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HomeMy WebLinkAbout0075 CROSSWAY PLACE - Health 5 CI-�-ss:,x a Place--, . Oslerville A- 165 -09Q , J ' V J v • o y : I ®®Mil 24 2016 19:36 Jim The Inspector Man 5085349919 page 1 I" ®dal 1&5-0 9® ®tee Commonwealth of Massachusetts Title 5 Official Inspection Fora' Subsurface Sewage Disposal System Form - Not for Voluntary Assessments C t~ 75 Crossway Place Property Address Catherine oatway, Estate Attorney = Owner Owner's Name information is Osterville ✓ MA 02655 7-21-16 required For every ! State Zip Code Date oflnspection page. Gity/Town 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. i Important:When �yunurtnprr A. General Information �,,,, �O OF S r forms � fillingout t A �tp'.•" an the computer, use only the tab 1. Inspector: key to move your JAMES m cursor-do not - James D.Sears use the return Name of Inspector y d Key. Capewide Enterprises, LLC ` ° �' N Company Name ��•.... 153 Commercial Street i st Company Address Mashpee j MA 02649 City/Town State Zip Code 508-477-8877 S1623 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 16.000).The system: ® Passes ❑i' Conditionally Passes ❑ Fails I, ❑ Needs Further Evaluation by the Local Approving Authority j �t'_4� .t.�s 7-21-16 nspe ctor's Sigriature t Date The system inspectors hall 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 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.doc•rev.6116 Title 5 oBicial Inspection Form:Subsurface Sewage Disposal System Page 1 of 17 V �o � E g Jul 24 2016 19:36 Jim The Inspector Man 5085349919 page 2 I Commonwealth of Massachusetts t Title 5 Official Inspection Form F Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 75 Crossway Place Property Address Catherine Oatwa , Estate Attorney Owner Owner's Name information is Osterville MA 02655 7-21-16 required for every State Zip Code Date of inspection page. City/-rown 13. Certification (cont.) I Inspection Summary: Check A,B,C,D or E/always complete all of Section.D, 1 A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: I The system is a 1000 Gal.Tank D Box and three chamber's Note outlet tee has a Zable Filter. i I B) System Conditionally Passes: i ❑ 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. i 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 isliess than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): . i I I I ' •Page 2 of 17 Ttle 5 ofricisi inspection Form Subsufacb Sewage Disposal System t5ms.doc rev.6116 Jul 24 2016 19:36 Jim The Inspector Man 5085349919 page 3 Commonwealth of Massachusetts Title 5 official Inspection Form F a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 75 Crossway Place Property Address Catherine Oatwa , Estate Attorney Owner Owner's Name i6formation Is OSterVllle MA 02655 7-21-16 required for every State Zip Code Date of Inspection page Cityrrown 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 (cost.): ❑ Observation of sewage back sp or duet aor break ut or brokenhsettltic ed orter unevenl in the distribution box due distribution box System will to broken or obstructed p pe( ) pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ❑ distribution box is leveled or replaced. ❑ Y ❑ N ❑ ND (Explain below): i I I s_- i. ❑ The system required pumping more than 4 times a year due to broken or•obstructed pipe(s). The system will pass inspection if(withlapproval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed i ❑ Y ❑ N ❑ ND (Explain below): j 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. I 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑- Cesspool or privy is within, 50 feet of a bordering vegetated wetland or a salt marsh _ Title 5 Official Inspection Form:Subsurfater Sewage Disposal System•Page 3 of 17 (5ins.doc•rev.611E I . z i Jul 24 2Q16 19:36 Jim The Inspector Man 5085349919 I page 4 I Commonwealth of Massachusetts j Title 5. Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 75 Crossway Place Property Address Catherine Oatway, Estate Attorney Owner Owner's Name information Is Osterville j . MA 02655 7-21-16 required for every City(rown State Zip Code Date of Inspection page. B. Certification (cont.) i 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: I ❑ 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 welly*. Method used to determine distance. I 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: I i - f I I i D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes ' No I I ❑ ® Backup of sewage into facility or system component due to overloaded or . clogged SAS or cesspool El ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool El ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in IN4111111111111 is less than 6" below invert or available volume is less ❑ ® than '/Z day flow/,£AQ/i/V • Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page a o1 77 151ns.doc rev.6116 I Jul 24 2016 19:36 Jim The Inspector Man 5085349919 page 5 j Commonwealth of Massachusetts] Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments a � • N 75 Crosses y Place Property Address I Catherine 0atwa , Estate Attorney Owner Owner's Name information is MA 02655 7-21-16 required for every Osterville - - page. City/Town State Zip Code V Date of Inspection B. Certification (cont.) Yes No I 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. I , ❑ ® 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 faecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.]. is ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,0009 pd. El ® 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. j Yes No = i ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system_is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) oir a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 115.304. The system owner should contact the appropriate regional office of the Department. -' f5ins,tloe•-ev.5115 i�. Title 5 Official Inspection Form'Subsurface Sewage Disposal System•Page 5 of 17 i Jul 24 2016 19:36 Jim The Inspector Man 5085849919 page 6 I Commonwealth of Massachusetts) Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments w 75 Crossway Place Property Address Catherine Oatway, Estate Attorney Owner Owner's Name information is MA 02655 7-21-16 required for every Osterville State Zip Code Date of Inspection page. City/Town C. Checklist Check if the following have been done.