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Home My WebLink About0233 CARRIAGE ROAD - Health Y a,"�y a��• 233"Carriage Road Oste" M e A. /- — 020 s' s i �i TOWN OF BARNSTABLE LOCATION,43-3 SEWAGE# ,16E - 337 VILLAGE 0Srw1I_U1 1 C, ASSESSOR'S MAP&PARCEL ®'p e•O Q INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type] (size) 14•T%S XcA— NO.OF BEDROOMS � t L:s4:i 1�"k e OWNER I / PERMIT DATE: 10 -1 .P� COMPLIANCE DATE: � l Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY bC3 =il6 vo f J A Z o � 4v"J y a No. 0(J 3 3 / Fee IS Z-i THE COMMONWEALTH OF MASSACHUSETTS Entered in computer PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es 01pplitation for Disposal *pstrm Construction Permit Application for a Permit to Construct Repair( ) Upgrade(--Abandon( ) [Complete System ❑Individual Components Location Address or Lot No. 733 ,CA r r'i 45er <s4k Owner's Name,Address,and Tel.No. OS�e�►`\fie, moor Soa.. Assessor's Map/Parcel 67( -0 Z(j Installer's Name,Address,and Tel.No. � 7 7 i `j; L signer's Name,Address)l and TTrql.No.,vyX,), 0,s1tit�S .a„� Mesh Sv3-�I Z�- ; '33Y Type of Building: ruu0N f> 83' , d ddw�. f Dwelling No.of Bedrooms Lot Size 37,$00 sq.ft. Garbage Grinder(0 0) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) $$0 gpd Design flow provided j o� gpd Plan Date PVC,W ZZ, Z01S Number of sheets Revision Date /`I l� �: v(h /6� Title �, ( ra ar_ rJ Ca/11C)i Size of Septic Tank 3600 (v, - 2 (oin rtie�1 Type of S.A.S. G-5all Cln-L-,6 Description of Soil _kc 4,19,Z3 -%-�) ®�I L� l�C C .� (o`IP.ZI L CAA y 5R 12-30 -t2�) LA�jEG3c 1o7R (ki l ftWww\ 5A►n� 3�-1Z�f�` C l_��rc.h toy�7 jy w►c�iuv� 5&N> Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and main nce of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental° od nd not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. gne Date Application Approved by ° Date Application Disapproved by Date for the following reasons Permit No. J J - 3 3 -7 Date Issued (e_ '(S' No.' 0� - 3 3� , Fee Sa Entered in computer, THE COMMONWEALTH OF MASSACHUSETTS gip. . "Yest N__,,_ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS *sue 01pplitation for Disposal 6pstem Construction Permit Application for a Permit to Construct Repair( ) Upgrade(.a Abandon( ) [.Complete System ❑Individual Components Location Address or Lot No. 2 j3.,,Cq c 1 (, <4 Owner's Name,Address,and Tel.No. f Assessor's Map/Parcel t)-t 1 - u Z o Installer's Name,Address,and Tel.No. 5UF--7?t-93q Designer's Name,Address,and Tel.No. �4lvCtllA t� tulN�� Sk1•v•. C+.;�!t�-er,�y �1�r5�11,:.� 4.�tkS P.e:3.� use. Su3-BIZ •33 s \\ Type of Building: ��')cude � = 0•k,cd„_� Dwelling No-of Bedrooms Lot Size 00 sq.ft. Garbage'Grinder Other Type of Buildings No of Persons Showers( ) Cafeteria( ) Other Fixtures I{ Design Flow(min.required) R$0 gpd Design. ow provided 0 gpd Plan- Date Scgo r,r:w ZZ, Z015 Number of sheets Revision Date Ohl r b� �. r/• :/r, Title 5A,,, �1 r,fox k lw„pcaJew,cA j Size of Septic Tank 300a colt- ? r o/n(�rr�Mc;.\ Type of S.A.S. (p-r3a% �.ha.v.'D8�`� ;,, Z .. Description of Soil �P�e 4$-14 e� 1h O-�Z Ae t A�j IT��7 t uk"Sig AA) 'R, (dry�&� 10`I K 411 mo,wn s 0'4 Nature of Repairs or Alterations(Answer when applicable) Date last inspected: r" Agreement: r � The undersigned agrees to ensure the construction and ma int nce of the afore described on-site sewage disposal system.in accordance with the provisions of Title 5 ofZEnvironmentod nd not to place the system in operation until a Certificate of Compliance has been issued by this Board S•gne Date - Application Approved by Date U Application Disapproved by -Date i for the following reasons Permit No. 2n / 5-- 3 3 -7 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliauce THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( .-) Repaired( ) Upgraded Abandoned( )by U A-7-9 k.,o_(AlC/llN A/ C71 oJ at Z 33 (r rr cl c I I _ has been constructed in accordance - j with the provisions of Title 5 and the for Disposal System Construction Permit No.;a/ -33 7 dated a- I Installer Designer ' #bedrooms Approved design flow JP",{rd gpd The issuance of this permit shall not be construed as a guarantee that the system � wilincnas desi . ed. Date n � Inspector �o . t ---------------------------------------------------------------------------------------------------------------------------------------- No. )c)15--33 / Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted to Construct Repair( ) Upgrade(/) Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. �K Provided:Construction must be completed within three years of the date of this permit. Date f 0 < - ( } Approved by IMI Town of Barnstable Regulatory Services Richard V. Scali,Interim Director- AM +BSTABLE' ' Public Health Division 039. .� 'OrFo nno�" Thomas McKean,Director 200 Main Street,Hyannis,MA 02601, Office: 508-862-4644 Fax: 508-790-6304 Installer &Designer Certification Form Date: Sewage Permit# a 7 Assessor's Map\Parcel-01 I -Q Z D Designer: .Su(1,V 4A Fk�-e-on yP- Installer: (,ons6-u on Address: earl< ZPo Ziox. Address: zfS �us�� Cat ei�,ll� A , Mar4ons MI I(s�� O lo�B II ( On ��11 116' �0'L �o �»S tYYi> '. 0 was issued,a permit to install a (date) (installer) septic system.at `�-�J (�a((V AC V 0(jr , based on a design drawn by (address) !'I'�4'h h I'heeC�h dated i o designer) k 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 arid/or septic tank. Strip outfif 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'lateral relocation of the SAS or any vertical relocation of any component of the septic system)but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if required)was inspected and the soils were found satisfactory.. I certify tha system referenced above was constructed i - Qm I'ance with the terms of the app al letters(if applicable) or n J. (Installer's Signature) (Designer's Signature) (Affix Designer °S(amp Here) PLEASE RETURN TO BARNSTABLE PUBLIC.HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. QASepti6Designer Certification Form Rev 8-14-13.doc EXISTING CONDITIONS AFFIDAVIT To: Buildin Inspector Town of Barnstable Building Department From: John O'Connor 232 Carriage Road Barnstable, MA 02655 Re:Affidavit for Existing Conditions for 233 Carriage Rd, Barnstable, MA 02655 September 22,2015 To Whom It May Concern: This serves as an affidavit verifying the existing conditions at 233 Carriage Road, Barnstable, MA 02655. Catalano Architects photographed and documented the existing structures as built.We have determined there are 8 existing bedrooms located in 3 structures on the property. As a neighbor since 2003, 1 verify to the best of my knowledge that no work has been performed upon the layout of the existing building since the year 2003. The three existing structures are a Main House,Cottage,and Garage with Suite.The bedrooms are broken up between these structures as follows: Main House: First Floor: 1 Master Bedroom - 1 Master Bath -2 Water Closets Second Floor: 2 Bedrooms -2 Full Baths Basement: 1 Bedroom/Playroom Cottage: First Floor: 1 Bedroom -1 Full Bath Garage Suite: 1 Bedroom 2 Bunk Rooms - 1 Full Bath This totals to 8 Bedrooms on the Property.Attached to this Affidavit are the drawn existing plans showing the location of each of the Bedrooms. Should you have any questions or require further documentation, please contact me. Sincerry, <ohn F. OL onnor �_Mr.Thomas Catalano—Catalano Architects Vr. John O'Dea—Sullivan Engineering Town of Barnstable P# 7-1 CF THE T P` Department of Regulatory Services BABNSTABIZ Public Health Division Date 9 KAS4. g 1659.Aim 200 Main Street,Hyannis MA 02601 n't.� Date Scheduled Time 0 t^'' Fe4 /d. / -D .T_• Soil Suitability Assessment for Sewa eDisposafl Performed By; v�� 444 Witnessed By: f LOCATION & GENERAL INFORMATION Location Address _ Owner's Name Z �Girr iGj 2 @�ya� Sal .eS Address Assessor's Map/Parcel- Engineer's Na ! NEW CONSTRUC17ON REPAIR Telephone# Land Use - s, Edt-t'iQ Slopes(%) 0'S Surface Stones It.44 n� Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way *" ft Property Line 0'2- 0 " ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) r . W_ �i. 1 f D ' Parent material(geologic)_6V4WP54 Depth to Bedrock a 61 e�� Depth to Groundwater: Standing Water in Hole: "/' B - Weeping from Pit Face *"_1,0_ Estimated Seasonal High Groundwater DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole:' in. Groundwater Adjustment ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level_ - PERCOLATION TEST —9 Date 2Z-Time W ad. Observation r Hole# ` 3 Time at 9" Depth of Pere qi7 ' Time at 6" Start Pre-soak Time @ (?) Q Time(9"-6") End Pre-soak Rate Min./inch Z M;11 ,4 Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,° Gravel 5-Y �. eM< s", / (o YR ' DEEP OBSERVATION HOLE LOG $ole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. _ Consistency.°o Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel z1 30- f 26 G to Y/? ?// DEEP OBSERVATION HOLE LOG 'Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel 0�d �` ✓��L' ��g•� � /ark �� tD d r ✓'7 � fo i/? Flood Insurance Rate Mao: / Above 500 year flood boundary No Yes y __._____. ...._._..