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0021 OAK STREET - Health
21 Oak Street Cotuit P A = 018 129001 it +I i TOWN OF BARNSTABLE LOCATION o�J y�{-j{ -'ST SEWAGE# (o VILLAGE ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO.- GC°.�r_ 93 R TY < SEPTIC TANK CAPACITY C;ZO OO LEACHING. Q" ( /off)CSi (size) NO.-OF BEDROOMS OWNER PERMIT.DATE: COMPLIANCE DATE: ASeparation'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 4 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 J 1V� two �: f . 1, i D04 �l1?/06, p, -erTl� No. DD NO( l 16- J-) l ` Fee C d'"c('`T���l f THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: L Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 01pprication for Mi pogar 6pgtem Con5truction Permit Application for a Permit to Construct( . )Repair( )Upgrade(tl)Abandon 2r&,mplete System ❑Individual Components Location Address or Lot No. .1/ Oak St C111f✓a`� Owner's Name,Address and Tel.No. � '�i7e:- c Assessor's Map/Parcel l�iQ �o?� -O'Qx 6© �a'; Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. ^vt a 0 .6 s- s 92 F- 41-1 Type of Building: Dwelling No.of Bedrooms Lot Size 45- 3j�sq.ft. Garbage Grinde �o Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 7 3 gallons per day. Calculated daily flow 4 gallons. Plan Date '&-e ;2A 106ti3- Number of sheets rRevision Date Title 5c-o4;c 5"st,W f,, Zzau /k 11 &k sa 73,1r &b1 Size of Septic Tank .2 00 Type of S.A.S._�6)- SOOcral 1,,.e4 e44- K Description of Soil:0/1 >Og a , Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued his H th. 6 l?_ Signe Date l 47 Application Approved by Date / ai Application Disapproved Yor the following reasons Permit No: )00 W —o 13 Date Issued 1 f No. 0d� `h _' 0 I I V Cj ) FeAI,6-ap THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: hYes PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE., MASSACHUSETTS 0(pplication fqr', .5po.5a[ *p5tem Cur truction Permit r , , Ap`phcation for a Permit to Construct( . )Repair(( )Upgrade d/r)Abandon(�-4e ,pmplete System ❑Individual Components t. Location Address or Lot No.al 04 k St Cplf y Owner's Name,Address and Tel.No. Assessor's Map/Parcel � 0/8/.0®?�j- o01 96 o Ma.'K IiA oa,o 35 Installer's Name,Address,'and Tel.No. Designer's Name,Address and Tel.No. /4 r� b's`S �se��9z8�3399 Type of Building: - Dwelling No.of Bedrooms Lot Size 45'3'71- sq.ft. k Garbage Grinder(=3)V0 Other Type of Building No. of Person ` Showers( ) Cafeteria( .) Other Fixtures t Design Flow a�3 gallons per day. Calculated daily flow gallons. Plan Date A-c lnn5— Number of sheets Revision Date Title Se-d,`r_ 5vs1&w /JearoAp T/ao 01+ -Bor,n5�aL P ((de,'A 1"1.4SS, Size of Septic Tank 1 02.DOD Type of S.A.S. /6)- 540a4 Description of SoilQ/i /,2 g )i/, t ZP' e 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 Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b this B�oard,of Health. _ .. /� Date�U//Z. Signed__ Application Approved by v 1LIN• ,�5 Date Application Disapprove for the following reasons i { , 4 .r'' PT+ 1 1 Permit No. )00(/013 Date I sued =)AM)4� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CE TIFY, that the On-site Sew,age Disposal System Constructed(X)Repaired ( )Upgraded14 ( ) Abandoned ( ) by i��r�//"l7 / at ?/ © k S51. Crn`rc„ has been constructed i accordance r with the provisions of Title 5 and the for Disposal System Construction Permit No.?60 6 013 dated 1 0 U Installer DesignerSv fi atf loci 1 n, 11 The issuance of this permit shall not be construed as a guarantee that the system will function, sd signed. Date a ' 2` ° F' Inspector - CJ 4 No. otEYu Q I"3 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migonl *pgtem Con.5truction permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) System located at 1 06-k Co-)vr¢- and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions, Provided: Construction must be completed within three years of the date of Pis peTit. Date:_,_ 1 1 Ikl Approved by �c%� i1 j. Town of Barnstable Regulatory Services s Thomas F. Geiler,Director . • BARNSTABLE, • 9MAS& Public Health Division Thomas McKean,Director E . 200 Main Street,Hyannis,MA 02601 Office:p508-862-4644 Fax' 508-790-6304 In''staller & Designer Certification Form- Date: � 07, Sewage Permit# ssessor's MaptParcel Designer:' c/!�( 9/, Installer: © /O /� ��cS g �� � l y _ � Address:l�. Address: I, On flee 44l'i'/� D� /� .&//,,/,was issued a permit to install a - (date) - (installer) r f se tic system at e ©C�, .� 12ta; `based on a design drawn by > l C2 C (address)LL-k U ��{ dated Z (designer) - 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. Stripout (if required) was inspected and the soils were found.satisfactoJt ry. f I certifythat the set system referenced above was installed with ma or changes i.e. greater han 16' lateral;c 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: Stripout (if required) was inspected and the soils were found satisfactory. P!F R (Inst is Signature) , SULLIVA `J.297 L ENS (Designer's Signature) ! (Affix Designer's Stamp Here) PLEASE'RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION.. CERTIFICATE OF COMPLIANCE, WILL!NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 03-09-06.doc 1 i Ni Town of Barnstable " 4 Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Sumner Kaufman,MSPH Paul J.Canniff,D.M.D. January 25, 2006 Mr. Peter Sullivan, P.E. Box 659 7 Parker Road Osterville,MA 02655 Dear Mr. Sullivan, You are granted permission to construct a soil absorption system designed to be connected to an existing dwelling with a proposed addition totaling seven bedrooms at 21 Oak Street, Cotuit. The septic system shall be constructed in accordance with the submitted plans dated revised December 23, 2005. Sincerely yours, Voqvte' Wayn iller, M.D. Chairman BOARD OF HEALTH TOWN OF BARNSTABLE Q:HEALTH/WP/Sixbeds I � � DATE: CS✓ dp N/A ram, z ° `iSeL REC. B BARNY MASIL A�� SCHED. DA A i / 7-6 6 Town* of Barnstable Boardi f ea h 200 Main Street, Hyannis MA 02601 Office:508-862-4644 Susan G.Rask,'R.S. FAX:508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A Miller,M.D. 6 BEDROOM POLICY VARIAN REQUEST FORM LOCATION Property Address: 21 Oak Street. Cotuit,MA Assessor's Map and Parcel Number: 018/129-001 Size of Lot: 45,331t square feet Wetlands Within 300 Ft. Yes ✓ Business Name: No Subdivision Name: APPLICANT'S NAME: Peter W.Evans Phone Did the owner of the property authorize you to represent him or her?Yes ✓ No PROPERTY OWNER'S NAME CONTACT PERSON Name: Peter W.Evans Name: Sullivan Engineering,Inc. Address: 960 Main Street, Cotuit,MA 02635 Address: P.O.Box 659,Osterville,MA 02655 Phone: Phone: (508)428-3344 VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) N/A Proposed new residence with greater than six bedrooms NATURE OF WORK:House Addition 0 House Renovation DRepair of Failed Septic System 00 Checklist(to be completed by office staff-person receiving variance request application) ✓ Four(4)copies of the completed variance request form ✓ Four(4)copies of engineered plan submitted(e.g.septic system plans) ✓ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) ✓ Signed letter stating that the property owner authorized you to represent him/her for this request a N/A Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense .(for Title V and/or local sewage regulation variances only) N/A Full menu submitted(for grease trap variance requests only) N/A Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/leasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) ✓ Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G.Rask,RS.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Wayne A.Miller,M.D. C:\HEALTH\Application Forms\VARIREQ.DOC t DATE FEE: N/A fF'URNSTAaLE aEc. BY ses SCAED. DATE: 2 PM 12: 45 Town of ijarnstable "Boar 200 Main Street,Hyannis MA 02601 Office:508-862-4644 Susan G:Rask,R.S. FAX:508-790-6304 Sumner Kaufinan,M. .P.H. Wayne A Miller, 6 BEDROOM POLICY VAPJAN REQUEST FORM LOCATION Property Address: 21 Oak Street Cotuit MA Assessor's Map and Parcel Number. 018/129-001 Size of Lot: 45,331f square feet - Wetlands Within 300 Ft. Yes ✓ Business Name: No Subdivision Name: APPLICANT'S NAME: Peter W.Evans Phone Did the owner of the property authorize you to represent him or her?Yes ✓ No PROPERTY OWNER'S NAME CONTACT PERSON Name: Peter W.Evans Name: Sullivan Engineering,Inc. 'Address: 960 Main.Street Cotuit MA 02635 Address: P.O.Box 659,Osterville,MA 02655 Phone: Phone: (508)428-3344 VARIANCE FROM REGULATION a i t Reg.) REASON FOR VARIANCE(May attach if more space needed) N/A Proposed new residence with greater than six bedrooms NATURE OF WORK:House Addition Q House Renovation ORepair of Failed Septic System 00 Checklist(to be completed by office staff-person receiving variance request application) ✓ Four(4)copies of the completed variance request form ✓ Four(4)copies of engineered plan submitted(e.g.septic system plans) ✓ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) ✓ Signed letter stating that the property owner authorized you to represent him/her for this request �— N/A Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicag s expense (for Title V and/or local sewage regulation variances only) N/A Full menu submitted(for grease trap variance requests only) (jy Ca N/A Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance re q-vals[same ownevleasee only],outside dining variance renewals[same owner/leasee only],and variances to repair failedM wage disposal syste-�ms [only if no expansion to the building proposed]) ✓ Variance request submitted at least 15 days prior to meeting data N VARIANCE APPROVED Susan G.Pask,R.S(=CChairn►nu NOT APPROVED / Sumner 14aufman,M.P.H.M REASON FOR DISAPPROVAL Wayne Miller,M.D. ekQ,'r,,�� ' a I2L ,� l i 4',k.n.v C:\HEALTH\Application Forms\VARIREQ-DOC AUTHORIZATION TO ACT ON BEHALF OF THE APPLICANT BEFORE THE BAR14STABLE BOARD OF HEALTH Date: �p I, Peter W. Evans, owner of property located at 21.Oak Street in the village of Cotuit, Barnstable, MA, authorize Sullivan Engineering, Inc. to act on my behalf as the applicant, representing me in the submittal of the Variance Request Application and attached development.plan to the Barnsta Boar of Health. Signature { COMMONWEALTH OF MkSSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL '�I WRI 3 ? 'i LE y DEPARTMENT OF ENVIRONMENTAL PRQ ECTION ROTAIDR 22 PPS !2: 3b Q)O DIVISION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:©Zj f � 4SYA,9.1 A Owner's Name: ✓ .� Owner's Address: _ (f � Date of Inspection: t.!► j Name of Inspec (please print: '- r' � j/ '7r✓/(�` Company Nam, s Mailing Address:,. 12�0- r Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of 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: i+ Passes Conditionally Passes Needs Further Evaluation by the Local Approving A az ails Inspector's Signature: a GS The system inspector shall submit a copy of this inspection report to the roving Auth card 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-ffie buyer, if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I TI Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property.Addresst /� 2 Owner— Date of lnspection: Inspection.Summary: Check A,B,C;D or E./ALWAYS complete.all of Section D A. System Passes: I have not found any informatio-z which indicates that any of the failure criteria described in 310 CMR 15.303 or in 3.10 CMR 15.304 exist.Any failure criteria.not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass section:need to be replaced or repaired. The system,upon completion of the replacement or repair; as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N.ND)in the for the following statements. If"not determined"please explain. The.septic tank is metal and.over20.years old* or the septic tank(whether metal or not)is structurally. unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent:System-will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup o_break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,seLrtled or uneven distribution box. System.will pass inspection if(with. approval of Board of Health): ' "broken pipe(s)are replaced obstruction is removed distribution box,is leveled or replaced ND explain: The system required pumping more than'4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with.approval of the Board of Health): brolon pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR-VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: C�w Owner: Date of Inspection: C. Further.Evaluation is Required by the Board.of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1."System will'pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water Cesspool-or privy is within 50 feet of a bordering"vegetated wetland or a salt marsh 2. System will-fail unless the Board of Health (and Public Water Supplier,if any).determines that"the system is functioning in a manner that protects the public health,safety and.environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS,is within 100 feet of surface water supply or tributary to a surface water supply. The system has a septic tank and SAS and the SAS is withir-a Zone I of a public water supply. The system has a septic tank and SAS and the SAS is withir 50 feet of a private water supply well. _ The system has a septic tank and SAS and the SAS is less tlan 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 DAP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution.from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 r Page 4 of 11 OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A. CERTIFICATION(continued) Property Address: . 