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0434 EEL RIVER ROAD - Health
434 Eel River bsterville 114—025 I 1� o �! k i 1 A O No. 101 00 Fee (. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2ppliLation for MisipbBal 6pstem Construction permit Application for a Permit to Construct(--< Repair( ) Upgrade( ) Abandon( ) Eeclomplete System ❑Individual Components Location Address or Lot No. y 3"( Fe,( pverefl Owner's Name,Address,and Tel.No. Assessor'sMap/Parcel �fl�lr -VA+e4- (A� 4 �Sevey¢. Installer's Name,Address,and Tel.No. �(- �� Designer's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size -`?/ l a y sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.req iced) !)� gpd Design flow provided ,�� gpd Plan Date '? 71 Number of sheets Revision Date Title Size of Septic Tank ,_) Type of S.A.S. f Pd ('a", d'. j r t Description of Soil ) k X Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not t icFrf�system in operation until a Certificate of Compliance has been issued by this Board of alth. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons Permit No. ')�U 17 _Dot Date Issued I,I,l,�..vpm ^-..**rr,�'r# �'A.i✓,,..,r{ s!n''}w„"'.7^t'1V^- p` � 7L ,ti r .. ...s. ,.r , rc . .•,�. 4 �. r.. , No. 0 V '. , .., Fee THE COMMONWEALTH OF MASSACHUSETTS w Entered in computer. zu n2 e`t ,,d f s Yes PUBLIC HEH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS application for Dispo"3570 pstem Construction Permit Application for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) '[J Complete System ❑Individual Components Location Address or Lot No: 3'i Ft ►Q,ueC Rd Owner's Name,Address,and Tel.No. Assessor's Map/Parcel f�cr�Q� 5- rvR.r �rt.r� LIr^t�°.r-�CJv ti GQvr Installer's Name,Address,.and Tel.No. �jil_;-�j9tl/~ Designer's Name,Address,and Tel.No. ei —K - ,,, 'f ` ''`"1 ll�.�ic✓riJ Sv(4 3 n 1 r, tl- 1 tJr, M a -L b Type 3 5- of Building: Dwelling No.c f Bedrooms Lot Size 'i 7, 1 o sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.re)aired) gpd . Design flow provided gpd Plan Date +'1 Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil /Z k u r k ' .. Nature of Repairs or Alterations(Answer when applicable) { a H1 . Date last inspected: Agreement: ,., t e )•�. L d 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 t „place—fhe system in operation until a Certificate of Compliance has been issued by this Board•,of .ealth. Signed CA" Date Applicationpproved by f .� Date i „ �r ' Applicaion:Disapproved)y Date r, t - 1 for the following reasons Permit No. . CJ( -7 '—t70 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS T 'CERTIFY,that the On-site Sewage Disposal system Constructed(�� Repaired( ) Upgraded( ) Abandoned( )b - L at �I3 f t l i'Vt' 4f, ffP has been constructed in accordance- with the provisions of Title 5 and the for Disposal System Construction Permit No.-)o/i�'t b ' dated 1 6 f 7 r Installer Designer #bedrooms Approved design flow 7J gpd '! The issuance of this permit shall not be/Icons•it/tied as a guarantee that the system wil func1,abn as ignedd 1, Date �} l� / Inspector No. o 17 'UGrr Fee P THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction Permit Permission is hereby granted to Construct(/ Repair( ) Upgrade(R ) Abandon 1; ) System located at t tl !' l /L r U".V /� 014,. V VIP 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. t Provided:Constructionrmust be completed within three years of the date of this permi. t Date / // 7 Approved by �lN �� Town of Barnstable .°`INE Regulatory Services Richard V. Scali, Interim Director • saxxsrnaLE, MASS. Public Health Division i6io- 10rFc Ma+" Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: Sewage Permit# 2--117-018 Assessor's Map\Parcel4Y �62 Designer: s�ll�� �h�;ti c��,'.,J f r s�, Installer: 'TQye�e Address: 7 al/', �� Address: 7 FflAl ®s r!e/ ,? / o/ filar s E�i s h,,6 On 0/4?0!?' S'v��lg�i C'' ,'n�rr,�` was issued a permit to install a date) (installer) septic system at �IK FW K,'Per gael based on a design drawn by n / (address) - ih ePf,' dated lt?V 0®7 (designe I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' 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 that the system ferenced above was cons ct iance with the terms . the approval i ers (if applicable) s RAL C RLES ® CI c.a 'Ins aller's Signature) 7 �., (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:\Septic\Designer Certification Form Rev 8-14-13.doc I No. �C �i � Fee 1 50 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2ppYication for Bisposai 6pstem Construrtion Permit Application for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) komplete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Tel.No. q2>4 4�L )z U5 r '2G1 �0. i 1 ►vl Jdl Lei &.S Assessor's Map/Parcel' OM tn,4 01 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. S�i1 �C�n rznc, vV.ttr-�.-� _ Type of Building: Dwelling No.of Bedrooms Lot Size 4 Z o sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 5 5-0 gpd Design flow provided 580 gpd Plan Date 3 Zo 1 (D Number of sheets Revision Date Title Pr�S,p $�,/T{-i[_ S�/S+Sry► Size of Septic Tank 150 0 Co t2oei Type of S.A.S. 5 - S-op C,Cc 11 ot1 ChA.m64-- Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by AP t2 -S Date 3- Application Disapproved by U Date for the following reasons Permit No. o,%(d - C Date Issued 3- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by at �1_33 V 55 L ,�u 15/ �L� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.-�O 10-U s dated 3^ d Installer Designer #bedrooms �j� Approved design flow 56 0 gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector - - ------------------------------------------------- No. ('Q d V — O S Fee 5c THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct( Repair( ) Upgrade( ) Abandon( ) System located at ! 51 L /C ( y_ d 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. Provided:Construction must be completed within three years of the date of this permitIZ Date �� - (] Approved by ` -."^`^^.-..'y--- .—.. - �. ---T-•r +--�.+..sti-...+ti'.+..n.+6+.s..r N..h ,.+^�siv. ...+.�'� nQir{::..-:. ..... -. .a - t'^ �1 No. fA C 0 r/U�" ' 'W�� C 5,2.1 ta, Fee �V 4. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -TOWWOF6BARNSTABLE,-MASSACHUSETTS Ye`�� /(, 'Application for BispoSal 6pstem eons*trUction Permit Vio Application for a Permit to Construct Repair( ) Upgrade( ) Abandon( ) Xcomplete System ❑Individual Components Location Address or Lot No. Owner's Name,Address,and Telt No. 4;y 4 L *R ju5r &C/ 1\4" Jalcrii�Gs{ Assessor's ap/Parcel Installer's Name,Address,and Tel.No. ;, ;;.. t" ;7` Designer's Name,Address,and Tel.No. f I o J.-O O Type of Building: `z. Dwelling No.of Bedrooms Lot Size -7 Z C) sq. ft. Garbage Grinder" Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 50,t7 gpd Plan' Date 3-%- Z.O l C7 Number of sheets Revision Date Title p r O,no!