__ Within 500 year boundary No (/ Yes Within 100 year flood boundary No Yes Death of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? t -C S If not,what is the depth of naturally occurring pervious material? Certification I certify that on 7 �� (date)I have passed the soil evaluator examination approved by the Department of Envtro ental Protection and that the above analysis was performed by me consistent with the required training,jqKpertise and experience described in 310 CMR 15.017. Signature Date Q:\SEPTIC\PERCFORM.DOC <' Commonwealth of Massachusetts TWe 5 Offi as Ihspectoon Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments :x> 233 Carriage rd Garage) _ Property Address - - - - ----- -- f James and Jean Owner Owner's Name information is / required for every Osterville ✓ _ _ __ _Ma 02655 8/6/15 page: City/Town State Zip Code Date of Inspection 0D Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information S� ! /� on the computer, � // (J use only the tab 1. Inspector: key to move your cursor-do not Michael DiBuono use the return Name of Inspector _....._.---- - ------------------ key. DiBuono Sewer and Drain — -- - --------------------------------- - ----------------- ab Company Name 8 Johns path------ ----- ----- -- - ... ----- ----- -- -- Company Address relwn S Yarmouth MA - 02664 City/Town State Zip Code 508-364-9587 S113522 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 8/7/15 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. 15ins•3113 Tille 5 Official Inspection Form:Subsurface Sewage Dispd�al es,,. ge 1 of 17 r � Commonwealth of'IVlassachusetts -- _ Title_ 5 Official Inspection F®rin Subsurface Sewage bisposal System Form - Not for Voluntary Assessments 233 Carria e r dj Gara e "y -------- -- -- ---��-- -- ------------- Prope'rty Address —� --James and Jean Cavanauu h Owner Owne'r's Name — ---- — ---- .....----- information is required for every Osteryille Ma_ 02655 8/6/15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) I Inspection Summary: Check A,B,C,D or E / always complete all of Section D A) System;Passes: ® 1 have not found'any information which indicates that°any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The system contains a 1500 gallon tank as well as a concrete Distribution box. All tees and baffles are in place_ The Distribution box is level and at normal level. The leaching is made up of 3 chambers B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The.septic-tank is metal and over 20 years old'' or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑-'N'. ❑ ND (Explain below): .r hs ,n i t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form. Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ,.• 233 Carriage rd Garage _ _ _- Property Address -- --------_— James and Jean Cavanauqh Owner - - ---- -------- ----------- -- --....-- - -- -- Owner's Name ----- information is required for every Osterville Ma 02655 _ 8/6/15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has aseptic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspecthoo.Form ., Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 233 Carria e rd Gara e Property Address James and Jean CavanaughOwner - -- .....-- --- ... ------- Owner's Name information is Osterville. . _Ma_ 02655 8/6/15 required for every _ page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): Observation of sewage backup or break out or high static.water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the.Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ _ . ..obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): -------------------------- -- ------- ------ C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if _ the system is,,failingi.,to protect public health, safety.or�,the7enyironment.,;.; 1 t ,. „�. ... , . 1. System will pass unless Board of Health determines in accordance with 310 CMR that'the system is not functioning inai`mra'nner'wliich will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 3 of 17 t' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 233 Carriage rd ( Garage ) Property Address ---- -- - James and Jean Cavanaugh Owner Owner's Name --- --------- information is required for every Osterville Ma 02655 8/6/15 _ Cit /Town page. y State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no" as to each of the following: Yes No ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ❑C ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil'Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to'Part C is at issue . approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): -------- Number of bedrooms (actual): — --- - DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 110 - t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection 8F®r'm Subsurface SewagebisposaI System Form - Not for Voluntary Assessments r`a 2_33.Carriage rd (Garage Property Address -- James and Jean Cavanaugh Owner Owner's,Name information is r required for every Ostervllle _ _ Ma _ 02655 _ 8/6/15 page. Cityrtown State Zip Code Date of Inspection B. Certification (cony) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. . ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with-no acceptable watet'quality.analysis. [This system passes if the well water analysis, performed at a DEP certified J ,,�•;. laboratory, for fecal coliform bacteria indicates:.absent:and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provid,ed that no other failure c,riteria.are,triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ' ❑ "' the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of'a tributary to a surface drinking water supply c1" • ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area — IWPA) or a mapped Zone II of a public water,sup,ply;well If you have answered "yes" to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 233 Carriage rd ( garage ) Property Address -- James and Jean Cavanaugh Owner Owner's Name information is required for every Osterville _ _Ma_ 02655 8/6/15 page. City/Town State Zip Code Date of Inspection D. Sy§tem Information Description: The system contains a 1500 gallon tank as well as a concrete Distribution box. All tees and baffles are in place. The Distribution box is level and at normal level. The leaching is made up of 3 chambers Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected.?: - ® Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 486 GPD 9 ( Y 9 (9P )): Detail: Home has a Pool and Irrigation Sump pump? ❑ Yes ® No Last date of occupancy: date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq,ft., etc.): — Grease trap present? _ ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts r _ Title 5 Official Inspection Form . sFr yi'i:ii ..:• v Subsurface'Sewage Disposal System Form - Not for Voluntary Assessments a . . 233 Carriage.rd ( Gara e� l` Property Address ---— r;:lz•r;=+l��) f1r"0 JamLaS and Jean C_avanau�C - Owner Owner's Name information is required for every Osterville' _ Ma 02655 8/6/15 page. City/Town State- Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Na Was system pumped as part of the inspection? ❑ Yes ❑ No If yes, volume pumped: gallons — How was quantity pumped determined? — --- — Reason for pumping: ---- f ype of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool I ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from.system owner) and a copy of latest _rr,inspection of the I/A system by system operator under contract ❑`j ' Nigh#'tank. Attach a copy of the DEP`approval. ❑ Other (describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not.for Voluntary Assessments '�,A,•''e 233 Carriage rd Gara Property Address — James and Jean Cavanaugh _ Owner — ----....--..-- - -- --- ----=----== -- — Owner's Name information is required for every Osterville Ma _ _02655 8/6/15 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and.source of information: ApEoximatey 1�ears ------- - ------ Were sewage odors detected when arriving at the site? ❑ Yes ❑ No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): - — Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage„etc.):... • System is vented throught the roof. Septic Tank (locate on site plan): Depth below grade: 3 ft feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene El other(explain) 1500 gallon If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate)- ❑ Yes ❑ No Dimensions: • 1500 Gallon - Sludge depth: 3„ 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection* Form — Subsurface`Sewage'Disposal System Form - Not for VoluntarylAssessments ' a a'' 233 Carriage.rd (-Gara Property Address — James and Jean Cavanauqh Owner Owner's Name — information is i required for every —sterville' _ Ma 02655 8/6/15 _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) 24 Distance from top of sludge to bottom of outlet tee or baffle — Scum thickness 2" Distance from top of scum to top of outlet tee or baffle 4 4 --- Distance from bottom of scum to bottom of outlet tee or baffle 1" Sludge stick How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): No evidence of leakin Tees and or baffles in place at time oftinspection Grease Trap (locate on site plan): ' Depth below grade: NA - Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimen-1 ion s: — Scum thickness _ Distarce from top of scum to top of outlet tee or baffle- — - Distance from bot om''of scum to bottom of outlet tee or baffle ` -- Date of last pumping: Date ---- t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal.System Form - Not for Voluntary Assessments 233 Carriage rd ( Garage ) Property Address James and Jean Cavanaugh _ Owner Owner's Name information is required for every Osterville Ma 02655 8/6/15 -. -------------------------.