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0232 CARRIAGE ROAD - Health
Et Carriage. Road rville P 071 017 f r . " 1 p a 4 TOWN OF BARNSTABLE LOCATION' Z, 7i /G, SEWAGE# fOD VILLAGE e �$ /` /�Q/"�®�`S ASSESSOR'S MAP&PARCEL 0 7/-0/,�7 INSTALLERS NAME&PHONE NO. 160✓ 7�/� j �'7J SEPTIC TANK CAPACITY LEACHING FACILITY:(type) r_ r�1 ?-�2'�Bi"� (size) / NO.OF BEDROOMS OWNER 69C-0000f PERMIT DATE:_31/5—l®X 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 FUR:^;!SHED BY I 3 � AZ- 7Z �3 a $q - qo' rrY /01) /� / ✓ No. U o6 l V Fee T +THok,.OMIMONWWALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -'TOWN OF BARNSTABLE, MASSACHUSETTS ZIpplitation for Migozal i�pgtem Con.5truction Perron Application for a Permit to Construct(x) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. `X-6% C 1112121 ACr E ROAD Owner's Name Address and Tel.No. C9 SfiERVII_LE, I'I'�/1Ss. THE O'C0A;Aio(Z'GroLj P 6-35 tviADI sON AtiE Assessor's Map/Parcel NA 0-7/ P O 1`7 P&LU Yoa is /V• Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No.6-0,9-y 2 R-3 3 4 4 > a - VVIL N1wy I V`, 7PAM�-FE(R tZrC � s� s�R1/iLL� j'l7195s' Type of Building: Dwelling No.of Bedrooms 1'Z Lot Size 5"84 37o - sq.ft. Garbage Grinder 40 Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min,required) 1 32® gpd Design flow provided i.33� gpd Plan Date JAW 27 200/a Number of sheets Z Revision Date 2—7—0 C Title S I-TE FLAW — P1ZO1--'oSED i m PP'd/1lT Mj=nTS Size of Septic Tank 000 Type of S.A.S.17-'X 1 i y' L E,9eH//y; 0—`AA11 GEL Description of Soil 0"I'1 L,69ves'S--wiciy r 0 '41 -L11 VERY QARtc ar'15 o B 12N splilDY Lo/9M i oyR 3/2- -A- /0" 1 RW- C-05H k3RNsoilDYLai9M -E-110' I'7t1DR'K YELiSH BRV514AP1 LOAN 1012q/l — 13-1— I'7" - 2g'i CL'iSN 6Riv LOAMY SAND IoYR61f,— 2�,Z�'-12o"OLIVEYEL•MEDSXjN1) '2P6'yh/(o-C — 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 Environme tal Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Hea0h. Sig r Date ! Application Approved by Date Q Application Disapproved by: Date for the following reasons Permit No. Date Issued .S /4 r: Fee OMMONWEAL—TH OF M SS, -ETTS}. Entered in computer: PUBLIC HEALTH DIVI•�tOf�n—rOWN OF B`ARNSTABLE;M SSACHUSETTS Yes - ZIppYication fdr Mi5po5al 6p.tem Con.5truction Permit Application for a Permit to Construct(X Repair O Upgrade'' aAbandon O ❑Complete System ❑Individual Components Location Address or Lot No. Z3'L C R QR IAC'-r= ROAD Owner's Name,Address,and Tel.No. 0S-rERV1L_L_e, /Yll4ss. THe C)'C0 'A/ oft GrouP ti. 53S, "MAA1 soN R✓E Assessor's Map/parcel M 07/ P O 1'7 Paw yo2 K /V. Installer's Name Address,and Tel.No. Designer's Name,Address and Tel No.609'H Z S- 3 4 q sPArze- N 6,VG►NLtr2iwy ING •7 P^21�ER (Z D cs7z-a✓1l-L� /YI/�S� Type of Building: Dwelling No.of Bedrooms 1"2- Lot Size S Si370 _ sq.ft. Garbage Grinder (M Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) am I BZ0 gpd Design flow provided 133-1 gpd Plan Date JAN 27 ZOO 4 Number of sheets Z- Revision Date Z 7—O G Title SITE PLAw — PtZa POSG D 1 nl Pra//c'/4,=_WrS Size of Septic Tank 3000 Type of S.A.S. 1 Z1X I I a/ L.EAr—P wy CA,4jw6 2 Description of Soil 0-4i1 Legyes r♦ LVIG-T — 01 4j- 6" VERY DARK Gr'1S hf BRN SA/YDYL.evm" IOyf2 3& —A; 6 /o" ORle- GASH BFW SA4 DYLOAM —E—II0=17i1Dak YEGisN B12VSAA,01 L.oQ." 1049S1�L t3-1r 1-7 -2q" VEL"SN BRN LOAMY SAND (oY12514-62-"'=120"oL1VEV46L.MEDSAW- 0 �. SYGy�(o—Cs Na ut re of Repairs or Alterations(Answer when applicable) Date last inspected: c ` 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 Environme al Code and not to place the system in operation until a Certificate of •�. Compliance has been issued by this BoardHea Signed 1 n . •» r"r"" Date (�/ i f g Application Approved by ��"• ��- r' 0 Date Application Disapproved by: Date for the following reasons Permit No. 00 ' /0D Date Issued, "I 3 / v ,a THE COMMONWEALTH OF MASSA HUSETTS BARNSTABLE, MASSACHUSE9TTS Certificate of Compliance THIS IS TO CERTIF ,that the OnJ�ite Fewge Dispo al System Constructed (x) Repaired ( ) Upgraded ( ) Abandoned( )by O/ �/� 1 © at Z3Z Csrrw-E Q.p , �STErA-Le /Y!/4SS• has been constructed in accordance with the provisions of Title 5 and the for Dispo[s .1.System Construction Permit No. z 00L loo dated Installer Designer SULU VAW 611AWAIC-EM No i/L #bedrooms a" Approved design flow 13 tD gpd The issuance of this p ermit ?all not b construed as a guarantee that the system 11-fun '.o�,� �,�si ed. Date / iJ� � g Inspector ct�i -------------------------------------------- No. VO 1 k) Fee J S� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS =igpo5at i§pgtem Con truction Permit Permission is hereby granted to Construct Repair ( ) Upgrade ( ) Abandon ( ) System located at Z37- CAMhaE RD O.SrEal&LE 17USS and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of yhi's pe `t o Date /S� bd Approved by �� Town of Barn t �ofTHE Regulatory SejFce� Thomas F. Geiler,Director * BARNSCABLE. 9 M Public Health Division s639. �0 A'Eo Hwy" Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office:. 508-862-4644 Fak: .508-790-6304. . Installer & Designer Certification Form — aptO � '/Date: � � Sewa' aPermit# 7-®0�-1 �Assessor's d \Parcel g 7 - 1 Designer: �/CI df� ��'✓,�'s� Installer: ,/;`��19.117 jG�rS/, :, d��' Address: Address Aal5&9.s y.5 17 On / �< � � � c5 was issued a permit to install a (date) '(installer) septic system at 23Z Cal'/�l4' e T, 51 based on'a design drawn by (adcrress) G�fZi,c.C,t vft� dated / (designer) y : .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 satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateraf 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. OF r� PM SLALLI IN (Insta 's Signature) ND: 733 CIVIL Via;• ��/ � :�, ' (Designer's Signature). r'4 (Affix Designer's Stamp Here) PLEASURETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE! WILL i 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 Town of Barnstabl - ofit+e ; �P�� o* •Department of Regulatory Services • ,• axnorarxav 1 Public Health Division Daie MAO �, i6J9• `e 200 Main Street,Hyannis MA 02601 rEn ram+" Date Scheduled �3 :Time:. b Fee I'd. , Soil Suitability Assessment for S wage Di t>7sal { Performed By: Witnessed Y. LOCATION J& GENERAL INFORMATION Location Address Z S7 C4 r 1"149Q RC Owner's Name i ®5t Mfg Address,' f r Assessor's Map/Parcel: 011—017 � + n� '' w.- Engineer's Name 1Wqn &I r'ItC�Itt NEW CONSTRUCTION REPAIR tom' f Tc1cplwnc N -508"4ZB-33 Land Use e e.4�i�r rn ice` Slopcs(%), 6—ZO A'o Surface Sloncs NO Distances from: Open Water Body ZOD` 11 Possible Wet Arca'Z.06 -- it Drinking Water Well Drainage Way AV/& R Property 6he'.__qo�_tt Othcr A/./A R ; SIKETCII:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) all p18785f y `' �I l �1 2 _ _ Parent material(geologic) 45� Depth to Bedrock 300 Dcpol to Groundwater: Standing Water in Hole: Af f►2 Weeping from Pit face Iu46• � Estinmecd Seasonal Iligh C S Groundwater L 2 (` 1 'l 1 Frt", -T.0 , b�,d n DETERMINATION FOR SEASONAL IIIGII•WATER TABLE Method Used: Nert — Dcplh Observed standing in obs.mole: in. Dcpth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment R• Index Well M Reading Date: Index Well level Adj.factor Adj.Gruuodwnlcr level_ PERCOLATION TEST Date l z!, Time q!Lb 1 Observation Hole H Z Time at 9" i1 t.10`n DcpUr of Pcrc 34 Time at 6", Start Pre-sonk Time© ZS _ Time(9"-6") ' 1n End Pre-sonk y Sm�^ " ��►+'� Rnte Min./Inch Site Suitability Assessment: Site Passed Site failed: Additional Testing Nccded(Y/N) Original, Public I-leallh Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' ofivetlan(l,you must first notify the Barnstable Conservation Division at least one(1)wcelc prior to beginning. Q:I IEALTI I/W P/PERCTORM 1�LEP OBSJMVA'JTJON HOLE LOG JJlll"It UcPth liunl ,;uil Ilutizun Suil'1'cslurc Suil Culor Suil Surfatu(In.) (USDA) (Munson) Plutlling (SUuclnlf,, tmcs,llt,tddcls. LI—(Q ll (• � (Aar: (c— ty t t Lual� toy 2 ja lD7dt <I& DEEP OBSERVATION HOLE LOG 1101C I'/ 2 Depth from Soil horizon Soil Tcxlure Soil Color Soil Other Surface(in.) (USDA) (Mwlscli) hfoltling (S(tuclutc,Slows,Muldcts. Cgllsistcllcy.%Graycl) _ 6 `oc s IS-Z8 �r io — �.� DEEP OBSERVATION HOLE LOG Hole 11 Depth from Soil liorizon Soil Texture Soil Color Soil . 011lcr Slit race(in.) (USDA) (Munscll) Muffling (Sltuclurc,Stuncs,Uvuldcrs. Qw—W ICILCY, I1�C�) DEEY OBSERVATION HOLE LOG JJu1e It Depth from Soil I Jul izon Suil Texture Soil Color Soil O111cr Sturnce(in.) (USDA) (Munscll) Mutlling (Shuctutc,Sloncs,Ouuldcts. CQ11SI5 Cllc °°lJ'-!_avcl Flood Jnsurmice Rate Mau: Above 500 year flood boundary No, Ycs Within 500 ycnr boundary No l Ycs '' ^ lO� bo�r1 Withhl!00 yerr flood boundary No ✓ Ycs Douth of Naturnlly Occurring Pervious Materifll Does at least four feet ofnaturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption systc1,17 NIE5 Jf not,what is die depth of naturally occurring pervious material? Certification I certify that on A;OV. ' 2. j -(dnle)1 have passed the soil evnluntor examination approved by the Department of Environmental Protection and that the nbove nonlysis ways performed by me consistent with the required traiuiug,expertise and experience described in'310 CMR 1.5.017. Signature Date Z (o Q:I ICA.LTI 1/WPIPE,XFORM Town of Barnstable Board of Health P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Wayne Miller,M.D.. FAX: 508-790-6304 Sumner Kaufman,MSPH Paul Canniff,D.M.D.. March 15, 2006 Peter Sullivan, P.E. Sullivan Engineering Box 659 Osterville, MA Dear Mr. Sullivan, You are granted permission, on behalf of your client, Jeremiah O'Connor, to construct an onsite sewage disposal system designed to be connected to twelve bedrooms at 232 Carriage Road, Osterville, Massachusetts. The septic system shall be constructed in accordance with the submitted plans dated January 27, 2006. Sinc ly your Wayn 1 r, M.D. Cha' an BOARD OF HEALTH TOWN OF BARNSTABLE Q:HEALTH/WP/12BedroomsSullivan0connor2006 DATE: 11 - g Rsc. BY 'down of Barnstable SCE. DATE: b //6& Board of Health 367 Main Street, Hyannis MA 02601 Otace: 508-86:-4641 Susan G.Rask,M. FAX: 508-790-6304 Sumner Kaufma n,M.s..p x Ralph A.Murphy,NI.D. LOCATION- Property Address: Assessor's Map and Parcel Number: _pZ?i - o C7 Size of Lot: Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name: F c" APPLTCA.NT'S NAME: Phone Sob-ti?