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Home My WebLink About0047 GROVE STREET - Health 47 GROVE ST, , GOTUIT MAP -- 020 PAR 109 ` 1. r-` i No. yJ. � � bZ� Fee BOARD OF HEALTH TOWN OF BARNSTABLE 0(ppYication ff or Derr Construction Permit Application is hereby made for a permit to Construct(raj, Alter( ), or Repair( ) an individual well at: Y 2 G./o u e S T Cep Location-Address Assessors Map and Parcel 6 s� 1 ,w Y7 . 6 ��e s T Owner Address DIC!A.)-jrS SCraNMc�� !0 8- DEG rGsj /�'j Ma's PC cx v'? Installer-Driller Address Type of Building Dwelling ✓ Other-Type of Building No. of Persons Type of Well C� /Q u L Capacity Purpose of Well /o N Agreement: The undersigned agrees to install the afore described individual well in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation-The undersigned further agrees not to place the well in operation until a Certificate of Compliance has been issued by the Board of Health. Signed L7 l a v Date Application Approved By ate Application Disapproved for the following reasons: Date Permit No. Vol Issued Date -------------------------------------------------------------------------------------------------------- BOARD OF HEALTH TOWN OF BARNSTABLE Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed( Altered( ), or Repaired( ) by S CCA.- A e- 6/ Installer at U S7" CoTZrT has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector a i J 1 No. Id �az �� Fee �! 4 BOARD OF HEALTH TOWN OF BARNSTABLE 01ppYication,4-for Vern Con.5truction Permit Application is hereby made for a permit to Construct(i.-), Alter( ), or Repair( ) an individual well at: 7 C,/nu. S7 Ce,7-Ui ( -)O - /0q Location-Address Assessors Map and Parcel 0e � Sr4r //, � GIOy� S77 Owner J Address' e ti/ S canJh /�Ie /o V rGS /� f /NGs Or / OZ 9/? Installer-Driller Address Type of Building Dwelling ✓ Other-Type of Building No. of Persons Type of Well c� /' u e_ Capacity Purpose of Well I r1 �4 c4 T1a ti Agreement: The undersigned agrees to install the afore-described individual well in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation-The undersigned further agrees not to place the well in operation until a Certificate of Compliance/has been issued by the Board of Health. Signed l7-r�-r..� ✓I�.�Y� r��?�J v /� Date Application Approved By �,. 12-r (� 11)4�1 Date i Application Disapproved for the following reasons: Date Permit No. W,�q 7 Issued ��, Date �0 •- — --- ---------------------------------------- -----------------------ode-env-------------_---- BOARD OF HEALTH TOWN OF BARNSTABLE (Certificate of Compliance THIS IS TO CERTIFY,that the individual well Constructed Altered( ), or Repaired( by C n»/ S C G ti .0 c Installer I ' at L� 6 �ouc 3 7~ CO 7 has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORILY. Date Inspector BOARD OF HEALTH _ i T-OWN OF BARNSTABLE Velt Con5truction Permit No. (nl y° ' V7 Fee / y v Permission is hereby granted to D c "U/y/S S Cn �,j Installer to Construct Alter( ), or Repair( an individual well at: r No. y7 G /Ovc S7r Street as shown on the application for a Well Construction Permit No. 1 r✓ v ' U; '7 A Dated Date / a Approved By k�lE9. , '4 �/�S_ r 4 LOT 44 4� 44 pp" TARP iv SHED SHED coLOT 46 PROPOSED ADDITION 5.2ft 20000.0 SQ. FT. 0.46 ACRES ` � DECK .r PAVED ' ,,,,, „�,, r ,'" ,,,r ° ,,,,,,,,,, ,,,,,,,,,,,,,,,,,,,, DRIVEWAleelloeeellooY ...,,,, ,,,,,,,,,.447 ,,,,,, ,,,,,,,,iiii,,,,,,,,, /`-- ' 2 ..*� 8.7 Gam. w 2 ' - LOT 48 30 } k..k t t LOT 44 00 0o N s4. 3 44Opry = TARP h' ,00 SHED SHED 20�ppJ PROPOSED ADDITION 15.2ft � LOT, 46 20000.0 SQ. FT. 0.46 ACRES DECK .. ...PAVE •Opp 8.7 LOT 48 r — - A All" If pi LOCUS MAP I PLAN REF` 15-67 j DEED REP 10973-137 ASSESSOR'S MAP 20-109 ZONING.- RF SETBACKS.• 30'-15-'15' FLOOD ZONE.- C PANEL NUMBER- 250001 0021 D DATED.- 0710211992 OVERLAY DIST' AP, RPOD, i SALT WATER ESTUARIES. gft ' PLOT PLAN OF LAND AVER .. LOCATED AT F. [ RlvEwAY;°' 0 4 7 GROVE STREET o CO:TUIT MA �^ ��•� � PREPARED FOR: D. SCHILLING FEBRUARY, 23, 2011 4REV , REV REV M, YANKEE LAND SURVEY.. GRAPHIC SCALE CO., INC. 30, 0 15 30 60 q= 119 ROUTE 149 MARSTONS MILLS; MA 02648 TEL 50B-42B 0055 FAX 508 420 5b53 i inch = 30 ft YA)1�1�E9UXVIs'Y1�G10MCAST.JV�T 1/1PiiYAN1�URVL'Y.44 , SHEET I OF 1 1.10B ,¢! 