—._...---- --- --- ----- _---- --- - - page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tees are in place and levels are normal._ Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑,metal ❑ fiberglass -- ❑ polyethylene. ❑ other (explain): Dimensions: Capacity: - --- gallons Design Flow: --- -------------- -- — gallons per day Alarm present: ❑ Yes ❑ No Alarm level: - --- Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date--------.---------- -- --------- Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection, Form Subsurface Sewage Disposal System Form -'Not for Voluntary Assessments 233 Carriage Property Address ----- James and Jean_ Cavanaugh Owner Owner's Name -- information is required for every Osteryille`= Ma 02655 8/6/15 page. .Cityl-Town — State Zip Code Date of Inspection D. System Information (cont.) bistribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert At normal level — — 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.): bistribution Box is level and at normal level with no signs of carry over or decay. ' �. / ,t' Pump Chamber (locate on site plan): I icl Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No" Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If-SAS not located, explain why: l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a,•• 233 Carriage rd Gara e Property Address —- James and Jean Cavanaugh Owner Owner's Name -- - -- information is Osterville required for every _ Ma 02655 8/6/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: — ❑. leaching chambers number: — ® leach ing.galleries number: 3 ❑ 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.): No signs of carry over and no signs of hydraulic failure. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration -_ Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts L ' Title 5 Official' Inspection' Form ; Subsurface""'Sewage Disposal`System Form - Not'fo'�Vol'uritar'y Assessments: 233 Carriage rd ( Garage-)_ Property Address James and Jean Cavanaugh Owner Owne'r's Name information is required for every Ostervil'le _ Ma 02655 8/6/15 page. _ City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)` No signs of ponding�or hydraulic failure. ` Privy (locate on site plan); Materials of construction: -- - Dimensions --- i Depth of solids - 1 Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): I i i . I I i I i t5ins•3113 " Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 << Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal,System Form - Not for Voluntary Assessments. °�.,,e>•• 233 Carriage rd Garage ) Property Address James and Jean Cavanaugh____ Owner Owner's Name ----- information is required for every Osterville . Ma _ 02655 8/6/15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts _ : s Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments c� 233 Carriage rd ( Garage ) e Property-Address' — - James and Jean Cavanaugh Owner Owner's Name --- — -- - information is Osterville Ma 02655 8/6/15 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope 1 ® 'Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 15+ ft feet Please indicate all methods used to determine the high ground water elevation: --' Obtained-from system design plans on record If checked;-date of design plan reviewed: pate ® Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USES database -explain: You must describe how you established the high ground water elevation: Test hole data on plan dated 3/11/96 shows NGE at 10' _ Before filing this Inspection Report, please see Report Completeness Checklist on next page. 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 � 1 � AssessI As-13uilt Cards Pace I of 2 TOWN OF BARNSTA.BLE LOCATION_ Ci4a,4fF�O _L SEWAGE 9 VILLAGE_0!y< +A_r;��PBo.c^s ASSESSOR'S MAP&LOT_O� INSTALLER'S NAME&PHONE NO.. SEPTIC TANK CAPACITY ISOO G 5T LEACHING FACILM:(type) F�r J Qt�F„s nA s (size) /O'x.30-y/' NO.OF BEDROOMS_ f)QA)G BUILDER OR OWNER SA,,uF.S A. CA ),qA), lc- PERMITDATE:. .-- COMPLIANCE DATP.: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) _ Feet Edge of Wedand and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i �►- !2" 39yyG'9 470Z- /6•s A3 2O..s— Oft v. Zq- AToS- 30' 9 its 6-a3 k64- 29' BYo3 a/- 3 BrcY-.39' Qrs-3/" y o � o $tab-Ze•' s 6 7 8-to?-2P.6 littp://www.towii.bariistab]e.iiia.Lis/Assessing/I-IMci1spIay.asp?mapl)ai-=O71020&sect=1 7/3 1/201 S •" ' Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 233 Carrie rd ( Garage ) Property Address — —------------------- — — James and Jean Cavanaugh Owner Owner's Name information is required for every _Osteryille Ma_ 02655 8/6/15 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ❑ System Information — Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file I t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 P a � , Commonwealth of Massachusetts W Title 5 OfficialInspection Form Subsurface Sewage Disposal System.Form , Not for Voluntary Assessments 233 Carria e rd Property Address. —--—-- ---- ;=- Jar'nes and Jean Cavanaugh o: • Owner Owner's Name — — -- -- -- --- information is - / .`. required for every Osterville_V — - _ Ma 02655 8/6/15 r,h page. City/Town State Zip Code Date of Inspection CC,' Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Iri t:When A. General Information fillingng out out forms oh the computer, use only the tab 1. Inspector: key 6`to move your c � G` Olt- censor-do not Michael DiBuono use the return.. . . key. Name of Inspector _ DiBuono Sewer and Drain N�> raa Company Name - 8 Johns path —_-- ---------------— ---- Company Address - — — - Pr�r^ S Yarmouth _MA 02664 _ City/Town State Zip Code 508-364-9587; -. . S113_522 Telephone Number License Number _ ---- B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 1 _ 8/7/15 Insector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth. of Massachusetts TitleOfficial Inspection For Subsurface Sewage,Disposal System Form - Not for Voluntary.,Assessments.. 233 Carria e rd �. Property Address James and Jean Cavanaugh Owner Owner's Name information is required r Ma 02655 8/6/15 requiredd for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/ always complete all of Section D A) System Passes: !.,haye•-not-found any information which indicates that any_of the failure.criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The system contains a 1500 gallon tank as well as a concrete Distribution box. All tees and baffles are in place. The Distribution box is level and at normal level. The leaching is made up of a single leach ip t and at time of inspect ion_p t was only half full. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND) for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank (whether metal or not is structurally unsound, exhiaits substantial Infiltration or exfiltration or tank failure fs-i nminent.'Sy stem will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. * A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): 0 j�I•i, t.illY !1r;1( a�:"," '.E re 7' ":lr 9 l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage'Disposal System Form - Not for'Voluntary Assessments 233 Carriage rd - Property Address --- James and Jean_Cavanau h Owner Owner's Name _ --g-- -.........—...... ---=---- --—---=--- - ' information is ir•, . required for every Osterville —_ Ma _ 02655_ 8/6/15 page. CityTown' State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ - obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1: System will-pass unless Board of Health determinesin accordance with 310 CMR 15.303(1)(b) that the system is not functioning in a manner which will protect public health, safety-and the environment: El Cesspool or privy is within 50 feet of•,a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts �(� Title 5 Official Inspection-,Form o .4"+.. - `•t i'•;. t{J:J� � . ..mot?.�:.'i.i t. £ �i , i Subsurface Sewage Di.sposal System Form - Not for Volunta;:ry Assessments 233 Carriage rd - - -- - Property Address --- - James-and Jean Cavanau h - ---- . - _._.-. .- - r Owner Owner's Name information is required for every Osterville Ma_ 02655 8/6Y15i page. - City/Town. State Zip Code Date of Inspection B. Certification (Cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) -.determines that the system is functioning in a manner that-protects the public health, safety and environment: ;. .<..;❑"The,system,has'a,septic tank and soil absorption system (SAS)-and'the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAs is within'a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet'of a private water supply well. ❑ The system has a septic tank and SAS and the SAS'is`less than 100 feet but 50 feet or more from a private water supply well". Method used,to determine distance: ;),101 T.h.is�system'passes if:the well"water analysis,.performdtd�at a DEP certified laboratory, for fecal ;r}- +ct i cf; 2 aiEolifor"rn,.bacteria-indicates absent and,the presence"of ammonia nitrogen and nitrate nitrogen is equal cie% ins ii r; o +sr cto 6r.1'ess-thah.5.ppm -pebvided,that no other failure b,rifeFiY-are triggered. A copy of the analysis must be attached to this form _ tryrs 3. Other.: 90 D) System Failure Criteria Applicable to All Systems: You-must indicate "Yes" or"No' to each of the following for all-i-nspections: Icua `Yes' Noia �Jr};; _. r ;t" ).EifQ7•`�"1 �,.