-B"'3�!u1(4 Did ll:e owner of the property authorze you to represe, him or her? Yes ✓ No t'= PROPERTY OWNER'S NAME CONTACT PERSON w .� Name: �2rf�i�� 1,�� ��`�arlBoi'��r, Name: S� 'tt<� l - zcc-s PCX- i>o. Sax ksV Address: My I07Ci) Address: — - Ln Phone: Phone: TICS`1Zt; VARLkNCE FROM REGULATION(test Rog.) REASON FOR VARIANCE(Nfay attach if more space needed) Nance �Zk ec�rrL� NATURE OF WORK: House Addition ❑ House Renovation ❑ Repair of Failed Septic System ❑ Checklist(to be completed by office staff-person receiving var:ence 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 labe:cd 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 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) ` _ Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals(same ownerilensee onlyl,outside dining variance renewals(same ownerlleasee only],and variances to repair failed sewage disposal systems (only if no expansion to the building proposed]) Variance request submitted at least IS days prior to meeting date VARLa.NCE APPROVED Susan G.Rask,R.S.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL, Ralph A.Murphy-M.D. -----� --- SlJ1rL.IVAN EiJG !NCPAGE 62 �+�� 18:ab 5i;�;4283i15 AUTHORVA' ION TO ACT ON BIB �ARD OF k � XPPLIC OR � sTABL Dec 11-ts L Wa. mm r.. thcar .Sufi Ex� Inc, to at on a as me in the tubmiU of die deve�flap>x p' AW reprogentmg w tlw Bo 11th. y 0`1 1 E-,ARCEL, O i ( 04 _0* TABLE T. DATE 11126104 PROPERTY ADDRESS 232 Cana iage Road . w Obte ZVi e-ee /jazz 02655 On the above d6te,^the4eptic system at the address above was Inspected. This system consists of the following:. 1., 1- 1500 ga-eeon eept.ic .tank.• 2. 1- Di,3.tai ut-ion Box 3.• 2- 1000 gaiion -eeaching pifz.• Based on inspection, I certify the following conditions: 4.' 7h.i3 -Li a 7.it ee rive zept.ic hyztem ( 78 Code) 5. The zept-ic zy,6tem .iz .in /zaopea woaking oadea at the* /22ehen.t time., . SIGNATURE Name: Robert A. Paolini Company: Josh P. Macomber & Son Inc . Address: P. O. Box 66' Centerville, Mass 02632 Phone: 508-775.3338 or 508-775-6412 ; s �• CD r-. •JOSEPH P. MACOMBER & SON}. INC* Tanks-Cesspoolsd,eachfields 'Pumpod .&••.Installed Town Sewer-Connection P.O. Box 66 Centerville, MA.026.32-0066 7754330 .' 775.6412 .\ COMMONWEALTH OF MASSACHUSETTS EXECUTm OPPICE-OF EI�TfR4•NMtNTALAFFAIRS a y DEPARTMENT OFNVIRQI� TA3,pROTCTION y TITL 5 OFFICIAL INSPECTION FORIVI NNOT-1 rORVOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address:z32 Ca22-iage- 1 6aD Owner'sNameyqaao De2o/2R Owner's Address: -3 a.m e Date of Inspection: 11/2 6/0 4 Name of Inspector: leaseprint) R.p'&e Company Name: �7: P—R co -SiDn Inc. Mailing'Add��ress: en ezv.c e, M ,3 T.,O2632 . Telephone Number: 5 0 8-7 7 3 3 3 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the.infortnation 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 Bite sewage disposal systems.I am a DEP approved system inspector pursuant to;5ection.15:340.of-Title 5(31.0 CMR,35:800). The system: XXX Passes -Conditionally Passes Needs Further Evaluation.by the Local Approving.Authority Fails Inspector's Signature: Dater The system inspector shall submit a copy of this inspection.repor0o the.Approving Authority•(Board of Health or DEP)within 30 days of completing this inspection.If the system:is.a.shaied system or has a design flow of 10,000 gpd or greater, the inspector and the system'owner.sWl'submit the report to the appropriate'regional,ofl'ice of the DEP.The original should be sent toA system owner and copies sentto the buyer;if applica6(e,and the approving authority. Notes and Comments ""This'report only.describes conditions at the time of inspectiaand under the conditions of use at.that tithe.This inspection does not address how the system will perform in the future under the same or different conditions of use. _ y 'Page 2 of 11 OFFICIAL INSP +,CTION;FORM—NOT FOR VOLUNTARY ASSESSMENT'S SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM i PART'A CERTIFICATION(continued) Property Address: 232 Caa2.iage Road O,s.tezvi_Ue Ma 02655 Owner:Naao ed De2opp Date of inspection: 11126104 Inspection Svmmary: .Chdck A,BC,D or.E/ALWAY�SIcomplete<all of Section D A. System Passes: NO I have not found any information which indibates'that any of the failure criteria described in 310 CMR 15.303.or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: The .3eptic zurtem iz in RaoR a woaking_ oadea at. .the Raezerzt B. System Conditionally Passes: NO One or more system components.as described in the"Conditional�Pass"sectiowneed 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. NO 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 theZoard 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: NO . 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 distribttion box b levelcW orteplaeed ND explain: NO The system required purnping.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 pipes)are replaced obstruction is removed ND explain: Page 3 of 11 OFFICIAL MPECTION FORM NOT SYSTEM. �INN.�RM OR VOLUNTARY TS SUBgtff ACE 91EW�I.C+E DI PART A . . 'CERTIFICATION'(eontinued) Property Address: 232 Ca22-.age j.oad U.s1_eay.,etp a Owner:.Ila2.o ed ego Date of Inspection: 26H V C. Further Evaluation•is Required by the Board of Health: NO Conditions.exist whichrequire further.evaluation•by.theBoard:of,Heaith;in-order.:to;deterniine ifthesystem is failing to protect public,health,safety or the environment. ( 1. System will pass unless Board of Health determinesdii aeeordance with 310.CMR 15:303.1)(b)that the system is not functioning it<.a�mariner-which-will•protect public health,safety•atr¢.the%environnment: no Cesspool or privy is within,50 feet of asurface water n oo Cesspool or privy is within 50 feet of-a bordering vogetated 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 proteets thepttblic Health,safety and environment: NO The system has a septic tank and soil absorption system-(SA•S).znd the SAS is within 100 fe.et-of a surface water supply or•tributary to a.surface water-supply. n o The system-has-a.sepfic tank and SAS and the;SAS is�within a Zone 1 of a-public watensupply. n o The system has a septic tank and.�AS:and the SAS is within-.50 feet of a private water supply well. n o The system has a septic tank and SAS and the-SAS is less than 100 feet..bizt 50 feet or.fdore froul a private water supply well**.Method used to determine distance-Vzz suai- **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•ttlis form. 3. Other: i Page 4 of 11 OFFICIAL,INSPECTION FORM--NOTFOR;YOLUNTARY ASSESSMENTS' SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 2 3 2 C a 22.i a ge' R o act ,6 e2v i -fie lea Owner: flaao ed De/Lo Date of Inspection: 7 ' Q4 D. System Failure Criteria applicable to all systems:. You must indicate"yes"or"no"to.eacb.of the:followhig:for all inspections: Yes No _ X Backup of sewage,:into-f'AAity.:or systemeomponent due_to overloaded.or clogged SAS...or_cesspool _ Discharge:or ponding of effluent to the.surface bf the.-ground or.,surface maters due to.anoverloaded or clogged SAS or cesspool X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ X Liquid depth in-cesspool is less than.6"below invert or available volume is less than Wday flow Required pumping more-than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped X Any portion of.the SAS;cesspool or privy is below High groundwater elevation. Ariy_portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. X Any portion,of a cesspool-or privy is within a'.Zone!1,of a:public.well.. _ 7- Any portion of a cesspool or privy is within.50-feet of a private water supply well. _ 7-_ Any portion of a-cesspool or-privy is less than 100 feet but greater..than 5,0 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 pollutlon;:fr..om:tbgt,facflity 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 niust be attached.to this form.] NO' (Yes/No)The system falls.I have determined that or -of:the:above. ..criteria exist as described in 310 CMR 15.303,therefore the system-faRs.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>faeility,with a design flow of 1,0000.0 gpd to 15;000. 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 X the-system is within.400 feet of a surface'drinking water supply X the system.is within 200 feet of a tributary to a surface drinking water supply ® ' " X . 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 15.104.The system owner should contact the appropriate regional.office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS �— �L*SURFACE SEWAGE DISPOSAL'SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:232 Caaaiage Road a Te/1521 z (7a Owner:Ka2o.9d e2o/z/z Date of Inspection: 0 Check if the followinp,have been done.You must indicate` s"or"no"as to each,of the following: Yes No X pumping information was provided'by the owner,occupant,or Board.of Health _ X Were any of the system components pumped out in the previous two weeks? X _ Has the system received normal flows in the previous two week period? _ ater been introduced to the system recently or as part of this inspection? X Have large volumes of w X _ Were as built plans of-the system'obtained and examined?(If they were not available tote as N/A) X Was the facility.or dwelling inspected for signs of sewage back up? X _ Was the site inspected for signs of break out? X . _ Were all system components,$a cluding the SAS,located on site X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge and depth of scum? — 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. _ X 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)] s � 5 Page 6 of 11 OFFICIAL.]ENSPEC'TION:FORK NOT FOR VOLUNTARY ASSESSMENT'S SUBSURFACE SUWAGE DISPOSALSYSTEMiWECTION FORM PART.0 SYSTEM INFORMATION Property Address: 232 CaAlta-ige Road Owner: Na2o.2c1 De2o Date of Inspection: FLOW CONDITIONS RESIDENTIAL Number of bedrooms(desip): :-6 . : .Number of bedrooms(actual): 6 D1;SIGN`.flow based on-310 C1Gik 15.2W (for example: 110 gpd z#of bedrootfgi 6 0 Number of current residents: . 2 Does•tesidence have a garbage grmder__(.yes or no) n o Is laundry on a separate sewage.system.