&va� Size of Septic Tank ISO Q �' I �r� Type of S"A.S. 5- son r40 11A,11 Description of Soil / Z 1 r-/a/ p 7 t• /!! Nature of Repairs or Alterations(Answer when applicable) Date last inspected: J � g Agreement: t 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 Health. ps Signed •r-. Date Application Approved by %"'"'� ,.;.";`�" � Date 3- 9- /o �= Application Disapproved by Date for the following reasons 1 Permit No. 90 16 " G S� Date Issued 3 - - --- -� ------------ ------------------------------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS r BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by. at 3 5l �S L ¢ �� � has been constructed in accordance jwith the provisions of Title 5 and the for Disposal System Construction Permit No.o�U 10'b S� dated Installer Designer #bedrooms `� Approved design flow 5 y gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Nl Inspector ---------------------------------------------------------------------------------------------------------------------------------------- - No. o U 10 `• Fee /Sy ' THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Bisposal 6pstem Construction Permit Permission is hereby granted to Construct(, Repair( ) Upgrade( ) Abandon( ) System located at 4/3 11 L < 6 /� .t 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. of Provided:Construction must be completed within three years of the date of this permit. (,-- Date - y Approved by 4-R- L/ c� TOWN OF BARNSTABLE /� LOCATION 7 3 / ��1 ��1(J� A` — SEWAGE#RO/7-00? VILLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. �c`OCJ Cf- SEPTIC TANK CAPACITY l 00 (,,j ffzp LEACHING FACILITY:(type) !-L-- 5-2)o (Q aJk (size) !ZrY '!to)(e- NO.OF BEDROOMS OWNER PERMIT DATE: (e COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY w ok Cl 7 V IpS` A 3 " yss 7, l Commonwealth of Massachusetts Title 5 Official. Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 434 Eel River Rd. + Property Address d , Ellen Valentgas Owner Owner's Name information is Osteryille MA 02655 - 9/28/14 required for every page. City/Town State Zip Code Date of Inspection a 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 on the computer, use only the tab 1. Inspector: key to move your cursor-do not Robert Paolini use the return key. Name of Inspector Robert Paolini Septic Service --v Company Name 17 Playground Lane Company Address Yarmouthport MA 02675- City/Town State Zip Code 508 362-3555 S 14454 - Telephone Number r 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: 0Passes ❑b Conditionally Passes ❑ Fails ❑ Needs Further E luation by the Local Approving Authority r 9/28/14 Ins Vector's Signature V 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. 0 , t5ins•3/13 Title 5 Official Insp F :Subsurface Sewage Disposal System•Page 1 of 17 Y 1 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Y.° 434 Eel River Rd. " Property Address Ellen Valentgas Owner Owner's Name information is required for every Osterville MA 02655 9/28/14 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ' 1 Inspection'Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: " ❑X 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: The septic system is in proper working order at the present time B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. - 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): ' t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 i h . R ' Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 434 Eel River Rd. Property Address Ellen Valentgas " a Owner Owner's Name information is required for every Osterville MA 02655 9/28/14 " page. City/Town State Zip Code Date of Inspection B. Certification (cunt.) ❑ Pump Chamber pumps/alarms not operational. System'wili pass with Board of HealthY 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): r C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,.safety or the environment. 1. System will pass unless Board of Health determines in accordance with 316CMR 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts QR - Title 5 Official Inspection Fora' t. . .: Subsurface Sewage Disposal,System Form - Not for Voluntary Assessments 434 Eel River Rd. Property Address Ellen Valentgas Owner Owner's Name information is required for every Osterville MA 02655 9/28/14 _ - 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: ** 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: 4 6 / D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: - Yes No 0 Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool El 0Discharge or ponding of effluent to the surface of the ground.or surface waters due to an overloaded or clogged SAS or cesspool El 0 Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ 0 Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow x t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 s . Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments' 434 Eel River Rd. P Property Address Ellen Valentgas Owner Owner's Name information is Osterville MA 02655 9/28/14 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: ❑ 10 Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ 0 Any portion of cesspool or privy is within,100 feet of a surface'water supply or tributary to a surface water supply. 0 El 0 Any portion of a cesspool or privy is within a Zone 1 of a public well.- Q• - 0 Any portion of a cesspool or privy is within 50 feet of a private`water supply well. T ❑ ❑x 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, t 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 and chain of custody must be attached to this form.] , ❑ 0 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 ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well ' If you have answered"yes" to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts a W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 434 Eel River Rd. Property Address Ellen Valentgas Owner Owner's Name. information is required,for every psterville MA 02655 9/28/14 page. City/Town 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 { ❑x ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ❑x Were any,of the system components pumped out in the previous two weeks? ❑ ❑x Has the system received normal flows in the previous two week period? ❑ N 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) ❑x ❑ Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ Was the site inspected for signs of break out? ❑x ❑ Were all system components, excluding the SAS, located on site? N' ❑ 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? • J. 0 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: - ❑ ❑x 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): 3 Number of bedrooms.(actual): 2 330 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 m' , N Commonwealth of Massachusetts Title 5 Official Inspection Fora, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 434 Eel River Rd. Property Address Ellen Valentgas Owner Owner's Name - information is Osterville MA 02655 9/28/14 required for every page. Cityrrown State Zip Code Date of Inspection ' D. System Information 4 Description: Number of current residents: NA Does residence have a garbage grinder? M', Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection ❑.. Yes ❑x No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ❑ Yes ❑O No 'na Water meter readings,if available(last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ❑ No Last date of occupancy: NA 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage-Disposal System Form -Not for Voluntary Assessments 434 Eel River Rd. Property Address Ellen Valentgas Owner Owner's Name information is Osterville MA 02655 9/28/14 required for every r page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Last date of occupancy/use: 8/28/14 Date Other(describe below): General Information Pumping Records: „ Source of information: r Robert Paolini Septic Service Was system pumped as part of the inspection? ❑ Yes ❑x No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: O 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 inspection of the I/A system by system operator under contract' ❑ Tight tank. Attach a copy of the DEP approval. ❑ f 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 Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 434 Eel River Rd. - Property Address Ellen Valentgas Owner owner's Name information is required for every Osterville MA 02655 9/28/14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Approximate age of all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ❑x No Building Sewer(locate on site plan): 2' Depth below grade: feet - Material of construction: ❑ cast iron. ❑x 40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10+ feet � Comments(on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of leakage.System vented through house vents. Septic Tank(locate on site plan): Depthbelow grade: feet Material of construction: 0 concrete- ❑ metal ❑fiberglass ❑ polyethylene '❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 3„ Sludge depth: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 . Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 434 Eel River Rd. Property Address Ellen Valentgas Owner Owner's Name information is required for every Osterville MA 02655 9/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 32" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle. 7" Distance from bottom of scum to bottom of outlet,tee or baffle How were dimensions determined? Measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump tank every 2 years.Inlet and outlet tees are in place.No evidence of leakage.Tank appears structurally sound. Grease Trap(locate on site plan): Depth below grade: °f 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: Date t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form , Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 434 Eel River Rd. Property Address Ellen Valentgas Owner Owner's Name - information is Osterville MA 02655 9/28114 required for every _ 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.): 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: r ti F. gallons Design Flow: ' * gallons per day Alarm present: y ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ YesY ❑ No Date of last pumping: Date - p . Comments(condition of alarm and float switches, etc.): ' "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17. Commonwealth of Massachusetts - Title 5 Official Inspection Form A Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 434 Eel River Rd. ' Property Address Ellen Valentgas Owner. Owner's Name information is required for every Osterville MA 02655 9/28A4 page. Cityfrown State Zip Code Date of Inspection D. System Information (cunt.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert NO 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.): Box is Ievel.Box has one outlet Iaterals.No evidence of solids carryover.No evidence of leakage. x • } Pump Chamber(locate on site plan): Pumps in working order: ❑' Yes ❑ No*, Alarms in working order: ❑ Yes ❑'No* Comments(note condition of pump chamber, condition'of pumpsand appurtenances, etc.):: , f 1f 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: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 434 Eel River Rd. ' Property Address Ellen Valentgas Owner Owner's Name information is required for every Osterville MA 02655 9/28/14 ' page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Type. L ❑x leaching pits number: 1-6'x6'with 2' stone ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ inriovative/alternative system Type/name of technology: ' Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation,etc.): Sandy soil.No signs of hydraulic failure. Leaching pit was dry at time of inspection. Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): , Number and configuration y "Depth-top of liquid to inlet invert Depth of solids layer Depth of scum layer .. Dimensions of cesspool O` Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 434 Eel River Rd. ' Property Address Ellen Valentgas Owner Owner's Name information is required for every Osterville MA 02655 9/28/14 page.' Cityfrown 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.). t5ins•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 14 of 17 4 + Commonwealth of Massachusetts Title 5 Official Inspection Form ` Subsurface Sewage Disposal System Form -Not for Voluntary Assessments' 434 Eel River Rd.`lug ' Property Address Ellen Valentgas " Owner Owner's Name information is required for every Osterville MA 02655 9/28/14 page. CityrFown 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 , - }} 3 s . 1 33 a(0 3 /Y vol 3 •B t5ins,-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 434 Eel River Rd. 4 Property Address Ellen Valentgas Owner Owner's Name information is Osterville MA 02655. 9/28114' required for every , page. City/Town State Zip Code Date of Inspection D. System Information(cont) ' Site Exam: ❑ Check Slope , ❑x Surface water ❑ Check cellar ❑ ,Shallow wells Estimated depth to high ground water: Bottom"of leaching 10' � feet Please indicate all methods used to determine the high ground water elevation: ❑x Obtained from system design plans on record " If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) x❑ Checked with local Board of Health-explain: As-Built ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: a ` You must describe how you established the high ground water elevation:: USED:USGS observation well data.USED:Technical bulletin 92-0001 annual ranges-of.groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 t Commonwealth of Massachusetts Title 5 Official . Inspection Form o Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 434 Eel.River Rd. T Property Address Ellen Valentgas Owner Owner's Name information is required for every Osterville MA 02655 9/28/14 page. City/Town State Zip Code Date of Inspection E.,Report Completeness Checklist 0 Inspection Summary: A, B, C, D, or E checked Inspection Summary D (System Failure Criteria Applicable to All Systems) completed ❑x System Information—Estimated depth to high groundwater 0 Sketch of Sewage Disposal System either drawn on page 15 or attached in separate fife m . ti t t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 ' No. C � ,,.�,,� bll'i. �{( Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es 0[pplication for �Bizpo.5al 6pqum Construction Permit Application for a Permit to Construct(--)--Repair( ) Upgrade( ) Abandon( ) �omplete System ❑Individual Components Location Address or Lot No. 6 Le_ o� f\c, l IJnv Owner's Name,Addres and Tel.No. O 3\eX\j Il# L-fto�(&+- 61grV%r\ Assessor's Map/Parcel Il O Z �C( MVrrAy�r. Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. SvI�W� Cr�\heer,r.� s Type of Building: Dwelling No.of Bedrooms S Lot Size L42 q'ZO sq. ft. Garbage Grinder (Lio) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures ��^^ Design Flow(min.required) S 30 gpd Design flow provided ,�t�3 gpd Plan Date 9 11110-7 Number of sheets Revision Date Titlee_ Size of Septic Tank " 1500 ���10� Type of S.A.S. 5'Sa� (v�,�, (1ur\ba5 \r Ae 17x4k, F Description of Soil CeC� I go 0-4 0 C.""m ' 4-1?" & (_�N"r I Z Z4 ( gAr (A.P, , Stinuk iNgf� (Q ZC1-Ca16 C► (.ay.y- sled SaYA Z,C Y 6(G Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned es to en a the construct'on d maintenance of the afore described on-site sewage disposal system in accordance with the provisio f Title of the nv' ntal Code and not to place the system in operation until a Certificate of Compliance has been issued by'his d of th Signe Date Application Approved b -.Date `7 Application Disapproved by: =Date for the following reasons Permit No. Date Issued M? THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired ( ) Upgraded ( ) Abandoned( )by at 16 LPa,A,,7& '(-'lJ`e_ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. °��7 J dated y�` Installer Designer #bedrooms . Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector os�No. Fee '�J► l 5 C THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PULL! HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIppYication for �h6po,%al p.5tem Construction Permit Application for a Permit to Construct(-)-'Repair O Upgrade O Abandon O 9-Complete System ❑Individual Components Location Address or Lot No. ,g L wn4rtk T_->r�v e Owner's Name,Addres and Tel.No. �3ks J�It e Ltongrck+- vrk{r �r,\ Assessor's Ma /Parcel 5- IZ 9 Murr'y�Or c�CU p II O Z �c me Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. kn,\1D (C Type of Building: Dwelling No.of Bedrooms .J Lot Size 47j yZd sq. ft. Garbage Grinder ((JO) Other Type of Building No.of Persons Showers( ) Cafeteria( ) ' Other Fixture,: Design Flow(min.required) SS(] gpd Design flow provided S W gpd Plan Date q IT$�� �c_ S Number of sheets Revision Date r» Title r'Opax� SPD� j v \v "M t Size of Septic Tank 1500 ju^ Type of S.A.S. 5'$ap (nab, C�wr, kn Description of Soil lRrL lu"gb O-yr 0 Caikf y i Z` 1� C�,y tr" SArvlk-r 66Y"\ IONI g 3f� IQyR 'Lg Z4—(r4t" Cr l�y.er mPc1 S��a Z,SY lo(G ' (ea-I Z.0" 07 LaV.er ;*d sv ck Z,S Y 7I Nature of Repairs or Alterations(Answer when applicable) f � Date last inspected: ! r Agreement: The undersigned agrees to ensure the construction a d maintenance of the afore described on-site sewage disposal system in '?.? (accordance with the provisions f Title-5 of the Envi,onmental Code and not to place the system in operation until a Certificate of Compliance has been issued by his Boa)d of .ealth ' Signed Date J Application Approved by _ Date 'V/l T l®-7 Application Disapproved by: Date for the following rea,ons Permit No. ''� t Date Issued - - " THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired ( ) Upgraded ( ) Abandoned( )by i at ( -pit trk&-P _- has been constructed in accordance / with the provisions of Title 5 and the for Disposal System Construction Permit No. `�K=G 7 15 5 dated G/ Installer Designer #bedrooms Approved design flow gpd The issuance of this permit shall not be"'6 onstrued as a guarantee thatythe systempwill function as designed. tis , Date Inspector —— No. -2 Fee /V 0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS 'x0i po.5ar �&pgtem Construction Vermit Permission is hereby granted to Construct Repair ( ) Upgrade ( ) Abandon ( ) System located at R Po a��1:�CIJ.SL__- and as described ir_the above Application for Disposal System Construction Permit.The a plicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Construction must/be completed within three years of the Plate of this p Date 0— Appro ed by �� _ f� Town of Barnstable o Department of Regulatory Services - 3 Public Health Division Date A�C auee eg 200 Main Street,Hyannis MA 02601 ' _ �• t 639:'� rFDrna+r' . .I Fee Pd. /D1� • Date Scheduled. 3 Time Soil Suitability Assessiaieni for Sewage Disposal /'I- r1 1 i WIGlessedB 7Pm..M1 p Perfonned•By:•- krk Vb �- Y LOCATION& GE,NERAL INFORMATION , Location Address ✓ Owner's onc�txrl�".� b i�a. $ LISONAR•D DRI VO- :7 rf Address t.4q :'Ma rroo y fir/ OSTerLVIL.L—Es MASS. ,"ckirn L,yr 54-n Assessor's Map/Parcel: M 1 14./ PO 2 6 Engineers name ' Gf—J51 Sul-"V-41v CNG•'ZN6B(LNG NI3W CONSTRUCTION . REPAIR Telephone# SO S-4 z8 -3 3'4 Land Use Keg Slopes(%) C)mold surface Stones Al 1JZ5 � � O� Il Drinking Water Well� wit II Distances from: Open Water Body 0 R Possible Wet Area,_ Drainage Way R Property Lill ,J R Other It - MUCH:(Street name,dimensions of lot,exact locations ortest holy&pert Costs,locale wetlands in proximity to holes) let ^-^s-14 16. lse ,•.r11 so lee 32 M►tNO,N pI 40 lee 3g '< 'eeeC . .� so xC- 'ssa l T�sc © �y4ss 105 �w lee s s e s t lee $ lee L � e • 1°e lee: ' s ,, a . � M ram• • ,., 42 rise at." AC- Parent maleriat(geologic) Depth to Bedrock �� _y Depth to Groundwater: Standing Water.in Hole: Weeping from Pit rote g _� _ a ,a , rn�Pl Cslintated Seasonal High Groundwater �_ �l%l � ��•��t�..(c$.�--- , • DE,TLRMINATI QN TOR SRASONAL.IIIGH•WATER TABLE Method Used: 1n, De U,to soil mottles:_ h� Depth Observed standing in obs.hole: p R Depth to weeping from side of obs.hole: in. Groundwater Adjustment_. Index Well p Reading Date:. Index Weil level Adj.factor. Adj.Groundwater Level 4 r - PRRCOLATION TE,ST Date,q{Z Timed Observation (i Hole# Z _ Tillie of 9' Depth of Pere jq_ y Z Time it 6" Start Pre-soak Tim Time(9"-6") __ E h End Pre-soak Rate Min./Inch Site Passed �� Site roiled: Additional Testing Needed(YM) ✓ ! Site Suitability Assessment: � I Original; Public Health Division OUservation Hole Data To Be Completed on Back---------- f �' ***If percolation test is to be conducted within 100' ofwetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q;i IEALTi UWPIPERCFORM DEEP OBSERVATION HOLE,ZOG hole It Depth fium Soil Iludzon Soil Texima Soil Culvr Soil Other Surface(it.) (USDA) (Munsell) Molding (Structure,Sluncs,Buuldcis. Cnnslstanay.°/a Gravcll_ zy Vo �, � z sy (�/� �� — Mom, „► � � :,� .lzo' k-D z,sy 7/3 DEEP OBSERVATION IiOLT•;LOG Hole# Z Depth from Soil 110rimn Soil Texture Soil Color Soil . Other Surface(in.). (USDA) (Munsell) Motding (Structure,Stones,Boulders. Consistency,%Gravel) �. r 61 1 z 6 C� DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other . Surface(in.) (USDA) (Muaseii) Molding (Structure,Stones,Doulders. Coiuistencv %Gtnvcll t S to (u-z2 DEL+'P OBSERVATION HOLE LOG Hole/I .Depth liven Soil llorimn Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Molding (Structure,Sloines,Boulders. Cunsistencv.%Grovcll ON Ll 2z- 6 C- -(ZO !"food insurance hate Map: / ' Above 500 year flood boundary .No✓ Yes Within 500 year boundary No Yes L� Within 100 year flood boundary No✓ Yes 12Deuth of Naturally 0ccurrinE.Pervious Material Wes at least four feet of natumlly occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? _ If not,what is the depth of naturally occurring pervious material?. O rtitication is rtify that on i 0 (date)I have passed the soil evaluator examination approved by the Department of I;nvirorm cintnl Protection and that the above analysis was performed by`rne consistent with the required training,ex rtiso and experience described h 310 CM1.5.017. Signature Dalc �� Q 11GALTI.11WPIPCRCFORM CA COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL RP'- tAr_IFgf'�"S ABA VO 5 DEPARTMENT OF ENVIRONMENTAL PFfM�5:, [qNAfN 9: 54 TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION r Property Address: 8 Leonard Road `� 30 Osterville, MA 02655 Owner's Name: Estate of Willis Leonard Owner's Address: c%Jonathan Leonard 199 Murrav Dr., Richmond VT Date of Inspection: June 8. 2005 Name of Inspector: (Please Print) James M. Ford Company Name:. James M. Ford Mailing Address: P.O.Boz 49 Osterville,MA 02655-0049 Telephone Number: (508) 862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: . ✓ Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature:P g Date: __.June 12. 2005 The system inspector shall sub 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. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 f Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 8 Leonard Road Osterville, MA Owner: Estate of Willis Leonard Date of Inspection: June 8 2005 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined",please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 8 Leonard Road Osterville, MA Owner: Estate of Willis Leonard Date of Inspection: June 8, 2005 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 8 Leonard Road Osterville MA Owner: Estate of Willis Leonard Date of Inspection: June 8. 2005 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level.in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than'/2 day flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ✓ Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool or privy is within a Zone 1 of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)The system fails. I have determined that'one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 8 Leonard Road Osterville,MA Owner: Estate of Willis Leonard Date of Inspection: June 8. 2005 Check if the followin have been en 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? ✓ _ Were all system components,excluding the SAS, located on site? ✓ _ Were the septic tank manholes uncovered,opened,and the interior of the.tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? ✓ _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes No , ✓ _ Existing information. For example,a plan at the Board of Health. ✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 v Page 6 of 11 OFFICIAL INSPECTION FORM-,NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 8 Leonard Road Osterville, MA Owner: Estate of Willis Leonard Date of Inspection: June 8. 2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 220 Number of current residents: 0 Does residence have a garbage grinder.(yes or no): No , Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): Summer use Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No - Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sqft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unavailable Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: _gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank,distribution box,soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Approximately 1982-ner owner Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 8 Leonard Road Osterville, MA Owner: Estate of Willis Leonard Date of Inspection: June 8. 2005 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron _40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) i I Depth below grade: 12" Material of construction: ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: _ 1000 Qal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" ` Scum thickness: 1" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: Measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert, evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert There did not appear to be any signs of leakage GREASE TRAP:. None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Connnents(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 8 Leonard Road Osterville. MA Owner: Estate of Willis Leonard Date of Inspection: June 8, 2005 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): The D-box was level. No solids were present. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 8 Leonard Road Osterville, MA Owner: Estate of Willis Leonard Date of Inspection: June 8. 2005 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: I -6'x 6'(1000 gal.)w/]'stone-per design plans leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: Innovative/alternative system Type/name of technology: Corrunents(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): The leach nit was dry and clean. The bottom to grade was 8 S' There did not appear to be any signs of failure. CESSPOOLS: None (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTIONYORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 8 Leonard Road Osterville:MA Owner: Estate of Willis Leonard Date of Inspection: June 8, 2005 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. BALk a 3 a � . y A B T 3 /Y (0o c� [3L]3 :l3 10 v s Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 8 Leonard Road Osterville, MA Owner: Estate of Willis Leonard Date of Inspection: June 8, 2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 20+/ feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: ✓ Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: According to the design plans on file, a test hole was done and no water was observed at 12 0'when the systetn was installed Using Barnstable topographic and water contours maps the maps were showing approximately 20'+/ to ground water at this site. This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed,written or implied,relating to the system, the inspection and/or this report. 11 No....df e_ 13 6 R .�� . FEB.. .._..... THE COMMONWEALTH ?OF MASSACHUSETTS _ BOAR® OF HEALTH Mire 11�-6a-S OCt�1lJ...........O F...../.& v-5r -& ................................... Applirtation for Disposal Works Tonstrnrtinn ramit Application is hereby made for a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal S e, 6 4�io....40_� ... A Lot No. ------• .iLtj1, - :....•----_.. .�LJ ............................ _... -.. Ull .. Owner Address ................................. _/_...0.a- ___ ....... ••----......_._.._ -•------- Installer Address // >� d Type of Building Size Lot.____._..__.!! Z...._ et aDwelling— o. of Bedrooms____________________________________Expansion Attic Garbage Grinder fi(�g� P4 Other—Type "of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) P4 Other fixtures ------------------------------• - -- W Design Flow..................... gallons per person jr day. Total daily uow_:__.-A ZA ......._.________ lons.y WSeptic Tank—Liquid capacitylL41__gallons Length__ _'le_____ Width___—�f1__ Diameter________________ Depth_____.:�__ x Disposal Trench—No_ ____________________ Width.................... Total Length.........._......... Total leaching area....................sq. ft. Seepage Pit No..........I--------- Diameter-_______-g�__...... Depth below inlet__C45.......... Total leaching area_.17-00...sq. ft. Z Other Distribution box (!< Dosing nk W4 / 9 Percolation Test Results . Performed by.... _ _ �... � _____ Date___ :__ ......... 14 Test Pit No. 1__4__Z__minutes per inch Depth of Test t...4F,I......... Depth to ground water...�eu!�C`Z f? Test Pit No. 2.........._.....minutes per inch Depth of Test Pit____—/0 _______ Depth to ground water.... ----•---•-- ---------• -- _ - ---- ------It---------.t---•-- ........................................................ O Description of SoilU----3-----�f� ..................... � --- l f<3-`- o'Z__►_----/!''� '-•----•-----•-----•---•-•-----•-•----- � i U •-•---•---•---------------• ................. •----------------------------------------------------------- ------------------------------------------------------------------------------------------------ W ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•------••_----•• U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ---------------------------------•---------------------------------•----•-•-•--------------------------------------------------------- ---•--------------......................... .. , . Agreement: The undersigned agrees•to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITTU 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beenLisWed t board h lth.Signed---•---_.. ------ --------------- ---•. --- •--• --------•--•--..........--Date Application Approved By___.- - i�Q.