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0248 NORTH BAY ROAD - Health
248 NORTH BAY RD. , OYSTER HARBORS A=073-033. OSTERVILLE e v No. 4210 1/3 BGB. C� ESSELTE 0ve-i,�6 © O 0 0 i ® TOWN OF BARNSTABLE LOQ'ATION SEWAGE# o26 a '" I a f 4.v VILLAGE a5lore.r✓=N C, AS SSOR'S MAP&PARCEL, Q7� ®3� INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY Z, 0 an LEACHING FACILITY:(type)(�\1 ^ZO ®4 (size) 15-.q"K { 3� NO.OF BEDROOMS OWNER tV, C4 PERMIT DATE: d COMPLIANCE DATE: a 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 iyry, J QyGQ� � ivorfte� 2d. D 3 7Z X4V` !K p� No. /�� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered inc mputer:_ Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppliLatlon for Misposal OpBtem Construction Permit Application for a Permit to Construct(t-*T— Repair( ) Upgrade( ) Abandon(Vj omplete System ❑Individual Components Location Address or Lot No. Mp rf �a R vow Owner's Name Address,and Tel.No. ton 01,4 PL Assessor's Map/Parcel C7 01 M � Installer's Name,Address,and T 1.No. Desi n�r's Name,Address,and Tel.N)0 /1�f'Cul �04,kIts o I Type of Building: . Dwelling No.of Bedrooms Lot Size 78eo d sq.ft. Garbage Grinder( ) Other Type of Building n CJ% t4(a No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 7-70 gpd Design flow provided 7 7 Z, `gj gpd Plan Date �/I �2c�2 Number of sheets Revision Date Title S;ie r6pt &3PO4 T+)ero t-e*eA-� J / Size of Septic Tank 2C*O Y^20 Type of S.A.S. Description of Soil TH ^q g R c.. Ca., e f e-oqMjZS4hc <� I 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 . Date Application Approved by Date ? Application Disapproved by Date for the following reasons Permit No. ��Cao Date Issued P-7 ${( No. —mil r. 1 l- -"f Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -,TOWN OF BARNSTABLE, MASSACHUSETTS: application for�Pispos4l,*pBtem Construction i3ermit Application fora Permit to Construct( ')"` Repair( ) Upgrade( ,) Abandon(t.� ®°Complete System El Individual Components Location Address or Lot No. U jfi�{) ti, /3- ` J?064 Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 07 510-1,"� N� tL Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. ao,) r,tf T)rpe of Building: " Dwelling No.of Bedrooms 7 r s Lot Size )LOrt,U t) sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided 7 gpd Plan Date y/ �% Number of sheets i Revision Date Title �441 .,j� S Size of Septic Tank 2C-OC-- 1 Type of S.A.S. {— Q4 6.,� , �l"Ade - ;n 3-4ort.Q Description of Soil rfA� ` ('a l ; (�, ✓ 2,`d`±. F u yr E �r .!,� sas�" �<shGt, C� p 112 t ;r c Nature of Repairs or Alterations(Answer when applicable) ti Date last inspected: t ( 14 4n t i a 4 ' Agreement: ` v 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 Bo/do rI " ;;o Sigx► �Y` �� ._.» Date Application Approved by ,. f Datew��� � Application Disapproved by r Date for the following reasons Permit No. Date Issued - D 7 --.----------.------ -- -- —-- -gip ------- ------------- - ---- --- -----.---- --- -- ..------•----- --------------- 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 Vr� at C( mo 114 1-3 has been constructed,in_accor ance with the provisions of Title 5 and the for Disposal System Construction Permit No '-.y+ 7 dated 7 Installer {;��l f Designer Su � n hS:h i'Y; ( 4-f`ai�S c tl ;n j, z, #bedrooms �'7 r Approved design fl w -70 gpd The issuance of this permits all of be construed as a guarantee that the system w"ill`function as designed. Date ij �-l Ins ector r No. I Fee t/ _ Jp� / THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS WposaY 6pstem Construction permit Permission is hereby granted to Construct( ')"� Repair( )1 Upgrade( ) Abandon( ) System located at Z Y8 A r-,*'4 and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be co'pleted within three years of the date of this permit. ^ Date Approved by._ ... ,f Locate Junction Box Outside of Tank Pump Power & Float Control Cables Installed In Accordance With Federal, State & Local Bldg. & Dec. Codes Alarm To Be On Separate Service From Pumps 112"0 Golv. Pipe For Float Support 5" Q To D—Box 4."0 Sch. 40 PVC 24"0 Opening Above From Septic Tank For Manhole Compartment Frome & Cover PUMP. COMPARTMENT PLAN VIEW DETAIL NOT TO SCALE Conduit Thru Chamber For 24"O Manhole Frome & Cover Finished Power & Float Cables 9" Min. Grade Cover 4"0 Sch. 40 PVC From Septic Tank Compartment Inv. 18:95r'� . !.Iv. Drill 1 8"0 Hole Emergency Storage For Drain Volume 124 Gal. To D—Box Min. 2" Cover Alarm On D. 17.95 Pump On El. 17.7 Pumps Off D. 16.7 Pump 0 A o .0 2"0 Sch. 40 PVC n Threaded Pipe IVnlvp Bottom D. 14.95 1 Bottom D. 14.45 Secure Pipe at Top " Bottom of Chamber 6110 H.P. Myers Pump Stable Com acted or Approved Equal* Base *Prior to Ordering Pumps the Contractor Must Confirm the Compatibility of the Existing Electrical Service PREPARED BY., ffi Engineering& Suvan Consulting,Inc. PUMP COMPARTMENT SECTION DETAIL teclt�ullmrWehmn.wwvaw111va m n.com NOT TO SCALE -Draft: CAR Field: CM -• - Review: JOD Comp: J00 Project: Lebow Project Lebow 71TLE: Pool Cabana PREPARED FOR; Pump Chamber Details At Mark E. & Down C. Donovan 248 North Bay Road 398 For reach Road Barnstable pyst®rHaftrs) Mass. Westwood MA 02090 DATE 9/28/2020 SCALE: N/A Locate Junction Box Outside of Tank Pump Power & Float Control Cables Installed In Accordance nth Federol, State & Local Bldg. & Elec. Codes Alarm To Be On Separate Service From Pumps 112"0 Galv. Pipe For Float Support 5 E Q To —Box 4"0 Sch. 40 PVC P4"0 Opening.Above From Septic Tank For Manhole Comportment Frame & Cover 1,31-2" PUMP COMPARTMENT PLAN VIEW DETAIL NOT TO SCALE Conduit Thru Chamber For 24 0 Manhole Finished Power & Float Cables Frame & Cover g" Min. Grade Cover 4"0 Sc=T.nk �= From S Comportment ent Inv. 18.95 Golv. Chair Drill 1 8"0 Hole Emergency Storage For Drain Volume_124 Gal. To D—Box Min. 2' Cover Alarm On El. 17.95 f ?Cb Pump On D. 17.7 m Pumps Off El. 16.7 c Pum 0 0 .0 2" Sch. 40 PVC d Threaded Pipe Check Ivolve Bottom D. 14.95 C1 Bottom D. 14.45 Secure Pipe at Top &• Bottom of Chamber 6110 H.P. Myers Pump Stable Compacted or Approved Equal* Base *Prior to Ordering.Pumps the Contractor Must Confirm the Compatibility of the Existing Electrical Service PREPARED BY., - - - Engineering. PUMP COMPARTMENT SECTION DETAIL Suffivan 1comulti.g,ina , ( 14 0"•M Ba 6W-M Melw Sbut Odmift MA 02655 - - sea@smtra��om.w*,x=11MumVn m NOT TO SCALE Draft: CAR Field: CTR - Review. JOD Comp: JDD Project: Lebow /�Pra'ct :Lebow - - RILE: POOI Cabana PREPARED-FOR: Pump Chamber Details At Mark E. & Down C. Donovan 248 North Bay Road 398 For reach Road Barnstable (oyster Harbors) Mass. Westwood MA 02090 DATE: 9/28/2020 SCALE: N/A Town of Barnstable Regulatory Services Richard V. Scali,Interim Director MAMPublic Health Division 1639- �� N, Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 r. Installer&Designer Certification Form 10/7/2021 2020-127 073/033 Date: Sewage Permit# Assessors Map\Parcel Sullivan Engineering&Consulting, Inc. Joyce Landscaping, Inc. Designer: Installer: Address: 711 Main Street/PO Box 659 Address: 68 Flint Street Osterville,MA 02655 Marstons Mills, MA 02648 On "j •-� � �O( was issued a permit to install a (date) PmGt"Q/1__ (installer) 248 North Bay Road,Osterville septic system at. based on a design drawn by (address) Sullivan Engineering&Consulting, Inc. dated 4/21/2020(Rev. 10/21/2020) (designer) - x 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 ' ce with the terms f the RA approval letters (if applicable) a 4F MA T. �G O sta 0is Signature) " 52 G SIOMAL E�' Designer's Signature) (Affix Designers 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. QASepticTesigner Certification Form Rev 8-14-13.doe CE r4Sh a s C>rn c� 2 * , r � � j 33 Commonwealth of Massachusetts 0--�-a-0 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd 1 Property Address Rewey Suzanne L Owner Owner's Name information is Clsterville Ma 02655 9/13/19 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, use only the tab Michael DiBuono key to move your Name of Inspector cursor-do not DiBuono Sewer And Drain use the return Company Name key. 35 Content Lane VQ Company Address Cotuit Ma 02635 Cityrrown State Zip Code 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 I have determined that the system: 1. ® Passes 2. ❑ Conditionally Passes 3. ❑ Needs Further Evaluation by the Local Approving Authority 4. ❑ Fails 9/13/19 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.7/26/201a Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 cam, Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. Cityrrown 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 contains a 2000 Gallon septic tank as well as a concrete distribution box and two concrete leach pits. System is functioning as designed with no sign of failure at this time. 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 248 North Bay Rd �V Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. Cityrrown 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 Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd . Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. CitylTown 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 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. CityTTown 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 1/z 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 II 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 248 North Bay Rd u Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 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 introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form Ala Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. Citylrown State Zip Code Date of Inspection D. System Information 1. Residential Flow Conditions: Number of bedrooms (design): 10 Number of bedrooms (actual): 7 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 1,114 Description: In accordance with the letter to the health dept dated Feb 1 2005 Baxter and Nye Engineering calculated design flow at 1,114 Gpd 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 d 318 Gpd 9 ( Y 9 (gP ))� 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. City/Town State Zip Code Date of Inspection D. System Information (cont.)Y � 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: l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form �a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 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 tank and Distribution box installed on 11/13/1995 Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): System is vented at the roof line. Tee's in place at time of inspection. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form I Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. City/Town 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: 2000 Gallon 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is at normal level. Pumping recommended if not pumped in last 5 Years for seasonal use. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 Commonwealth of Massachusetts �n Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. Cityrrown 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 day t5insp.doc•rev.1116/2011 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection Form Flo Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13119 page. City/Town 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? ❑ 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.): No sign of levels above normal. t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 18 Commonwealth of Massachusetts 21 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd v Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. City/Town 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.): * 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: 2 ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Clean and dry 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.): l5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 18 c , Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments V 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 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.7/2 612 0 1 8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts ,j Title 5 Official Inspection Form I a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd ' V Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. Cityrrown 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: ❑ hand-sketch in the area below ® drawing attached separately t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 9/13/2019 Assessing As-Built Cards �TO�zWN OF B/ARNSTABLE LOCA17��� NeKf �/Qy.mil SEWAGE N VILLAGE �O *rt//I/i' ASSESSOR'S MAP&LOTj!2S INSTALLER'S NAME&PHONE NO. 40l't,0Ile COixsy; SEPTIC TANK CAPACITY 7U'OD94� LEACHING FACILITY:(type) (size) 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 1 i R 00000 Its � Prq tjl �k � Qi At . r g3— bo a 3 https://townofbarnstable.us/Departments/Assessing/Property_Values/HMdisplay.asp?mappar=073033&seq=1 1/2 c Commonwealth of Massachusetts Title 5 Official Inspection Form is Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .��.� 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 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: feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Permit pulled 11/13/95 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Permit on file 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 l°1 Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 248 North Bay Rd Property Address Rewey Suzanne L Owner Owner's Name information is required for every Osterville Ma 02655 9/13/19 page. Cityfrown 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 3� 0-73 V 3 s• f { r, . 'tk,r 4 r..r{= r°i € . F t: ga 'BORTOLOTTI CONSTRUCTION, INC. rya ���0 765 WAKEBY ROAD,MARSTONS MILLS, MA 0,C� r 1 6 508-771-9399 508429-8926 °FAX: 509 428-939 0 0� j999 SUBSURFACE SEWAGE DISPOSAL SYSTEM 1NSPECTI ORM�4 ` PART CERTIFICATION' Property Address: _Q2 V9 az& V.J_A Date of Inspection: --2/8—/903 Inspector's ame: Ow er's Name and Address: 0. /t/A CERTIFICATION STATEMENT* I certify that I have personally inspected the sewage disposal system at this address-and that the informa- tion reported below is true,accurate and complete as of the time of inspection. The inspection was per- formed based on my training and experience in the proper function and maintenance of on-site sewage V disposal terns: The System: - Passes TO Conditionally Passe Needs Further.1,2ti a Local°Aproving Authority. , rFails x. A Inspector's Signature: Date. The System Inspector shall submit a copy of this,inspection report to the Approving authority within thir- ty(30j 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 EIVEt1n office.of the Department of Environmental Protection. The original should be sent to the system owner - l g and copies sent to the buyer, if applicable and the approving authority: 'NSTgg�E INSPECTION S IMMA RY. T. A)SYSTF,IGI PASSES; , V I have not found any information which indicates that (lie system violates any of the failure ' criteria as defined in 310 CMR 15.303.'Any failure criteria not evaluated are indicated below.