(yes or.no):.n o [.if-yes separate inspection required] Laundry system inspected(yes or no): ri o 2V . r Seasonal use:(yes or no): n o 0 � � y�tlfr 6• P D, Water meter readings, if available(last 2 years usage(gpd)): /CI :q? Sump pum (yes or no): n o Last date o occupancy: /2 a e,6 e n z` COMMERCIth/lIbUS TRIAL of esia nt: Type b Yp - —1 Design ffil ` �d on 310 CMR 15.203) NA d Basis.of d i`'Alow(seats/persons/sgR,etc.):, IN Grease trap*present(yes or no):%V{l Industrial waste holding tank present(yes or no):NR Non-sanitary waste discharged to the Title 5 system-(yes or no):N Water.meter readings, if available: NA Last date of occupancy/use: . N R OTHER(describe):. •QENERAL INFQVIATION Pumping Records Source of information: 9124104 pump7 Nain.t 7.40 Nacon2 e2 Was system pumped as part of the inspection(yes or no):— If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for.p..umping: _ TYPE OF SYSTEM , X Septic tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Altetmative.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 a of all compo ents;,date installed(if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): n o 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: 232 Ca22�ac/e RoadU,st e2v.e.LlZe Owner:Na,zo dTe-1,131212 Date of Inspection: 4 N , BUILDING SEWER(locate on site plan) Depth below grade: 2' Materials of construction:_cast iron X 40 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): �o ant cite Licrh.t. Vented thliourlh house vent No .s ipn� o� ,eeakage SEPTIC TANK:-ye 4locate on site plan 5 0 0 ga,,e o n .tan k Depth below grade: 6" Material,of construction:_concrete X 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) N ' !/ ! p �0 6 Dimensions: LX 5 8 ions: GIXS 7 .K Sludge depth: .t 2 a c e Distance from top of sludge to bottom of outlet tee or baffle: t 2_ a�e Scum thickness: t 2 a c e Distance from top of scum to top of outlet tee or baffle: t z a c e Distance from bottom of scum to bottom of outlet tee or baffle: 2 a c e How were dimensions determined; m e a t u.,z e d Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural inte as related to outlet invert,evidence of leakage,etc.): gnty,liquid levels /)um even 2 ea2.s oa main.t.� Inlet outeet teen ace in 12iace., tank &3 pound. No n.6 o. Peaka ye. GREASE TRAP: NRlocate 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 conditio structural irate as related to outlet invert,evidence of leakage,etc.): n' testy,liquid levels 2ea�e tea c� not 2eAenl-� TitlA G Tne.,prt;r.n Fnrm F/1 S/,)Ml1 7 Page 8 of I I OFFICIAL I1108•PECTION FORM—NOT FOR VOILUNTARY ASSESSMENTS SO&W".ACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:232 Ca/t z is e Road 0,3 e2v.c fz z e own er.•haao ed D e zo-PR Date of Iispection: 7 9/26•104 a TIGHT or I Q-LDING TANXW0 (tank must be pumped at time of inspettion)(locate on site plan) Depth below grade: Materiat of construction: concrete metal fiberglass TAolyethylene other(explain)- Dimensions: Capacity: gallons Design Flow: gallons/day A.lam 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,) 7.ight oa hoed.ing tankz ate no. - pzezent., DISTRIBUTION BOX:b e-3 (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 0 Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box, etc.) Diit2.igut.ion 9-ox hays 2 .Vciteaaiz. N•o evidence o� noi-ids ca22y ivrilsgv_ -in oa out oZ &oz.. PUMP CHAMBER:NO (locate on sife.plan) Pumps in working order(yes or.no): Alarms in working order(yes or no): G Comments(note condition of pump.chambFr,condition of pumps and appurtenances,ett:.): Puma chamee2 -ins not R2e,3erzt., Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS r , SUBSURFACE SEWAGE DISPOSAL SYSTEM I.NSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 232 Ca/z/tiage Road 0.3teay.iiie Na Owner:Na2o.ed -'e/zo Date of Inspection: I I/2 6/0 4 Hk n SOIL ABSORPTION SYSTEM(SAS):_.(locate on site plan,excavation not required) If SAS not located explain why: See 12age 10 Type X leaching pits,number: 2 leaching chambers,number: leaching galleries,number: leaching trenches,number, length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure,level of ponding, damp soil, condition of vegetation, etc.): -�. n� h Loamy .Sand to medium sing sr Nn .tip»,c iir/nn�i0ir �/7JOi�no o,z 12ond.inc , SO i.A aae days Vegetation z.A nnmma9 CESSPOOLS: NO (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.): Cezz-poo.ez ate not R2ezent , PRIVY:NO (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.): 12.iyU j.6 no/ .1217vAvnf - 9 Page 10 of 1-1 p O ;Y�TSPF1��`TON•I'O'RM *NOT FOP.•?V•QI�IIJNTARG-INSPECT-ION TS S�Si•�RFACE'SEWAGEDISPOSAL'SYS ?EA�i.IN SYS`FE1VI F1�iFORhl iT`I.ON(�corift'red)' Property. Address:Z32 Ca2��aae l2oacl 0z;te/zv7Tee Na Owner:K a 2�D 12-EP Date of Inspection: 9 SKETCH OF SEWAG9 DISPOSAL SYSTEM reference Provide a sketch of the sewage disposal system includin er esublic least to at two supply enterstthe building. or benchmarks.Locate all wells within 100 feet.Locate wh p ,.:� fix,t.�� n s�.� � _4 '+� s t ,•3� a 3..: , nr�rz�. 00 -A)s'haiA f o -VuvJ4 CD • 2 0 . . ��pp�• YSitJJ ZlZ 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:Z,3 2 e 17Z 7 7 e Ma/2 o-6 5 5 Owner:ha2oid DEL22R Date of Inspection: SITE EXAM Slope Surface water Check cellar. Shallow wells Estimated depth to ground water z 0 feet Please indicate-(check)all methods used to determine the high ground water elevation: N 0 Obtained from system design plans on record-If checked,date of design plan rgviewed: N 0 Observed site(abutting property/observation hole within 150 feet of.SAS) NO Checked with local Board of Health-explain: TU_Checked4ith local excavators,installers-(attach documentation) Te hAccessed USGS database-explain: You must describe how you established'the high ground water elevation: used;Gaherty & Miller model 12 1 used;USGS observation w 1 used• 'Technical bull — — wa er a eva ions. • Leaching Pit 8'• &St Groundwater:1 Z Feet Below Bottom-of Pit . High Groundwater Adjustment 1.8 ft per F�LirnptejMethod Therefore,the.vertical•separation distance between the bottom of the leachingpit and the adjusted groundwater table is 9-' 6 feet.. .. a .�.� ,� ��,,,•,•..-,-.-..,r:.m^....,.-...*.•...r..n.•.,T.,r.r.,,,.r..,,.,,,.r.,,.,,..-.r.,�... [IUARU OF 11EA.LTII '1-ONN 01 Barnstable CTION FORM - PART D•- CERTIFICATION 9l1tI9l)I1FACR 9FNAGF t)ISf'OraA{� SY9TF.M IMS[F rvnn•n.rr,rn�v.+�r� ..r:nr.+n•nnr*wR�rm�n+''r��nrnrrar+nn�*r'nerw+�nre�r�nw'nr� �,•,41h.T....•; �...n-- - -TVPC OR PFIN'T Cl'"RLY- PROPERTY INSPECTED STREET ADDRESS 212 Ca22-iage Road 0i'�e2vi��e 071-W ASSESSORS MAP , D1OCK AND PARCEL # Naaoid Deaopp OWNER' s NAME PA R T' ll - CERT X FI CAI T'ION Ro alLt P ao e.iali. NAME OF INSPECTOR COMPANY NAh1E Joseph P. Macomber & `Son Inc COMPANY ADDRESS Box__ Centerville Mass 02632 n or c xY state LIP strit 790-1.578 FAX ( 508 j COMPANY TELEPHONE ( 508 ) 775-33.38 ,. CERTIFICATION. STATEMENT I certify that I . hRve personally inspected the sewage is system at diaposa� :this nddr.ess and that the innspectioon, Therinspectionewascperformednand any Nomplet,e as of the time of �inspec • dr.ade-, maintenande 1 ana repair are consistent .'recoinlnendations regarding ul=d with my' training and experience in the proper fttnction and maintenance of on- s i to sewage disposal . systems , check one : XXX System PASSED The inspection which I have conduc-ted .has not tfond any otectormation which indicates that th.e system falls to adequately ailtire Iteaitll or the environment as defined in the FAILURE 3CRITERIA f section of critert,a not evalUAted Are this form , System FAILED The inspection which I have conattoted. has found that the system fails t Protect the E)ub.lc health and the environment o tn PART C FAILURE 5 , 310 Ch1R in accordance Title 15 , 3Q3 , and specifically CRITERIA of this inspection forpl., La.7 Inspector Signature . 4ate 0 of this c rc.tfication must bep,rovided to the OWNER, the-BUYER pine c PY ,'( where apPlicabe l ') And tha 130nR>] QV 1I1 o 'FL If the inspection FAILED , f. theninsp t l a t ectionAunlesse,1lowedorrgquiredm within one year oP the cote of in 3.10 C�iR otherwise as provided 16 . 3.Oti partd .d, RECEIVED DEC 1 0 2002 DATE :11 /22,02____ TOWN OF BARNSTABLE PROPERTY ADDRESS232 Carriage_Road_-_-___ HEALTHCJEPT. -Ostervi l le,Mass_ 02655 ------------------------ On the above date, I inspected the septic system at the above address. This system consists of the following: 1 . 1 -1500 gallon septic. tank. 2. 1 -Distribution box. 3. 2-1000 gallon precast leaching pits. 6 'X10 ' Based on my inspection, I certify the following conditions: 4. This is a title five septic system. ( 78 Code) 5. The septic system is in proper working order at the present time. 6. Pumped septic tank at time of inspection. 7. #1 pit. Waste water is 42" below the invert pipe. #2 pit. Is presently dry. . . . . . . . . . . . . has never seen water. / SIGNATUR Name :_ J ._ P . _Macomber_Jr . Corripany :josQeh Pam_ Macoml2tr 8 Son, Inc . A d d re s s :__BQx -6_�---------- __Win- .BzYUI.e.,_Ija _0-2-632-0066 Ph one:__508- 775_ 3338 -------- THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY IOSEPH P.- MACOMBER & SON, INC. Tanks•Cesspools•Leachfleids Pumped & Installed Town Sewer Connections P.O. Box 66 Centerville, MA 02632.0066 775.3338 775.6412 f, i. jr - �-\ COMMONWEALTH OF MA.SSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL, INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 232 Carriage Road Osterville,Mass. Owner's Name: Harnl cl Dc-ropp Owner's Address:11 /22/02 Date of Inspection: Same Name of Inspector: (please print),Tospph P-Mac!r)mhttir Jr. CompanvName: J_P.Marnmhpr & Son inc. Mailing Address: Rr x 66_ Centervillp,Mass. 02632 Telephone Number:508-775-1118 CERTIFICATION STATEMENT I certify that 1 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 ,ratnme and experience in the proper function and maintenance of on site sewage disposal systems. I am a DE approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes T _ Conditionally Passes _ Needs Further Evaluation by the Local Approving Authority F il?1111,0e"Wzz Inspector's Signature: Date: The system inspector shall s mit a copy of this inspection report to the Approving Authority(Board of Health or DEP) within 30 days of c pleting this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authohry. Notes and Comments •—This report only describes conditions at the time of inspection and under the conditions of use at that ttme. 