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0159 MAIN STREET (OST.) - Health
159 MAIN STREET, OSTERVILLE A= 165 079 t - I J is i o � ' [� CO Certified Mail Fee �PNS t aEr $ Fxdra Services&Fees(check box,add tee as appropriate) 0, _ ❑Return Receipt(hardcopy) $ N 3 ❑Return Receipt(electronic) $ N -.Ok/P,QAstfeark QN 1-3 ❑Certified Mail Restricted Delivery $ C3 ❑Adult Signature Required $ ,A ❑Adult Signature Restricted.rwNerv_s_LJ : $ostage Total Postage and Fees ."" WEBBER, JAY L TR' $ ; C/O D_ E_NISE&WILLIAM FINARD. � 7-7 Sent To i PO BOX 200 5'rieefandApt No.,o�x OSTERVILLE, MA 02655 MO r r r rrr•r- Certified Mall service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail •A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the •A record of delivery(including the recipient's retail associate. i' signature)that is retained by the Postal Service' Restricted delivery service,which provides T for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent - Important Reminders: Adult signature service,which requires the o ■You may purchase Certified Mail service with signee to be at least 21 years of age(not First-Class Mails,First-Class Package Servicee, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which •Certified Mail service is not available for requires the signee to be at least 21 years of age International mail. and provides delivery to the addressee specified ■Insurance coverage is notavallable for purchase by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase (not available at retail). of Certified Mail service does not change the ■To ensure that your Certified Mail receipt is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a a certain Priority Mail items. USPS postmark.If you would like a postmark on+l •For an additional fee,and with a proper this Certified Mail receipt,please present your i endorsement on the mailpiece,you may request Certified Mail item at a Post Office'for the following services: postmarking.ff you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion 6 of delivery(including the recipient's signature). of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. a electronic version.For a hardcopy return receipt, T complete PS Form 3811,Domestic Retum Receipt attach PS Form 3811 to your mailpiece; IMPORTANT:Save this receipt for your records. Ps Form 3800,April 2o15(Reverse)PSN 7530-02-000.9047 le Complete items 1,2,and 3. A. gnature ■ Print your name and address on the reverse ❑Agent so that we can return the card to you. X "�' � ❑A dressee ® Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. D to of Delivery or on the front if space permits. J/ /Q 1. Ar" D. Is delivery address different from item 1? ❑ es If YES,enter delivery address below: ❑No Illlll WEBBER, JAY L TR i C/O DENISE&WILLIAM FINARD PO BOX 200 OSTERVILLE, MA 026553. Service II I�III�I loll I6I I II II I illl I III II III I I III I III ❑Adults g e n ture ❑RegisterMail ed Maip ss® rm ❑ dult Signature Restricted Delivery ❑ egistered Mail Restricted 9590 9402 3759 8032 3745 17 ertified Mail® elivery Certified Mail Restricted Delivery etum Receiptfor ❑Collect on Delivery Merchandise 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation*m ❑Signature Confirmation 7 015 17 3 0 0 0 b 1 2 4 9 8 7 9=3 61• .,Y 0)I Restricted Delivery Restricted Delivery�S Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt LISPS TRACKING# ..,, Pir„st,Class Mail Postage&Fees Paid USP r; Perms No.G-10 I 9590 9402 3759 8032 3745 17� `, i United States, •Sender.Please print your name,address,and ZIP+4®in.this boxy Postal Service -. 77 I CON". Town.fofBarnstable Health'Division 200 Main Street I Hyannis;MA 02601 I I I l i I Town of Barnstable aarnstable Board of Health 200 Main Street,H A.� . Yannis MA 02601 s l l 9�'OrFD MPt s`°� 2007 Paul J.Canniff,.D.M.D. Office:508-8624644 Donald A.Guadagnoli,M.D FAX: 508-790-6304 John T.Norman F.P,(Tom)Lee,P.E.,Alternate Certified Mail#7015 1730 0001 4987 9361 November 16,2018 WEBBER,JAY L TR RE:UST- 159 Main St.Osterville C/O DENISE&WILLIAM FINARD Heating Oil Tank: 550 gallons PO BOX 200 Tank Number: 1 _. �STERV1i�LE;I�I1OZ655 ` Tag Number: -00416 v Board of Health records indicate that an underground fuel(or chemical)storage tank at the above location------ exceeds-thirty(30)years-in age and has not yet been removed as required by the Town of Barnstable Code Chapter 32.6, Section 3,Fuel'and Chemical Storage Tanks. You are directed to remove this tank within sixty(60)days from the date of this Notice. Upon completion of the tank removal and within ninety(90)days of receipt of this Notice,please submit to this office a copy of the permit for storage tank removal issued by your local Fire Department. This permit is required to be obtained prior to the tank removal. This copy of the removal permit serves as documentation that the underground storage tank was properly removed and disposed of. Should you be unaware of the existence of the above mentioned tank or its possible previous removal, an independent third party(i.e.oil company,tank removal company,or environmental services company) may be able to assist you in physically locating and/or verifying the current existence of the tank. Should this be the case,a written document from the independent third party is required within ninety(90)days of receipt of this notice as verification that the tank had been previously removed and/or does not exist. You may request a hearing before the Board provided that a written petition requesting same is received by the Board of Health within ten(10)days after this order is served. Failure to comply with an order of the Board of Health will result in automatic scheduling of a hearing before the Board at a future public meeting. If you have any questions or would like to discuss this problem,please call Tim Lavelle,Hazardous Materials Specialist, at 508-862-4645. Thank you. Per.Order of the Board of Health Thomas A.McKean,RS,CHO Public Health Division,Director Q:1Hauna\Undergound Tanks\2 0 1 8\3 0 yr old UST 159 Main St OST.doc CENTERVILLE • OSTERVILLE • MARSTONS MILLS FIRE DISTRICT UNDERGROUND TANK REGISTRY PROGRAM Owner of Property: S/4- Kc,,- Date of Installation: Address: Description: Installer:- Oki Size: 55 O Certification: Location of Tank: w1'< INSPECTION INFORMATION DATE COMPLETED BY Site Inspection Air Test on Tank—Above Ground Air Test on Tank—Within Hole i00 Test on Piping Cathodic Protection Test Continuous Monitoring System Type Backfill Operations Vent and Fill Pipes I . r: i I r oFtNE Town of Barnstable • BARNMB LE, Board of Health ArEp���a P.O. Box 534, Hyannis MA 02601 Office: 508-8624644 Susan G.Rask,R.S. FAX: 508-790-6304 Ralph A.Murphy,M.D. Sumner Kaufman,M.S.P.H. To: HANS,PATRICK R&GAYLE Date Monday,March 05,2001 227 FALLIGANT AVE SAVANNAH GA 31410 . RE:Underground Tank at 159 MAIN STREET(OST.) Map/Parcel 165679 Tank NO: 01 Tag NO: 00416 The Town of Barnstable Public Health Division records indicate that your undergroud or chemical storage tank is 15 years of age,and has not been tested as required under section 07:(5)of th health regulation regarding fuel and chemical storage systems. You are directed to have each tank and its piping tested within thirty(30)days of the receipt of this notice. Results of the testing shall be filed with the Board of Health and the Fire Department. You are reminded that you shall have the tank and its piping tested during the 10th,13th, 15th,17th, and 19th year after installation,and annually thereafter. Failure to comply with this order may result in a fine of up to$300.00.Each day's failure to comply with an order shall constitute a separate violation. You may request a hearing if a written petition requesting same is received by the Board of Health within ten(10) days after this order is served. Per Order of the Board of Health Thomas A.McKean,.RS, CHO Health Agent r Commonwealth of Massachusetts Town of Barnstable 367 Main Street Hyannis, Massachusetts 02601 CERTIFICATE OF REGISTRATION Date: 03/09/99 Fee: $22.50 In accordance with the provisions of Chapter 148, Section 13, of the Massachusetts General Laws, the undersigned hereby certifies that SLIFKA, ALFRED & GILDA , Address PO BOX 9161, WALTHAM. is the holder of a license granted on 01/01/86, Book , Page for the lawful use of the building(s) or other structure(s) situated or to be situated at 159 MAIN STREET, OSTERVILLE. . Parcel # 165-079 Underground Y, Above-ground Tag # Total capacity, and type of fuel, in Gallons 416 550 FUEL OIL (Received by) (Signature) (Official Title) (Owner, Occupant, Holder) Date (Address) NOTE: This Certificate of Registration must be signed by the holder of the license if said license was granted prior to July 1, 1936, otherwise by the owneer or occupant of the land licensed. 6W v Town of Barnstable Barnstable Board of Health AS-MainCly BAWMAHM * 200 Main Street,Hyannis MA 02601 1 ' MAM 9$,,r 03g `0 2007. Paul J.Canniff,D.M.D. Office:508-862-4644 Donald A.Guadagnoli,M.D FAX: 508-790-6304 John T.Norman F.P.(Tom)Lee,P.E.,Alternate Certified Mail#7015 1730 0001 4987 9361 November 16, 2018 WEBBER, JAY L TR RE: UST- 159.Main St. Osterville C/O DENISE&WILLIAM FINARD Heating Oil Tank: 550 gallons PO BOX 200 Tank Number: 1 OSTERVILLE, MA 02655 Tag Number: 00416 Board of Health records indicate that an underground fuel (or chemical) storage tank at the above location exceeds thirty(30)years in age and has not yet been removed as required by the Town of Barnstable Code Chapter 326, Section 3, Fuel and Chemical Storage Tanks. You are directed to remove this tank within sixty(60)days from the date of this Notice. Upon completion of the tank removal and within ninety,(90) days of receipt of this Notice,please submit to this office a copy of the permit for storage tank removal issued by your local Fire Department. This permit is required to be obta ned prior to the m the tank removal. This copy of the removal perit serves as documentation that the underground storage tank was properly removed and disposed of. Should you be unaware of the existence of the above mentioned tank or its possible previous removal, an independent third party(i.e. oil company,tank removal company, or environmental services company) may be able to assist you in physically locating and/or verifying the current existence of the tank. Should this be the case, a written document from the independent third party is required within ninety(90) days of receipt of this notice as verification that the tank had been previously removed and/or does not exist. You may request a hearing before the Board provided that a written petition requesting same is received by the Board of Health within ten(10)days after this order is served. Failure to comply with an order of the Board of Health will result in automatic scheduling of a hearing before the Board at a future public meeting., If you have any questions or would like to discuss this problem, please call Tim Lavelle, Hazardous Materials Specialist, at 508-862-4645. Thank you. Per Order of the Board of Health Thomas A. McKean,RS, CHO Public Health Division, Director Q:\Hazmat\Underground Tanks\2018130 yr old UST 159 Main St OST.doc r ` .No- ---" Fee. --=- BOARD OF HEALTH TOWN OF BARNSTABLE Zipp[ication-*rlefl Conotruction Permit Application is hereby mace for a permit to Construct ( Alter ( ), or Repair ( )an individu Well at: Location — Address Assessors Map and Parcel — ---Owner Address ----.._�--������r_—�c�,?��fit,i,►�- _ � �0.�2 . 5 _ �._z't�t�-v�.� � ---- ----- ------— ------- -------------- Installer — Driller Ad ress Type of Building ✓ Dwelling -----_—_-----______-- Other - Typepe of 3uilding—=---------- ----- No. of Persons--- -------.----- -------- Type of Well "1 �� �v� -- Capacity-- -- - - --——.--- --_— Purpose of Well.--�_-zj- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until a Certificate .of Compliance has been issued by the Board of Health. Signed _-- dat Application Approved By — --—---- Gate - Application Disapproved Zthe following reasons:--------------------------- ------ —--- _ date `�' ��- -------- Issued--_ -�� Permit Nol✓` -- ---- ------------—_---______.__-------- .date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS,,Tnq,CE RTIFY, That the Individu,;l Well Constructed (N/), Altered ( ), or Repaired ( ) by5— ��— --�'�-- �'� -- —— -- ----- ——_--_- ---------- _ Installer has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit Nol;.S?°=`/ `U--Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE ---- __ _ Inspector------------------------_____--__----____-- t No. --------------4 Fee---------------------- BOARD OF HEALTH TOWN OF BARNST-ABLE 0putication-for Well ConotructionVermit Application is hereby made for a permit to Construct ( Alter ( ), or Repair ( )an individua Well at: 1.5Q__m _- Location — Address — Assessors Map and Parcel ILL Owner i� � Address Installer — Driller Ad ress Type of Building Dwelling--------- Other - Type of Building-=-----_--__— No. of Persons---..----.•____-_____—_--____ ` Type of Well " ?UL------------ Capacity------------------------------------- Purpose of Well---� Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to { Place the well in operation until a Certificate.of Compliance has been issued by the Board of Health. Signed - ---------- �----- dat Application Approved By. date Application Disapproved fXthe following reasons: ---------.