HomeMy WebLinkAbout0131 OCEAN VIEW AVENUE - Health 131 Ocean Vi
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LCO,'ATION d ®�t '`� �-/ ``' �'°�— SEWAGE # Z9,)
ILLAGE C ASSESSOR'S MAP & LOT
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INSTALLER'S NAME&PHONE NO. �-
SEPTIC TANK CAPACITY
LEACHING FACILITY: (ty�p ) CC �s y '� �°� (size)
NO.OF BEDROOMS
BUILDER OR OWNER OC EL- ✓J'&Ctt "cr.ALI
PERMTTDATE: V-2)- 02 COMPLIANCE DATE:
Separation Distance Between the:
M
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
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TOWINt OF BAFtNSTABLE
LOATION l �O, �A/� V l W AVf-. SEWAGE #
V L 'AGE C�V-,1 ASSESSOR'S MAP & LOT 39 06b
INSTALLER'S NAME&PHONE NO. -JQMe5 lX F'Oral �i,/S,O
SEPTIC TANK CAPACITY v� , ) O w
LEACHING FACILITY: (type) off=' CessP 0015 (size)
NO. OF BEDROOMS S
BUILDER OR OWNER rf!-1lcI S pit,ke,
PERMIT DATE:
Separation Distance Between the: % otyOS
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 faci� - Feet
Furnished by Cn ����
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No. ------ --- Fee----f-..&-----------
BOARD OF HEALTH
TOWN OF BARNSTABLE
0(pplication for Well Cootructioni3ermit
Application is
is hereby made for a permit to Construct ('V(Alter ( ), or Repair ( )an individual Well at:
W�l���• Location - Address V
Assessors Map nd Parcel
Crvl
-6wner— }C��j�2)�'I Nt-� ---Y Address — --- -
tFl --pv= --------------
_- ------Installer- Drille ---^ Address
Type of B 'lding- � �- c� Sc7 ®(ZI:Gs��{S
-� -�
�,_ Dwelling— _—_--.-- �`� � ' Ca
Ot er - Type of Building-=—.----_____ No. of Persons- T,�.
Type of Well nn L- Capacity---- - - --—- a- —
Purpose of Well----�
-0
Al
Agreement:
The undersigned agrees to install the aforedescribe individual well in accordance with he provi�ons df I he
Town of Barnstable Board of �iea r � Well otection Regulation - The undersigned furthers ees > to
place the well in operation unt Certif'cate.o ompliance has been issued by the Board of Health.
Signed - _._. ___ _ 3
date
Application Approved y a � ' i ea- �—__—___— 1 a-- .2 f
4 bqq DIFp M S 1 I0d`0 �/-S,4'70L date
Application Disapproved for the following reasons:
.. .—��-------^------------------ ---date --
Permit No. W ,_U0 Zf- 0 Issued---1 L-2 1-0 ----- -----------------
date
- - - - ---------------------------------------------- --- -- -------------------
BOARD OF HEALTH
TOWN OF BARNSTABLE
(Certificate Of (Compliance
THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( )
by--
at --
------------------------------------
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 SATISFACTORY.
DATE ------ _-- _ Inspector-----______.-_______________ ---�_----___-.
No. ----- ------ E Fee----F ----------
BOARD OF HEALTH
TOWN OF BARNSTABLE
2ppiicationArVeli Con0ructionPermit
Application is her
�efby�made for a permit to Construct (1/), Alter ( ), or Repair ( )an individual Well at:
• �V_ _�7. 3l�C lam— --ryA
.1-�? A11-
W Aelr — Location - Addtesy Assessors Map and Parcel
y��
'-Ow wr -• �OM Address
21D 2 PV-Q nl- 67-C t 2-+ - 'D -----------
Installer - Driller Address � � � S
x Type of B ilding- -73 -44 ' �CC >
( . Dwelling -- — r-7 ..
w^
Other - Type of Building-=-- No: of Persons----___--=.--
Type of Well I G� `TE2 M (.. "O p y—_-- -------- ---„ -f Y — P Ca acit
Purpose of Well.---�'-�-�
Agreement:
2
The undersigned agrees to install the aforedescnbe /individual well in accordance with the provigions ofzThe ,
Town of Barnstable Board,of Hea h'I'nvate Well Protection Regulation - The undersigne&further agrees not to
place the well in operation until Certificate o Compliance has been issued by the Board of Health.
Signed
— date —
Application Approved By � _—__—____ e I a - �2 1
' p D F/ V:� date
Application Disapproved for the following reasons:
date
Permit No. L'4 2 UO 0 3�-- — ---- Issued—La
date
s_________________________________,.___-----------__-__--------_-_____.___--__----------------------�----
BOARD OF HEALTH
TOWN OF BARNSTABLE
t Certificate ®f �om�Ciance
THIS IS TO CERTIFY, That the Individual Well Constructed ( ), Altered ( ), or Repaired ( )
by
Installer
at
---------------------------------------------------------------------
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 SATISFACTORY.
DATE -- _ _ Inspector
---------------------------------------------------------------------------------------------------- ----
BOARD OF HEALTH
TOWN OF BARNSTABLE
Ve[I Construction-permit
Nod 2 0oc1--0 Fee --_ Fee-
Permission is hereby grantedto Construct (Construct ( �), Alter ( ), or Repair ( ) an Individual Well at:
No. 1 3 I d r.2�. 1/i?t/ / n re/ --------- -_- -----------------------------------------------
Street
as shown on the application for a Well Construction Permit
No.--� 00�}-G Z 2_ ----- Dated-i 7 ! �-------------------------------------
� Q
DATE
?b 1/d Board of Health
1 — _ —
14 be/ w Ore04 m Opt wiw�r s A 6 00 (06U 104, 11
t!�i✓1 u����1 � o�{�r rPfl't/�'M�Siyl1 v��lef �'������.�e�,�Ps �t- GS�IP wellf
r, FDIC registration Barnstable 131 Oceanview Ave-Yahoo! Mail Page 1 of 2
A 1400V MAIL
Classic
UIC registration Barnstable 131 Oceanview Ave Friday, December 11, 2009 1:58 PM
From: "Cerutti,Joseph(DEP)" <Joseph.Cerutti s a .ma.us>
To: "David Jenkins" <djenkins70ta@yahoo.com>
Cc: health@town.barnstable.ma.us
Hi Heidi,
I'm writing to provide you with MassDEP Underground Injection Control(UIC)registration number
MAS41AO2021 I-5A701(the last character is the letter"I")for the installation of one open-loop ground source
heat pump(GSHP)return well at the private residence located at 131 Oceanview Ave., Cotuit. The ground-
loop portion of the GSHP system will consist of one dedicated supply well and one dedicated return well.
The well driller for this project will be Paul Jenkins&Sons.
The HVAC contractor for this project will be Tavano Mechanical Systems, LLC.
This approval is only for the installation of the GSHP return well and is not an approval for system start-up.
The installation of the supply well does not require MassDEP approval. Prior to receiving system start-up
approval MassDEP requires that groundwater laboratory analyses be completed and submitted to
MassDEP on a raw water sample collected from the supply well and a post heat pump sample analyzed for
coliform bacteria. See the Guidelines for Ground Source Heat Pump Wells for a list of the required laboratory
analytical work at the following web site http://www.mass.gov/dep/water/drinking/uic_htrn(3rd item on the main
column). You may submit the laboratory results in stages. For instance, you may wish to submit the raw
water analytical results prior to the installation of the heat pump equipment to make certain that the well water
is approvable as a groundwater discharge. If the raw water results are acceptable you could then install the
equipment and collect the post heat pump water sample for bacteria analysis.
The ground source heat pump system shall be installed with an automatic system shut-off device in the event
of significant pressure loss in the refrigerant system. The heat pump discharge to the well shall not contain
any chemical additives(i.e.water softening chemicals or corrosion inhibitors).
The GSHP system shall also be installed with automatic shut off controls in the event that the return well is at
risk of overflowing or pressurizing(as the potential result of long term build up of blockage of the well screen).
Once the installation is complete,the system designer shall complete one of the following:
• If the system was installed as designed,the system designer shall send a letter to MassDEP
UIC Program, 1 Winter Street, 5th Fl., Boston, MA 02108 indicating that the system was installed as
designed and shall submit a copy of the well completion report that was sent to the MassDEP Well
Driller Certification Program and local Board of Health(including latitude and longitude of the well
location).