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 I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 232 Carriage Road Osterville,Mass. Owner: Harold Deropp Date of Inspection: 11 2 2/0 2 Inspection Summary: Cbeck A,B,C,D or.E/ALWAYS complete all of Section D A. Sys em Passes: I have not found any information hich indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system- is—in pr per wor ing or er a J the present time. B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If`.`not determined"please explain. 4. 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 existiAg 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: 4-16 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 r ND explain: 2 Page 3 of I I ee OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property' Address: 232 C arri age Roam Osterville,Mass_ Owner: Harold Deropp Date of inspection: C. Further Evaluation is Required by the Board of Health: VQ 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 orthe environment. I. System will pass unless Board of Health determines in accordance with 310 CMR I5.303(1)(b) that the system is not functioning in a manner wbich will protect public.bealth, safety and the environment: AO Cesspool or privy is within 50 feet of a surface water W2 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: tid The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or rributary to a surface water supply. .(Ill The system has a septic tank and SAS and the SAS is within a Zone I of a public water supply. /Ul 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,00 feet but 50 feet or more from a private water supply well". Method used to determine distance K "This s\stem 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 rriggered. A copy of the analysis must be anached to this form. 3. Other: 3 Page 4 of I 1 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 232 Carriage Road OstervilleRMass. Owner: _Harold Deropp Date of Inspection: 11 12 2/o 2 D. System Failure Criteria applicable to all systems: You must indicate"yes"or``no"to each of the following for all inspections: Yes No// _ _:✓iBackup 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 Ap_aqj'"41Ae h iquid depth in c*sspee4-is less than 6"below invert or available volume is less than -day flow Required pumping more than 4 times in the last year HOT due to clogged or obstructed pipe(s).Number of times pumped I. Witty portion of the SAS,cesspool or privy is below high groundwater elevation. rL Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface — �water supply. y portion of a cesspool or privy is within a Zone 1 of a public well. /Kny portion of a cesspool or privy is within 50 feet of a private water supply well. 1/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, perfumed 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/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 f/the system is within 200 feet of a tributary to a surface drinking water supply _ the system is located in a nitrogen sensitive area(Lnterim Wellhead Protection Area—IWPA)or a mapped Zone 11 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 f Page 5 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 232 Carriage Road Osterville,Mass. Owner: Harold eropp Date of Inspection: 11 2 2 0 2 Check if the following have been done.Yod 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 t/ 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? _ZHave large volumes of water been introduced to the system recently or as part of this inspection? r/ 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 onents system com y p ;,wluding the SAS, located on site . . Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of tiie baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? Z_ 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. , 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 l l OFFICIAL INSPECTION FORM.— NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 232 Carriage Road Osterville.Mass. Owner:HArnl d Dernpn Date or Inspection: 1 1 f 59110? FLOW CONDITIONS., RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.201(for example: 110 gpd x a of�ooms):6X1 1 0=660 GPD Number of current residents:4J -- Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system yes or no).YR (if yes separate inspection required) Laundry system inspected(yes or no): Seasonal use: (yes or no): YES Water meter readings, if available(last 2 years usage(gpd)): 2002-56, 000 gallons=1 53. 43 GPD Sump pump(yes or no): D -� Q oe 2002-58, 000 gallons=1 58. 91 GPD Last date of occupancy:ZM,61 COMM ERCLAL/MUSTRIA L 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): /why Industrial waste holding tank present (yes or no)-4,0 Non-sanitary waste discharged to the Title 5 system (yes or no):A�4 Water meter readings, if available: Last date of occupancy/use: 110A OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as part of the inspection(yes or no):Z-1117 If yes, volume pumped: gallons-- How was quantity pumped determined? Reason for pumping: Heavy scum & solids layerswere pre e T YP,F OF SYSTEM XSeptic tank,distribution box,soil absorption system .J Single cesspool ',to 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 systeLn owner) Tight tank 4V Attach a copy of the DEP approval Other(describe): Approximate age of all components,.date installed (if known)and source of information: Were sewage odors detected when arriving at the site(yes or no):?�d 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: 232 Carriage Road, Osterville,Maks, Owner: Harold Deropp Date of Inspection: 1 1 /2 2 f n 2 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:g&cast iron Z0 PVCLL other(explain): W,4 Distance from private water supply well or suction line:iG'4- Comments(on condition of joints, venting,evidence of leakage,etc.): In_ _,_nts appear tight .No eyi-donce -f 1-eaI age Thasrctom is vented through the house vents. SEPTIC TANK: ✓(locate on site plan)if 94-�)6es A�- Depth below grade: /'Z Material of construction: 1/concrete4A!:5 meta lfafiberglasstidPolyethylene itle other(explain) 4M If tank is metal list age:Afd Is age confirmed by a Certificate of Compliance(yes or no);.2(attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: Q Scum thickness: O Distance from top of scum to top of outlet tee or baffle: 4 a Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: Pumped at time of inspection- Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of.leakage,etc.): pump the septic ank every 23 years 'Tnl t- & n r 1 P{- tpps arP in =l.are,'j'hp tank i s ctiirtlira 1 1 v sn,u8 i, and of leakage. GREASE TRA33(&&(locate on site plan) Depth below grade: Material of construction;y concrete,K&meta�fiberglass�'�polyethylene421gother (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: eO 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.): Crease trap is not nrPCPnt- 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: 232 Carriage Road Qstpryilleflvlas Owner: Harold Derorm Date of Inspection: 1 1 /2 2/0 2 TIGHT or HOLDING TANK,, (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construct concrete,41R metal,t/1¢ fiberglass Il.� polyethylene.e/A other(explain): Dimensions: /1M Capacity: allons Design Flow: A gallons/day.; ` Alarm present(yes or no): Alarm level:A_ Alarm in working order(yes or no):',f�A Date of last pumping:--..IZA-- Comments(condition of alarm and float switches,etc.): Tight or holding tanks are- not present DISTRIBUTION BOX:Zif present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 16 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.): Dct-ri hnti an hay hac twn 1 ataral c Tievidence of cal i r1c carry PUMP CHAMBER (locate on site plan) Pumps in working order(yes or no): ,UR Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): Pump chamber is not present. i 8 Page 9 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) y Property Address: 232 Carriage Road Osterville,Mass. Owner:Harold.iDeropp Date of Inspection: 1 1 /2 2/0 2 SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) 2-1000 ctallon precast 1eag:hinQ ip'tG_(F 'X1O ' ) If SAS not located explain why: Located: See page 10 Type ,/ leaching pits,number: 40 leaching chambers,number: a leaching galleries,number: d/,� leaching trenches,number, length: 1) 2,0_leaching fields,number,dimensions: d overflow cesspool, number: innovative/alternative system Type/name of technology:ji7�e Comments(note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation, etc.): T,QAmY canrl to mark iim fi na Gann Nn Gi gnG of hYrlra»1 i c- fai 1 ire n_r r nnrli nc Sails are rlrV VPcjPtati nn i G nnrmal „#1 ja:tt Wastes water is 42" below the invert pipe. #2 pit is dry. Has never seen wat CESSPOOL(cesspool must be pumped as part of inspection)(locate on site plan) Numbt;r and configuration: Q Depth—top of liquid to inlet invert: Depth of solids layer: r1J,9 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.): r'p�aCls are not present. PRIVY l (locate on siie plan) Materials of construction: Dimensions: Depth of solids; Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): Privy iG not nreSant 9 Page 10 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 232 Carriage Road Osteryille'MasG_ Owner:Ha o1 d DPrnp Date of Inspection:) 1 /2 2/0 2 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 where public water supply enters the building. 232- Corrz.v JZ,, , Z \ ,d i h �N, / 1 i as W.41-e 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: Harold DeropA 232 Carriage Road Owner: Os tervi l le,Mass. Date of Inspection: 11 2 2_/0 2 SITE EXAM Slope Surface water r Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: NA YFG Observed site(abutting property/observation hole within 150 feet of SAS) NO—Checked with local Board of Health-explain: N n Checked with local excavators,installers-(attach documentation) Yew Accessed USGS database-explain: table.us.ma. ' You must describe how you established the high ground water elevation: Used: G3hLe_t_y & Miller Model 12L16/94 Ground water elevations above" sea level . Used: USGS; Observation well cla a Tuna 1992 --- Used' USG Technical bulletin Q7 400 1 U1a11-e #2 Annual ranges of nand water un - elevations. at.. Leaching f Pit9 ,eet Groundwater: Feet Below Bottom of Pit High Groundwater Adjustment 1.8 f, per Frimpter Method Therefore, the vertical separation distance between the bottom Of the leaching pit and the adjusted groundwater table is 461 - feet. 11 • Sol 'r•nrnr+ —rtrr�.TT�lrnrmrnisT ru�nr..lsnrr..1r:-nrrTnr:TTrnrtn nr*1�ana•sflcr.rrn , TOWN OF Barnstable BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL ,SYSTEM INSPECTION FORM - PART D •- CERTIFICATION •••T•• •T••.