-Jii:latV Yt�l�3 k :. ,Vii fir"� ,may. C.7•j'il 7 .1.�1 a arc 3f11 F'—I l� „•�I/.c� P ;, ® L:o Backup of sewage into,faclli�ty.lor system component dueato overloaded or, clogged SAS or cesspool ff; c Discharge-of.ponding of effluent to the'sur_face:of.the`'grourid or surface waters due to an overloaded or clogged-.SAS_or desspool r . Static liquid level in the distribution box above outlet invert due to an overloaded -or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than-6" be' low'invert or available volume is less than 1/2 day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments -ate•` 233 Carriage rd -- ----- ------- ------- Property Address James and Jean Cavanaugh Owner Owner's Name--- -- — -- ------ information is Osteryllle _ _ Ma _ 02655 8/6/15 required for every _ _ —_ -_ page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: . .:.❑. ,a-:Any,portion of the SAS, cesspool or-privy-is below high ground water elevation. El ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy,is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified ,-laboratory, for fecal coliform bacteria-indic.ates.absent and the presence of.ammonia nitrogen and nitrate nitrogen is equal ta.or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] . ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000g pd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be ' necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface;drinking water supply the system is located in a nitrogen,sensitive area (Interim Wellhead Protection �'❑ "`�' ❑''` c� ''Area --IWPA) or a mapped Zone,ll'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. 15ins•.3/13 - _ Title 5 Official Inspection Form:Subsurface Sewage Disposal System`Page 5 of 17 1 r s Commonwealth of Massachusetts Title Official lnspecti®npF®rrn .., Subsurface`Sewage Disposal System Form 1 Not for Volu"E ry Assessments 4 Y e 233.Carriaa e rd _ ----------------- „_.,,,,,r1 r Property Address — - — _— James-and Jean Cavanaugh ri,r..I�E3r!i,'�'r; riaeL brr Owner Owner's Name -- information is required for every Osterville Ma 02655 8/6/115, _ page. -. City/Town' State Zip Code Date of Inspection T C. Checklist Check if the following have been done. You must indicate"yes" or-no" as to each of the following: Yes No ❑ ® Pum"ping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components.pumped out in the previous two weeks? ® ❑ Has the system received normal flow•s'in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® O 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'sewacje'back up? ® ❑ Was the site inspected for signs of break out? ® ❑ t`Were aH system components, excluding the SAS,'located'on site? ® ❑ Were the septic tank manholes uncovered,,op`ened;'abd the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at`fhe Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. S.ystem ,info;rmation ___ ... __ .... ,_ Residential Flow Conditions: Ij -f 29Y �-� Number of bedrooms (design): 3 Number`of%edroonr s"`(act al): 3 -- ot Li 330 DESIGN flow based on 310 CMR 15.203 (for example: 1-10 god x#of bedrooms): V --- ------ t5ins•3/137 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ' 233 Carria e rd Property Address - James and Jean Cavanaugh Owner Owner's Name ----- -----------------.--:--- ------------------------- information is Osteryille _ Ma 02655 _ 8/6/15_ _required for every _ — page. Cityrrown State Zip Code Date of Inspection D. System Information Description: The system contains a 1600 gallon tank as well as a concrete Distribution box. All tees and baffles are in place. The Distribution box is level and at normal level. The leaching is made up of a single leach pit and at time of inspection pit was only half full. Number of current residents: 2---------------- Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readin s, if,available last 2 ears usa e d 486 GPD Detail: Home has a Pool and Irrigation Sump pump? ❑ Yes ® No Last date of occupancy: Date --- Commercial/Industrial Flow Conditions: Type of Establishment: -- -- --- --- - Design flow (based on 310 CMR 15.203): Gallons per day(gpdj Basis of design flow (seats/persons/sq.ft., etc.): ----, ------ - --- ----- --- Grease trap present?. ❑ Yes ❑ No .,, Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: -- ------------ t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Off ic al -'Inspection °'Form' Subsurfaee'Sewage bisposal System Form=Not'for-Voluntary"Assessments }'1i a„tl' 233_Carria e rd Property Address ._._..Jamts.and Jean Cavanaugh Owner Owner's Name —�— information is required for every Osterville _ _ _ Ma 02655 8/6/15' page. City/Town State Zip.Code.. Date of Inspection D. System Information (cont.) I.Cast,date of occupancy/use: Date --- Other (describe below): General Information Pumping Records: !201.5 Source of information: -- Was system,pum15ed as part-of the inspection. 'E Yes ❑ No - - T`1500i' ;ris,lc;lrijr., ;(�e;, . If yes, volume pumped: gallons ---- - How was quantity pumped determined? Site on truck Reason for pumping: Maintenance _- Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) and.a,,copy of latest ,3- inspection of the I/A system by system oper'rator`u'n(deer`contra`ct r- :��' vd ba,—Ii"tnC:1 o c. Tight tank. Attach a copy of the DEP approval. ❑._ _._ Other(describe): t5ins•3113 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 8 of 17 cN Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 233 Carriage rd Property Address — - ----- ----- ,f ---- -�— James and Jean Cavanaugh_ - Owner. -- - - Owner's Name information is Osteryille _M_a _ _ 02655 _ 8/6/15 required for every _- page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: Approximatla� 34 years_—__ Were sewage odors detected when arriving at the site? ❑ Yes ❑ No Building Sewer(locate on site plan): Depth below grade: 18�� feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): ----- --------- Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc..)-. ._., System is vented throught-the roof. Septic Tank (locate.on site plan): Depth below grade: 3 ftfeet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 gallon If tank is metal Ilsf a:ge: _ ,� _ ---- - ------ ft, ... . , years Is age confirmed by a Certificate of.Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Gallon — " Sludge depth: 3 -- ---------------- t5ins•3/13 `- Title 5 Official.lnspe6oh Fo�m:,Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection ®rrn J — _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments i 233 Carnage rd — _ Property Address —- -James and Jean Cavanau h — --- — — —— — ------- 1 Owner -- Owner's Name ----- ------- — - infcdrmation is required for every Ostervilie _ Ma 02655 ` 8/6/15 pale. City/Town State -- Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.). Distance from top of sludge to bottom of outlet tee or baffle — ---- Scum thickness 3 —_ Distance from top of scum to top of outlet tee or baffle 42 - ------..- Distance from bottom of scum to bottom of outlet tee or baffle 1_Sludge stick How were dimensions determined? Me Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): No evidence of Ieaking,Tees and or baffles in place at timb-of-inspection. Grease Trap (locate on site plan): NA Depth below grade: feet --- Material of construction. concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain): Dimensions: _ .. - - --- - — --- Scum thickness - Distance from top of scum to top of outlet tee or baffle -- -- ---- - Distance from bottom of scum to bottom of outlet'tee or baffle --- ------------- --- Date of last pumping: fete — — t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 110 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form . Subsurface Sewage Disposal System Form - Not for Voluntary Assessments Via,•° 233 Carria e rd Property Address James and Jean Cavanaugh — Owner Owner's Name — -_-- information is required for every Osterville _ Ma 02655 _ 8/6/15 _ page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tees are in place and levels are normal Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: — - Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other (explain): Dimensions: - -------------------------- - — Capacity: --- ----------- gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: ----------- — Alarm in working order: ❑ Yes ❑ No Date of last pumping: date - — Comments (condition of alarm and float switches, etc.): * Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonvvealth'of Massachusetts Title 5 Official Inspection rj,rim ` t m8 Subsurface Sewage�Di`s`pos`al System Form - Not forrVo2luntary*Assessm ents - 1a r e e _233_C.aruac�e Property Address — —- _ _ .James and Jean Cavanaugh -- ` ;�•:4,, Owner Owners Name information is required for every- Osterville' - _ Ma 02655 8/6/15 pace. `City/Town _ _ _ State Zip Code- Date/�f Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level a Atnormalaevelbove outlet invert ---.