• 1f the system was not installed as designed,the system designer shall submit a BRP
WS06e modification registration form with the above referenced UIC registration number, completing
only those parts of the form that were changed, including any revisions to attachments such as design
plans or specifications. A copy of the well completion report.that was sent to the MassDEP Well Driller
Certification Program and local Board of Health (including latitude and longitude of the well location)
shalt also be submitted.
I
Please be aware that the issuance of the above UIC registration number only indicates that MassDEP's
M UIC Program has received the information that we have requested. If you haven't already done so,you shall
http://us.mc594.mail.yahoo.com/me/showMessage?sMid=2&filterBy=&.rand=l 1420772... 12/14/2004%",
UIC registration Barnstable 131 Oceanview Ave-Yahoo! Mail Page 2 of 2
submit a copy of the application package submitted for this UIC registration to the local board of health. There
may be other local permits, ordinances, or regulations that apply, including but not limited to board of
health permits for well installations and Building Department regulations regarding trenching work. MassDEP
understands that the well will not be used as a source of drinking water. Please be aware that if the well is to
be used as a source of drinking water in the future it would require an approval from the local board of health.
The issuance of a UIC registration number by MassDEP does not supersede the requirements of any
other state or local regulatory entity.
This email has been copied to the local board of health.
Joe Cerutti
Hydrogeologist
MassDEP
1 Winter Street, 5th Floor
Boston, MA 02108
617 292-5859
fax 617 292-5696
httpalus.mc594.mail.yahoo.com/me/showMessage?sMid=2&fdterBy=&.rand=l 1420772... 12/14/2009
No. �0 ` „ Fee r
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer.
,
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS
Zipplication for Zigooaf *pgtem Conztruction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components
Location Address or Lot No. /3/ 4V& Owner's Name,Address and Tel.No. ®(6A,,j i!?15-u✓ Alro
Asses is UParcel;-? Z AQ12.C,5L,
Installer's Name,Address,and Tel.No.PWSrons Fit.anvil esigner's Name,Address and Tel.No. �1 L1��6"tJra4 F�'b Ste'1)Jv
17 O L?0/_ /7,2? 9 1 LI 1 'l_vc�usT 5'T._ itA-t.rM4007NN 02-5 Na
Type of Building:
Dwelling No.of Bedrooms Lot Size 2t?j sq.ft. Garbage Grinder( )
Other Type of Building No.of Persons Showers( ) Cafeteria( )
Other Fixtures �/
Design Flow �� gallons per day. Calculated daily flow � b d gallons.
Plan Date 7 7- Number of sheets Z_ Revision Date a`��—'—
Title
Size of Septic Tank op — 0 Type of S.A.S. ON At-Alz5eg' J00
Description of Soil 5 �d�t- ��-�✓''�� �/2 ��'/� �X2
Nature of Repairs or Alterations(Answer when applicable) l 12-4 0?f Or
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 the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been is y Elclard of-Health.
Signer 's Date
Application Approved by Date I — 27—U-7
Application Disapproved for the following reasons h1aTQ ^^0 a✓�+�i ., H r- T[d C rv� s;,2s3Ci-(�
Af.EC'� e IQVN vn d z C P /? vIG ?' r !A.',, �V t
Permit No._2 Date Issued 9-2 7 d 7 t
l { t-40
00
No. Q 'r i , 7 t +�cs , - Fee .-
+ : Entered in computer:
THE CO WE LxTH OF MASSACHUSETrTS
.' Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., Ma4SSACHUSETTS
A
2-ppYicatiou for i� o�aY. pgteut .�or�gtructior� errrYit
Application for a Permit to Construct( )Repair( Upgrade( )Abandon( ) *Complete System ❑Individual Components
Q� N���� Owner's Name,Address and Tel.No.Location Address or Lot No. /3/ 405 ��� pu���►/,j jv✓ A 16
Assessor's Map/Parcel +
Installer's Name,Address,and Tel.No. signer's'Naive,Address and Tel.No. FAL_Jkg6 t11�1 b� 1 lu
ZS$ I�ASr rzs� Qr v> � IW1 4ovuST ST.. r-qL�o� L
. OZ'S y
Unssf� z� n (saL�y 93� sv Li 5 S_ l Ulf
Type of Building:
Dwelling No.of Bedrooms -5—, . ,Lot Size 2`I'r 0&0 sq.ft. Garbage Grinder.( )
Other Type of Building �� '` No.of Persons Showers( ) ''Cafeteria( )
Other Fixtures
Design Flow �5 gallons per day. Calculated daily flow .��O gallons.
•
Plan Date 7 - Z-S - y Number of sheets 7— Revision Date "� C!--4 -0'?
Title T
Size of Septic Tank /16-dv �{` 0 Type of S.A.S. GN AM915QK 40 9 1 N
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) UPyr�01� 0' AW 11,a _r,`'S79y*-f
rY
Date last inspected:
4
Agreement: x-
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 the Environmental Code and not to place the system in operation until a Certifi-
cate of Compliance has been is e Bo d of H�eaalltt1h t „
Signe _ Ate " Date D
-._,Z.A lication-A , roved-b -�N 4h:. 5- i :Date; _ .
Application Disapproved for the following reasons _ xvdy/ to Jy vir�i�nr/�, O rl p. -�/r it RE/ _T10/c w . /Se2
, s3����
Al � TI ►> On 1,"T..n f�`�no f•P J. )D� d.DC {IG�O ,/D-PirC •.FF�((r��r+ o !iV i ♦r ,�. ire
Permit No. G0'7 Date Issued (/—7
^:.,.xa_,....:..s-.'r--...ems. ,-._-�,c-.,-._�:,�'_"•^xr.":rf ..,..::.w.s. _ "'-- j -4 ]G'sv" �-.1-�'....,.-:..-.::Sa.�. _
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS ,
(Certificate of Compliance _
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded( )
Aban_doned( )by Fos7� IC t A iM j7A)
at Aug rj=:tuN ' has been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 2cdl, dated / 7w-7
Installer 6X6A 111M PV Designer Mttf o 1 iznn x ja
The issuance of this permit sh 11 of e construed as a guarantee that the Ad
y to will functii`on a-a,, esignU U.
Date � � �� I Inspector ��t��JX / /:'U�J ;1� /(�tl,'d d✓ �
L
No. cw"7 u V Fee AA—
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS
Migpogal *pgtem Con5truction Permit
Permission is hereby granted to- llonstruct( )Repair( V)Upgrade( )Abandon( )
System located at 131 OCGArs1 y)F W A11f; . CjC..'T U�l-
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 tl�i &peertiul.
Date: t��"71 J 'ii —Approved b \f /i
Y
- L r f tp �J1
1�U� tU. f.1rAtd tnl, r {ncw^rU4'�LQ! td �C� �1�Csf u,y�! I v�7�[ o� /cvP✓S Yvv4iG�
dl fvcb c./! ✓Z f! i l ur 'u;.c{i fJ� Sri j tv r -/S 4faU-P F
OCT-18-2007 09:38 Falmouth Eng. , 506 495 3229 P.01i01
Town of Barnstable
Regulatory Services
I Thomas F. Geiler,Director
MAS& Public Health Division
s6gp.
a '+a Thomas McKean,Director
200 Main Street,Hyannis,MA 02601
Office: 508-862-4644 Fax: 508-790-6304
Installer&Designer Certification Farm
Date: Sewage Permit# 0 - H 3 ,assessor's Map\Farcel q/ z
Designer: iCXZ 4, L;7' 52V6 - Installer: Af5 400
Address: Address: R O 8 01 Z2 8
U."ivy
on e f ' a _ f7,g57 776 T;XCA✓ was issued a permit to install a
(date) (installer)
septic system at _QCG17R)►1 V 1T;w AVE based on a design drawly by
(address)
X:X)Wd a�q dated
(designer)
v - I certify that the septic system referenced above was installed substantially according to
the design, which may include minor approved changes such as lateral relocation of the
distribution box and/or septic tank.
I certify that.the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system) but in accordance with State &Local Regulations. Plan revision or
certified as-built by designer to follow.
MICHAEL J.