••.• —T.l IT.^�.T T�1n•lI.'1T TS1r.1TT]'TYT11'r•5.1 rirs+r.'s�nrrn-TnTevnR RrN11Rti'tw'ItTt 7sn.11 ..—irrr•Tr-1. .�.. -TYPE OR PRINT CI,EARLY- PROPERTY INSPECTED STREET ADDRESS 232 Carriage Road Osterville�y,Mass. ASSESSORS MAP, BLOCK AND PARCEL OWNER' s NAME Harold Deropp _ o PART D - CERTIFICATION NAME OF INSPECTOR Joseph P.Macomber Jr. , COMPANY NAME J.P.Macomber & Son Inch` ' COMPANY ADDRESS Box 66 Centerville,Mass. 02632 Street Tovn or My Stat• LIP COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX (508 ) 790 -1 578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposaj system at this address and that the information_ reported is true , accurate , and omplete as of the time of -inspection . The inspection was performed and any recommendations regarding upgrade , maintenance, and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . • � Ilirl, Check one : - • ( Sys tern PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or Lhe environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* The inspection whicfl I have con ircted has found that the system fails to Protect the public health and the environment in accordance with Title 5 , 3.10 CMR 15 - 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature Date ecopy of this certification must be provided to the OWNER, the BUYER On Where applicable ) and the I30ARD OF HEALZ'Jt. * If the inspection FAILED, the owner or".operator shall u d within one year of the date of the inspection, unless allowed ortrequiredm otherwise as provided in 3JO CMR 16 , 305 . partd .doc ASSESSORS MAP N0L j7/ VJ1 PARCEL /zl-o. G-V No... f � Fxs.... .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiou for Uinpo ial Wor1w Tomitrurtiou ranfit Application is hereby made for a Permit to Const-�uct ( ) or Repair (x) an Individual Sewage Disposal System at: 232 Carriage Road Oyster Harbors ............................•-•------..............-----•---•------------...---......•-•---------. ----•-•--•-----------•-------...-----•-------•------------...........---------------------------- Harold De Rbviyn-Address same or Lot No. ......................_.......................................................................... ------------------------------•---------------•-----•---...----••--............------------....... Owner Address a ....................ARON---COsS.T.._CO......IiYANNIS--.............. Installer Address UType of Building Size Lot............................Sq. feet t t Dwelling—No. of Bedrooms......... ---------------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building --------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) QOther fixtures --------------------_ •----.......------------------....----------------...----------- ---•-•-------••-•---......---........_-------•---...--------- w Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity150-0-galIons Length---------------- Width---------------- Diameter................ Depth................ x Disposal Trench—No- -------------------- Width-------------------- Total Length-_..____-....__--_-- Total leaching area....................sq. ft. Seepage Pit No------2--------.... Diameter........b--------- Depth below inlet-------fi---------- Total leaching area..................sq. ft. z Other Distribution box (x ) Dosing tank ( ) Percolation Test Results- Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ �14 Test Pit No. 2................minutes per inch Depth of Test Pit-_.-------_-____-_ Depth to ground water----_--__-._-___--_-___. a ----------•---------------•----------------------------------•------------------•--••-•-------..........-•---------------•-•----------••-•-•---••-----.-•--- .0 Description of Soil........................................................................................................................................................................ w UNature of Repairs or Alterations—Answer when applicable----ADD_---C-J._)----1.0.0-0...1ear-h...p.i.t,...to.................... ... xsi-t.ing......1.5.0.0s t.._and...10001p-----UPGRAD.E...LEFT---SYSTEM...T.O...TIT1tE...v............................. Agreement: 1000st Dbox and 10001p 2 feet stone The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees of to place the system in operation until a Certificate of Compliance has been issued by the b)-oafd of i Signe1�......_.............. ........................ -------- ......3.12.�19.5......... Date Application,Approved By - .... ...... : _... - --------------------................ ............... .... G-' t1FG`� 5� Application Disapproved for the following reasons: ............................ --------------------------------------------------------------------------- ....... -- ............................. ..................... .............. ... ...... ..................................................... ......... ................... am Permit No. ..... -... � -. Issued Date -r..-..-`-�.- ----- r Date r - - 41 ?/ No.... l7 17 Fa$.... .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratinit fur Divi-putittl Workii Towitrnr#inn rami# Application is hereby made for a Permit to Construct ( ) or Repair ( x) an Individual Sewage Disposal System at: 232 Carriage Road Oyster Harbors ..............................•----....---••------.......----------------------•••••.....•-_------ --•-•••----•--•--•---------•---•-•---•-----••-.....-•••----•---•••----•---•--•--•-•.........---•-- Harold De RLuOW11-Address same or Lot No. ....------•---............................................•----------------•------•...•••..._.... ---•---••-----•---•--•----••-•-•-.....----....-•-•••......----•-••-------.............---......._. Owner Address a --•........-•----....NaCH... ans71.,ao......Ry.Ry.&tj.N_T.S............... Installer Address VType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms.........6.--_-----.-...._-._---.-.----Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons.-.-----.-.--_------------- Showers ( ) — Cafeteria ( ) dOther fixtures --------------------------------------------------------------------------------------- w Design Flow............................................gallons per person per day. Total daily flow--------------------------------.....:.......gallons. WSeptic Tank—Liquid capacity.1.90Ggallons Length................ Width..---.--.------- Diameter---------------- Depth................ x Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No------- ......---... Diameter........F...--.... Depth below inlet..--...f---------- Total leaching area..................sq. ft. Z Other Distribution box (x ) Dosing tank ( ) Percolation Test Results Performed by------- ...........-...................................................... Date...........................-------•--- a a Test Pit No. I----------------minutes per inch Depth of Test Pit..........---....... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.................--..... ........................................................=-•------------ •--------------------- •-----------------------........-------------------•------------ ODescription of Soil..........................................................................---------------------------•-------------•---•----------•------------•-•-•---•-••-••--------- x c.> w U Nature of Repairs or Alterations—Answer when applicable...ADD....(-1_)___1000---leach--- Alt---to............... emslt "�g �� 1 ' ...X.f1.(?n iJ1PC}ADD ,1~FT 5 5'i?LM 'p TITLE V Agreement: 1000st Dbox and 10001p 2 feet stone The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees of to place the system in operation until a Certificate of Compliance has been issued by the board of ea th Signe ................................- ` 4t................................................... .. ... 3/24/95 , ......... .... ........... Dace Application.Approved By ---------------��' ......._...... �-��- ... / �.-- Dae ` l Application Disapproved for the following reasons: ----------------------------------------------------------------------------------- ...................................-------------.......--------...-- .......... Dace Permit No. ..... --------- Issued _2. --- --- '..te) - ----- Dace ----------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE C'IEr#if rate of C�umylianrE THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by ---------------------------------------....ARC ..... ONST--CO-.--------------------------------- ----------------- Installer at 232 CARRIAGE ROAD €�;STERR HARBORS - - - ..---- _-----. .............---------- -------...--- _.._ -- ---------------------------------------- -----.-------- has been installed in accordance with the provisions of TITLE-5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. dated ------ • .�._r THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTR S A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. UED DATE-------- ''': -.-------`- --`-"'----------------------------- Inspector -----` - ------- ----------------- ---' /- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � '' No...:r. TOWN OF BARNSTABLE.................. � FEE.......---� Disposal Norkii Tnnn#rur#inn "anti# Permissionis hereby granted..........AR!aa... Q st-an----•-----•--•--------------------•---------.......----------------.........---............... to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at No........232... ARRIAGE-_ROAD..._OYSTER H.kRa — -------- -- ------- ---------------------- ----T)r,.R(igR.---•--.... Street d � �— as shown on the application for Disposal Works Construction Permit, b ._» %',�ated_-, ..... ..............> Board of Health DATE..............................................