�You must indicate"yes' or"no"as to,each of the following: j Yes No i ® El 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? E I ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? i ® El Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility orldwelling inspected for signs of sewage.back up? . i ® ElWas the site insp cted for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® Was the facility owner (and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined ibased on: ® El information. For example, a plan at the Board of Health. I ❑ ® 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)] I ; D. System Information Residential Flow Conditions: 3 Number of bedrooms (design): 3 Number of bedrooms(actual)_ DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 i 15in's.dx•rev.606 Title 5 OYicial Inspection Form:Subsurface Sewage Disposal System•page 6 of 47 • i Jul 24 2016 1936 Jim The Inspector Man 5085349919 page 7 I Commonwealth of Massachusetts W Title. 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 75 CrosswaY Place b Property Address Catherine Oatway, Estate Attorney j I . Owner Owner's Name information is MA 02655 7-21-16 OStery required for every llle page. City tery State Zip Code Date of inspection D. System Information Description: The system is a 1000 Gal. Tank D Box and three chambers. i i 0 Number of current residents: i ® Does residence have a garbage grinder? Yes No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes No information in this report.) Laundry system inspected? ! El Yes ® No w. ❑ Yes ® No Seasonal use? j 2014-171,000Gal Water meter readings, if available (Iasi 2 years usage (gpd)): 2015-173,000Gal's Detail I I j I I I ❑ Yes No Sump pump? I I NA Last date of occupancy: I Date I , Commercialllndustrial Flow Conditions: Type of Establishment: i I . Design flow (based on 310 CMR 15.203): Gauons per day(gpd) Basis of design flow(seatslpersons/sq.ft., 1 ' Grease trap present? ❑ Yes El No j Industrial waste holding tank present? ❑ Yes El No Non-sanitary waste discharged to the Title 5 system? El Yes ❑ No Water meter readings, if available: j - - Title 5 Official Inspection Form:Subsurface Sewage olsposel System:Page 7 of 17 e l5ins.doc•rev.6116 I Jul 24 2016 19:37 Jim The Inspector Man 5085349919 page 8 i Commonwealth of Massachusetts Title 5 ®fficoal Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments f } 75 Crossway Place i Property Address Catherine Oatway, Estate Attorney. i — Owner Owner's Name information is MA 02665 7-21-16 required for every Osterville State Zip Code Date of Inspectionpage. City/Town D. System Information (cont.) i Last date of occupancy/use: Date i = Other(describe below): I j i i General Information I Pumping Records: 10114115/ 16 Source of information: Was system pumped as part of the inspection? ElYes ® No If yes, volume pumped: gallons I How was quantity pumped determined? Reason for pumping: Type of System: ! I ® Septic tank, distribution box, soil absorption system i ❑ 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 inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval D Other(describe): i ISins.doc•rev.6116 I Title 5 Official Inspeclion Form:Subsurface Sewage Nspdsal System•Page B of 17 . I Jul 24 2016 19:37 Jim The Inspector Man 5085349919 I page 9 I i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 75 Crossway Place - Property Address j Catherine Oatway, Estate Attorney I Owner Owner's Name ' information is MA 02655 7-21-16 required for every OStervllle Stafe Zip Code Date of Inspection page. Citylrown i D. System Information (cont.) i i Approximate age of all components, date installed (if known)and source of information: 1994 Permit # 94-541 Tank/2007 Permit#2007-464 D- Box and chambers. i Were sewage odors detected when arriving at the site? ❑ Yes ® . No I Building Sewer(locate on site plan): j 22' I Depth below grade: feet Material of construction: i i ❑ 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.): I j { i + I i Septic Tank(locate on site plan): Depth below grade:' feet Material of construction: ® concrete Elmetal I Elfiberglass ❑ polyethylene ❑ other(explain) I I j I , I If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ElYes ElNo 1000 Gal. Precast H-10 Dimensions: Sludge depth: 15ins.doc-rev.6116 Title 5 Official Inspection Form:Subsura e,Sewage Disposal System•Page 9 of 17 - i i Jul 24 2016 19:37 Jim The Inspector Man 5085349919 page 10 I Commonwealth of Massachusetts ! f Title 5 official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments i 75 Crossway Place Property Address Catherine Ciatwa , Estate Attorney Owner Owner's Name MA 02655 7-2146 information is Osterville required for every State Zip Code Date of Inspection page City/Town ®, System Information (cont.)• i i Septic Tank(cont.) 29" Distance from top of sludge to bottom of outlet tee or baffle. 