00t,6 Owner: Date of Inspection: 31, �s D. System Failure Criteria applicable to all systems: You must indicate."yes"or"no"to eaci of the following for all inspections: Yes No/ ; _ �V{ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ J Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or Jclogged SAS or cesspool _ Static liquid level in the di-tribution box above outlet invert due to an overloaded onclogged SAS or / cesspool _ V Liquid depth in cesspool is=ess than.6"below invert or available volume is less than.%z day flow Required pumping more than 4 times in the.last year NOT due to clogged or obstructed pipe(s).Number ' of times pumped Any portion of the SAS, ce=-spool 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. V . Any portion of a cesspool c-privy is within a.Zone I of a public well. _ Any portion of a cesspool c_privy is within 50 feet of a.private water supply well. Any portion of a cesspool c_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 an alysis, performed at a DEP certried laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the,presence;of ammonia nitrogen.arid nitrate nitrogen is equal to or less than 5 ppm, provided that.no:other failure criteria are triggered. A.copy of the analysis must be attached to this form.] (Yes/No)The system fails. I have determined that one or more of the above failure criteria.exist as described in 310 CMR 15.303,therefore the system fails.The system;owner should contact the Board of Health.to determine what will be.necessary to correct the failure. E. Large 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. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no the system.is.within 400 feet of a.surface drinking water supply the system is within 200 feet of a tributary to a surface.drinking water supply the system is located in a nitr�jgen 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 famed 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. .Q T Page 5 of 1] OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: Owner: Q Date of Inspection: J Check if the following have been done. You must "yes"es"or"no"as to each of the followinu: ` Yes No Pumping information was provided by the owner,occupant, or Board of Health j"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? _iZHave 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 NIA) 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 owne-)provided with information on the proper maintenance of subsurface sewage disposal systems? 0 The size and location of the Soil Absorption System(SAS)cnthe site has been determined based on: Yes no jZ Existing information. For example,a plan at the Board of Health. ZJ_ Determined in the field(if any of the:failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: n Owner Date of Inspection: FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based:on 310 CIv1 15.233 (for example: 11.0 gpd x#of bedrooms): Number of current residents: ` Does residence have•a garbage grinder iyes or no). /✓� Is laundry on a separate sewage system(ySX or no)-a [if yes separate inspection required) Laundry system inspected(ye .or no):�U Seasonal use:(yes or no):I/O . Water meter readings, if available(last 2 years usage(gpd)): Sump pump(yes or no):� Last date of occupancy: 1t' • �r✓` /rL a COMMERCIAL/INDUSTRIAL t Y Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgfr,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yrs or no): Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of.occupancy/use: OTHER.(describe-): GENERAL INFORMATION Pumping Records .- Source of information: Was system pumped as part of the in pzctio es or no) If yes, volume pumped: gallons--How was quantity pumped determined? Reason.for pumping: TYPE OF SYSTEM �ptic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes, z:.tach previous inspection records, if any) _Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank _Attach a copy of1he DEP approval _Other.(describe): rox' to age of all components, da e installed(if known)and source of information- Were sewage.odors detected when arriYing at the site(yes or n Y1 6 i Paee 7 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM:INFORMATION(cor;tinued) Property Address• _ 0-k 'l Owner• Date of Inspection:' BUILDING SEWER(locate on site plan Depth below.grade: Materials of construction:_cast iron _40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints, venting,evidence of leakage,etc.): SEPTIC TAN : (locate on site plan) Depth below grad Material of construction: .i concrete metal_fiberglass_polyethylene _other(explain). If tank is metal list age: . Is age confirmed by a Certificate of Compliance(yes or no):_(attach a copy of certificate) Dimensions: ..ej '� . . Sludge depth — 1 j Distance from top of sludge to bottom of outlet tee or baffle: 6 Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bo of outlet tee or baffle How were dimensions determinedx 1401 / Comments(on pumping recomm8ndation inlet and outlet tee or baffle condition, structural integrity, liquid levels related to outlet invert evid nce of leakage, etc.): Jax✓Y / 't N .I!/v'.. ,.