PARCEL 050 1 " OAK / ��p ) / FLOOD ZONE: "C" o � / / / / AQUIFER PROT. OVERLAY DIST. Y o NEW 1500 / GALLON O TANK O hQ���o A�09 y ®') SEPTIC SYSTEM #12 8 7 / `i �L o 10I AK •9 / CATCH REPAIR/UPGRADE PLAN ^0A. � T.O.F.=35.70' / BASINS t� APPROX. G.I.S. / LOCATED AT: 1 OA 26DATUM ., , `®) #128 COTUIT COVE ROAD ��� tK BREEZE COTUIT, M A. 10.0 cv �`�' 2—CAR PREPARED FOR OWNER APPLICANT: � GARAGE J / / (SLAB) � � �`� P PATRICIA D . �, `\\ 34.8 J O p �� � 0 CON N ELL.. EXISTING o v� �� `. ` /' JULY 11, 2006 LEACH PIT \o /� .Qi `• / 0 TO BE PUMPED � ) ,� LF� Q AND FILLED 7#2 �w..A♦ , W CLEAN SAND Ss9° cF ° �� a �' �� tK >�� � SCALE: 1 =20 PER 310 CMR 15.255 �R . 11.4 F M F 10 OAK �� \ M;�, o STEPHEN d O G. ~ t DO. �' ; MacDougall Surveying 0 MURPHY s713l+ ' Bc Associates ° J G No. i #37559 P A.M. 006 7Op / �� / i °Ftcc,o�' P.O. Box 2428 F " . a o C, R t •1� PAR. 067 '�0 ° // �,������,` � ►� S� vE'��.• Mashpee, Ma. 02649 } 08419-1086 HOUSE #112 \ / f x' R08�419-1087 '.. (TOWN WATER) �' email: macs u allsurve omcast.net SHEET 1 OF 2 J# 1058 4" SCHEDULE 40 P.V.C. T TOP OF FOUNDATION MIN. PITCH 1/8" PER FOOT ELEV.=35.70' 10' MINIMUM 2" LAYER OF (v 1/8" - 1/2" WASHED STONE ....... EL= 35.0 N�P1` OR FILTER FABRIC .,....,.. ........ EL= 35.5 ......................... ............................................ A ............... - 33.2 .. EL .... . ............... ............. .'.'. CONC. CONC. .......... .......... coNc. INVERT 4" SCHEDULE 40 P.V.C. OR EQUAL COVER COVER RISER & EL= 30.3' CLEAN SAND FILL , ,..., MIN. PITCH 1/4" PER FOOT COVER LEVEL `ti�CQ`� PER 310 CMR 15.255 9 43.0 FOR 2' LONGEST RUN �� MIN. OW LINE 19.o s=o.O1 EL= 3t.1 INVERT INVERT 110" 14" INVERT INVERT ° °° ° O C� C� O MIN. a wMa �E30 T °°o o° °o ° EL= 31.70 EL= 31.45 4' GAS EL= 31.20 EL= 30.75 .5 �2ea o �° qy BAFFLE 6" BASE OF CRUSHED STONE OR °° °° m°°°� EL= 28.3' MECHANICALLY COMPACTED 4.0' PROPOSED 8 5' 4.0' 6" BASE OF CRUSHED STONE OR DISTRIBUTION 42.0' MECHANICALLY COMPACTED BOX 4-500 GAL. DRY WELLS (4'-10" X 8'-6" X 2'-9") PROPOSED PROFILE OF W4SHEDSTONE" SOIL ABSORBTION (TRENCH FORMATION) ui 1 ,500 GALLON TANK SEWAGE DISPOSAL SYSTEM SYSTEM (S.A.S.) 12.83' X 42.00' (NOT TO SCALE) BOTTOM OF TEST HOLE ELEV.= 22.7' (NO GROUND WATER) GENERAL NOTES OBSERVATION HOLE #1 EL.=33.2 TEST PIT RESULTS: 33,2 ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER 32.7 0-6" A SANDY LOAM 10YR3 2 ------ 107gCOBBLES SOIL TEST DATE: 06 26 06 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P., 31. 6- 4" B LOAMY SA D 10 4 6 ------ FRIABLFE E B.O.H. AGENT: DONNA MIORANDI, R.S. >t TITLE 5 AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS 22 7 24-126" C FINE SAND 10YR6 6 ------ NO O STONES SOIL EVALUATOR: STEPHEN J. DOYLE, R.L.S. FOR SUBSURFACE DISPOSAL OF SEWAGE. S 2. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE NO GROUNDWATER ENCOUNTERED EXCAVATOR: AMERICAN EXCAVATING roA CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10' OF DRIVES OR PARKING AREAS THEN THEY OBSERVATION HOLE #2 EL.=32.8 * NOTE: NOTIFY MACDOUGALL SURVEY MUST WITHSTAND H-20 LOADING. PERCOLATION RATE <2 MIN./IN. BOTTOM AT 48" 48 HOURS PRIOR TO INSPECTION 3. UTILITIES SHOWN ON PLAN ARE APPROXIMATE ONLY, 32,5 IELEV, DEPTH (IN.) HORIZON TEXTURE COLOR MOTTLING OTHER THE EXCAVATION .CONTRACTOR SHALL CALL "DIG-SAFE" AT 32.22 0-7" A SANDY LOAM 10YR3 2 ------ 10%COBBLES DESIGN DATA: 1-800-322-4844 AT LEAST 72 HOURS PRIOR TO ANY EXCAVATION 30.8 7-24" B LOAMY SAND 10YR4 6 ------ FRIABLE AW TO VERIFY LOCATION ,> NO STONES NUMBER OF BEDROOMS(EXIST.)...__3____ 4. ANY MASONRY UNITS USED TO BRING COVERS TO GRADE 22.3 24-126 C FINE SAND 1OYR6 6 ------ NO GRAVEL OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. NO GROUNDWATER ENCOUNTERED NUMBER OF BEDROOM S(PROPOSED)....___2_ 5. FINISH GRADE SHALL HAVE A MINIMUM OF 2% GRADE GARBAGE DISPOSAL................. OVER THE S.A.S. AND DISTRIBUTION BOX. TOTAL ESTIMATED FLOW 6. SEPTIC TANK SANITARY TEES SHALL BE CONSTRUCTED OF (110 GAL./BR./DAY X 5 BR.) __550 SCHEDULE 40 PVC AND SHALL EXTEND A MINIMUM OF 6" ABOVE OBSERVATION HOLE #3 EL.=32.4 550GPD X 200% = 1100 GAL THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND 32.4 ELEV. DEPTH (IN.) HORIZON TEXTURE COLOR IMOTTLING OTHER USE 1500 GAL. SEPTIC TANK LOCATED DIRECTLY UNDER THE CLEANOUT MANHOLES. 31.82 0-7" A SANDY LOAM 10YR3 2 ------ 10%COBBLES 7. THE SEPTIC TANK SHALL HAVE A MINIMUM COVER OF 9 INCHES. INSTALL: 4-500 GAL. DRY WELLS (W/4' CRUSHED STONE 8. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS 30.4 -24" B LOAMY SAND 10YR4 6 ------ FRIABLE STONES BAFFLE, 4 INCHES IN DIAMETER AND CONTRUCTED OF 4" PVC. 22.4 24-120" C FINE SAND 10YR6 6 ------ NO GRAIL ON THE SIDES, 4' ON THE ENDS) 9. LOCUS PARCEL 050 ON ASSESSORS MAP 006 IS NOT AFFECTED BY NO GROUNDWATER ENCOUNTERED SOIL CLASSIFICATION................ A SPECIAL FLOOD HAZARD AREA. DESIGN PERCOLATION RATE..... <_._WC-/J-N. 10. CHANGES OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION OBSERVATION HOLE #4 EL.=31 .6 EFFLUENT LOADING RATE.........__74 TO MACDOUGALL SURVEYING FOR B.O.H. AND DESIGN ENGINEERS REVIEW PERCOLATION RATE <2 MIN./IN. BOTTOM AT 48" REQUIRED LEACHING CAPACITY.....550 GAIDAY AND APPROVAL. ELEV. DEPTH IN. HORIZON TEXTURE COLOR MOTTLING OTHER LEACHING CAPACITY PROVIDED.....561_04 GAL/DAY 11. CONTRACTORS / INSTALLERS SHALL VERIFY GRADES AND 31.1 0-6" A SANDY LOAM 10YR3 2 ------ 0%COBBLES SIDEWALL: (12.83' + 42')x2x(2 SIDES)(.74)= 162.29 GAL/DAY ELEVATIONS AND SITE CONDITIONS PRIOR TO COMMENCING 9,6 6- 4" B LOAMY A 10 4 6 ------ FRIABLE FE f' WORK ON THE SITE. NO STONES BOTTOM: (12.83' x 42')(.74)= 398.75 GAL/DAY lI 12. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE 21.18 24-125 C FINE SAND 10YR6 6 ----- o GR WITH DEEDED OR ZONING REGULATIONS. OWNER / APPLICANT NO GROUNDWATER ENCOUNTERED TOTAL= 561.04 GAL/DAY IS TO OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. JULY 11, 2006 SHEET 2 OF 2 J# 1058 STAMP: Polo S c � o � 'Q o' 2 � � ` o m O E C2 z wQ w o > zQ O Oz o U w U U) = O O 0 `— U O I onm, 1 11 1 11 1 111 ' 44 T- 44 �4 ❑a❑❑ ❑❑❑❑ _ 49 _- 94 ._ Mi . _ - ❑00❑ -_ ❑00❑ _ -�- IU -- - TITLE: Existing House New Addition FRONT ELEVATION Front Elevation DATE ISSUED: 07-12-06 REVISIONS: DRAWN BY: NL PROJECT#: DRAWING NO.: E I STAMP: ]1-10�- 16'-0' 1]' 9'-14' 16•_0• C , m LIVING s° C BEDROOM ENTRY 2 t It I -.. - - -GARAGE CIO ILL Gas Smve C C FARMERS ` -11 PORCH C Q V C KITCHEN \ -- T = N BEDROOM = m - V C DINING -TH Y j - �j A ry 12-2— '-n'�o_5. 13-0' �12'-3'� 9'-la�' 0 16._6• LNING AREA2 - 11B9milt O_ NON �J Existing Floorplan z w o 0 > ¢ 0 � z 0 i U cn ZD O -16'-0' �10'-2'�3•-]'�16'-3' O O O LC ap N S ht fi(l BEDROOM _7 - TITLE: MASTER BDRM ---__-_- y LAB EXISTING CONDITIONS BEDROOM - TER BATH IJ 01,10 DATE ISSUED: 07-12-Ob REVISIONS: LIVING AREA , 1186pfl Existing Floorplan DRAWN BY: NIL PROJECT#: DRAWING NO.: EX I STAMP: c New Addition Existing c co �0 r) > M 'O 'a 0o C c ,-1 0 0) Q __14,_0. I5._4' A" ._6. _10,_2. _ _17,_4• —]0,_0, —16 0 � � O Im C 0 CCQ � �QjY N Make Existing -< N 0 O Closets Deeper LIVING \` --- //, 184 sqR ENTRY, 121 sq 8� - l Cased Opening L--- -------- o Gas Stove z Q n, Master Suite (/J .o GARAGE O _ . 260 sq R O '� .�//�!//�- ro� _ 11—_—.. _ 416 sq ft �i PORCH / F— BEDROOM _.._._ .. / r _ _ 134 sq R Uj 0 33asgre �---- (�,i ��` i'b [._ Under Counter KITCHEN z O .\ � ,.... _ �. i Washer and 166 sqR Q -� Dryer DINING BATH \� / 187 sq ft O = O L.� L Cased Opening O U CD a N $ r— Seaioh °J DINING 212 sg it Semen. TITLE: New Dining Room LIVING AREA 1681 sg ft _ PROPOSED _ FIRST FLOOR 14'-0• 10'-0' LO'- ' _ DATE ISSUED: - 07-12-06 REVISIONS: Addition Existing . _ DRAWN BY: NIL PROJECT#: DRAWING NO.: - STAMP: v • U _C C c o ,0 1118> p t v m o8 C _ 2 'wr- 0-0 C v 16'-0' 10'-2' 3'—T 16'-3" j MLo 7 rp Skylight ❑ 10 Skylight 0 M j � Q Q Walk In Closet Lu CC EDROOM - z Q G 163 sgft Q LEz U Q C) ZD MASTER SUITE N U L, Cn Q N 248 sq ft F.— Back Wall to remain in Q Q• U /same location 3 O Q m ` CD CN OFFICE vo BATH ATH BEDROOM �m 114sgft ! 