ORSELLI
B �
CIVIL
(Installer s' Signature) No 86054
signer's Signature) A esigner's Stamp Here)
PLEASE RETURN TO BARNSTAALE --PUBLIC HEALTU DIVISION. CEAZMCA'ITE OF
COKPLLANCE WU L NOT BE ISSUPD UNTIL BOTH TH5 FORM AND AS-AUMT CARD ARE
RECEIVED BY U—M BARNSTABL rUBLIC REALM AMSION. THANK YOU,
Q:Health/Septic/Designer Certification Form 3-26-04.doc
TOTAL P.01
Stanton, David
From: Stanton, David
Sent: Thursday, September 27, 2007 8:51 AM
To: Dudley, Brian (DEP)
Subject: Another septic question, risers under driveways
' Good morning Brian, t:
I have a question about septic tanks located under driveways. Obviously they have to be h-20, but is there a requirement .
in title V that they must have risers to grade? I know common sense would probably say yes, especially with paved
surface, but what about under a gravel driveway? I couldn't locate anything in Title V on it.
,t
Thanks,
David
r
1
No. '30 Fee ! UV
THE COMMONWEALTH OF MASSACHUSETTS,, Entered in computer:
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS
RpPlication for Mi.5pogal A*pgtem Qcon!6tructfon permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) XComplete System ❑Individual Components
Location Address or Lot No. G��A) VP SW �VG Owner's Name,Address and Tel.No. Z�� CJu:Fh,Li; u- A
Asses or's ap/Parcel , Z �=
✓Cil �. (7'i'✓l C
Installer's Name,Address,and Tel.No. C�4ti� �1 esigner's Name,Address and,Tel.No. i3ti-i-h6 �u�y y41 l•a'
- u
Type of Building:
Dwelling No.of Bedrooms Lot Size 20 d 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 7 7 - Number of sheets 7 Revision Date ' g9—a-�
Title
Size of Septic Tank '� 0 Type of S.A.S. rFl 14tAF��irL�;
Description of Soil C S Ot<= �f���J 1/•d l �� �X 2
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 is y B d of Health.
Signe ('C�Q i� Date - _d .
Application Approved by i 5-- - Date q — 9-7—U"7
Application Disapproved for the following reasons r-Sfo C WALiT,,253����
a
Permit No. �007 Date Issued . w9—2 7— e) 7�
7 .
THE COMMONWEALTH OF MASSACHUSETTS
i BARNSTABLE, MASSACHUSETTS
' Certfffcate,of Com-phance J
THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( 1)Upgraded
Abandoned( )by ne'r A
at 6�1 (�C}F��J 1F,t�..� =A1D=iS� l'�-1r1'�C>� - � has�been construct;iri ccordance �{ a
with the provisions of Title 5 and the for Disposal System Construction Permit No ��"�"" dated ¢I�` �7 v'��;� :, ,�,�
The issuance of this permit sh 1 not e construed as a guarantee that the yste, wI 1 unch n a�. sig 8 ��, u
j 1 / I // T
bate / �� f/� l Inspector �X
'��,� r .ue�t-, $.�� f�� �' '� �r i;�� a,' .3•F �� .,".�e ��.� t"t,.u: ��.,� .3 ,�,,;a�xL ,3 � � a
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,. •-,:.t ,. � .� � ,_r �cs•.z5 , �,�Y+ �"YM1 c a t- f;._"� F � , .Y.:3� � E*r����s,.�'.y � r `,"• fi,�.y'{,�r�y'�� '- 9
4
wv
TOWN OF BARNiSTABLE
Health Division — 200 Main Street - Hyannis, MA 02601
of the rod 1
FA
A
'
Date: D
BARNSTABLE, +«
y MASS. a
p 1639 ,�a, Number of pages including cover sheet:. a
D MPS A
aw
To From: SHARON CROCKER
Town of Barnstable
/ Health Division
Mail t6` 200 Main Street
Phone:�72 ,39Z— j , 5 Hyannis, MA 02601
Fax phone: !_. Q —9�� Phone: 508-862-4644
CC: u Fax phone: 508-790-6304
REMARKS: ❑ Urgent ❑ For your review ❑ Reply p y ASAP ❑ Please comment
�31 d� 6
r
Town of Barnstable l� _
�oft►tta roky
a�P o Department of Regulatory Services T�
•
BARN STAafE. Public Health Division Dale
� '
MASS. a
9c� 16.79. `pro 200 Main Street,Hyannis MA 02601
prE�MP't�
Fee Pd. 00
Date Scheduled l l
Soil Suitability Assessment fog° Seivaue Disvosal
Perfonned By: ���d /n//'��� Witnessed By: y-Nd✓I /1'Ya�Ql VL
LOCATION & GENERAL INFORMATION (-
Location Address 3 DU-0-n V Qt �-lfQ_ Owner's Name
131 Ocemtn View P..ecu- vw.R o►q'a3
t;,1J/� Address (0o &/t i /-hh'll D ,
Assessor's Map/Parcel: Q3-I' lapo Engineer's Name Ru(,YY1N,d4l tl1G�
NEW CONSTRUCTION REPAIR Telephone H '9-4
Land Use �w Slopes(%) b /0 Surface Stoics --4044
Distances from: Open Water Body 7/0-c:- It Possible Wet Arej?U V 11 Drinking Water Well tt
Drainage Way N ft Property Line 7 r t ft Other ft
SIM,TCII:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to.holes)
Parent material(geologic)pUTwIX AI Depth to Bedrock /yi4
cc Nv
Depth to Groundwater. Standing Water in Hole:,l�f�(JCOc,K/"i '' W I pin g from Pit Face
Estimated Seasonal High Groundwater 27 r V6,07'4
DETERMINATION FOR SEASONAL IIIGII WATER TABLE
Method Used:
to soil mottles:
th
Depth Observed standing in obs.(pole: in. Dc p in.
d
Depth to weeping from side of obs.hole: in. Groundwater Adjustment
Index Well H Reading Date: Index Well level Adj.factor Adj.Groundwater Level_
I
PERCOLATION TEST mate 9 6�6 Time /o=d
Observation pat r
Tinle at 9' _
Hole Al
3 r Time at 6"
Depth of Perc 3 -
Start Pre-soak Time a !41/1,0 A-6T Time(9"-6")
End Pre-soak +'
Rate Min./Inch 22
/ L
Site Suitability Assessment: Site Passed J Site Failed: Additional Testing Needed(Y/N)
Original: Public Healtlp Division Observation Hole Data To Be Completed on Back---------
***If percolation test is to be conducted within loo, of wetland,you must first notify the
Barnstable Conservation Division at least one(1)week prior to beginning.
Q:HEALTI-I/W P/PERCFORM
DEEP OBSERVATION MOLL LOG Bole#
Depth from Soil Horizon Soil Texture
Soil Color Soil Other
(USDA) (Mansell) Mottling (Structure,Stones,Boulders.
Surthca(In.) ravell_._.
Censlstenev °/af3 �
23�yZ
DEEP OBSERVATION HOLE LOG Hole# Z
Soil Other
Depth from Soil Horizon Soil Texture Soil
Mottling (Structure,Stones,Boulders.
Surface(in.) (USDA) ( ) Consistency.%Gravel
6
« yo voti ivy�s��
s'Y'/Cf U
DEEP OBSERVATION HOLE LOG Hole#Soil Other
Depth from Soil Horizon S(USDA) ( Munsellr Mottling (Structure,Stones,Boulders.
Surface(in.) (USDA) ( ) Consistences %Gravell
i
DEEP OBSERVATION HOLE LOG Hole#Soil ether
Depth from Soil Horizon Soil Texture Soil
Mottling (Structure,Stones,Boulders.
Surface(in.) (USDA) ( ) Consistency,°o Gravel
Flood Insurance Rate Mali
Above 500 year flood boundary No_ Yes
Within 500 year boundary No— Yes
Within 100 year flood boundary No '� Yes
Depth ofNaturall Occurrin Pervious Material 1 .
e
j
Does at least four feet ofnaturally occurring pervious material exist in all areas observed throughout th
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring pervious material?
Certificationination
I certify that on (date)I have passed the soil evals stwasxaerformed by me consistent with
Department of Enviromnental protection and that the above analy P
the required train' ,ex erfse nd experien described in 310 CMR 1.5.017.
Date �//3/O-7
Signature
Q:1-I GALTI-l/W P/PERCFORM
SENDER: COMPL IV COMPLETE THIS SECTION ON DELIVERY
■ Complete items 1,2,and 3.Also complete A. Sig ature
item 4 if Restricted Delivery is desired. X ❑Agent
■ Print your name and address on the reverse t ❑Addressee
so that we can return the Card to you. Received by�rinted Name) C. Date of Delivery
■ Attach this card to the back of the mailpiece, _
or on the front if space permits. t do
D. Is delivery address different from item 1? ❑Yes
1. Article Addressed to: If YES,enter delivery address below: ❑ No
Leslie Fran"is &
Victoria Pic'lcering
16OO'Michigan Avenue � 3. Servi*Type
Sa1T Lake ( 1Ty, U7 $41 US ! rtrfied Mail ❑ Express Mail
' ❑VRegistered ❑ Return Receipt for Merchandise
— ❑ Insured Mail ❑C.O.D.