011 Scum thickness 8r Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Asbuilt-Tape - Plan How were dimensions determined? I Sludge Judge E Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): r's at V below grade. Inlet baffle,outlet tee w/zable filter. No Tank at working level.Tank and cove sign of leakage or over loading i i i . I Grease Trap (locate on site plan): i Depth below grade: feet Material of construction: ❑ other(explain): concrete ❑ metal fiberglass ❑ polyethylene ` 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: Date Title 5 Midst Inspection Form:Subsurface Smvdgs Disposal System•Page 10 of 17 l5ins.doc•rev.6116 -------------- Jul 24 2016 19:37 Jim The Inspector Man 5085349919 page 11 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 75 Crossway Place Property Address Catherine Oatway, Estate Attorney Owner Owner's Name information is Osterville MA 02655 7-21-16 required for every State Zip Code Date of Inspection page. City/Town t 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.): -- i 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 i Date of last pumping: Date Comments (condition of alarm and float switches, etc,): Attach copy of current pumping contract (required). is copy attached? ❑ Yes ❑ No t5ins.doc•rev.6116 - Title 6 Official Inspection Form:Subsurface$swage Disposal System•Page 11 of 17 Jul 24 2016 19:37 Jim The Inspector Man 5085349919 page 12 Commonwealth of Massachusetts z Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 75 Crossway Place Property Address Catherine Oatwa , Estate.Attorney Owner -Name information is psterville MA 02655 7-21-16 required for every State Zip Code Date of Inspection page. City(rown D. System Information (cunt.) z. Distribution Box (if present must be opened) (locate on site plan): i 0. Depth of liquid level above outlet invert 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.): D Box is 16"x16"-41 below grade wlcover at 2': Two lines out, Inlet tee. Box is clean and solid. No sign of over loading or solid carU over. Pump Chamber(locate on site p1lan): Pumps in working order: ❑ Yes ❑ No' Alarms in working order: ❑ Yes ❑ No' Comments (note condition of pump chamber, condition of pumps and appurtenances,etc.): i 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: - Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 112 of 17 t5ins.doc-rev.6116 I Jul 24 2016 19:37 Jim The Inspector Man 5085349919 page 13 E Commonwealth of Massachusetts I' _- Title 5 Official Inspection Form R Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ` a. W 75 Crossway Place _ Property Address Catherine Oatway, Estate Attorney Owner Owner's Name information is Osterville MA 02655 7-21-16 required for every page. City/Town State Zip code Date of Inspection D. System Information (cont.) 4 Type: ❑ leaching pits number: ' 3 ® 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.): . Leaching is three 500 Gal. dry well chambers w/4'stone_ Chamber's are 4'below grade wlcover at 1'. Chamber's are clean and drv. Wall's clean like new. 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 El No s •Pa e. 13of17Title 5 OfficialInspectionForm:Subsurface Sewage oispoal System. t5ins.doc•rev.6/18 _ b Jul 24 2016 19:38 Jim The Inspector Man 5085349919 page 14 Commonwealth of Massachusetts. Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments. 75 Crossway Place Property Address Catherine Oatway, Estate Attorney Owner Owner's Name information is required for every Osterville MA 02655 7-21-16, 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.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): l5ins.doc-rev.6116 Title 5 Off ioiel Inspection Form:Subsudaoe Sewage Disposal System•Page 14 of 17 Jul 24 2016 19:38 Jim The Inspector Man 5085349919 page 15 . Commonwealth of Massachusetts , t Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments E 75 Crossway Place t Properly Address Catherine Oatway Estate Attorney Owner Owner's Name t information is Osterville MA 02655 7-21-16. required for every page. City/Town State Zip Code Date of Inspection i D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to I 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: s ® hand-sketch in the area below ❑ drawing attached separately q �3� F� / - � = a3 W tV . l I n doc•rev.6I16 T le 5 officia,Inspection Form:Subsurface sewage oisposal system•page 15 of 17 t5 s. i Jul 24 2016 19:38 Jim the Inspector Man 5085349919 page 16 *� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 190 75 Crossway Place Property Address Catherine Oatway, Estate Attorney owner Owner's Name information is Ostelville MA 02655 7-21-16 required for every _ page- CitylTown State Zip Code Date of Inspection D. System Information (cost.) Site Exam.- El Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells lvo 10'+ Estimated depth to igh ground water. 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: 10-12-07 Date ❑ 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 USGS database-explain: You must describe how you established the high ground water elevation: T.H. on Design plan 10-12-07 no G.W. at 10'+. Bottom of leaching at 6' below grade. Bottom of Leaching at 4'+above T.H. Depth. Before filing this Inspection Report, please see Report Completeness Checklist on next page. ISins.doc•rev.6/18 Title 5 Official Inspeclion Form:Subsurface Sewage Disposal system•Page 16 of 17 Jul 24 2016 19:38 Jim The Inspector Man 5085349919 - page 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora _ F Subsurface Sewage Disposal System Form - Not for Voluntary Assessments .9M 75 Crossway Place Property Address Catherine Oatwa , Estate Attorney Owner Owner's Name information is OsterVille MA 02655 7-21-16 required for every State Zip Code Date of Inspection page. City/Town 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 = I - i = 15ins.doc-.-ev.6H6 Title s official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 TOWN OF BARNSTABLE LnC'TION CroS S ?lacR SEWAGE# Z,007 r q( -�• lam' VILLAGE . 0 S r u, ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY:(type) S C�f� L C size) g X 3 3.Sr NO.OF BEDROOMS ' OWNER. ' T ro.A tc-A%h re� V v r PERMIT DATE: 10"a 5' 1007 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility AU &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 t Aoto" e ftrOssseS G4,C ' f,w I '^ y� V gi s�•d � 3 38 0 as �Z' � E4 34• 0 �3 ,,3 �S \cl .n J , -4 - (� No. . Fee v THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2ppYicatton for Mtgozar bpftem Con0tructton Vermtt Application for a Permit to Construct( ) Repair( ) Upgrade(►'1 Abandon( ) .Complete System E Individual Components Location Address or Lot No. 