-•;-J--=-�'--�..................... � FORM 36508 HOBBS R WARREN.INC..PUBLISHERS Harald S. de Ropp Box 2025 Ostervi l l e, MA 02655 April 20, 1995 BY HAND Mr. Ed Barry, Health Inspector Town of Barnstable Health Department 36 r Main Street Hyannis, MA 02601 RE: Sewage 95-658 232 Carriage Road Dear Mr. Barry: I just wanted to confirm my phone conversation with you of this morning regarding the repair permit to my septic system dated 3/24/95 and what I must do in connection with an addition to the north side of my house. From our conversation this morning and as a result of the installation on 4118/95 of another 1,000 gallon leaching pit to my existing system (a 1 ,500 gallon septic tank and one precast 6 x 6 pit with 2 feet of stone installed about three years ago), my existing house which has 6 bedrooms, is 1n full compliance as of 4118/95 with Title 5 as per a copy of the attached card. Secondly, I understand that if I add a three bedroom addition to the north side of my house, a 1 ,000 gallon septic tank, a Distribution Box and a 1 ,000 gallon leaching pit would have to be installed and that the repair permit issued 3/24/95 fuliy covers this installation under Title 5 regulations in effect prior to 3/31 /95 for the three year term of the permit. I understand that I would have to .pay an additional fee of $70 ($ 100 less $30 paid). I would appreciated it if you would let me know if the above understanding i is incorrect or incomplete in any regard. Thank you very much. Sincerel yours, ASSESSORS MAP NO: Q 7 I PARCEL NO: j No. ._..�' ..* V ... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE Appliratiun for Bispuaal Workii Tonstrurtiun runfif Application is hereby made for a Permit to Construct ( ) or Repair (Individual Sewage Disposal System at: ... ................................•-• -..... ......................... C/ys-�•E••�......••� ..C3G-� ...---•--......................--•-....... Lo,ation-Address or Lot No. �q�d l� ...---- --•------------•......................••-•----- Owner Address ....-------•.................................................... Installer Address UType of Building 3 Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) of Building a Other—Type g ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) Other fixtures W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacity/S25y�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 ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water.---...............---.. f� Test Pit No. 2................minutes per inch Depth of.Test Pit---:................ .Depth to ground water..--................---. a --------...••-----•---------------•------•-•-•--••----•---....-•----......--------------•-----...--•......................................................... 0 Description of Soil........................................................................................................................................................................ W x ----••..: -------------------- V Nature of Repairs or Alterations—Answer when applicable.4 f l� 4f}.�1 .--..�......��7-� .-.....�.......... v� ./vr�o .....................•----------------------------------------------------------------------------------------------•-......---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance h s-been ' ed ¢the health. Sig 3 ..........................---- ---------------- ------- Dare Application Approved By ---- ......... .. - Date e Application Disapproved for the following reasons: ................................................... . ................ ..................... --............ ----------------------- ------.....--- --...... ------------------------------ ------------------------------------------- -- ---- ------------ ....--------. ------. ---------- -- ................................ Permit No. `' ..,�-- �... Issued - .-f " - -- Date 7 , -7 No......................... VYmB THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I TOWN OF BARNSTABLE Appliration for Bi,gVniial Workii Cnnnitrurfinn 'ramit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sew' e Disposal System at: _....,...... ...fit Sys:-- a . ? ..s=....................................... Location-Address or Lot No. f/A /��-•-- f..l� ....------• 5....�, O ner Address ..... --•........................................ Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d , Y - Other fixtures ."-"---"----------------------""-----""""--•-----------------••••--••••----•-•••-------.----•-•----•-•---•-•-•----.....•--••---------..............-- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity!_F.�Ugallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth.to ground water........................ w -•-•--......•...•--•••••.........................•••••••-----........__._._......:...._...__._•••............................................................ 0 Description of Soil......................................................................................................................................................................... V ....................w....... -------••••---••-•------------------•••--------_.....•--••••••-----•-----•---•-•--•••-•---•--••----••••••----------••--------...........-------•----- W -----------------------------------"-----"--------------------.....---------------------"--------------------------------"------------------"--""-----------•""-""--"---"-•••••......•-_......---.....-- U Nature of Repairs or Alterations—Answer when applicable.U, _ _��+_ __._-7-_____7�.7__��-....._._�__.___.__.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has-beXissued by the tia'?d health. Sign� ��... .... .... ...... - ... �/3...----.......------ JDate Application Approved BY - .�`�gi. ....�/...... .; .- ... 'l.e Date Application Disapproved for the following reasons: ....................................... .. . ..........................------------...------------------------------- --------- -------- ----------------------------- -------------------.....................................................------------------------------------------------------------------------------ --------............................... eDate � � Permit No. ----------- Issued ....... .- -- Dace THE COMMONWEALTH OF MASSACHUSETTS { t BOARD OF HEALTH TOWN OF BARNSTABLE '&itifi ate of (11ampliartce THIS IS TO CER�TY, That the Individual Sewage Disposal System constructed ( ) or Repaired (� b A.A,' o ti7G Y ....... ----------------------- --------- ------------------------------------------- -------------------------------------------------------------- I.............................................------ Installer at ....---.1. 3..,�-------.("?,"Z ���.E......... .... - (_ .5'-T F OZ �.�4 /3 v � S .-------................................................. has been installed'in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ......�' ....."FI'1............. dated .... 7e.... 2 -- .. - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT E CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE........................................... ....................................................... Inspector .------.....--..�---y ..........:................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � TOWN OF BARNSTABLE No..' FEE................... I Disposal Workii T11n#rnr#intt rrtni# Permission is hereby granted............ � If �� . ----•-•••••..............••---....------••-•-----•--•----••••••-•-••••----.....•••-•-•---..........•-•....----•-----...... to.Construct ( ) or Repair (v an Individua , Sewage Disposal System at'No........................ = ..._..._�............ .-------"-•-•------"....._...------`..-----------•-••------�-•-3----•--•-------•-•-"-"------. .---... Street as shown on the application for Disposal Works Construction Permit _��Dated......�n r , DATE. ................... Board Board of Health FORM 36508 HOBBS 6 WARREN,INC..PUBLISHERS DESIGN DATA Sao Nate 11 Single Family- 12 Bedrooms F.F EL.27.5 With NO Garbage Grinder F.G.EL.26.5 F.G.EL.26.p Daily Flow= 110 x 12= 1320 GPD czz See Note 4(typ.) Septic Tank: 1320 GPD x 200%=2640 GPD SRe�� Use 3000 Gallon H-20 Septic Tank EL.25.0 Gue3 House . Pool House _ IS'Min. ; ' EL.24.0 Main House _ Top fit.23.0 LEACHING AREA �23.4 t;:y`�ry J ��k .b'�'c, -�'Y���•� 3000 Gallon Septic Tank 7 D Boxy r7l 1320 GPD/0.74 = 1784 SF Required H-20 H-20 FlowE tlili LeachingSldewall=2(12'+ 110')2'=488 SF AS Required ,=rKA EL 2zo r: chamber Bottom Area=(12'x 110')= 1320 SF Bot.El.26.0 1808 SF Total Provided Bedding"T"s,&Baffels Nas Per Title 5 1f Encountered Remove&Replace M;,t All OitaUnsttit Perimeter eterofoils heSyshin t LEACHING CHAMBER DESIGN P � 10'Min.-Slab (See Note8) TheOutarPerimeterofTheSystem DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM EL.2.5 p SULLIVAAti EAU.297� All Pipes to be Schedule 40. Use C1V1L NOT To SCALE Pe T.O.B.Gt sterMap 12-500 Gal. Leaching Chambers in 12'x 110''Washed Stone Fields as Shown. J PERC TEST: 11,207 PERFORMED BY SULLIVAN ENGINEERING SEPTIC NOTES Finish Grade Location of Utilities Shown on Th is Plan Are A rox.At Least 72 Hours WITNESSED BY DONALD DESMARAIS,R.S. 1.L pp -_ :.;{rw�T�>__.ae••�_�ailr�,r;:.-�:;_;; JANUARY 23,2006 3'M nr if ;i.i u� �T , T�1 �y i JY;f ^i, 7 Yi ,>> Prior to Any Excavation For This Project the Contractor Shall Make 9 Min _. Filter Compacted Fill Fabric the Required Notification to Dig Safe(1-888-344-7233). TEST HOLE - I EL.25.5 TEST HOLE - 2 EL.25.5 �" urn ; 1B^-1/2" 2.The Contractor is Required to Secure Appropriate Permits From Town O LAYER O LAYER 2 f�f Pea storre Agencies For Construction Defined by This Plan. ^?tea �'FxrxC. W ` 3.The Proposed Water Line Shall be Constructed in Coordination With PARTLY DECOMPOSED PARTLY DECOMPOSED �F .� _ > �Wl AKA� p Barnstable Water,and Shall be in Accordance With 248 CMR 1.00-7.00 4" LEAVES&TWIGS 25.2 3" LEAVES&TWIGS 25.3 w A LAYER 1 OYR 3/2 A LAYER 10YR 3/2 3 i &310 CMR 15.00.The Water Line.Shall be Sleeved Where Required. VERY DARK GRAYISH BROWN VERY DARK GRAYISH BROWN 3/4"-1 1/2" 4.Install Risers to Within 6 of Finished Grade(6 Required). 