` B)SYSTEM CONDITIONALLY PASSES; One or more system components need to be replaced or repaired. The system, upon comple tion.of the replacement or repair, passes inspection. Indicate yes;nor,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,cracked, structurally unsound, shows.substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing sep- tic tank is replaced with a conforming septic tank as approved by The'Board of Health. Sewage backkup or breakout or high static water,level observed in the distribution box is due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. The system will pass inspection if(with approval of The Board of Health): - 1 ' . V2SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM „���..�' . ,.. .. � PART A , „• CERTIFICATION(continued)^ _ Broken pipes)replaced O i removed ns. � 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 inspection 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 MANNER WHICH WILL 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 WILL FAIL UNLESS THE BOARD OF HEALTH•(AND PUBLIC WATER SUPPLIER,IF APPROPRIATE)DETERMINES THAT THE SYSTEM IS FUNCTION- _ING IN A MANNER THAT PROTECT THE PUBLIC HEALTH'AND SAFETY AND THE y, . k=,,��ENVIRONMENT:• : , _ .. ' ., _ The system has a septic tank and soil absorption system and 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 is with a Zone I of a public water supply well. The system has a septic tank and soil absorption system and is within 50 Feet of a private water supply well. The system has a septic tank and soil absorption system and 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 the facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. - D)SYSTEM FAILS:' 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. Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. Discharge or ponding of efluent to the surface of the ground or surface waters due to an. overloaded or clogged SAS or cesspool. Static liquid level in the distribution box above outlet,invert-due to d11 verloaded or clog= �.god SAS or cesspool:. ,.. .. t -.,.,Liquid de th in vess 1_is less than 6".below,invert or:available.voluine"is less than 1/2 ' P P� _ day flow. ,; , , s':>t > ,• e :Required pumping more than 4 times in the last year,NOT due to clogged or obstructed pipe(s)..Number of times pumped r�• 2- I` I <ti.::-:.{ 'f. + .'e2 fl.a.{.7 .:;. t,z "�'g a _.-- -•. °.;..r : SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ' CERTIFICATION (continued) , 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 publi(c: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. E)LARGE SYSTEM FAILS: The following criteria apply to a large system in addition to the criteria above: .The design flow of a system ris 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 E a ? ; The system is within 400 Feet of a surface diinkuig water supply t; r y system is witlim'200 Feet,of a tributary to'a surface drinlung,water supply _ r The system is located in a nitrogen sensitive area Interim;Wellhead Protection Area (IWPA)or a°mapped Zone II of'a public watef"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 G 00.;.Please consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Check• ifjhc following have been done: . "v Pumping information was requested of the owner,occupant,and,Board pf Health. Y _None of the system components have been pumped for atleast two weeks and the system has been receiving normal flow rates during that period."Large volumes of water have not been introduced into the system recently or as part of this inspection. As-built 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 _ The system does not receive non-sanitary or industrial waste flow _ /The site was inspected for signs of breakout E ✓All system components;excluding the Soil Absorption System,have been located on site. _i/The septic,tank manholes were uncovered;opened,,and,the interior,of the septic tank was in deped fo eondition'of baffles or.tees;materialof construction,dimensions,depth of liquid, of sludge,depth of scum. - :* 4 The size and location'of"the-Soil Absorption System onahe,site;has,Ueen determined based on existing information or approximated by non=intrusive.methods fi 3, . ' SUBSURFACE SEWAGE'DISPOSAL SYSTEM'INSPECTION FORM PART B r: . CllECKLIST(con(inued) V .The facility owner(and occupants,if different from owner)were provided with information on the proper maintenance of Subsurface Disposal System SUBSURFACE SEWAGE DISPOSAL SYSTEM`INSPECTION FORM PART C SYSTEM INFORMATION.