'IF d fo5SLj4 Owner's Name,Address,and Tel.No. rzo,4 4. r4-c f u!c 0S'rce2 "�.�e / G `7fCdOSSwa4Y P/#c2. Assessor's Map/Parcel f�S ® L/li0 3 l07 3 o 5axulw�_ Installer's Name,Address,and Tel.No. �,4ye de -07telom jef Designer's Name,Address an o.d Tel.N �C E '� i? v• Sv< -7&3 z 5y i"7 /A``Y Avig y2,1 LloZF 6e4xatvr)/e M,74 rofr- 2.73-6371 fASrrW o Type of Building: Dwelling No.of Bedrooms 3 Lot Size y, ZOo ± sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ' Design Flow(min.required) �3.a gpd Design flow provided 3`T b gpd Plan Date J U° 111/2©07 Number of sheets Revision Date Title �7S L<c�bS Size of Septic Tank Qo® i Type of S.A.S. A9t 5 r er / Description of Soil 1' C► d 3 X �' Nat f Repairs or Alterations(Answer when applicable) �) )-)30X T bo y (.3 S 5� ure (f L . -94-L 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 Certificate of Compliance has been issued by this Board of alth. Signed Date Application Approved byPk"mAlDate /@ 't_57-G 7 Application Disapproved by: Date for the following reasons Permit No. �p'� �`� Date Issued /o—0 _107 ——————————————————————————————————————————-- -, n-',�.�.: ,.;.N�+"s"'r1r'h+-.-...�..��t.rtt*-• ,-..,,.�.-.•r-ti....r`�i..,J'-........;.,.,.:�_.r}f zv..,^i+r.,:r•�7.,:.. -.r,._ ....._ ,.> . . i . No. ) ' Fee / 60 ' in computer: t� THE COMMONWEALTH OF MASSACHUSETTS EnteredYes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS application for B 5pont *Pgtem(Con tructiori Permit Application for a Permit to Construct Repair Upgrade Abandon( ) p ( ) Upg (1i� (,) ❑.Complete System.®Individual Components Location Address or Lot No. "7 5' e oloSSLJ 4� P�rF}C�' Owner's Name,Address,and Tel.No.rl4g4 41f r- -S j1j< OST6q�:.�� !'C✓oSSw/�y Assessor's Map/Parcel ��s- �O q 18 31ri' Installer's Name,Address,and Tel.No. CA?Iec.V+GG' C-rI1'el, ,)es Designer's Name,Address and Tel.No. i �o8 ya M-Za tErlvirl� 44,n �v?' ?3�.0 3'7 �s� w�t✓cN c 3� k Type of Building: it Dwelling No.of Bedrooms Lot Size y{ Zoo f sq. ft. Garbage Grinder ( ) << Other Type of Building 11 No.of Persons Showers( ) Cafeteria( ) r\ Other Fixtures Design Flow.,(min.required) 330 gpd Design flow provided gpd Plan Date 'l I l 1120ol Number of sheets ( Revision Date Title 7S G1c;&S A Size of Septic Tank reap t Type of S.A.S. '3 Sbo. c� t C S fj.A Description of Soil � a low ,� ° 170 Nature of Repairs or Alterations(Answer when applicable) /1&,y I)— BOY To (3 (rt/ .Si4A Date last inspected: M j Agreemenfi , j 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 Certificate of Compliance has been issued by this Board of ealth. Signed Date Application Approved by ,e. L Date /o — (5--o"7 Application Disapproved by: Date for the following reasons Permit No. (jg'�—y�t� Date Issued to—(S '1 7. 'i THE COMMONWEALTH OF MASSACHUSETTS w.. �i BARNSTABLE, MASSACHUSETTS Certificate of Compliance g; �w THIS IS TO,CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded (1/� Abandoned( )by ✓i PS L(.•L at 157 61635 L—)Af P14tt os of U I de has been constructed in accordance with the provisions of Title 5 a,d the for Disposal System Construction Permit No. 2 0o-7— Yb I/ dated w— S—ct 7 Installer frail �- 0-'4.5 LLr. . Designer �2�j�f #bedrooms 3 Approved desi n flow Q gpd The issuance of this permit shall not be const ed as guarantee that the system w" 1 )nction as designed. o Date Inspector ------------------I-------- --------------/ No. 7ho 7 p 1 Fee ��d - - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS =t5po5al *p!gtem Construction ermit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade ( ) Abandon ( ) System located at 7 S U0 5 S w+mot. and as described in the above Application for Disposa'1'System Construction Permit.The applicant recognizes his/her duty I to comply with Title S and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of thir it.Date /a /rf�` o Approved by I ' a l Town-ol Barnstable Regulatory Services s Thomas R Geiler,Director ]Public Heall:h Division Thomas McKeon,Director 2.001vI W Street,Hyannis, MA 02601 Office: 508-862-4644 Fax; 508-790-6304 Installer & Designer Certification Form bate: 10-f 9 .0-1 Desigpxer: Gn �r� Installer: G��p .,�•ctQ _ v���r�r�Ses Address: 13 5 Ccagilvc('r bill L Address: RO. Bo!� u.?or e1u►o+nn M�' p 7 3 6 S- 273-o 5,77 On '10— 6- oo l CAtic •d ✓ )e was issued a permit to install a (date) (installer) - septic system at 7.5 re55wq P t ac e- � based on a design drawn by address c 6)SC:ne e-cin 1nC , dated IG 1 Z ~G (designer) ZI certify that the septic system referenced above was installed substantially accordingto the design, which may include minor approved changes such as lateral relocation o he distribution box and/or septic tank. I certify that the septic system referenced above was installe'd.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. 1 JOHN L. CIiURCHILL a M. (In 'ller's gnatur r 41eo7 esig er'si tgnatur �. (Affix D igner's-St ere) P E TURN NSTABL EAI, C +' T, Cam',' , O CO I. C WILL N E ISSUED UNTIL BOTCH IS FORM AND AS- B LT RECEIVED R THE BARNSTABLE PLTBL TH DIVISION. TRANNYO Q:Hea*SepticMesioer Canificanon Fomi 10 'd li9£0 24Z 809 ON.Ia33NTON33f WV ££: 0T Z00Z-6T-100 TOWN OF BARNSTABLE L C4ION 7 �. S fv S$ ?to SEWAGE# Zc'�o ` VILLAGE 0 S}-er u,\ c 7" G Y ASSESSOR'S MAP&PARCEL 14,57- o INSTALLERS NAME&PHONE NO. e SEPTIC TANK CAPACITY v LEACHING FACILITY:(type) ' NO.OF BEDROOMS "U L l+� Ysize) 9 X- 33.S— OWNER Ivy- PERMIT DATE: 10- r i- 'Z o 07 COMPLIANCE DATE: Zoc 7 Separation Distance Between the: Maximum Adjusted Groundwater Table to.the Bottom of Leaching Facility Private Wafer Supply Well and Leaching Facility(If any wells exist V Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching FacilityFeet within 300 feet of leaching facility) �f any Wetlands exist FURNISHED BY Feet L) b ` 18.0 1�5 13 1•3,0o 3� v E- (0 4t . Town of Barnstable P# qSq Department of Health,Safety,and Environmental Services �THf Public Health Division q101 , 1� Date Di 367 Main Street,Hyannis MA 02601 BARNS'rABLE, • - 4' 9 MA 93. �DIEdrAOI►`� Date Scheduled Fee Pd. �f -Sroil Suitability Assess'inentt brY Sewage Disposal.'