---------_---- date Permit No / � -O—Zd Issued _ ----- date BOARD OF;.HEALTH TOWN OF ` BARNSTABLE Certificate Of Compliance THIS IS,TO CERTIFY, That the Individual Well Constructed (V), Altered ( ), or Repaired ( ) installer has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No Dated A THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL Ir SYSTEM WILL FUNCTION SATISFACTORY. DATE----- _ --_- Inspector---------- ---- BOARD OF HEALTH TOWN OF BARNSTABLE f Well CongtructionPermit . No. ozo Fee ----- Permission is hereby granted-= -�-`�P 016 Vj C-u'" k 44 u. AJ ------_____ to Construct (<), Alter ( ), or Repair ( ) an Individual Well at: No. t 5 /I I.rJ S nS Ta✓ !t street as shown on the application for a Well Construction Permit No._l.�-� I d 2. U Dated- 09 --------------- - .----------- _-...._-_...__ h Board of Health DATE l Town of Barnstable P# 1366Department of Regulatory Services Public Health Division Date 7 / x„►�a 116 Via, 200 Main Street,Hyannis MA 02601 Date Scheduled /CX Time Fee Pd. SOIL � • . Suitability Assessment for S e d�asposal Performed By: Witnessed By: LOCATION& GENERAL INFORMATION Location Address 159 Owner's Name Address Assessor's Map/Parcel: �� /0 Engineer's Name `/Nd,4 NEW CONSTRUCTION ( REPAIR Telephone D Z7 y' 7 3 Y 7 . Land Use I.e�,2n i Slopes(%) 5"3 C1 l a Surface Stones Distances from: Open Water Body li! `ft Possible Wet AreaJ 5 ft Drinking Water Well ft Drainage Way ft Property Line ft Other N In ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) 7A Parent material(geologic) &(A ll (g B ) �'Jh( Depth to Bedrock _ Depth to Groundwater. Standing Water in Hole: I"I Weeping from Pit Face Estimated Seasonal High Groundwater DETERMWATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed standing in obs.hole: In. Depth to soil mottles: In, Depth to weeping from side of obs.hole: in, Groundwater Adjustment f. Index Well# Reading Date: Index Well level- Adj,factor Adj.Groundwater Level PERCOLATION TEST bate , Tana Observation rr�j Hole# Time At 9" • it Depth of Perc ltl Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak 9100 Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back--------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the. Barnstable Conservation Division at least one(1)week prior to beginning. Q:ISEPTICiPERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. -onsistency.%Gravel) gti-'IV ;(ESL . - "z- C, LS DEEP OBSERVATION HOLE LOG bole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Grave 23�Z SL - 3,o 3� — �o C, ML-S . DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Noll Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency, Flood Insurance Rate Man: Above 500 year Hood boundary No Yes Within 500 year boundary No V' Yes Within 100 year flood boundary No. Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervio s material exist in all areas observed throughout the area proposed for the soil absorption system? ---q If not,%fiat is the depth of naturally occurring pervious material? Certification , I certify that on DJ (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 trai ng,expertise and experience described in 310 CMR 15.017. Signature o Date Q:\S.EPTiC1PERCPORM.DOC Town of Barnstable Regulatory Services Thomas F. Geiler,Director MAW Public Health Division A`� Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: ` Dal Q Sewage Permit# Assessor's Map/Parcel 1(!�S °79 Installer&Designer Certification Form Designer: Installer: ���.����z rr,Sn c Address: 9 63 0A �-0 3 0 Address: 'Te +)cic& M� 2`S3� ,.��,�L..�rn��as�3 On 13 �'�_ e®� c�ovGJ' was issued a permit to install a (date) (installer) G septic system at � O S�. DSl r v sk based on a design drawn by (address) LAL �1��o dated `� (o d k Q, (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout (if required) was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' 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. Stripout (if requ'r . pected and the soils were found satisfactory. _ �',;ti- �y1H of MgSs fZe-cD-_)95ur&6 n eP 16Ach (ie J A —AO � LINDA J. q�yG o. PINTO (Installer's'Signature) 4 ,s _ �GI T E e✓ ot� . SS/ ECG Al esigner's Signature) (Affix Des p 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. gAoffice formsWesignercertification form.doc SEP-29-2014 14:52 FROM: - T0:15087906304 P.1 OA 6V) Y/ V ;d 1 0 Air Safe, Inc. 61Endleott Street,Bidfi 32-1 Norwood,MA 0206; W.762.3390 Experts In Asbestos and-Mold Removal lop l� v FAX T.RAN'SMISSI.ON DATE: 0// TOTAL NUMBER OF PAGES INCLUDTNC,COVER:r , F T0: BARNSTABLE BOARD OF HEALTH FAX RECEIVING: 508-790-6300 PHONE 508-862-4644 FAX SENDING, 781-762.2815 /v�c '` SEP-29-2014 14:53 FRCM: T0:15087906304 P.2 AQ 04- Asbestos Removal.Notification form ANF-001--Cransaction#689565 Page 1 of 4 Commonwealth of Massachusetts 1100200438 Asbestos Notification Form ANF-001 AobeeWeProsetNumber Project Rai l.F fJ Project Canceltallon A. Asbestos Abatement Description 1. Facility Location: •t59 MAIN ST TRU57 �f _ 77 `159 MAIN ST Name or padllty Street Address 13ARN$TA5LE V' MA 02965— t117.7r37.0725 City/Town Stata Zip Code Telephone GAY�VEBDER RRU.,TCC ` Faaley, m Contam Perim Name Facility COMW Peraon Title .. .... . --------... Irtstrutttona 1 All Workslte Location' i EXTERIOR DRIVEWAY . ,-- --..•,. ---._..... ,. yectienpar JN4lean must Building Name,Wlni Floor,Room,etc. bocomostetltn order to 2 Is the facility occupied? oomph whin Masai F1 I Yea Al No nodflastion regrirememB 0310011Yvt7.115and 3. Is this a fee exempt notification(City,town,district, municipal housing authority, state facility,or owner- Dapartmant of labor occupied residential property of four Units or less)? Q Yes IM No Standaros(DL$) nogntatton requirements a.Blanket Permit Project Approval, if applicable' of a53 CMR 612 Appr"ll4 A 5.Non-Traditional Asbestos Abatement Work Practice Approval,it appliCal)W MaeaDEP use Peiv Approval 10 it g Asbestos Contractor: f _ I DateRecelvaa _........ ---.---.._...__._.......,. - -- F-- j Nsm4 Address 2.Submit original ------ Fwm To CNITown Stale Zip Coda Telephone eontaror Wealut of AC000aa4 _l Contract Type Q !! n':0 v"L' tYt#ese6fiuAr►tta oLS License if Asbestos Program ... .._..... -............_......................... R.o.[hex 420087 ?a00 Bo 0 Name of ConMor8 On-,Site SuperviOWIForeman OLS Cartifieation ill MDfy07a7 0087 Name of Project Monitor DLS CoMScaaon N. Name of Asbastari Analytical Lab DLS CarGbcallon A 10.;oa/28t2t)1a ._.:. ... ....... .......� riproir2ota-_._......_..._.....,. .--....-.._.. .._.::_..—r.� -- - ......_.._... .......... . . -- - .._....... ..:......._—.— Projoct Stan Date iMMIDDIYYYY) End Date(MMIDDNYYY) `!AM 0PM AM-a PM � VVofk Hotrrs-Monday Thrairgh li Work Moula-Swtwdny&$ureiay bttps://edep.dep,mass-gov/WebForms/Asbestos/BWPAN.FOOI.aspx 9/29/2014 } SEP-29-2014 14:53 FROM: TO:15097906304 P.3 AQ 04 - Asbestos Removal Notification.Form ANF-001- "transaction#689565 Page 2 oi`4 11. -- ......._._, Demolition Lu Renovation I p Rapeir 'lath®r-lyteaes Spociry: ; 12.Abatement procedures(check all that apply) Glove Boo r ErnGspaulation I Enclosure r71a 03tt1Onl ' mertt j Qi p y �;Cleanup I p 01 Full Conlain ,IOther-Plea rtMrafy- �EYTERInR CLEAN Uh YIItrYi lrinlildldl it f.—........ ' uo nm�m.m,onm®emu ii®iuo mill L la i I I I nrllal,U1na11KI,0_11.TLAL Mill lm 11 Ill 10111013 Ill III IN1 1 t' fill "�11��,mwoumrol1I 1'�rw Lw..lwtivn lip .—J P—___� anv[wren C 1 Lin.Ft 84.Ft. Lin.Ft 6 Ft.- SprBY-C1n FlPfytPflrlRflQ i Tronfito Pon41>a I F Lin.Ft. Sq.Ft. Lin.Ft. Sq.Pt. GI03.WOVW Fabrics' l -._..._.' nthpr-Plaam RltwnirV Lin Ft. 3q.Ft Ineulptinp Lemont �_^_ MEPA vAC WORK AREA Lin Ft Sq.Ft Lin.FL Sq.Ft. 15. Oescribe the decontamination system(s)to be used: '3 GI�AMBFR DEGUN -. --""""'-1 �I i V' 1G. Describe the Containeozation/disposal methods to Comply with 310 GMR 7.15 and 453 CMR 6.14(2) 8 MIL r'OLY BAGS 1 A, ............._.._._.._..._.....•..••. .....----................... ...... _...__...----_..._-..._._......—v l 1T1 fir 6mirga y A192112A gan'rannn mr,mminnFP rind Ill h tl nInIr On Pulue M thn emergency: 18. Oo prevailing wage rates as per M.G.L. c. 149,§26,27 or 27A-F apply to this , p Yea Np project? I I , B. Facility Description 4 ' https-.//edep.dep.mass.gov/WcbFornis/Asbestos/BWPANFOO I,aspx 9/29/2014 , 1 - SEP-29-2014 14:55 FROM: TO:15087906304 P.1 AQ 04-Asbestos Removal Notification.Form ANF-001-Transaction#689565 Page 3 of 4 *1Asbbslbswntahlq C. Asbestos Transportation & Disposal - wstlt@ ntstgdal is only - 890A*d al Me ptaaeof 1.Transporter of asbestos-containing waste material from site of generation:. business of a DLS liceyr ed Asbatuoa I�;blreepy to landrlU or To Temporary storage L=t 0mTrensfer 3totlan emwacw or a trander 1 "' station Thal Is permitted _..----...._........ .. - - --........... .. i'-' - -... ----- --- by MMOEP and {AIR SAF£ 1131 ENDICOTT J Name of TrAnrparter Address Operated Ut compliance - � r_.._........ with Sad wade NORWOOD MA F2062 781-762.3390 Reputations 310 CMR CilylTomi steto Zip Coda Telephant 19.000 2.if a temporary storage locationitranSfer station is Mad,list name of transporter of asbestos containing waste materials from temporary storage lowtionitransfer station to final disposal site: 1SERVICE TRANS � j5B PYLES RD Name of Transporter Address ANEW CASTLE v !DE f01872 { '977-999 855® - ................:............. ...:.•.,,:.,......,:.•,.,..,,...........r t............3 r.,..,,..,..,..•.....,�...,..., 1,.., .,..,..,,.�,�, ,..._.,,.,�«w....,,•r,r... Cdyllown stet® Zip code Telephone 3 Name and eddress of tempotary storage Iooatior/transfer station for the asbestos containing waste material: , :AIR WF- } sSAME Temporary Stomps Wcollon Name Address F... ....--__...................,,....-„--.............._........._.,.' :.1....—, a.........._.._......._... SSAME i tMA r02062........ 781.762-�390 ; CIIV/Io n state Zip COdo Telephone 4_Name and location of final disposal site(asbestos landfill); jMINERVA � MINERVA INTRP --_ • ifinal Dtapasel Site Name Final piapoUl Site Owner Norne '9000 MINCRVA RD 1,,... .. A NOR:CoulnKlar riwo Addrow ` wAYNFSaLIRG. tiN� ease '.__� 111.111.111� aWt lfua form for OILS � •-—........,•,,...,..-_�,.._-T__: � llwrk.di o p,,,pnaes City/Town State Zip Coda Telephone �DF WAL$li Name Authorized Signature PasitianlTitl9 Data(MMf DD/YYYY) �781-782-3390 __.... .,_... Tolepflane Represenpne 1 ENDICOTT NORWiSf�D Aadreas city/rown r....._...__.._...,. .._......__.__. Stota Zip Code littps://edep.dep.mass,gov/WobForms/Asbestos/B WPAN•FOOI.aspx 9/29/2,014 SEP-29-2014 14:55 FROM: TO:15087906304 P.2 Aft 04-Asbestos Removal Notification Forth ANF-001-Transaction 4689565 Page 4 of 4 D. Certification 'I nanny that I have personally examined the foregoing and am familiar with the information captained in this document and all attachments and that.Wised on my inquiry of those individuals inmrfmdiatdly rasponsibleVobtaining IN information,I balieve that the information it true,aenurate,and complete.i am aware that there are significant pamallias for submitting tting false information,inOluOL-Ig possible rhos and imprisrnmant.The undersigned hereby states that I have read the Commonwealth of Massaohusens regulations governing asbutos abatement(453 CMR 0.00 promulgated by the DOpollrmmnl of Labor Standards and 310 CMR 7 15 prornulgeted by the Oeperpttsni Of Environmental PretectloWj,and trial i am aware trial this permit application Or notification Sh011 not ba deemed valid unless payment of the apphrAbla fas to maCa' m } 6 r https:/Iedep.dcp.mas.s.gov/WebForms/`Asbestos/BWPANFOOI.espx 9/29/2014 TOWN OF BARNSTABLE kOCATION M A:r. SEWAGE# Q=71 a- Cr-(3 VILLAGE ��e-�r�J��t,-G ASSESSOR'S MAP&PARCEL toS� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ;I S'�t:o LEACHING FACILITY- (type) t:koS 04c: 36t( (size) YY C�� a•ac.� NO.OF BEDROOMS 1.-�'ct�. �`� 4' ra I Pn ` a OWNER ` ... e PERMIT DATE: 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) t p3` T-o o oO� Feet FURNISHED BYV, T y f, Roo� 3 b Zel if) No. (/�/ Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS -� Application for disposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade(vl Abandon( ) ❑Complete System �dividual Components Location Address or Lot No..A 57c( q' ,\-•w S� Owner's Name,Address,and Tel.No. � %.L k_- 'NA%a n S \ S- � �v.� s'�'� _5-cac7v Igg- Assessor's Map/Parcel k(0 S p'7<=l Installer's Name,Address,and Tel.No.Q_C, 4\c j esigner's Name Address,and Tel.No.L-�� � `"A vCT'O P.Z 1Z(5-x37/ Type of Building: Dwelling No.of 3edrooms Lot Size LI _ S sq.ft. Garbage Grinder( ) Other Type of Building G_S No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) - 7 )(2�;? gpd Design flow provided ~(` ( gpd Plan Date j � Number of sheets Revision Date Title Size of Septic Tank �CS ��.$'. t'; l Type of S.A.S. e6 ps Description of Soil 'S-,f--,f Nature of Repairs or Alterations(Answer when applicable) s�ij � Date last inspected: Agreement: The undersigned ag-ees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued Ly this Board of Health. Signed Date Application Approved by Date Application Disapproved by Date for the following reasons v Permit No. � ' (/ 3 Date Issued --------------------------------------------------------------------------------------------------------------------------------------- r � R No. D-0/ y " Fee ,..► THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplicatlon for MisposaY slwAlonstrUctiott,Permit Application for a Permit to Construct( ) Repair( ) Upgrade(Abandon ) ❑Complete°System [Alfridividual Components Location Address or Lot No. Owner's Name,�ddress,and Tel. i G J 2✓L\1 �� 1r� �'')v �CS 4 l j d Assessor's Map/Parcel m A clD cs-_ Installer's Name Address,and Tel.No.�r� �� ��`�-'ri ,pesigner's Name,Address,_and Tel.No. P.® max - 7 50�3-�2�'-6o5S' �?q • E3c�x JC730 ' Sow'-�`�`�- 3 S© ��.�S2cs..�_.L4- Y�� c>�S•�,3 \...�;..z.:.t..L�, �„y ��.S3Co Type of Building: Dwelling No.of Bedrooms I Lot Size L I . ��irs sq.ft. Garbage Grinder( ) Other Type of Building C S No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min..required) 7 b gpd Design flow provided �( l gpd Plan Date �l re ho u Number of sheets Revision Date Title Size of Septic Tank .5'Q(3-� t-.