�._, .......................B,l----------- ------------------ -- ------------- Date Application Disapproved for the following reasons_____________________________________ ---••--------------------•-•-------------------•---.___ ---......_...- --••-•---•------------------------------••---•-----•---------...-•---•---...-----._..._..--•----------------••------•-------------------=-------...--------------------------------------•-•------------ Date PermitNo......................................................... Issued....................................................... Date �� ��, �. ; r I �� '. V' :, � 'l: No.... . " { • THE COMMONWEALTH•OF MASSACHUSETTS BOARD OF HEALTH ,....- .............................................. Appliration for Disposal Works Tonw1.rurtion rrnti# Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: J 14 11-9 1�' ��—/ /,-)/20, A' -_- �v //1-/ Location Address J/ f` 3 �) t �, C�? (/.i� r Lot No. ,,. - -- Owner Address .................................... .............••-•----......•----....•-•--•---•----........----...........--•------••- ------- Installer Address / Type of Building �r 4 Size Lot----------.f:°�. ._F;�t Dwelling No. of Bedrooms............................................Expansion Attic (� Garbage Grinder;( ) aOther Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fixtures ---------------------------------------------------- ---------------------------------------------------------•---:--------------------------------- W Design Flow....................:..�..._...._..._..gallons per person per day. Total daily flow.....�.��-':.�............... gallons.f WSeptic Tank—Liquid*capacrty6��>.�allons Length- -..f..__. Width�-/.:1.1,.�. Diameter................ Depth_....j.f..t I' x Disposal Trench—No.......... .........Width..^...--........... Total Length.................... Total leaching area......._....__...sq. ft. � Seepage Pit No.........I.... Diameter...::..�!<-..--..-. Depth below inlet..(�=:?....._.__.. Total leaching area.:� ....sq. ft. Z Other Distribution box ( Do"sing.,tank (0k) Percolation Test Results,� Performed by------ ---- ------------- ------------•,-..••----.-•_---...._.---: _:...._ Date-- -= ?-....._..--- .....----_-..-. d 1 / Test Pit No. I.`-:....-'...minutes per inch Depth of Test I t.. _ �......_.. Depth to ground water..-r..J...........--. (];4 Test Pit No. 2................minutes per inch Depth of Test Pit.--- _�........ Depth to ground water.---�t,1k� . . by ........... •-..-•---•-•................. ...•--••••-- ................ ..... ---------------------------------------------- DescriptionO of Soil��'7: .....13�&V_r' !?J r{ L .:.% ��� / gyp✓ ..--•-{... =--- .............. V ...........--•---•-••-••-----•....•-----------•--•-•_....-•-•----•••-•-•--------•-•-••-•---•---•-••-•----•---•••----••-•------••---•-•---•------••---•--•••--•-•--•-•-••--•-----...-•-----•••---------•-- W + U Nature of Repairs or Alterations—Answer when applicable................................................................................................ --------•-------------------•---•---------------•-----------------------•-----------.......-----•------•-----••-------------------•-----------------------...........-----------------..........__•... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of A I T L 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i b t board lth. Signed------.... . ------ --------------• .•-• --- --.. Application Approved BY Date Application Disapproved for the following reasons:.......................................................•........................._..........Da�_.........- ..----•-----•-••--•-••--•-•----•-----------••--•----••-•-•---------••••••-------------••------•-----.....-••--•---•----...--------•---•-•-•-••-•--•--------•••---•-------•--•-•-----••......--•--.....- Date PermitNo....................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t,7+ .............OF.... `.... ....................................... Trrfifiratr 'of Tontplianre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) by................................... „� •.... ..•....---------•--• -••------•.._.............---•----•---•__.........._....----•--•-...........--•---•-••-•___..._ has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.0./_1:°'.•`�✓_'_'J 4................. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. � DATE G Inspector. A ---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH I 40�%P t.......0F.... ........... Disposal- ks �ons#r ion umit �h'Permission.is hereby granted-••••-----=- C I-------------------------------------------•--------------.--------.--.-..-.-------.-.-.-_._.. to Construct k'or Repair ) an Inddiividual Sewa Disposal System atNo........ .:� ........ ------------••----------------------------------------------------••••--...... Street as shown on the application for Disposal Works Construction Permit No..................... PAted.......................................... i•y/ eJ '� �t - BPer of Health DATE............................ ...................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS f ST. C"tG TJ�` 1 a A,, f pis r eok to y 4 j p LON- IT �^- � r lUU C �K�✓• v _ 4-G - i a �I�•GP j 2 0 ' \�Y iN*� 5 cam?t—tG(oz �c ~y ev3.n a k t� OF z Slauc 1 ] ton f 40, 193,34 k �,•G �` tea. r /-0 144 ' r L Z Pit}� ! NG 0 ! P, t T EF ... a "1 .►�t� = 2-Z-n k t 5�- 3 C� GA<c� l�/ L L ! LF0.Q r t 5 1v 8 ' y , - w' r ram, F , ,+` i 2. 3 4 8'—On 16'-0" 11 PAN Y SHW 5 ———.——s o I W CA . • I I 9'—On 5 10 I 18'-6n :,. Z- KITCHENCABINETS / SHELVES MASTER 5'-0" 2668 - LIN. 3068BEDROOM4,_6. 8,_0" 2668 MASTER 103 --1-- BATH ISLAND 101 '`''�' 102 LAV. 142" GREAT ROOM - I REF. ...._. 109 x _..... ..._..... ..: 2668- M ® ® 2668 I _ BEAM ABOVE — 2668 Co Go N ——WC WC T—Or" HALL 11'-7" I - N , ji 2668. 26 8 I oiA 2668 2668 M -_ '`' I ;.� DINING N I 8 " 6' 4. 8— BEAM ABOVE f BE ABOVE ————__ —-BEAM AB — 8—8 .----------- BEAM ABOVE ---6 6.--- _ P o 104 BEDROOM " 1 TV ABOVE i I BEDROOM BATH 106 3—4 2-7 Co 2668 105 ORAGE BEN STORAGE B 10" GA�FP Co I T CH GE BENCH 15'-61" —5 10—6 ICE d- P I 5 " 54 �, U FOYER d 2668 _ 3068 NOTE:_. 2668 CONTRACTOR TO VERIFY ALL DIMENSIONS 4'_8° 4'-8n 4' 8" 4'-8" IN FIELD 16'-On 17'-0° i 19'—On 24'-0n FIRST FLOOR NOTE: SCALE: 3/16' 1'—O" h CONTRACTOR TO BUILD ACCORDING TO ALL STATE AND LOCAL BUILDING CODES - 4.. �. N 0 niq S��`•�$ �' STRUCTOcp URAL FIRST FLOOR Architectural Design Services Valentgas Residence a� No.29488 i ��i FLOOR PLAN 44 Parkway Lane 434 Eeel River Road p �O °-,- A- 1 .O Marion, Massachusetts, 02738 r Osterville, Massachusetts, 02655 �`� Date` scale: % i 1/25/2017 AS SHOWN . r' � r $ �pk ' - Arnc < 36'-0" 15-8" 2668 UN . I a " ATTIC r N o M - 5" 3'-4" ATTIC 3'-3" " 2668 5 . NEW SECOND FLOOR DN 3" NEW SECOND FLOOR BATH " ENTERTAINMENT ROOM --- 6' 8" 5 2668 o . ACCESS _ PANEL CV i . NOTE. ATTIC CTOR TO VERIFY Al a 2X6 ALL SECOND FLOOR CONTRAl- DIMENSIONS T EXTERIOR WALL (3) 8" LVL's IN FIELD AT WINDOW HEADER CONTRACTOR TO BUILD ACCORDING TO ALL STATE AND LOCAL BUILDING CODES SECOND FLOOR SCALE: 3/16" WIL AM O• s = P R STRUCTURA I SECON FLOO . 9488 2 1 NO 1 FLOOR PLAN A 1 • /. L Residence F %7 REGISTE�(c �F=�,c,.