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Home My WebLink About0092 NORTH BAY ROAD - Health 92 (forth Bay Road Oster ville A = 072 028 002 _ r ;1 io 1 ' Commonwealth of Massachusetts D:� a-D a.a—QOa. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley Owner Owner's Name information Osterville Ma 02655 4/6/21 required for every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. Inspector Information on the computer, Michael DiBuono use only the tab key to move your Name of Inspector cursor-do not DiBuono Sewer And Drain use the return Company Name key. Content Ln Co � Company Address Cotuit Ma 02635 City/Town State Zip Code ,arm, 508-364-9587 S113522 Telephone Number License Number B. Certification I certify that: I am a DEP approved system inspector in full compliance with Section 15.340 of Title 5 (310 CMR 15.000); 1 have personally inspected the sewage disposal system at the property address listed above; the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my training and experience in the proper function and maintenance of on-site sewage disposal systems. After conducting this inspection 1 have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 4/7/21 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection.If the system has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth of.Massachusetts , �.� Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes: ® I have not.found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: System is in like new condition with no signs of failure. New leach field in 2005 2) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health.. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally Passes (cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 3) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. a. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, 'safety and the environment: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 P Commonwealth of Massachusetts � Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. Cityrrown State Zip Code Date of Inspection C. Inspection Summary (cont.) ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. c. Other: 4) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. Cityfrown State Zip Code Date of Inspection C. Inspection Summary (cont.) 4) System Failure Criteria Applicable to All Systems: (cont.) Yes No ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/2 day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public water supply well. . ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain.of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000 gpd- 10,000 gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. 5) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section CA. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone 11 of a public water supply well t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley ' Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate"yes"or"no"for each of the following for all inspections: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been in to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ❑ ❑ Were all system,components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered,opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ❑ ® Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. El Determined in the field (if any of the failure criteria related to Part C is at issue ® approximation of distance is unacceptable)[310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form �- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. Cityrrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms(design): 6 Number of bedrooms (actual): 6 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 660 Description: Number of current residents: 2 Does residence have a garbage grinder? ® Yes ❑ No Does residence have a water treatment unit? ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ® Yes ❑ No Water meter readings, if available last 2 ears usage 484 g ( Y 9 (gpd))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Date t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 18 f PS Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont j 2. Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: Not provided Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 r c Commonwealth of Massachusetts x Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments' 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known) and source of information: New leaching 2005 Were sewage odors detected when arriving at the site? ❑ Yes ❑ No 5. Building Sewer(locate on site plan): Depth below grade: 3.5 feet Material of construction: ❑ cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): System is vented through the roof i ` t5insp.doc•rev.7/26/2018 Title 5 Official inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts _ F Title 5 Official Inspection Form r i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,.� 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade: 3 feet Material of construction: ®concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Sludge depth: 3 - Distance from top of sludge to bottom of outlet tee or baffle 24" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 4" Distance from bottom of scum to bottom of outlet tee or baffle 30" How were dimensions determined? Tape Measure/Data On File Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tee's in place at time of inspection t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): 8. Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: concrete ❑ metal ❑ fiberglass ' ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per dayJ t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 18 r Commonwealth of Massachusetts U Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 8. Tight or Holding Tank(cont.) Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): • Attach copy of current pumping contract(required). Is copy attached? El Yes ❑ No 9. Distribution Box(if present must be opened).(locate on site plan): Depth of liquid level above outlet invert Level and at normal level Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): i •If pumps or alarms are not in working order, system is a conditional pass. 11. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ® leaching fields number, dimensions: 20'x45' ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts _ P Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �. s-P 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Cisterville Ma 02655 4/6/21 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (coat.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): No break out no ponding r ' 12. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 Commonwealth of Massachusetts _ Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 13. 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.): t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 I 4/1/2021 Assessing As-Built Cards TOWN OF BARNSTABLE L ATION_ !x SEWAGE#.2Wt- ,17�/ GE ASSESSOR'S MAP&LOT67Q'? o�"rcme INSTALLERS NAME&PHONE NO. S/�9 i�i �fg�1 Ar�ee�u )7zq� SEPTIC TANK CAPACITY /-ire 6c L LEACHING FACILITY:(type) F.Ird (size)-A0 NO.OF BEDROOOOMS 6 BUILDER OI:OVt'NHR PERMITDATE: /Z- 7-41 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 weUs exist on site or within 200 feet of leaching facility) "r Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 fe,Ipf leaching facility) JSd f- Feet Furnished by Y' Al e ;46%c - yr� https://town.bamstable.ma.us/Departments/Assessing/Property_yalues/HMdisplay.asp?mappar=072028002&seq=1 1/2 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: 0 hand-sketch in the area below ® drawing attached separately C t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 I , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 92 N Bay Rd Property Address James A Daley Owner Owners Name information is required for every Osterville Ma 02655 4/6/21 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 15.,Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: 5' Seperation. See plan feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record 2005 If checked, date of design plan reviewed: Date Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database,-explain: You must describe how you established the high groundwater elevation: Test hole data on plan Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 18 Commonwealth of Massachusetts -. Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 92 N Bay Rd Property Address James A Daley Owner Owner's Name information is required for every Osterville Ma 02655 4/6/21 page. Citylrown State Zip Code Date of Inspection E. Report Completeness Checklist Complete all applicable sections of this form inclusive of: ❑ A. Inspector information: Complete all fields in this section. ❑ B. Certification: Signed & Dated and 1,2, 3, or 4 checked ❑ C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6(Checklist) completed ❑ D. System Information: For 8: Tight/Holding Tank- Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high groundwater included t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 18 of 18 TOWN OF BARNSTABLE [ ` LOCATION �� :�d�' � ` 2 SEWAGE #.24W 31Y t'. ° ASSESSOR'S MAP & LOT67 Q dai-coa, INSTALLER'S NAME&PHONE NO. 302�/"Zyll ere., 7 22 SEPTIC TANK CAPACITY f mD Gi LEACHING FACILITY: (type) t 4C4 (size)-00 X'yr x 4 NO.OF BEDROOMS BUILDER O OWNER � -- PERMITDATE:� fz- �JD� COMPLIANCE DATE: /`Y/ Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet ' S 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 fee ofleaching facility) f r0 Feet Furnished by �� .� . _ F��-�- - . J\ �' 36� .. 4�G" �y% O f �� (� �,.j-, �, No. / Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: i Yes PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLE, MASSACHUSETTS 01pplication for ;Dig000l 6p5tem Contruction Permit Application for a Permit to Construct( . )Repair( )Upgrade( a)Abandon( ) O Complete System O Individual Components Location Address or Lot No. Nonce // �' wner's Name,Address and Tel.No. Assessor's Map/Parcel �I` ,Z ®2� /,0 0 2 J�-u e* �/ 6&Y Installer's Name,Address,and Tel.No. ` Designer's Name,Address and Tel.No. �PiA�'ul�L j21 Type of Building: Dwelling No.of Bedrooms Lot Size f 8 "444%.ft. Garbage Grinder( ) Other Type of Building 5 No.of Persons Showers( ) Cafeteria( Other Fixtures Design Flow gallons per day. Calculated daily flow In gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. 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 Certifi- cate of Compliance has been iss ed by Bo of th. ) 17• C� Signed Date ` ✓ Application Approved by _ Date Application Disapproved for the following reaso Permit No. Date IssuedKill a No.• _ I �� °�.� y � ..'.