-k$;*f uA. Type of S.A.S. c, 0_5 i�y� ��,�� �a'dG�R ��►Awt{tG/S Description of Soil c`. 1• Nature of Repairs or Alterations(Answer when applicable) Z!4,j �7' •� h �Y 7 Date last inspected: ,. 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 t s Board of Health. M1 j • ...,� �Qeg Signed Date73/ Application Approved by Date Application Disapproved by k Date for the following reasons \ i M / Permit No. Date Issued a t THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded(-I Abandoned( )by at �J- has been constructed in accordance / with the provisions of Title 5 and the for Disposal System Construction Permit No?ND 161 .3dated Installer�;?-Gs� �nG J'• �C� Designer �.• i ,� '�-�� #bedrooms Approved design flow 0 gpd The issuance of this per/mitt shall not be construed as a guarantee that the system w,I functio si ed. Date "� l)q ^� Inspector No. 4)O/ P- --C) _-5 Fee �y THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Ira lo8aY: p�tEtTD �D e"IiCtiD1Y Permit— Permission is hereby granted to Construct Repair Upgrade(X , Abandon ( ) System located at 1 S \ ~ Q-�`' S� ` s ] T C-j \fir✓ - 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{rtyst be�c t}iplet�within three years of the date of this permi A t. Date pproved b , 3. 74Ar IT TOWN OF BARNSTABLE LOCATION 1 //� ST SEWAGE# o170/11- d y� VILLAGE ASSESSOR'S MAP&PARCEL I6S —079 INSTALLER'S NAME&PHONE NO. W—si-ILY SEPTIC TANK CAPACITY 3 - 11 c�1( LEACHING FACILITY. (type)S06,r C4/q1"ei ( 1 (size)/a2/a'X 38 NO.OF BEDROOMS OWNER L. (,tJ e�o� 1%I T Ft V101C— PERMIT DATE: 2-a 3'6y COMPLIANCE DATE: /1(�5'• o20/S 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 C S Mrf�i./ Do�P All2 � Y e ° IS� M��a ojJ cleAAZ (Iut2 1 C yLr/b TOWN OF BARNSTABLE LOCATION J59 /�/,1(,VS/, SEWAGE# , Of/ (--o2V VILLAGE Q S L e r-V L r, ASSESSOR'S MAP&PARCEL A��- ()7 Q INSTALLER'S NAME&PHONE NO. C,��, Tr yZ SS�� SEPTIC TANK CAPACITY 3 a-Co m . < <c LEACHING FACILITY: (type) .5oo 6g• C Ak(kel 66 (size) /a/DX M kr(c OJ) NO.OF BEDROOMS OWNER c sl A(A PERMITDATE: COMPLIANCE DATE: )9U6- 620/5- 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 toS ci 0 a No. Fee T E COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS ._ ftplitation for Nsposal 6pstrm Construttion i9endit Application for a Permit to Construct OK) Repair( ) Upgrade()o Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. t 5,9 MANkA S j(D5,%_Eev ILcv Owner's Name,Address,and Tel.No. •fig-c{�_�-�� Assessor's Map/Parcel I G / 6-7 9 `�A'( L w i;3 ogs2 Z'2 el(O 1 IM A,ry S i't 1Z 0 Installer's Name,Address,and Tel No. Designer's Name,Andress and Tel.No. SZ�b- Zr334 '$,t�,c�,,,1,lCs'►� �8-YdQ- Sv�1.v,�r�C,�.��►a�c—�2i�.G1�c Type of Building: ,1 Dwelling No.of Bedrooms Lot Size A L%ZES sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.requi-ed) S&O gpd Design flow provided i 0 Z.( gpd Plan Date A?a%L t ck Zb 4 Number of sheets q Revision Date Title Size of Septic Tank "s, oco G,-"-L_0,l'. Type of S.A.S. 12 't Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned)agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this BoarW Health. /a�///f 0, Date OF Application Approved by Date Application Disapproved by Date for the following reasons Permit No. Date Issued 1„k }/( —. h4 � � 1 ! 'SQ^`.�;x`�'i" s$fF `-t.t,?"� � 2 y o. a Fee E COMMONW ALTH OF MASSACHUSETTS f f Entered in computer:' PUBLIC HEALTH,DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Ye plicatlon for lbisposal`.pBte tt Construction jhrmit 1 rEv , Application for a Permit to Construct( Repair( ) Upgrade( i Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot Nor t �9(� � S (Ds��u+t-t.Z, Owner's Name,Address,and Tel.No. �-42e_�-z J#AX ! VJi✓��-714 Assessor's Map/Parcel5 d? 9 , 'n-t E 15'9 wtr+,1vS;-nzQST Installer's Name,Address,and Tel.No. 4 Designer's Name,Address,and Tel.No. . . c,� /ate \G.G��11;} 1� �-" _ r, SU t-L% v"a.\ G..iGiN ILL 1f.<< V,L• :,pr lJ� �' Obi o N,�>-. oN7 L.c_v s Type of Building: Dwelling No.of Bedrooms Lot Size �i a �' -� sq.ft. Garbage Grinder Other Type-of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) `d£�C� gpd Design flow provided \ gpd r , ,.'Plan Date A)';L+t-l q, Z614 ,Number of sheets �\{� Q Revision Date Title Size of Septic Tank � �.+-Ot Type of S.A.S. ' X tO � r Description of Soil O-� �+ �-�. �,` — \\ hoA. .Y S; 1\ — 'L-7 " 5A��7 -Z.> Y C/q "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 BoardHealth. !� Date 'Application Approved by Date w Application Disapproved by Date for the following reasons '4• Permit No. M" Date Issued 1.. N., _ 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 \5,9 i`�1 a+r y J1Qf—r<i C)G�CYI LL E has been cons ted i co d with the provisions of Title 5 and the for Disposal System Construction Permit No. Installer,6 E l u C C (r., f r t'�, c Designer J tt C c"/ t ✓'� #bedrooms Approved design flow /Q'13 J--_ - gpd The issuance of thi t`rrft t shall not b co strued as a guarantee that the system wi fi+ tio as desig ed. Date co ( Inspector ------------ ----- - -- - ------------- -------------------------------------------------------------- ----- _ No, �01 -- -- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS misposal 6psteltt Construction i9ermit Permission is hereby granted to Construct()t) Repair(: ) Upgrade( ) Abandon( ) System located at J'3 9 1��A' rJ 3-r i• 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:Constructi717 �t a comp lte tthin three years of the date of this permit. Date ! Approved b PP Y 'town of Barnstable P# IPepartiment of Regulatory Services : ' =,Public Health Division Date A 206 Main Street,Hyannis MA 02601� lFD IAAt A I Date Scheduled Time'-` :Fee Pd: soil S tabili Assessment or Se e ,s osa a ' f or SoLL Perfmed By: Witnessed By. .}.j.; LOCATI6N;&GENERAL NFORMA TION A _ Location Address +� �� 1' .. 1S9 I'I d t�i1.' �( QSt�gWiL'LG Owner's Name 1 S9 M��v, { I } Address SjUxSoYL5;o,.15-r :. .. Zosro;.t �A A,vzt l(o Assessor's Map/Parc,61: 1 Sl 07 9 Engineer Nameec��;n l NEW CONSTRUCTION I •`'REPAIR' Telephone# Land Use K.�51�:t✓tie It-l`kL { (96 r { , " Slopes ) (L► Surface Stones Distances from Open WaterlBody' to ' ft Possible Wet Area 1 ft Drinking Water Well Dramage Way, I'' ��' _ft'' Property Une:<� 1� ft Other t { } ( , SKETCH:(Street name dimensions of lot ex act locations of test holes&pert tests,locate wetlands{n proximity to holes),.!, � 14 0- T' Rt2�e� r Q� L4C_S1�( (L 7. r o Vp k 1 { 1 I 1 I I i� �� •,,�. -+ Parent material( eola is O'Y` � � ' , �"� g g ) th De Be roc A t�. I, P o Q k De th to Groundwater Standing Water m Hole. Weeping from PIE RR�E , _~14 KI/� " P ig` Estimated Seasonal High Groundwater, Zi-. r f'i, 11 f -• i . DETERMINATION lFOR SEASONAL HIGH WATER-TABLE Method Used `Depth Observed standtrig in obs'hole yla " Depth tU'soll mottles" Depth to weeping from side of obs.hol l In ClroundwatprAdjusttnent ft. Index Well# Reading'D to Index Well level�, Adj.Actor AdJ Groundwater level,, !> i. PIJRCOIaATI0N TEST bute ,;'t'fmn,f .,r. C Observation ; ' g Hole# I K 12'. _ Tune at 4" -7-777 DD1pt�of.Pert fy fir. T1me tttb' l Start Pre-soak Tiime @ 5 I. �'� ±' 4 i ime(9"6") and Pre-soak Rate.Min./Inch s ii 1. 1, t Site Suitability Assessment Site Passed ✓/ �� Site Failed Additional Testing Needed(Y/N) Original: Public Health Division f, Observation Hole Data To Be Completed on Back----- ---- **Ifpercolation test is tobe conducted within 100' of wetland,you must first notify the, Barnstable Conservation.Division at least one(1)week prior to beginning. Q:\SF-PTIC\PERCFORM.DOC DEEP OBSERVATION HOLE LOGHole#' Depth from Soil Ho zo n' Soil Texture Sdil Color Soil. Other Surface(in) (USDA)` (Mansell) Mottling (Structure;Stones;Boulders. ong:ifitency.%Oravel) --(o v rI lL fi Ley 'tt"Aj 4 - 3 t R , i DEEP 611SERVATION HOLE LOG Hole# = Depth from Soil Horizon. Soil Texture Soil Calor Soil- Other Surface(in.) (USDA) (Mansell) ! ; Mottling '(Structure;Stones,Boulders. Consistency.%Gravel) -110 C ; -DEEP O, NERVATION HOLE LOG Hole# Depth from Soil Honzon Soil'Texture Soil Color Soil' Other Surface(in) (USDA) (Munsell) Mottling (Structure,Stones,Boulders' C i toGravel) IA 5 t I ,ik DEEP O SERVATION HOLE LOG Hole# Depth from Soil Honzoa - Soil Texture Soil Color 5011 Other Surface(in.) (USDA) (Munsell) Mottling (Structure,St.0 Boulders: Consistency.% J r r `I I I I t� j• k Flood Insurance Rate Map Above 500 year!flood boundary No Yes Within 500 year boundary No �' Yest ,`� la r_ '� 0- Within l00 year flood boundary No.. I' Yes v�o� Depth i of Natu'rallv Occtirring Pervious Material Does at least four feet of na[drally;occurring per sous material existfin all areas observed throughout the . ,. b h t e soil a so lions stem. area proposed for h , ,rP Y . z i I ial 7. ed depth of nrurallyoccurrin ervious meter �..._.. .�.If not;what is th p g P • Certifiication he oved b t ami n ation a r or ex Y evaluator P'1 eve pp roved the sot e passed .ate I hav e, a 0 d , I certify that on (date) P fY . rfo rmed b me con sistent with was e Department of Envtronmentai Protection and thatthe above analysts performed Y _ the required training,a pertise and experience described in 10 CMR 15.017. Signature . Datey Q-\,SEPTICPERCPORM.DOC l _ I I Town of Barnstable 1"E Regulatory Services Richard V. Scali, Interim Director * BARNSTABLE, 9�A MAn Public Health Division TEc �°i Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 Installer & Designer Certification Form Date: gv�Ll,�.0 LS Sewage Permit# ,20 67 Assessor's Map\Parcel /65- 0'7 q Designer: ��� �,,�� �✓�c��ccr►�1� Installer: hcC_C_aA sl<< Address: `� �R 2[ � Address: LS�e����t�On was was issued a permit to install a (date) (installer) septic system at s? ®sew, /f based on a design drawn by (address) C )CO.- dated LI 1 `( 17-°I`f (designer) 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 referenced above was constructed in compliance with the terms of the I\A approval letters (if applicable) ZH OF1[14 0 JOHN C. tiN (Installer's Signature) U CIVIL ODEA Cn No.48168 9F�/STE c`yQ esigner''s Signature) _ (Affix Designef`s•SUnip 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 --------- Fee---- BOARD OF HEALTH TOWN OF BARNSTABLE 0(ppCication-*rVell Congtructionj3ermit Application is hereby made for a permit to Construct Alter ( ), or Repair ( )an individual Well at: -- --------------------------- --------- Location — Address Assessors Map and Parcel _f�u?e«I� ------------- —-- 1�`t_/k .-_----al ------- -'------ Owner Address '4"X a 6 y Installer — Driller — Address Type of Building Dwelling--------------------------------------------------------- Other - Type of Building------------------------- No. of Persons--------------------- Type of Well— - `-' -----______ ----- Capacity Purpose of Well Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a Certificate.o Compliance has been issued by the Board of Health. ,Signed r b O!o0 �*�"9/, --------------------- ----- ------ date Application Approved By ----- --------- ----- date Application Disapproved for the following reasons:------------------------------------------------ --------- — date Permit No. — -— ----- Issued----- -- - - --- ---- -- ------- date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate ®f Compliance THIS IS TO CERTIFY That the ndividual Well Constructed (-I, Altered ( ), or Repaired ( ) by-------�A-�c a�a.�-��- - ---- -- ---— - -------- Installer at---�S9'. Mai ST` eC- ', l6 "4--k ' has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. ----------------Dated---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE-------- —-- -- Inspector-------—-- -- ------- GS a"7S Noy ----�--- Gl0 Fe = - BOARD OF HEALTH TOWN OF . BARN.STA LE `u `f [ccatlori for eCr`fort truction've it Application is.,hereby'made for a perm tAo Construct (� Alter ( ), or Repair"._(--)art-individual Well at: < � /k a ... o _��L/ /u�, • /`'' >. [ocatlon Address ,: F• �, ,P4.• Assessors Map.and Parcel ✓_`4 —sT— Owner nn / Address Cl e2X �t G O _ ✓ e u ,L tr J� is Installer Driller ( Address Type of-Building Dwelling.----- ---- ------- ------- ------ Other - Type of Building / No'. of Persons--_----- ---------- -=-- YP g----------- 1--, Type.of Well-� Capacity-- -— -- — Purpose of Well---- 'Agreement;. The undersigned agrees,t install the aforedescribed individual well in accordance,with the provisions of'The . Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation.until:a Certificate .o Compliance has been issued by the Board of Health. S ?(fir Oo: Signed - — — --= -= -=- --- -- date r Application Approved-By ' Application Disapproved for the following reasons. date: Permit No. _— Issued-----=-= - - — -- date — — Y.yerT:@isS:T:Ti@:f.!?@i@a@i4.e. .i�:eiTi@.�iriesea@aer:4 w_i!oveaiv:era•seQ.aive»:se@a@iss�ara�reaeaes@aaa�avart�s:esmrrasieaea'asawe�snaT4Ter-ceres�rwa�awa:a@a@rea�a.;:T;,=:=;,sA< BOARD.:OF HEALTH- TOWN OF BA,R.NSTABLE C.ertif irate "N Compliance . • THIS IS.TO CERTIFY, That the Individual Well Constructed ('I, Altered ( or.Repaired by s -- • n taller I S n,+ut S7 c3�Yr » at -� has been installed in accordance with the provisions of the.Town of Barnstable Board of,Health"Private Weil Protection' l Regulation as described in the application for.Well Construction Permit No. -___�_____—�_�Dated—=-- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS-A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION'SATISFACTORY. DATE --- —- — Inspector- ---- - ---- _ �K .l•' � . n 1 •'4�:: H.-s_.: L ms....t,. M 1 1 i:.,,�. 4 •A• ;.�1 i •.. y F t• u,Y. .... + l.r-.iTii.@e eA1o'As!