� c` Scale: V alentgas ,o Date: ices 434 Eeel River Road ` v;'v 1/25/2017 AS SHOWN assachusetts, 02655 Architectural Design Sery osterville,M 44 Parkway Lane Marion,M tt 02738 assachuses, - J �� r 2 3 _ 4 90 ATTIC 19'-10r 15-1° LIN. 2668 t. o fi05 5'-8 ° 3'-3r 6'-0" 5 ° 26681 3'-4"° 3.5"X 3.5" PSL HEADER POSTS ^ ATTIC • ATTIC oO �3A NEW SECOND FLOOR BATH _____ -----— 6'-8° 15n ———. RIDGE ABOVE —-— 5 DN 2668 ACCESS NEW SECOND FLOOR BEDR OM PANEL 3.5°X 3.5° PSG VALLEY POSTS ATTIC_ N 2X6 ALL SECOND FLOOR `EXTERIOR WALL (3) 8° LVL's r AT WINDOW HEADER NOTE: CONTRACTOR TO VERIFY ALL DIMENSIONS IN FIELD - NOTE: CONTRACTOR .TO BUILD ACCORDING TO ALL SECOND FLOOR STATE AND LOCAL BUILDING CODES SCALE: 3/16" = 1'-0° r - o ell AM o, I�j CT Architectural p Architectural Design Services Valent as Residence O�STERE�\���cF SECOND FLOOR •^/AL ENS.�; FLOOR PLAN 44 Parkway Lane 434 Eeel River Road A- 1 .2 Marion, Massachusetts, 02738 Osterville, Massachusetts, 02655 Date: Scale: 1/25/2017 AS SHOWN - j 2 3 4 52'-0' 89_0° 16'-0" g'-80, _ 4 PAN Y SHW 5� ' p F----- o � I W I CA . o I n 9'-0' S 10 I 18—6 KITCHEN CABINETS / SHELVES �5t LAUNDR UN. T07 3068 MASTER .� - 5'-0'. 2668 _ . BEDROOM ° n n '� 2668 MASTER 103 4—6 ISLAND 101 / / , BATH LAV. • 142° - '� GREAT ROOM �.../ 102 M REF. 109 ® ® t ' 2668 2668 ———— . ------ — ---I Ue R 2668 I r- 11'-6' _ a I 00 e BEAM ABOVE o 6'-10 ° 114-9n. HALL -�• I. :N r N N 0- we - o WC 7'-01° 11' TF - o Im 2668 L 2668 2668 2668 M DINING C _ 168 I LO --- '-- ........ N 18-8r 6_4..... 8-8 BEAM ABOVE— I '—_— BEAM ABOVE ———— _____ _ BEAM AB __ _ 004 I' BEAM ABOVE 6' 6' G Q� o . ... I� 104 I TV ABOVE a, DROOM _ 2'-7' 1 BEDR I NEW M 10 . 3 4 I I m ei BATHROOM ® 10° ► GA�FP I I STORAGE BENCH STORAGE BENCH 15,-6 '_ A8 10 5—5 0'-6' co I _. 5 5 en UP - 2668 I CL M FOYER -: �... 3068 COTE: - R TO VERIFY ALL DIM ENSIONS 2668 CONTRACTOR ry n ' IN FIELD 3 24'—On 16'-0' . FIRST FLOOR NEW °° NOTE: • SCALE: 3/16° = 1'-0' _ STATE I PORCH RAND LOCAL TO BUBUL BUILACCDING ES RDING TO ALL ❑ ❑ ❑ �i STEP 6X6 PT POST S�F IH O A� SNo TURgL Op FIRST FLOOR Architectural Design Services valentgas Residence 10- �� 29483 FLOOR PLAN /� 1 4 Parkwa Lane 434 Eeel River Road Fs ��srERo) ,�¢ 1 ' .4 y S/ONq���- Date: Scale: Marion, Massachusetts, 02738 Osterville, Massachusetts, 02655 1/25/2017 AS SHOWN =rt. 2 3 4 F---------i I I I I I I I ————————— ri L--------------------- I I I 1 3.5" LALLY COLUMNS WITH 3/4"X12"X12" STEEL BASE PLATE -� I ON TOP OF BASEMENT SLAB FROM 7 STRUCTURAL RIDGE 3.5"X 3.5" PSL's 3.5"X 3.5" PSL's TO STRUCTURAL RIDGE TO STRUCTURAL RIDGE I MAIN BEAM PO LOC TION I I 8,_2 " T-11 " 7 8'-0 " 31_0" I ol 1-3" I 3.5" LALLY I 3.5" PSL COLUMN WITH I I TO KITCHEN LVL 3.5"X 3.5" 3/4"X12"X12" I I PSL's SET ON FRAME NEW FLOOR SYSTEM TO I STEEL BASE I I EXISTING MATCH EXISTING MAIN FLOOR OVER PLATE ON TOP I FOUNDATION EXISTING SLAB GARAGE FLOOR OF BASEMENT I I SLAB I I NEW I I I BASEMENT STAIR I LOCATION I I I I I 14'-10 I I I I I I " 3'—e I I I of ----- ——— 3.5"X 3.5" I I r— — NOTE: PSL's SET ON I CONTRACTOR TO VERIFY ALL DIMENSIONS _ ----- EXISTING I I r , 3000 PSI CONC. FOOTINGS IN FIELD FOUNDATION L--------------------� AND PIERS (3) #5 BARS I ----------------------J BOTH DIRECTION 0BOTTOM " I- OF FOOTINGS 1`" NOTE: 1'-0" 11 " (2) #5"BARS FOOTING INTO ^ I CONTRACTOR TO BUILD ACCORDING TO ALL EXISTING FOUNDATION PLANT H2112 X12 PIERS (TYPICAL) STATE AND LOCAL BUILDING CODES ---� O O ---- SCALE: 3/16" Efl O --— ---- 13'-4 " 4'-0" 14'-10r '-0" '-0" pQ�` E LT STR 'S"°p° EXISTING FND Architectural Design T VG m 'tectural Desi Services Valentgas Residence "°'29 BBA� NEW STAIR PLAN A-0, 1 434 Eeel River Road �SiC S'ERE q o 44 Parkway Lane �NL F�iG�taFFh 'mate: Scale: Osterville, Massachusetts, 02655 1/25/2017 AS SHOWN DESIGN DATA SEPTIC NOTES ZONE: ASSESSORS REF.: •e �, 4 .. �, ; 4 Single Family-5 Bedrooms 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours p 114 , Parcel 25 v With NO Garbage Grinder Prior to Any Excavation For This ftimt the Contractor Shall Make RPOD Daily Flow-110 x 5-550 GPD the Required Notification to Dig Safe(1-888-M4-7233). Area (min.) 87,120 $F , • �'" }"Y" ' 2.The Contractor is PPS Fron tt7 a min ' 20 REFERENCES: e Septic Tank:SSO GPD x 200%-1100 GPD to Secure A Permits From Town Agencies For Construction Defined by This Plan. (min) UselsooGailonSeptieTank Width (min) 125 Land Court Case # 2664-72 3.if Required the waterline shah be Constructed in coordination with Width LEACHING AREA COMM Water,and shall be in Accordance with 248 CMR IA-7.00 Front 30' Cert. # 151198 ....,,. i &310 CMR 15.00.The Water Line Shall lie Slaved Where Regtrired SSO GPD/0.74-743 SF Required 4.Install Risers to Within 6"of Finished Grade(5 Required). Side 15' Sidewall-2(12'+46)2'-232 SF S.All Structures Buried Three Fat or More or Subject Rear 15' OVERLAY DISTRICT: .•. . �� Bottom Area-(1 2'x 46)=552 SF to Vehicular Traffic to be H-20 Loading.It is the Engines AP - Aquifer Protection District "` 4`." ' • 784 SF Total Provides Recommendation that H 20 Always be Used . .o t x 6.Septic System to be Installed in Accordance With 310 CMR 15.00& a '" °" • LEACHING CHAMBER DESIGN 248 CMR 1.00-7.00 Latest Revision and the Town of Barnstable a FLOOD ZONE. t b Board of Health Regulations. . All Pipes to be Schedule 40. Use 7.All Piping to be Sch.40 PVC. Zones B, BCC `` 5-500 Gal.Leaching Chambers in 8.Inlet Tees Shall Extend a Minimum of 10" • 12'x 46'Washed stone Fields as Shown. Community Panel No. Below the Flow Lane. #250001 0016 D 9.An Outlet Tee With a Gas Baffle Shall Extend 14"Below the Flow Line. t o,� Jul,, 2, 1992 Location Map: Fiber ANDIOR Scale: 1"=2000'f r te•-trr thanes - s 3+•-t 14• - 1.BAC M &me ea1�e CHAMM PERC TEST: 11,690 v"t+v PERFORMED BY:JOHN OIXA,Err-SULLIVAN ENGINEERING tr WITNESSED BY:DONALD DESMARIAS,R.S.-TOWN OF BARNSTABLE CROSS SECTION OF CHAMBER APRIL 13,2007 Ivor To scA p t r.E TEST HOLE- 1 EL.15.2 p seN.1¢�(4yJ O LAYER PARTLY DECOMPOSED LEAVES&TWIGS 15.0 A LAYER IOYR 3/3 Za aco 3t Tee tuo DARK BROWN 1s000a Septic Taalc D Bur 12" SANDY LOAM 14 2 A Nt Flow oateas s-2o B LAYER IOYR 5/6 As `� + Lad,toa YELLOWISH BROWN C�� 24" LOAMY SAND 131 C1 LAYER 2.5Y 6/6 Bakfine."ra Baft2lt OLIVE YELLOW MOIL (See N�aa9 Ai S0bR=WW"s� 68" MED.SAND 9.5 tonao.sta71eo"tathdee,cor7ae3yaas C2 LAYER 2.5Y 7/3 PALE YELLOW DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM MED SAND 52 Nor TOSCA t+edesaa"aQ 1 " i.E NO GROUNDWATER ENCOUNTERED Lot 60 TEST HOLE-2 _ EL 15.2 O LAYER PARTLY DECOMPOSED �Z'OO" w, \ 3" LEAVES&TWIGS 15.0 o " e 1y� \\ 5 70 ,t4,34 A LAYER IOYR 35 DARKBROWN e $CSR�e�`t ►5 198 \` Shed - SANDY LOAM 14.3 B LAYER 10YR 5/6 i \`_r _ - `•.--... `..-;5- 1 YELLOWISH BROWN 26" LOAMY SAND 13. ,6046 5g W `•..,�yr" ` CI LAYER 2SY6/6 A. �•= \` ~` ` `, g OLIVE YELLOW \�- _MED_SAND _- ca,0- ti _ 44 PERC TEST _11.5 25 GALLONS IN 6 MIN 10.1 C2 LAYE:2.5Y T3 - � '"" � ` ``�' PALE YELLOW 120" MED SAND 52 NO GROUNDWATER EkODUN7FRED , t 1 ` TEST HOLE-3 ( ! /.. ,`/ / /'' '-,�,."t^' ""'�.••.•,,, \ �.• 1 9�v ''• ; �°at°°e'") O LAYER oV I ! - \ i \ 1 olt `.•:� t ,b,,, PARTLY DECOMPOSED ,� \ ! ;� /+/ I / / 1 \ \ ` \ t�, I o •' S" LEAVES&TWIGS 14.8 \t50'\ \ 1 0�.:,= Y.f:O A,LAYER 1 OYR 3/3 DARK BROWN 10" SANDY LOAM 14.4 .-•�� pair B LAYER 10YR 5/6 v f 1 f ! ! f ( i I--_�`t .` \ \\ \\ \\ ` \ \ °•; a t YELLOWISH BROWN 22" Cl LOAMY�� 13A 6 , Wetland OLIVE YELLOW / � MED.SAND _ / t \a \\ \\ l t t t\t oo j 42" PERC TEST 11.7 t 1 f ( • 1 \ 1 1 0 '' r ,moo• 25 GALLONS IN 5 MIN.30 SEC. 62" <2 MINAN/ 1 it 1 \t it } e / a� i 1! 10.0 1> \ C2 LAYER 2.SY 7/3 ! I 1 i / t^ PALE YELLOW by am 1001MAW ")'' 1 1 ( 1 1 , \ a -- 120" MED SAND s 2 / ; I NO GROUNDWATER ENCOUNTERED \ \ $ \\ \\\ \\\` \ ��►�:`�---'i��' �/ /'/////// / // °" ' TEST HOLE-4 do EL 15.8 O LAYER nw PARTLY DECOMPOSED AV 4" LEAVES&TWIGS 15.5 A LAYER IOYR 3/3 \ ,. ` � •�"'"'. •_,_ / � �� / / .':' :-. 