-"",•,�° Fee . THE COMMONWEALTH'OF MASSACHUSETTS Entered in computer: .. s Yes ° PUBLIC HEALTH DIVISION:-_TOWN OF BARNSTABLES�MASSACHUSETTS 2pplication for �Zi�pogaf *pgtem Cott tructior� ertuit Application fora Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System O Individual Components Location Address or Lot No. ND � �G wner's Name,Address and Tel,No, i Assessor's Map/Parcel v Z D z�1037 /D O 2— Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 77/ Type of Building: Q�L�i Dwelling No.of Bedrooms � }4• Lot Size�8sq.ft. Garbage Grinder( ) Other Type of Building ^ 5 No.of Persons Showers( ) Cafeteria( ) r Other Fixtures / Design Flow ,/U gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision'Date Title Size of Septic Tank 'Type of S.A.S. Description-of'—Soft, . Nature of Repairs or Alteration-s'(Answer when applicable) t Date last inspected: Agreement,:— The under"signed 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 Certifi- ' cate of Compliance has been issued by da Boar o FHealth. �_ I �� oF Signe l / Date Application Approved by o�/ ��-/ ;Ut Date /7 Application Disapproved for the following reason r Permit No. � 'Date Issued o 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 G'I; /-/,( ", op at 617 ®,-.P 141)1/ has-been constructed in accordance with the provisions ofK�v the�rDisposal System Construction Permit No r ated Installer 1 Designer l S'`�A)--,- The issuance of this permitfsha I n tbe construed as a guarantee that the system will function as designed. Date Inspector _ _ eeT THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS lizponl *pgtem (Construction Permit Permission is hereby granted to Construct( '�)Repair( )Upgrad ( )Abandon( ) System located at �Z y � and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his)her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Const uction must be completed within three years of the date of t Date: a 7/u5__ � �/ rUr(�7(M I I Approved by Town of Barnstable Regulatory Services -?2 �6 -60a ' Thomas F.Geiler,Director F ,. .. .erg Public Health Division Thomas McKean,Director. 200 Main Street,Hyannis,MA 02601 .Office: 508-862-4644 Fax__ 508-790-6304 Installer&Designer Certification Form Date: Sewage Permit# a DG 5-395' Assessor's Map\ParcelDO/0� ' Designer: Sh�Vhm Iswn �.P. E Installer: tSorl-ale Address: G a r kr IJ a Address: t?o, (3 Lx20`f ?Er morJ YYIo Wl:L13 On Le-.2'� �-�S Gor+-t l�.W G K51 . was issued a permit to install a (date) (installer) septic system at Z , ,a ,51 based on a design drawn by (address) lih soy,_ z?tr dated ?-2a - Zoo S (designer) L 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. 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 certi ed as-built by designer to follow. a� STE?HEN Cam` A UYN / (Installers Signature) ` . o WA ILSOw No'3021® ss/4�iAl Ei�'� esigner's Signature) (Affix DNesirn tamp 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:I-IealtWSeptic/Designer Certification Form 3-26-04-doc &Z00' y-/S-V RUG-1-2005 08:27A FROM:JK HOLMGREN ENG. INC 15084283750 TO:815087757877 P.1 ?2N G. � Post-W Fax Note 7671 Date y 6 s #ofpages2 To C.v'c.t From Co./Dept. Co. Phone# ,ter ry Phone i ejT*i h- Fax# Fax 9 79-7 Y e �a D � IMILq rlA IMb ` -T Ris (Z&OW 40 Town of Barnstable MAM Board of Health P.O. Box 534 Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,RS. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. August 4, 2005 Mr. Stephen Wilson, P.E. Baxter,Nye, and Holmgren 812 Main Street Osterville, MA 02655 Dear Mr. Wilson, You are granted permission, on behalf of your client, James A. Daley,to construct an onsite sewage disposal system designed to be connected to six bedrooms at 92 North Bay Road, Osterville. - The septic system shall be constructed iri accordance with the revised submitted plans dated July 20, 2005. Sincerely ours, Way Mill , M.D. Chairinan BOARD OF HEALTH TOWN OF BARNSTABLE Q:HEALTWWP/WilsonStephen7beds MAM 9 1"9 Town of Barnstable Board of Health - 367.Main Street,Hyannis MA 02601 t Office: 508-862-4644 Susan G.Rask,RS. FAX. 508-790-6304 Sumner Kaufman,M.S.P-L Ralph A.Murphy,M P_ rt Request for Approval of Septic System in Excess of Five Bedrooms LOCATION Property Address: 'j Z. Oc,r 1-k R.a j d e s 1-t r- N 2 r 6 o r•S • s { , C Assessor's Map and.Parcel Number. IM��f3r-I PIP-Z Size of Lot: y/ e-fY 7 Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name: APPLICANT'S NAME: A, me It Phone PROPERTY OWNER'S NAME CONTACT PERSON Name: Tk^e—S A V Z l c w Name: Sarphew A l li lsoM 1 R E. 134u3rr� Address: -'(Y LIes hr/., RIP, zJe s k��►_ )yg " Address: A r? Me,,!3 S f- . ('rjxe- I(tly. Y1r q Phone: Phone: (ge8) Sri 8- -S/3/�: cx fi t3 f Checklist(to be completed by office staff-person) Four(4)copies of engineered plan submitted(e_g.septic system plans) Four(4)copies of floor plan submitted(e.g.house plans or restaurant kitchen plans) a Susan G.Rask,RS. Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. c � e f i K lTUrtti+- 4 S L.Ll) O z CAMPO o 5 yri j3'Er0 IDWAr �vp IL CLD5 G V 0 5 .., lot eo -07 TL� �Cl,p P �ib �l5 R vaw� ` lac. a. lqv R oi.t� Town of Barnstable P# pp IN ipk Department of Regulatory Services BAANBTABLIr Public Health Division Date y MASS. 039• . 200 Main Street,Hyannis MA 02601 �A1F0 MAC a �00 J Date Scheduled Time I D POO Fee Pd. Soil Suitability Assessment for Sewage lhposal - Performed By: Sit VC Ul1 160n- Witnessed By: ` U v�' � /`�• '1 LOCATION & GENERAL.INFORMATION QQ`�oo Location Address 9 Z Nvr Owner's Name c7Gw" A . r-sa ley 1 D k Kavbaex �S I�I�IPi Address �iL �ordi C3o� `fit ,-. o�sfs.• Assessor's,Map/Parcel: pU,, 7Z, pe.t Zg—, Engineer's Name 54e pkr.4 A /of PC U NEW CONSTRUCTION REPAIR Telephone# � / .e,!jF L? Land Use Slopes(%) Surface Stones Distances from: Open Water Body I Ic0-r_ ft Possible Wet Area it Drinking Writer Well ft t Drainage Way ft Property Line 10 ft Other ft SKETCH: (Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) t 'il ' -' + 't nr.M.m xa.p he tiara.• rtAn nr � .. w � � 'e•a eo.ei�� 4 nan n,a ;;, ••° i `.I. r•.0 11 A.wG•p 9i" � ! ' IS f � � ,r.°cm \ \ y L-- a wv n•�e�`r�,�r�"`�rt r.° ',.i::e ;,'\`.