." Performed By: t4%WA6L*?1MENT&_; e2Y'_ CS(% Witnessed By:-J o"NA M.*94ouyi . LOCATION & GENERAL INFORIVIA'TII .. Location Address '715�rosS w �)��� Owner's Name n�N 7 (� t �U✓ d 8-+(-rV\ �' ry-1 1'4 Address -75 C,1'C�53W( P�CteQ 08'1-e--✓i/i IISL Assessor's Map/Parcel: t(Vq 1oq c Engineer' Name �( - �n C. E�,4 .t'CrTvi I , NEW CONSTRUCTION REPAIR Telephone#(�z)&)v?33 �i � Land Use RETIOEWA`; Slopes(%) VI.- 2-o Surface Stones N R Distances from: Open Water Body >ISc ft Possibl&Wet Area-714b :' .ft Drinking Water Well Drainage Way � To ft Property Line �k��;; .ft„ Other N/A- ft i SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) ti SFJE AWAU4E0 SITE fV �a (ri `y` G ^� ZE Parent material(geologic) ourw R 1I 6AIM •• Depth to Bedrock 130•, .S• 1 Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face l3C" �. •S, Estimated Seasonal High Groundwater l�� �,G•S. :: ......... ..................:.... ... ......:...:..::............................................ bT1�TA.'fONOt SASbN�kOT 'wATtt �, � Method Used `0dttra 08SElttlAnonl Depth Observed standing in obs.hole: �qW IS.G•S. in. Depth to soil mottles: 513p �•�•S• in. Depth to weeping from side of obs.hole: >I�}p� g,G,g, in. Groundwater Adjustment >136" S.G,S, ft. Index Well# N p Rr.adin.g Date: N A Index Well level �p Ad' factor N�q Ad'.Groundwater Level N� �- - �. -.._. --I—- -- J' _ _ J _ . PRCOLATTE7IV TESTat ` z Timc xrbo Observation 1 Hole# —fP l Time at 9" Depth of Perc CIO-"j'�j� i . Time at 6 Start Pre-soak Time @ W00 Time(9"-6") End Pre-soak Rate Min./Inch <2 MPI s' Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YM) Original: Public Health Division Observation Hole Data To Be Completed on Back j Copy: Applicant a BEEP OBSERVATIbN�IOI,E LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.' ravel o-tL" F'iw li-qa" '$ t.eg41Y $ANO le1t�.� to _:. Yy]EP OBSR�jATYON HOLE LQG �- Hole Depth from Soil Horizon Soil Texture Soil Color I Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,° ravel r Y - . DEEP OBSERVATION HOLE LO`G Hole ... . Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.%Gravel . DEEP ODSER'VATION HOTE LO;G Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.° Gravel) CO e: 4�. Eldod Insurance Rate Man: Above 500 year flood boundary No Yes C Within 500 �year bound ' No—v Yes', Y I .Within 100 year flood boundary No V Yes y1 t Depth 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? YE5 If not,what is the depth of naturally occurring pervious material? r.. Certification I certify that on mill " (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required training expertise experience described in 310 CMR 15.017. Signature c Date y� 7 r 1 TOWN OF BARNSTABLE L6CAT1ON 5 1 )9057g SEWAGE #9 — � VILLAGE ;ej,�/� ASSESSOR'S MAP INSTALLER'S NAME & PHONE NO. ,, SEPTIC TANK CAPACITY pp O LEACHING FACILITY:(type) (size) (DOO NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUUA)E•R OR OWNER DATE PERMIT ISSUED: ' DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No f� I s ;y P ^ k $ 30 00 No...,? .-. � Faa...................:......... THE COMMONWEALTH OF MASSACHUSETTS 1 JS BOARD OF HEALTH TOWN OF BARNSTABLE Appliratiun for Divi-puittl Worltu Tunitrurtiun rrrinit Application is hereby made for a Permit to Construct ( ) or Repair �X) an Individual Sewage Disposal System at: 75 Crossway Place Osterville ....................................................................•---••-----•---............... ------•----------------------•--------•--•------------•-----------....---------------------------• Location-Address or Lot No. Tail o r._.___. Owner Address W J.P.Macomber Jr. Installer Address UType of Building Size Lot............................Sq. feet Dwelling X-No. of Bedrooms----------------3..........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ___________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures _______________________________ __ W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity------------gallons Length---------------- Width......---------- Diameter................ Depth................ Disposal Trench—No. .................... Width-------------------- Total Length.................... Total leaching area....................sq. ft. Seepage Pit No_____________________ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) � Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1________________minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_.-___--_-__-__---____-. 0 Description of Soil.............................................Sand & Gravel V ---------------------------- -----------------------------------------------------------.....-----------................................................ UNature of Repairs or Alterations—Answer when applicable----Adding 1-1000 gallon pit to an e. sting Tank % Pit . -•-----------------------------------------------------------------------------------------•..--••••------------•-----------------------•------------------------------•---------------••-•----•-------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been 'sssued by the Poard pf health. �/�Signed . --------- r. .............9/1.2.�.Q ........................ Dare Application Approved By -------- .---... . ... ............ Application Disapproved for the following reasons: ............................ . ....... ..... ............................. ... ................................... -- . .........-----------------------------------------.............----------------......------------------------------ ---------..----------------------------- Z Dace Permit No. ... �..' ....... Issued ..... . . ............ Dace No.. .