� (Jx may' _ GREASE TRA locate on site plan) Depth below grade:_ Material of construction:_concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thickness: Distance.from top of scum to top of outlet tee or'baffle: Distance from'bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 7' Page.8 of I I OFFICIAL INSPECTION FORM—NOT FOR.YOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C . SYSTEM INFORMATION(continued) Property Address: r A Owner: Date of inspection: Cpa. TIGHT or HOLDING TANK/UFtank must be pumped at time of inspection)(locate on:site plan) Depth below grade: Material of construction: concrete metal fiberglass_polyethylene other(explain); Dimensions:' Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and floc_switches, etc.): DISTRIBUTION BOX: ((if present must be opened)(locate on site plate) Depth of liquid level above outlet inver � ,/� Comments(note if box is level and discibution tA�outl equal, any evidence of solids carryover, any evidence of age�into of out of box, etc PUMP CHAMBER/ (locate on site.plan) Pumps in working or/der(yes or no.): t Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 4 _ � I 1 Page 9 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:. !, ,l Owner: Date of Inspection: SOIL ABSORPTION SYSTEM (SAS): (locate on site plan,excavation not required) ' If SAS not located explain why: Type .. leaching pits,number: leaching chambers,num er: 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, rG 6 P 1.%W/1• � ��f/ C� 0 5 ,. CESSPOOLS (cesspool must be pumped as part bf inspection)(locate on site plan) Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of.groundwater inflow(yes or no): . : Comments(note condition of soil,signs'of hydraulic failure, level of ponding, condition of vegetation,etc.): PRI (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.): 9 Page 10 of l l OFFICIAL INSPECTION-FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PropertyAddress:,v 6e Owner: Date of Inspection: SKETCH OF SEWAGE DISPOSAL.SYSTEM Provide a sketch of the sewage disposal system.including ties to at least two permanent.reference landmarks or benchmarks. Locate all wells within 300 feet.Locate where public water supply enters the building. i t 9 b 10 Page I 1 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(coatinuedj Property Address: 2, Sty` Owner: J JX0 Date of Inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water t feet Please indicate(check)all methods used to determine the high ground wa—.r elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet cf SAS) Checked with local Board of Health-explain;, Checked with.local excavators, installers-(attach documentation) ✓Accessed USGS database-explain: You must describe how you established•the high ground water elevation: r f l l - PErmit Number: Date: — —_ — Completed by: HIGH GROUNDWATER LEVEL COMPUTATION Site Location: 2-1 �Q� �� C� l//� Lot No. Owner: 7'w LL°e/ Address: Contractor: ��� O � v`/ Address: Z15 I Notes: STEP 1 Measure depth to water table / to nearest 1/10 ft. ...................................... Date '7 3//s— month/day/year STEP 2 Using Water-Level Range Zone and Index Well Map IDcate -_ site and determine: OA Appropriate index well..............................:.1..'{, l,? ••„ ' BJ Water-level range zone ............. STEP 3 Using monthly report"Current Water Resources.Conditions" determine current depth to / — water level for index well .........................' month/year STEP 4 Using Table of Water-evel Adjustments for index well (STEP 2A), current depth ` to water level for index well (STEP 3), ti } and water-level zone (STEP 2B) = z_ determine water-level adjustment ................................... S T STEP 5 Estimate depth to.high'water by subtracting the water- level adjustment (STEP 4) from measured depth to water i level at site (STEP 1) .........:............................................... I7 / Y i - f t Figure 13.--Reproducible computation corm. = s - F 15 , -- - v h .. ,. - ,VA _ VF - s, f rv�w+ t � - ... ... � � C`. _ � '�� -� }A � ;�. s �1 "' 3 � � � �`. I t. E _ ; ii I _ 1 { ,. fi .F. � � i .. t' � i. i� is`. .. 4 t _ � � - i T f @� � � � � � _ i.i � _ � - i� .� .� - t 7 _ 3 .. 4 _ .. `-1 :� r �� . ,s 1�, � � .. �'~ Q� E �_. �. : . t r __� f _ -� � .. � fi - � . } � . . ' . . * k t _. �� - i T - � ) .i ' � l _ f �_ �� ._ w ;�- � � ., w�. ___ TOWN OF BARNSTABLE LOCATION / � o4a SEWAGE # VILLAGE- ASSESS R'S MAP & LOT .._J►45060R.�5' NAME&PHONE SEPTIC TANK CAPACrTY �• LEACHING FACILM. (type) DF o�1r y�pJ N..r� (siae) x NO.OF BEDROOMS n�. BUIL.DER OR OWNERZO A �J y F ^ PERMITDATE: 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 `� / � (`� �_ v�j/ O.s �� A �/ Vj �4.T�v "/// �' � ''���� � �-V � . �� ..M y -v -- ._�` i Fps .... .... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH f. - .................OF..........�,� _ , ppliration for Dippoiial Marks Tint' trurtion Vernfit Applica' n is hereby made for a Permit to Construct VLor Repair ( ) an Individual Sewage Disposal System at-'Va,I -•• �.Zxs.qe...... .. .ma�d.go ........................ -.�---o-r-L--o -N--o-.-•--------------..-.-•-------------------- -Aation - oi .. .... t.... ..... J19t Owner Address a ......................-••--••----------------•-•--.._....---......••---------...._................ -•-...----------........•----•----•----------•--•-----•--•--.....................--•_.........--•- Installer Address Type of Building Size Lot.' 6-35 1.---Sq. feet U Dwelling—No. of Bedrooms........... ..........................Expansion Attic ( ) Garbage Grinder ( ) PL4Other—T e of Building No. of persons............................ Showers — Cafeteria a' Other fixtures ............................ . d ;. ------ --------------------- Design Flow........,._________________________gallons per person � d� Total da' fl? ......... .................... , Septic Tank—Liquid*ca acitY gallons L � . _ eter._ ... De .._.... .� x Disposal Trench—No..................... Width_._ ....... Total Length.___._.-.___�...... Total leaching area.........--._.. ...sq. ft. Seepage Pit No......./........... Diameter.._. ........ Depth below inlet...... Total leaching aZSa 5 - -At Z Other Distribution box (9j Dosin tank ( ) 9 aPercolation Test Results Performed byQb(d..�Q, I �./� ._ Date6... ___I . Test Pit No. 12�- ......minutes per inch Depth of Test Pit---13�...,_. Depth to ground water./ 44 Test Pit No. 2.A.Z....minutes per inch Depth of Test Pit...12XZ.... Depth to ground water.-_f�/�_.._... ---•---- --------�- - Descri ion of 01 So>Z_..l cl.....7���11e� /.._._y... ............... 1.__f�l�D.T�__CFA �------ -----i3.1a..........m.,. y.... .._..fir . 5 ate- 2 je J U Nature 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 TLNU 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. S i�g ;e 4d.. .. ...... 