}ii@tl! Ti@:1rT er9a4 4^:@:ied9iRi9ieali!Fi!9i.TGTiTY96Pi@b@ieaei9a@aei@c9r9wrS@ibi@i!4@itaTG@a�'a<a9aTRi9i'9i!iSa.Afi989iRr96Tb@A i a@a@ii!e.b@wAsTi_0..rri9ira6Ts@d*. f BOARD'OF,HEALTH TOWN OF BARNSTA'BLE �Conaruction Permit:E , No. 7icT�U -t/n Fee- -S � .t— -- --- Permission is hereby grantedto Construct ( "T', Alter ( ), or Repair ( ).an Individual Well at: No. Street as shown on the application for a Well Construction Permit (Al p- Z - o zo- No._ Dated--- -- ------------------- - ---------- Board Health DATE — __. �,, �, G � f 5 ` M wiw S� - <,., ��� ���' -, � `Y, � o COMMONWEALTH OF MASSACHUSETTS s ENVIRONMENT � MAW EXECUTIVE OFFICE OF NVIR DEPARTMENT OF ENVIRONMENTAL PR CTIO 1 7 199R ONE WINTER.STREET, BOSTON MA 02108 (617) 292- � 4 A F. � TRUDY CORE WILLIAM £ °t, Secretary Governor ARGEO PAUL CELLUCCI DAVID B. STRUHS A Commissioner Governor (J SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM (NI�"{" t t s PART A CERTIFICATION \ 4 Property Address: ��`� A ttu 5�� �Si2`C�J��� 0�-' J Address of Owner: A� Q�(d, S\'Tk,A . Date of Inspection: (If different) - Name of Inspector: M ic-"wt-\_ I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000) Company Name: r L-- Mailing Address:7.i—i .4_; R�L�D r t— < <` ►� `j2.�cy Telephone Number: 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 training and experience ence in the proper function and maintenance inspection was performed based on my g p P P complete as of the time of inspection. The insp of on-site sewage disposal systems. The system: Passes _ Conditionally Passes j _ Needs Further valuatio th oral Approving Authority Inspector's Signature: Date. t .I'O ci The System Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (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 Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ' INSPECTION SUMMARY: Check A, B, C, or D: A] SYSTEM PASSES: _ I have not found any information which-'indicates the system violates any of the failure criteria as defined in 310 CMR 15.303. Any failure criteria not evaluated are indicated below. , C011EMYMS: 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. Indicate yes, no.or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not. ' The septic tank is metal. unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection. or the septic tank. whether or not metal. is cracked, structurally unsound, shows substantial infiltration or exfiltration. or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank as approved by the Board of Health. (revised 04/25/n. Page 1 of 10 r � f ! 11f y SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A . �.' CERTIFICATION (continued) ,. a Property Address: Owner: ` Date of Inspection: r BI SYSTEM CONDITIONALLY PASSES (continued) _ Sewage backup or breakout or high static water level observed in the distribution box is due to broken or obstructed pipe(s) of due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health) Describe observations: broken pipe(s) are replaced obstruction is removed distribution box is levelled or replaced The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspecti( if(with approval of the Board of Health): broken pipe(s) are replaced obstruction is removed 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 the public health. safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A • MAIrT'ER WHICH "'ILL PROTECT THE PUBLIC HEALTH AND 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 "ILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IF APPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A NIANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet to a surface water supply or tributary to a surface water supply. _ The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. _ The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis 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 ppr, Method used to determine distance (approximation not valid). 3) OTHER (revised 04/2S/97 Page 2 or 10 r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM, PART A - CERTIFICATION (continued) Property Address: Owner: Date of Inspection: D] SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: I have determined that the system violates one or more of the following failure criteria as defined in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be,contacted to determine what will be necessary to correct the failure. Yes No Backup of sewage into facility or system component due to an 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,boz above outlet invert due to.an overloaded or.clogged SAS or cesspool'. Liquid depth in cesspool is less than 6' below invert or available volume is less than 1/2 day flow. — 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 Soil Absorption System, cesspool or privy is below the high groundwater elevation` Any portion of a 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 I 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. If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. El LARGE SYSTEM FAILS: You must indicate either "Yes" or "No" as to each of the following: ' The following criteria apply to large systems'in addition to the criteria above: The system serves a facility with a design now of 10,000 gpd or greater (Large System) and the system.is,a significant threat to public health and safety and the environment because one or more of the following conditions exist: , 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 its located in'a nitrogen sensitive area(Interim Wellhead Protection Area -IWPA) or a trapped Zone II of a public r water supply well) The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for further information. (revised 04/25/97) Page 3 of 10 r - . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property ert Address: t fie) IMal�v`' Owner:S l t F 1L Date of Inspection: Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following: Yes No i in was provided b the owner, occupant, or Board of Health. Pumping P Y P P g — None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rate! during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. — ks btfi t plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. X — The system does not receive non-sanitary or industrial waste flow. — The site was inspected for signs of breakout. — All system components, excluding the Soil Absorption System, have been located on the site. X — The septic tank manholes were uncovered, opened, and the interior of the.septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of.sludge, depth of scum. —The size and location of the Soil Absorption System on the site has been determined based on: The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of Sub Surface Disposal System. IA Existing information. Ex. Plan at B.O.H. — Determined in the field (if any of the failure criteria related to Part C is.at issue, approximation of distance is unacceptable) [15.302(3)(b)] (revised 04/25/n Page 4 of 10 f SUBSURFACE SEWAGE DISPOSAL SYSTEM IIVSPECTION FORM PART C SYSTEM INFORMATION ' Property Address: t S ct IA 1 dv Owner: St Date of Inspection: FLOW CONDITIONS RESIDENTIAL: . Design flow:` b p.d./b droom for S.A.S. y ' Number of bedrooms:_" ` Number of current residents: Garbage grinder (yes or no):�► Laundry connected to system (yes or no): z Seasonal use (yes or no):_t-3 Water meter readings, if available (last two (2) year usage (gpd): 1` Sump Pump (yes or no): , Last date of occupancy: S4;AAA^t_+l'` COMMERCIAL/INDUSTRIAL: r Type of establishment: Design flow: gallons/day Grease trap present: (yes or no)_ Industrial Waste Holding Tank present: (yes or no)_" , Non-sanitary waste discharged to the Title S system: (yes or no)= Water meter readings, if available: Last date of occupancy: ' OTHER: (Describe) Last date of occupancy: - GENERAL INTF'ORMATIOti - PLTN PING RECORDS and source of information: System pumped as part of inspection: (yes or no)--L-b ' If yes, volume pumped: Gallons 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 ; I/A Technology etc. Copy of up to date contract? Other APPROXIMATE'AGE of all components,"date installed(if,known) and source of information: Sewage odors Jdetected when arriving at the site: (yes`or no) .+ r (revised 04125/97) y Page 5 of to s ` F SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: wit,, Owner: S I i r"k A Date of Inspection: `41 `b '4 BUILDING SEWER-" \ (Locate on site plan) V "`j Depth below grade: Material of construction: _cast iron _40 PVC _other (explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints, venting, evidence of leakage, etc.) SEPTIC TANK: (locate on site plan 4 Depth below grade: �D Material of construction: 1�concrete _metal _Fiberglass _,Polyethylene —other(explain) If tank is metal, list age _ Is age confirmed by Certificate of Compliance _(Yes/No) Dimensions: w 0 r,10 Sludge depth: v it Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness:_ k Distance from top of scum to top of outlet tee or baffle: Vz << Distance from bottom of scum to bottom of outlet tee or baffle: l`fi How dimensions were determined: fV#-c 4AAA ix Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles. de tth ofli Vid level in relation to ou et invert, s ruc ural int city, idence o leakag etc.) V�►'\ ^� eveCQ GREASE TRAP: (locate on site plan) Depth below grade: Material of construction: concrete _metal _Fiberglass _Polyethylene —other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity. evidence of leakage, etc.) (raised 042V97) Page 6 of 10 SUBSURFACE SEWAGEDISPOSAL SY STEM,INSPECTION:FORM PART,C SYSTEM INFORMATION (continued) k 4 4' ' Property Address: S°► (M(At W Owner: s'1�F 1►� y _¢ rt' '... ` Date of Inspection: ((1j 'S TIGHT OR HOLDING TANK:. (TanVmust be pumped`prior to,or at time, ofAnspection) r °, (locate on site plan) Depth below grade: .. Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain),' , w Dimensions: ` gallons Capacity: �+ Design flow: gallons/day ,d Alarm level:' Alarm in working order ".Yes �No '' u F Date of previous pumping: Comments: (condition of inlet tee, condition'of alarm and float switches etc.) h " ., a .ham- ..... tISTRIBUTIWBOX:V3 (locate on site plan) ' • 3 r s.� Depth of liquid level above outlet invert: 0 ' Comments: (note if level and distribution is ual, evidence of solids carryover evidence of leakage i to or out of boz, etc) 1!Z Oi! PUMP CHAMBER: _ t (locate on site plan) X,o, x' ..�,x. Pumps in working order: (Yes or No) 5 t Alarms in working order (Yes or No) (note condition of pump chamber;'condition of pumps and appurtenances, etc.) - : V JV v. a ^g, s , r Page 7 of 10 " V SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: Date of Inspection: 1� a C;' SOIL ABSORPTION SYSTEM (SAS): ,� t (locate on site plan, if possible; excavation of required, but may be approximated by non-intrusive methods) If not determined to be present, explain: Type: leaching pits, number:JIGX leaching chambers, number: leaching galleries; number: leaching trenches: number,length: leaching fields, number, dimensions: overflow cesspool. number: Alternative system: Name of Technology: Comments: ( ote condition of oil. signs of hydraulic failure, level of ponding, conditio f ve tion, etc.) JJ p tYr�iA l�rAX CESSPOOLS:... (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 (cesspool must be pumped as part of inspection) 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.) (revised 04/25/47) Page 8 of to �r SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: Owner: S tk'r�L 6 Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks ry locate all wells within 100' (Locate where public water supply comes into house) a . 2 k: y t .114t g Y e (revised 04/2s/97) Page 9 of 10 r.• r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 9'1 I Kj Owner: 5k t FK k Date of Inspection: t Zi Depth to Groundwater}3S Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observation of Site (Abutting property, observation hole, basement sump etc.) Determine it from local conditions Check with local Board of health Check FEMA Maps Check pumping records Check local excavators. installers Use USGS Data Describe in your own words how you established the High Groundwater Elevation. Must be completed) 4 (To -- "Pt (revised 04/25/97) Page 10 of 10 N z IG� �- o Ls n' . B o' Q O rJ d 0 f i w Q TOWN OF BARNSTABLE a LOCATION l l4�'� :. �� SEWAGE # - VILLAGE 0S+Cr u ASSESSOR'S MAP & LOT C�) M INSTALLER'S NAME&PHONE NO. ICI c d C-ne. LCP+ie 778- 06aq SEPTIC TANK CAPACITY - - - --- LEACHING FACILITY C1 Hi Cap�,c;h In (size) (type) NO.OF BEDROOMS BUILDER OR OWNER j PERMITDATE: .COMPLIANCE DATE: ?it - a Separation Distance Between the:. ?: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist s 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) y Feet Furnished by TOWN OF BARNSTABLE ✓ �r!CA T IC N 5 ( SEWAGE # VTLLAGEf` iP ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACTIY I noo 15 pA LEACHING FACILITY: (type) D[ (size) NO.OF BEDROOMS 1?Ov C Ry7 5< BUILDER OR OWNER f-I! Ik PERMIT DATE: < l Co COMPLIANCE DATE: Separation Distance Between the: t Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility . 3 S Feet Private Water Supply Well and Leaching Facility (If any wells exist Nr� 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 SU WeL�� '3 o •\V� _ � 3 Ark- 10 bt P Az, 0, A� f�3- t 63_ ado TOWN OF BARNSTABLE LOC;ATION, r SEWAGE VI LAGE 0,*r u+llC ASSESSOR'S MAP & LOT 0 - INSTALLER'S NAME&PHONE NO. 1' M CC ca0C SCO"1�. 778 0_4sI SEPTIC TANK CAPACITY i / LEACHING FACILITY: (type) —�j I"H% ' Cawci!lllnF��fP46 (size) II X 540 x a NO.OF BEDROOMS. BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by u e ' IOc 0 . o 0 ° o CO i �O �VCae.p� �96���i1p1 CY1 L0CA-T, ION SEWAGE PERMIT NO. w'�' s GI M�,� Ste' ___-_-- �� -23 TF L. A G ASSESSORS MAP Na � ��- � PARCEL NO• n-7 1 H S T A LLER'SINA F4 E ADDRESS U I L D E R OR OWNER ti Et A T E P E R Ti T I S S Ia E D DAT E COMPLIANCE 15SUE ® Le v Gv•+clz go.c���.