__._ Fp $s....... 30'00 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH � (/b TOWN OF BARNSTABLE Appliratiun for Diuvuuttl Workg Tunutrnrtiun Frrniit r Application is hereby made for a Permit to Corstruct ( ) or Repair TX; an Individual Sewage Disposal System at: 75 Crossway Place Osterville --------------------------------------•----------...-----------------------------........--.-----• ----------•----------•-----------•------••---•---------•---............-•---------•---...--------- TaLocation-Address or Lot No. ylor W J.P.Macomber -Jr. Owner Address Installer Address........................................... UType of Building Size Lot............................Sq. feet DwellingX-No, of Bedrooms---------------3---------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons-_--...__.-_--_____---..---. Showers ( ) — Cafeteria ( ) QOther fixtures ---------------------------------------------------------•----------------._........--- ------------------------------------------------•-----------. W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity__-_---___gallons Length---------------- Width_._----_--__-- Diameter---------------- Depth______________- x Disposal Trench—No. .................... Width.................... Total Length...----------------- Total leaching area....................sq. ft. Seepage Pit No...................... Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water........................ 4 Test Pit No. 2................minutes per inch Depth of Test Pit___-_--__..._--_-_-. Depth to ground water........................ W -----------•----------------•-------------------------------•-------------------•-•---------..............--------------•-•----••-------.......-------------- 0 Description of Soil.............................................Sand & Gravel x ---•---------------------------------------------------------------••----•--•----------•---•-------.•---• W UNature of Repairs or Alterations—Answer when applicable.__.Adding 1-1000 gallon pit to an existing Tank % Pit. .............................................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the oard of health. /J 9/12/9.4 Signed .. !!/�,�,t � `f... ........ 1� R Date Application Approved By --------- 3-. -.------ Date Application Disapproved for the following reasons- -------------------------------- ------------------------------------.........................---------------------------------------- ..... ....................................... .............................................................. ......... .................................... .... . --------------------------------------- L � Permrt No. ----------------------- ------------------------ ...............................Date..... .... - -��'J Issued - Date t THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE ITTez#if ra e of CZompliance J.P.S comberIF�fThat the Individual Sewage Disposal System constructed ( ) or Repaired (XXX) by -----------------------------------...._..------------_------------------------- 75 Crossway Place Osterville Installer at .--------------------------------------------------------------------------------------------------------------- ...........-- ----------------------------------------------------------------------------------- has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ....�� ..>:__ .. .�.-........ dated .......__.._---------------------- _.... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. / y DATE ................, ------- _ _....��.. Inspectcr�---- -�" 1 . �✓ ft————————— ———— —————————— —————————— ——————————— —————_——__— ! THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE $ 30.00 No...l..y_...S . FEE........................ Uiupuual Workii 011unutrurtiun "antit J P Macomber Jr . Permissionis hereby granted----- _'....'------------------•-----------------------•----...-----------••----•----•-----........---------------.._......----............ to Construct G or Repai�(a e nOstervallSe age Disposal System i� r sswa atNo.... ..... ----... -- -- -- -•------- -•--••.--........ Street � as shown on the application for Disposal Works Construction Permit No��_.;t.tfl_. Dated----- �>..�_._.... ---- ---- ------Board of Health DATE - FORM 36508 HOBBS♦!t WARREN.INC..PUBLISHERS OSTERVILLE SCUDDER LOT 5 BAY 1k ti� C;p Flo MAR 7'17A►r11:18 LOT 6 LO U.S S�3°� ,10" LOT H >> EAST AREA=14,200f S.F. 5 OQ BAY FO N 46.3' LOCUS MAP M PLAN REF: 181/129 cV TITLE 'REF: 30185/331 LOT 7 1�6, 39.8' PARCEL ID: MAP 165 LOT 90 ZONING: "RC" - SETBACKS. 20'17-10'S-10'R MAX. BUILDING HEIGHT = 30'-; 2Q Q' / , WIND ZONE EXPOSURE: "B" FLOOD ZONE:- "X", ESTUARINE WATERSHED O q0 26 COMMUNITY PANEL: 25001CO563J DATED:07/16/14 . pI T-/ON 23 8 0 3 .�.;... DD/T7'ON 28.9' / CERTIFIED PLOT PLAN (FOR ADDITION) M #75 / LOCATED kAT: �gRgc / 75 CROSSWAY . / 0 - OSTERVILLE, MA. ��,, i ii rill, : •� cy l " rri.'. rr iir,, rr r / PREPARED FOR. 29t7 ! az / i /�y MATTHEW J. D'OOLIN SCALE: 1"=20' R,3�S.36- / / FEBRUARY 17, 2017 21-28 /. N8j*26#4 „ �-'? /\cBAS. MacDougall Surveying r �. _ � 2640 �/ , ���, OF ,ygss �_ 8c Associates- - - - - — ter / o2`�FPEDWARD oy GRAPHIC SCALE CR�S o A. P. O. ,Box 2428 Swq Y NST8 o Mashpee, Ma. 02649 20 0 10 20 40 80 a PH. �508�419-1086 � F� sTE o�'� fax 508419-1087 • �Opq ANp S �� • 1 email: ( IN FEET ) �i , macdougallsurvey@comcast.net 1 inch 20 ft. SHEET 1 OF 1 J 1900 PLANS FOR PROPOSED ADDITIONS AT•THE -DOOLIN RESIDENCE 75 CROSSWAY PLACE OSTERVILLE, MA. 02655 PAGES: 7 (SCALE 3/16" = ro l R P -G #1 EXISTING & PROPOSED :REAR ELEVATION. _ PG #2 - EXISTING & PROPOSED LEFT ELEVATION PG' #3 - EXISTING & PROPOSED RIGHT ELEVATION r PG #4 - ADDITIONS FOUNDATION 'PLAN PG #5 - ADDITIONS FLOOR PLAN PG #6 - CROSS SECTION A PG #7 - CROSS SECTIONS B & C PG #8 -.ADDITIONS FLOOwR &. CEILING FRAME PLANS PG #9 - ADDITIONS ROOF.,FRAM`E PLAN, l t P.G #10 - DETAILS 69'-O" . :, 21'-8�" F .•21'-O" 6'-2" -. 20'-1�" u TYPICAL 8":BASEMENT'WALL: ; - --; ------ ------ -- -=r --- ---- ----- ,. 