---. Comments (note if,box is level and distribution to outlets 'eb :eq.ual;,any evidence,of solids carryover, any eviden �of leskage into or out of box, etc.): Distribution Box is level and at normal level with no.signs'of'carry over or decay. to ` i ;VT �, Ji]li)f!G� , l QcrlC '•i;':�is �: i":jv el.' ?,t. i:,�r�1 nY t i mrn i" iritj r/i �.0,1 =iii3t it C'+_ Pump Chamber (locate on site plan): IEl i, Cam, � Pumps in working order: ❑ Yes ❑ No" Alarms in working order: ❑ Yes ❑ No' Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): If pumps or alarms are not in working order, system is a conditional pass. Vci Soil Absorption System (SAS) (locate on site plan, excavation not required): -- - __ If SAS hot located, explain why: l5ins'3/13 '' '"£" Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 i Commonwealth of Massachusetts _ Titlev 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 233 Carriage rd Property Address. .. James and Jean Cavanaugh Owner Owner's Name- ----T information is required for every Osteryille --Ma--.-- 02655_ 8_/6/15 ------------------------------- page. City/Town State Zip Code Date of Inspection D. System Information (Cont.) Type: ` 1 ® leaching pits number: - ---- - ❑ 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.): No signs of carry over and no signs of hydraulic failure. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration -- --- - --- Depth -top of liquid to inlet invert - - Depth of solids layer -------- Depth of scum layer Dimensions of cesspool - ---.-__-.- _ Materials of construction ------_ _________._____—__ Indication of groundwater inflow ❑ Yes ❑ No (Sins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection* a y�rrn` . 'I :31P�Y fl G4.:- ,t.t Fti- =�V. L/ !c :J i~.L4l.4l m a Subsurface`Sewage`Disposal System Form -'Not-for Voluntary Assessments 233 (,arriage-rd Property Address fi+;James and Jean-'Cavanaugh - - - -- - - - — Owner Owner's Name 1'1 information is c t`3 required-for every Osterville _ _—_ Ma 02655 page. City/Town ' _` State Zip Code - Date of Inspection D. System Information (cont.) - Comments (note condition of soil, signs of hydraulic failure„level of ponding, condition of vegetation, �. etc): J. No sins of pondin hraulic failure. " Privy (locate on site plan): Materials of construction: --- — -------- t Dimensions Depth of solids ,�` -- --- --- ---- -- Comments-,(note condition of'-soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): ., i i 3 i t5in1s 3/1�3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 i Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage'Disposal System Form'- Not for Vol untary'Assessmen.ts - 233 Carriage rd Property Address - James and Jean Cavanaugh__ Owner Owner's Name --- --- — — — ---- information is required for every Osterville _ Ma 02655 8/6/15 page. City/Town . State Zip Code Date of.Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately t. PC)3 l D 0 t5ins•3113 Tille 5 Official Inspection Form;Subsurface Sewage,Disposal System•Page 15 of 17 . 4 Commonwealth of Massachusetts Y ' - _ Title 5 Official Ins ecti®n-F rm (\ _ Subsurface Sevvagebisposal System Form - Not for Voluntary Assessments \ .233-Carria e-rd Property Address _ t - - — Jam6s-and Jean Cavanaugh - - Owner Owner's Name information is r required for every. Ostery'ille_ Ma -02655 _ 8/6/15 page. - City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: Z Check Slope Surface water ❑ Check cellar Shallow wells Estimated depth to high ground water: 15+ ft feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: pate - - I� Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: E ❑ Checked with local excavators, installers - (attach documentation) ❑ Accessed USGS database - explain: You must describe how you established the high ground water elevation: Test hole data on plan dated 3/11/96 shows_NGE at 10' Before filing this Inspection Report, please see Report Completeness Checklist on next page. i t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 233 Carriage rd Property Address -- James and Jean Cavanaugh ` Owner Owner's Name — -- information is required for every Osteryllle Ma 02655_ _ 8/6/15 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked 1 ❑ Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ❑ System Information — Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file l5ins•3/13 Title 5 Official Inspection Form.Subsurface Sewage Disposal System•Page 17 of 17 G° TOWN OF BARNSTABLE p0�� LOCATION 233 c 4 g4jac.-c- RA SEWAGE #_ VILLAGE o +fir 1J.1'@,6045- ASSESSOR'S MAP &LOT O11 ®O INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY '45-00 GST— LEACHING FACILITY: (type) PLa�J 6.1kJ,,:5 nA_g' 3 (size) NO.OF BEDROOMS Voa3i�7 BUILDER OR OWNER TdmE75- . C AL7 AU(I sd PERMITDATE: /// q _COMPLIANCE DATE: 2 L 9 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by C. X� Ott 1 - ►�-TOZ- �G.s 197b 3o31 B roz- 2q' i ASSEWORSWp CFO No. f Lc_ 1W.PAMEL Fee 100 , THE COMMONWEALTH OF MASSACHUSE PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for Di!5pooY *r5tem Cow5truction 3pCrmtt Application is hereby made for a Permit to Construct or Repair( )an On-site Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. G k,ssG..J� ?'1 D YYS� Type of Building: Dwelling No.of Bedrooms Garbage Grinder(oJO) Other Type of Building Cj,dA4 r No. of Persons Showers( ) Cafeteria( ) ,Other Fixtures g a� GSA a Design Flow /[0 gallons per day. Calculated daily flow Ito gallons. Plan Date Number of sheets Revision Date Title Description of Soil Nature of Repairs or Alterations(Answer when applicable) ; 5n2 o G 5 j d A® 1t Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Heal Signed Date Application Approved by Application Disapproved for the following reasons Permit No. ��' � Date Issued 07/ a '` No. A . O R O Fee �:f p THE COMMONWEALTH OF MASSACHUSETTS $ 'J I PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ZIpprication for Digool *pgtem Construction Permit Application is hereby made for a Permit to Construct or Repair( )an On-site,Sewage Disposal System at: Location Address or Lot No. Owner's Name,Address and Tel.No. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. "Arj G 9 T&k) lam,! w. , Type of Building: Dwelling No. of Bedrooms Garbage Grinder(4;0) Other Type of Building 69 No. of Persons Showers( ) Cafeteria( ) Other Fixtures 444a � f t-" Design Flow gallons per day. Calculated daily flow 110 gallons. is Plan Date Number of sheets Revision Date I Title j Description of Soil j Nature of Repairs or Alterations(Answer when applicable) ' 05 'I Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described n-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Application Disapproved for the following reasons. Permit No. 7 4 A0%(fl Date Issued�,"N THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS , Certificate of (Compliance �. THIS IS TO CERTIFY,that the O -site Sewage Disposal System installed( or repaired/replaced( )on J,r by / P ' 42dezjg for"IA ,J' ~"° 1 t ~,0,6 .� as Aje_ has been constructed in aKcocordance with the provisions of Title 5 and the for Disposal System Construction Permit No.i� dated'"? ... ...� Use of this system is conditioned on compliance with the provisions set forth below: 401, No. ®�► I Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE, MASSACHUSETTS w1i5po5ar *pgtem Con!5truction Permit 01 Permission is hereby granted to to construct( repair( )an1Onpsite Se.age System located at i and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within two years of the date below. Date: i Approved b� e_.41141tf.1 �- i CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL NVOItKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, 1665(1Y j c , hereby certify that the application for disposal works construction permit signed by me dated 3/rr,� 76 , concerning the property located at 2.33 C 6J ono k oLcl meets all of the following criteria: • There arc no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom or the leaching facility • There is no increase in (low and/or change in use proposed • There are no variances requested or needed. SIGNED: DATE: LICENSED SEPTIC SYSTEM INSTALLER IN.THE TOO BARNSTABLE NUMBER [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. - '� AL J; yd 3 , �={` 14 4 ------------' a pox /►,� CIL THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �1 (�LQ�aIC...................OF.......................... 6 Ami iratinn flay. Disposal 38orks Tonstrnrtion Frrmit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: ._. (^/ (/..1l1:u/w.d err.........5...... �.�:.. .......�........._..............................( � ./.J_..._...�--.�.Q._(7��.(.�n_..._.... .._.A�.!�«�� _.L::.._at�On.ArV�7 .........................._...- .LwI..1JfeJf/if.'��J-.--•.�:^.':...... «�:........... wo.�..�:.. .�.o ►?owner ..1 -------------------••.. 1e .�5... ,.a ................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—T e of Building ....... No. of persons............................ Showers Cafeteria 04 Other fixtures ....---•-----•--••--•-•-•.......................•- .- WW Design Flow............................................gallons per person per day. Total daily flow............................................gallons. W. Septic Tank—Liquid capacity............gallons Length th................ Width................ Diameter................ Depth................ Disposal Trench—No..................... Width........ .... Total Length..................., Total leaching area...................sq. ft. Seepage Pit No...........1......... Diameter....10!X. _.. Depth below inlet...(*............. Total leaching area..�.4....sq. ft. Other Distribution box ( I ) Dosing tank ( ) a' Percolation Test Results Performed by............................................ .............................•-•• ••---•--------•-•---............. Date........................................ Test Pit No. 1................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....--.................. .......... .... ..... •........... -............... ............_._....---- -- - -.. ............ 0 Description of Soil...............................................................-........................................................................................ ................ aC W .......................--•-•----. . . ......................................:....--- --------- U N re of Repairs or terations— saver when applicable_... k st*t ..........................................�� ...�...6K.W 4" ..�7 ---.. .04..✓..... GZ7B�¢ICE6C.Y �'...�-6?4QcL'E I��.1. ..................................... ------•........................ Agreement: The undersigned agrees to install the afore scribed Indivi al Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary ode—The u er ' ed furth r agrees not to place the system in operation until a Certificate of Complianc has issu y e rd of health. ...._.. ......._. .�. ju .... �. as Application Approved By_ ... --••---. .... ..0........................................-.................... -•--•� l . . •-•••-. Date` Application Disapprov or he f ollounng reasons:.................................•-•---------........-----•--.......................................... .... -------•----••---•--•--------•------ •------------------- ---------------------- _-•----------- _-------•------.--- ------------------------------------------------- ••--Date----- Permit No............................ Issued...-............ ..0.............----•-•--...... Dais 7' an A l` THE COMMONWEALTH OF MASSACHUSETTS r BOARD OF HEALTH _ J�Vplutt#inn for Disposal Works Tonsuvr#fun Prruttt Application is hereby made for a Permit-to Construct ( ) or Repair (X� an Individual Sewage Disposal'r System at: ._caw . 1. ..............»_.._»».............--... -...-....- ------- ` 2 l' Location-Address OZ ............. SC ..... ......o .. { ... Ad.�.. T t «.. ,..� ... .». .......—.... Installer 'Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms....................................I........Expansion Attic ( ) Garbage Grinder ( ) 04 Other—T of Building No. of persons............................ Showers — Cafeteria 04 ' Other fixtures .Design,Flow............................................gallons per person per day. Total daily flow..........-..... .___..... :............•...._gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter..._......._._.. Depth.....` '.:....._.. W Disposal Trench—No. .. Width.................... Total Length . Total leaching area...................sq. ft. Seepage Pit No...........�......... Diameter.....1�r f.... Depth below inlet..4.............. Total leaching area..W4....sq. ft. Al Z Other Distribution box ( I ) Dosing tank ( )-- I ; Percolation Test Results Performed by.................................:/ Date...........11;11-•-•--................. a •- • • ....- .-•..•. .1 Test Pit No. I................minutes per inch Depth of,,Test Pit.....;.:............ Depth to ground water.."......_._._......... ta, Tesf Pit No. 2...............minutes per inch. Depth of Test Pit.................... Depth to ground water........................ - ® Description of Soil---.-----•------- -- ----•--................-- ......._......--- . - ............................................. -•._......... ..-•••..........-----.--- ---....... - - --------------------------- ----------------------------------•----------.....`.....-._...... 1 ..-.... - ----- Nature of Repairs or Alterations—Answer when applicable... . �-°T�+t,�.....- I Sv v C - I.(01C� t�Jt�. _» r...-`� ...................................e c-� .......................... Agreement The undersigned agrees to install the_aforedascribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary ode The deigned further agrees not{to place the system in operation until a Certificate of Complianc has issued by the bold of health. / .. ---------•-_---» ......... at ».... i. w F Application Approved By.. ... �� »' ---- ...... .... ._ .._ Date Application Disapprov or he foil ng reasons:.......... ................................:..: ....................... ..............................................................................._...---••--------•-----•--•---•-•-................._.............. .D�...._....»» Permit No......................... ..__-....» Issued_....».....». ..._._........._._-....... � -- { lc� THE COMMONWEALTH"OFAMASSACHUSETTS i BOARD I OF HEALTH ...... l .............................................. Terfifutt#r ',arf Toutpliunrr 411� eT IS TO CERTIFY, That the Individual Sew a Disposal S-stem constructed ( ) or Repairedby. ..... .----- •--------»---------- ............. -•------•--.......•.....--••-----...._......-----..... at.. ..... a..........- .--•--- ------------ 'I has been inst In accordance with t prov ions of I 5 of tate Sanitary Co a ed in the 'application f r Isposal Works Co ructi Fermit No..-- [ _?'" dafed...? THE ISSUANCE OF THIS IFICATE SHALL NOT BE CONSTRUED AS A-GUARANTEE THAT THE SYSTEM WIL /FU C TION SATISFACTORY. DATE../ ' � ✓5..... -•-- ...................... Inspector. r:.............. ....................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH `Tcn F3, 5-�--.A...8 c e OF...................................................................................:: No.................... FEE........................ Disposal Works Tonstrurfinn Vrrutft Permission is hereby granted ..:. � •�v.tom..,...•f-t -e' _»».. to Construct ( ) or Repair ( ) an Individual Sewage D* ''sal System � v at No........E_ /? IL:L•`�.-e-Vol -• �......... »`5:a_L l.'�1'�:_.... ? ... ... street as sho pli on for Disposal Works Construction Permit No.. _ .... Dated ..�... '� ---------------•- .......................... ...... --------••..............•........................................... Board of Health PUBLISHERSIr ` — :1 rvl _ ---- -- _- _ >_" : a2' : :- -- _ - _ _ - _ - _ lI _ -- - — Al =-_ _-- r-- �1 a _ _ 11/02/15 BUILDING PERMIT PACKAGE - -- - _ __- - - --- - __ - _ _ - .t _ 4.'iLi�Tr' t,l-1 1 _ .... �i -a *- rl nr� - Tr �T11 rr{�tlj l� , --------------- w _- — 1rY t :T!7 L_ '�._ ' .-._:__ _... __=k-- _::__ ______ "_.. -: :. ,-S .L _ i_� ;�• r'r fi —,. r ..i x .. ..�" - KIT if1 _ ----------------- -_ - , ------------------------------ 1: -- i - ��9-- /: Lr - �y — { _ v _ , :-- _:._. O - _ a� - - - '� I ��•a:;dr .ry. � �-;;.!, :i , I ,- � , : t'1.I _ _I __�;;��'. i.�l It. I ..1 _1 ' s i I I S - I ?t .-r»t a�' ��- t++�- ,.-t +'• , � -'�--'-'-' r r, : :._' �--. 11 +.. �_. t r .ALL_.L :.I - ram- s r. .. Li ll , - .'.ar<-^ `gyp..; ..ate..- •' � 'r'd =,. ,.., � a �*' •,. � _. .f _ _yam �,. ,.. ,. � r" c ra.. ...; ..:.., ...5,:. "'a-; ,. y, .^A.' . M,. ,>. ate.. .. � . ;_.. .: '.,,.c.. o- .,. .. , .:: Z ..+: _ .. 't �' r : r , r SOSTON. INDEX OF DRAWINGS- Permit Sete s Monday, November 2, 2015 itects Inc. DRAWING INDEX O'CoHouse uest A1.0a Basement Floor Plan S1.0a Foundation Plan 233 Carriage Road Oyster Harbors MA A1.0b Basement Floor Plan S1.0b Foundation Plan A1.1 a First Floor Plan S1.1 a First Floor Framing Plan AM b First Floor Plan S1.1 b First Floor Framing Plan A1.2a Second Floor Plan S1.2a Second Floor Framing Plan ) S A1.2a Second Floor Plan S1.2b Second Floor Framing Plan �d �� COVER SHEET A1.3a Roof Plan S1.3a Attic Framing Plan A1.3a Roof Plan S1.3b Attic Framing Plan C�� SCALE: S1.3a Roof Framing Plan J DATE: 11/2/15 A2.1 East Elevation S1.3b Roof Framing Plan �d i A2.2 West Elevation A2.3 North Elevation A2.4 South Elevation _ ' Catalano Architects Inc. A4.1 Wall Sections }1 Ci-' � ��" �� 115 Broad Street Boston.Massachusetts 02110 telephone 617-338-7447 VV IC o�ry/„ti. facsirrile 617 338-6639 — PLAN KEY we t 54 � MATLH LINE MATLH LINE 1 I I I I I MECHANICAL I 0to 11/02/15 BUILDING PERMIT PACKAGE i 5 -r-t-�' r 1--1 r i' _ -- 0 - ---- MECHANICAL om - ' +15.6 ._�'/ VESTIBULE urTo is Ewon LLT� +t 6o STAIR HALL NORTHoGa - ----°-- BATH LQ MECHANICAL `l' BEDROOM an on DEsN k11°. _ Ii III STORAGE I ----------�1 L o 003 --- _-_ -- -- - ....._- . Closer ! - - OOQ _0 QUEEN I 1 J urio sr noon _ IL� STAIR HALL ®�6 1�a 002 ------ ---------TV-------- — - +16.0 { r t 0 BOSTON. \ � M S. • \� ROOM PLAYR + 3 5 t / A3.2 --------- 1 \\J I Ar hiteds Inc. 1 I 1 i � O'Connor Guest - ---- --- House — 233 Carriage Road Oyster Harbors MA j o125 • 4. � i L Basement Plan SCALE: 1/4" = 1'-0",1/32"= 1'-0' MATCH LINE MATCH LINE BEDROOM DATE: 11/2/15 ----------------------------------------------------------------------------------------------------- -i--------- l � Catalano Architects Inc. ! a I 1 1 115 Broad Street Boston,Massachusetts 02110 I telephone 617-338-7447 facsimile 617-338-6639 { 012E i f last Isa: +�+ sras etas --_-- (DFro o5M Basement flan -All:1/4" = i'-O' o z .0 A awl � I$;i t j j�8i STAIR HALL PLAN KEY 4 - MATCH LINE MATCH LINE III' PLAYROOM \ 01 ------------- \� I I VVV I I 11/02/15 BUILDING PERMIT PACKAGE F l 7 I I y I a I 6 7 8 i I A3 -------------------------------- MATCH LINE--- I BE--- ------ --------------- ----------MATCH LINE----------------- t 1 I 1 I a I 1 I I I I 1 I 1 D12E, rOirt _ 10-12C,__ I BATH Iy� 014 I 10l L IIPTn Si ROOfl �� STAIR HALL SOUTH 60 MECHANICAL j 016 UNEXCAVATED y� O LQ i MASS.Ell CLOSET 019 BATH r018i I chitects Inc. O'Connor Guest House MECHANICAL I 020 ----_J i i 233 Carriage Road Oyster Harbors MA A3.6 A3.6 BEDROOM s Basement Plan R — -- _ SCALE: 1/4" = 1'0" 1/32"= 1'-0" a DATE: 11/2/15 1 Catalano Architects Inc. 115 Broad Street Boston,Massachusetts 02110 1 telephone 617-338-7447 1 facsimile 617-338-6639 r A3.5 A 2 Frolgooed Basement flan 5CALE 1/1V" = T-0" 0 z 4- w 1 -O b PLAN KEY a MATCH LINE MATCH LINE �(o 5 16'.1112 i 16'-101/j° 4'-41/4_%. ". , ,..