-. FLOW CONDITIONS RF.SIDENTLAL* Design Flow: Xg ilons Number of Bedrooms: Number or Current Residents: Garbage GrinderLaundry Connected To System: Seasonal Use:�a Water Meter Rea vailable: Last Date of Occupancy p ^W D COMMERCLAiJINDLISTRTAL � Type of Establishment:- - ,•� Design.Flow:--- Ions/day- Grease Trap Present: (yes or'no) Industrial.Waste Holding Tank Present:--- Non-Sanitary.Wasle Discharged To The Title V.System: •.. 7 Water Meter Readings,If Available:. Last Date of Occupancy: . OTHER: Describe) j Last Date of Occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: �r1�Lp System Pumped as part of inspection:AJO __If yes,volume pumped:, gallons. Reason for pumping'' TYP OF SYSTEM: Septic Tank/Distribution Box/Soil Absorption System Single Cesspool Overflow Cesspool Privy Shared System(If yes,attach previous inspection records, if any) Other(explain): PROXIMATE AGE of all components,date installed(if known)and source of information: Sewage odors detected when arriving of the s:te%oO6. YSUBSURFACE SEWAGE DISPOSAL;SYSTEM W.-INSPECTION, .. . > PART C ECTION FORM GENERAL-INFORMATION (continued) a SEPTIC TANK: Depth below grade._SPQr' Material of Constniction:'✓concrete° metal FRP' Other (explain) -- Dimisions: Sludge Depth: Scum Thickness: Azrxe - Distance from top of s udge to bottom of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffler Comments: (recommendation for pumping,condition of inlet and outlet tees or bales,depth'of liquid' level in relation to utlet invert,structural integrity,evidence of leakage.etc.) GREASE TRAP:�LS) •. t. `Depth Below Grade: Material of Construction: concrete metal <FRP' Other (explain) —. ' -- -- Dimensions: Scrim Thickness: s. Distance from top of scum to top of outlet tee or baffle: Comments: (recommendation for pumping, condition of inlet and outlet tees or,baffles,depth.of;ligWd level to relation td outlet tnvert stitictur:►t:,u�te grit evtdence of le.�ik "e• etc..). °`6 ,y ._� TIGHT OR HOLDING TANK:�� 1 Depth Below Grade: Material of Construction:' concrete metal ` FRP Other(explain)_ Dimensions: Capacity: gallons Design Floc.• gallons/day Alarm Level: Comments: (condition of Inlet tee, condition of alarm and.Iloat switches:e(c.) a DISTRIBUTION BOX: _ Depth of liquid level above outlet invert: Comments: (note if el and distribution is equal,evid tee of solids carr}over, evr nee of leakag into or out of box,etc.) PUMP CHAMBERl� Pump is in workingorder: i„ Comments (note condttton of pump chamber,coitdiUon of primps and appurtemances;.etc) 1 t ;; ;. ► ;SUBSURFACE.SEWAGE DISPOSAL":S.YSTEWINSPECTION FORM PART C , SYSTEM INFORMATION(continued) SOIL ABSORPTION SYSTEM(SAS): ✓ (Locate on site plan,if possible;excavation not required,but may be approximated by non-Intrusive methods). If not determined to be present,explain: Type: Leaching pits,number: e,2 Leaching chambers,number: - :L'eaching galleries,number: Leaching trenches, number,length: Leaching fields,number,dimensions: Overflow cesspool,number: Comments: (note condition of soil,signs of hydraulic failure level of po dh)g,condition of vegetation, etc.) 0 AZ^ .i X t`c2 CESSPOOLS:_AQ J 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 soilk,signs of hydraulic failure, level of ponding,condition of vegetation, etc.) PRIVY: Materials of construction: Dimensions: Depth of Solids: Continents:(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation, etc.) ....:....:-. '«... .... ... .. .. ....,...a ....... . ... :. - ,+ ' ..........«+..«..x�......ww....«.....r. ....t...»..�L . .:.....-....rn. w.�.:..,.r.....:.. w .......__ .tr..y...� ....:.ram.,. ...t.._ 6 III � .. •q � SUBSURFACE SEWAGE DISPOSALSYSTEM INSPECTION'FORM PART C SYSTEM INFORMATION (continued) SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to atleast two permanent references,,landmarks or bench n arks.: Locate all wells within 100 Feet. ri -,q(PLP „ ,s ¢+ ^_ .. .. Jo y.4 +:F"s>v,a,.,:.< k .€ Y.��x�8 7 ''yi •�,(�� ,Y' +t': I`,,x : :xr '�� DEPTH TO GROUNDWATER: i Depth to groundwater. 2 y Feet Method of Detemunati n or pproximation: APPWI#V /� 4151 ,de ;, A r, DATE:__ 6 711.2 PROPERTY ADDRESS:_?48 North_B� 02655 On the above date, 1 Inspected the septic system at the above address. This system consists of the following: 1 .2-4 ' x6 ' Lbaching pits. Packed in 4 ' stone. j i Based on my inspection, I. certify the following conditions: 1 . This is not a title five septic system. 2. The system in proper working order at the present time. # . " If any exterior changes are made a 2000 gallon septic tank would have to be installed at that time. ` 3 . Cover must raised on the first leaching pit. SIGNATURE: i Name: Macomber-Jri______ I Com an _J_P_Macomber_& Son Inc. INN Address:—Box 66 --- RECEIVED N Centerville-LMas$.