54858 f y TOWN OF BARNSTABLE LQCATION _4/7 brava Sr SEWAGE # 97-5'03 VELLAGE �eTill7- ASSESSOR'S MAP& LOT I):1O—/O� INSTALLER'S NAME&PHONE NO. z2e ��rro3 SEPTIC TANK CAPACITY /SOa LEACHING FACILITY: (type) (size) i�o 1) y�2 NO.OF BEDROOMS -12 BUILDER OR OWNER PERMITDATE: 97 COMPLIANCE DATE:—,-1/a —97 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist ion site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 f et of leachi g fa ' 'ty) Feet Furnished by Y e to _ F .. e Commonwealth of Massachusetts w, Title 5 Official Inspection Form 1 R i�I Subsurface Sewage Disposal System Form -Not for Voluntary Assessmentsi y, may' 47 Grove St. ' Property Address Jane M. Mason Owner Owner's Name information is Cotuit Ma. 02635 7/1312010 required for �— -- every 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 i i I1 I � i i I I I i i I I - i I iI t5ins MOB Title 5 Offic,at Inspecluon form.Subsurface Sewage Disposal System•Page 15 or 17 r —7� 'Y Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 47 Grove St. 4^M Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 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. ImpWhen filling A. General Information When filling out forms to the I I computer, use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC. Company Name P.O.Box-763 Company Address Centerville Ma. 02632 ' Cityjown State Zip Code (508)428-4028 S14454 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 16.340 of Title 5 (310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Faiis = ri r� ❑ Needs Further Evaluation by the Local Approving Authority r ^� U) 7/13/2010 s lnsIWT0r's'St`gnatuW Date { 9 ad 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. V t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Dispo I System• agei017 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in porper working order at the present time. 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-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every page. Cityfrown 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 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every page. City/Town 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-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 4 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every page. CitylTown 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): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ ' No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage 2008:48,000 9 ( Y 9 (gpd)) 2009:49,000 Detail: 2008:131gpd 2009:134gpd Sump pump? ❑ Yes ® No Last date of occupancy: unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow (seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title b system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 it Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every 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 ® 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•09/08 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 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1997 Were sewage odors detected when arriving at the site? ❑ Yes ❑ No Building Sewer(locate on site plan): Depth below grade: 2.5 feet Material of construction: ❑ cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of leakage.system vented through the house vents. Septic Tank (locate on site plan): Depth below grade: 2'feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gallon Sludge depth: 3" t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts L W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every 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 29" Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 6" 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 two years.lnlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound. 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 um in p p g Date t5ins•09/08 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 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every 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-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is Cotuit Ma. 02635 7/13/2010 required for every 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 one outlet Iateral.No evidence of solids carryover.No evidence of leakage. 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page Q of 17 I ' Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 47 Grove St. ^M Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: 1-60'x4'x2' ❑ 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 dry soil.No signs of hydraulic failure.No ponding or damp soil.Leaching field was 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•09108 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 .