01 Application Approved By....... .. .............................................................. 2 J, v Date e - ...... Da Application Disapproved for the following reasons-----------------------------•--•-----------------------•--------------------•--•-----------------------•--•---- ................................•-•---•--....•--••---•-•-------•---------------•-•--•-----------•--------•--•------------------------•-•------------------•-----------••-------•-------------... Date Permit No.---------� .�.,••...�"""`+� Issued--•---yj�Q Date/� �_1. . r ...__. C r r£f i THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH . ..-•-•---..._OF...-..-,3A.?. ���.�-1� � . ........................ AvPfiration for Disps ai Works Tonstrnrtiun ramit Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: P+ Location-Address • or Lqt No, m ............................................ .. � i.....r0__. ?_ ...... ' }-- W Owner Address - ............... ...... ......... --•--.... ... Installer Address ,4 UType of Building Size Lot____,. ..__: ..1..--Sq. feet Dwelling—No. of Bedrooms______.._.:...........................Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—T e of Building _..._...... No. of ersons____________________________ Showers YP g ----------------- P ( ) — Cafeteria ( ) Otherfixtures -----------------------------------•------------•-----.•-----••.._..•••-••-•----•-••••-----•-..__....... == W Design Flow.... ___ _________________________gallons per person ,fir day. Total da ...flow_.____._. + _:__.._____________ o WSeptic Tank—Liquid capacitye � .gallons Length._ __ ____ Width__. .-(Diameter________________ Depth_.,��'__."_aj. x Disposal Trench—No_____________________ Width.................... Total Length______:::¢:F...... Total leaching area_.___...._____. ...sq. ft. Seepage Pit No.......f_-_........ Diameter.... _........ Depth below inlet.......__......... Total leaching area_ �_��__--- Rto Z Other Distribution box Dos' tank ( ) " '-' Percolation Test Results Performed by ,764U._+ d 1 F/i?!? __�A✓_C._ Date __..® Test Pit No 1 minutes per inch Depth of Test Pit � ___ ;._ Depth to ground water/Zh`- ..... f14 Test Pit No. 2__�_�.___minutes per inch Depth of Test Pit . Z�__- Depth to ground water ,l/... ........ 04 - ••• --------------------••-- -- D Description of Soil/ € ` �rf�' _ �i�� �'�/ � / /r 5 t�+ ` 16+e y}r 1 afrsrYA ? ci LyYf, m <r e`f -�-- -----�`�'�P°�Y p t�"-'s-•-- U Nature 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 TITIE 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 ,__.. ApplicationApproved BY � ...... ................................................. -•-- . -------- / 7 Date Application Disapproved for the following reasons:------••-------•-•------------------•-------------------------•----------------------------•---••----........._ ---------------------------•---------•------------•-•--------./...------q=---....--------•-•-----..._._..--•--•-----------------=:..------•----------------------------/--------------------••---------- ----•-------------- IssuecL -� ',C 7 Permit No..........._7�....... Date ..... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ........... P "...............o F................ ......:. ................................................... Trrtif iratr of TaantViiFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by................t ------------------------------------------------ •--------------- has been installed in accordance with the provisions of TI of Testate Sanitary C� described in the application for Disposal Works Construction Permit No............... ___. dated_.-,______-_. .................................. �7 ••• - • THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................6....-..... J .................... Inspector................ .................................................. -°DESIGNING ENGINEER MUST SUPERVI THE COMMONWEALTH OF MASSACHUSETTS+NSTALLATION AND CERTIFY IN WRITIN THE SYSTEM WAS INSTALLED IN STR;� j BOARD. OF HEALTH ACCORDANICE TO PLAN. 6wN........................ �-� /� No......................... FEE.................... Disposal Workii Tnnntrurtuan rrntit Permissionis hereby granted.......................------------------••--.---....•-•----••------••••-------•---•-----•----••-----•-•.......__......._...._-•---.... to Construct J or R it ( try ivie tI t_ ewa Dis ,osal ,System . p atNo.................................................................................... '-' _ Street �. as shown on the application for Disposal Works Construction Permit No.__._____ Dated..... �/l1_��� .......... DATE_ _--•--- Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS oFTHETp`O TOWN OF BARNSTABLE OFFICE OF BAHYSTuLL : BOARD OF HEALTH MMl w`s639. e� 367 MAIN STREET HYANNIS, MASS. 02601 Sewage Permit I : W '9 Applicant �jQP�� Proposed Installer: The plan-for the on-site sewage disposal system at L-Of A CbAl/_ S:4 has been approvedc-16ith the condition that the design engineer must be on-site and supervise installation as well as certify in writing that the system was installed in strict accordance to the approved plan. Approved By Dat6 Permit Number: Date: Completed by: HIGH GROUND-WATER LEVEL COMPUTATION Site Location: �. S y �� A2S�-4 ►� Lot No. Owner: QCGe-r EDE1.4 iiy► _ Address: 30 GI?_EA::J, P 1!.F 8P- , ehAS HPSG Contractor: Address: Notes: STEP 1 Measure depth to water table to nearest 1/10 ft. Date ........................................................... . month/day/yey STEP 2 Using Water-Level Range Zone _ and Index Well Map locate r site and determine: t�A Appropriate index well................................................... © Water-level range zone..................................................... STEP 3 Using:monthly report"Current Water Resources Conditions" determine current depth to water level for index well .............:............ month/year STEP 4 Using Table of Wate[-level Adjustments for index well (STEP 2A),cu.rrent depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment .......................................................................................... STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water level at site (STEP 1) TOWN OF BARNSTABLI LO ATION �6 O�i�'Sf' fry FWAGE'#. VILLAGE � � —..._—._. ASSESSOR'S MfAP & 1.0T�� Z 00 INSTALLEWS MAKE & PHONE NO.C�ry�� SEPTIC TANK CAPACITY—M dd LEACHING FA.CILITY:(t ) , J —(size) NO. OF BEDROOMS PRIVATE WELI. OR. PUBLIC WATI?R����L BUILDER OR OWNER --- DATE 'PERMIT ISSUED: _ DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes 41 1L�•• y �G 2,7,7 o I HEREBY CERTIFY THAT THE SEPTIC SYSTEM HAS BEEN INSTALLED ON 'THE LOT As; SHOWN AND THAT ALL WORK HAS BEEN COMPLETED IN AC RD CE WITH TERMS OF THE PERMIT AND APPROVED PLA L O T D T RAYW YES. DATE 70.00 LOT A 45331± SF , Z' y_r I— 2z L 0 T B m G P' A W W w Qo' ,o. I— SEPTIC-` °a EXZS11 NG o ' n TANK. 0 .,p., Q.3� `2,b r 6' BOX � . fD 4 co rn ° h z�a •A LEACHING PIT ¢ . Q O A5 6A Q Q J� M - EXISTING SEWAGE DISPOSAL SYSTEM ��� °F ,�qs. LOT A OAK ST & RUSHY MARSH ROAD r �:✓ R°PERT ��, BARNSTABLE MA JZAYMON " «»- "®' lsa'S ARROW ENGINEERING INC. FLOOD ZONE ,o� £ is 10 CAPE DRIVE, SUITE B COMM. N0. M A 02649 MASHPEE, '. EFFECTIVE BATE SCALE: I"=40' DATE: JUNE 21 '88 B AS C i la a,/Y carNt:FLLED PITr. jI �.aoT•.,�Y o�P j I ------------------------------- ItbNc FooTUTa,w. _. I I I 1 amc r —I I I Aeroe atAu CONTRACTOR AIN Os•YTNYUY FOOTHO 001tRA0E J I F 19 I(�TI P. I '�I INS �"PaR I I I t I I ' ,:-. !r I I I x � I 2 a— r,—.ON Fq� Y' I 1 � ' ' � � ' rmione�dcienoTOii or � �i I 1 I I s�iPPaRT Aeon e I I I I I ro aDGEI FOISO}naN I I L 1 I I I I - FROM ac°°""ac I I , � �� � I I -r I -------------------------- I ---------- ---------- ------ I TD►DD,ND 1 I I I I I ' j --- ---------- -----T•- 1 -. � �"s-sno yEAY\� "' { T� I 1 I I I and•Ie•�G oNIP.1�1 _1 I I I FRpI R CRA SPACE I I I I I I I I I I zr Dan.FLOOR oc To AU ./ I f TO f0011N0 r--� r--� I I I I I •, I ----- J ' ,Y0. �V[RTYII 1 I I I I I i, ; 1 T ' I ' I f I I F�QJ TN7N ETA[ M10 I L--J L--J I I a I i I r— ----- I (�N TOM Ppup 1. 1 I I 1 I I I I, Ono e,e• 1 COOP TOP aw I to Nos CONTINUOUS. OFI I T-6' + I I WALL Ir NJON 1'y ri I �— -- — -- -- --�-- ----�-- ---------------""— ------ J . L------------ — 3 ' XXXXXXII --------------------------------- ttl J L, r� I 1 SAw-cur s-tr aPvao �. I l 0 I I 1 I m A Z atATw sPACF 1 I i 4, 11 1 I - •' f � I � I CONTRACTOR SHALL I 1 10 1 _ PROVIDE P SARs O - 41 1 I MAINTAIN M'YNMA1 ---- ---------------------------- —, i i 'Fd laOAllONwMl Tom[NiD Co 1 CROP TOP GARAGE SLAB FOOTING caeRAct --- 1 Of WALL 1Y PrICN, PER rOOT I --- --- I I I CCNNDCIIFROST�ON W44M POUR CONTRACTOR TO CUT/�• I r— ------ ------.------------ 1 TOWARDS DOCIRS r TNt•a-O• ---, IS NO OONTNlDUS. COSTING FOUNDATON I I CONC.WALL ON I I 1 ' 1 I WALL FOR NLYT MOOTS I I COYPACTFD roaTTi+'cS�e'. I I I 19 1 I I CONTRACTOR SHALL r INN:c-o•MAINTAIN 4r MINIMUM CONC.WALL ON 1 I I I I 1 I-I L1 FOOTING COVERT z CON'r,ow comm I I I I I f FOOTING I i 1 ' I L A AS I I I I 1 I I I 1 I f OF w Is* I I I 1 >e I I a°rwAUPIY I I I I I 1 � a I I i i t A5 I I I EXISTING TO 1 F 1 I 1 j I Fo siwP rno�":RTOUS 3 I 1 I 1 I I ON REMAIN I I its ca FOCTMs ------------- ---- • I j c--- ' 1 � I I I I _ I I 1 I I ----- — I r----, I I I I I I I I I ; I 11 i I 1 ; ; BATH � UTILITY 1 r } I 1 I I j0i 1 I I I I 1 I I I 11 L-----J ----- ---- ------ KPRC . --- //6 -- — ----------------------Tw 06r.YERTW�Y N FOUNDATION WALL TIC INTO - FROST WALLA TYPICAL . - CONECTION WIk7rE POUR IS NOT coNTNutNTs FOUND ON PLAN scALE: ,�..�,^ ® NDUTU E70511010 FOU OAVON A e AS .• r ZINI A T .. ltHy 1R.M TpMb a 1R.N Tf2Mp � . qq� i SUNROOM PAW p M.BE)ROOM LAUy, u•-Year-a- awn CLOW DECK Fis DINING KIT CHEN — � u•-e•ea•-a• po1aaam) q AS g I COVEREDPORCH m!acrrnc°o'"0 p ° S FOYER mm) EMT.AT ROOM REtae�C TE n= t oow Immm a- IV•Dix v w. 11 Cm. eAM mR. clm/ooum) GUEST ROOM 10 NorthSide Design Associates [I] - -- Nul n FIRST FLOOR PLAN 141 Main Street SCALE: 1" = 10' Yarmouthport, MA 02675 �w�sec,Q ,�o3/aoob Tel: (508) 362-22:10 e AS e ue. cL 4 _ 6 'DROOM - AS . R aPv�m 2-1.6a p mwJ A - `am= LaF T L7 - K NorthSide Design Associates 141 Main Street - SECOND FLOOR PLAN SCALE: 1 = 10' Yarmouthport, MA 02675 Tel: (508) 362-2210 1 1. • 4+ i A ra«s ra++a ra446 1NQ44"S raMa i� raMe races • ra..e ®: q � F it ! SUNROOM f M.BEDROOM q raa,ar races 'a _- =3�r�=3�_�=3�T- \ TO BE MOVED I. AUGH I i i { I c I I I I ce g!l L+ i l2E�K I CLOSET { I CLOSET I A o 1 J.\ V •\•\' Jr ------- --� ----- ' ---------- - -ii— Z------ �� f � + • • + + DINING \2 r-4' r-4' KITCHEN A / COVERED ,OOSTM AS H CONIRACTOR TOFOYER J II a ER pn=lt FROM °' (n °°aa') I! GREAT ROOM BE aw 000a TOS Com !I —__O ! C � 1 ouAu.nv. I I��I I L t• , - — V-- _ - * OOST - BATH Aq (RE" ) I GUEST ROOM ! I f FIRST FLOOR PLAN SCAM >�IM C " - c • AS IF I r--ANANDERSEN---i -w,AN tii�---� I I s,/Y CON Fs,Eoa PNT ON 30 Wdr OP ------------------------------- I (GONG FOOnNa(YP. I I f -- — -- -- - -- -- — -- -- I r 'I CON7RACM SHALL � --- -1 I I I I FMAoNTTAINTIM 4W;MINIMUN PRovil i I , I I ,I _. I I I ,Y a Na r————I o �yW1 s 'INTOI I I I wcr I J L I J i I FOUNOA TIE. II 1II (I—(I I P 1, �II a I, FatNiot ni• 1'I 1'•I ` j .I,mo, rI —S(� Ii CN 1e•LLO wA.e•O m w.T FooTcOOT C ONO TO 2 ore T° a _ r-w° _ ------------------------------- POST DOWN N �ABOVE h I I TOO Roma ———— ——————————— I I I I I I o 14 I I 11 I I _ I {Y1.. _.. ®� •I I I I FROM ,_ 2-WO I I I I to I I I Wj a Ie•�a;ONIP.TLe CRA SPACE I ! I I TO FOOnNO II II ' N� � 1+•R a s T o aoN w I i � I�_ / wa , I II L N ----- ao e,e w _FROSTL... AtICN� Yi,ALL , •' I ow I- — — -- -- — -- -- — — -- ------------ —————— J L__ --------! I� -------------------------------------, r------ _ , I ---------- F J' t i I o ass ter° iNo I , I I 1 I i I I I , I I 17'o0.=ONNCONTRACTOR SHALL OF WALL,Y ------------------ FOUNDATON WALL TIE W O0000 —_ ORav TOP GARAGE SLAB Fnwen , CONNECTION SR CONTRACTOR O OUT CTow1 R oosO uiwI r— ------ —_----------------_ —-- , U DUTING FOUNDATION WALL FOR NEW WINDOWS w6 tae owe. CON O I T CONTRACTOR SHALL t-O• IIIII . .!i, ? I 1 I I I 1 MAINTAIN 4e•MINIM CONC.�,T WALL ON IwW CNIa I I I I I I FOOTe10 COVERAGEFOomD I I I I I L---- �P i ---------- -------1— I I I I L---- (J ri A A5 I I DROP TIP CROP I I a te' I I I I � I I wAuvil• I I I ' AQ I i i I EXISTING TO I 2.4BEARVIO WALL ON I I I j j I REMAIN I I STR DO uousw�A I I I I I I I 1 I I r--- ------ --------J e•- i t 1 I I I I - i I 1 FL - - b — -------- ' -- I ------------------------------- E I I I 1 1 BATH UTILITY I I I l I I 1 1 L--- J --------- ---.