•,. a ann .. v ,rsd n a� Parent material(geologic)G laeldl 0'r4iur'.01 Depth to Bedrock Depth to Growidwater: Standing Water in Hole: _ _ Weeping from Pit Estimated Seasonal High Groundwater. GI 2 1 fur (2) 2,S7 DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Depth Observed stinding in obs.hole: ill. Depth to soil mottles: i�,• Depth to weeping from side of obs,hole: in. Groundwater Adjustment ft. Index Well# Reading Dater Index Well level Adj.factor Adj,Groundwater Level PERCOLATION TEST Date •/ 10 eS Time/0 d Observation Depth of Perc L`t Time at 6", Start Pre-soak Time u . I D;3d Time(9"-6") End Pre-soak 16_�ND Ve'eJak V Soar Rate Min./Inch G wtih�t��ch Site Suitability Assessment: Site Passed to site railed: Additional Testing Needed(YIN) Original: Public Hearth 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:H>ALTH/WP/PERCF0KM DEEP OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other. Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.% el A S4r A . Lcoc.wi toy r? 24. 32. . ��. Y11cdJ, Saab t o.Yro rid/2. a nd1 Pees F l o Y t2 2 DEEP OB ERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (US.DA) (Munself) Mottling (Structure,Stones,Boulders, Consistency.%Qrnvel 3 2,i go" �}... L�c4 rH /p ji2 T/3 Ao L`'' c sA�.� rn�.r ►® rzAe I o y t2 DEEP OBSERVATION HOLE LOG Hole# Depth.from Soii.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.. Soil I Other Surface(in.) (USDA). ., (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Graven I Flood Insuranee Rate Man: Above 500 year Mood boundary No Yes Within 500 year boundary No_ Yes V Within 100 year flood boundary. No Yes Depth of Naturally Occurring Pervious Material - Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the. area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification I certify that on T 9•� (date)I have passed the soil evaluator examination approved by the Department of Envi.onmental Protection and that the above analysis.was performed by me consistent with the required training, expertise and experience described in 310 CMR 15.017.. �+ T.. 41 Signature ' ;. Date Q:1•IEALTI /WP/PERCFORM l . . IO�CAT10N *el, > ' SEWAGE PERMIT N0. �. I N S T A LLJOR'S NAME i ADDRESS HN A. AALTO 13ACKHOE SERVICE Street Mfest,BarnstableA Mass. 02668 BUILDER OR OWNER Paley s DA T E P ERMIT ISSU E D DAT E COMPLIANCE ISSUED -Is� r�� 0�7 No...... ....... - _ "� >G' Fps.. .' . THE COMMONWEALTH OF MASSACHUS `s BOAR® OF HEALTH /� / ' SUBJECT O AP'��t3v;'+� 1 7j .............OF... / /qh/ ................................. �/ RNSTABLE C®NSERVATI'oN Appliration for Uis niial .ern mmaSSIO Applicati n eby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: � /� p: ------------------------ -----•---------..-•--.--..............•-- o ation dd �j' -- - Owner.............. S✓� 12 . Installer Address Address Type of Building Size Lot....... ku.Sq._feet a1—Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder , pi Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtur W Design Flow............... ......................gallons per person pFr Jay. Total daily„flow..............I..........................gallon. WSeptic q uid capacitv.�'-��_...gallons L ength_�__:__.... Width "�___ ___ Diameter.__-_---_..._. De th..4-_l,_.. x Disposa�ll—No. _..�5.._.._._._.. Width.....Ve......... Total Length--- _...... Total leaching area___-�'.6-...sq. ft. Seepage Pit No--------------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box (V6s Dosing tank ( ) i Percolation Test Results Performed by......................J911-D-W-✓-_�?_� �!. ._. Date..l�_° _ . ............ ,a Test Pit No. 1.0.&4 5mmutes 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-/'�.1......___. a O Description of Soil------------- lv�-----��-- �------------------------------------------------------------ ••-•----•--------------••--------------------------•----- ............................••---------------------------------------------------------------------------------------------- x W -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- VNature of Repairs or Alterations—Answer when applicable_______________________________________________________________________________________________ -------------------------------•------•--------------...----•----............---•-•-----•-------•---•-•-------•----------...----•-•------••---......-------------•--...._....--••----•-------------•-••. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal Syste in accordance with the of TITLE S of the State Sanitary Code—The undersigned further agrees to place the system in o er n until a rtlfi to Com lianc has been issued b the board of health. P P Fl@YWC1 S m e6e t;Gr 2 F_.. Si ed s Date / Application Approved B r�_4 �� PP PP Y " ` 1 - �t;Application Disapproved for the following reasons:.............................. ........... ........................ . ..._ -•--- Date PermitNo--------------------------------------------------------- Issued------------------- ................................ Date THE COMMONWEALTH`OF MASSACHUSETTS BOARD OF HEALTH i . .---........oF.... `140*4, 1- '---------------------------- AV#firafiun for Bi-spugal Workii Tontitrurtiun Famit Application is hereby made for.a Permit to Construct ( or Repair ( ) an Individual Sewage Disposal' System at: `� ..... ........................ p ........._ ..... - ..... '..._.. ._........ Location-iAddr or t No. 176 Owner Address ;A-6 -.7.F= Installer� Address Type of Building Size Lot_____:� __t'f Sq. feet tl *Hwelling—No. of Bedrooms................_...........................Expansion Attic Ab Garbage Grinder PP4 Other—Type of Building ............................ No. of persons........................-... Showers ( ) — Cafeteria ( ) a' Other fixtures ------------------------------ -- — - --- W Design Flow................I' .�....... P�gallons per person pgr day. Total daily flow................................................._.....___gallons. WSeptic T iSuid capacity t....gallons Iyength-_ Q" ... Widths ZG�r ___. Diameter... ............ Depth_. _.- x Disposa � �l =No. .....: :........... Width_ ._�4a_......... Total Length.......ZX....... Total leaching area _19, ft. Seepage Pit No...........:......... Diameter-------------------- Depth, below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box (�,~f' ;`' Dosing tank ( ) ~" Percolation Test Results-' Perfffmed by.