--_------ 3.2 7L- I owe POWDER ,MUDROO�z 13$' RO M �° / / B NG PERMIT PACKAGE -PANTRY _ '--- DNioenssMEW 110215 BUILDING tos _ -- - --------1 NORTH.PORCH -� --- F am ✓ _.L { -I_.-_I I_'�-y- - ur to sxo noa I I = HALL k 6STAI%R HALL NORTH - - L. o 10j 26.0 I 25.5J- l T I I - i9 ,.YI �$ 2- CL. I CL , I f v S i REEKED PORCH' _i ,_ 882 I -- ---- ----i ------- - w�144II - I GREAT ROOM 11 1 ^ y--✓ lo - - - - - - - - - L I ^ I +26.e DINING ROOM a . _." I - I I 1Jf ` \ I 1 = _ S_ ? sa STAIR KITCHEN .{ --- - -- - I - � - \- I 104 O�� - - L`4✓J I _-i: _S _6xm cur I i +2, AI 12" y 2'-0"y 21'-10" _ 312' - \ 16'I I/ Sy ��-CO Dctrc 16 5 _ C e +25.0 91 zl 3, �io3n snick Dc[ccco ��A - -- -------------- -_ I a'-D I/2' z's 1 � 7 G •'/ 11 J I 0III 21'-23W za 1.J/9-------_---.-- 1._12 t 3/p._.:.-_.._ L - �. al r rr 11 /gyp » N. 'G +25.0 II 1 fYf I. �.. CENTER LINE Of MAI NHOU y i I 1 I l JI 1 rcNtects Inc. -MAIN GREAT ROOM 1 •�" � °, I I I o O'Connor Guest p- -- C House • 233 Carriage Road Oyster Harbors MA a POWDER c -— - - - ��ROOM - 6 First Floor Plan =I ./.--_ (u2n., -yy__�,LJIa. 31re..,;b,-.�3�/a;..• :' 6 N s, m SCALE. 1/4" = 1'-0",1/32'= 1'-0" MATCH LINE �I MATCH LINE --—- DATE: 11/2/15 441/4" I '_r 9_Qy 1731/4" I 3 6 I.-.i.— 't.. F 7L_ 1 :}\ I Catalano Architects Inc. l'.`.- S T ---'-'--- r � 115 Broad Street r—a-- I SIDE Boston.ston.Massachusetts 02110 GREAT,ROOM I I i telephone 617-338-7447 facsimile 617-338-6639 I "T , f pro ooed First Floor Plan A CCALE:1/4" = V-C' D r n' e' a r" PLAN KEY 1a -f• a I--.T. _ ___ __ --"1-- _ _- �-N; ' 1 a'-f" i' a•.0�" 2•-9• � a va 3'-e 12_ �_ I -_. _........._-I .. , I m _ -1I _1T�11 " �7 J{ ,- ! — 4 MATCH LINE MATCH LINE 12.13/4 /- I . q _ \-26.0 -- I y N CENTER LINE OF MAIN HOUSE ENTRY DOOR- - = v MAIN GREAT ROOM 3 ' 11/02/15 BUILDING PERMIT PACKAGE I � I - - -- _ _.-___.....----.-- ---..-_..- :...._._ _ ...-.__.......__.... .__-.._.. ..\__—__ - \__---__-_ A IOTA! _.-- �.— __—_• \—\ —__—.._•-_— -__-_..__— -.-...--.- t POWDER e c ----` - -- ��ROOM I - ----- --------..--- 6_93/�`31 •�5'-I 1/4' 312'j/_3_y I/ - B 3 3. MATCH I.INE �I� - MATCH LINE _I ------------------------------------------ ----------i--------- -- ----- m — - — -- — ---- --------------- --- -- ------ ----------- 4 -I---- -- "� -'-- 363/4 —41 �I w b � SIDE`I 1 I r--�-� I ! I { ENTRY t I I I GREAT ROOM i-i I I i eos I I o �E , 112POWDE -OM -. ONTO E I L n 20'-53/4" 312" 5'-fl2" 312 ff w T-51/4�T�12", 51/2' F �` STAIRH�A LSOUTH I i I - {-. ' - ) I T'• cAecE J,— I - ! OM BOSTON. � .lj 255 MASS. In a } 1260 �t9 A1UDROOM SORE - r --CREENED PORCH" a ----- `, -__soa -- KITCHEN < { �\ �6 , Yf - �` ' Itects Im. 114 O'C nnor Guest \ \I I House c� I 233 Carriage Road Oyster Harbors MA 11'-�—� 11'5 6-0IM rl I I L_- 114 SOUTH PORCH -\_—_—_— r; a -^r„„1=•-T __- I --_-I I -� __1—__�__�II-1 A3.6 A3.6 First Floor Plan SCALE: 1/4° = 1'-0°,1/32'= 1'-0' m DINING ROOM '16 _ _ a__ . DATE: 11/2/15 Catalano Architects Inc. I r14 �I� N 115 Broad Street w;' I w/ wi --- Boston,Massachusetts ns 10 telehoe617 3387447w: z 5 2 -'/ facsimile 617-338-6639 '-412 .F A3.5 A 2 Fro o5ed First Floor Ian SCALE:1/4" = r-0" e 7 a• 1 A b PLAN KEY a MATCH LINE MATCH LINE: 00 e y T-S 3/a__. � e S va EGPE592 G6ESS ...-W, __.----.......,,. WINODW.+'WINDDW.........--... -------- ., ._-..... 11/02/15 BUILDING PERMIT PACKAGE 5 f 9-II1/4 312" - 13 b E'— -3-12" -.- b �„-, 31 4 I I'-10 12 I STIR BATH ( BEDROOM 1 - ..__) 2D5 FD - 210 --- _— UNTO ITT 11nax ., STAIR HALL NORTH208 © , 207A 2A6Ai f -- I / a BATH,, / - CL 206 2W /_\-..._ _.__ .._._-__J ::..- .__ - . - ` \ -.-15'_53/4'--._-._-_ 1,({ 3'-212I 12�-4'712" N2 6012' 1/2 ...9 __ .—_/21 '(-__ .-.:.:.. -._.• .. .. - .." I C; _' SHELVES i I. —�r=1 VE$il Bu,l — - r- — MASTER 224 BEDROOM 1 �I aoser ��l �Nt 1 - 1 -KING z06 I-� � i 'I I SITTING ROOM 1 !_ I / r---OPEN TO I - 204 �� .... -....- '-... .'... OPEN TO GREAT SCREENED PORCH ROOM BELOWBELO nK - 1 ----- i- . - ---- --T. - -' `_' AIM <1 I - -- N --- - \ E R ml �2T1R CL � -- --- -__.-____- -_ ____d _____ ____ i STAIR HALL al. t - �.J - - - - �, r . 1 r' -1 i — - -- i ... I _ 2R down�6` I: CH3'-0'us uss 1,. WINDD -E:ININDDW �P 6'-53/4' -/ 5'-8' 5-8' / 6'-53/a^ � 6'-23/a" /-L 5'-II" 51/2 3'-T' 91 ! 7-81/4" - 51/2' S'-112" 31/�' 7-21/2 512 ' I 12.13/4 7•a3/a^ / 23•-z3/a^I �. za 91/a" /--- 512'-, ..____.12'712 512i v C__-s-• O l ( ---- -- � .4 IJ 3 5 z a \ ---+I--- - - - - -BUNKROOM- ©� -� A3.ZU 203 �I._ - COMMON �,_ SITTING ROOM I _ Imo; - el I oA cis lnc. 11p- - --- I 1 �0 O'Connor Guest .,J 6- CH�D ml � House 233 Carriage Road Oyster Harbors MA 2R down :. 1•. 51 /2�43/-_ _I/2._$'tl[( 31�" ___511/�__,312. g3/4,>f 311 I/ti' �512- I ' VESTIBULE <I 223 m1 N . BATH iNl zt4`�` Il�-• zt Second Floor Plan _-\— - 1 1 (223A SCALE: 1/4' = 1'-0",1/32"= 1'-0" MATCH LINE MATCH LINE ;,1 — --------------------------------------------------------------------------------------------- --. —— -- - - -- ----------------------- DATE. 11/2/15 _ < i 1 LAUN.DRYI=I1.13=a3/a- --- --./-- w' 215 -/�'71/4' 3 9 T 312 � 6_91/4 Catalano Architects Inc. ----------------- -- S ' 115 Broad Street M I I Boston,Massachusetts 02110 telephone617-338-7447 c _ facsimile 617-338 6639 - �` -- �1I ❑ SITTING I vj ROOM2 Fro oeed Second Floor Flan A �' 5CALE:1/4" = 1'-0" U 2' e' ^ 1 .2a .2a ie�.li �11_ sI a202 e — I 1 - _ PLAN KEY 1 I SHELVES y: EGRE 24A'.3.aI/a EGRESS A3.2N„aF 1III.I 12--'-I 3--I-(//4,--"FC��MoN<mmN ai--•�'I I II - m\ ...S - _: : k2fl dOW WNO NDW 3T91 312 T-212" 12- 4' -1" 512 h \ 1. _..-.... _• -. 3 i. - - 6:--9 4N-NO-DS-S-,A-3�. M_A_T_CH_LINE — I _y ' r —ry MATL�H- LNE 1112i ::2 -BUNKROOM 203 COMM O � ___--- SITTINGROOM ot _ — - 11"/'02/1, 5 BUILDING PERMIT ERM IT PACKA- ,eG E ti5 2P dw 6" CH-6'-D' 2 @L4 1/4 5 I/2 LE AT, 41 _ 22 MATCH LINE MATCH LINE ------------------------- ------ -------- 3% 2a-PIa D - _ .-- 21 1a _T 312° 0f2" oflrEfl fl Eggs___ __ _ of __ 4 -- -- .'..,.,II—�3 5•1.,... /99'-5':031/4"" I2 iiI{!I'i ------- SITTING 14l.'l�1T•i-'1Ij:3 1_a_1II-Du-_la.,2l:s_r�rw �-_2_16i—3_-I__II 'G _T1 1 11/4•."_ri"1s,'.H-9ExRW0'_r�srh/3!i IC)Nf�I4z12zz"n l-" -,- 212 __ ROOM 2 STHAGELIOflYOSFr II oGt a_—_oaI-_I-�_--__----� ----�, 4-I-/g---'I•--- 5-1/2!•-�I --- - -�- ov\f l T a$ Lit,- �_ 1 12 1-1014' m. IN,12 /2 STAIR HALL SOUTH VESTIBULE° lk 219 i ' �I C ~ w om MASTER BEDROOM 2 17 I AS& CLOSET r 1 - - - - - - 21e is MASTER BATH MASTER2z1 LOSET 2 r K[ects I On c.222 DECK A--BEDk ----- ROOM 2 2ts o O'Connor Guest House IN BATH zn 233 Carriage Road Oyster Harbors.M1z�,n'ys A g 5 ------------------ SecondFloor an SCALE: 1/4" 1-0",1/32" 1-0° DATE: 11/2/15 7:77- - Catalano Architects Inc. 115 Broad Street Boston,Massachusetts 02110 telephone 617-338-7447 facsimile 617-338-6639 rn 143/4"n _ VESTIBU A3. A 2 f'ro o5ed Second Floor flan .� SCALE 1/4" = 1'-d' .0 z a' i --- - I-- --- - - -- ---- '- - --- - - - --1 PLAN KEY - - - -- - - --- - - -- - - - - ----- , 3WO1/AA6LM II1,,2 N5 _ .G_J 0:TO-0roO6TG 5F,M(24.57_7A$H _E_P_ MATCH LINE MATCH LINE - �� I r• � I I I I 24'-3 t/a" , 12_7 3/4" 1_ I P o_ 1 I 11/02/15 BUILDING PERMIT PACKAGE I di I I I .! / _... I 4� rl3o I j I I r- , I j 63'-2 - I I I ( I -E .43.6% MATCH LINE i 435 - z MATCH LINE ALL__ I-0'-31/B'1257d'I_ ! I boo ' �TQ T MING$HEN! ' oN f 1 0 oN Ti. I- ---°- -r- - -- - - --- - ---- - - -- - -!- I- - -- - - --- - - --- - - -- - —— LI �__ _ _ —__ _ _ —_ _ , I EXCAVATED '-�.. I - — — ——— — — —— — __ _yN F O.FOOTING_.—_ 10 0116 01 _. cr LO WALL____ 0,, I I I iNickened 51ab at Load I— ——— — —bL -031/812574) I F--1 I <----Bearing Stud Wall,See i I. _10-FRAMING .SHEIF�_ 1 1 I Deca'1 1'-51/8.12d,57'I ' 1 1 I I I BASEMENT SLAB I � ( ! ,�Q��t jV �(y`.�•� 5LA(3 ON GRADE �- I I GARAGE 51AII I - 1 4xW WWF 6W/REIN6x6 W " A N RADE ---- L - -- L— — — _.�'� -- REINF.W/6x6 WI 4xWl4 WWF t I � Cj—— — ! — — — — — — I _ I- N m _ a 0. I _ 1i - 'I 00II iT Op_GW99A0') SOS-TON L0._WALL UNCAVATEO I' . IX AL 60L1 0 2GEFOOLInG_L TO PORCH FOOTING I0 5-01 -5-0'21.0) hilect I 1 1 I r __ _ _ _ —_ " - - ; O'Connor Guest I - --- - 1 - - - ---- - -- - - - L House 03/4" o' a', 19'-83/4" 4" 01 t2'-61/2' I 4 I — ——— — — - — — — —— — — — — — — ——— — J ?