° 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every page. Cityrrown 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.): Privylocate on site plan): ( p ) Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-09/08 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 M 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every 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 5 17 �� t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ^M 47 Grove St. Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of leaching 18' 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: 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 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 16 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 47 Grove St. M SV a Property Address Jane M. Mason Owner Owner's Name information is required for Cotuit Ma. 02635 7/13/2010 every page. City/Town 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 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE. LOCATION -/;7 raL4 S'r SEWAGE # 97-Sd VILLAGE �',oTyIT ASSESSOR'S MAP & 1,0170�20 INSTALLER'S NAME&PHONE NO. y 9 ,�es��Li Dc G�6SrH`'03 SEPTIC TANK CAPACITY /SOO/ / LEACHING FACELrTY: (type) 4�'40Gh (size) (ol0 NO.OF BEDROOMS BUILDER OR OWNER 417 a Vim' PERMTTDATE: 9 I S.•97 COMPLIANCE DATE: —1 ' `/7 Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 f et of leachi g fa ' 'ty) Feet Furnished by �� o vi_ j Q��lc � o sa E L a-1 --- 'S 6—S, r `--_ /d (p Fee No. Wp� �J S-0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Migogaf *pgtem Construction Permit Application for a Permit to Construct epair )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 7 6r oVz, S p Owner's Name,Address and Tel.No. 710— 0 S O 1/ �. J'dn Assessor's Map/Parcel G'�;ra;r / Installer's Name,Address,and Tel.No. 41 J`9 03 qr Designer's Name,Address and Tel No. ✓ze./9 i Oe/,U—,-0 s Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of epairs or Alterations(Answer when applicable) / ti o ��`rZ 0o 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 card of Health. Signed V, i Date Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: tom' Yes PUBLIC HEALTH DIV ISIbN-a-TOWN OF BARNSTABLES MASSACHUSETTS Appff"cation for Diopogal *p6tem Con6truction Permit Application for a Permit to Construct air )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components t` Location Address or Lot No. y 7 �PO�� f; Owner's Name,Address and Tel.No. -Iq0— 0 10 y _ Join God% Assessor's Map/Parcel' Corv/r Installer's Name,Address,and Tel.No. 4111'03 yfo' Designer's Name,Address and Tel.No. gi )W,, A'I/ %/s Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of$epairs or Alterations(Answer when applicable) aml5rl y "W / 1,rvo 6m . S GD X e/ Date last inspected: Agreement: i 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 Doard of Health. Signed Date Application Approved by Date Application Disapproved for the following reasons , 1 fit. Permit No. 0 3 Date Issued ——————————————————————--- — --- ----- i _ j THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certif irate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(4-T`Repaired ( )Upgraded( ) Abandoned( )by ✓oS��i �� l �rrc�,5 , at -97 &o l/f. Sr <arNi r - has.be n constructed in accordance' with the provisions of Title 5 and the for Disposal System Construction Permit No. I)0 dated Installer ✓ostxO:e= &rra5' Designer ✓ese�! /,f aro-dS The issuance of this ermit shall not be construed as a guarantee that the system will function as designed. Date l_ . Inspector N '1� — ------- --------—�—/ —————————— — No. ( So 3 A — ( 70 �V 9 Fee V THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS Diopozal *pgtem Construction Permit Permission is hereby granted to Construct(4-)'%epair( )Upgrade( )Abandon( ) System located at Y7 6rotZ& ,5 r ro r4ei r 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. I Provided:Consoctiog must be completed within three years of the date_of_t�Sis�e...'t. Date: �S / Approved by I �— U �k CyisT�� e 5 C rss O � 6c r d F y'� NOTICE: This Form is to be used for the Repair of Failed Septic Systems Only CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL NVOItKS CONS'I'ItUCI'ION PEItMI'I' NVITHOU'I'DESIGNED PLANSI i, Jo hereby certify that the application for disposal works construction permit signed by me dated 9'—l5'- ZZ , concerning the property located at y7 6110 .S'f �a _ meets all of the following criteria: C—There are no wetlands within 300 feet of the proposed septic system b,—Thcrc are no private wells within 150 feet of the proposed septic system .