-•-__--.-_--'--__----• pe?.' C._... ...&�•-_..... Date...d� _' Test' Pit No. 1.. e .cy,._mmutes per inch Depth of Test Pit------4---....__ Depth to ground water___-__'_�_�:...._.... vo Test Pit No. 2................niinufes per inch Depth of Test fit..... _-------- Depth to ground water-- -7:'_......... p,O Description of`Soil !�� ' --- l ----5 , --------------------•--••----------------------------------------- ------ ------------------------- W ------------------------------------- = ------------------------------------------------------- -------------------------------------------------------------------•-••-•-----..... U Nature of Repairs or Alterations ,",Answer when applicable---------------------------------------------------------------------_............................ ...................................................... Y_ ___.__........._....._..._........_.................______._..._________....._..........__.._____._._..___..._.____.____.._..___.__...._.... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions'''of i L °5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate Of Compliance has been issued by the board of health. t S med _... P R ;; -+-----Ltiat,fi � Date Application Approved By.......: a_ ._..-�-1--.. G + /�Date Application Disapproved for the following reasons: ......-- =; `--•-•-• ---- C/ Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALT .... .........OF...... .. ."..- Trr$ifiratr of Toutphaurr THIS IS TO CERT FY, That t4, Individual Sewage Disposal System constructed ( ) or Repaired ( ) ......... ................ at "" 12.o. .KdYs 1 � has been installed in accordance with the provisions of j oThe tate Sanitary Code as described in the application for Disposal Works Construction Permit N-9---- � .40).1 dated----AV.' `�--fir................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY: DATE. ..................................................... .................. Inspector............. THE COMMONWEALTH OF MASSACHUSETTS 7(f ( BOARD F .HEA T J�I...............OF........, �.... 1'��..t.................. ...--- ti..r/ No......................... FEE ........................ Permission iereby granted.......... �iy .....�az-Z------•-•-------------------------------�--------------•--- .... ✓ .............. to Construc '�r Re air ioual %e age Di; s, System atNo. t ................ ................ Street as shown on the app ic�ioor•Disposal Works Construction Permit N ._ Dated...... f� ' -••••-• ' l� 11 •-------•-•----------.. Board of Healt DATE................ ................................... FORM 1255 HOBBS & WARREN. INC., PUBLISHERS F i rr a 1 O EXISTING -;, CLOSETS t'-- ExtsTlNc A MASTER BEDROOM ,q ^,c z �a Li I I s I II - i I I w >., it — — x r EXISTING / 1 i BEDROOM PXIa CING EXISTING —ERB— DRESSING VNEW NEWT` _- - - —._------20'-7'_ 4..- V NEW _ CLOSET O O I BATH i EXISTING HALL l W N CL CL J 6 0 4.-O_�.. I r n a ' j • I -- New ` In .a-1 .D•-------- En 19 - 10 I/4.. �: 4 2 3:4 ✓. b I - - - '--------------- - m • i _--- _-- - ResslN _ ♦.. m, od .. ..-....:, ,.... .. NEW D AREA O N�II BATH >- `X EXISTING DRESSING ` _ _.I .� O c I f ...----- a W z c ROOM j EXISTING ' rts�lrt eow wrtroowsu 0 I ' TV ROOM I m' �I I CL CL C NI' j NEW ^I NEW I I- j BEDROOM t— -r-- ,� -_„ I.. I r r�ao ur. BEDROOM I I NEW lF j D 'I ao BATH 1 s SCALE:1/4"-1'-0" ' .. DATE:MM/DD/YY REViSK)i bI $ NS 6-4- 8._9" 6._4„ 4 - ._..-------- - p — - ---'3 5.-0.. PARTIAL FIRST FLOOR P—�N PARTIAL SECOND FLOO PLAN p was VV I-V scale va••r-o• - p k------ -- ------ 3 S -0----—..._..---------- ----------' FOUNDATION CL MBR PLAN, s I FIRST FLOOR — — PLAN PROPOSED..� ME DR ADDITION \ YT" D L DESIGN E /. LIB K SET m�l IssuE FIRST PI.00R KEY PLAN A2. 1 f!u L` - Io II I I! , \ z `on 's F ---- Z I I i i fA Ildl � it I I I I; - i NAY BFAEIptY ASSDL w ! \ I ! EXISTAIG I I GARAGE I I I I W iv - -----------------------_.--.._-..._�----.._-. I_ Z G1 4 10 '' ; .--. I • NEW rnl I I I I I i, I STORAGE I I i N N i NEW � GARAGE It . SCALE:1/4`=1'-0" DATE:MM/DDM' l \D I I REVISIONS: PARTIAL LOWER FLOOR PLAN ROOF PLAN 0 Sete V4'•I'-0' SME 1/4-.I'-0' SECOND I�-p Cl/ MeR FLOOR PLAN F'L L_ ' ROOF PLAN PROPOSED MEI DR YVl'l�I ' ADDITION D � • L DESIGN / LIB E R ,il SET M �J ISSUE FMST FLOOR IMY PLAN A2.2 ' rt COPLANAR" � •\ i�� F•$ 'Cl)'J I�— �/ •`�\ �/ FALSE, '`\. I_ —., L I RAID Bill -EXISTING _) AAexxAt AL I � CLA19GMlD 3W, wax NAQxc��r.40C,K. I I Vrrw'' 0 w - a H W zo i a � ca i SCALE 1/4.�1.�., III DATE:MM/ODNY I 1__t_J I J J� I � ' ` J_;i - - i IrT — REVISIONS: �. t� �, - � � I �, III,. � 0 ----- ---- ---- -- --J._.J EXTERIOR - - --- L___._Jl-1....._- --.. -------------- --_- -.:..-L- �- - - --1 ELEVATION; --- 1 •,� �i DESIGN SET �r r ISSUE N � A3.0 I EAT eA Y' -J 1 s�4 � I y 4., / Jti tv -Nei OV -I L 4 n -t t'� - � l 1 � ',yl� A + r l fir'..,,� � -✓" 'j /--Iz A CA &-�F: LET t✓.c_, ��` �s4 - c. _ t� "� s [Ac'N c �_.)t` c!-t K... f-'�-+ D r F�"� A �. ; rV�N •,�„� - _..._. Ci ` ;;.T-r .,t..., `t L 2, j''w.:"..t� �\/'6,�► lz- r.r• _.,► I ►r j' F .�lr 4 !` X t SG !. _ l At_a Q' PI P ,.. !) ,►' v X. i l. ';F 4 4F. r;+' t, F x Z`5 ��;F - � � _ i __ - h.� �: Q tom' ► �.-tf �r1 'TGrT h z . V r ►G, �.� = / �„j', t. 4� GLaT F (� ; , , r Arc: ►.j '�A:? i 1�1eN DL�+.> lKI `�' .- r=� -re-Tle V ; L tom. .5' h 1 1, a l ._ i _. C'.'..._�:,�-Jf:.l.� ..�f�,►.3,(„ Gr1Z. l 'E".'/�.lac, L. 8 !n Sri-'; , t, M LIAM ;�Z dk. I �" �TTG►✓ !,, (q + •10 � � �►�j -* �t� C. �":', °; rF '� tr NYF L V�ej .t ( f« 4 •* `!t".. C` v e 4k% a r 41,5 d I tSC. Suzy. r j� C lj)) tt tl.; �3Eyc_t. �MuvE u►.rSu,T} _ 1 A l L_L Ate ' I IT-7 -- N0+1' 5eyE.►,A,t,t� v..�, -i`l." �'..r"'� i`� aF �t• )Z� 14 C.