4. Restricted Delivery?(Extra Fee) ❑Yes
2. Article Number
(Transfer.from service label 1) �� 1 L7 D 00 )3 C?Sl 9 o i�E7 t lio `8
(r ) T
PS Form 3811,August 2001 Domestic Return Receipt sss-o - -15401
'�; 1
UNITED STATES POSTAL SERVICE First-Class Mail
o Postage&Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4 in this box •
PUBLIC HEALTH DIVISION
TOWN OF BARNSTABLE
200 MAIN STREET
H." f,]NIS, MASS ACHUSETTS 02601
Q 4 lllfij.tiif�l�ijl lfllfjjild!j'ffillilhiIl lflijjftllltidfifl
A, .,.
rl OF ,..
O
O Postage $ n rC,A Q2�
Er
LrI Certified Fee
Co J ! Postmark`
Return Receipt Fee
R7 (Endorsement Required)
a O Restricted Delivery Fee W
M (Endorsement Required) h
O Total Postage a Fees
.A S ntTO
. F'r�src 5 eke� �J ..................
------------------------- ----------------
S r t,Apt.No.;or PO ox No.
I C3 1 Do 'e-----'(7�a r
p C'State,ZIP+4 �/� �O C"";
a#'�a�e tf
I g .
Certified Mail Provides:
a A mailing receipt
o A Unique identifier for your mailpiece
o A signature upon delivery
o A record of delivery kept by the Postal Service for two years
Important Reminders:
o Certified Mail may ONLY be combined with First-Class Mail or Priority-Mail.
o Certified Mail is not available for any class of international mail.
n NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For
valuables,please consider Insured or Registered Mail.
c For an additional fee,a Return Receipt may be requested to provide proof of
delivery.To obtain Return Receipt service,please complete and attach a Return
Receipt(PS Form 3811)to the article and add applicable postage to cover the
fee.Endorse mailpiece `Return Receipt Requested".To receive a fee waiver for
a duplicate return receipt,a USPS postmark on your Certified Mail receipt is
required.
o For an additional fee, delivery may be restricted to the addressee or
addressee's authorized agent.Advise the clerk or mark the mailpiece with the
endorsement"Restricted Delivery".
o If a postmark on the Certified Mail receipt is desired,please present the arti-
cle at the post office for postmarking. If a postmark on the Certified Mail
receipt is not needed,detach and affix label with postage and mail.
IMPORTANT:Save this receipt and present it'when making an inquiry.
PS Form 3800,May 2000(Reverse) 102595-99-M-2087
COMMONWEALTH OF MASSACHUSETTS
EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMVNTS,
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A =
CERTIFICATION {
C) CO
Property Address: 131 Ocean View Avenue
Cotuit. MA 02635 t
Owner's Name: Leslie Francis& Victoria Pickering ;
Owner's Address: 1600 Michigan Avenue m
Salt Lake City, UT 84105 rn
Date of Inspection: July 27, 2005
Name of Inspector: (Please Print) James M. Ford
Company Name: James M. Ford
Mailing Address: P.O.Box 49
Osterville,MA 02655-0049
Telephone Number: (508) 862-9400
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:
Passes
Conditionally Passes
Needs YTrther Evaluation by the Local Approving Authority
✓ Fails
Inspector's Signature: Date: Aurtust 2, 2005
The system inspector shall sub 't 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 1.0,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP. The original should be sent to the system owner and copies sent to the buyer,if applicable, and the approving
authority.
Notes and Comments
****This report only describes conditions at the time of inspection and under the conditions of use at that
time. This inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 page I
Page 2 of 11
5
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 131 Ocean View Avenue
Cotuit, MA
Owner: Leslie Francis& Victoria Pickering
Date of Inspection: July 2.7, 2005
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:
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 over 20 years old* or the septic tank(whether metal or not)is structurally
unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the
existing tank is replaced with a complying septic tank as approved by the Board of Health.
*A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with
approval of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will
pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
2
4
Page 3 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 131 Ocean View Avenue
Cotuit. MA
Owner: Leslie Francis& Victoria Pickering
Date of Inspection: July 27, 2005
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 CNVIR 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 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,perfonmed at a DEP 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
Page 4 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 131 Ocean View Avenue
Cotuit, MA
Owner: Leslie Francis& Victoria Pickering
Date of Inspection: July 27. 2005
D. System Failure Criteria applicable to all systems:
You must indicate either"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'/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,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 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.]
Yes (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 System:
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 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.
4
Page 5 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 131 Ocean New Avenue
Cotuit, MA
Owner: Leslie Francis& Victoria Pickering
Date of Inspection: July 27, 2005
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?
n/a 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:
Yes No
✓ _ Existing information. For example,a plan at the Board of Health.
✓ _ Detenmined 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: 131 Ocean View,4venue
Cotuit, MA
Owner: Leslie Francis& Victoria Pickering
Date of Inspection: July 27. 2005
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): n/a Number of bedrooms(actual): 5
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550
Number of current residents: 0
Does residence have a garbage grinder(yes or no): n/a
Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required]
Laundry system inspected(yes or no): No
Seasonal use(yes or no): n/a
Water meter readings, if available(last 2 years usage(gpd)): Unavailable
Sump Pump(yes or no): No
Last date of occupancy: Unknown
COMMERCIAL/INDUSTRIAL "
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):
Industrial waste holding tank present(yes 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: Unavailable
Was system pumped as part of the inspection(yes or no): No
If yes,volume pumped: _gallons--How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
✓(2) 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)
Tight Tank Attach a copy of the DEP approval
Other(describe):
Approximate age of all components,date installed(if known)and source of information:
Date of installation unknown-no information available
Were sewage odors detected when arriving at the site(yes or no): No
6
Page 7 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 131 Ocean View Avenue
Cotuit, MA
Owner: Leslie Francis& Victoria Pickering
Date of Inspection: July 27, 2003
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 TANK: ✓ (locate on site plan)
Depth below grade: Tank A -20": Tank B-S"
Material of construction: ✓ 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: Both tanks- 1000 gal. H-10
Sludge depth: Both tanks-2"
Distance from top of sludge to bottom of outlet tee or baffle: Both tanks-30"
Scum thickness: Tank A-2": Tank B- I"
Distance from top of scum to top of outlet tee or baffle: Both tanks-6"
Distance from bottom of scum to bottom of outlet tee or baffle: Both tanks- 10"
How were dimensions determined: Both tanks-measurinz stick
Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence of leakage,etc.):
Both of the tanks were under a dirt driveway and were H-10 loading. Both of the tanks need to be made H-20 loading.
GREASE TRAP: None (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 11
OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 131 Ocean View Avenue
Cotuit, MA
Owner: Leslie Francis& Victoria Pickering
Date of Inspection: July 27, 2005
TIGHT or HOLDING TANK: None (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/day
Alarm present(yes or no):
Alarm level: Alarm in working order(yes or no):
Date of last pumping:
Comments(condition of alarm and float switches,etc.):
DISTRIBUTION BOX: ✓-(System B) (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: Even
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.):
The liquid level was even.
PUMP CHAMBER: None (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no)
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
8
' Page 9 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 131 Ocean View.4venue
Cotuit, MA
Owner: Leslie Francis& Victoria Pickering
Date of Inspection: July 27, 2005
SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits,number:
leaching chambers,number:
leaching galleries,number:
leaching trenches,number,length:
leaching fields,number,dimensions:
✓ overflow cesspool,number: . 2
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.):
The cesspool in System A was 5'W x Y T and had 4'o f liquid on the bottom. Solids were present. Part of the cesspool was under
a dirt driveway There were sins ofpast failure. The cesspool in System B was 4'W x 2'T and was dry. The cesspool was too
small and there was not enough reserve. Both cesspool covers were within 2"of grade.
CESSPOOLS: None (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 or no):
Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.):
PRIVY: None(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 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 131 Ocean View Avenue.
Cotuit. MA
Owner: Leslie Francis& Victoria Pickering
Date of Inspection: July 27, 2003
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 100 feet. Locate w"here public water supply enters the building.
-
T �0
3 a9 3o a
yl Ya
q boor
O Sy:non Q
3 A _
a
T ,
GrAve-1 t�cwt
' 0(-W V1 Gw AVE.