-'The observed groundwater table is 14 feet or greater below the bottom of the leaching facility There is no increase in flow and/or change in use proposed mere are no variances requested or needed. SIGNED: /�/' DATB: 9 /j + 7 T LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER Jy IAllach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submittedl. TOWN OF BARNSTABLE :LOCATION SEWAGE # 97-So3 ELLAGE �'eT�/l 7 _ASSESSOR'S MAP& LOTO D— ,. D 41 INSTALLER'S NAME&PHONE NO. .SEPTIC TANK CAPACITY /S'00 LEACHING FACILITY: (type) Ti=y�CLj (size) :.NO.OF BEDROOMS_ 3/ / 3UILDER OR OWNER ✓�G,r! o V.�' PERMTTDATE: 97 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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 f et of leachi g fa ' 'ty) Feet Furnished by h os 16', � w I 8 � CO 2-0y f G `� u� ro G ,1' l�F� BORTOLOTTI CONSTRUCTION, INC. 765 WAKEBY ROAD, MARSTONS MILLS, MA 02648 Z 508-771-9399 508-428-8926 FAX: 508-428-9399 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION Property Address: r Date of Inspection: In pector's Name: Owner's Name and Address: .122 _CERTIFICATION STATEMENT: I certify that I have personally inspected the sewage disposal system at this address and that the informa- tion reported below is true,accurate and complete as of the time of inspection.The inspection was per- formed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. The System: Passes. Conditionally Passes Needs-FurtherEv tion By th ocal Aproving Authority Fails Inspector's'Signature: Date: The System Inspector.shall submit a copy of this inspection report to the Approving authority within thir- ty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable and the approving authority. INSPECTION SUMMARY* A)SYSTEM 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 criteria not evaluated are indicated below. B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced or repaired. The system, upon comple- tion of the replacement or repair, passes inspection. Indicate yes, nor,or not determined(Y,N,OR ND). Describe basis of determination in all instances. If "not determined",explain why not. The septic tank is metal,cracked, structurally unsound, shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing Sep- tic tank is replaced with a conforming septic tank as approved by The Board of Health. Sewage backkup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of The Board of Health): - .1 - r a SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Broken pipe(s)replaced Obstruction is removed Distribution Box is levelled or replaced The System required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of The-Board.of-Health):— Broken pipe(s)are replaced Obstruction is removed C)FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: . Conditions exist which require further evaluation by The Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1)SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: Cesspool or privy is within 50 Feet of a surface water Cesspool or privy is within 50 Feet of a bordering vegetated wetland or a salt marsh. 2)SYSTEM WILL FAIL UN LESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTION- ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system and is within 100 Feet to a surface water supply or tributary to a surface water supply. The system has a septic tank and soil absorption system and is with a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supply well. The system has aseptic tank and soil absorption system and is less than 100 Feet but 50 Feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. D)STEM FAILS: V I have determined that the system violates one or more of(lie following failure criteria as defined in 310 MR 15.303. The basis for this determination is identified below. The Board of Health sho tcontacted to determine what will be necessary to correct the failure. kup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of efluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. ' box above outlet invert due to an overloaded or clog- Static liquid level in the distribution Sta Q , go SAS or cesspool: Liquid depth in cesspool is less than G"below invert or available volume is less than 1/2 day flow. � r Requiredpumping OT more than 4 times in the last year N due to clogged ed o obstructed pipe(s). Number of times pumped -2- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Any portion of the Soil,Absorption System,cesspool or privy is below the high groundwater elevation. Any portion of a.cesspool or privy is within 100 Feet of a surface water supply or tributary to a surface water supply.,Any portion of a