�•_Q.2632 - JUL 1 1 1995 T=Wwmw cc 508-775— 9� I THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY (JOSEPH P. MACOMBER & SON, INC. Tanks-Cesspools-Leachflelds Pumped & Installed Town Sewer Connectlons P.O. Box 66 Centerville, MA 02632-0066 775.3338 775-6412 • 7 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION ,FORM Address of property 248 North Bay Road Osterville O.H. Owner' s name Edward Varnum Date of Inspection 6/27/95 PART A CHECKLIST Check if the following have been done: Pumping information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for at least two weeks _�/_ and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. /As built plans have been obtained and examined. Note if they are not available with N/A. D/ The facility or dwelling was inspected for signs of sewage back—up. The site was inspected for signs of breakout.. All system components , excluding the SAS, have been located on the _Z site. 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. ZThe size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. , The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance -.of SSDS.' RECOMMENDATIONS 1 . Raise cover on the main leaching pit. 2. If any exterior changes are made a 2000 gallon septic tank would have to be made.at that time. 8 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential .3 number of bedrooms number of current residents _APO garbage grinder, yes or no' 114S laundry connected to system, yes -or no lVa seasonal use, 'yes or no If nonresidential, calculated flow: Water meter readings, if available: 5D'�640 CoAUW5 = GPD41< Last date of occupancy GENERAL INFORMATION .Pumping •records aid �o�rrye _qf information: lye KeceA�{ 1 _A System pumped as part of inspection, yes or no if yes, volume pumped Reasop f r pumping: Type of system d Septic tank/distribution box/soil absorption system Single cesspool Overflow cesspool 0 Privy Shared system (yes or no) (if yes, attach previous inspection records, if any) !, Other (explain) Approximate age of all components. Date installed, if known. Source of information: s Sewage odors detected when arriving at the site, yes or no 9 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: None (locate on site plan) depth below grade: material of construction: concrete metal FRP other(explain) dimensions: sludge depth distance from top of sludge to bottom of outlet tee or baffle 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 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, recommendations for repairs, etc. ) DISTRIBUTION BOX:None (locate on site plan) depth of liquid level above outlet invert Comments: (note if' level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc. ) PUMP CHAMBER: NONE (locate on site plan) pumps in working order, yes or no Comments: (note condition of pump chamber, condition of pumps and appurtenances, . recommendations for maintenance or repairs, etc. ) lU bUBSUR"!kCE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORXATION continued HOC6te on site pjaj-, , f po' __ . ss ible ; exca%'ati0n, not required, but may be approximated by n01'1- 11'1tr*Us1ve methods) If not deterF.-ined, to oo pl.esc-11C , explain : Ty pc n g Pits and * " 7;�6 l.e a c h i n 9 chambers EiridriumL'or --- leaching galleries al',d number leaching trenches , number, length leaching fields , number, dimensions overflow cesspool , number Comments : (note condition of soil , signs of hydraulic failure, level Of ponding, co dition of egetation, recpmmendatioDs.,for maintenance or repairs, etc. ) - - No CESSPOOLS ( locate on site plan) : number and configuration j depth-top of liquid t.:- j invert depth of' solids layer -------- depth of scum layer dimensions of ces-zp0c),'., rriziterials of indication of inflow (cesspool must be pumped as part of inspection) -------------- Comments : (note condition of soil , signs of hydraulic failure, level of pond.ing, condition of vegetation, recommendations for maintenance or repairs, etc. ) PRIVY : ( locate on site plan) materials of construction dimensions depth of solids Comments : (note condition of soil , signs of hydraulic failure, level OfpondingconditJon of % eccL_ ti ,—nators for maintenance or repairs, etc. ) . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION ,FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE L=SPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' 0 ` O DEPTH TO GROUNDWATER �D ra depth to groundwater met;,hod of,determination .or approximation: le- e)7- f9Z AVO 6vX 1velf �v r"S141 ti ! 12 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined', , explain why not) Backup of sewage into facility? M Discharge or ponding of effluent to the surface- of the ground or surface waters? } Static liquid level in the distribution box above outlet invert? �Q1 Liquid depth in cesspool <6" below inve rt or available volume< 1/2 day flow? _.1A10 Required pumping 4 times or more in the last year? number of times pumped Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? l Is any portion of ,the SAS, cesspool or privy: _ below the high groundwater elevation? within 50 feet of a surface water? Ne within 100 feet of a surface water supply or tributary to a surface water supply? within a Zone I of a public well? within 50 feet of a bordering vegetated wetland or salt marsh- (cesspools and privies only, not the SAS) ? AO within 50 feet of a Rrivate water supply well? 