�°C. Q C�e SS(�scl-S i'` �? P-► Gar►• No. v, Fee—�� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2ppritation for ni-4pozal 60tem Congtruction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) 'Complete System ❑Individual Components Location Address or Lot Nc. G!/,A-- Owner's Name,Address and Tel.No. Assessor's Map/Parcel S 71 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. -C E4P SC Type of Building: Dwelling No.of Bedrooms 7 _ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow C) gallons per day. Calculated daily flow —7 gallons. Plan Date Number of sheets Revision Date Title L_ Size of Septic Tank 1 '5 Q® 31T. Type of S.A.S. CC, PC t I- ::r"— Description'of Soil &Vea -!!�i 14"4 Nature of Repairs o Alterations(Answer when applicable) 'J�6V s� c -4 cl J L e.3 Gt/ /!.Date last 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 tal Code not to place the system in operation until a Certifi- cate of Compliance has be e y t is oar a It . Signed Date Application Approved by Date Application Disapproved for the following reason Permit No. Date Issued No. a Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS t Ipplicatton for Migonl *potem Comatruction Vermtt Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) 'Complete System O Individual Components Location Address or Lot No.,/ S9 la Gi I A-, $T Owner's Name,Address and Tel.No. Assessor's Map/Parcel r L t Cam, Installer's Name, ame,Address, and Tel.No. Designer's Name,Address and Tel.No. as 7A-K T(- Type of Building: Dwelling No, of Bedrooms Lot Size sq:ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ^� Design Flow � 9 U gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1 S O o 5 T. Type of S.A.S. kA a V, cc, PC i T Description of Soil Nature of Repairs o Alterations(Answer when a plicable) , l4 c, C' T 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 al Code not to place the system in operation until a Certifi- cate of Compliance has be ue by Iris oar ealt . Signed Date Application Approved by Date Application-Disapproved for the following reason Permit No, Date Issued 1j ———————————————————————----- THE COMMONWEALTH OF MASSACHUSETTS__�"o BARNSTABLE, MASSACHUSETTS -- - Certfficate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded(x) Abandoned( )by H ID C at I tv 1 s e constructed in accordance with the prod ions .f Title 5 ano the for Disposal System Construction Permit No. dated Installer : - Designer The issuance of this permit shall rn,�ot be construed as a guarantee that the system will function as designed. Date !a- 23- / 9 Inspector Q. — —�------------------------------- No. + Fee, THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS =t5pool *potem Construction Vermtt Permission is hereby granted to Construct )Repair )U gra )Abandon( ) System located at sand as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/jber duty to comply with Title 5 and the following local provisions or special conditions. Provided:Cons t ction ust b ompleted within three years of the date of thi e C Date: Approved by I 16/9/97 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only: CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT ENGINEERED PLANS) T 1 e > , hereby certify that the application for disposal works construction permit signed by me dated concerning the property located at L52 c.7 ,/1 W s f 0S7a"i !E meets all of the following criteria: "• There are no wetlands located within 100 feet of the proposed leaching facility V• There are no private wells within 150 feet of the proposed septic system ,/• There is no increase in flow and/or change in use proposed There are no variances requested or needed. s �If the proposed leaching facility will be located within 250 feet of any wetlands,the bottom of the proposed leaching facility will=be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation. Please complete the following: A)Top of Ground Elevation(according to the Engineering Division G.I.S. map) _ B)Observed Groundwater Table Elevation(according to Health Division well map) SIGNED : DATE: LICENSED SEPTIC SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE NUMBER [Attach a sketch plan of the proposed system.Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. r aq:health folder:cerh I q.::Y,c7M CDCd 31G A' 1 r0H 5 E VV A +6 L PE RMIS NO. ASSESSORS MAP NO: � c� 5'Z r v c.l PARCEL NO.: �? 6C T AT A LL/ER'S NA M E A ADDRESS \-� G rX -a✓ �o �,c v�� i O U I L D F R 0R OWNER " AKA �. S A-OA� OAi E PERMIT ISSUED DATE C 0 M F L I A N C I I S 5 U ID i r i oao 5?-%\c 1%gyv ►"�`'�STD i�e,)r � �� I, tea, No........... ....._....... Fps..... THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ..................OF......................................-----------------.................... Ej Appliration for Dhip ial Works Tonstrur#'tun Vamit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Location. r dress rL N o ......... .. .. .....F : . _ .........•... ....................................................... Address� . ... . n .............O �-:._. _ $4 Installer Address d Type of Building Size Lot.................... .....Sq. feet U Dwelling—No. of Bedrooms.__.... .G'. `t--------__-...Expansion Attic ( ) Garbage Grinder ( ) p`4 Other—Type of Building `1 1_._ c1+f` No. of persons............................ Showers ( ) — Cafeteria ( ) G4 Other fi es -------------------------------- - xt W Design Flow........... 3.0 ................... per person per day. Total daily flow............ ._�_Q....................gallons. Ix Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ W Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ (T4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 •-••--------••--•-------••----•---......•---------------•---------------•----•--••--""""--'''............................................................ 0 Description of Soil........................................................................................................................................................................ x U W -----•--•------ ---------------------------------------- •-•--------- •-•--•-•-••--------------•----••------••------ ------------••-•••......•.._....._ UNature of Repairs or Alterations—Answer when applicable......�►_.�r .___ __..... �. ....... 9 '.. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iITL% 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Complia the r�. Signed...... "3- ..... •. ..--- •--•- ----------- ------ _.... f� te 1yApplication Approved ..� . ..t—..................•---------•------- .......... -a-----�---�--•----"--•- Date Application Disapproved for the following reasons:............................................................................................................. --•-•....-•----------'--••-•---•--'•---•----•---•----•-------------------------------•-..................-----•-•'-••-•'•--•-----------------•----------------------------••----•••-•--••------••....--- Date PermitNo......_..-!z�-;: r-f----- ---------•---• Issued....................................................... Dau L- - -- - - -- -- ------ �. --- ------ - - - ---- - Grp; 40cw't_ - -' - ....... F�a. ......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF '.HEALTH ..................... .................._OF....................................I.................................................... Application for Dhipasal Works Tonstrurtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: , 66 ? ............ � ...................• ------..... F S ....... -.`.... .................................................... Locatioa'.�lid ss � or Lot No. ` ....... Ka . . •---•................ ---...........� .......... . ^ 7-4 KII .---•-- ................ ... ................................ .._ .................••Installer Address Type of Building Size Lot............................Sq. feet - "".. .Ex Garbage Expansion Attic Grinder.., Dwelling—No. o: Bedrooms_____________ ___ _ ._.__.____.. p ( ) g ( ) Other—Type of Building ` ._. .. .`. o. of persons............................ Showers ( ) — Cafeteria ( ) C4 Other fig. es .-------•--•-•-•-•---------•-•-. . W Design Flow............5 ........................gallons per person per day. Total daily flow.............-_1?....................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......................... ............. r Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water.....-.-................ a ....*-•-------------- 0 Description of Soil.........................................................-----...------------•---------•---••------•-•-------------...---••----..........-••-•-•-•--------•--...__---•• x ------------------------------ -----•---------------------------•---•-------------------•----.......----•-......--- U Nature of Repairs or Alterations—Answer when applicable...__.N_�P�___.`N'�`'`' `~....:. �ti s'z- ? ------------ -ice p - 1 ` -!;-"`- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL E k,5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate pf Complianr7fica'S"` b fr'issne the b rd h It _ �� . �_. . Signed----- -................--...rr................................................ .......................... ---- Application Approved By..."."..... ... ._........... •... --- --- --------- Date Application Disapproved for the following reasons:--------•-----••-•--•---.......--•-----•----•----------•------------------------•---.....--••--•--•---•--•--••- ...........................•-----••-•--•-----•--._...---••--•----•---------•---•------••-...-•------.....-----•---------------•------•-•----•--••------------•-•-•--•••---•-•--•----••--•-•----•••-••--- Permit No....._.. �... .............. 1'... ._._. Issued--------------------•••-•-•---••.............at<------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD' OF HEALTH .. ....... ........... (Irrtif iraft of (romp atta ,. THE 0 CERTIFY, That the I l ewaND' osal System constructed ( ) or Repaired ( ) by;- ........ :t.......... C. •--- .................•..........---•----•---•----•--................--•--...-•---------•-- Installer j at.................... �` ---••--•--•. ------ _-•------•- 5 c:.'.lr.+.i..-• ;...........................•............................... has been installed in accordance with the provisions of TIT F of The,,State Sanitary Code as described in the application for Disposa! Works Construction Permit No........................_ .°':_.._ `. ...... dated-------- �_.�.=1 y.. _._.._.____. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE.............................{..�..,-: .................................. Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOAF Q,9F HEALTH vv ....OF...... ..sc�vt�- � .tc ra •. No��..^�.......��.... FEE........................ 14s.rrr _3M_p r�S inn n �erMit Permission is hereby granted.......... ......... .' .......... ........ to Construct ( ) or Repair r'mn Individual Sewage Disposal System :: .: 1` f .. �4� Street t.rcicf - �. as shown on the application for Disposal Works Construction Permit No.. ............. Dated... �r����G? " ........................................................ � -----.............................................. Board of Health DATE......- .....=' = ` � FORM 1255 A. M- S L "N, INC., BOSTON LftEO �l.`� KP 4 LL- _ �o0� f � ci ask 40 % Ar o oco r p L-1,c 3` S�oti�tG U SroNF G�`� THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................:... ----...............OF.......................................................................................... ApplirFation fnr DhipmFa1 Works Tonotrnrtiun Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Location-Address or Lot No. .. lc. ........ ..It . K ..................... .....�' GA......... qct s"-.._Sett--• .._...--....•------ lZner ^ Address ,i/_.. _�. - �� a ��ilt,%. !c. ��: A............................ Installer Address d Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms............................. .....Expansion Attic ( ) Garbage Grinder ( )►� Other—Type T e of Building No. of ersons____________________________ Showers a yP g --------•----•----•--------• P ( ) — Cafeteria ( ) 04 Other firs -•--------•--•-_-•--- W Design Flow............. .0>....................gallons per person per day. Total daily flow--------Le_(.9....................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No_____________________ Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet_................. Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I________________minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ a' .......................... _______________•_•_....___..........____........ ...._..._------•--.......................................................-- 0 Description of Soil..................................................................................................................................................I ---•--------------------------------------------•-----------------------------...-------•-------------------------------------------------------------------------•--- U Nature of Repairs or Alterations—Answer when applicable__._._P A`Q_______ 6-_0�_�_. _____.. _________ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System,in accordance with the provisions of LITL% 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certificate of Complia een the . ar Signed---------- -------•--••_..... .. ............ ............................ --- Date Application Approved By.............. - -- ----- ...: ....... --• ....