0 86 sgft 61 sgft 105sgft n m � o� o TITLE: �121—II'-1-24— 7'-7' 7-I1" '-5�- 13'-0' 0'-0' PROPOSED SECOND FLOOR LIVING AREA 1472 Sq ff - DATE ISSUED: 07-12-06 REVISIONS: DRAWN BY: NL PROJECT#: DRAWING NO.: A2 STAMP: _C C fA 'y O 1 O e� C N C_ 4? '(3 O Q U Existing Foundation o E o " New Addition 02 ,71 co 000 � ------------------------------------------------------------------- m 0 M . -------------------------------------------------------------- J V r— �_ ____________________ J ----- ----------------------------- II I I I 1 ------------------------------------- I I I j I I I I I I 1 O I I I N L- - LLJ I I 1 Q N New Foundation Existing Foundation 0 L P- � o FarmersO Porch O Foundation ion i i i' i V U to Addition i i GARAGE 112� 00 I I I I 1 I I 417 sgft I I N I I I I I I Saw Cut wall to Addition I I I `---------------------------' 1--------------------------------------------- ------------------------------------------ i---------- �--------------------------- --------------------- ---- - I - I I I I I I I I C I I I TITLE: IL______________________________--I I I I 1 New Foundation FOUNDATION PLAN I I I I I I I I I I I I -DATE ISSUED: -I 07-12-06 EVISION$: 151 o, ------ LIVING AREA 1814 sq ft DRAWN BY:' NL PROJE:T#: DRAWNG NO.: F I STAMP: U C � O � a � � g mo V 0 9 0 C N E C Q 0 Uji I LLI Q L z < C O isms, Z U F= 00 O N �^ TITLE: 7 STEPS REAR ELEVATION New Addition Existing House New Dining Room Addition DATE ISSUED: 07-T2-06 Rear Elevation REVISIONS: DRAWN BY: NL PROJECT#: DRAWING NO.: E2 STAMP: U C C � c N cn 0 � @oa c vc� o C N mav� ma 47 u v, a ^ 8 p E -� @� c 3: § � Ec: � $' FsL � co O 4 > Q w p � z O IIH z U 0 () v') Z:) O 00 OU O U ® FFH p LIJTW I I I I I I I-L.-L-LQ mill 11111111 STEPS TITLE: Left Side Elevation Right Side Elevation New Dining Room Addition SIDE ELEVATIONS DATE ISSUED: 07-12-06 REVISIONS: { DRAWN BY: NL PROJECT#: - DRAWING NO.: E3 STAMP: 2X8 DORMER RAFTERS 2X8 CEILING JOISTS R-30 INSULATION U C ASPHALT ROOF SHINGLES c %" CDX SHEATHING p) c R_ U, o 30 INSULATION Q M 2X10 RAFTERS > ,p 0 � 0 � ot � � o . mama LL O E -i c o - -U' N " C to F-- Sa 2x10 Floor Joists 16"O.C. d %" BLUEBOARD SKIMCOAT WHITE CEDAR SHINGLES 5"TW HOUSEWRAP %2" CDX SHEATHING ASPHALT ROOF SHINGLES zz O R-13 FIBERGLASS INS. %2" CDX SHEATHING t_ � 2X4 STUDS R-30 INSULATION w Q j < 2X10 JOISTS 2X10 RAFTERS z Q O U 3/a" PLYWOOD SUBFLOOR h; z2X12 LEDGER WITH O R-19 FIBERGLASS INS. 1k. HANGERS BOLTED TO U v7 � 2X6 P.T. SILL ``, 4" POURED CONCRETE FLOOR '' HOUSE O O p UO a %a O U " SILL SEAL '��' OVER COMPACTED FILL `` of DO POURED CONCRETE : 10"X 16" POURED CONCRETE Cl- N 2x10 Header WALL ON 8"X 16" FOOTING :°c KEYED FOOTING : ' %2" BLUEBOARD 2x4 Stud an Jack SKIMCOAT double 2x4 Sill WHITE CEDAR SHINGLES 5" TW Section A-A HOUSEWRAP %2" CDX SHEATHING TITLE: R-13 FIBERGLASS INS. f: 2X4 STUDS 2X10 JOISTS CROSS SECTIONS PLYWOOD SUBFLOOR R-19 FIBERGLASS INS. f; 2X6 P.T. SILL " SILL DATE ISSUED: r= a L SEAL 07 12 06 ` x 8" POURED CONCRETE REVISIONS: WALL ON 10"X 16" FOOTING Section B—B DRAWN BY: NL PROJECT#: DRAWING NO.: S1 -c7