8",CONCRETE FOUNDATION WALL 20" WIDE x.8" DEEP ; -' ; d ASP'ALT D14MPPROOFING CONCRETE FOOTING c/w 2 - RUNS I5M REBAR PROPOSED GARAGE FLOOR EXTENSION Y ; 1FLOOR " CIONCRETE SL�AIS c/w " •- -------=---------------------- --------- FIBRE- ; - -- - MESH REINFORCEMENT - i -- --- - - - � I I I COMPACTED.GRANULAR FILL _______-- _y__-________.____ _.__________________._________________-____,__--_,____---__________________-___-__--_____________ �___ ____ _ _ -______-_ _-_-_-_ _____ __ -------------------- ' VENT,,.. , _ ,. T - _ _f _ _ �_ ___ _ .. .______________________-____._-__________-_______._ . ; 2" RIGID FOAM FROM TOP OF FOUNDATION TO SLAB`ON INTERIOR PERIMETER VENT PROPOSED CRAWLSPAGE --- --- -- - ' -- - -- ----- -- - - ; 1 vUva v0 va. v4v a, . v�.0 va �,1 - Is ---------------- -------------- _ _ _ __ __ __ ------ _ ____ _ 'd 777 d ..D d 4" - •' .I 1 v. 1 -______-.________-__________ __ _______ ------- _- - ..i I ------------------------ ---- --- Al 1 . 1 ✓ I n I I I EXI-STING BASI=i`1ENT o EXISTING GARAGE FLOOR 4 , , 0 . LJ PROPOSED FOUNDATION FLAN r 21'-0" 26'-3%2" 1O'-3,1/ 2'-4 2'-4" 4'-3" S,-6" 10'-O" tv-6" 4'-2�'a" -10" �'-1" 13'-144' _ 2'S4g'_ � x a'-ors° PROPOSED GARAGE_ADDITION W/MUD 001'1 - y _ U > - \ R _ ° 2 536" x 4'-4Tg1 .2_5S6".x 4'-4.36" ,. ._2,-5a6'� x 4'-0-%n , a . e PROPOSED � = ° 'TYPICALO GARAGE FLOOR — MASTER BEDROOM V Qr m _: cn -4 •CONCRETE SLAB;c/w. tt = ADDITION FIBRE o MESH u �'-5!g'rx W/BATHROOM REINFORCEMENT — •^ V s , a PROPOSED DINING 4 KITCHEN ADDITION: . 2-2x8 uI 2x8 FLOOR JOISTS o r1Co a.c. �.r f _ x 2x8 FLOOR JOISTS o Ir o.c. cri W/ 2x8 CEILING JOISTS,m 16- o.e. _ - - = sue_- -- - - - -- --- doove -- _ , - - - 4 x. POST ,„. ., - 4-2x4 POST:.• - e 4-2x4 POST A 4-2x4 POST -. v r , _ g X 2 �_.l `" 3�1 3/4 •X 1�oLVL"DROPP 3 1-3/4 9. SLVL 3 3/4 X 18LVL + \0 , a„ n • n n x ,v ro — FOLDING COUNTER h lillN hill 11 ' - . PROPOSED ADDITION FLOOR FLAN FRAME ROOF: 0225 ASPHALT SHINGLES 1/2" CDX PLYWOOD { 2xIO RIDGE BOARD" - ^ 2x8 RAFTERS a 16 o.c. 2X6 COLLAR TIES (W/1-12.5A HURRICANE TIES) 2x8 CEILG JOISTS a 16" o.c. TYPICAL 2x(o SIDING EXTERIOR WALL: TYPICAL 2x4 SIDING EXTERIOR WALL: VINYL CLAPBOARDS -- - VINYL CLAPBOARDS 1/2" CDX PLYWOOD SHEATHING (VERTICAL) TYPICAL CEILING ASSEMBLY: - "1/2" CDX PLYWOOD SHEATHING (VERTICAL) 2x6 STUDS a 24" o.c. 1/2" SLUE-BOARD W/SKIMCOAT PLASTER 2x4 STUDS a 16" o.c. R-19 FIBERGLASS BATT INSULATION 6 mU POLY V.B. 2x8 CEILING JOISTS,m 16" o.c. ' R40 BATT INSULATION R-13 FACED FIBERGLASS BATT INSULATION AND 1/2" BLUE-BOARD W/SKIMCOAT PLASTER f AND 1/2" BLUE=BOARD W/SKIMCOAT PLASTER HURRICANE tiES,51MPSON H2.8A TYPICAL FLOOR AT ALL RR PLATE-CONNECTIONS FINISH FLOOR OVER 3/4" TtG PLYWOOD SUBFLOOR GLUED 4 FASTENED TO 2x FLOOR JOISTS w/R-30 FACED FIBERGLASS BATTS ^ E ISTING ROOF— ' ATTIC ATTIC 2x8 CEILING JOISTS 0 16 o.c. 2x8 CEILING JOISTS s 16 o.c. ------------------- -----`--*- ------------- ----- 2.m 1-3/4 X 1-114LVL 2 m 1-3/4 X 1-1/4LVL NEW DROPPED.LVL BEYOND + T GARAGE MUD ROOM KITCHEN DINING ASTER BAT MASTER BEDROOM TYPICAL GARAGE FLOOR: 4" CONCRETE SLAB c/w FIBRE MESH REINFORCEMENT o o o ,2x& FLOOR JOISTS ® 16" o.c. 0 2x8 FLOOR JOISTS a 16" o.c. GRADE �< CLEAN FILL `. RAWL SPAC CRAWL SPACE ao CRAWL SPACE a, _ o a o TYPICAL CRAWL FLOOR: 4" CONCRETE SLAB . a TYPICAL.CRAWL FLOOR: 4" CONCRETE SLAB �t c. 8° POURED CONCRETE FOUNDATION WALL OVER 10X18 S 6-1 PC KEYED FOOTING —�' FOUNDATION BOLTS P _ 6-12�� FROM END/JOINT OF PLATE EMBEDDED 'I" W/3"X3"XI/4" WASHER 2 N4 REBAR 2" DOWN FROM Tor- CROSS SECTION A r 42'-8'2"' ' cli , �!f T ' a r a a �4 r' .. r ... ¢, Y ol -I U511 x 4 - w , 1 F _ 1 e . ` - Y e , v a , r s' ♦ - - ti _ (mil � � .. � .. � � � « � � - � � � I'll 18'-O" 25'-0 n 26'-O n FINISHED GRADE OVER TANK EL. = 49.7± PROVIDE PRECAST CONCRETE EXTENSION RISER WITH CONCRETE FINISH GRADE OVER D-BOX= 49.6'± FINISH GRADE OVER CHAMBERS= 49.6' - 49.1' GENERAL NOTES TOP OF FOUNDATION COVER TO WITHIN 6"OF FINISH GRADE SLOPE @ 2% MIN. OVER SYSTEM ELEV= 50.4 ± CONCRETE RISER AND COVER OVER INLET AND OUTLET COVERS. TO WITHIN 6"OF GRADE 3/4"TO 1-1/2" DOUBLE WASHED STONE TO 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION FINISH GRADE 4"SCHEDULE 40 PVC MIN SLOPE 1% ACCESS BOX WITH COVER TO GRADE CROWN OF PIPE ! METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL @ FND. EL.= VARIES 5" DIA. OUTLET(S) (SEE NOTE#21) CODE AND ANY APPLICABLE LOCAL RULES. 2"OF 1/8"TO 1/2" DOUBLE WASHED STONE - 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE PLACE RISERS ON ALL DESIGN ENGINEER. TOP OF SAS = 46.63' CHAMBERS WITH -EXIS,-iNG 4: PROPOSED 4" 9"MIN. INLET PIPES TO 6"OF 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL SEWER PIPE ��� PVC SEWER PIPE 45.80' 36"MAX. BREAKOUT EL = 46.30' FINISHED GRADE + SYSTEM UNLESS OTHERWISE NOTED. = 3" DROP MAX PROVIDE WATERTIGHT 4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN -- ---- 2" DROP MIN 714 JOINTS (TYP.) ELEVATION =46.30' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A MIN.SLOPE Q 1% 0 10" 4" PVC IN FROM �Cp 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF " �*47 4'± SEPTIC TANK 4" PVC OUT TO 0 0 0 0 0 0 0 0 0 00 THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION. • LEACHING FACILITY oO 0 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM. T o0 0 0 000 0 0 0 0 00000 12" I o 00 SHALL�VERIOFY SIZE 48" VERIFY CONDITION OF OUTLET TEE TOR46.17' MIN. 46.00' 2' o 0 0 000 o000 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL. SHALL 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK AND CONDITION OF EXISTING TEES 22"ZABEL FILTER - 6"CRUSHED STONE 00 o o oo FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS EXISTING SEPTIC AND REPLACE AS MODEL#A1801-4x22 ..-_. OVER MECHANICALLY d 0 0 0 o NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH TANK NECESSARY COMPACTED BASE 4.0' g 5'(TYP) _ I 4.0 2 0' 4 9' 2 0' AND DESIGN ENGINEER. 5 OUTLET DISTRIBUTION BOX T 9' 8. ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM OF 50.00' ESTABLISHED TO BE INSTALLED ON A LEVEL STABLE 33.5 ( ON A NAIL SET IN UTILITY POLE#561/6 AS SHOWN ON PLAN. BASE. FIRST TWO FEET OF OUTLET GROUND WATER ELEV= < 38.37 /'43.80' 8.9' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION EXISTING 1000 GALLON CONCRETE SEPTIC TANK PIPES TO BE LAID LEVEL. 3 - 500 GALLON CHAMBERS CHAMBER END VIEW THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT SEPTIC TANK PROFILE CROSS SECTION VIEW 5'MIN. 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES "CONTRACTOR TO VERIFY EXISTING ELEVATION PRIOR NOT TO SCALE DISTRIBUTION BOX DETAIL TYPICAL CHAMBER PROFILE CHAMBER DETAILS TO THE DESIGN ENGINEER. TO ANY WORK& NOTIFY ENGINEER IF DIFFERENT. NOT TO SCALE NOT TO SCALE 10• ALL JOINTS WHERE PIPE ENTERS AND EXITS CONCRETE ___ _ - - - - ---.----- -- -- STRUCTURES SHALL BE MADE WATERTIGHT. 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING -- TEST PIT DATA REGULATIONS. OWNER/APPLICANT IS TO OBTAIN SUCH DETERMINATION FROM ♦ 00 APPROPRIATE AUTHORITY. X� • • ' INSPECTOR: Donna Miorandi 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS X� • 0 EVALUATOR: Michael Pimentel, E.I.T. LOCATED UNDER PAVEMENT, DRIVES OR TRAVELED WAYS IN WHICH CASE DATE: October 12, 2007 THEY SHALL WITHSTAND H-20 LOADING. J X�X +C ► s 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES. l / ) � ' `k�k-.,X\ � �: � • � � * to � TEST PIT#: 1 (Pere. # 11959) MAP 165 ELEV TOP = 49.20' 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE k " ' MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY. PARCEL 62 ELEV WATER= <38.37' REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY, //500, F tp FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3). .r ♦ ' PERC RATE _ <2 Min/In l > ��\ X�k\X •� . ' ' i" 15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN / \ �X� •• • ,.. DEPTH OF PERC= 40"-58" SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK. �` - \5 `X�X� / •" ' , .: TEXTURAL CLASS: 1 16. PROPOSED PROJECT IS LOCATED WITHIN: / ��, /� k�k\k . . • '='y ASSESSOR'S MAP 165 PARCEL 90 OWNER OF RECORD: FRANKLYN H. & MARGARET S. TAYLOR 011 / MAP 165 / / d ,�:'• rr Fill ADDRESS: 75 CROSSWAY PLACE X CB/DH (FND)_ J `k �# OSTERVILLE, MA 02655 � / PARCEL 90 / / E +GO , .': � 12" 48.20 FEMA FLOOD ZONE C / 14, 200 S.F. COMMUNITY PANEL# 250001 0015C MAP 165 g Loamy Sand C l� _`• 10 Yr 5/6 17. DEED REFERENCE: PARCEL 67 LOW/ , I B ' BOOK 3384, PAGE 298 Ct 40" 45.87' 18. PLAN REFERENCE: Pere PLAN BOOK 1E1, PAGE 129 1 \ X , 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION. It l \S0 x 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY Medium Sand FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY C 2.5Y 6/6 FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE. 21. A 4" PERFORATED SCH. 40 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3"OF FINISH GRADE. A h N 50\ LOCUS PLAN REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS. N B.H. \ / SCALE: 1"= 1000' _50J _ _ __ 130" 38.3T No Mottling, Standing or Weeping Observed EXISTING \ / DESIGN DATA - - --� EXISTING 1000 GALLON SEPTIC TANK TO X TEST PIT DATA LEGEND G E N D BE UTILIZED AS PART OF THIS DESIGN 3-BEDROOM GC 2 �\ / N ;_ y (EXISTING OUTLET TO BE PLUGGED) -- DWELLING °c� 1/ NUMBER OF BEDROOMS (ASSESSOR) 3 - - 50 - - EXISTING CONTOUR TOF =50.4'± h J V INSPECTOR: Donna Miorandi A � NUMBER OF BEDROOMS (DESIGN) 3 i" co a j DESIGN FLOW 110 GAUDAY/BEDROOM EVALUATOR: Michael Pimentel, E.I.T. r� PROPOSED CONTOUR EXISTING DISTRIBUTION BOX ; DATE: October 12, 2007 TO BE ABANDONED GARAGE Q TOTAL DESIGN FLOW 330 GAUDAY ❑/H/W EXISTING OVERHEAD WIRES i Q TEST PIT#: 2 (Pere. # 11959) 10 ( a� DESIGN FLOW X 200 % = 660 GAUDAY ELEV TOP= 49.4' �✓'---- EXISTING WATERLINE EXISTING LEACHING PIT TO BE z STOOP (1)0 .9, (2) Z o USE EXISTING 1000 GALLON SEPTIC TANK - < 7'( d ELEV WATER- 38 5 -X-X-X-X-X EXISTING FENCELINE PUMPED, FILLED WITH CLEAN, _ _ _ _ __ 1 COARSE SAND AND ABANDONED GC 1 10.11 ( ' V PERC RATE _ LA/V os WALK 7 CoNCR - _ ` - TEST PIT LOCATION E@ �T DEPTH OF PERC- 0\ EXISTING LEACHING PIT --- INSTALL 3 - 500 GALLON CHAMBERS TEXTURAL CLASS: 1 Lp o / SIDEWALL CAPACITY Q Q EXISTING 1000 GALLON SEPTIC TANK = GAUDAY 0" 49.40' \ O _ _ FLAG POLE TO BE REMOVED (33.5'+8.9')(2 ) (2' ) ( 0.74 GPD/S.F.) = 125.5 GAUDAY Fill PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE 13" RED PROPOSED 3-500 GALLON 12" 48.40' PROPOSED DISTRIBUTION BOX / / / LP MAPLE 3 LEACHING CHAMBERS BOTTOM CAPACITY 13 CB/DH (FND) � 5 0 TP 1 PROPOSED (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY g Loam Sand / ( ) ti ) y 0 PROPOSED 500 GAL. LEACHING CHAMBER / DRIVEWAY - - 49.2 � � �/ DISTRIBUTION BOX (33.5 x 8.9) (0.74 GPD/S.F. = 220.E GAUDAY 10 Yr 5/6 _. , TP 2 4 - 49.4 TOTALS: 40" 46.07' R� DATE BY APP'D. DESCRIPTION -- / CB/DH (FND) ) TOTAL NUMBER OF CHAMBERS 3 PROPOSED SEPTIC SYSTEM UPGRADE �. \ L-81.02, , 3 (4) PREPARED FOR: .----..� TOTAL LEACHING AREA 467.8 SQ.FT. CONTRACTOR TO SLEEVt "� " { ` Fr °� / (3) 0' ., TOTAL LEACHING CAPACITY 346.1 GAL./DAY CAPEWIDE ENTERPRISES PROPOSED SEWER PIPE 10' `' t✓ -- -49 -� Medium Sand EACH SIDE OF CROSSING ~- 1v ( -ab� , C 2.5Y 6/6 LOCATED AT 75 CROSSWAY PLACE Benchmark ( SHRUB ►,/ �� N81°26' Ov Nail in U. P. 561/6 \'� �� l 21.28, _. OSTERVILLE, MA 02655 Elev. =50.00' SHRUB 1 / SWING-TIES _ Approx. M.S.L. LIGHT POLE 1 > DESCRIPTION GC 1 GC 2 130" 38.57' SCALE: 1 INCH = 10 FT. DATE: OCTOBER 12, 2007 0 5 10 20 40 FEET L- LEACHING CORNER(1) 16.0' 17.2' No Mottling, Standing or Weeping Observed SH OF CROSSwA Y P EDGE OF PAVEMENT (TYP.) LEACHING CORNER(2) 22.6' 23.5' RESERVED FOR BOARD OF HEALTH USE JOHN L. uT PREPARED BY: CHURCHILL JC ENGINEERING, INC. (40'WjpELgYO TALE LEACHINGCORNER(3) 28.3' 51.1' CIVIL 2854 CRANBERRY HIGHWAY NO TE:MAGNETIC MARKING TAPE SHALL BE ) LEACHING CORNER(4) 23.3' 48.5' EAST WAREHAM, MA 02538 PLACED ALONG THE TOP EDGE OF EACH SITE PLAN 508.273.0377 DISTRIBUTION BOX(5) 15.T 40.2' - _- ___-----._------_- -------_.__ __._... __-- SEPTIC SYSTEM COMPONENT. SCALE: 1"= 10' Drawn By: BSM Designed By:MCP Checked By:JLC JOB No. 1295