•--••------•--•-•--_.... ......... -5 4 --- Date Application Disapproved for the of owing*reasons:-------------••--•--------------.._..-------•----------------••-•---------------------------------..........---- -----•-•-•....................••--•------•---•--•----•---•---•---•--••--•--•-----•-•-•-----•----...--•--------•----•---.....----••--------..._.....------------•---..-.--------•------------------------ Date PermitNo........................................................ Issued........................................................ Date No. :......y 7 Fsa ~^. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................_OF....................-.......................................... , rfiration or Diipoiitti Works Tonotrur#inn "ermit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: Location-A dress .. or Lot No ....................... r Address a ....__ :. - .�`.±. �' . .! -•--•...... .. .. .. .... 5.....P .A ............................. Installer Address UType of Building +�_ Size Lot............................Sq. feet I—I Dwelling—No. of Bedrooms.._to...............:....................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building� YP g ---------------•------------ No. of persons............................ Showers ( ) — Cafeteria ( ) dOther fi~xtu s .._---•-•......-•-----•••--...... •---•------.•-------•••---------•••-......-- Design Flow........... k.._---•-------------gallons per person per day. Total daily flow_._.....(_.W.0-•-•-----•--..----- gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width...................: Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by............................... l.. ......................... Date.................................... .. Test Pit No. 1................minutes per inch Depth of Testf Pit.................... Depth to ground water........................ P� Test Pit No. 2................minutes per inch Depth of Test"Pit... Depth to ground water........................ P4 •------------------------------------------ ---------------------------------- .---------------------- ---------- •-------- ---•-------------- •--- •............... Descriptionof Soil..........................................................----•---•--------•--------------------•..:--------------•••------...........------.....--------.........•-•--- xo •••-------•------•••-----•-••...._..--•---••-•-•-•--------•-•--••--•----------------------••--••.....---•-•--•-•--------•--••----••••-•---•••-...---..._....-•-------•--....•--.......--••••----•---- 11 q3. .................................................................................................. �g ture of Repairs or Alterations—Answer when applicable ..... .`� ... .#- `._ ?*�:N'±.-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—.The undersigned further agrees not to place the system in operation until a Certi icate of ComplianRe•4 "" ee6"n ss"s�red the, ar health— Signed. l ?� • --•-------•......--•- Date Application Approved By............... •. ....... . --- ........................ )Le Date Application Disapproved for the of wing reasons:-----•------ ----------------................................................................................ ......................................-..................................................................................................................----------•-----•-•--•-----•---•••--••--•-•--• Date PermitNo................................................... .._ Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 77. (9rrtif irate of Tome ianrr THIS E IFY, ThatLhe idgal Sewage Disposal System constructed ( ) or Repaired ( ) ..�b -....._....=:_.. ........." -------.......................... Installer at. ........tz� !— `......--V!"\C!l r M "� ' �1"C ✓�r b . ......... 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.... -i9.............. dated__.i.:_:._.<_ _:....._....___PP P T ,�1 - �G' THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILLi FUNCTION SATISFACTORY. DATE.... .............•--••-•-••----...-•-•- - •-•---------------- Inspector .......................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH S- q•� ....""" 't .........OF....... { �!' ?�`4 . No........................ FEE. �. � �io�o,� . orko trnrtiun ��ermit Permission is herebyranted-- r. � .+: c� .w'�.S.---•--•............................... g p ........-- to Construct ( or Repair ( ) an Individual Sewage Disposal Syy(Stern at No.......... tn: vtr T 'i r w t,r a t. ^e \A/'� VA! ' .• T. ... ...... ._ _...•--- ----- ............................................. Street PP P Dated..---- ' as shown on the a lication for Disposal Works Construction Permit No, -••-•---•--••--••-----••.......... ...... •-•-- . -- E�. .... ealth DATE 0 e ►Q ` ` --••-------- FORM 1255 A. M. SULKIN, INC., BOSTON a 1 Coniferous Tree Lawn J/ Cedor "0 Holly —30 Beech ('b (D N R-37.0' N A- CD R-371. Lawn I D!i. PROPOSED DRI VEWA Y 0 Lawn -G SEPTIC A K own 0 'C� CBIDH MNI e Fr)d OI IL TBA,( E1=42.5'NGVWV "29 TIVL IL to oil CB �4 ID IL IL it IL IL IL IL" IL 'L 'A I 'A IL IL 'L A IL IL IL it IL I IL 771, C) * Cogolet IL , e AprL*n I IL IAL VL IAL IL io IL �6 IL IL IL IL -A IL A PROPOSED # 759 IL VEN * 'DIL , Y. % ,L A 'A IL IL Y. 'A IL IL IL DWELLING 2 S ty WIF IL IL IL A I'L 'A IL % % I % Dwelling *A IAL VAL Y. IL 'A X5 F. EL. 41.0 L % % IL "L , 112 IL Y. IL 'IL, 200 IL * , IL IL 'A IL IL Z.- IL IL IL IL IL 7L BANK IL IL 'A .,L 'L 40 IL"IL IL r-7U -------n 1%, IL IL 'L I'L, , �L/IL 4VHANCEMENT IL,iL, >t TI % I % , .,� AREA ,L 1"I IL ___j L- -------- L IL VL Y- In 4, I P—Stone Wks IL % '.*y- " \,\ 325 S.F. hed' r---------- - !-JL IL VLA IL A.J I .!� '\T1 A IL I'A IL VL! -4- L 'LIL 'L IQ -8x2 \, � 11 I& IL S IL IL 'L L-------- IL 0 L IL L VL 11 38 IL IL VL IL 7L IL 11 Wn Lawn IL IL CW IL Top of Coastal Bonk 'L I* 'L'L IL 'L 1, 1 IL IL PROVIDE WORK 'L LIMI T7 a 1/4" 5'-8 3/4" 5HOWER 10 i i 5EAT GRILLE 0 5EAT CUB. CUB. —— KITCHEN --- --- o u� _ � e GHNG./ THERMA-TRU HALF BATH 5MOOTHSTAR 5220 TV (2-8 X (5-8) UP 5 I/2" R.O.: 2-10 1/2 X 6—II 6'—O I/2" 10'-3 I/4" ' W.G. SHINGLED COLUMN: &X6 P05T W/ 2X BLOCKING IN51DE FACE5 $ 1/2" PLYWD. WRAP M 1/4" X q 1/4" ROUGH 5TUD DIM.; II 5/4" X 11 5/4" SHINGLED DIM.) i ly ---------------------- LU } m Q� CVry gT lf1- xx mx �mm I AA um (A Z :Z 1L Qcx� zti q 1/4" 7'-8 5/4" A A i SALTWATER ESTUARIES PROTECTION DISTRICT ASSESSORS REF.: See Article XV Section 360-45 of Barnstable Code Map 165 � w Parcel 079 SEPTIC NOTES 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours DESIGN DATA Prior to Any Excavation For This Project the Contractor Shall Make Existing Single Family the Required Notification to Dig Safe(1-888-344-7233). Approved Flow 8 Bedrooms 2.The Contractor is Required to Secure Appropriate Permits From Town 47x3 x r Agencies For Construction Defined by This Plan. Proposed Single Family Required 3.Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shall 14 Rooms-7 Bedroom Design eq •red Be Constructed of Class 150 Pressure Pipe and Shall be Water Tested to Designed for 8 Bedrooms per Room Labels t Assure Watertightness. In General,Water Lines Shall be Constructed in No Garbage Grinder ~� - Coordination With COMM Water,and Shall be in Accordance Total Daily Flow=880 GPD Street(40' Wide - Public Layout) ! •} �.r With 248 CMR 1.00-7.00&310 CMR 15.00. Use a 3000 Gal 2 Compartment Septic Tank ain 4.A Minimum of 9"of Cover is Required for All Components. (Multiple Kitchen Areas) 5.All Structures Buried Three Feet or More or Subject 47x' _ 47x1 47x3 + . to Vehicular Traffic to be H-20 Loading.It is the Engineer's __. �. -- ._. ---`a="H.... ...._..f 7 _ 47x7 Recommendation that H-20 Always be Used. LEACHING AREA W_ N _ - - . _ •• .�• 6.Install Watertight Risers and Covers to Within 6"of Finished Grade 880 GPD/0.74(LTAR)=1190 SF Required �H 9 79 Within Landscaped Areas,or to Grade Within Driveway Over Septic Finish Grade -- - , Pe Y eP Sidewall=2 X 2(12'-10"+38')X2'=406 SF .._ '104.49 • Tank Inlets,Compartment Walls,and Outlets,D-Boxs,and 1 Leaching Bottom Area-2 X(12'-10"x 38')=974 SF _ _ /- _ / 25.3D •• .10 Chamber Per System. 3' Max. Y. Compacted Fill Fabric .� .!/ •• _. _ \RiS vi: '.\ .•+ Y 1380 SF Total Provided 9" Min / 7.Septic System to be Installed in Accordance With 310 CMR 15.00& 248 CMR 1.00 7.00 Latest Revision and the Town of Barnstable th Regulations. LEACHING CHAMBER DESIGN And/Or r / -All \ 8.All Piping oBoard of �be Sch 40 PVC. 8 Concrete Chames to be cbersume2 0. Use " 1 Pea Stone " � 9.The Septic Tank Shall Have 2 Compartments. \ \ IT-10"x 38 Double Washed Stone Fields as Shown. 3/4 - 1 1/2 The First Compartment Shall Have a Volume of Not Less Than LEACHING Double Washed 1,760 Gallons and the Second of Not Less than 880 Gallons. CHAMBER Stone �- �� _ - , Locus Map I The Compartments Shall be Interconnected by a Minimum 4"0 __- = -ti- _ ___ _ _ Vented Inverted U-Shaped Pipe. 4' - 10 -; / - - -- -7. - Scale: 1"=2,000±' 10.D-Box Shall Have a Minimum Inside Dimension of 12",and a Minimum O Sump of 6„ ,- 12' - 10" X °\ 11.The Separation Distance Between the Septic Tank Inlets and Outlets Shall be No Less than the Liquid Depth.Inlet Tees Shall Extend CROSS SECTION OF CHAMBER '` ` ZONE: RF-1 a Minimum of I O"Below the Flo, 'Ane.Outlet Tees Shall Extend 14" and Shall be Equipped With a Gas Baffle. ' /` ° `• 12.Installer to Confirm Inverts Prior to Any Work. NOT TO SCALE Area (min.) 87,120 SF (RPOD) Fronto Width e (min) 20in) 725(m Vent - Provide Charcoal Filter ' Final Location to be Determined at , Setbacks: Time of Installation so as to be as I Front 30' Inconspicuous as Possible 41 j° � Side 15' Rear 15' See Note 6 (typ.) Provide ° F.F. EL. 41.00 Clean out � ' � FLOOD ZONE: F.G. EL. 39.5 Flow Equilizers F.G. EL. 41.25 Max. EL. 38.00 Min. /• i I Zone C & A 13 (el 12) •` �. '. � r As Required _ - Community Panel No. EL. 38.50 (EAST WING EL 3000 Gallon I' #250001 0016D EL. 36.89 (WEST WING H-20 g0FF11 Too EL. 35.25 f- 30' i, ' Jul 2, 1992 EL. 38.25 (CABANA) 2 Comportment EL• H-20 To Breakout vi y Installer to Confirm Septic Tank D-Box 4.55 Elevation 4riC.^ tC work /err "1�TE n� _ 1 [✓ � I _� , H-20 EL. 34.25 Leaching rr j To 8e Installed On Chamber as a ose _ 5 ! REFERENCES: 10' Min. Bedding,"T"s, ' LC Plan 19921 A Distance Varies Inspection Port, If Encountered Remove & Replace �, J I See Plan View & Baffels All Unsuitable Solis Within 5' of as Per Title 5 The Outer Perimeter of The System N { , DEVELOPED PROFILE OF SYSTEM No Groundwater OVERLAY DISTRICT: Per Test Hole 1 I NOT TO SCALE EL, 18 . AP - Aquifer Protection District o roun wa er -o; i Per Test Hole 5 PERC TEST: 14,375 PERFORMED BY:JOHN O'DEA,P.E.-SULLIVAN ENGINEERING SOIL EVALUATOR NO.291 t i WITNESSED BY:DONNA MIORANDI,RS-TOWN OF BARNSTABLE , MAY 30.2014 TEST HOLE- 1 TEST HOLE-2 TEST HOLE-3 TEST HOLE-4 TEST HOLE-5 + ' Legend: EL.41.6 EL-41.6 EL.41.6 EL.41.6 UNWITNESSED EL.23.0 0 0 FILL FILL FILL FILL FILL ° o " Light Post a1.1 " a1.1 " a1.1 a.1 2 .5 B LAYER IOYR4l4_ _ B LAYER.IOYR414 B LAYER I OYR 4/4. B LAYER 10YR4/4 B LAYER 10YR4/4 ❑!cv Irrigation Control Valve DARK YELLOWISH BROWN DARK YELLOWISH.BROWN DARK YELLOWISH BROWN DARK YELLOWISH BROWN DARK YELLOWISH BROWN Column w/Ligh t LOAMY SAND 7 LOAMY SAND 8 LOAMY SAND 4 LOAMY SAND 40 2 LOAMY'AhID I8.0 , i j I CI LAYER2.SY6/4 CI LAYER 2.SY6/4 Cl LAYER 2.5Y6/4 CI LAYER 2.5Y6/4 NO GROUNDWATER ENCOUN PED { j I ' ° { { ( ( '� I 0 Water Gate (round) LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN MEDIUM SAND-FEW FINES MEDIUM SAND-FEW FINES MEDIUM SAND-FEW FINES MEDIUM SAND-FEW FINES I o 1 I ® Drain 24" PERC TEST 39.6 30" PERC TEST 39.1 MN mO mall 25 GALLONS GONE IN 13 MIN. 25 GALLONS GONE IN 12 MIN. ( g ) 87" 34.4 PERC RATE<2 MINAN TAR-0.74 ( + 34.7 34.9 PERC RATE<2 MIN/IN TAR-0.74 9 C2 LAYER 2.5Y 6/3 C2 LAYER 2.5Y 613 C2 LAYER 2.5Y W 0 LAYER 2.5Y&3 CB/OH LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN �' '+., ti ' � � , i O Vent Pipe MEDIUM SAND MEDIUM SAND MEDIUM SAND MEDIUM SAND 132 30.6 t2 " 316 1 0" 31.6 120" 31.6 O Electric Manhole K-) ® Water Manhole SITE PASSED W & Hose Bib ; v } p - -25- - Elevation Contour 0 S - Utility Lines (underground) Parcel Area I I 'I !.° i ,� -- -- -- - Setback Lines 140,350fSF 3.22±Ae (To 'BA'N{ ) I 30'min Front 15min Side ,\ \\\�\ \\ TH- Kai Pond 4 Acf (TOTAL PER ASSESSORS). i " Deciduous Tree x Concrete Lined / Id \ \ W/Stone / Surround { Coniferous Tree Lawn V1 U1 Cedar Q I PRO OWED a �� ,� _ -- / o Holly v) T - EL �' `\, _ -30-- Beech ZE nm - -..... .% , CD rp t N rj C] R-37.0 st'' _ Lawn O eh �-L. TH G ° \ \ R-3Z4' _... O If QL CL 1 PRC POS D o �,` io N. 1 10 �BO ° PROOPdSED y I -' DRIVEWAY ; 2 MI 12 10' ° MIN. \ P -- -- -- Lown ca SEPTIC A K awn - t PROP _ vent - -- -- -- - ,-- - I -- -- - -- -- -- DR1 � � - 1 O 1 a SLAB tF1 7'lay PROW YWELL E n 1 FOR P L D WDOWN, i iwO 1 Fnd �**x i rt AND OOF, ATIO, & _: _ _- __- i * e TBM Ef=42.5 NGVD 29 * * DRI V WAY RU Ffs�yT*p * * x * ° to of ce °" * * ! IL Tennis & Poo! EXIS SE TI i * * * * * x + Cabana CTO B RM ' * * * * * * * I \ * * to Lawn I * * * r * * sp I I * *Co¢cte Alor2fn * * * -' * *a 1 ROSE - * * - * i CABANA IL OP ------- / * % * * *� * x * * \ q - IL F NO TE 12 IL * Con° TYPICAL i i **C it €' �d T : % * ;Y Lee * ' 4i - - - O PROPOSED # 159 Fnd f * x7 _ O DWELLING 2 Sty W/F / X*� {* �' '� , ,* I*� * * * \ , * * * I 357 Dwellin _� * IL IL * * Y)'sit * - .F. EL. 41.0 9 , * * * * * *y�' '*, * * * * ! Pool - ° 112xs 200' m� - -=�^I * x * * x * * i4aw * * * I�+� */ ''r; r \\ * * , PROPOSED -- =-- ---- I * * * * * * * * * * *, \ ,� BANK * * ' POOL n * * * * * * a * . * * Lawn ---- ," lE� ------- * * * * * * * * * *�%* ' * r * �NHANCEMENT * * ONE FILTRAT N * ;~ �x; AREA *P$ I* OR PROVED EQL. --� ---- L� * % % x * % * * *; x * \ + 325 S.F. P-Stone Walks * * * * ;* * l,gd1 * 10 * `} - r' %-I* * * % * * :l * \ 'j• j I t * *I IL * * "" * * x1* r n 38x2 I I - * S * * x % Sculpture �'' I u-------- * * ; O S ' Base _ . . * * Yf •v eth o w foci `w - 3ak� LJ------- IL O * x ILI' �`I Lown 38 IL * IL * * * 'A * * * IL - �'/ Lown * * IL ��v� % IL Top of Coastal Bank ,L * *� * IL * * PROVIDE WORK LIMIT x A1E�A * * 80.E S fflrber 5eP o• 3B ALFS W SILT FE CING * Y.