� i.1�_L`. Zd Ct;A* 1e., Ag�7X _ov`� i F. efrl : ,'klkml-'� �' , _ -.•� '� ,,. �tal .tz 1� ! U . J Z . 7 J � c 1/1; 'c ✓ � 7 -M H /cr'E*47 T'C i-EAe-/l !N,Q�•!F �' . . ,t' �.l-,t_. �7r✓ ,r:l<�►.� f� 1' ! J C�►, C . • y r ° , l i . ; LEGEND /ABBREVIATIONS ,. 7 .vY .R .. DEP FILE No. SE 3.440 u F SITE r p ` ORDER OF CONDITIONS ISSUED JULY 18, 2005 C UTILITY POLE GUY WIRE •. UGE UGE UNDERGROUND LINES , . • .� : z , ,00 CONTOURS o• SPOT GRADES o . •. ••.• . • - LIGHT POLE Q .� •� LOT 1 DD z - a A �• �y, :x:s ' MAG NAIL +� L.C. PLAN 15354-W g p O = TREES & SHRUBS • :. a s r f .. S a N/F MICHAEL A. do MAUREEN 0. CHAMPA • a ♦ i' if Srt'^ ar tb.,r aU s4F gtit+ - ,�: � � o � '> . �. {�' s � , .,: �- �� , ,•4� .• • . 'O U Ac - AIR CONDITIONING UNIT TEST PIT r a ` v ♦°.:M } r Lk , ,u x 5 9 50' OFFSET FROM g ® ELECTRIC METER n " w ' an n' �•• - - S 89 42'11" E 167.63' LCB NOT FND (LC. PL. 1r221 54 W do 57) - - TOP OF COASTAL BANK 2.0 EL = ELEVATION •° m LCB 0 = LAND COURT BOUND 5.2 5.3 S 89.42 11' E 't TO OBS. MHW 5,g S 7 LCB FND 5 6 3.6 4' PICKET FENCE .02 5,5 ' PICKET FENCE S.s 5,8 .I 1 i+ DH DRILL HOLE • o # r f ' ` r p J s 5.052 LANDSC PED ARE `�_ i FND FOUND 6, TEST s,6 --- I G, INV = INVERT 1 T PIT t LO `2&.dc 59 COMBINE �� + , LOCUS MAP Scale: 1" 2WO� 6'0 5 LAWN TO CREJJ►T� LQCUS �I LAWN ^ F.F.E. = FINISH FLOOR ELEVATION 1 �� > \ , j 5,6 61 ,8 � TOTAL PARCEL. AREA , i + iii•"111 EP = EDGE OF PAVEMENT LOCUS NOTES : �� 5.� 5,4 5,5 �Q .:; - ?1 TO Mf/W HIGH WATER •; I a 2.2 RET. _ +, 6. ;.,� --__ti 41,477f SO. Fr. o -4 I ; I 1 RETAINING WALL - - 8 --_ o.95t ACRES $ ` '' 1.) LOCUS AREA IS COMPRISED OF ; PAVED PARKING ,� 6 � g 5 �--, - �'i �x 4 SEPTIC SYSTEM NOTES : -on BASRNSTABLE ASSESSOR'S MAP 072 PARCEL 028 002 ` 6.4 LOT 59 0 LAND COURT PLAN 15354-69 6 '� 6.5 7'1 " 9 ~�'`- - ' ® ND COURT PLAN 15354-57 6 - 6 �t&�# '� L.C. \15354-57 -- 7 6,9 N i 1 1.1) PUMP AND REMOVE EXISTING DISTRIBUTION BOX AND LOT26 LA U 7 5.9 6 10 -� I 1 LEACHING CHAMERS. CERTIFICATE OF TITLE # 83,002 (9-24-1980) s ;° 5 8 ;� 6.8 _ x-$.1 �i + II 10.7 i 1 2.) EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING OWNER: JAMES A. DALEY, TRUSTEE 1 I 11'7�� _ \� ��, i�+i i j ; 21 > SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5, PER 44 WESTERLY ROAD �� +1 i 1` 3,o z 310 CMR 15.255. WESTON, MA. vE_� s.9 �,'' ,t " '., / ' 6' h \ \ \� -i'+'''��'1 _ • I ►••� I / 4 �- 3 z_ �. '' 3.) ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4 PVC., SCH 40 2•) ZONING INFORMATION- LI ` ,� 6.1I 9% �` ,-'a,; � �� z �I; jl �t y 4.) THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN Q 4,4 �' \ , , ` I , APPROVAL BY DESIGNING ENGINEER ZONING DISTRICT: RF 1 ` 14,4 \� o OVERLAY DISTRICTS: AP N AQUIFER PROTECTION 6,6 x 5,8 i s:. �� \ j I i 'i RPOD N RESOURCE PROTECTION � � I �� ' � � � N 5.) WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFlWNG, I LAWN 1 I o 14.6 14,7 � � � � x 8.6 � � NOTIFY THE ENGINEER dt BOARD OF HEALTH AGENT I-3 ` 8 0 12 x `� � s° ' ' ', $ FOR INSPECTION. MINIMUM CURRENT ZONING REQUIREMENTS ` � � 7,1 $ � \� �\ \ ', �� • � � i x`, � MINIMUM AREA: 2 ACRES (RPOD) � 8�; v+� _ 13 14.7 � w� \ � \1 ; � `,� �2 6.) ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING BY DESIGNING ENGINEER. MINIMUM FRONTAGE: 20' N MINIMUM WIDTH: 125' b i `1 �� 1 8 � � �,` 1 � LAWN � �,� � \ 2,4 V� FRONT YARD = 30 SIDE & REAR YARD = 15 ° , X s,,� 8,5 g 7- �` 14,7 �`\ ` , }41`, , \ 7.) ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH � 14,4 OpA, 9 `� r„ , ,` , �, TITLE V OF THE STATE SANITARY CODE DATED MARCH 31, 1995 3.) COMMUNITY PANEL NUMBER 250001 - 0018 D �` 01 �� c 1 `, I • `, �i M\4 2 ` ANY LOCAL RULES APPLICABLE. THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS, a , + , ST 12,11^ v+ :' �` I , x ZONES A13 (EL. 12.0) �� ! 4ETAINING WALL \ �pM,O�f�5p3 14 13 ' 2.6 8.) PROJECT BENCHMARK: DATUM NGVD 1929 BASE FLOOD ELEVATION = 12.0' (NGVD29) � �� MIN s �� `, \ / 10,8 � ttio g2 14,6 � 9,1 8,2� � - 41 �` � �' LGHT POLE BASE BY 0.M 36 (FIRM MAP OH 1 MAINBGATE = 19.33' `� 1�500 NG/GLL. ` 14,3 .'j.5 )7 5 SOIL LOGS DATE: 12-10-04 T, y 14,6 / / C - j to -r TBM: = L.C.B. O S�W. CORNER OF LOCUS P#=P-10,883 N � 61 SEPTIC 14A I ` 9.4 7 e�`�.1 ' \ , EL. - 9.44 (NGVD) 10.3 v/ x S y A 10, ,` 14,s � o 9.) A TITLE SEARCH WAS NOT DONE FOR THIS SITE; SHOULD ONE SOIL EVALUATOR: STEPHEN A. WILSON, P.E. b l 13,6 x ��ry ' ; 3 �/ _ ____ ` BE REQUIRED IT SHALL BE PERFORMED BY OTHERS. B. 0. H. AGENT. DAVID W. STANTON R.S. N �. 8.4 - -- m- - ---- i 9,�f-- -' TEST PIT 1 TEST PIT 2 r 10.) THE PROPERTY LINE INFORMATION SHOWN IS BASED ON G.S.E. = 5.4'f G.S.E. = 7.8'f 2.4 �./ = `13,2 14,g J �''% � CURRENT AVAILABLE RECORD INFORMATION CONSISTING 0" A O" TEST PIT _ J 9• �G 13.3 �� 0 �i' ,, "- � OF PLANS AND DEEDS. THE EXISTING FEATURES SHOWN P 7.8-� I r ":� I DSBOX / x 12,6 13 14.3 �/' 6,6 LAWN HEREON WERE OBTAINED FROM AN ON THE GROUND SANDY LOAM FILL a x jJ 4.3 ob LCB FND 12" 10 YR 2/2 32" 5'0 y ,� ` Ss C ` 9'2 g�o� 11, TH W � d HOLMGREN, NC.FIELD SURVEY ER2006E0 BY BAXTER, NYE & B AP , - 9.3 11 �Z 8. G,`00 ' SANDY LOAM SANDY LOAM ` x 9.0 9.1 � x 11.9 11.4 ® s 5.6 11.) PLAN REFERENCES: EXISTING- STONEWALL - .11.3® - ,� LAND COURT PLAN 15354-W, 57 & 69 32" 10 YR 4/6 40" 10 YR 4/3 8.6 ACH CHAMBER w / _ 9 ---_ D-BOX TO BE REM ` _ LAWN 10,3x 9.4�� 0 7.2< g 12.) UTILITY INFORMATION SHOWN HEREIN: C 1MEDIUM SAND SANDY LOAM 9.3 `� LAWN 8.3 ��``' �9 '0; 6- RET F- WALL/ MwW I OFFSET FROM LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND 9.4 O, 8,5 10 �'' X. i' TOP OF COASTAL BANK MUST BE VERIFIED IN FIELD BY THE CONTRACTOR AND 56" 10 YR 6/2 56" 10 YR 2/1 9 9.1 P"P 8./ Bi ---- ___ �•---'� 9��' APPROPRIATE UTILITY COMPANIES PRIOR TO ANY CONSTRUCTION. C 2 C 1 W /�• LC. PLAN 15354-69 SANDY PEAT SANDY PEAT 9,5 13. EXISTING SEPTIC SYSTEM LOCATION IS