cesspool or privy is within a Zone I of a public well: Any portion of a cesspool or privy is within 50 Feet of a private water supply well. Any portion of a cesspool or privy is less than 100 Feet but greater than 50 Feet from a private . water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable, attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. E)LARGE SYSTEM FAILS: The following criteria apply to a large system in addition to the criteria above: The design flow of a system is 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following - conditions exist: The system 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 (1WPA)or a mapped Zone Il 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 a regional office of the Department for further information. t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B k.. _ CHECKLIST Check if the following have been done: P/Pumping information was requested of the owner,occupant, and Board of Health. 17 None of the system components have been pumped for atleast two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection: �As-built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up., ✓The system does not receive non-sanitary or industrial waste flow. ✓The site was inspected for signs of breakout. ✓All system components,excluding the Soil Absorption System, have been located on site. _ The septic tank manholes were uncovered,opened, and the interior of the septic tank was in spected for condition of baffles or tees, material of construction,dimensions,depth of liquid, /depth of sludge,depth of scum. !/ The size and location of the Soil Absorption System on the site has been determined based on existing information or approximated by non-intrusive methods. -3- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST(conlinucd) The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION FLOW CONDITIONS RESIDENTIAL* Design Flow:3c� allons Number of Bedrooms: Number of Current Residents: Garbage Grinder: Laundry Connected To System:UjC q_ Seasonal Use: Water Meter Readings, if a ilable: o Last Date of Occupancy: tL20Lz Q7J I_ Altl► COMMERCLAIJLNDUSTRi_AL• Type of Establishment: Design Flow: gallons/day Grease Trap Present: (yes or no) Industrial Waste Holding Tank Present: Non-Sanitary Waste Discharged To The Title V System: Water Meter Readings, If Available: Last Date of Occupancy: OTHER: Describe) Last Date of Occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information System Pumped as part of inspection:_ If yes,volum pumped: gallons Reason for pumping: TYPE OF SYSTEM: Septic Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool Privy Shared System(if yes,attach_previous inspection records, if any) Other(explain): AP ROXIMATE AGE of all coin onents,date installed,(if known)and source of information: Sewage odors det ed when arriving aIrthe site: c) -4- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C GENERAL INFORMATION (continued) SEPTIC TANK: Depth below grade: Material of Construction: concrete metal FRP Other (explain) Dimisions: Sludge Depth: Scum Thickness: Distance from top of sludge to bottom of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert,structural integrity,evidence of leakage,etc.) GREASE TRAP:iVQ Depth Below Grade: ,Material of Construction: concrete metal FRP Other (explain) —. —. Dimensions: Scum Thickness: Distance from top of scum to top of outlet tee or baffle: Comments: (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity,evidence of leakage,etc.) TIGHT OR HOLDING TANK:A)J Depth Below Grade: Material of Construction:_concrete_metal_FRP Other(explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm Level: Comments: (condition of inlet tee,condition of alarm and float switches,etc.) DISTRIBUTION BOX: /_b Depth of liquid level above outlet invert:. Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) ~PUMP CHAMBER: n _ Pump g is in working order: , Comments: (note condition of pump chamber, condition of pumps and appurtenances,etc.) -5- SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) SOIL ABSORPTION SYSTEM (SAS): Y (Locate on site plan, if possible;excavation not required,but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: Leaching pits, number: Leaching chambers, number: Leaching galleries,number: Leaching trenches, number, length: Leaching fields, number,dimensions: _ Overflow cesspool, number: Comments: (note condition of soil,signs of hydraulic failure level of ponding, condition of vegetation, etc.) -- --- —--- CESSPOOLS:_ , Number and configuration: -?j/ 'X 5 Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of Cesspool: �,j'CJ Materials of construction:6,'T P tindication of groundwater: Inflow(cesspool must be pumped as part of inspection) Comments: (note condition of soilk, signs of hydraulic failure, lev I of pondin ,condition of v getation, 4 PRIVY�(.L Materials of construction: Dimensions: Depth of Solids: Comments: (note condition of soil, signs of hydraulic failure,level of ponding,condition of vegetation, etc.) -6 - SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART(.' SYSTEM INFORMATION (continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references, landmarks or benchmarks. Locate all wells within 100 Feet. V _ III DEPTH TO GROUNDWATER: r Depth to groundwater: & Feet Method of Determin ion off Appro 'oration: 7 I LEGEND ®EXTERIOR EXISTING WALL ®INTERIOR EXISTING WALL • C=_=WALL TO BE DEMOLISHED ,col) d4 {4 563 I ° I o t O1-----1 f-------- — I I I I I I I I REMOVE ANMin'G VANDMlS CARZn LLv AND R_FU5E IN NEW GARAGE ADDITION. 0 REWq%T EY 5-1ING WALL ASI.NDICATED TO CREATE A NEL'J 3'X a-3'CASED OPENING T?NaTCM EXISTING CM"NG W THE W N G E00M. - I, I I',I \ ii '/ O_ 2EU,0`h IXISTI.>L N!ONC FI.n1NIN N BA_.ME\i'7 R00F.EEMOVE AD.IACENT ,j - PA&TTI 5 MD B I.NILLV.�"'EC a:INDI ATED� - r REMOVE PARTITIO\S=TVF_EX CX,.n•.,GAFA.a.AND FAMILv ROOM TO CREATE AIN'mv DOOR.WAY.. / -- EkISTING DOGE TO BE REN.OVED AVIDREPACED W M A CASEMFuT\Y DO v VD C ERE5TORv IMIDOW TO MATCH ADJACENT WNDONS IN FAMI Lv ROOM.. O. EI5TI.N'G WND.OV+5 ARE i0 BE REPACED\VTM NEW V.1NQOk 5.5E_E WNDCM1V '!lo R IRE FcRK-W SWIND.EE.SPECIFICATIpuS FO2 ME4.,`_Z:A\9 JACS STUD REOLIIRED FOE NEW W.NDOLt"--.. O I I O I L—J O I • } O W-EX'\vPLL AND tHIMNEv REMO\RD NOi E NE1V STOVE TOP EXh'AUSi W THIS LOCATI!Y. / I \ __ I O• a\ a r I 1 IF,—_ —-- .• ----_\_.\..-...a--...- REMOVE Ex6r "�? `ael� wRri?GUNCEs.AND S+NR. I�+—— ® ® / � g' .ZN*V Ca "r� - TO PiEPAZ'FO2 Fu1.L MEIG�:?'AEi ITI.�N. ___ `I OJ .REMONT FRENCH DO2i AND:-NGS AS INDICATED. ._.._...................... ,I I" R'_MO1'E CLOSET`NAL:ti.EOD a SI;sI.F.a\D DOORS. � II III I O !i I 11 I.lel RENF:VE IXISiING CASSMtTit:SNDrXV FO2 NRV CLOSET.WlNDIX15T0 BE EE�USED i - 1 �/ X ADJACENT SPACE r ��LL ..................—,r'_____= __ ___ ____ .. ... ..... PROPOSED D0J6LE GARAGE W DTH I IO REMOVE c/11'E ru\G\\9vJOW A•D nDJnCEuneA.L FCe nE:V[H°v.:'u'^ RI/vi »Gx 1,� E_-MOVE IXISnNG Ba;rxxN X-EBBS.Paxnno.Ns,auD oraGt. J,i OR ..._---- I............................................... ......... I O REMOVE REMOVE RCVWSTI r R IOF G PK.5ALVAG9 51VC AND FAUCET FOE RE-USE • I y��yy� I II O --� I I p q I I I I to GE wAL"PE METNG Fa NCATIOX':,EM IRE JAI F- I 1 I I O 'WALLAND SAB- FCErSAav FOa\`FV GARAG=?OLINDATION. L J 1 1 11 •' I I O REMOVE E\'ISTLNC INTERIOR WAta 5yEA"HING vn"SRIAL"O 5mos , ----- ----------------- -- O OURING CT A5 IN,=AT D OLC tYOEK IS IX'OSED"Ev-O RELOCATE r9� I LIXA DUCT A INDICATED G H:`l0 2 P C N1M1G IF"M"D`CT lS L J II - NAIX.E TO BE RENTED NEW CLOSET A"d1T Mwv CHANGE dJE TO TMS L— __J iO' .�I aD CGXDI IrY. rF� r 4 IL FE- ® 1 NO. REVISION DATE NORTH CLIENTI: Mactachern Schilling Re5ldence DEMOLITION FLOOR PLAN 47 Grove Street,Cotuil 02635 SCALE: 4' = I'-011 - TITLE: DEMOLITION PLAN. - DATE:NOVEMBER 12,2010 NHCHAEL A.JIlIIERSON A.I.A. ARCHITECTURE&INTERIORS 193 Horseshoe Lane Centerville,MA.02632 508775-4264 majarch@comcastnet LEGEND a. Existing Exterior Walls - "• Existing Interior Walls New Interior Walls 41 New Exterior Walls New Millwork sq O aav eLue sDNE t `D-r.STEP varh aRIC O L____ Demolished Items axPP�R-iRISeR vE x t.N TtNv C -LE/IEIE ro s w s o �RAVIVG j EN-hRGE LANDING A\C 5-EP AS INDICATED C`NTP • OVER NRV VT \ LAND �' I OL-I'G DENIOIJT IICN DN LLICT IV.-c 15 EX'O50 t"'O RELOCATE \ - T./N2 _ QV`-A D 5TORA TO 7 9NIS PA FOe 5TOJ,GE 1 O INTO DUCT A WMA J ON P N O 2 E e,I n RAVING WT RU•T-RAL l O D PANEL FLOOR L I `COVERED-ORCh FRAVING AVD ROOFING 5 TO BE xA 7 S tOlss)TO AUGN I a N NPR TO hAV T 6 .LG hT 4 JJ2 TOP A C E7 OPENING GUEST BED OM O tY riTi E.TnE TIVO GAE END5 O.N EACt'5 CE O TO E=-ERaM1TILE;E J..h W-,5W,,J J'50-IL EURPA-E V.A-ERIAL _ I CryW.15 AR.E TO a rEA r,ED-N AEK�rzu 5cmD--sEE SO JTn AT w. vA1_,FLOC A Q CE ro eE CERAMIC TIC xAv1 n_ 1f e nw k J-N15n!D am CONTRACTOR IN5TALL 7.Px0 IDE O EA5 PLE-T ON POR'IN ORMATIO MN. A \AT 2 PG OR A.iA_O?APLIAVT 0.RBLE ItO.1 R Z< "'NG 1 O BA SU,NnO.\5 iO B_FcE?P -EO VA h VAIVIN INTEC I2. ALL I__Dt DOI FL Jc`RAVLNG ND A'L&R\'cNaRA\E VS CY E O1F2 PAN I 2'-3h 1'-7 hUNG N_11.ANTR sh t-t DEPTh MUP,w:.ouD WD•_D suPPoxr.; •G '; EXISTING DECK O hAL'MEIGMTLVALLTOBE PULLhEIGMT,NNRvpOO,RToeA-E,V.E\.. O ENDS AN'D 30•O.Lws.C. o l �VO CAEO OP PING. ` AND SJcrJ\L SUE TREATED A� }7 y _R O RAIEELhNERED DEC ('GI NEW 3er3eLVGOD.