* * * Y. Lo�v tone WoNs + � ,* � .*� •.x x � - � ....,- _ �_._ _ _... _ _ _ _a- - •., _ - - Panel t TIO See 250001 0016 f. .. ..... ... .. _._ .. rev. J 1992 - . -- July - a• - -- _ Cone * � ��y�"�r" -,a '.._.. (✓ %. �_ ... -• ..._ .. _ � _ .. _ •--,•..... _ '� .• c v.... iL • 1.5�\1 _. *r _ y W/ w x. x.*.,. - - ter'' / Boathouse :.. - _. 15 W/Deck Above * * .. .* - , ": �.. _ _ _.. _. _ -- _ - :: _. : _. Oo_ - _ - t - SiOb _10 m Cone EXISTING TREES A Bottom of Bank TO BE REMOVED �- 5 v 4' WIDE EROSION SCARP TO BE REPLANTED 188 S.F.__ �- -- - _ DIRECTIONS: %� 11 From Hyannis -Follow Main Street to the Mean High Water West End Rotary; Take Scudder Avenue PSM As Shown On to stop sign, and then take a right onto LCC Plan 19927A Smith Street, which turns into Crai ville W-,V33 ' Beach Road; At the stop light turn left L l�e R►veronto Main Street, which turns into South CenterviMain Street; Site is on the left, #159. TITLE: Site Plan PREPARED BY.• PREPARED FOR: NOTES: Proposed Improvements 1.) The property line information shown was p p Sullivan Engineering, Inc. CapeSury compiled from available record information. (Septic & Utilities) PO Box 659 7 Parker Road Jay L. Webber, Tr. 2.) The topographic information was obtained � At Osterville, MA 02655 Osterville MA 02655 from{� �/ (] -� (508)428-3344 (508)428-9617 fox (508) 420-3994 (508) 420-3995 fox The / 59 Main Street} Trust w On the ground survey performed On or between 06/FE8/14 and 05/MAR/14. A 159 Main Street copesurv@copecod.net _N 3.) The datum used is NGVD '29, a fixed mean O Barnstable (Osterville) Mass. sea level datum. BM used "M28QT Draft: JOD Field: WHK/MJD/RRL/JVB 20 0 10 20 40 80 -Q [7AE: SCALE: Review: PS Comp./Review: RRL April 14, 2014 1 "=20' Project: 34003 Project: C82892 TOP OF FOUNDATION 241diameter concrete covers O5TERV1 LLE, EL=38.5 raised to wrthm 6"of Anr5h grade 4"PVC VENT MA (or as noted) lnspection Port and cap with magnetic CAP BY"5WEETAIR" FORTY FOUR(44)ADS ARC30HC (30 I G5D2) marking tape to wrthrn 3'of grade Cn 36"MIN LEACH CHAMBERS IN BED CONFIGURATION e11 o\3AQ` KEY MAP Existm EL=377+ FL=37.5+ EL=375-394 C�ei ro9 All r'! 77777, V 40 V N �OA. SCALE: I " = 100' XA ���j/, / 1 . : Ventre � 5.0' � 5.0' � 5.0' V5.0' � 5.0' � 5.0' � 5.0' Je5.0' 15" min Cover for O 35.4 * H 20 Loadin Ex15t1ng 35,/+ g gl -a' Parcel A 33.b+ Area=4 Acres-• oa Exrstm 34.3-- N W �w Pond 33.60 33.40 W Qc� North 34.0+ 33.77 N Existing V Existing N r -BOX Gas Baffle J 32.50 N N y Coleman's Lon est Run i Z Pond \J /2,+ g FORTY FOUR(44)ADS ARC36HC 5.l Existrn-� �- l0 12 N N Main Street �t g (36/62502)LEACH CHAMBER5 IN BED E45TING 1500 GALLON (H-20 Rated) CONFIGURATION pa cal \\� s�Pr�c TANK o-�oX LEAC-� CHAMBERS EL=274±Bottom of Test Hole Inspection Port(See Note#4) �y eased Otwe � � LOCUS (H-20 Loading) O FLOW PROFILE PLAN VI EW Manmade SCALE: I " = 1 0' Pool House 51 TE LOC U S Coy Pond NOT TO SCALE � Lined Tennis s Court Existing Dwelling �? cp �k NOT TO SCALE I .) Assessor's Map I G5 Parcel 79 5Y5TEM DE51GN CALCULATIONS 22 2.) Certificate #15171 2 3.) Land Court Plan 1992 1 A Parcels A C 5EWA6EOE5/61VFLOWREQUIRED: 7BEDROOMDWELLING(MIN ALLOWED)9 ` RJe� 4.) This property Is not in a Zone 11 of a Public l l O GPO/BEDROOM= 770 GPD REQUIRED ., N e����e Water Supply SEWAGEDE51GN FLOW PROVIDED: TWE1VTY(20)AD5VN/7_5/N3E0 U� �o Geri 5.) Flood Zone: C Panel 25000 1 00 1GD CONF/DURATION/N FOUR(4)ROW5 OF F/VE(5)UNIT5 EACH. 24 Waterfall �� p Vt=[(770/0.74)/(4.8)IT2/FT)/5.O LFJ = J 43,4 AD5 UNlT5 REQUIRED(44 PROVIDED) 6 Store�a\\ LEGEND 76/ GPD PROVIDED> 770 GPD REQUIRED INSTALLER TO VERIFY THE LOCATION OF ALL 5EPTICTANKCAPACITYREQUIRED: 7706PDx200% = 154061'DREQUIRE0 UNDERGROUND AND OVERHEAD UTILITIES EXISTING SPOT GRADE PRIOR TO THE START OF ANY EXCAVATION 24x5 PROPOSED SPOT GRADE SEPTICTANKCAPACITYPROVIDED: EXI5TI1VG 15006ALLO1V5EPTICTANK ACTIVITIES AND RELOCATE A5 NECESSARY �e�Or�Je EXISTING CONTOUR A GA RBA 6E015PO5AL 15 NOT PERMITTED WITH THI5 DE516N FLOW (5EE NOTE #1 5) ��5t`r0 a ;" / 24-- PROPOSED CONTOUR W WATER 5ERVICE LINE 0 OVERHEAD UTILITY LINES Parcap el 78 u UNDERGROUND UTILITY LINE5 �w c GAS 5ERVICE LINE �w Planter ° TOP OF BANK fXistmg Septic Components to N I CERTIFY THAT I AM CURRENTLY APPROVED BY THE r be Removed(See Note#22) LIMIT Of WORK DEPARTMENT OF ENVIRONMENTAL PROTECTION PURSUANT TO 3` w\w 310 CMR 15.017 TO CONDUCT SOIL EVALUATIONS AND THAT EDGE OF CLEARING THE ANALY515 BELOW HAS BEEN PERFORMED BY ME ~- FENCE �i CONSISTENT WITH THE REQUIRED TRAINING, EXPERTISE, AND (� TE5T HOLE LOCATION CONSTRUCTION NOTES 12 Tree EXPERIENCE DESCRIBED IN 310 CMR 15.017. I FURTHER CERTIFY THAT THE RESULTS OF MY SOIL EVALUATION AS ST SEPTIC TANK 2 N �w `' INDICATED ON THE ATTACHED SOIL EVALUATION FORM, ARE DB DISTRIBUTION BOX %1, c+'b�e �w� / !; ACCURATE AND IN ACCORDANCE WITH 310 CMR 15,100 5A5 501L ABSORPTION 5Y5TEM 1 .) ALL WORK SHALL CONFORM TO THE STATE ENVIRONMENTAL CODE, TITLE 5 (3 I 0 CMR a THROUGH 1 5.107 Reserve Existmg5eptic�TanktBbea ° ;, i RESERVED FOR FUTURE U5E 1 5.000): STANDARD REQUIREMENTS FOR THE SITING, CONSTRUCTION, INSPECTION, r per �� UbGzed(Sec Ndte#20) UPGRADE, AND EXPANSION OF ON-51TE SEWAGE TREATMENT AND DISPOSAL SYSTEMS AND � �s_eor�y ° _ UTILITY POLE FOR THE TRANSPORT AND DISPOSAL OF SEPTAGE, AND THE LOCAL BOARD OF HEALTH ®Lawn �� �! CATCH 5A51N REGULATIONS. Per �1y1/�� a.3��� �� ! !� ! j, /i record �� i' �� 13 I i L FIRE HYDRANT 2.) ANY SEPTIC SYSTEM COMPONENT INSTALLED IN A LOCATION WHERE THERE IS POTENTIAL 2 As-Built I 3G"T _� / ;,%' DRINKING WATER WELL FOR VEHICLES OR HEAVY EQUIPMENT TO PA55 OVER IT SHALL BE DESIGNED TO WITHSTAND N> S ��\ c ! Linda J. Pinto, Certified Soil Evaluator ■ CONCRETE BOUND AN H-20 LOADING. IF UNDER AN IMPERVIOUS SURFACE, SYSTEM SHALL BE VENTED TO THE -1 27.1' / 0b 0 ATMOSPHERE. O k ����> Vent n �� !, mO\4:bb 5- �S _ u o 3 3.)TO MINIMIZE UNEVEN SETTLING, ALL SYSTEM COMPONENTS SHALL BE INSTALLED ON A *�� ~� / �` I / STABLE MECHANICALLY COMPACTED BASE ON SIX INCHES OF CRUSHED STONE. 7113-1 5t\r0 F o\)rd TEST HOLE LOGS Ten Lawn ji rG� p� 4.) COVERS OVER THE INLET AND OUTLET TEES OF THE SEPTIC TANK, THE DISTRIBUTION BOX, Court �oP AND THE SOIL ABSORPTION SYSTEM SHALL BE RAISED TO WITHIN G"OF FINAL GRADE. Otr`r Clump 7P-2 f + Test Hole#I (EL=37.8_) P#13000 LEACHING FIELDS, TRENCHES, AND OTHER SOIL ABSORPTION SYSTEMS WITHOUT ACCESS Planter MANHOLES SHALL HAVE AT LEAST ONE (1) INSPECTION PORT CONSISTING OF PERFORATED 4" !; Pool House/ v�IJotk Depth Layer Sod Class Sod Color Comments PVC PIPE PLACED VERTICALLY TO THE BOTTOM OF THE 501L ABSORPTION SYSTEM WITH A CAP, i Two TIED WITH MAGNETIC MARKING TAPE, ACCESSIBLE TO WITHIN 3"OF FINAL GRADE. ! Firnsh Floor G"Trees \-`m\t !', EL = 4I .0 ! ' 0"-20" Fill 20"-22" A Medium Sandy Loam I OYR 3/1 5.) PIPING SHALL CON515T OF 4"SCHEDULE 40 PVC OR EQUIVALENT. PIPE SHALL BE LAID ON A MINIMUM CONTINUOUS GRADE OF NOT LE55 THAN 2% FROM THE BUILDING TO THE SEPTIC 3 22"-28" B Fine-Medium Sandy Loam OYR 4/2 28"-42" C I Medium Loamy Sand I OYR 5/G TANK, AND NOT LE55 THAN I%OTHERWISE. 7 42"-1 25" C2 Fine-Medium Sand I OYR G/4 Perc @ G I" G.) DISTRIBUTION LINES FOR THE SOIL ABSORPTION SYSTEM SHALL BE 4" DIAMETER Patio Planter SCHEDULE 40 PVC (OR EQUIVALENT) LAID AT 0.005 FT/FT. UNLESS OTHERWISE NOTED. LINES ! 35 - 40 5�or Test Hole#I (EL=37.8±) SHALL BE CAPPED AT END OR AS NOTED. 3 Patio Walkway Depth Layer Sod Class Soil Color Comments 7.) LINES FROM THE DISTRIBUTION BOX TO BE LEVEL FOR THE FIRST TWO (2) FEET BEFORE PITCHING TO THE 501L ABSORPTION SYSTEM. DISTRIBUTION BOX SHALL BE WATER TESTED TO Pool 7.1 0"-23" Fill ASSURE EVEN DISTRIBUTION. Patio 23"-24" A Medium Sandy Loam I OYR 3/1 24"-30" B Fine-Medium Sandy Loam I OYR 4/2 8.) GROUT TO BE USED AT ALL POINTS WHERE PIPES ENTER OR LEAVE ALL CONCRETE gj Parcel A 30"-40" C I Medium Loamy Sand I CYR 5/0 STRUCTURES IN ORDER TO PROVIDE A WATERTIGHT SEAL. $ p Area=4 Acres± 40"-1 25" C2 Fine-Medium Sand I OYR G/4 �.� 9.) HEAVY EQUIPMENT SHALL NOT BE ALLOWED TO OPERATE OVER THE LIMITS OF THE SEWAGE _ _ _ _ _- DATE OF TESTING: 04/03/1 2 DISPOSAL FIELD DURING THE COURSE OF CONSTRUCTION OF THE SYSTEM. BENCHMARK 501E EVALUATOR: LINDA J. PINTO, P.E., CSN ENGINEERING 10.) IN ACCORDANCE WITH 3 10 CMR 15.22 1, ALL SYSTEM COMPONENTS SHALL BE MARKED EL=40.00 (Assumed Datum) BOARD OF HEALTH AGENT: DON DAN 2 IS, BARNSTABLE HEALTH DEPARTMENT Top Corner Patio WITH MAGNETIC MARKING TAPE. - - ) �� "�� ram. _..�- PERCOLATION RATE: LESS THAN 2 MIN/INCH IN "C2" LAYER 1 1 .)THERE ARE NO KNOWN WELLS WITHIN 100'OF THE PROPOSED SOIL ABSORPTION r� r NO GROUNDWATER ENCOUNTERED SYSTEM. doe o{ 12.) FROM THE DATE OF THE INSTALLATION OF THE SOIL ABSORPTION SYSTEM UNTIL RECEIPT OF THE CERTIFICATE OF COMPLIANCE, THE PERIMETER SHALL BE STAKED AND FLAGGED TO Map I G5 PREVENT USE OF THE AREA THAT MAY CAUSE DAMAGE TO THE SYSTEM, Parcel 9 1001 13.) THE DESIGNER WILL NOT BE RESPONSIBLE FOR THE SYSTEM AS DESIGNED UNLESS Town Water �tN OF MASS' CONSTRUCTED AS SHOWN ON PLAN. ANY CHANGES SHALL BE APPROVED IN WRITING BY THE DESIGNER. �So`� LINDA J. Goa 14.)THE BOARD OF HEALTH REQUIRES INSPECTION OF ALL CONSTRUCTION BY AN AGENT OF / o PINT N THE BOARD OF HEALTH AND THE DESIGNER. THE DESIGNER SHALL CERTIFY IN WRITING THAT THE SEWAGE DISPOSAL SYSTEM WAS INSTALLED IN ACCORDANCE WITH THE TERMS OF THE a 46 .1 PERMIT AND THE APPROVED PLANS. 48 HOURS ADVANCE NOTICE IS REQUESTED. Dark 'GIs 15.) LOCATION OF UTILITIES IS APPROXIMATE AND CONTRACTOR SHALL BE RESPONSIBLE FOR 6otto�ok �SSIONAi �� DETERMINING THE LOCATION OF ALL UNDERGROUND AND OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF ANY WORK. THIS INCLUDES, BUT IS NOT LIMITED TO, REQUESTS TO DIG5AFE, ANY PRIVATE UTILITY COMPANIES, AND THE LOCAL WATER DEPARTMENT. Kitchen Bdrm #3 1 G.) CONTRACTOR SHALL VERIFY THAT ALL WA5TELINE5 ARE CONNECTED BY WATER TESTING SITE PLAN WITHIN THE DWELLING PRIOR TO INSTALLATION OF ANY SEPTIC COMPONENTS. �atec Surveil Work bp.• 17.) CONTRACTOR SHALL VERIFY EXISTING INVERT ELEVATIONS PRIOR TO INSTALLATION OF 20 5CALE: 1 " = ' Living ANY SEPTIC SYSTEM COMPONENTS. \crate A & M Land Services 18.) INSTRUMENT SURVEY CONDUCTED FOR PROPOSED WORK ONLY. SITE PLAN SHALL NOT PPp�o �\ Kitchen B18 Route ,28, Suite 3 BE USED FOR STAKING, OR ANY OTHER PURPOSES. � Living Bth B#4 West Yarmouth, MA 02873 Bth Pb. (508) 737-1777 Bmafl.• anmlandfcomcast.net 19.)THIS PLAN DOES NOT CERTIFY, GUARANTEE OR WARRANTY COMPLIANCE WITH ZONING `C�\ 5dr BYLAWS, SPECIFICALLY, BUT NOT LIMITED TO, SIDELINE SETBACKS AND BUILDING HEIGHT �� Foyer 17- RESTRICTIONS. ��� Bth Bdrm Prepared for: 20.) EXISTING 1 500 GALLON SEPTIC TANK TO BE UTILIZED (APPROVED UNDER PERMIT Bth r Dining #5 Bdrm Bth Patrick it Gayle Hans #98-G 13, 9-20-98). PVC TEES TO BE INSTALLED ON INLET AND OUTLET PIPES IF NECESSARY, Bth #I 159 Main Street, Osterviile, MA 02G55 AND A GAS BAFFLE INSTALLED IN THE OUTLET TEE. First Floor 2 1 .) EXISTING D-BOX TO BE LOCATED, PUMPED DRY, FILLED WITH CLEAN SAND AND Bdrm Proposed Sewage D15p05al System ABANDONED IN PLACE. AREA TO BE COMPACTED TO MINIMIZE SETTLING. #G Bdrm#7 159 Main Street, 05terville, MA 22.) EXISTING SEPTIC COMPONENTS TO BE REMOVED. ANY CONTAMINATED 501L SHALL BE VARIANCES REQUESTED REMOVED FOR A DISTANCE OF FIVE(5) FEET LATERALLY FROM THE SOIL ABSORPTION SYSTEM Prepared by: AND REPLACED WITH CLEAN SAND. AREA TO BE COMPACTED TO MINIMIZE SETTLING. Local Upgrade Approvals: 3 10 CMR 15.403 Second Floor Great Room Variances: 3 10 CMR 15.22 1 (7) General Construction CSN CONSERVATION N OT E5 INSPECTION NOTE: Requirements for All System Components: F LOOK PLAN , .) Sod Absorption System > 30" Below Finish Grade �l, Engineering 1 .) LIMIT OF WORK SHALL BE AS SHOWN. A ROW OF DOUBLE STAKED HAYBALE5 SHALL PRIOR TO FINAL INSPECTION BY THE ENGINEER, SYSTEM BE CONSTRUCTED ALONG THE LIMIT OF WORK LINE PRIOR TO THE COMMENCEMENT OF NEEDS TO BE COMPLETE INCLUDING BUILDUP FOR COVERS. G7" Held 3 1"Variance Requested NOT TO SCALE OF ANY WORK. (Not to Exceed 72") (Not to Exceed 3G") Sunroom O 20 40 60 P.O.Box2030 Phone:(508)299-3250 SCALE I "=20' 1 Teaticket,MA 02535 Fax:(508)548-5478 C:\C5N\RR-Main\RR-Main-5D5 Plan.dwg Date: 04/10/12 1 Scale: As Shown I By: L1P I Check: MTA I Project No. C5N0235 E v E 1 8 u f V� -10 0 'v N � C6LID 0 .� N CD 00 � v V c� .— L Cu 4-J ua X F G H EATING N A- -10 -10 -10 y 0 o +; y � V --- - ----- ---- DN. 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A-11 Q It A�2 0 IN N N ISSUED FOR REVIEW snt of GENERAL PLAN NOTES C x x O — Q iT ww V f x x -ALL EXT.WALLS TO BE 2X6'5 @ 16" 0 o O o of O.G(UNLESS NOTED OTHERWISE) U ALL INT.NALL5 TO BE 2X4'5 @ 16" Cu A-X O.G.