10
Page 11 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 131 Ocean View Avenue
Cotuit. MA
Owner: Leslie Francis& Victoria Pickering
Date of Inspection: July 27 2005
SITE EXAM
Slope
Surface water
Check cellar
Shallow wells
Estimated depth to ground water 20+/- feet
Please indicate(check)all methods used to determine the high ground water elevation:
Obtained from system design plans on record-If checked,date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
✓ Checked with local Board of Health-explain: topographic and water contours maps
Checked with local excavators, installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you established the high ground water elevation:
Using Barnstable topographic and water contours maps the maps were showing approximately 20'+/-to ground water at this
site.
This report has been prepared and the system inspected and failed as of the date of inspection. This report is
not a warranty or guarantee that the system will function properly in the future. There have been no warranties
or guarantees, either expressed, written or implied,relating to the system, the inspection and/or this report.
11
t a�
No.......!j �....... 't Fims...�:-..............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD ® �HEATH........ OF.......... ....................
Appliration for ]isposal Vorko Tonotrurtion Errant
Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal
System at: �Q &4-j
.•. • •. . ... ..... .. .............................................................
.._ . Loca' n s or Lot-No.
.. -
....._.. -
Owner Address
a ..................................... ................................... ----•-.....................................
er Address
Type of Buildi Size Lot............................Sq. feet
Dwelling No. of Bedrooms............ .. . ...................Expansion Attic ( ) Garbage Grinder ( )
Other ' Type of Building - No. of persons............................ Showers — Cafeteria
aOther fixtures ......................................................
Design Flow....................... gallons per person per day. Total daily flow.._.............. T-__gallons.
Wd---•----g P P P Y Y. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter.................Depth.............._.
x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
PercolationTest Results Performed by................................................................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
Test Pit No. 2................miuutes per inch Depth of Test Pit.................... Depth to ground water........................
•-------------------------------------•-••----------..........-•-------•----•----•----...-----.....•.........................................................
0 Description of Soil......................................................................-•--------------------------------------•--------------------------------------------------------
W -•-•-----------•-------•••••--.....--•••-•---•-----•--••••-••---------•----••..........-•----...... ------- ---- ---- ------ -----------------
VNature of Repairs or Alterations Answe when applica le. ....y ... ......... -- -- __ ..... __._..:,Irl
........................... `'• .... ..... 5- ✓Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage D' ; osal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has bSF issued by Yie board of health.
Aign�e ...X.......
�n ----------/------------------ D to
Application Approved BY--.. :.. . ..-- -- --------------------------------
�r�� = - 1`� 7 'c?�
Application Disapproved for the following reasons:......................................................
---•............................. Date--•-----......
•----••-•--------•--.....---••--•--........--••----------------------------------••-----•---•-------.......-------•---.......------------............--•---•-- �....... ----------•---
Date
Permit No......................................................... Issued------ .= - `
Date
---— ................� ----n
IVo. ................
-. .....
r" THE COMMONWEALTH OF MASSACHUSETTS
BOARD Q H gip,� ....��„�
.------ .OF......... � ....
Appli.ration for Moposat Works Tonstrurti n Prrutit
Application is hereby made for a Permit to Construct ( ) or.Repair an Individual Sewage Disposal
System at:
j� f
:............ Cad :�*'�:� +� .. f !'�✓.. � Y ..... L..:1F1..�.....t��r� .. ...........
...........
Loca' n-Ad s or Lot No.
•• .. ..t..... /� .............................................................
Owner Address
W _..+....................................... .........................
aller
Address
Type of Buildi Size Lot............................Sq. feet
:No. of Bedrooms._______Dwelling Expansion Attic ( ) Garbage Grinder
aOther . Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures --........................................----•••--••-•--••--------------••-•-----
Design Flow:.___________________ ""'rt__.____.gallons per person per day. Total daily flow .-
.. .............gallons.
Septic Tank-Liquid capacity.___.:__.__gallons Length................ Width---------------- Diameter____._.._______. Depth..................
Disposal Trench—No.____:_______________ Width:____:__________:_. Total Length:;.__.____.____.__._Total leaching area....................sq. ft. .
Seepage Pit No............ Diameter........_._.......... Depth below inlet......................Total leaching area..................sq. ft.
Zj,` Other Distribution box (., ) Dosing tank ( )
Percolation Test Results Performed by •------ -•-•------------------••-•-••---•-_-• -•-•••-•----••-•-•-•- Date-------------- •------• •••• -
aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
fi, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
a •-••------•---••-------•-----•---•-•-•-•-•-•-•••----.................................................................................................-.......
0 Description of Soil................................................................................................................................... ................................
U -••---•---•-•--------•-----•-••--••--•-....---•.............•-•••--•••---••--•-•-------:_._...-•••• •-. = ......• .....................................................
W ----------------------- - r `
V Nature of Repairs or Alterations Answ,eT when applica _:. __: __�__._. __:_
Ej / �+s
Agreement: M.,....,..(The undersigned agrees to install the aforedescribed Individual Sewagei posal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to.,place the system in
operation until a Certificate of Compliance has befa issued by e board of health.
Ddte
Application Approved BY ------- -�-` L --------,.� -- /�� �`:} %
Application:Disapproved for the following reasons:---_•----------------------............. ._.......................................................
.-.,f.
Date
• s
PermitNo.......................................................... Issued.........................................................
si Date
THE COMMONWEALTH OF MASSACHUSETTS -
p
BOARD OF EALTH
j`.#e-Z.. ............OF.......... ::. ,. r'' .........................:.
Trrtif iratr of Totttp.lia, na
TH JITO C TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( )
by.. - ••-•••--•-•-•------•-----
t taller
04
has been installed inAcor ance with the pro sions of Article XI of The State Sanitary bode s de ribed m the
application for Disposal Works Construction Permit'No....'_____ __:__,_ dated..___:_-s_ �__ D .._.........
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUD AS A GUARANTEE THAT THE
SYSTEM WILL FUNC ION SAT SFACTO Y.
DATE - .: -.... ..... - -- -------------
--------- Inspector.............. ...............
THE COMMONWEALTH OF MASSACHUSETTS
BOARD 017 HEALTH
t. ........OF..... l .......................
...................
No....4...�.__......__ FEE. ...... ..........
Dispo r� Ott $r #i tt .rrutti#
Permission is hereby granted...... -., ........ . ._ ....... ------------/1------------------------------
........
to Co str ct ( ) o Rai r an Individual ewagr? Dis /System a- /
at No.
Street ./
as shown on the application for Disposal orks Construction P No _ .._. ___ ated___, ..L...............
Lr ,'`�`
r r Board of Health
DATE.... .
FORM 1955 oBBS & WARREN; INC.. PUBLISHERS ,�
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D 131 ocEAN-VIEW AVE. COTUIT BAYSIDE BUILDINGS INC.
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S BAYBERRY SQUARE, CENTERVILLE, MA:02632
_, PLAN PHONE: 508-771.1040 FAX: 508.77"155
FBARNS
TREET TUI
PR03ECT
LOCATION
131 OCEAN
TABLE VIEW AVENUE
colur
ol
m
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PARCEL 45
a #71 OCEAN VIEW AVENUE
i RECENTLY INSTALLED N/F LOCUS
BENCHMARK: 2it3/DH SEPTIC SYSTEM KATHLEEN S. CRAWFORD, NOT TO SCALE
TOP OF HYDRANT �4fIFOUND TRUSTEE
EL 38.12 CA H 14 �4.1 CB H
AIN � 32.3
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pg -8-- THE _Vr
' CATg r I�i�CEDARS 1• 31.5 / w A��4t LOCUST 66 6. W 22" #71 OCEAN VIEW AVENUE
BASIN ?133.8 30.7 ArW �� : ?,ems,,. 1 18 W W W LOCUSAboT
f0A 32. A ��c-�,� 31.6/ 26 5 {W lJ�' l MAPLE '�`W W W W KATHLEEN S CRAWFORD,
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SUMMARY OF MITIGATION
Tg
AFTER REDEVELOP E . ,.
- s/18/o9 RE1nSE NOTE FoR F� m GRASS.
1. AREA Oc'1 Fa00_ �D 1&RZ??lf6t1S Mfr4lQW l#17111$'112'6f-lff M4lVO RE,S6VRi T AREA = .Z 42,f SA_ 5/28/09 MICREASE AREAS OF UI�OWED GRASSES AND UPDATE SUIrtYARY OF II�TIGAitON 1rifEASURES.