'sje'd"� a DARK BROWN `4 r ". i - . / / :'` -' n+-+ 13" SANDY LOAM 14.7 l • . _ •, -, _ /.: B LAYER IOYR 516 YELLOWISHBROWN to \\ ,. •;a,. �, ° " LOAMY Cl LAYER SAND �6 14.0 ` LOT E51 + /Q_ V V_ _ ,. rota 47,42 1 t ,. OLIVE YELLOW ... J)n 5 " MED.SAND 11.0 .....w. ..... �� 44 ra � t59.67 / - ` oY) C2 LAYER 2.5Y 7/3 / / / .•' �' , ,ems Pobttc PALE YELLOW / -35.74' �� (a 120" MED SAND 5. \ R-30.00*o r.- d ! NO GROUNDWATER ENCOUNTERED LEGEND: na-""� ' 3g7 Notes Deciduous Tree Paved �/ 1.) The property line information shown was Light Post 0r✓w i' compiled from available record information Coniferous Tree © Gas Gate - � 4Wp� pa ' 2.) The topographic information was obtained --� Sign catch Basin /, I from on on the ground survey performed on p CB/DH _ , c a a7 or between 20/FEB/07 and 21/FEB/07. Light Post 0 BRB Barnstable Road Bound 1 �1 , D Wetland Flag J` l 3.) The datum used is NGVD 29, Based on FEMA To -0 Guy benchmark data. Test Pit -Q- Utility Pole ' -25--- Elevation Contour -oHw- Overhead Utility tires Title: Site Plan PREPARED FOR: PREPARED BY- Sullivan Engineering, Inc. CapeSury Proposed Septic System (b Ellen Val en tgas PO Box 659 7 Parker Road Osterville,Key 7r MA 02655 Osterville MA 02655 At G�i " PO Box 1026 Q '�,■ 'A (508)428-3344 (508)428-3115 fax (508) 420-3994 (508)420-3995 fax v f --� Osterville, MA 02655 PsullPE000Gcom capesurvOcapecod.net 0 .� Bay stable, (Osterville) Mass. 30 0 15 30 60 9O Comp./Draft: JOD Field: WHK/BWB Date: Scale: Review: MD/PS Comp./Draft: WNK April 17, 2007 1 " = 30 Proi. # 27002 Drawing # C493_2G1 ZONE: AS S F.: ° DESIGN DATA SEPTIC NOTES ,o • • ' 'a • , a , Single Family-s Bedrooms 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours RF-1 Map 114 Parcel 25 '• Q a Yam,`�� '} •+ ' Prior to Any Excavation For This Project the Contractor Shall Make RPOD n With NO Garbage Grinder the Required Notification to Dig Safe(1-888-344-7233). Ad Daily Flow=110 GPD Area (min.) + ';°° � • '` a,. 2•The Contractor is Required to Secure Appropriate Permits From Town A 87,120 SF REFERENCES. Septic Tank: 0 GPD x 200 a/o=1100 GPD (min) , rc' • ' Fronta e (min) 20 Use 1500 Gallon Septic Tank Agencies For ConstructionDetinedbyThisPlan. Width (min) 125' Land Court Case # 2664-72 3.If Required the Water Line Shall be Constructed in Coordination With Setbacks: Cert. # 151198 COMM Water,and Shall be in Accordance With 248 CMR 1.00-7.00 LEACHING AREA Front 30' &310 CMR 15.00.The Water Line Shall be Sleeved Where Required. 550 GPD/0.74=743 SF Required 4.Install Risers to Within 6"of Finished Grade(5 Required). '= Side 15 ' OVERLAY DISTRICT. Sidewall=2(12 +46�2 232 SF 5.All Structures Buried Three Feet or More or Subject Rear 15 Bottom Area=(12'x46)=552SF to Vehicular Traffic to be H-20 Loading.It is the Engineer's AP - Aquifer Protection District l 784 SF Total Provided Recommendation that H-20 Always be Used 6.Septic System to be Installed in Accordance With 310 CMR 15.00& FLOOD ZONE• LEACHING CHAMBER DESIGN 248 CMR 1.00-7.00 Latest Revision and the Town of Barnstable All Pipes to be Schedule 40. Use Board of Health Regulations. >< ✓ � x 7.All Piping to be Sch.40 PVC. Zones B, & C 5-500 Gal.Leaching Chambers in 8.Inlet Tees Shall Extend a Minimum of 10 Community Panel No. • ' 12'x 46'Washed Stone Fields as Shown. Below the Flow Line. 9.An Outlet Tee With a Gas Baffle Shall Extend 14"Below the Flow Line. P1�01.1. #250001 0016 D July 2, 1992 3'Mc Location Map: € Mm C-P tdRU Scale: 1"--2000't AND/CP. 2 1/a• 117' r.st- T -f 13/4•-11/C' 3' Doable W.bd 2 LEACHING sane CHAMBER PERC TEST: 11,690 4'-10• PERFORMED BY:JOHN ODEA,ETT- SULLIVAN ENGINEERING IT WITNESSED BY:DONALD DESMARIAS,R.S.-TOWN OF BARNSTABLE CROSS SECTION OF CHAMBER APRIL 13,2007 P NOT TO SCALE TEST HOLE- 1 EL.15.2 P.O.EL 15.0 O LAYER S.Nft4 ftp.) PARTLY DECOMPOSED 3" LEAVES&TWIGS 15.0 A LAYER 10YR 3/3 DARK BROWN 1500 Galion Tao El-1320 12" SANDY LOAM 14.2 Septic Tack D-soo B LAYER IOYR 5/6 H-20 Flow Ega7ven; H-20 r.eaehing YELLOWISH BROWN �" CI1avlber 24" LOAMY SAND 13.2 H-20 C1 LAYER 2.5Y 6/6 o<EL.1 OLIVE YELLOW Bedding,"T"s,&Barrels la as Per Tide 5 1rBsm®and P.®a &Pp� 68" MED.SAND 9.5 Mm ( es s 9) All Uwe",soo.w�s ar C2 LAYER 2.5Y 7/3 la Mm.-slb see No The Odra Pc®eaorTbe Sys" h 20' Mm.-Fouadstm PALE YELLOW DEVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM El.s2 120" MED SAND 5.2 No Omandw.aablmd NOT TO SCALE NO GROUNDWATER ENCOUNTERED Lot 60 � \ TEST HOLE -2 EL.15.2 \ O LAYER -`16 `N --- PARTLY DECOMPOSED e Z - \\`\ "1q 00" W - F \ 3" A LAVES&TWIGS YER IOYR 3/3 15.0 o - e W 5 70 44.34 o a' N f- �o)R' /F \ - DARK BROWN c O C) $Uea Shed - \ 9g 11" SANDY LOAM 14.3 3 0 p Robert �t1'51 \ B LAYER 10YR 5/6 YELLOWISH BROWN 26" LOAMY SAND 13.0 46'- W `-....;t. ` \` °- CI LAYER 2.5Y0/6 160 7t.3T59r -^ \ ` \\ o 'OLIVE YELLOW J - _ - a z s - - MED. _ aN• _ d \ 44" PERC TEST 11.5 25 GALLONS IN 6 MIN. 61" <2 MIN./IN 10.1 C!3 �II°= \ `` m C2 LAYER 2.5Y 7/3 o•'`\d( ° _ w4P.,. �\0a' PALE YELLOW •1"rap -: read J+Z o 120" MED SAND 5.2 C, GROUNDWATER ENCOUNTERED NO \ \ - \ \\ \ ``tlr lr '' _- .__-- _ �• \ 1' \ �\\ TEST HOLE -3 EL.15.2 /r o •• ` �SbsPpaa 1 Cwd)d) O LAYER oa srop r°aas PARTLY DECOMPOSED of `1`/ l /� - \ \ �\ �.•` ( ax•;•'"':.:.: \ 5" LEAVES&TWIGS' 14.8 !!r o A LAYER 10YR 3/3 \\ \\ ! ! \\ \ >o' DARK BROWN ts t�D \ L: 11 ° ;. . A ` �I 10" SANDY LOAM 14.4 N ! , r/ ! \ \ \ \ CF\ t. B LAYER IOYR 5/6 Rio \ \\ \ \\ \\ \'' n ae ti \ YELLOWISH BROWN I \. -4 '` \\ \ \ \ \ ` \\\\ \ a 22" LOAMY SAND 13.4 C 1 LAYER 2.5Y 6/6 OLIVE YELLOW ! I 1 Wetland Area 3,226 f s� \` n MED.SAND ! ! 1` 42" PERC TEST 11.7 \ \ l 1 !`\`! !• \� \ \Q\ 1 �` \, c :;:;�... 25 GALLONS IN 5 MIN.30 SEC. �. \ P. e J r ! I 1 ° .• \ N 62" <2 MINJIN 10.0 �> ' P° C2 LAYER 2.5Y 7/3 0 1 i ! / P, ..d as sw I ! / s PALE YELLOW 1 1 l t�` I we. P.lie \ MED SAND 5.2 �� \ !\,\` ,\11 41 \\ by am 1e/Pm/w w�Flot t !! !! !} f ! 1 \\ 120„ \ t I ( � \ NO GROUNDWATER ENCOUNTERED ^� r 1 i l ` ��\ % - ,- .r! JI JI r� if , F � TEST HOLE / t / f J I I / DrM �-- EL.15.8 O LAYER 1X PARTLY DECOMPOSED O 4" LEAVES&TWIGS 15.5 A LAYER 1 OYR 3/3 IL DARK BROWN SANDY LOAM 14.7 B LAYER 10YR 5/6 YELLOWISH BROWN / 22" LOAMY SAND 14.0 LOT E51 P Q C 1 LAYER 2.5Y 6/6 "W Iv V OLIVE YELLOW Total - 47,42o/ff ' 967, Wetfond=_.3�216sff p r 58" MED.SAND 11.0 up�- 44,194 1f 15 :' / WoY� C2 LAYER 2.5Y 7/3 de Public PALE YELLOW (40 � 120" MED SAND 5.8 _ -- --35.74' r� NO GROUNDWATER ENCOUNTERED \ R=30.00 Pd Fes°' / .d ra• � a1� "--�r j on LEGEND: _ +F�=-l" �_ e_ N/Fdergo^ Note: Deciduous Tree 1.) The property line information shown was o Light Post caved tk compiled from available record information t Coniferous Tree © Gas Gate �� _ 2.) The topographic information was obtained ® catch Basin _ from an on the ground survey performed on -rT Sign 0 CB/DH or between 20/FEB/07 and 21/FEB/07. � Light Post El BRB Barnstable Road Bound ! 3.) The datum used is NGVD '29, Based on FEMA Wetland Flag -� Guy - ' `- ,�l benchmark data. T, e Test Pit -0 Utility Pole --25--- Elevation Contour -oHw- Overhead Utility Wires Title: Site Plan PREPARED FOR: PREPARED BY.• I CapeSury Sullivan Engineering, nc. Proposed Septic System PD Box 659 Ellen Val en tgas ostervl/eaMAro2655 At /r r� I �)dv, t3� L` Os tervill e, MA 02655�o W - l�� PO Box 102v 508 428-3344 508 428-3115 fax (508) 420-3994 (508)420-3995 fax � Ostervill e, M� 02655 ( ) PSuIIPE*noLcom capesurv®capecod.net j Barnstable, ( ) Mass. -,, Osterville so 0 15 30 so so Comp./Draft: JOD Field: WHK/BWB Date: Scale: �� Review: MD/PS Comp./Draft: WHK April 17, 2007 1 = 30 M Proj. # 27002 Drawing # C493_2G1