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 anal, . for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. f �.-r.:.�:rs-izrs�sLrs.��:��.�T=azss:�arasar:•s�=::irr_�ss_�—Ls ter.:--st_.:. TOWN OF Barnstable BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION �ii.T.L•L—JCiL�:TiT-tiL�L:.'iQii'IiC:Yt'����CSL:1LS1t'CT3y�, i�C'�3SSTt(1aS . I — i=r•+s+c.-n:tx:arsarstrtarls.nr-rsris::..sr^rr;.•'-TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRfZS _1 8 North Bay Road Osterville O.H. ASSESSORS MAP, BLOCK AND PARCEL # OWNER' s NAME Varnum PART D - CERTIFICATION NAME OF INSPECTOR J P Macomber Jr COMPANY NAME J.P.Macomber & Son Inc. COMPANY ADDRESS Box 66 Centerville Mass . 02632-0066 Street Town or City State COMPANY TELEPHONE (508 ) 775 - 3338 ZIP FAX ( 508 ) 790 - 1578 CERTIFICATION STATEMENT —_ I certify that I have personally inspected the sewage disposal system at this address And that the information reported is true, accurate, and complete as of the time of inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with/lay training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : xxxx System PASSED The inspection which " I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* The inspection which, I have conducted has found that the system fails to protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature Date .. . b One copy of this certification must be ( where applicable) and the BOARD OF HEALTI;Vided to the OWNER, the BUYER * If the inspection FAILED, the owner or operator shall u within one year of the date of the inspection, unless alloweddortrequiredsystem otherwise as provided in 310 CMR 15 . 305 . partd.doc Water .. . Conservation SAVETips . . . ME! CHECK FOR LEAKS :. Water Loss in Gallons Due to Leaks Leak this Loss Per Day . Loss Per Month Size : 120 3,600 300 10,800 • 693 20,790 1,200 36,000 1,920 57,600 ® 3,096 92,880 .0 4,296 .128,980 ® 6,640 199,200. 6,984 200,520 ® 8,424 252,720 9,888 296,640 ® 11,324 339,720 12,720 381,600 QP 14,952 448,560 r.: I Ccmmcnweartn of Masscc^userrs ExecuTive Office of Environmenra►Affcrs Department of Environmental Protection Water Pollution Control Technical Assistance and Training Secrions WUUm F.weld Gommw Trudy Cos@ Thomas&Powers k"Cormrwonr 06/12/95 ATTN: Joseph P. Macomber, Jr. Joseph Macomber and Son PO Box 66 Centerville, MA 02632- Dear_Joseph P. Macomber, Jr. , I am pleased to inform you that you have attended training, met the experience qualifications, and have passed the Title 5 System Inspector exam, pursuant to 310 CMR 15.340. The passing grade for the exam was 39/52 or 75!k. This is an official notification that you are a Certified Department of Environmental Protection System Inspector pursuant to 310 CMR 15.340. You will receive' a System Inspector certificate at a later date. If you have any futher questions, please write to me at the following address: Kimball Simpson D.E.P. Training Center 50 Route 20 Millbury, MA 01527 Thank you very much for your time and consideration in this matter. Sincerely, Kimball T. Simpson, DEP Training Center Director (2 4 0 5) Route 20 9 Millbury, MA 01527 9 FAX 50&755-92S3 • Telephone 508-756-7281 1: TOWN OF BARNSTABLE LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY LEACHING.FACILITY:(type) (size) NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILD?p OR OWMVP DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED a t ® , x I 12A ), Oe L1 /TOWN OF��BfARNSTABLE LOCATION - Lqb /I�D/l`"�! �Qy r�� SEWAGE # VE.LAGE (�S Ile ASSESSOR'S MAP&LOT ?I:STALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type L-G' sal�`S (size). `1 �� � �►'�2 NO.OF BEDROOMS BUILDER OR OWNER a��1 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 .f r No. �S/L,�/1 13 Fee PARCEL No- =, 33 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETT 0[ppliCdtion for MigozaY bpztCTlt Conztrurtion Permit Application is hereby made for a Permit to Construct( )or Repair(Y)an On-site Sewage Disposal System at: Location Add re s or Lot No. Owner's Name,Address and Tel.No. o s 7-0 d % amo Installer's Name,Address and Tel.No. 7/ g39/ Designer's Name,Address and Tel.No. Bart Type of Building: Dwelling No.of Bedrooms Garbage Grinder(v ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow ss &_ _ tyJ gallons per day. Calculated daily flow 8� gallons. Plan Date W9 OOV. 0 l q'� Number of sheets I Revision Date Title `D�?l C�i2A�l�1G� pLAg or-- Lmgs w UySTI72_4. Fitz Description of Soil" AA >)Qvy. G A a1, Nature of Repairs or Alterations(Answer when applicable) �PQST_106- ,�A&l4 St' o iwG PS IpiP �-00 Sl"5 W-RIlyG; w5mg, Moo Gam., w1t=-Ar Ss7 IG eX O - 241 Lwys Date last inspected: 6ADv m� W A-� 6.&A'1J� Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued t ' of H / Signed Date I�/9l Application Approved b Application Disapproved for the following reasons Permit No. ! eza Date Issued6 �� S Fee THE COMMONWEALTH OF MASSACHUSETTS ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETT 0(ppYication fors Migool *pttem Contruction Permit Application is hereby made for a Permit to Construct:( );or Repair.