5/1/09 REMSE MITIGATION PLANTINGS AND NOTES.
2. AREA Or E.VS17NG GUPERGIG�1S W,09aY lHTf11N 100'GYM"#f£Tl.i i nL:::6VIfGE AREA TO 9E'fzwopED = 4w SF
4/9/09 ADD TOPOMMW WORMA110K ADD W SWIOUS SURFACE NOTES AND UPDA•IE 1riZ=710N PLAN7NM
J /NG/PEA,9-Or 100,9Nfa/S_WfXXac3'N1711IN 1Gb'a"!f -7LAN0 if.':cS:.V/ii'ZE AREA = 1,9&7,SF. - DATE -: REVISION
4( AREA AFA//AYX176WPYAN17NGs'AN0 UN110AIE0 GRASS' l_al1/�7 5,-?./9.�f PLOT PLAN OF PROPOSED RE-DEVELOPMENT
5 W W . W . . AREA a71a17cA17aV a4V17NGS' _ JaV.SF. FOR #131 OCEANVIEW AVENUE
i W . - PREPARED FOR
GENERAL NOTES. ,o- _ BAYSIDE BUILDING, INC.
6. A2Ef Orf7EZO GRASS 0 6E410AV_ 1NfCEPEl1 Sc��G�, 2.900 ,Sf.
COTUIT MA
1. HOUSE NUMBER: 131 7. TOTAL AREA 6FPRGIOO,SO 017GAllOV IL41VIPYa AN0 UN41Olf�.7 a"'F SS PRO{ W = ,f950,S/ PLAN DATE: MARCH 18, 2009 PLAN SCALE: 1" = 20'
2. ASSESSOR'S NUMBER: MAP 34, PARCEL 60 �tN OF CIVIL ENGINEERING L M o WEII.ANDs PERMITi1NG
up
3. ZONING DISTRICT' RF L
WASTEWATER DESIGN y" � COASTAL ENGINEERING
4. FLOOD HAZARD ZONES: C, B & A13 (EI-12) F~` o y i1TLE s PLOT PLANS or` PIERS AND DOCKS
5. TOPOGRAPHIC INFORMATION COMPILED FROM AN ON THE GROUND SURVEY. JISM
eP�' � INEERI�
20 0 10 20 40 LAND USE PLANNING COiIUtERCIAI/R�SiDENIIAL
6. ELEVATIONS SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM.
Se-mg c4" Cad and Sa ffiv l*" ,!/�ilAwas
SCALE: 1 INCH = 20 FEET 141 LOCUST ST. UNIT A - FALMOUTH. MA - 02540 - 508.495.1225 - ,503.495.3229 fax
PROJECT NUMBER: 09023 AD FILE NAME: 09023LS DRAWN BY: LM.,D.H.M. SHEET 2 OF 2
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SCHOOL STREET OTUI
• � I PROJECT
LOCATION
131 OCEAN
ts.
BARNSTABLE VIEW AVENUE
...... ./ co71/IT
/ BAY
1 /•
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i
_.. PARCEL 45
#71 OCEAN VIEW AVENUE
m RECENTLY INSTALLED N/F LOCUS
BENCHMARK: SB/DH SEPTIC SYSTEM KATHLEEN S. CRAWFORD, NOT TO SCALE
- TOP OF HYDRANT 4 .;, FOUND
EL 38.12 .,.I TRUSTEE
CA H - CB/DH
A IN 321.3 FOUND
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' PARCEL 45
_-s- -TREE 1 OCEAN VIEW AVENUE
CAT H � CEDARS 9. ;1.5 -/ -•, � .` , ��. LOCUST 66� -- 6«
BA INC SU./ � � .. . + }• LOCUST I
�as.sV % �; . � \ wAu m� � "'� � 18" � N F
GA / N R/ 31.6/ R okm Ar MAPLE Y. • • • • • �\;
SERVI�E� �"WA _ _ r s� sr,� oe . . .�. ` . . .12 r o\ KATHLEEN S. CRAWFOM
_ �6 \
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STGWE WALL � �. ,� �, BIgCH,� ry
CATCH / - - - _ _ I trig : o.:, BERE//OtfD,� 6" TREE IDLE 4i . 6'' \
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.� 6., 8.• . TREE �-: . . . . . . .4 . S"9S,44aT fAZF 7Z9 aW0Pi Y417aV Sl'*' DETAILED
o GI/t1V o ,i TING , EZ - Ma F EE • W . . . . .8". . \ y_` LAND.Si:4PYVC PLAN.9�IALL BE.SY/Q!//J7ED AND ARIWk D 717
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: ::.:::'�+•_ _ W \ GI STALL 4 17a V REfE R 17 a 1 "ZNC UST A 7 7,4 N077ar0W TO
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GARDENS �*�•<' mQ '.:::/..:.::/ 0
& 6, PER SEASaV
oos O 7s o, a/n FAULT'."� !:: " z? 1:':':::':::_::.. :: 0 v202
._
01341
t+- \ �` Ns4 -.•, ::: �. �.,Z.� �A04
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\�` J 68 42•�t, S - lQ O\ 1Rcr{/A/N \ N 6352 O ,I,.
36 £X/S 8 \ d0 AO[�/ljON_ :::::'::
�/ o - , .SE%4SYiV : : : : ...i.f... BORDERING\ \ Nc ,o •��s L ;T A \ \ \ \ \� t o 11
\ \ \ :::::::: VEGETATED
w S.F. ::' o o \ \ WETLANDSTONE" WgLL
c.� Y36,887± o .
o \ \ Jill-,
'il�` 0 O
w - FORMER'_LOT NNE \ E.t7SANG :::':: :::'I�/l REV54INS 0
r. -�-- --- --�- \ 16\ OF {fCETAAAY �: } i � 59TOHAlf \ O
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O \\ \\ \c AREA ( \ �� x \29.6
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93.14 i \� �s DE9QV Bl�OAIERS \ �' \ y \ ` V104
I LOT B \\\� \ // \ I T`B1 \\ \\ \ \ \ \\ ��o�odL
�\ \
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cp
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EXISTING
w \ \ GU \ \ \ \ \ \ \\ --� �7
HOUSE \ \.l: \\ \2A� \\\\ \\ 14'" -APLE\��`• ��.� `__-J' •----•� 0• ,
F \ \ \ \\ A13 (EL.12
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I •. `DOUBLE TREE LOT <� \
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1.6f ACE < ` `�•\; \\ \\ ---2� OAK __ ------------_14
24" MAPLE
I
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i fir•
SUMMARY OF M111GATION MEASURES
AFTER REDEVELOPMENT:
6 18/09 REVISE NOTE FOR FIELD GRASS.
I �� ; ��' AREA OF PROPOSED/rLfPEf W0Z1S SURFACES `f1Tf//N 10d OF-hfM4NO RESOURCE AREA = 2,425 S.F.
5/28/09 INCREASE AREAS OF UMOWED GRASSES AND UPDATE SUMMARY OF MITIGATION MEASURES.
7 5/1/09 REVISE MITIGATION PLANTINGS AND NOTES.
2. AREA 07 ZX/STING'109Y,RY/011.9 S11if1X S' ` 7NIN 100'OF HET,4NO ,?SOURCE"AREA TO BE REtifOI/EO = 4.oj SF.
4/9/09 ADD TOPOGRAPHIC INFORMATION, ADD IMPERMOUS SURFACE NOTES AND UPDATE MITIGATION PLANTINGS.
J INCREASE 0Y /4IRZIf OtIS SURFACES fYITf/IN 100'OF hf71AN,9 RZ r,11?CZ AREA = 1,98.E S.F. DATE REVISION
EA 6F411TCA77ON RMNNSN !NIMO CRASS EU1OEAR PLOT PLAN OF PROPOSED RE-DEVELOPMENT
s . " . W . ` . AREA 0/_&1rlcanON PLANTINCS J,950 SF !PRFOR #131 0 EPARED i OR AVENUE
. .
BAYSIDE BUILDING, INC.