6" SANDY LOAM 25.0 6" SANDY LOAM 25.0 LEACHING � - Double Washed 5.All Structures Buried Four Feet or More or Subject E LAYER 10 YR 4/2 E LAYER 10 YR 4/2 2h CHAMBER ' stone to Vehicular Traffic to be H-20 Loading. ' ter H-20 6.Septic System to be Installed in Accordance With 310 CMR 15.00& DARK GRAYISH BROWN DARK GRAYISH BROWNy� '� 248 CMR 1.00-7.00 Latest Revision and the Town of Barnstable 10" SANDY LOAD 24.7 9" SANDY LOAD 24.8f ' T` " _ - B 1 LAYER 10YR 4/6 B 1 LAYER 10YR 4/6 I p I Board of Health Regulations. 4'.10" 7.All Piping to Sch.40 PVC. DARK YELLOWISH BROWN DARK YELLOWISH BROWN 8.Inlet Tees Shall Extend a Minimum of 10" 17" SANDY LOAM . 24.1 15" SANDY LOAM 24.3 ` lr Below the Flow Line. B2 LAYER 10YR 5/6 B2 LAYER 10YR 5/6 YELLOWISH BROWN YELLOWISH BROWN CROSS SECTION OF CHAMBER 9.An Outlet Tee Shall Extend 14"Below the Flow Line. 10.Existing Septic System to be Removed,or 29" LOAMY SAND 23.1 28" LOAMY SAND 23.2 �NOT TO SCALE Pumped and Filled With Clean Material. C LAYER 2.5Y 6/6 C LAYER 2.5Y 6/6 l 11. y Vent Required.Location to be determined OLIVE YELLOW OLIVE YELLOW MED.SAND MED.SAND by Engineer. 4" PERC TEST 22.7 40" PERC TEST 22.2 25 GALLONS IN 4 MIN.30 SEC. 25 GALLONS IN 7 MIN.0 SEC. 124" LESS THAN 2 MIN.INCH 15.2 120" LESS THAN 2 MIN.INCH 15.5 NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED REWSONd Add Proposed 5e tics tam d•sheet 4 1 DAM., D2 -� PREPARED rOR. PREPARED Br 77TL Site Plan rnE O'Connor Group Sullivan Engineering,Inc. CapeSury Proposed Improvements d. 535 Madison Avenue OstePd0e x 59655 osterMlle Parker 01ea At c New York NY 10022 f 3"(spe)4aants rm (aoa)42D-31M(ede)4so-.twa m* 232 Carriage Road d' PEeoa1can °� " Barnstable (oyster Harbors) MaSS. m Draft: Fleld:lNiK ,�M comp.: cam : 04KIlli t. Date: January 23, 2006 Soak As Noted ether: Drarin9/C15fi_3 1 r � �a 4 v k r I ' j x 10 . i somoo® n As.,4 !: & r a I:l—s. nc, f c �, lo�smm�o Mom.6rxn.e si„ y E T N rrmsurr ------ I :I ..I:, wE.nu I ..I J.�.. ....._ .. .�... .� I ]..a. r I •is. ® mn wl - _ f : = 1 Yo: a'Aa7 .... .... it t j: ,. iw .---� -- + — --- URETA,IERI OFFICE ; I. h AV ............. tt 0.:::.. t l .�3 — 7 zb-.m.L, �I1I'.uEaccv:,ti..rcut tiCcn�5 GENERAL CO NTRA CTO R ............ EB Nam BS®SedsSeet'Ide a ) � s 2 1 : I telephone 508-775-04 oe ERnA U.M. fcsimile 50&775.7877 j--- ---- -- LANDSCAPE ARCHITECT ............. ------®------'� 0-- i- 11 Stephen iate aTto -... I SITTING xO w PLAYRD Falmouth.Massachusetts 02540 1 I I I EtEvmoR HALLtelephone 50&54&8119 facsimile 508548-7718 ..._..__.. .. ........ ...I.... 1 .. _..... ! 1 I , r--- ---------- --'---- ----- - - --- --- - ----- ---- I STRUCTURAL ENGINEER: �� � rasseur Engineering �� I �R23 Pleasant Street j I , ` c -n' -v�' ,rFifi I I I r E ATOa HALL' \\J i Neaten Centre,i . _ Il__ I I Mas @4°9 F ———_———_———__ telephone 617.965. 5— I facsimile 617-965-5962A! i. ................... 'i"" ................. HVAC ENGINEER: I I _ ling _-- _ -` .... ... ...... .... - ... .. ._ .. _... ... 0® ..... I _ Sun Engineering g a Ja' 8Eastern Ave Gloucester,Massachusetts 01 MID .: .._. `-' I :\ .I .. ........ ... telephone 97&2B3-8443 PowaER Hlp \ -. ...-_ .,.. _ .... I_.. � facsimile 97&282-A232 INt \\ .:. ...... , ...I. .. ..... MECH.Enml'pEM r — ®� ELECTRICAL&PLUMBING ENGINEER: —— I7.. I — d - I Johnwn Engineering and Design .... 'SEml Street Suite 14 Damers,Massachusetts 01923 w1s have 978-6469001 I facsimile 978-646-9002 Asa ISSLC Imeeriora,Inc 1 ad Eetls O I' ''...^"'� �P'la<nII��Macc'aiu 1 � ewe. 982 j I ono E telephone NBAS84a30, i' q ar "a a 97&` 4684350 ` I I araf wls1" I I I_ i mrulim-1sume I., ` _._.� — __ _ _ —bect' A38 L i !, L J O'Connor Residence 232 Carriage Road -' cma. a Oyster Harbors,MA r I. Attic Floor Plan ! ATT F600R�LAN J lone sanlon rwloa Axn SCALE: 174'=V-0' ,1 Y DATE: October 29,2008 Oatwano Architects Inc. 115 Broad Street / l Boston,Massechusens02110 x E '+� telepMne 617-338-7447 77 _._._.—.g� � facsimile 617.338 6639 �t . A � 1.3 - I j DESIGN"DATA See Note 11 Single Family- 12 Bedrooms F.F EL.27.5 With NO Garbage Grinder Daily Flow= 110 x 12 = 1320 GPD F.G.EL.26.5 F.G.EL.26.D See Note 41t p.> Septic Tank: 1320 GPD x 200%=2640 GPD SR acreUse 3000 Gallon H-20 Septic Tank ]VEL. 5.0 Guest House 15,Min. , Pool House _ I Too E1.23.0 1 LEACHING AREA 24.0 Mein House EL.23.a 3000 Gallon Septic Tank D-sox NYC.3 1320 GPD/0.74= 1784 SF Required H-20 H-20 Flow E ttifi2ers Sidewall=2 12'+ 11 0' 2'=488 SF As R uired �s.�v to^i� �, ��r Leh .� 7.,�nw4 ( ) �l EL.22.0 %kY Chamber �1; Bottom Area=(12'x 110')= 1320 SF � Bot.M.20.0 1808 SF Total Provided Bedding"T^s,&Baffels as Per Title 5MUL 11 hEU Replace Unsuitable soils Within of 10'Min.-Slab (See Note 8) The Otrtet Perimeter of The Syaem LEACHING CHAMBER DESIGN 20'Mm--Foundation DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM EL.2S All Pipes to be Schedule 40. Use NOT TO SCALE PST o.B.G°�rMap 12-500 Gal. Leaching Chambers in 12'x 110'Washed Stone Fields as Shown. PERC TEST: 11,207 PERFORMED BY SULLIVAN ENGINEERING i SEPTIC NOTES Finish Grade WITNESSED BY DONALD DESMARAIS,R.S. i.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours JANUARY 23,2006 : may, Prior to An Excavation For This Project the Contractor Shall Make 3'Max ,,;�tt 4.:.� -_! :,-,i4t. fe;Y. }�,r y;'ii.. 'ti •-�� r,.:.s,--. i Filter Y J 9"Min Compacted Fill Fabric the Required Notification to Dig Safe(1-888-344-7233). TEST HOLE - 1 TEST HOLE - 2y, 2.The Contractor is Required to Secure Appropriate Permits From Town EL.25.5 EL.25.5 ry t. 1 tB^•tir' z �;rt r r pea storte Agencies For Construction Defined by This Plan. O LAYER O LAYER '� ,�. s�� ;• e 3.The Proposed Water Line Shall be Constructed in Coordination With PARTLY DECOMPOSED PARTLY DECOMPOSED Barnstable Water,and Shall be in Accordance With 248 CMR 1.00-7.00 4" LEAVES&TWIGS 25.2 3" LEAVES&TWIGS 25.3 A LAYER lOYR 3/2 A LAYER lOYR 3/2 3' _ &310 CMR 15.00.The Water Line Shall be Sleeved Where Required. 4.Install Risers to Within 6 VERY DARK GRAYISH BROWN VERY DARK GRAYISH BROWN 3/4"-1 1/2" of Finished Grade(6 Required). 5.All Structures Buried Four Feet or More or Subject 6" SANDY LOAM 25.0 6" SANDY LOAM 25.0 �, LEACHING y Double washed 2' r�, CHAMBER ,F to Vehicular Traffic to be H-20 Loading. E LAYER 10 YR 4/2 E LAYER 10 YR 4/2 t� {. H-20 ��'�"-��� 6.Septic System to be Installed in Accordance With 310 CMR'15.00& DARK GRAYISH BROWN DARK GRAYISH BROWN ,Y�,� FX t i 248 CMR 1.00-7.00 Latest Revision and the Town of Barnstable 10" SANDY LOAD 24.7 9" SANDY LOAD 24.8 B 1 LAYER IOYR 4/6 B 1 LAYER IOYR 4/6 Board of Health Regulations. DARK YELLOWISH BROWN DARK YELLOWISH BROWN a' 10^ 7.All Piping to Sch.40 PVC. 1 17" SANDY LOAM 24.1 15" SANDY LOAM 24.3 12' 8.Inlet Tees Shall Extend a Minimum of 10" OF B2 LAYER IOYR 5/6 B2 LAYER 10YR 5/6 Below the Flow Line. YELLOWISH BROWN YELLOWISH BROWN CROSS SECTION OF CHAMBER 9.An Outlet Tee Shall Extend 14"Below the Flow Line. PTE� 29" LOAMY SAND 23.1 28° LOAMY SAND 23.2 NOT TO SCALE 10.Existing Septic System to be Removed,or WV C LAYER 2.5Y 6/6 C LAYER 2.5Y 6/6 ( Pumped and Filled With Clean Material. W.2971 OLIVE YELLOW OLIVE YELLOW 11.A Vent is Required.Location to be determined CIVIL MED.SAND MED.SAND by Engineer. 4" PERC TEST 22.7 40" PERC TEST 22.2 25 GALLONS IN 4 MIN.30 SEC. 25 GALLONS IN 7 MIN.0 SEC. 1 " LESS THAN 2 MIN.INCH 15.2 120"1 LESS THAN 2 MIN.INCH 115.5 NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED REVISION: wed Proposed Septic s tem a sheet •t 1 DA7E: 0211)7106 PREPARED FOR: l PREPARED Br. nne Site Plan TAe O'Connor Group Sullivan Engineering,Inc. CapeSury Proposed Improvements d. 535 Madison Avenue PO Bay 659 7 Parker Road At New York NY 10022 OstaWne, MA 02655 ostar0a MA 02655 232 Carriage Road d. C.1mW9-.M"v&z)42&.X is tar ra"asd-»w rsae ek. Barnstable (Optar Harbors) Mass. Draft: Fleld:u«,c ,,PM camp.: I Carnp., K- RRL Dat`' January 23, 2006 scate: As Noted e ew: IDrairing/C456_3 1 I • _ DESIGN DATA See Note ' Single Family- 12 Bedrooms F.F EL.27.5 With NO Garbage Grinder 'F.G.U.26.5 F.G.EL. Daily Flow= 110 x 12= 13 20 GPD � See Nate 4 ctypa Septic Tank: 1320 GPD x 200%=2640 GPD Use 3000 Gallon H-20 Septic Tank ap Ei.25.0 Gust Hose Pool House ( IS'Min , 3 ' AEL.24.0 Main House L.23.4 Too E1.23.0 1 LEACHING AREA E 1 Y F 'n . '7 27'' 3000 Gallon �:i�y ay . a.P�`�i� �fr"� Septic Tank E D-Box v ^ �� 1320 GPD/0.74 = 1784 SF Required H-20 H-20 Q Flow E uilizers t As Required :xe �r[Z EL ac 220 w r Leaching Sidewall=2(12t+ I10)2t=488 SF Chamber f r. H_20 `x Bottom Area=(12'x 110')= 1320 SF BA.El.20.0 1808 SF Total Provided Bedding,"T"s,&Baffels 10, to Per Title 5 IFEncounteted Remove&Replace Min All Unsuitable Soils wdh 5'in of 10'Min-Slab (See Nate 8> - - The otter Perimeter of The System. LEACHING CHAMBER DESIGN 20'Mtn-Foundation . DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM U.2.5 All Pipes to be Schedule 40. Use er NOT TO SCALE Pe pz o.B.rourAwaaterMap 12-500 Gal. Leaching Chambers in 12'x 110'Washed Stone Fields as Shown. PERC TEST: 11,207 PERFORMED BY SULLIVAN ENGINEERING SEPTIC NOTES WITNESSED BY DONALD DESMARAIS,R.S. �Ftntsh Grade 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours JANUARY 23,2006 u " 3'Max Excavation For This Project the Contractor Shall Make ...try,.his... ,-* _ ,.r,�:.- �,:-,-.y.1.L.? {,,,.._.... Filter Prior to Any 9"Min T Compacted Fill Fabric the Required Notification to Dig Safe(1-888-344-7233). TEST HOLE - 1 EL.25.5 TEST HOLE - 2 EL.25.5 fti rnartaa`. 1B^-lie" 2.The Contractor is Required to Secure Appropriate Permits From Town 2 O LAYER O LAYER , { � x a Pea srone Agencies For Construction Defined by This Plan. w Y�'y - 0'.i at " ' PARTLY DECOMPOSED PARTLY DECOMPOSED 3.The Proposed Water Line Shall be Constructed in Coordination With I { '` q LEAVES&TWIGS 25,2 3 LEAVES&TWIGS 24,3 ,2I9..;��,� Barnstable Water,and Shall be in Accordance With 248 CMR 1.00-7.00 A LAYER lOYR 3/2 A LAYER lOYR 3/2 3' &310 CMR 15.00.The Water Line Shall be Sleeved Where Required.. VERY DARK GRAYISH BROWN VERY DARK GRAYISH BROWN 3(4"-1 la" 4.Install Risers to Within 6"of Finished Grade(6 Required). 6„ SANDY LOAM 25.0 6" SANDY LOAM 25.0 'a i, LEACHING �-- Double Washed 5.All Structures Buried Four Feet or More or Subject E LAYER 10 YR 4/2 E LAYER 10 YR 4/2 2' `" CHAMBER slOIIe to Vehicular Traffic to be H-20 Loading. DARK GRAYISH BROWN DARK GRAYISH BROWN K H-20 .