-``_Na.VELANpINGAVDI2'TZ- K OAU GV I.1 luJACENi DECK `// F2_,..-RE tREAT`iJ FRauE AND SJ"CRi_ O NEW aC'DEEP N+'•R(-„JR-ACE W'i/ST C U.UINATE TO'e EDG.. - IOj -1 ^IT tvl�L w!SO D SLUR"ACE CA` PROVIDE&_OCVNG Fh f - . t`A2 AV757E OF-OV aLCNG 5.-4 ICE D11'DDD:A[D 5TEP5 T. _E\:.RLINEO - E FINIS"EDFCOR. BATH RO .ALCOVE O' O It 1.-2te. 22 LAUNDRY/PANTRY I n '-}3�4 r-1o3/a = i 7'-5-Y4 3' OY4 1'-10• i n I FAMILY ROOM i HOME OFFIC ® i - _ 12' � I y - 1'-6' of i 2� /l• I 7 1'-6' n2'-9'a Vr -._.---- r.l. 12'-9J¢' 'ram '-SJz' Y-10' ry + �� ;t RELOCA ED VOi ORIZED .. N - 14._10Y4 t. .ir -4-y4 4�4 Q I 1'-93/4 21 WALK-IN- CLOSET LIVING ROOM • MASTER BED ROOM I �,. SUITE -6Ya' I '-6Ya ..p i V j DRESSING ,I I k i I - TWO CAR GARAGE ;ROOM ............13'-1�4 3'-7Y4 '.2'-0)4 -52• _ 2'- a �......._... .......��. i I VIIA, ' SITTING ROOM �I i' 17 i� _-24 I I I.... ....., z'-to' a� �I,._. •-n' FRONT PORCH A. 1 �'� •I ' OUTDOOR ^ i STORAGE -tt' I I �l I J rcLOSE7-H I•I I �' e CzJ 4<51 NO. REVISION DATE 0 o '! -7-3Y2' 11'-L1Y4 - 7-4Y4 CLIENT: MASTER MacEachern Schilling BATH 26'-Y Residence NORTH ROOM 47 Grove Street,Cotuit 02635 SCALE: a" = I -O" p TITLE: FLOOR PLAN FLOOR PLAN DATE:NOVEMBER 12,2010 lOIICHAEL A.JIlI4ERSON A.I.A. ARCHITECTURE&INTERIORS 193 Horseshoe Lane Centerville,MA-02632 508 775-4264 majarch@comcastnet LEGEND Existing Exterior Walls Existing Interior Walls —New Interior Walls New Exterior Walls P wDGe vwr. R Eeireay.—Tle'.cwva New Millwork +nrtl.:.1,z is"m 5r e.Rism. FOROH ROD-5eO TC P4GN HtTry t- ——_, ADL%T GAIL'reADcR nelGnrS L____J Demolished hems 1 4 WD1GT[D. ADVAVL•D TRIN—W TAZ[K ORONN a!K n'mul�NG I?O59�WRAGe TRANS@A •c.K_.•.rxoDE s?o-ex;u. neFc[R5. - ADVARc[DTx1m'.aslGyTueKreezc Az[K <•.1c=AsaA eoNco. cRowu rACGL1'.13. Aze!:eru,2^Ro�F soF Txr,A. 9'-9'GABLE HEADER HT. 1=.6•:3C.ti G--1•x:r3tD:^+'eiOA[I. R S.C,A ^`A' n _ n" —A' ( .4 dti.eK GARPGe DOOR Gti nGS. VG S S° f OSLRe.�IP� 5'FRi;NG CCJRS[. ' -e AreK'.ViNOO'.V O:51NGaa Z?V. AZeK (1`scD:IA N. LD..NG. _ wu[D�It:NGG-1 FP_< AIc4i W�,IOr:fT C-Z/J[=ECFx_'M1.n'GL^5 :'.:SiCxIC e�L 0�35. Y,Ylll -M F%.EXPO912e.i'tIP STARTING COUxSe. 211-M15HED I Si FLOOR P GRADE�G1 F2i ONT ELEV. IXLTWG COWMN55H[ATH[O\YiH tiFC d TE0 eONtD. -Iq" Tea-"[Oe Ater:al iz cC=OTIA ANDOAnih OFPhi.l3[K -TRIM POAFO.ISOR:CRONM MCL'L NG. P1 ADVA\tiED TRIiA.WRIGHT,INC. SOUTHEAST ELEVATION �5'JN TLN'eL--T. 1 S-1 1 TOP OF GARAGE RIDGE — 1 a • 9'-9-3I4•RNI5HED CEILING HEIGHT. 6-5-1/2'GARAGE DOOR"RANSOMI V1 iA I I I i I I I I I I I I I I I I I I I I I I I I I I I I A. 2 WNDOW HEADER hEIG]-ff G=161/2'DOOR a NnNDOW HEADER HEIGHT O NO. REVISION DATE AzeK r+1c F,As,:u emAR.a � ., Fxer sDFeD RAee£iED. AIfK eK"+rR-11"N. - ' •.e•AzeK wRNex emaxD,T•PiCAu. AAIa[,;.N0.NTJCNe1`G4FCe ieOFR�:.N 25 s MAv.erosr,[.rR1nz 5TA:T�NGca_se CLIENT: A:Ei TxCA gOASN,[Ni MacEachern Schilling 05. Residence 0..0:GRADE 47 Grove Street,Cotult 02635 z SCALE: a' = I 1-O" si TITLE: SOUTHEAST&NORTHEAST ELEVATIONS NORTHEAST ELEVATION DATE:NovEnneER Iz,zolo DUCHnEL A.arnIERSON A-LA. ARCffiTECTLTRE&INTERIORS 193 Horseshoe Lane Centerville,MA.02632 508 775-4264 - , majarch@comcastnet LEGEND Existing Exterior Walls Existing Interior Walls -New Interior Walls New Exterior Walls New Millwork 15.11 TOP OF GARAGE RIDGE eRovloe AuulnuvGUTIEe � � r L----�Demolished Items ____J ono oowN9FaU;s. ' 5'-9..v4'NNI5HED CBUNG 751G� 6-5-I/2-C-ARAGE DOOR AT 501M - -DJ HEADER HEIGHT , G'-IO-IM DODR a WINDOW HEADER$ EIGHT •�/ -,; •.Ia FAs:.0 scAeDa � O V - - - BOARD RABB=_Teo. El4'a 2 ROOP.'OP iRIM. O i I I•.6•AZE1:c_RnER BCA3J i;YRcoy. '0.uillCr.FF G.RAOE OE�AR 9c—F -M<•A�ERT.21N.1$,;�J:�)lE�'T IY.YDJw ZF •tAOR. O-0'GRgDE — n ' u.EED oecK�.vE�ew'Iuxw. 4-rae<Tc.:�nrw crsoo'.v . � uEly AZf\M.00.Rl.TFORN.� r•ODOR . AaD siwR Deno:•d A2Er. • TRIM eO;aO RUERs. �. NORTHWEST ELEVATION 12 a4, e e e - °Vrax rO1ro.�', We::, �°µ:°"mr•:r°M<, nAreme ' g15-II TOP OF GARAGE RIDGE r.x°s r.r.eu. naebx< ^ nnr». •+'aa newt evu. �� rnlm rwwnnr.am°. .can nx<a 1� - ruxca a�erxOa�p<m`a Q+' wxrm rwioa„Iaxmo. - 9'-9-3/4'RNISHED CEUNG HEIGHT. wr mama a000ruxm.orxtrrn«ta iwvrd �, 6'-S-1/2•DOOR DOOR.TRANF WNDOW ®••'m OCxM CASING MOULDINGS hEADER hVGh v.rwrr - • $G'-10-1/2'DOOR a W ND HEADER HEIGHT cox neolnr�xarx°e r o xm. °0Or rY'•< A- 3 e me DOOR SCHEDULENO. REVISION DATE Ell A I/4-FINI5.40 FAMILY RM.F=R o Y a: 001pp 5•Iry ofcO W- Fr T®G MIU CLIENT: 1/e'GARAGE IN. L D'-0• ry<L°,��e=°1cF=L YePcr f°a _-�¢ -''_&a„• MacEachern Schlilmg Re-51dence •�:. Imxna• unv - - c03 :°.._....,..., .