-- ------------------I I 1 —————— K ————— — -------- ------RONOE/py WARS O FOUNDATION aC ON W IN MAIN FROST WALLS. WALL TIE N4T0 FROST WALLS,TYPICAL CONNECTION WHERE POUR Is NOT CONTINUOUS. FOUND,-TION PLAN SCALE: ,/4�t-�0 ODICATM EXLSTNO FOUNDATION 8 ' A5 C A5 11P148 1M246 rRMb 1M24e rwom rrtwe r 2"6 a 7=40 � 4 Oil SUNROOM lb'-0"x1Y-4' b 8-4 x12 T 11� M.BEDROOM LAUN• W-3'x21'-0" M4" M40 I I at RUAOM mm I cLosEr j CLOM N --------- --�--J L -—-—-—-—-—-—-—-—-—-— I--n --- j DINING 0 KITCHEN -0' 11' 8' i} _I (I�YOOFIFO) �I -—-—-—-—-—-—-—-—-—-—- A. COVERED TO BE w A5 PORCH FOYER A RUCONimimcaaTOo GREAT ROOM =TEDoor COMM TOBEPSIO ---- II 2- =JLUr am 0 CMMW I >; rn. 1 IuN. I I CL I 1, - lr BAIIJ , OM"0DMO) Q QUEST ROOM ' I fol M444 n FIRST FLOOR PLAN SCALE. 1/4"-1'-O' ' INNUTES um C01161 ue" I B A5 ' C A5 I II I I �ww •� BEDROOM I ( i ! I BEDROOM PI F A5 I I to eeLnw 7 • A5 BELOW IV Ir I I s- II LOFT —CL- --- �P II BEDROOM '-3 ,I r SECO ,D FLOOR PLAN SCALE 1 4�0 1 • l , y xC819ibb o, O O oil er Q ` \ d n �i 10o: . •t{ ,fit Corys� , / . . , n D-19 Ld 13 QFTql--LL]LL {o 0 i i ` >• °i,• � 'r 1 are �-'" ,yam �6, zst Location Map: ch ! 1 ,goy ASSESSORS REF.: J/ / \ / Map 18, Porcel129-01 a 11 ` ` 9� J� / O [See Detail Above) �� / ,Q/ (6 0 gallon sue, y OVERLAY DISTRICT. J0\,\� '..,.Sep�xcls9t� PT L14rith Stoneeach mbers �OY9 Rl�,x Parcel A d�rb Ta.f3e Removed / (12.8.3'x59) /� AP - Aquifer. Protection District 1 I ! j ��- /'•.... / Pj/ti ��� As Shown on Plan Entitled II i 45,331 f SF \ "Revised Groundwater Protection Overlay Districts" - April, 1993 /Pr�$sedl tQfJ Mi I I Tt)iOc 2a�/ b Mt" I I / 1 / Sep 7a 226E / /21 o as M� R ce Hall / FLOOD ZONE: RI 2 ty w/f St ;59rOb Zone B, C & A11(el.11) 3 D�ellinq airs J Community Panel No. f250001 0021 D as July 2. 1992 Pro osed Pr4osed / I I so F Wood Deck Existing Ca ge / '"°°°aak ., ZONE: v l RF Relocate hed b Proposed / _ Area (min.) 87,120 SF (RPOD) I I m Addition o Stairs \ p 30° Fronta a (min 20' ----- --- L------------- -- -- --r- -- -- -- - -- -- -- -- -- -- -i n ao Width gmin) 125' I I CB�H / ' 1s'sidaywd j fb6ck - t -- 1 / Setbacks: II I I Fnd 1 \ / Fron f 30' I I C) I o`oo Side 15' ce/oH' �(z) Rear 15' Fnd \ N _11m Elizabeth Schm t ' ml mT 1487YI37 � � PETER 0 10 20 JO 40 60 80 FEET m \ � 97� Scale: 1"=40' �tV l FEMA F1,00d Zone Lines \ civic D O as Sho on FIRM Panel j�250001 002.1 D \ O I l \rev July 1 1992, PLAN DATE: December 23 2005 SHEET TITLE PREPARED BY: PREPARED FOR: NOTES: 1.) The property line information shown was Sept/" compiled from available record information. C System Upgrade Sullivan Engineering, Inc. C pe S u�/ Peter W Evans 2•) The existing.structures shown were located by O f2 P.O. Box 659 7 Parker Road Ca eSury b an on-the-ground surveyperformed Plan At 21 Oak St. osterville MA 02655 C ville MA 02655 on orbetween 051DEC105 and 07/b /05. 960 Main Street 3. The new building footprint shown was provided b (508) 428-3344/428-3115 fox (508) 420-3994 / 420-3995fax ) 9 P P Y / copesurv@capecodnet COtUIt MA 02635 Northside Design. Barnstable (Catutt) Mass. F I •RR K Rob w:RR 4.) The topographic information was provided by 25044 Draft:RRL'WMK Job . C-615.1 the Town of Barnstable GIS. Om r win C= :RRL WMK r win PERC �, r f✓j/ - TES PERFD aY SULLIVAN ENG Finish Grade WITNESSIDY, D13N DESMARAIS NOTES DEC 2L - - . 200D 9" M- in 1. Water Supply For This Lot is Municipal Water, BAREffTEST HOLE - 1 ' 3' MAX _ filter PER7F'ES BY SULLIVAN ENG 2. Location of Utilities Shown on This Plan Are Approx, Compacted Fill Fabric DEC 21.zooz At Least 72 Hours Prior to Any Excavation For This � an.a 2- Min 1�8 - 1/2- + O&A °LEA ES DEC SED Project the Contractor Shall Make the Required Pea $tO/le A LAYER (OYR4/2 Notification to Dig Safe (1-888-344-7233) • r e'-ll DAMP SAND a Dy. ® 0 O 1•-13 L AMr SAND 3. The Contractor is Required to Secure Appropriate 3 E LAYER,l0YR5/3 Permits From Town Agencies For Construction 01 a 0 8 LAYER 10YR3/6 Defined b This .Plan. 13-34 LOAM- AND L-1 y T- 21 4a 34_-I26 C LAYER 2.5Y6/6 16.7_ 4, Install Risers to Within 6" of Finished Grade. (5 RegJ a � o a a 3/4� - 1 1�2" M DRUM 0 - Double Washed7712 PERC TEST 5. All Structures Buried =>. (3) Feet or Subject Stone RESULT 2MM/MCM to Vehicular Traffic to be H-20 Loading, < I _ NO GROUNDWATER ENCOUNTERED 6. Septic System to be Installed in Accordance With 4'-10" --j TEST HOLE - 2 310 CMR 15,00 Latest Revision and the Town of . PERFORMED BY SULLIVAN ENG Barnstable Board oT"C Health Regulations, 12'-10" DEC 21.2005 7. All Piping to be Sch. 40 PVC. CROSS SECTION OF CHAMBER D LAYER DECEW13SED LEA 8. Wherever Sewer Lines Must Cross 'Water Supply VES 6 TWIGS - NOT TO SCALE A LAYER IOYR4/2 Lines, Both Pipes Shall Be Constructed- of Class 150 LOAMY ANMA E LAYER I0YR5/3 Pressure Pipe And Shall Be Pressure Tested To 1-13 LOAMY SAND _ Assure Watertightness. - 8 LAYER 10YR5/6 Q Zb �/ 13'--34 LOAMY SAND 1a? 7, The intent of this drawing is for securing kIPERG C LAYER 2.5Y6/6 34_-1-12p MEDIUM SAND BOH permits and is not for construction. 25 GALLONS IC IN<T 15 MM I . J RESULT.<2MIN/MC" NO GROUNDWATER ENCOUNTERED - Design Data TOF EL. 21.0 Single Family - 7 Bedroom Daily Flow = 110 x 7 = 770 GPD r. F.G. EL- 20.0' See Note 4 (typ.) See Note 4 (typ.) F.G. EL. 20.3' See Note 4 (typ.) Septic Tank: a D-Box 770 GPD x 200% = 1,540 GPD t Lv.Y w•, ;n: H-20.. Filter Fabric Use 2,000 Gallon r • - Septic Tank PROPOSED INVERT : A-------------JTO 0. . -f _ ro. TOP El. IZY (Min.) Leaching Area EL. 16.6' � O O O O 770 GPD / 0. 74 = 1 IGas ti EL. 16.3 ryr y' O C L3 O C3 `� ,Q41 SF 2.000 Gal Flow EquR7izers rr O O O O O :r � Septic Tank Baffle.y As Required w ��� SF Required . H-20 t ---- �? : .,, 1 _got. El. 14.3' Leach chambers Sldewall — 287 SF 2x(12.83'+59')x2 T Bedding. ^T-s.Baffels'u•s. (6) 500 gallon Bottom Area =L 757 SF (12.83'x59 FOUNDATION ') BY - ; `- tr-2o 1,044 SF Total Provided �-a y as Per Title 5 m / s , i If Encountered Remove & Replace OTHERS All Unsuitable SoRis Wthin 5' of i�t 10' . The Outer Perimeter of The System {O' Leaching Chamber Min. Groan wat r ®f 2.5' Design 0' Peryf T'O.B� Meads Min. a All Pi es to be Schedule 40.. K0.29M33 Use �6)-500 Gal. Leaching Chambers CIVIL PROPOSED SEPTIC SYSTEM PROFILE In a Washed Stone Field as Shown. NOT TO SCALE F Check: (7,044 x 0. 