�' a 6.Septic System to be Installed in Accordance With 310 CMR 15.00& �t a, y, , 10" SANDY LOAD 24,7 9 SANDY LOAD Zq g "7° - '�- k.� 8 248 CMR 1.00-7.00 Latest Revision and the Town of Bamstable B I LAYER 10YR 4/6 B 1 LAYER 1 OYR 4/6. Board of Health Regulations. DARK YELLOWISH BROWN DARK YELLOWISH BROWN 4'-10" 7.All Piping to be Sch.40 PVC. 17" SANDY LOAM 24.1 151, SANDY LOAM 24.3 lY 8.Inlet Tees Shall Extend a Minimum of 10" B2 LAYER IOYR 5/6 B2 LAYER IOYR 5/6 Below the Flow Line. OF YELLOWISH BROWN YELLOWISH BROWN CROSS SECTION OF CHAMBER 9.An Outlet Tee Shall Extend 14"Below the Flow 'ne. 29" LOAMY SAND 23.1 28" LOAMY SAND 23.2 NOT TO SCALE 10.Existing Septic System to be Removed,or PETER C LAYER 2.5Y 6/6 C LAYER 2.5Y 6/6 Pumped and Filled With Clean Material. .SULLIVAN OLIVE YELLOW OLIVE YELLOW 11.A Vent is Required.Location to be determined W.297: MED.SAND MED.SAND by Engineer. C111 . 4' PERC TEST. 22.7 40" PERC TEST 22.2 A 25 GALLONS IN 4 MIN.30 SEC. 25 GALLONS IN 7 MIN.0 SEC: , A O 124" LESS THAN 2 MIN.INCH 15.2 120" LESS THAN 2 MIN.INCH 15.5 1t NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED REWslauv: Add Proeosed:earn S tem er sheet 4 DAIE: 02 7 os PREPARED FOR: PREPARED Br. 117I.E Site Plan Th- O'Connor Group Sullivan Engineering,inc. CapeSury Proposed Improvements �. 535 Madison Avenue PO eax 659 7 Parker Road New York NY 10022 OstervNe. MA 02655 OsterW?le MA 02655 At o fsae,.ae w.fdoe aA�nts A& (MV•M-W4(-W) 232 Carriage Road tl. P9,tlPE!"loes, �pKo6n�! Barnstable (O-W r Harbors, Mass. Drag: Meld:NHX JPM - � . Camp.: camp.. AHK/RRL Date., ..-January„23, 2006 scale' As Noted 0-wing f C4a6-3 1. 151L6A'k FAQ T It ' y CpFtGE , , 1 X (a2��T 0..oah'► ' ' I kirG�+eN ' Ib X zb �►Z J Dir4iivv , t L1v lnu t , 18' x Z� f ii. 1 I ( �-- I)ry ---- 1;fLootl CcrAPL)TE)L ' • r r CLOSE ' r l ' Po4roE1L n 1 I `- I L. - MvpX.cor1 aXrGr ' I 've I The O'Connor Residence L 232 Carriage Road t. Oyster Harbors, MA C, E First Floor Plan 1 1 iI h l c, 4 � t X t qr" h ry dP ti1V r LA LL iiTTiNU a The O'C onnor Residence 232 Carriage Road Oyster Harbors, MA i Second Floor Plan 1/s••=ir-o f I • ♦ _ I I _ I � SSA IM F{i.�.L - �. I ,�,\ � ___ �� _--� I. i PC!- II � I I E I _ i I I L Guest House Guest House First Floor Plan Second Floor Plan The O'Connor Residence 232 Carriage Road Oyster Harbors, MA s�mnw. 4 (i/rILIe►L C 2.4131 LNI N le 4 F�p"IA� 00 1 � l j IL IS, Garage and Pool House Plan The O'Connor Residence 232 Carriage Road Oyster,Harbors, MA Maid Suite Plan r t � i t1 lik it, t � 1 � i � Is s�m�w CIY tjcD The O'Connor Residence 232 Carriage Road Oyster Harbors;MA Attic Floor.Plan 1/8"=1'-0 .� DIRECTIONS: ZONE. o � u • : From Hyannis — Take Route 28 into Osterville; RF—? 61 a At the lights by White Hen Pantry, take a left Area (min.) 87,120 SF(RPOD) onfo Osterville West Barnstable Road and follow ( \ Fron t0 e (min) 20 � � \ \\ 5 4 a ` xR,� x}$ to the. end, Take p left onto Main Street; .Take Width (min) 12 a right onto Parker Road, At the stop sign Setbacks: , ; K `h,= N r \ take a right onto West Bay Road; Bear left Front 30' o° ;o'xA ,izxs n \ '\ onto Bridge Street, and follow to the Gate House; Side 15 \ \ , Continue straight on Oyster Way, and then take a Rear 15s left onto. Pheasant Path; Take a right onto zrf 1< f Carriage Road, and site is on the left, #232. \ oyfip� v � • \ \ \ Location Map. ?"—2,Doot' co FEMA Zone Line \ ` as per FIRM Panel M # 2500011 0018 D 20*2 N Top of Coastal Bank ASSESSORS REF: \ (by Town Definition) o \ \\\\ \�\\ , \ `` Map 071, Parcel 017 \ o OVERLAY DISTRICT: \ \ \ \\\ \\ \ \ PROPOSED ° 25 \ \ N \\\\ \\\\ \\ �, \ \ \ \ ViEW CHANNEL AP - Aquifer Protection District / ` \ \ Q \\\ \\\\ \\ \ ` �r. �o• As Shown on Plan Entitled '�- \ `� Q Revised Groundwater Protection , , Overlay Districts — April, 1993 FLOOD ZONE. _- -- — — — — — — —, �•�-- a � • N .�` \ \ \\ \ o \ 1 �---' Zone C & A 14 (see plan) 63 2 p( - a \ \ Communit Panel No. o \ �.�`\ \ \\\ \ \ \\\ �\ \ ��. #250001 0018 D ''0ee o%` _ 5a d pier July 2, 1992 o� e PROPOSEDLA WN PROPOSED ,--� DRYWELL FO\R ° 't66F RUNOFF (1\YP.) cr 25a) 114 1 PROPOSED ' ••'••.• STA1R • .. � � . ... •• E ONFIGURATION \ � \ , \�\ \ ( •� '\ , GARAGE l - r" •� r,• b �\ \\\� .,� •, SLA8�1'r7.� O (SEE S 3 OF 3) \ \ \ \ \ , o \ p O N c11 C� tr \ �\\ X\\\ \\\ \\ e \ s PROPOSED , __ , , o YWELL FOR ` N�� :o p \ \ \ \ N a f \ PROPOSED c o / _ �N o POO DRAW DOWN \\ PATIO 10 2 \ 9 EL. 26.5 PROPOSED \! \\\ \\\ \ \ o I, off. PROPOSED jA WN PROPOSED , • l DWELLI G \\ \ ° �` � �' � TERRACE ��°• \ \ 's \\ \\ `: � � . POOL ( ,: ROPO.cif jqL, / F.F. 2 Z 5 EL. 26.0 PAR k —26-' M p o \� 110 � `• '' �,\\\�\�\ PROPOSE D VIEW CHANNEL O \r, NN O` 15Ep EM rn r, OppSE RAH c \ 100% p 90 55�OF c�) PR E� pc0 a o pp °Hose e p�5 T• PROPOSED /'' COvE EL. 7. \ LAWN s.5 0 �09e , >� 10 `6� PROPOSED \ 7? `, GUEST HOUSE W 2a6 t W F.F. 27.5 ' Z$Sevr 9 xzzol N i 0 PLAN NOTES: 1. FOR PROPOSED LANDSCAPING (INCLUDING 0 989 tr TERRACES, PATIOS, STEPS, DRIVEWAY, PLANTINGS) SEE LANDSCAPE PLAN BY OTHERS. LEGEND Q 3 6 w REPORT DEVIATIONS TO ENGINEER. rn_ °g % z4x9 2. FOR PROPOSED DWELLING, GARAGE, POOL HOUSE, & GUEST HOUSE � Light Post �.""�� ,// SEE PLANS BY OTHERS. REPORT DEVI TIONS TO ENGINEER. SULUVA ® Catch Basin Y" �' N 3. GRADING & DRAINAGE SHOWN ARE CIVIL 33 Gas Gate© - �,(f e ® Water Gate w° a Sty ,005 FOR PERMITTING PURPOSED ONLY. Or,o9 ' DEVELOPED CONSTRUCTION BY ENGINEER. BE {� Hydran t O CB/DH O SB/DH -4 Guy -O- Utility Pole REVISION: Add Proposed Septic System & Sheen 4 DATE: 02/07/06 -bnw-- Overhead Utility Lines SURVEY NOTES: PREPARED FOR: PREPARED BY. TITLE:Deciduous Tree ' Site Plan °� 1.) The property line information shown was The O'Connor Group Sullivan Engineering, Inc. Ca, peSury Pro ose Im535 Madison AvenLre gProposed Improvements compiled from available record information. PO Box 659 7 Parker Road At MA 02655 Osterville MA 02655 Coniferous_ Tree �� New York NY 10022 Osterville, � p o 2.) The topographic information was obtained ( ( ��� Carriage Road from an on the ground survey performed an (508)428-3344 508)428-3115 fox (508) 420-3994 508) 420-3995 fox („j �, (,,� PSullPE@ool.com copesurv@copecod.net Holly TreeBamstable (pyster HaJ"bOrS or between 041AUG105 and 11/AUG/05: ) Mass. 3. The datum used is NGVD '29, a fixed mean Draft: Field: WHK/JPM ) 20 p 10 20 40 80 sea level datum. Comp.: Comp.: WHK/RRL Dote: c�C7!'lU(T/"'/ 27, 200 Scale: Review: Drawing "-2O' # C456_3g1 DIRECTIONS: - �- a -• :. � ' CTIONS: ZONE: y ------' ' From Hyannis - Take Route 28 into Osterville; RF-T At the lights by White Hen Pantry, take a left Area (min.) 87,120 SF(RPOD) onto Osterville West Barnstable Road and follow20' � Frontage (min} to the end; Take a left onto Main Street; Take Width (min) 125 a right onto Porker Road; At the stop sign Setbacks: take a right onto West Bay Road, Bear left Front 30' \ \ ', onto Bridge Street and follow to the Gate House; Side 15' Continue straight on Oyster Way, and then take a Rear 15 ps Y„ Y ? N i; r` left onto Pheasant Path; Take a right onto fi f {t` \ i \ Q► r \ ' , Carriage Road, and site is on the left, #232. \ ` •� 1 ' .ta a 't Y 'V K ' ` \ \ \\ Location Map: \AIL \ `\ 1„`2,Oo0f' o FEMA Zone Line c° as per FIRM Panel ko cr) \\ \\\\�\\ \ \ \\ \ / ASSESSORS REF.. N Top of Coastal Bank \ \\\� \\\ \\ \ 1 `�\ \ �\ Mop 071, Parcel 017 a N (by Town Definition) A OVERLAY DISTRICT: PROPOSED ViEW CHANNEL AP - Aquifer Protection District 250c, As Shown on Plan Entitled ALI` "Revised Groundwater Protection Overlay Districts - April, 1993 a,1 FLOOD ZONE. � ` — _ „� °�\\ Zone C & A14 (see plan) _ _ _ a` 0 � a o 6, \ `•,, \ \\ \ \ \\\\ \ \ \ \!` Community Panel No. N6 ,°FteG \ \ \ \ \\\ \� \ \ \ #250001 0018 D July 2, 1992 o�,nee °fiber �'. 50 �'`.\ \ \ \\\,.\! \ \ \ \\ \ 't�` '`\ 'S°,d p`e` G°it ct{ i \�\ \ \ \ \A Sre 210 ° PROPOSED �' a ti\ \ \\ Rai fe° LAWN PROPOSE � \\ �` � \ � \ \ ,ALURYWELL FOR ROOF RUNOFF (-AYP.) o ood �. \ (' \ \ \ o f -C f ,- -- PROPOSED ° I PROPOSED- o STAIR 'fl �RE ONFIGURATION -o GARAGE �, 6, ` (( )) -o N �\a� o rn O (SEE SH OF 3) �' o o SLAB-f7.U r o PROPOSED O a cr �, Q •\ �\\\ \\ \\ \ un `. O / YWELL FOR ` 1 \``\ \ \�\ \\ \ Gt° `�:.� ,�1� \� w� , PROPOSED G c•� � \ � \ �\\\ \\ �\\ \ t ` \ Na , POO DRAW DOWN �` PATIO 91 a EL. 26.5 PROPOSED c " \\ l PROPOSED J LA WN ` \ PROPOSED \ 1 DWELLING i TERRACE ROPOSED �\\ \\ \\ 6, •� POOL / F.F. 27.5 / N \ �� \aa \ PAR COURT -2s- EL. 26.0 26" -71 Ck 0 \ \ 50'2 \ \\ \ \\\\ \\ 1 \\ 11a rn•.-•. ,,.-'... ' �\\\\ , PROPOSED ViEW CHANNEL \ \TH2 o_ ls o` `. /. oPpSE \ o 1 gyp% ,(��6 f �) - v�REp p O0 ° rw Hose B 5 PROPOSED LAWN ss > a 68.q 2^ ` \gam PROPOSED ` a� ? `, GUEST HOUSE W ZRe w�� F.F. 27.5 2 s awn cs W x , ,., `^' j PLAN NOTES: 1. FOR PROPOSED LANDSCAPING (INCLUDING ao�fo�tn TERRACES, PATIOS, STEPS, DRIVEWAY, ss xw Bit ct# '4109 REPORT PLANTINGS) I NGS) SEE LANDSCAPE PLAN BY OTHERS. C� 6 v� e� e,,,- IONS 0 ENGINEER. LEGEND 3 � 2. FOR PROPOSED DWELLING, GARAGE, os ?°X9 POOL HOUSE, & GUEST HOUSE OF Light Post SEE PLANS BY OTHERS. Catch Basin �� REPORT DEVIATIONS TO ENGINEER. PETER NIP AM G �/ w/f 3. GRADING & DRAINAGE SHOWN ARE. �LLi� Cos Gate N� z s�y6 No-Se FOR PERMITTING PURPOSED ONLY. CIVIL 33 ® Water Gate �� CONSTRUCTION PLANS TO BED 4 Hydrant DEVELOPED BY ENGINEER. El CB/DH 0 SB/DH -0 Guy -& Utility Pole REVISION: Add Proposed Septic System & Sheet 4 DATE: 02107106 —ohw— Overhead Utility Lines SURVEY NOTES: PREPARED FOR: PREPARED BY. TITLE: 00 � �'Deciduous Tree ° Site Plan °X 1.) The property line information shown was The o Connor Group Sullivan Engineering, Inc. CapeSury Proposed Improvements compiled from available record information. 535 Madison 1 Avenue PO Box 659 7 Parker Rood At 4- Coniferous Tree Osterville MA 02655 Osterville MA 02655 0 � 2.) The topographic information was obtained New York NY �0022 ' from an on the round m atron performed on (508)428-3344 (508)428-3115 fox (508) 420-3994 (508) 420-3995 fax 232 Carriage Road g y p PSullPE@ool.com copesurv@copecod.net or between 041AUG105 and 11/AUG/05. Bamstable (Oyster ) Ma�+�+.Holly Tree Harbors a7a7 3.) The datum used is NGVD '29, a fixed mean 20 0 10 20 40 84 Draft: Field: WHK/JPM sea level datum. Comp.: Comp.: WHK/RRL Date: JoI7Uary 27, 2006 Scale: 1 Pt 20' � Review: Drawing # C456_3g1