GENERAL NOTES: IN -
AREA 0/F/EL0 GRASS TO BE'� 0#0 MrZ_PER 2;�,50N = 2.900 SF. COTU I T MA
Y ' 1. HOUSE NUMBER: 131 PLAN DATE: MARCH 18, 2009 PLAN SCALE: 1" = 20'
7TOTAL AREA 0/ PROPOSED 411=4170N PLANT7NGS AND UN11M O C,•?ASS P1f0WM,0 = 5,950 S.F.
iy 2. ASSESSOR'S NUMBER: MAP 34, PARCEL 60 CIVIL ENGINEERING WETLANDS PERMITTING
3. ZONING DISTRICT: RF P' _
WASTEWATER DESIGN COASTAL ENGINEERING
4. FLOOD HAZARD ZONES: C, B A13 (EL.12)
TITLE 5 PLOT P_ ' *IS PIERS AND DOCKS
5. TOPOGRAPHIC INFORMATION i 'II..ED FROM AN ON THE GROUND SURVEY. NEE 1Z
20 0 10 20 40 LAND USE F'' I,N� COMMERCIAL/RESIDENTIAL
6. ELEVATIONS SHOWN ARE BASE[ J.v NATIONAL GEODETIC VERTICAL DATUM.
Serving Cope Cod and Southeastern Massachusetts
SCALE: 1 INCH = 20 FEET 141 LOCUST ST. A - FALMOUTH, MA - 02540 508.495.1225 - 508.495.3229 fax
PROJECT NUMBER: 73 CAD FILE NAME: 09023L] DRAWN BY: L.M.,D.H.M. SHEET 2 OF 2
SC STREET OTUI
PRO CT
I JE
LOCATION
131 OCEAN
BARNSTABLE VIEW AVENUE
- ...�CDTU/r
BAY
R PRGIDOMV (!J 500 CALZOV \N
N MAA/BERS Of)W •f MN /
w
� BENCHMARK: SB/DH S7L71�E
TOP OF HYDRANT 34.4 FOUND y°APPROXIMATE LOCATION PARC`E! 45
EL 38.12 CATCH 4.1 OF EXISTING SEPTIC SYSTEM 131 CLEAN Vfi W AVENUE
BASIN - 32.3 PU PORYANO REMOW N LOCUS
30.6 31.3 0 s� *6 N JOHN H. PICKERF14G, TRUSTEE NOT To SCALE
Z C RS N � 5 Tpp. PUMP DRY AND REA/Ol�
W C7r 0_ _ 0.4`�1 IP 11S pp. F EA SANG SrP71C r4NKS (2) FOUND
6' H Y HED
CAT� \ 33.1 SH D / 1
1.5
BA I 133CmARS 30.7
GA PRU°C.SxD l I �,\N�
SERVI '
3 O 1500 G 26.5 7474
00
J po• PAN
Ip - - ---r�, O K N � £ GN
FOUND I I I LOT 3 #71 OCEAN VIEW AVENUE
/ 17 I EXISTING GRAVEL / pRIVE � ,� ti f N /v
i
,s.4 , o• _ 41,306f S.F. N
CATCH �� -�--- ___ / 3 1 �� LOT �° 1 16.9 15. 66'399 KATHLEEN S. CRAWFORD,
BASIN / , 54.9 _.�, B R 2 ,060f/ S.F. co / --_
i N TRUSTEE
l 7 _ -
!� \ ,� DECK
EXISTING 1 1 I -
o N -
$ HOUSE G / / / 5.7 V101 y
o wAr�� g\ SERl�CE F.F. EL. 3625
1 BASIiI
-
4� / 11' CATCH ` GUTER _ 0?l �IL�.
PA'�O 29.6 / BASIN / 20. .+ / I / 0 \�H
a 1 22.0 2016 1 o �ill� �illc /N
f 1 \ 21.9 1 , 0
o \
�30.2 \ 6� N �\ 1 CON ETE iy / V202
LAWNAREA 0"
1 \ \ \ \ \ o�
36J £k/S� \ STONE o�0 1 \ \ \ \ \ \ \ G BORDERING
3 `\ NG �0000 \ \ \ \ \ , j �, V103 VEGETATED moo
1 \ \ \ \ \ pE X \ °� \ \ WETLANID O STONE WA
LL
C \ \ I 0
W _ N88'02'00~w \ + x pF \� \ \ 1 I \ I \ o
/ \\ �\ c \ 219.04' 32.3 \ / I I ` 0 O MAN-MXOF
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LAWN . 31.8 \ 1 I I ILL � q
\
• O � \\\•\\• �,C AREA I \ 29.6 ' \ \ \ 1\ 21.2 17.5 \ �
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\ \ '
• 9314 I \�\ �3,__\.. \� I � • /,/ \\ \\ \ �� \\ \ ` V104
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\ 28" MAPLE
� EXISTING `\ \\ \\ �� \\ \\
\\ 32" TREE 1\ GUEST \ \ \� \\\ \\ \�14" MRR E \� 24 - 1 /�/ \7O.
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\\ DOUBLE TREE -
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1.6f ACRES
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LO
C0 �, GENERAL NOTES:
0
30.7 � 32.3
40 29.6 40 28.7 1. HOUSE NUMBER: 131
40 TOP OF D.E.P. COASTAL BANK
22.0 8.6 do TOP OF BARNSTABLE 2. ASSESSOR'S NUMBER: MAP 34, PARCEL 60
TOP OF D.E.F. TOP OF D.E.P. Q 1 COASTAL BANK
30 6.2
1 16.9 COASTAL BANK 30 5.3
1 18,8 COASTAL BANK 30
15.9
8.7 -- TOP OF BARNSTABLE 5.6 3. ZONING DISTRICT: RF
8.9 - TOW OF
CONSERVATION COMMISSION 1 BARNSTABLE COASTAL 3.8 4. FLOOD HAZARD ZONES: C, B & A13 EL.12
20 COASTAL BANK 20 BANK 20 Q 1 7.5
6.1 PER ARTICLE 27 5.6
FLOOD HAZARD ZONE A13 EL 12) 1 Q 1 FLOOD HA ARD ZONE A13 EL 12) �1 5,1 FLOOD HAZARD ZONE A13 EL 12) 4,� 5. TOPOGRAPHIC INFORMATION COMPILED FROM AN ON THE GROUND SURVEY.
10 5,7 10 10 6.3
1 6. ELEVATIONS SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM.
p - 85 130 135 0 40 58 116 0 31 111 131
9/26/07 REVISE S.A.S. CONFIGURATION.
TkANSECT A-A TRANSECT _ B-B TRANSECT C-C a DATE REVISION
SCALE: 1"=20' SCALE: 1"=20' „, SCALE: 1"=20'
I
PLOT PLAN AND TRANSECTS
PREPARED FOR
131 OCEANVIEW AVENUE REALTY TRUST
IN
COTU I T MA
PLAN DATE: JULY 25, 2007 PLAN SCALE: 1" = 20'
CIVIL ENGINEERING WETLANDS PERMITTING
ELM 0 ur
c� MICH AEL J. WASTEWATER DESIGN COASTAL ENGINEERING
' BORSELLI
" TITLE 5 PLOT PLANS ` PIERS AND DOCKS
r0 CIVIL� T 1�T
20 0 10 2I 40 No 35054 LAND USE PLANNING ��1 NEE COMMERCIAL/RESIDENTIAL
A9� 9�CISTE4ti� i
'`�s p 44 Serrsr�y Ceps Coo'a"o'SawlY�sosfern Mossahussffs
SCALE: 1 INCH = 20 FEET
141 LOCUST ST. UNIT A - FALMOUTH, MA 02540 - 508.495.1225 - 508.495.3229 fax
PROJECT NUMBER: 03073 CAD FILE NAME: 03073Lot2 DRAWN BY: L.M.,D.H.M. SHEET 1 OF 2
DEEP OBSERVATION HOLE LOG F/NMV GRADE SHALL BE 2R'M/N/MUti! OkER ALL SEPTIC SYSTEM COMPONENTS
USE 4"D/,4. SCHEDULE 40 Pl2' OR CAST IRON P/PE
DEEP OBSERVATION HOLE: #1 DATE: 7/6/07
DEPTH OTHER (s7RUCTURE, 20'41/NIA1UM SETBACIw' FROM! EDGE OF STONE TO CELLAR mALL
FROM SOIL SOIL TEXTURE SOIL COLOR SOIL STONES. BOULDERS,
SURFACE ELEVATION HORIZON (USDA) (MUNSELL) MOTTLING CONSISTENCY, 10 M/N/MUM SETBACK h� a� U
(INCHES) X GRAVEL) �'
�� oC y
0-6 31.0 A SANDY LOAM fOYR 3/2 "`` C� t Ju� T• J I`0
31.0 �`� REMOVABLE COVERS SET TO WITHIN 2�\ REMOVABLE COVERS SET
6-30 2&5 B LOAMY SAND IOYR 516 ' 12" OF FINISH GRADE (TOTAL OF 3) ^ p�c��`��r^� TO WITHIN 12" OF FINISH
•�e�°�ta g�� re �� GRADE (MIN. OF 2)
30-120 21.0 C COARSE SAND 2.5Y 7/4 NO \�\,.\\�,\ .\,,\.\�\\C\\.\ .\.\�\.\\.\�.\� \,.\,.\\.\�.. \,,\ \,\ C\\/\\,\ \\.\\.\ \,.\,.\�\ C\.\,.\ .\ \ ,.\,.\,.\ ,\\C�\,.\,,\\.\,.\�\. ,,\ ,\ ,\. \..\,.\� C\,.\,.\,.\\.\.\, ,.\,,\,.\\C\ \ .\ .\\,.\\�\�<\\, ,.\
21.5
EXISTING GRADE: EL 31.5 v
GROUND wATER: NONE S = 02 /NI�ERT ELEI! 3' MAX.