APPROXIMATE. C. PER INSTALLER'S CARD PERMIT #79-0701 54" 10 YR 2/1 66" C 10 YR 2/1 OBSERVED GROUNDWATER 0 61" (EL 2.7) / I' ~'`- s - 05 Ls 5 C COARSE SAND 2 COARSE SAND D\ 9,5 �c TBM: LCB \ C1K 7.7 k COBBLES 108" 10 YR 4/1 72" 10 YR 4/2 �� EL. - 9.44 (N VD) C 10.1 I 3 10,2 LOT 58 92 North Bay Road MEDIUM SAND L.c. PLAN 15' ' 69:` oyster Harbors N/F BARTON TOMLINSON Osterville, Massachusetts 120" 10 YR 4/2 1i3 '0 8.3 PREPARED FOR PERC O 72" RATE- 2 MIN/IN UNABLE To Saar N 10.2 James A. Daley Leaching Area Requirements DESIGN SCHEDULE ELEVATION 6 BEDROOMS AT 110 GPD/BEDROOM = 660 GPD TM Q FINISHED FIRST FLOOR 15.03 ADDITIONAL 5OX FOR GARBAGE DISPOSAL -NA,_.GPD Wetlands Permit Plan Proposed Addition N FINISHED BASEMENT FLOOR 6.8 PERC RATE _ MIN. / INCH (CLASS 1 ) 0; EXISTING SEWER INVERT AT FOUNDATION 10.2 LIAR = 0.74 GPD/S.F. L. SEWER INVERT INTO SEPTIC TANK 10.0 SEWER INVERT OUT OF SEPTIC TANK 9.7 MIN. LEACHING AREA OF SAS. : J.K. HOLMGREN ENGINEERING, INC. oSEWER INVERT INTO DISTRIBUTION BOX 8.8 660 GPD/ 0.74 GPD/S.F. = 892 S.F. MIN. N SEWER INVERT OUT OF DISTRIBUTION BOX 8.6 PROPOSED SYSTEM: BOTTOM 20 X 45 = 900 S.F. BAXTER, NYE&HOLMGREN N SEWER INVERT INTO LEACHING SYSTEM 8.5 SEPTIC TANK - 660 GPD X 200% = 1,320 GAL. I Registered Professional Engineers and Land Surveyors ��,��H°f 6 BETWEEN INLETS 4 STEPHEN BOTTOM OF LEACHING TRENCH 7.7 EXISTING SEPTIC TANK IS ADEQUATE. 812 Main Street, Osterville,Massachusetts 02655 WATER TABLE: OBSERVED AT ELEV. 2.7 Ft H GRADE 9" MN' � MAX OIL AI"L -o FINISH FLOOR EL Exc,.ua,uc TOPSOIL Phone - (508)428-9131 Fax - (508)428-3750 N = 15.1 FILE 2" MIN. LAYER DOUBLE WASHED COMPACTED ewac » 2" 0� �GIs CONSTRUCT ACCESS a MANHOLE OVER INLET TYPICAL SYSTEM PRO STM t/8 to 1/� OVIER " 12 DOLSLE-WASHED Fss, FINISHED GRADE = 14.5t TO TANK TO AT LEAST NOT TO SCALE DISTRIBUTION LINE 4. pErWnRAim EFFEC NE ZM s ISrW 3/4" ONAL � t WITHIN 6" FINISH GRADE - 1n t t/2'xv SCH 40 20 0 20 40 7 dS -. FINISHED GRADE OVER TANK = 13.0± I ' o _•» "MIN. SEE PLAN VIEW FOR FIELD LAYOUT SCALE IN FEET N 8 3" (mi PROPOSED FINISFIED GRADE OVER LEACHING FIELD - to.ot L.EA = 4" CH. PVC 4" SCH. 40 PVC FIRST 2' (TO BE LEVEL) NYS SCALE: 1„ 20' - TYPICAL �( ) - 0 2.0% then O 1.Ox 2" LAYER 1/8" TO 1/2" STONE 9" MIN COVER DATE. 04/26/05 o _ OL2 (� IF 3 ji0 CITEES - 6• sump „ 0 4" SCH. 40 PVC DOUBLE WASHED STONE FINISH GRADE LLJ :- No s. , : Y_:, (3/4' to 1 1/27 6 2" LAYER DOUBLE WASHEo �• ', TOPSOIL% 36 Elf ..�. --ter ,.� EL - 7.7 STONE 1/S to 1/2 2 2. SAW 7-20-05 REV. ADDITION & SEPTIC Cal 6" CRUSHED OVER DISTRIBUTION LINES g» STONE BASE 5, STONE a/4" m t t/2'to• LAYER OF DOUBLE WASHED 1. SAW 7-19-05 ADD RESERVE & WATER LINE 00 n FOOTING .-'• j GROUNDWATER OBSERVED o EL 2.7' NO. BY DATE REMARKS DRAWING NUMBER ocl� LEACH#NO FELD CROSS-SECTION (4)- on LINES PVC 0: 2004 SURV WRKSH 2O04-158w 2.dw E=TM 1600 GALLON SEP11C TANK DISTRIBUTION BOX NTS NTS 2004-158 O O N O LEGEND /ABBREVIATIONS DEP FILE Now 9E 3.440 ORDER OF CONDITIONS ISSUED JULY 18, 2005 C �' = UTILITY POLE GUY WIRE UGE UGE UNDERGROUND LINES 1 � •wr., p ri f CONTOURS X�oo.o = SPOT GRADES 4 s.- °.• ,a .■.� ' LIGHT POLE .4' �. ;� LOT 1DD Z • = MAG NAIL L.C. PLAN 15354-W g N/F MICHAEL A. do MAUREEN 0. CHAMPA TREES & SHRUBS b • sty f `}r i -.,.4 pi;f ,t t`. �.♦ 0 AIR CONDITIONING UNIT 8 - v - TEST PIT • o° �` x ' :� �r 50' OFFSET FROM g ® = ELECTRIC METER tie y ay t �; 5.9 - / - - - S 89'42'11 E 167.63' LCB NOT FND L.C. PL 1 W do 57) - - - TOP OF COASTAL BANK 2,0 EL = ELEVATION A LCB I = LAND COURT BOUND ,� , ` > `' , /� . 1 n v` • 6.ip � w LCB FND 5,6 x � n a: � 5.2 5.3 S 89'4211 E 221 t TO OBS. MHW 5,8 5.7 3,6 a• �` ri; �� ';`4r it',' "� ,`� ��0 4' PICKET FENCE 00.02' S,0 5,5 ' PICKET FENCE 5,5 5,8 ,I 1 M DH DRILL HOL= E � 4 a r • 4.9 5.2 LANDSC PED ARE _ _ FND = FOUND ,• tied f i, r _. ' // O J.. • .��- ��-_-,_ /"� I I I TEST PIT 5'6 't 1 LATS-28-_,Sc 59 COMBINE ��' ,I I INV = INVERT LOCUS MAP Scale: In = 2000' /6.0 5 LAWN LAWN TO CREATE'ums ( I i 5,6 `,�I i >� ^ F.F.E. = FINISH FLOOR ELEVATION TOTAL PARCEL LOCUS NOTES : �\ 5.5 5.4 5.5 6.1 8 6 - WATER .; I ; �� 1 EP = EDGE OF PAVEMENT i 7.1 - I a 2,2 RET. 6, ;.,� _ 8 _ - 41.477t SO. Fr. o .a I ; I ; = RETAINING WALL 1.) LOCUS AREA IS COMPRISED OF ; PAVED PARKING 6 ` 0.95t ACRES Q° �.� i x 1 4 8.s x ' C� SEPTIC SYSTEM NOTES : BASRNSTABLE ASSESSOR'S MAP 072 PARCEL 028-002 '` � � 6.4 '-� _ _ � � I I I LOT 59 ® LAND COURT PLAN 15354-69 5'6 -' �� u 6.5 7'1 _ 9 -'`�- ' 6 ter,, { LC. 15354-57 ` 7 1. PUMP AND REMOVE EXISTING DISTRIBUTION BOX AND LOT 26 ® LAND COURT PLAN 15354-57 6 7 I 5,9 6 • , z� �o �0 -� �\ } I ; S LEACHING CHAMERS. CERTIFICATE OF TITLE # 83,002 (9-24-1980) .5 �� Nam " { 6.8 °'7 _ i� 1 r i ' i Fi �. , 2.) EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING 5,8 � _ ' �;�� 11,7 11 \ w � I 1 II I I m ' OWNER: JAMES A. DALEY, TRUSTEE �� \\ ", -v -1 l I , 2,1 z SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5, PER 310 CMR 15.255. 44 WESTERLY ROAD ' 1 5.9 ` rid`" pR% 6;17 �\�� \ �� 91 Nt'l ,1 WESTON, MA. __ s - i �z �; 3 z o11 l c� / 9 � �Op�R `\-,,` �\ \ -' ,7��,y x 3.) ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4 PVC., SCH 40 / / . II ' ' 4. THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN 2•) ZONING INFORMATION 6,1 -, �. a _,_ �� ' r-� ) ZONING DISTRICT: RF-1 O I ° ' \ � \ ` `�9 -4 I 1 1 0 APPROVAL BY DESIGNING ENGINEER OVERLAY DISTRICTS: AP N AQUIFER PROTECTION 6,6 f , O� � _ 14,4 \` ` `\ �\ o i � ; ', I x 5.8 %\ � i I , , N 5.) WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFIWNG, RPOD N RESOURCE PROTECTION r LAWN I �•''i � �` , 1 I ` NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT i 14,6 14,7 � � \ � x 8,6 ` �I I , t O� MINIMUM CURRENT ZONING REQUIREMENTS ', 71 8.0 12 x �� ?, � 8,0 , �� $ FOR INSPECTION. MINIMUM AREA: 2 ACRES (RPOD) IT 13 14.7_ �', i N� w, 6.) ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING MINIMUM FRONTAGE: 20 N MINIMUM WIDTH: 125 I \ � � � ,� �,,�� 2 4 BY DESIGNING ENGINEER. FRONT YARD = 30' SIDE & REAR YARD = 15' ° , 1 .8 14,7 t '�` 1 y LAWN > x Al 8,5 g ` a ', I ', ', '� 7.) ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH \ ! ! .1 >� t 144 ? ' �t` �; 'i f`.' ' `, �\ TITLE V OF THE STATE SANITARY CODE DATED MARCH 31, 1995 3. COMMUNITY PANEL NUMBER 250001 - 0018 D , �Z� 110, 1 ,� ANY LOCAL RULES APPUCABLE. THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS, s t , , S 011 121`F'p� y15. �` tt I t1 t` 4.2 ZONES A13 (EL. 12.0) �� STAINING WALL pM�� '��5�5 `� 1�I. 51 j ) BASE FLOOD ELEVATION = 12.0' (NGVD29) `, 10•0' 5, / 10,8 % ,�4g > 3 2'6 8. PROJECT BENCHMARK:RM 36 (FIRM M MAP 250001 0018 D) MIN .p 1f`0 c 92 14,6 9,1 8,2 4� r- � DOSTING . 14,3 / �.5 5 7�s LIGHT POLE BASE BY 0. H. MAIN GATE = 19.33' SOIL LOGS DATE: 12-10-04 I '_ 1,500 GAL. o / SEPTIC TANK ` �' TBM: = L.C.B. O S.W. CORNER OF LOCUS P#=P-10 883 \ 6 fi ' 6 14.4 14.6 y /9.x tD ' EL. = 9.44' (NGVD) N t / 10,3 10, , �� x 7 Pt%V�/ `x 3,8 �\ SOIL EVALUATOR: STEPHEN A. WL.SON, P.E. Oy' ( 14.5 / ; 3 ' o �, 9.) A TITLE SEARCH WAS NOT DONE FOR THIS SITE; SHOULD ONE `�• BE REQUIRED IT SHALL BE PERFORMED BY OTHERS. B. 0. H. AGENT: DAVID W. STANTON R.S. �} RAII' 13'6 x --- ,��' L ----------- 1 - - �-t"- ' 9, f 2,4 TEST PIT 1 TEST PIT 2 0.0 � • 10.) THE PROPERTY LINE INFORMATION SHOWN IS EASED ON G.S.E. = 5.4 f G.S.E. = 7.8 f '�'; �70 �13.2 1 .3 0 �';- CURRENT AVAILABLE RECORD INFORMATION CONSISTING r `� » » TEST PIT 13.3 / 10 � , OF PLANS AND DEEDS. THE EXISTING FEATURES SHOWN ® AP 0 7 8r/ I s ' EXISTING x 12.6 13 14 . /�/ 6.6 LAWN HEREON WERE OBTAINED FROM AN ON THE GROUND SANDY LOAM FILL $ , . �g; F � D-Box 4.3 9 ` LCB FND " » TO BE y,► ` 9.6- / FIELD SURVEY PERFORMED BY BAXTER, NYE & LL 12 10 YR 2/2 32 _ 9 2 9 3 s�p� 11, �Z pu, C TFI ONCE o HOLMGREN, INC. 12-06-04 B A / 8 O`w8 `''Q 11.) PLAN REFERENCES: x 11.9 LAND COURT PLAN 15354-W, 57 & 69 SANDY LOAM P SANDY LOAM x 9,0 1 9.1 `yam �13® ® 5.6 32" 10 YR 4/6 40" 10 YR 4/3 EXISTiNMB` �STONE`WAL�__ 1 8 6 ACH CHAMBER � B / 9 _ D-BOX TO BE REMO \ LAWN 10,3x 9,4 o. 7.2x , _ 12.) UTILITY INFORMATION SHOWN HEREIN: C 1MEDIUM SAND SANDY LOAM 9.3 ��`, LAWN 8.3 4��' �9 \ �10; WALL MrlcM 100' OFFSET FROM LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND 9,4 s�\ g,5 O /�` �' i' 136 TOP OF COASTAL BANK MUST BE VERIFIED IN FIELD BY THE CONTRACTOR AND 56" 10 YR 6/2 56" 10 YR 2/1 9, 9.1 P'40 8•/� 1�---_ __�_-� 9�9s• �td�' APPROPRIATE UTILITY COMPANIES PRIOR TO ANY CONSTRUCTION. Q rl L.C. PLAN 15354-69 _ 2 C 2 C 1 b'o � w / / • SANDY PEAT SANDY PEAT e' 13.) EXISTING SEPTIC SYSTEM LOCATION IS APPROXIMATE. 54' 10 YR 2/1 66" 10 YR 2/1 w 9 5 r ��`_ �r,G ` S e? , PER INSTALLER'S CARD PERMIT #79-0701 OBSERVED GROUNDWATER 0 61 (EL 2.7) 8 - LS C 3 C 2 � � •IRS COARSE SAND COARSE SAND 9,5 Z Cfc 7,7 & COBBLES 1 TBM: LCB F10 108" 10 YR 4/1 72" 10 YR 4/2 EL. - 9.44 (N VD) C 10.1 10,2 LOT 58 92 North Bay Road MEDIUM SAND • L.C. PLAN 15354-69 Oyster Harbors 120" 10 YR 4/2 1 3 N/F BARTON TOMLINSON Osterville, Massachusetts 8.3 PERC O 72" 0 11 .0 PREPARED FOR RATE- 2 MIN/IN I UNABLE TO SQAK i N James Daley 10,2 � y Leaching Area Requirements ii DESIGN SCHEDULE ELEVATION 6 BEDROOMS AT 110 GPD/BEDROOM = 660 GPD TiiLE Q FINISHED FIRST FLOOR 15.03 ADDITIONAL 50% FOR GARBAGE DISPOSAL _NA-GPD Wetlands Permit Plan Proposed Addition N FINISHED BASEMENT FLOOR 6.8 PERC RATE _ MIN. / INCH (CLASS 1 ) O o EXISTING SEWER INVERT AT FOUNDATION 10.2 LIAR = 0.74 GPD/S.F. SEWER INVERT INTO SEPTIC TANK 10.0 SEWER INVERT OUT OF SEPTIC TANK 9.7 MIN. LEACHING AREA OF SAS. : J•K• HOLMGREN ENGINEERING, INC. 0 660 GPD/ 0.74 GPD/S.F = 892 S.F. MIN. O SEWER INVERT INTO DISTRIBUTION BOX 8.8 BAXTBR, NYE &HOLMGREN SEWER INVERT OUT OF DISTRIBUTION BOX 8.6 PROPOSED SYSTEM: BOTTOM 20' X 45' = 900 S.F. �11A OF SEWER INVERT INTO LEACHING SYSTEM 8.5 SEPTIC TANK - 660 GPO X 200% = 1,320 GAL Registered Professional Engineers and Land Surveyors BOTTOM OF LEACHING TRENCH 7.7 EXISTING SEPTIC TANK IS ADEQUATE s' BETWEEN INLETS I 812 Main Street, Osterville,Massachusetts 02655 sAU WATER TABLE: OBSERVED AT ELEV. 2.7 � FINISH FLOOR EL FINISH � 9*�:�Dnre Phone- (508)428-9131 Fax - (508)428-375000MPACTED � 1e N = 15.1 CONSTRUCT ACCESS 8 c " MANHOLE OVER INLET TYPICAL SYSTEM PROFILE . 2" MN. DYER DOUBLE tUAS1iFD 2' 9 /STEA O STOPE 1/8 in 1/4 OVER 12 DOU61E-NDISl1ED FSS�ONAL L FINISHED GRADE = 14.5f WITHIN 6 TO GRADE WIRIBUI LINE »P I Sr;N EFFECTIVE oEPTII s" TO 1�/4 20 0 20 40 ds � . . NOT TO SCALE 4 � • - FINISHED GRADE OVER TANK = 13.0t ' o •-'-• » - 45' --� SEE PLAN VIEW FOR FIELD LAYOUT SCALE IN FEET j :s 8 MIN. " 3mi PROPOSED FINISIED GRADE ovER 1.154cHnrc FIELD - 10.0f LEACHN DUAL _ 4 CH. PVC 4" SCH. 40 PVC FIRST 2' (TO BE LEVEL SCALE: 1" 20' co TYPICAL -� O 2.0% �then O 1.0% 2" LAYER 1/8" TO 1/2" STONE 9' MIN COMER DATE: 04/26/05 0 6" SUMP n 4' SCH. 40 PVC DOUBLE WASHED STONEL�j Iv _ e FINISH GRADE _ -•r -. EL 7.7 2to I 1/ ' LAYER DOUBLE WASHED 9• ) TOPS/ 3r MAX D 6' CRUSHED STONE 1/8" to 1/2" 2" Cal OVER DISTRIBUTION LINES 2. SAW 7-20-05 REV. ADDITION & SEPTIC _ Wk � FOOTING v ti - STONE BASE 5' g 10' LAYER OF DOUBLE 1/2' 1. SAW 7-19-05 ADD RESERVE & WATER UNE GROUNDWATER OBSERVED O EL 27' + STONE 3/4' TO 1 1/2 N0. BY DATE REMARKS DRAWING NUMBER SLOTTED PC 0 LEACHM FELD CROSS-SECTION (4 DISTRIBUUTION UNES 0: 2004 SU WRKSH 2O04-158w 2.dw EXISTNG 1500 GALLON SEPTIC TANG DISTTFMUTION BOX LEACHNQ FELD ITYPICALI o NTS "� 2004-158 O N O 1 t ————————————— t tiM I I ' ---•.—----------------------_T------ z EXISTING L CLOSETS ; ti --I - - - f WASTING I I C/1 w �yI MASTER BEDROOM 1 •ti 1 I I I i. 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