- 233 Carriage Road Oyster Harbors MA 1\ - - ' I -`-- -I L I .__1� I I ,:'' UNE%GVATEO I ' 43.G..1 <.. I I II a Foundation Plan SCALE: 1/32°= 1'-0",1/4' = 1'-0" i n DATE: 11/2/15 N TO ) -5'-O'121.0WAL1 L_.- I I I o ' -5'-O'127.W0' ' Catalano Architects Inc. I t I I L - - -- - - --- - - -� — _ 115 Broad Street ---- - - --I- -- Boston telephoneSachusetts 617-338-744710 6'-41/2• I 15-0 facsimile 617-338-6639 t/2" � — •—_ 13'-21/2" 11'-@3/4' 21_91/2"_____—___---__.-___. L —_ _ _ _.4.5 J Foundation flan 5CALE:1/4" V-o" a x• 9' 1 .2b .2b • - .. . sue. /��f-.E... -_"" /ns�:- •---- �`- + �y f,crf f � /`'1 tom, 9&36wve All 6k' / ® 2 f t1 I / /.mod cz/37, g p 7_eo'rz 3 rGat �.2 t,,,,a tZ• d •' F! Gv � � ��T tZ. L7.00 Z'or z s*' L1 zy,ZEll- eaz.22oo r � SAD ti a ft�,f2>c 14 /fed o AD - v�' _ . ?.`77 _._ ..._ g5 4—" �, .� , J Pic. c. ffQ ' tCE2G y, A.6-. f .32a. 7-1 - MI Almum 4vl LDtl1la eve-reock 1 a, AL' _ / = so — _ o _ o�iT —is 51m O 9' 'VOUNOATIOW A&AN H 04 TO D AQ. 2%a WWtT41M ONS FbOT OF MPJ ISH CRAPS ov ER LEACH AREA u a ,, 2OF ,A Ft r �M PsRvi -5 PRF_vV_NT ro4ras.sox > o .f4" - CA�.1 P Y 12rMtl. ::r - - ;-- og Wi4.40 r4 dt wov-7i 1 NUN. rr Tz � 1%z.oI!°�• 7-3.7S- 1 .Y Z3.33 1.EAGFt aWA9NRV /soo _ i 2z .so T/ 1 ST'otE INVERT GALLON 4rj�ft,1 lNVis�2t /! z3.5'o Cp,P CITY ZZ.�7 �} QiA. C, cr 3o p►RO�r►.t� S 1 tG TANK �Nv�E,RT Pip k eNAT� - ZZ'00 G i✓o GAR8Ac6E GRIM 7ER /9.00 0 J - 20'miM. s tun PeILA , -� 5EP'rl G 5Y5TEAA CON STR uc noN 1 5 ALL CONFORM TO THE MASS. �: NUM�F.g of P�Sv uoonn5: F vIRONMENTAL CODE Rev I SV_v7 - 1-7-7 -rkE 'rOWnt /v ` ` �� ►` Die AIJ rL.0 / : �30 �' P, D` 00ARD OF NSAL*4 IMCAUl„All0f15 l ` L SA GN 1 i�l la RATE- 5 EPTi�TAN k o i 5TR 1 B�'tioN --- — .P /= r ' sp,•': REQ'O. i,6AC--�. CA�RA-GTS 2 IV C. -z., AN 17 L 5,^CN 9dx PIT O 10 139 O� IZEm IJFoRc.v,1D coNGRETE : PRoPoSEV LEAL4 CAPACAV ' n H 10 LOADI t4Ux-OF o LOG�f�O DR�lE1�A�y/GI�o�T�AT ��.�� Ov EFt �i O-MM UIJ LEA.. Al-L F1 PF_,F7-ro Pie WAT59T 1 µT sy3r3 '`o REFER��1 GE • 2°� ® - - - 5Y5T� 1-0 Pis � ri� E 4)y� j 0ARN15. ate:of D ADS 'reVcv : CA4t tRMJ M FRE-CMPT PA SO. ocr A7 L�81 FILE# - -- -= — -- ENGINEERING- ® DESIGNING BUILDING INC. NEAI,TI-1 ACaetJ"r AP?gaNIAL- HORT DENNIS, MASS. 3 8 5 u;'o?0 0 RF-1 OVERLAY DISTRICT: Area (min.) 87,120 SF(RPOD) AP - Aquifer Protection District Frontage (min) 20' w Width (min) 125, . Setbacks: Fron t 30' - Side 15 Rear 15' � 4 FLOOD ZONE: Zone X (not a flood zone) FEMA Map Number 33 25001CO756J Effective July 16, 2014 Location Map: 1"=2,000f' 0 ?4+� LCB FndX�G C) ASSESSORS REF.: Ma 071 Parcel 020 LOT COVERAGE: a p , Upland Lot Area: 37,800 SF �(�s� P�°°`e ��) ( � ' Proposed Lot Coverage: F d N_ ,� • � � .� DESIGN DATA 5,935 SF (15.7%) N�� \A0" �( 2, Single Family N° N° xR -8 Bedroom @ 110 GPD SEPTIC NOTES Proposed Floor Area: Jt\o\ 0t\0\ 1�$2�2 _ a } No Garbage Grinder 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours 10,819 SF (28.67) M M Total Daily Flow=880 GPD Prior to Any Excavation For This Project the Contractor Shall Make (Floor Area Ratio Per Architect) /j. p y - ` ` N; Use a 3,000 Gal 2 Compartment the Required Notifications to Dig Safe(1-888-344-7233)and contact Septic Tank(2 Kitchen Areas) Sullivan Engineering&Consulting Inc.(508-428-3344). 2.The Contractor is Required to Secure Appropriate Permits From Town �4 P to (}� �Q°�° R L t LEACHING AREA Agencies For Construction Defined by This Plan. 3.Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shall t ZgxS Q• tie+ \�� - 880 GPD/0.74(LTAR)=1,189 SF Required c / R=2�.a N PR ,, Q ��_ Be Constructed of Class 150 Pressure Pipe and Shall be Water Tested to Q � / , �� , „ ,_ Assure Watertightness. In General,Water Lines Shall be Constructed in �' +Za 3 r RO 0 Sidewall 2(12-10 +33-6 )2 =185 SF'x 2 ffi 370 t� 6 S�Q ©- �� P Q�8 a �- Bottom Area=(IT-10"x 33'-6")=429 SF x 2=858 Coordination With COMM Water,and Shall be in Accordance �{ OP Q C 2ax7 �1 With 248 CMR 1.00-7.00&310 CMR 15.00. ' Y Total Provided=1,228 SF PRSEP 4.A Minimum of 9"of Cover is Required for All Components. o- 5.All Structures Buried Three Feet or More or Subject co LEACHING CHAMBER DESIGN to Vehicular Traffic to be H-20 Loading.It is the Engineer's Q ___ All Pipes to be Schedule 40. Use Recommendation that H-20 Always be Used. ° RVE O 6-500 Gal.Leaching Chambers in 6.Install Watertight Risers and Covers to Within 6"of Finished Grade 16.0' R2E5� � y L 2-IT-10"x 33'-6"Double Washed O Over Septic Tank Inlet,U,and Outlet,D-Box,and Two Leaching Chambers. 00% P cJ ° I O 4- Stone Fields as Shown. All covers are to be maximum 18"for concrete or 24"Cast Iron. rjs5 -((5 S 7.Septic System to be Installed in Accordance With 310 CMR 15.00& N�F ( Lo G(een � S`de�°rd' N- P 4 7.3 \ Board 24 o Hea/h Regulations. 0 Revision and the Town of Barnstable 5 ,,6 \ o N 00y &�g " o 33 0, o ✓ 8.All Piping to be Sch.40 PVC. en(y NOyt G,\51 %;, +S �- 9.D-Box Shall Have a Minimum Inside Dimension of 12",and a Minimum \A N „• C �sE( Sump of 6"• t/ P G . : aid / PRE LL,N Q • d 10.Septic Tank Shall be a 3,000 Gallon,with 2 Compartments. -' ? 1 ePti guiltD26 N TH-1 y The First Compartment Shall Have a Volume of Not Less Than ?3+2 ��' { , Exe1 ps HMO Z�j. E�. \ S 2K, /� 1,760 Gallons and the Second of Not Less than 880 Gallons. - e 1, r ✓ 1 ... .. E TH-2 , ° ,I The Compartments Shall be Interconnected by a Minimum 4"Q1 / ` g Lows 5 Vented Inverted U-Shaped Pipe with a Gas Baffle on the Outlet. 23 LP \ 11.The Separation Distance Between the Septic Tank Inlets and `� CB 1, ti EL• ,/"� Outlets Shall be No Less than the Liquid Depth.Inlet Tees Shall Extend 11C n 1R J Fnd � q p �; U i' r � a Minimum of 10"Below the Flow Line.Outlet Tees Shall Extend 14" f Il� r Below the Flow Line,and Shall be Equiped With a Gas Baffle. aao ti , is F'n' h Gr ade o 3' Max. a o ` 9" Min Compacted Fill Filter S _.... �1 CB N S �Y .� *n Fabric �y H �\ __. ° rys+ry f ati �`� ndD And/or PERC TEST: 14,823 1/81, - 112" PERFORMED BY.C SULLIVAN HARLES ROWLAND,EIT SULL A ENGINEERING t SOIL EVALUATOR NO.13586 Pea Stone ?R+3 3' H-20 Pea WITNESSED BY:DAVID STANTON,R. . SOWN OFBARNSTABLE Wn TBM„A EI=24.63' NAVD'88 LEACHING - 1 112 SEPTEDouble Washed BER2220 S SITE PASSED CHAMBER Parcel Area N k To of CB DH stone 4' - 10" TEST HOLE-1 EL.24.5 TEST HOLE-2 EL.24.5 r�. F,•a 37,800.E SF ° i \ Zk+ j FILL FILL 12' 10" x 30" 22.2 \ \' � � ° �'•��_.....� CROSS LAYER lOYR 2/2 AE LAYER lOYR 2/2 * SECTION OF CHAMBER x2 l VERY DARK BROWN VERY DARK BROWN 34" LOAMY SAND 21.7 32" LOAMY SAND 21.8 NOT TO SCALE 3 � B LAYER 10YR 6/8 B LAYER I OYR 6/8 u:, _- ✓ /' 23 BROWNISITYELOW BROWNISITYELOW X 54 CMEDIUM LAYER OYR 7/4 20.0 52" C LIAYER I YEDIUM R 20.2 7 4 Y PALE BROWN W ' VERY VERY PALE BROWN � 01 tjG . ,.-,,' 20 MEDIUM SAND .. .:.,._. MEDIUM SAND S`deY 6x 9 �M�ED°- 54 25 GAL PERC IN 4 MIN. 0 15 To 132" PERC RATE<2 MINAN(LTAR=0.74 13.5 132" 13.5 NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED ° I. Sh Final Location of Vent Q\ C3�C1 To Be Coordinated With pY l b l Landscape N CY) 2 00 see Notes t TEST HOLE-3 EL.24.5 TEST HOLE-4 EL.24.5 �'� AE LAYER 10YR2/2 AE LAYER 10YR 2/2 ^ ZJ F.G. EL. 25.00* - *Final Foundation Lands To Be F VERYDARKBROWN VERY DARK BROWN oor ina a ith Landscape Plan _ 23.5 10' 23.7 12" LOAMY SAND.. LOAMY SAND Y p� Flow Equilizers B LAYER I OYR 6/8 B LAYER I OYR 6/8 EL. 23.2 As Required 30„ MEDIUM SAND � � •' Installer To BROWNISH YELLOW BROWNISH YELLOW RQ• Confirm Prior 2 Compartment 22.0 30" _ MEDIUM SAND_ 22.0 EL: C LAYER lOYR 7/4 C LAYERlOYR 7/4 P \ r To Any Work Se tic Tank H-20 Ton EL, 22.00 ✓ EL 21.75 VERY PALE BROWN VERY PALE BROWN H-20 D-Box L. 21.33 MEDIUM SAND MEDIUM SAND SEE NOTE 10 30" PERC TEST 22.0 \\ H-20 25 GALLONS IN 3 MIN.30 SEC. Chamber G(e On 1.00Leaching PERC RATE<2 MIN/IN(LTAR=0.74) oL6��15 Stable ompac a To Be Installed B a se - 0 GG 0 Bedding,"T"s, 1261 14.0 126" 14.0 �6�DH Inspection (port, !f Ehcownt(l`e(Y(teftloVN B6 Ro 1000 NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTURED & Baffels All Unsuitable Soils Wlthln 5' of 9) as Per Title 5 The cuter Perimeter of The System 'o EL. LEGEND ! No Groundwater- Per u No Groundwater .y�•� ..`P` DEVELOPED PROFILE OF SYSTEM Per Test Hale , y Light Post Groundwater `y ® Catch Basin NOT TO SCALE Per Lo.B. Groundwater Maps O �01r) f li Water Gate ,481t-1 H dron t ,R Irigation Valve - FSS/OVAL 0 CB/DH - Concrete Bound El LCB - Land Court Bound Utility Pole Revision: ISwitch primary & reserve to avoid trees. 1 14 2 5 -ohw- Overhead Utility Lines NOTES:-24- Elevation Contour PREPARED FOR: PREPARED BY. TITLE: Site Plan 2ax3 Spot Elevation1.) The property line information shown was i%nEnoeidno CapeS compiled from available record information. Proposed Improvements T.., • Deciduous Tree Joan B. O'Connor SUI an 41ll '�ri. 23 West Bay Rd, Suite G L� 2.) The topographic information was obtained (506)4043"-PQ8ax659-7ftkuRmd,Q"vfiKM0k02655 osterville MA 02655 At O from on on the ground survey performed on (508) 420-3994 / 420-3995fax + Coniferous Tree or between 29/JUN/15 and 07/JUL/15. www.copesurv.com 233 Carriage Road Barnstable Oster HarborsaSS 3.) The datum used is NAVD '88, a fixed mean sea level datum. 20 0 10 20 40 80 Draft: JOD Field: RRL/MML . W Cedar Tree Review JOD Comp.: RRL DATE: SCALE: (_ Project: 22048 Project # C291 September 22, 2015 1 rr=20r