(UNLE55 NOTED OTHERWISE) 0 ��p pp p cc O O OIQ -WALL5 WITH POCKET DOORS TO N z� z� z BE 2X6'S(TYPICAL) C �(� v W v vI� -WINOOW5 AND FRENCH DOORS TO BE L O ELEVATIONS FOR GRILLE PATTERNS) �, U) PELLA"ARCHITECT-SERIES(REFER TO N N DH- 159 L1, — cc -REFER TO ELEVATIONS FOR WINDOW cM V �\ dy R.O.HE16HT5 ABOVE 5UBFLOOR t1'? L (� ALL EXT.WALL SHEATHING FASTENED 04 WITH 8D NAILS SPACED b"AT ED6E 8 12"AT FIELD 0 \--ED6E OF FLAT/ a +J LO 6 ! SLOPED CEILING `-� N N 0 A-X A-X A-X p p y I A-X o o +; ' I y O CUSTOM ARCH U5TOM ARCH �p O ---------------------- o BEDR OM #5 A-X G 13-0 X 18 (234 SF)'it •— , r^ YI OH-33 OH-3359 __-- ___-, /A ________ ______ __ �\ __-- __-- - - - I ------ DH-2941 OH-3359 DH-3359 DH 3359 ----------------------- - ------ I I, � E-2941 CASE-2 I , i I I I -------------oEAT------------- ---- -------------- ---- --- -----------ilia----I ----------------- O Cu LIN. -- L -- ---' L 1BAX 6-3(99TH �J5F) �+ BATH #2 BATH #5 DN. 9-1 X 8-b(81 SF) 8-O X S-b(b8 5F) ` I I A■ ((1 W 5838 p �� BUNK BEDS IT I I [I � � I v � •- j LIN. BEDROOM #5 ry BEDROOM #2 12-6 X 11-0(213 5F) w 14-6 X I6-0(232 5F) 3-6 X Il-O(225 SF) Q WRITING STUDIO ------ I L O -- -- 15-1 X 11-1(29b 5F) Cu LI I p l I I w•I•G• ---- IIIII' IIIII' BATH #6 GENTER OF � GA1 5E-2525 p1-10 X 9-3(13 5F)NDRY. #2 LINEN RIDGE ABOVE 9-O X 1-6(68 5F) 5-10 X 1-2(48 5F) 6-1 X 5-6(35 SF LINEN LLI --------------- ----------- II,I DN. II 6mx A-X 2 X 5-O(51 5F) - --- - -------- -- T ------------- ET ------------5 ------------- ON. ------------ -------------------- ----------------- nko L ___ p DH- 953 I DH-:_5q DH-3359 p -3 p - I Ln OATH ?#4, I 5-1 X 10-6(54 5F) p mINN I L ------------------INow 2 p A-X O I I I I BEDROOM 13-0 X 11-6(225 5F) E --------------- t I 1 I I I I � -- ----- I 1 ON. �o saa �_ca2� a�s � E -- - -----J AWN-2929 a`> rno > Q` o o y� 1 N"" _Q10-`L O C E ID 1 , I , L U�.+• N N C �� Lj aOJOQ O O C C OCLOT o'U VAL-246 o0NOc-3� wa� No � rnvo, 1 I C O"-0.-() O« U - BATH 75F) a °' a� o�m o - 1 I to �� anC: 1 "cam 1 1 9-1 X 5-6(4 -� �, o^ ESQ o_c c a� 1 Qa� ar-=V dy °� m i I Ld3-.O..Q �NU �tl-y to NC _ O T , I O ----------------- U � PH GUS OM DH-3353 ' BUR. �-- _ o T y Q o o ado-o , =• c a "L N w V_N '� O CD y 3 C O-O N � asQ �a3coaaoi41_CC: f!::.. cic Q m. : � m a>H E"in o .o� 0 - zp w— m BEDROOM #7 n w� _ b-b X 12-6(206 5F) 7L 6 N N SEATmcf r 1 I ' In C m ry a Ll 'a 4a � V p I ' I 0 �� _• O I I � •— 5� LL I I � I I ry W I = Tay& L eVy O r i v, •� V s M LO � N o — A-X CAN BEDROOM #g ■ 21-0 X 12-6,(211 5F) U. N I O I I I I ' I I _ � I I I MW ------------------- job no.: 401 BATH #5 date 28 APRIL 2014 13-1 X 5-b(10 5F) CA- scale : AS NOTED I I y� I -- S E � *I� D F L 0 y R F L A N m U S E LIVING AREA = 5,869 SQ. FT, 1 OH-3359 DH-3359 drawn 5 G A L E 1 /4 _ ! - 0 " rev. N rev. A-X A� 3 N m O N ISSUED FOR REVIEW F.ht of E v E O M � Q U-1 (a (� N •V ��' 'OWO cu c0 U) L17 (0 •Q 4) Q Ids co Lo L V CN c c U LA-> •- L_ CD cc 4-J M QD tG O ti E i1 v , iI B 6 B -X -X X ---- -- ---- ostor0n a�V-+ O GUS --------------- GS235 -------------- PH- 165 PH- 301 1 1 I I I 1 I I I 1 C I I I I I ui I IUJ 1 I N m I 1 I n i 1 t- SITTING " 3-I X q-b(125 5F) A -X i 1 �----------------- -X z m GA5E-2541 -X i -- - - ------- 1 _ I I 1 1 La i L1 _ At •\/ ----------------------- -----------------� ---- - - ------—---- ---------___.__-_____ —---- DH 3365 CD I I ( I }+ 1 I I II I I 1 t--W------4- 1 u V' d 1 d d At m MASTER/ UNF I N I SHED N BATH #1 MASTER/ BEDROOM #I Q o qq Ib-O X Iq-I (313 5F) zo I Ln tt 1 I d 1 I 1 1 - i 1 4 I 1 I 1 ; 1 I 1 � i 1 I --- --------------------.. _ ..--- ►--1 — — — ----------------- --------------------- DH-335q PH-415q DH-535q -- --- -- I 1 I I I I I I 1 1 I I I I I I I I I I I 1 1 I I I I I I i i DH-335q �- 1 1 I I I I 1 I I I I I WALK-IN CLOSET 1 3 X 12-6(Ib4 5F) I ll I I I I I • 1 I I I in umi osso� assaz N L) E �. �' yam. QUO-CL c E 0-- 0 1 - 0 0 yQ C d 1 U Q.�OQ 0 o c p CL 0 Q Lj� O-�b � � y QY0 I C O-C C� O«. ,o O 0 _ -------------- N O U � I — r S -• y C ; PH- q53 o 1 y Sy-C �Q N yr---• � . y-C � � -------------------- 0 8 C-O 0-0 d QLQ p xN o O U C V a�H- E-N-o m (D y C I..L 'A L i O L0 ER LE `✓ EL fi LAN M A 5 T E I Nrz, FIRST FLOOR FLAN a MASTER WI NS 5Er-, OND F L 0 0 R FLAN a MA5TER WI N � SCALE 1 /4 O " SCALE : 1 / 4 " _ ! ' - O " SCALE : 1 /4 " = I ' - O " A♦ n' U � a� CO ca .S; m L L0) _ L Ca C � aD'— � N O e � job no.: 1401 date 25 AFRIL 2014 scale AS NOTED drawn JLW rev. rev. 0A�4o �r 0 N ISSUED FOR REVIEW snt of C, LAP 4'-11/4" 5'-91/2" 4'-11/4" I � -10 C 1 I V, - I I v 1 I I I ....--- STONE VENEER ABOVE WINDOW GA51N6 TO BE X SUPPORTED W/STEEL F 2 G (..I LINTEL(TYP®ALL 7 A-X WINDONYELLS) -10 -ID B ... .... .. - THICK GONT ONC bRADE 1 1 1 v A-c{ CAM TO SUPPORT STONE ' ' I A v !O"CONCRETE FROSTWALL VENEER;DRILL•4 REBAR 4"INTO Q W/STEM WALL 4 SHELF ' v ON 24'XI2"ONG.FOOTING 9 �UREE VV EPDXY 1&ROUT 4"C. WALL ON 1 MAINTAIN 4'-0'MINIMUM FROM A'1 '1 BBEAMTYPICAL KET, FOO11N6 TO SUPPORT ---- - ---- ( I--t�---L �---�--�---- --- ---- GRADE TO BOTTOM OF FOOTING I i --- a _.i-- F--'-- _J----- ---- T L---- II _______ VENEER. _ _______ __ _____ _ ____ ____ __ ___ ____ _____ ______ ____ _____ ___ -------------------- STONE __ � �1 - ---- ----- --- --- ------------- .- (B LOW) 1 (3)II l/8"LVL BEAM ,1 1 -- --------------------- --------------r-- - , i II 1 ------ -- - - - --------------- ----------------- - - -- - ---- - ----- -- ---- ------- ---------------, (-----------� - ---- - -- - -- ---- ------- -- - t l 1 FI ' - t------------- i I; --- 'I ------ ----- -- ------ -- '1 LLLW»> I 1 l i 1 DC{ p� 1 '1 4"THICK CONT.ONG GRADE 1 1 i 1 s i � TOP OF STEM WALL! i 1j BEAM TO SUPPORT STONE � _ 1I, 1 11 1 1 VENEER,DRILL•4 REBAR 4"INTO 6'OF GOMPAGTED iv ' I 1 ELEV.40'-0'(40O') 1 '1 V 1' i A_cj 1 U i ' r f1a 1 1 (U 1 i i 5ECURE W/EPDXY GROUT i CRUSHED STONE kul~ ' 1 �1� i � �� ' }.� �✓'V 1 1 ' 1 "Q ' .•. ' 33Y 1 i m 4 i ETOP OFLEV SHELF ® i 4 SHELF O N 24 W/STEM WALL -_,..__._. -•e.t,...-r.>.-..,..-. A 1 1 1 1 1 10 1 1 I ' 1 1 4'(39.357 1 1 4 SHELF ON 24"X IM FOOTING g 1' 1 ' 11— 1 • I 1 ' 1 1 I MAINTAIN 4'-0"MINIMUM FROM 11 1 1 1 -_ ___.._________________ ________________ _______ ______ _ _____ ______________________ GRADE TO BOTTOM OF FOOTING A-9 - -- - --- - --- - ---- I ii 1 i .� ii �r ___ ___ __ ___ ___ __ __ i ---- WIOX2� 6 STEEL ------� 1 1 r I I ___J L_____________--____ 4_ ______________________. __1 ' --6'OF COMPACTED it ' 1 _____________ . •_____________ __________ ________ ___________________ __--__________ __--_____-______________-______ __-___-__ 1 I 1 li Ii - it �I Q I CRUSHED STONE 11 BEAM POCKET, a�x __ __ _-_ __ i 1 1- % i TYPICAL m i -- - -'- -- - 1 ' 1 \Y 3 II l 8"�L BEAM ———1 O� --- O 10"CONCRETE FOUND.WALL(BEL YV 11 , __-�.____ _ _______ _____ ____. ON 24XI22ONGRETEF r - S- FOOTING W/KEY .- I BEAM POCKET, m 1 1 1 1 1 TYPICAL Nl v 1 1 1 11 ___ ' ________i 1 ._ ____________________________________: 1 I II 1 1 '1 2 5/4" 1 1 '1 ' 3 I/2"DNA.SCHED.40 PIPE (3)9 I/4"LVL _ (3)9 I/4"LVL BEAM 1 i 1 (BELOYl1 1 1 L�--- 1 .. 1 TOP OF SLAB.• 1 ' ELEV.31'- /2`(3.3') 1 `--------------------------------------- `--------. . - 11 a..wr 1 1 i 1 3-0 X 3-0 X 12" 1 1 4 ' 1 3 1/2"VIA. D.40 PIPE I i YW N5 BARS OTOGEYI a Y TYPICAL 1 DEEP CONC. BEAM POCKET, I gyp' 3-0 X 3-0 X 1.2 ' DEEP GONG.F )TINS O W/M5 BARS o 1 "O.G.Eri. _ 6 I - i ON ONGRETE ROSTWALLL m i TOP OF STEM WALL® W/STEM WALL 4 SHELF i t STONE VENEER ABOVE TOP OF SLAB.• 1 ]� M„•..N 1 I i 5'-b I/2" EQ. E0. EQ. W. EQ. EQ. E0. EQ. ' 1, ELEV.40'-T I/2"(40b37 l I/4° 1 WINDOW CASING TO BE ' MAINTAIN 4'-0"MINIMUM FROM S NDOA CA IN STEEL -, i A ELEV.31'-1 1/2"(31.139 v 1 i l'-O' 2 1 E TO BOTTOM OF FOOT 11 1 LINTEL(TYP.B ALL '' . 1 TOP OF SHELF® --- ------' ----_--- -"" -- v ' 1 'D WINDOW MLL5) i i 1 ELEV.39'-l"(39.587 i - ---- vw � 1 N 1 1 I 1 I I 1 I I I 1 I I 1 I BEAM POCKET, i (�' II l/B�LV' �I(3)II T/8'LVL ' O� ' —— (3)II T/8"LVL ' l� (3)II l/B'LVL ♦ (5)II 7/8"LVL ——(3)II T/8"LVL 1 1 (3)II l/8"LVL (3)IV T/B'LVL (3)II T/8"LVL - 1 TYPICAL _ --- ------- ------ ; +— I — +— -� BEAM�P.ELOYm1` — —'�hF�'(t�€Col�'— — —eEAr�(e�L01�—�,— B�AMTiELOWI—;'�—;e�MLOv I—-�-~—BEAMT9EIAWU— �'— ? BEAM - ' n ry II ----- - /vc -' ~ �- ---� i--------' --- - 1 I Ii 1 ' I i M(BELO Q I I 1 I 1 1 1 (3)II 1/5'LVL BEAM - 1 1 - 1 1 (BELOW) _ __ __ _ _ ____ __ _ _ I� i� -T PORCH I� A X o "STEM _ _L L A II ; J v A M WALL DE AI FOUND. , TOP OF STEM LL• 1 1 1 10 S E!SHE.F ALL " i i i Q 1 — --- -------- --- ---------7 ------ _- - ----------------- ��---- --- - 6�--------- -------- -t ELEV.40' I/2"(40637 ------ - GOMPAG� i v ON 24'XI2'CONCRETE 1' ' 1 .. 1 m 1 ---- . - _ , 1 _ 1 CRUSHED STONE 1 1 ii 1 . i ' ' 1 i i 1 FOOTING YU KEY ' , , 1 _ _ ____ ___ ' TOP SHELF 6 1 1 O 1 1 ____________ 4'THICK CONT.CONC.6RADE 1 1 I1 ---------- -- - - - --T r --11 1 I — , ,1 T'(39.5B') I I 1 I I F= BEAM TO SUPPORT STONE TOP OF FtIDNfa119.F ..'� O�_________________ 'ELEV 69 VENEER;DRILL"4 REBAR 4'INTO AT/OR BH.OW bRADE CONCRETE WALL 6 12'O C., ' _ 5ECME W/EPDXY GROUT' ,1 1 11 .. • M , 1 A•I 1 ; 1 •0 1 1 ,___t� -L ----------4"GMU WALL ON - E 1FOOTING TO SUPPORT 1 STONE VENEER. A-9 TOP OF FNDN./SFEIPWINDOW WELL DETAIL 1 i - 1 1 --m i 1 1 1 1 AT/OR BELOW GRADE 1 i 1 i 1 m 5-6 ' 10"FOUNDATION W15TEM WALL � 1 � I � -'----' 1 4 5FELF ON 24'X 12'CONT. - I '. 1 5'_6.. -- --- - - -- -- --- --- ` 1 i --- r STONE VENEER ABOVE 1 1 �l ____ -_._ _____ ____ _ _____ ____ _s__ _ 1 1 OOTINb WITH KEY 1 1 ";1 1 1 SUPPORTED W/ST EL :.1, i (SEE DETAIL) 1 ---- ----- - - i / PIN SLAB TO FOUND. 'I i ------- -'-- ' 1' LINTEL(TYP.®ALL ' ' WALL W/w3 REBAR 1 S- --------------- ------- __1__ 1i WINDOW WELLS) I i f'-' "'-"' 10"GONGRE FRCS L --- ®IB"O.G. i1 - 1 1 ON 24'XI2 NG FOOTI . _ --------- w------- e . . ,1 ui i l i IU I 1 1 iv MAINTAIN 4'- "MINIMUM TING EDGE OF SLAB TO BE -'------------------ ---------- GRADE TO OM ._ __ _ k � 11 , I �i J i @ TT OF 00 HELD 3'BALK FROM 1' 1 STONE VENEER ABOVE 11 -- ---- ---- --- ----- -- --- - �i ED6E OF FR05T WALL WINDOW CA51N6 TO BE 11 1 4'CMU WALL ON FOR STONE VENEER SHELF j 1 - .�NJI'PORTED W/STEEL FOOTIN6 TO SUPPORT 6'C.ONGRE SLAB W/ AUNGHED EDGE; ,I LINTEL(TYP.0 ALL A-x I _ -------- ------------- STONE VENEER. 6X6(2.IX2.1 AUGE)W.W.ME5H(SET IN WINDOW WELL5) --- (- ----- CENTER OF AB)ON V POR BARRIER FLOOR OF PORCH 1 FLOOR PAVERS® ,1 4"THICK ONT GONG.GRADE ON B"OF ACTED RUSHED STONE (PITCH FLOOR 1/5'PER 12" 13FAM TO SUPPORT STONE A 1 b'-0" COWSECURE TE AA EPDXY 12'O, 10'1 1/4" 3'-0'" 10'11 I/4" T'-0' S'-6" AWAY FRO 5'-B I/2• 3'-6" b-2" 1 2 B 1 1 VENEER;DRILL•4 REBAR 4"I O 1'-O 1/2' I'-0 I/2" 3'-b- 1W-O" Ib'-0` T'-6" 3'-0' T'-b` 6' '3" 3' ONGRETE WALL® R O.G.; 5 1/`IUl' 4il/2` 4 IYl" 5 1 I/2" � I I� I 24'-6 II/2" 19'-6 I/2" 'I 1 24'-0" f"' STONE VENEER ABOVE j1 1 PIN SLAB TO FOUND. WINDOW CASING TO BE 1 WALL W/i5 REBAR SUPPORTED W/STEEL �--- ----t LINTEL NE o ALL ®IB"OG. 1 I WINDOW WELLS) I' 1 O EDGE OF SLAB TO BE i i i 1 TOP OF STEM WALL.6 _ F O U N D A T I O N - M A 5 T E R W I N G HELD 3"BACK FROM ELEV.40'-T I/2"(40.63') E06E OF FROST WALL i 1 5 G A L E 1/4" = 1 -O" FOR STOPS VENEER SHELF 1 SLAB®bARA5E DOORS 1 1 BEAM TO SUPPORT STONE ELEV.39'-II 5/8'(39.91') Jv I _ 1 1 4'THICK GONT.GONG.GRADE 1 1 �-_ ..� ' - •-...,,� BLUESTONE PAVERS a FLOOR OF 1 - AWAY FROM HOUSE) /B'PER 12' 1 VENEER, 012"REBAR 4"INTO 1 4'-O" 4'-O' `Q SECURE W/EPDXY GROUT 1 I I .. .I 1 ' IO'CONCRETE FR05TWALL ON 24"X12"GONG.FOOTING; 'I ' -M'- ��•••••// MAINTAIN 4'-0'MINIMUM FROM 11 ' GRADE TO BOTTOM OF FOOTING i 1 I1 M o -6"CONCRETE SLAB W/HAUNCHED ED&E; 6X6(2)X2.1 GAUGE)Wri.MESH(SET IN - 1 GENIER OF SLAB)ON VAPOR BARRIER ON 8"OF COMPACTED CRUSHED STONE I 1 I t 1 j1 1 I I I I II I I I 11 1 T -___________________________ ________ ___________ li 1 TOP.5SHELF6 REAR ----' ELEV.39'-10 5/8"(39Uj9) 1 TOP OF SHELF a FRONT ELEV.39'-T T/Ib'FROM 7 I 11 1 II 1' 11 II .________________________________________ --_--__ ,I fV 11 F O U N D A 71 O N - H O U 5 E ---- ----------- --- --_ ------------------------- 5 GALE: 1/4" • 1 '-0" N A-11 E v E Mcli U � cu c/) N •0 � 0 cu O (a •V � p LO cc cM (� uMl L nU' C O = V LO .— L— eczg cu C�'M i0 FIELD5TONE CHIMNEY VV O L 4"POURED CON,.GAP y Cc BUILD OUT GABLE E TO BACKSIDE OF 7� DECORATIVE - ALIGN RAKE W/DECORATIVE Q 5HIN&LE5 BRACKETS BELOW •— BUILD OUT GABLE----- CURVED ROOF® Q TO BACKSIDE OF EYEBROW WINDOW RAKE N DECORATIVE �� V BRACKETS BELOW 12 CUSTOM,URVED 12 DECORATIVE �85./- CROWN MOULDING �9 SHINGLES ` AND FASCIA 00 2 ua-� I3E TR0�4IM asrcr+ cusron r �12 IT IL AI IT5 12 IT IT 12 cu rm _. DH4159 D4-4159 D1F4159 -mq �=4SUB FLOOR_ L 9 SECOND FLOOR 12 — -- -- -- -- -- --- °n oM Et 1 TT IT 12"DIA.F.6.COLUMNS E,ATIONZ9711 IT ITIT CCCJJJ U BLUESTONE PAVERS mr-am n Dw4m -am case-�s41 AT PORCH FLR.Yy/ (VENEER)RISERSL-1 i ��, DIH%5 vH-3565 FLOOR tilDrHxn vn-41n Dwsm Drum DH-am Drr-ssn u�ssn 5 eca oFIRST FLOOR — _ --_ - _ __ .. ._—_ - �sbyb A5GP696 nsc b _ - � 4 07 IX/ i 14"DIA.F.G.COLUMNS ' (REFER TO GENERAL 5TONE VENEER ON 1 1 1 ELEVATION NOTES) CONCRETE GRADE r W G.SHINGLES NV BEAM WEAVED CORNERS 4 BLUESTONE PAVERS AT FLARED BASE PORCH FLR.N FIELDSTONE (VENEER)R15ER5 R E A R / 5 0 U T H E L E V A T I O N 5 C,A L E B/16 1 -O" OAS O_� pLL. OZH ps U E O)O-` y �-� 0 o c I, �c) 8os0 U � — U� yO C-- Cv� Nm ON p �+ p `porn O 3 y-- p p�— �y Q1:--" N C U C Z3 I -C 7 U p— ? C O CQ Cps C p N> H OYr O O_C p U p_Q p 0 sa� 3 ¢ ` p-- 5 .oyoo � c L 0-215 3 _ �0 3 FIELDSTONE CHIMNEY W/ I h pL U O ID 4"POURED CON,.CAP S p to U ? L•-" u� 3 C d O N O y C p_U C C N N ` dL.Q '«' O XpNO UCU Q p.f. a_ E-yam cy C p w CUPOLA BY"GAPE GOD CUPOLA"OR SIMILAR ( iL GAPE GOD GUPOLA-•5(,P-6) DECORATIVE— BUILD OUT GABLE SHINGLES TO BACKSIDE OF RAKE N DECORATIVE 1511LD OUT 6ABLE BRACKETS BELOW ,uA, TO IIACK5IDE OF ALIGN 12 _I RAKE N DECORATIVE BRACKETS BELOW ALIGN RIDGE W W/CREASE 2 , �9 12 V/^8.5 N- � V 0 > SHUTTERS BY NEW HORIZON 54JTTERS (OR SIMILAR) �� 5 � •� —FFJ 1 5 �12 Q12Fu 0 12 DN1159 p041y1 — aD a5 . _.SUB FLOOR �/ ®SECOND FLOOR �� 748 U. N 0 E�T5 DH- NC SHINGLES I J�HEAVED CORNERS 6 FLARED BASE I SLAB® SUB FLOOR_ ®FIRST FLOOR date Job nO"� 40 6ARA6E CUSTOM CARRIAGE STYLE BLUESTONE PAVERS 28 APR)L 204 O.H.DOORS(PAINTED) AT PORCH FLR.N FIELDSTONE scale AS NOTED (VENEER)RISERS 2'-O"CONCRETE APRON 12"DIA.F.G.COLUMNS A TO ENE�E ELEVATION ON NS drawn �Lw R I G H T / W E S T E L E V A T I O N rev. SCALE: B/16" = 1 -O" rev. A�6 �r 0 �r 0 ISSUED FOR REVIEW snt of