74) = 773 gal SHEET TITLE PREPARED BY: PREPARED FOR: Septic System Upgrade Sullivan Engineering, Inc. CapeS u ry Peter W Evans DATE: DEC 23, 2005 1 2�f2 Plan At 2 I P.O. Box 659 7 Parker Road Oak St. Osterville MA 02655 Oster,Ule MA 02655 960 Main Street SCALE. As Noted (508) 428-3344/428-3115 fox (508) 420-3994 / 420-3995fax Barnstable (cotuit) Mass. :R copKsurevFev:RRL ecod.net Cvtuit MA 02635 so44 Droll:RRL K .lob f. c-615.1 PROJECT off: 25044 om .: r wm COm .:RRL TMK win 61 1 1 a I 12.8� 59' \ .� o � I v\ e F C 1 I \ d n to 2d1 a I I l Son ` I / 0-Boxtj \ 'ao QFTAII I too" c I I I 1 I I 1• = 20 - l I �Oecorar r a + A �Nvrt/H/F I \ o $w 1 I l \ � eabt�,Ttreet 1 Location Map: R 1 ► 1..=2,oast' - ASSESSORS REF.. Map 18, Parce1129-01 D a is I I / Ti �SeeoD i7 Above) Robert N -,l, / �2/ (6 So0 gallon s !mil , 1 I Exisfifig P7 2 Leach Chambers °pt O)y R/ OVERLAY DISTRICT. la�l II I , "/r Septic System 114th Stone 8 °ux I f I ► I Parcel A To a Removed / (t283'x59) /� AP - Aquifer Protection District As Shown on Plan Entitled 6 1 I / 7i "Revised Groundwater Protection 45,331fSF /�� 1283 a 9.0 \ Overlay Districts" - April, 1993 I2pP�r 888 se�dv la �� \ I I � `� I �. ISeptiic -tank/ �. 0 Min 1 m I v; I 226f / 11 Q m 1 i % I I / f 21 o aX� ;W A,� R �A" FLOOD ZONE: f 2 ty w/f 5t • +ss r� Fnd / Zone B. C & Ail(el.11) Dl�elling aim 17u, et J Community Panel No. I I o Z / \ \ \. r as Pro�7osed e / 2 J00 2, 1992 D . 1 I \0 3 /l� I 1 D CF " I I // �/ 1 Wood Dsec Nb ttn�gCk Ga�ge ` l / .� ZONE: RF Proposed Relocate hew ! ^ �° H 0F! t I a Addition o r Area (min.) 87,120 SF (RPOD) . I I I wood ao Fronts a (min) 20' I 1 I LJ- ----------L...-•-- -- -- -- -- -- -�- -- - Stairs - 3 PETE'� G Width gmin) 125' 15,sideywd sstb&k - -- -- - -- -- -- -- -- - -- - h Q� qj► ��" i -- �--- �`-_._._ // � i�. ZglV � Setbacks: 30' 1 I O o oh ClvtL Side 15' 3i3 es I 1 \ ( ce/1 ' Rear 15' Fnd ,�F \ Elizabeth M. Schm}�t \\ a I ` . � 1487YI37 1 � \ >;° 0 10 20 30 40 60 80 FEET 1 \ Scale: 1"=40' 1,00d 1 \ K 1 FEMA F Zone Lines \ \ D O as Shown on FIRM \ 1 N ' m 1 Panel d)2 50001 0021 D \ n~ \ l O I ,rev July 2\ '992 Z. \ PLAN DATE: December 23 2005 SHEET. TITLE PREPARED BY. PREPARED FOR: NOTES: 1.) The property line information shown was Septic System Upgrade compiled from available record information. Sullivan Engineering, Inc. CpeSu�/ Peter W Evans 2.) The existing structures shown were located by O f� P.O. Box 659 7 Parker Road �+y, CopeSury b an on-the-ground survey performed Plan At 21 Oak St. Osierville MA 02655 , C -villa MA 02655 960 Main S eet on or between 05/DEC/05 and 07�/05. (508) 428-3344/428-3115'fox (508) 420-3994 / 420-3995fox 3•) The new building footprint shown was provided by Barnstable, Mass. .• 25044 caPesurv�capecod.net ^^ww 6 c 4-) The Design. Cotwt Fi 'RR K R vi :RR LJL/tUtt MA 02635 the The topographic Ile GIS.information was provided by Drank:RR K Job C-615.1 the Town of Barnstable GIS. Om r win � � .Cam :RRI WHK r ,,;,, - PERC TESTS 11,192 NOTES - PERFORMED DY SULLIVAN ENG. Finish Grade - WITNESSED BY- DON DESMARAIS - - DEC 21.2003 9" Min III III 11113=1111 _ 1 L Water Supply For This Lot is Municipal Water. 3' MAX Filter TEST TE HOLE - 1 2, Location of Utilities Shown on This Plan Are Approx. —— RNES DEC Compacted Fill Fabric PERT EST •BY SULLIVAN ENG 21305 At Least 72 Hours Prior to Any Excavation For This 2" Min 0 LAYER DECOMPOSED D•-B LEAVES& TWIGS Project the Contractor Shall Make the Required 1/8"Poo t 1e Notification to Di Safe (1-888-344-7233) Poo St011@ A LAYER 10YR4/2 g -.•;. 22 B•-" °AMYSAND 3, The Contractor is Required to Secure Appropriate E LAYER 10YR5/3 a a ® a 01 1P-1 LOAMY SAND Permits From Town Agencies For Construction 3' 1 a 0. 01 a B LAYER 10YR3/6 17S Defined by This Plan, 13•-34 P LOAMY SAND 2, a o a o a ,, C LAYER 2.SY6/6 4, Install . Risers to Within 6' of Finished Grade, (5 Req,) 34__,6 MEDIUM SAND �g " - 1 1/2" 5, All Structures Buried => (3) Feet or Subject a o CO a a 3,4 Double Washed PERc hsT 23 GALLONS a`13"°` Slone REsuLr<214I14/0CH to Vehicular Traf f is to be• H-20 Loading, NO GROUNDWATER ENCOUNTERED 6, Septic System to be Installed in Accordance. With - 4'-10' TEST HOLE - 2 310 CMR 15.00 Latest Revision and the Town of PER1-°RHED.BY SULLIVAN ENG Barnstable Board of Health Regulations, 12'-10" DEC 2''Eon Barnstable All Piping to be Sch, 40 PVC. CROSS SECTION OF CHAMBER & TVM LEAVES 6 TWIG O LAYER S�D 0'-B . 8. Wherever Sewer Lines, Must Cross Water Supply - NOT TO SCALE 81-11 A LAYER 10YYRf4/2 Lines, Both Pipes Shall Be Constructed of Class 150 E LAYER IDYR5/3 Pressure Pipe And Shall Be Pressure Tested To . 11-13 LOANY SAND - Assure Watertightness B LAYER 10YR3/6 17•-34 LOAMY SAND_ _L - 9,,. The intent of this drawing is for securing C LAYER 2SAND 34_-120 MEDIUM SAND B❑H permits and is not for construction, irt� - Pc'R TEST GALLONS �RESUL 31I <IS"M T< N/p1[H NO GROUNDWATER ENCOUNTERED Design.- Data TOF EL. 21.0 Single Family - 7 Bedroom Daily Flow = 110 x 7 = 770 GPD F.G. EL_ 20.0• See Note 4 (typ.) ?: See Note 4 (typ.) F-G. EL. 20.3' See Note 4 (typ.) Septic Tank: 3. a D-sax 770 GPD x 2007. = 1,540 GPD ,,;...: H-20 Filter Fabric Use 2,000 Gallon Septic Tank -L_ J '? a z s'a_ Top El. 17.3 (Min.) s PROPOSED INVERT - _______-____ Leaching Area j 000 00 13 j EL. 16.3 r , ,- s•000 Gal I 1 Gas y s- c 0 0 0 0 � 770 GPD 0. 74 = 1,041 SF Baffle now EQuilizers 0 00 0 0 r SF Required Septic Tank H-20 ' Rot. El. 14.3 Side wall = 287 SF 2x(12.83'+59')X2- j Bedding. "T's, 'U's• Leach Chambers & eafels (6) 500 gallon Bottom Area 757 SF (12.83'x59') FOUNDA T10N x ;T`•r H-20 1 044 SF Total Provided -t ;,_ -�=.�,,;...,�. ..�:;-. �_; . �N as Per Titles aD , BY �.. If Encountered Remove & Replace OTHERS zt s° -••.�� ,.,..- � ' ..�,.�dd� All Unsuitable Soils Within 5 of 10• The Outer Perimeter f The e system Leaching Chamber Ch m r Min. Desi n " HQlF!{ � TGroundwater -M s _� 20 Per T.O.B. cw-Maps All Pipes to be Schedule 40. Min. P�� SULlivw"1 ' Use (6)-500 Gal. Leaching Chambers PROPOSED SEPTIC SYSTEM PROFILE � "� In a Washed Stone Field as Shown. � fgJ.297�: NOT TO.SCALE RAP >y Check: (1,044 x 0. 74) 773 gal SHEET TITLE PREPARED BY: '�PREPI FOR: . ///��� SeptlC System Upgrade Sullivan Engineering, Inc. CapeS u ry Peter W Evans DATE: DEC 23, 2005 2�f P.O. Box 659 7 Parker Road G Pion At 21 Oak St. Osterville MA 02655 Osterville MA 02655 960 Main Street. SCALE. AS Noted (508) 428-3344/428-3115 fox. (508) 420-3994 / 420-3995fox Barnstable, ccotult) Mass t capesurvOccpecod.net Cotwt MA 02635 • 25044 Oroft:RRL K Job P C-615.1 PROJECT iyF: 25044 Om .: r win C .:RRL K win 61 1 1