PERCOLATION RATE: < 5 M1N./IN. v . S = 28.00
= BOARD OF HEALTH REPRESENTATIVE DONNA MIORANDI a - �� 2"LAJ2ZR OF 1/8" TO 1/2"
SOIL EVALUATOR: DA VID MARTIN --
• 1,500 y G A LLO N SET FIRST SLOPE OAR/ES _llY�4SHE0 STONE
SEPTIC TANK 2'LZ-W-L S = .01 MIN.
H-20 LOADING ®®®® 0 ®®®®
®®®®®®®®®®®®®
==000=01121=1mcom Como
DEEP OBSERVATION HOLE L oisr. aoX I £L£l1 = 26.00
(11--20 LOAD/NO)
DEEP OBSERVATION HOLE: #2 DATE: 716107 W W W
DEPTH OTHER (STRUCTURE, SET SEPTIC TANK AND 01S1-R1,BV1-70N BOX , INSTALL .�,/4" To 1 >/2"
FROM SOIL SOIL TEXTURE S01! COLOR S01! STONES, BOULDERS, ~
SURFACE ELEVATION HORIZON (USDA) (MUNSELL) MOT77JNG CONSISTENCY, ON F> LAYER OF CRlJSI/EL7 STONE
(INCHES) X GRAVEL) Z AROUND H MBERS AND 00MV 5�
0-6 30.5 A SANDY LOAM 10YR 3/2 TO THE B01TOM OF T11E CHAMBER
30 � � SYSTEM FUR MORE DETA/�T OF
6-36 2Z5 B LOAMY SAND 10YR 5/6 BUILDING' SZ-HER /Nkf-RTS�2� ARE ESTIMATED AND, PROFILE Z (BOTTOM OF TEST/10LE,) EL£fl = 210
MUST BE EXPOSED BY INSTALLER PRIOR TO NOT TO SCALE
21.0 30-120 20.5 C COARSE SAND 2.5Y 7/4 NO INSTALLA77ON OF THE SYSTEM
EXISTING GRADE: EL 31.0
GROUNDWATER: NONE
PERCOLATION RATE < 5 MIN.,4N.
BOARD OF HEALTH REPRESENTATIVE: DONNA MIORANDI
SOIL EVALUATOR: DAVID MARTIN
BASIS FOR DESIGN , 3 - REMOVABLE 24"O✓A CDI�RS REMOI�ABLE 24 D/�4. CDI�£R
f
TOTAL DA/L Y FL OW/S BASED ON 5 BEDROOMS, NO GARBAGE DISPOSAL t `-��TF,�" OPEN AT TOP SET '
INLET KNOCKOUT 5 MIN FRG / TANir 00kFt? '
r OUIZET
,OTAL 'PAILYROW = 110 G PD/SEOROOMX 5BEDROOMS 550 GPD KNOCI(OU
/NL T TEE SET CU ET TEE SET
BOTTOM AREA PR6POSEI) = 5J9 Sf: 10 MIN. BELOW 14'�BEL OW
LIW1,0 LEk£L b'W1,0 LEkEL
S/OE AREA PROPOSED = 219 S.F. GAS 9AFIFE s
TOTAL LEACHING AREA PROPOSED = 758 S.F.
APPL/CATJON RATF" - 0.74 GPD/k»F. ,
DESIGN LEACH/NG CAPACITY = 550 GPD > 550 GPD JAr i
. . : .. . , .,..r..,.,�'•. • :�, •1':f ;:..�'•. :' CONSTRUCTION NOTES:10' - O" 5' - 2"
11• - O" 6' _ 2" I INSTALLATION OF THE PROPOSED SEPTIC SYSTEM SHALL SE/N ACCORDANCE W/7-/ 17)LE 5
ANO 7HE BOARD OF HEAL 1H REGULATIONS.
8' _ 3 1/2" 2. A COPY OF THE PLANS SHALL BE A 0A/LABLE ON S17F FOR REFERENCE Ar,4ZZ TIMES
GDURING ,THE INSTALLA77ON OF TN£ SEPTIC SYSTEM.
6" 1500 A LLOI lI SEPTIC TANK (H - 20 LOADING�
J NO CHANGES TO THE OES/GN SHALL BE PERFORMED if /7-/0Z/T THE APPROVAL OF BD111
® ® ® ® O ® ® ® ® NOT TO SCALE FALM0U7H ENGINEERING; INC AND THE BOARD OF HEAL 7H
34" 4 THE SEP77C SYSTEM IS SUBC'C) TO INSPECTION BY FALMOUTH ENGINEERING, INC.
AND THE BOARD OF HEAL Th!
24" ® ®
® ® ® ® ® ® ® ® ® ® ® ® ® 5. Ni- CONTRACTOR SHALL NOTIFY FALMOUTh' ENGINEERING, INC. ANO THE BOARD OF HEAL 1H
TD INSPECT THE SEP77C SYSTEM PR/OR TO BACKF/LL. IN SOME INSTANCES, MORE )71AN ONE
/NSPE0170N MA Y BE NEEDED. 1HE CONTRACTOR SHALL OML Y BA0VRZL TILE PORTIONS OF THE
8' - 6" SYSTEM 11/AT HA kr BEEN /NSP£CTry AND ,4PPROkrO BY FALMOU7H ENGINEER/No, INC. ANO
IHE BOARD OF HEAL W.
CROSS—SECTION 6. IF 111E CONTRACTOR ENCOUNTERS ANY IiAR/AT7ONS IN SITE CDND/)IONS SUCH AS DIFFERING
SOILS, TOPOGRAPHY, NEIZANOS OR OTHER CDND/)IONS THAT MAY RM11RE RE-EI1ALUATI'ON OF
i?1E OES/GN, THE CONTRACTOR SHALL /MMEO/ATFL Y CONTACT FAZMOU71-1 ENGINEERING, INC.
8' - 6"
S v 4"
A'
•,
'v 1 3/4"
5" KNOCKOUT 2 - OUTLETS
4 OUTLET _ INLET
21" DIAMETER COVER • TYPICAL OF 5
N '— INLET L6.-
8" '• 9/26/07 REVISE INVERTS AND TEST HOLE INFORMATION FORMAT.
4"
•' DATE REVISION
I 5" KNOCKOUT — 5" KNOCKOUT 2 - OUTLETS SEPTIC SYSTEM DETAILS
24" 24"
PREPARED FOR
' PLAN ; CROSS-SECTL,QA
131 OCEAN VI EW AVENUE REALTY TRUST
5" KNOCKOUT IN
COTUIT MA
A
DB-j5 DISTRIBUTION BOX H- 20 LOADING, PLAN DATE: JULY 25, 2007 PLAN SCALE: AS SHOWN
• '
PLAN VIEW NOT TO SCALE gVIL ENGINEERING WETLANDS PERMITTING
�tN of 0 U
MICHAEL J.
?,rr
WASTEWATER DESIGN �7 COASTAL ENGINEERING
BORSELLI
� TITLE 5 PLOT PLANS .� `'
500 GALLON LEACHING CHAMBER (H - 20 LOADING CIVIL PIERS AND DOCKSRIB
SCALE: 1' = 2' No 35054
�GI
.o LAND USE PLANNING lr F'E COMMERgAL/1RESiDENTiAL
90 9FQ G\.I.
'�ssl A S&-k*q Cape Cod anal Southwstwn Mossochusefts
141 LOCUST ST. UNIT A - FALMOUTH, MA - 02540 - 508.495.1225 - 508.495.3229 fax
PROJECT NUMBER: 03073 CAD FILE NAME: 03073lot2dt DRAWN BY: L.M.,D.H.M. SHEET 2 OF 2