„e.;,�,�,,�. .,,,,..,,.., 47 Grove Street,Cotuit 02635 . •.•^• aEQer/eruxmttic rcqu.Lxix -wlr er wc.� 1I _ $ BOTTOO'FOOTING SCALE: a _ II_�I1 M TITLE: EXTERIOR ELEVATION RAGE SECTION/ELEVATION OF GARAGE TWA d° G WI OWSCHEIDULE DOOR& rF=lv DATE:NOVEMBER 12,2010 MICHAEL A.JIMERSON LLA. ARCHITECTURE&INTERIORS STREET ELL AnOJ CA51NG MOULDING5 193 Horseshoe Lane V:9NDWJ CASING I./OIILDINGS . Centerville,MA.02632 508 775.4264 WINDOW SCHEDULE majarch@comcastnet LEGEND Existing Exterior Walls- - Existing Interior Walls y� ®New Interior Walls New Exterior Walls New Millwork r —1 Demolished Items FF1 El 0 I o P, 7 , ® .�. ee a -- __ o _ �. .r.4T:C702 TC, 1-C-1 RENWAD[111 J I,, . Vtly l�rL.t FcAMIN_:iS C��ArI;Tt TC IC�T"c C.�l_'_iS iC":PJ'.N=S, � - ' POWER,TELEPHONE,AND DATA FLOOR PLAN TELEP,-E•nNe REFLECTED CEILING PLAN � A.4 NO. REVISION DATE ' CLIENT: Macfachern Schilling Re5ldence 47 Grove Street,Coluit 02635 SCALE: A= " = 1'-O" TITLE: REFLECTED CEILING PLAN POWER,TELE.&CABLE DATE:NOVEMBER 12,2010 bUCHAEL A.JDIMRSON A.IA. ARCHTCECTURE&INTERIORS 193 Horseshoe Lane Centerville,NIA.02632 508 775-4264 majarch@comcast.net LEGEND " Existing Exterior Walls Existing Intenor Walls ®New Interior Walls New Exterior Walls Y New Millwork r ,— Demolished Items L____J ///7z - .7 ,. eye ° ROOF FRAMING PLAN 1 5-1 1 TOP OF GARAGE RIDGE ARCHITECTURAL TAB ASPHALT SHINGLE AS MANUFACTURED BY CERTAINTEED /."T.6 G.WOOD STRUCTURAL 'LANDMARK TL'. - 5HEATHING W/METAL W CLIPS@ JOINTS. GRACE ICE E WATER 5HIELD'4'BACK FROM EDGE OF ROOF.OVER .A5TM 4869 , ASPHALT SATURATED FELT UNDERLAYMENT(30 LB.FELT)ENTIRE ROOF, "STRUCTURAL WOOD PANEL WON ' BOTH SIDE5 OF RIDGE FOR ATTIC FLOOR. 1 2' BLOCKING IN-BETWEEN EVERY RAFTER. 4 SIMPSON STRONG-TIE HURRICANE 5TRAP5 Q ALL RAFTER TO STUD(SEE ROOF R-30 INSULATION.CEILING JOISTS® FRAMING PLANS). en=rise cu,a s=rice I I I G'O.C.(SEE ROOF FRAMING PLAN LEAD COATED COPPER DRIP EDGE. FOR SIZES). V-9-3/4"FINISHED CEILING HEIGHT, BLOCKING AS NECESSARY. - AZEK I"x I O"FASCIA BOARD t 1"x 6"FREIZE BOARD RABBETED. J 4MIL VAPOR BARRIER STAPLED TO �— AZEK 1/2"BOARD SOFFIT w/CONTINUOUS PVSTIC SLOTTED VENT STRIP. — STUDS OVER BATT INSULATION. 2"x 4"STUDS Q I G"O.C.w/FIBERGLASS BATT INSULATION R-1 9. TYPE i('GYPSUM WALL BOARD TAPED ;BEDDED,PRIMED,AND PAINTED. MABEC'NANTUCKEP GRADE FACTORY STAINED CEDAR SHINGLES B"MAX. . �� J EXPOSURE. TRIPLE STARTING COURSE. 1 e'CDX PLYWOOD 5HEATHING. x�sxc cum srac `y SILL PLATE OVER FIBEROUS SILL SEALER. GRACE'lYCOR PLUS'UNDER SILL SEALER. cENJ.AMIN OBDYICE 'HOME SLICKER PLUS TYPAR" HOU5E WRAP. qy C-ALV.METAL DRIP EDGE. •. I e]ty:iN� U-2.1/2"GARAGE FIN.FLOOR ae back I i2)2°x 4"PRESSURE TREATED SILL PLATES w/GRACE'VYCOR PLUS'Q OUT SIDE S . 1 FACE OF SILL PLATES. or garage sloped%y"per foot Towards ° yarege doors. _ -O'-6°TCP OF CONCRETE FOOTING I .._ NO. REVISION DATE ® eu=.ur r+; v., .,•y -A- O'-C"GRADE rnsnuc cxuu�_ou;. 4"SLAB ON GRADE w/6 x 6 x W I A x Y erg°,Q ANCHOR BOLTS 2-4°0.C.(USED WITH 51MP50N STRONG-TIE HOLD 4 W I A W.W.P.1"FROM TOP OF SLAB. �i��-� a" .,.. _ j DONM ANCHOR PLATES#HD7 W/(3)BOLTSQ ALL CURNERS AND GARAGE DOOR --- 6 MIL POLYETHYLENE VAPOR BARRIE `r L� °) OPENINGS). UNDER SLAB.ALL EDGES LAPPED 6" .;tl MIN,G"COMPACTED;CRUSHED STONE. CLIENT' AND TAPED. ')T' MacEachern 5chillln En nc a—tl— COMPACTED SUB GRADE. �_ •�'c h #5 DOWEL Q 2'&O.C. 3'-0°L Residence 9 4•. (2)#4 5 p TOP AND BOTTOM � F� eL• 8 CONTINUOUS. "I I.P A in.E: 47 Grove Street,Cotuit 02635 _ - ..•tl� -PROOF MEMBRANE SPRAYED APPLICATION OF GRACE'PROCOR 75'. _ WATER " SCALE:au = 1'-On (2)# :�) . .f•`�1[: '2"DEEP x I'_6"WIDE FOOTING 4,-0„MIN.BELOW GRADE. I— 5'5 CONTINUOUS. _ TITLE: FOUNDATION PLAN,ROOF EXISTING BASEMENT PLANE _ esecricN oe c„aczae roeruc�c-xnae rce FRAMING PLAN&WALL SECTION PROPOSED GARAGE ADDITION =' �a "FOUNDATION PLAN DATE:NOVEMBER 1 2,201 0 , TYPICAL WALL SECTION OF GARAGE ADDITION g I AUCE AEL A.JE14ERSON A.I.A. ARCEIrfECTURE&INTERIORS 193 Horseshoe Lane Centerville,MA,02632 506 775-4264 majarch@comcast.net i LEGEND Existing Exterior Walls Existing Interior Walls ®New Interior Walls New Exterior Walls New Millwork r —i Demolished Items L___—J _ 1 I ' 3\I1.123d022 - 4 H i j o_ w S . pN ' . ann uxa2oxa NO. REVISION DATE F CLIENT: MacEachern 5chilling Re5ldence 47 Grove Street,Cotuit 02635 TITLE:SITE PLAN DATE:NOVEMBER 12,2010 MICHAEL A.dII1EERSON A.I.A. t - ARCHITECTURE&INTERIORS }1 193 Horseshoe Lane Centerville,MA.02632 508 775-4264 i - majarchQwmcast net r