(')an On-site Sewage Disposal System at: Location Addre s'or Lot No. """ Owner's.Name,Address and Te`Hiroo. o sTE2. `t�o2S /,% . f l % �= ��/-9399 .9. , !Installer's Name,Address and Tel No. Designer's Name,Address and Tel.No. f 76s1,,�q/ged� rod ✓�f1ee_5 l-/i Type of Building: j Dwelling No.of Bedrooms .) Garbage Grinder(V ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures -Design Flow_ S5. Ell.• CV4 gallons per day.'.Calculated daily flow 82 gallons. Plan Date I�al 0 a Iqq'� Number of sheets - , Revision Date Title 'C' hAP9 v__ Co4j' its n Fin 'D ,rWL)e n (� fr. Description of SoiL ' M E2)IUV\n !�A 9t� Nature of Repairs or Iterations(Answer when applicable) EilSrl► , �L 6 L4 STD�iE 1W7 .00 �IcAIS O AWIUAG — 1 L.t.. ISoo 6ac..-`2. e-ov" c'llrwus-Ar 5spnc, 'tAk. luI?11 U-R�1t - cagser +V b%40- PM — T200M IDYL exPAt4S fM% 24' keoy6 Date last inspected: ; Agreemt: t The Iindersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system t" in accordance with the provisions of Title 5 of the Environmental Code and not to place the system ins operation until a Certifi- _ cafe of Compliance has been issuedWtof H 1 -�� ' Signed k Date Application Approved b Application Disapproved for the following reasons }{ 5 Permit-No ` Date Issued THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Certificate,of Compliance - THIS IS TO CERTIFY>l that the On-site Sewage Disposal System installed( )or repa' ed/re laced(✓ on dz 4 by �Ol�OL / CDhSJ`/yG7�/OH for _ as :� '� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit NOR�� `:5 dated J Use of this system is conditioned on compliance with the,,provisions set forth below: _ r2 No.9L,�L/f, ! THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE,.MASSACHUSETTS Disspogal *pgtem Contruction J)errYit Permission,is hereby granted to to construct( )repair(V )an On-site Sewage System`located at WIN 15N4 I& wvl_ and as described in"the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. All construction must be completed within two years of the date below. Date: ! /� Approved / Baxter Nye Engineering & Surveying 78 North Street,Hyannis,Massachusetts 02601 February 1", 2005 Mr. Craig Ashworth E.B.Norris& Son,Inc. P.O.Box 486 Hyannis Port,Massachusetts 02647 Re: Septic System Capacity, Rewey Residence 248 North Bay Road, Oyster Harbors Dear Craig, As per your request I have evaluated the capacity of the existing septic system. • Septic Tank—2,000 gallons/1.5 = 1,333 gpd 1,333 gpd/110 gpd per bedroom= 12 bedrooms • Leaching System—Two 6' dia. x 4' ht.pits with 4' stone Sidewall: 161 s.f. x 2.5 gpd/s.f. = 403 gpd Bottom: 154 s.f. x 1.0 gpd/s.f. = 154 gpd 557 gpd per pit x2 1,114 gpd 1,114 gpd/110gpd per bedroom= 10 bedrooms If you need any further assistance please call me. Sincerely, Stephen A. Wilson,P.E. #95107;#96069; #2000-070 ReweySeptic.doc Phone(508) 771-7502; Fax(508) 771-7622 TOWN OF BARNSTABLE-- jf AGE# �� /g'I 2-1 LOCATION VI LAGS S r ASSESSOR'S MAP LOT `I DiSTALLEWS NAME&PHONE NO. SEPTIC TANK CAPACITY Z BOO Q/ t LEACHING FACILITY: (4`7) (size) �� SC�►52 NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: �6"' COMPLIANCE DATE: — : Separation Distance Between the: Feet Maximum Adjusted.Groundwater Table and Bottom of Leaching Facility private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within 300 feet of leaching facility) Furnished by A,� gQ i lL 000 its ,, 0 P 3 N J i 4`) i u !„ v a --------------------- --------------------- --------------------- a y 0 0 •p fl i STORAGE �• I M r , a C F1 EXERCISE, ,GOLF SIMULATOR _ --� PLAYROOM/5ILLIARDS ' � � PLAYROOM - lJ 1/- i ¢ LOWER HALL - HALL - III r STORAGE/MECH. - f�la9- n�+uls�l f, STORAGE - I 5TORAGEMEOH. �=�:6 S'E,e m 'as ors R6� •'BATH-i ES�cJa es .ee�g% - oG oeu e6 Zc =l VIfl-6.1€ �ya4�—Ca au m'.2'. 'E S•geo�e��c'cgo�^ LOWER LEVEL PLAN SCALE, 1/4' . 1'-0' .. `p W LIVING AREA.1.�98 EF(I—GOLF 9 MW W 1MJ.3Rs 9F M-AYI— ..M Ef. c ca � V d N N L cuZN 3 p co O N® rj II{{r ki `'a....�„_..__...�._ ..._ ..p.._ V...,_...r..e..�Y..__._.._.__�,_._.... �.,..�:.� .eta.,.._ j ._;.....-....,..__ - —,. ..a... . .— _ -.- ,�._._---�— -. - - - ;- � ,.- ,{r'r•y^•.--.., .._.-,.. __.—,_...,._ ._ ......,..._ ._ S o E v a m N 'o 5 N 0 r N L N N m 10 CL,/ ' � w 77 .. ------------------------- v O L M i ❑ DECK ❑��//�\/\p V' ❑ o y ro x Isa � �Y� � ❑ f° o eo 0 ❑ ❑ ❑ ❑ ° s 7:: COVE RED PORCH__.____ _________;______ __ _ yoxN0o � HH ❑ ,_., cc - - _ „ „ „ -- - --------f' .MJ ,EATIN;/r-I HEN C GI OIG MASTER BATH O F 11-iREAT- ------------------ u� no x no ____ '_____ _ __ _____ ___ _____ _____ _ _______ __ ________ s all ` O x 1' „ , N ❑ HIB HERS _-- �./ ❑ �r®ceruro wTi 6a o�x 6S _________ j, MASTER ` _____ a.__ _____ Mn _ _ __ =_t _ ______ _____________ p•' I, i• HALL HALL ❑_ ___ DRE551NG _ ___r___________ ____ Rio ____ ____ ,y . ___ GOATS C '' o r FOYER ------- HALL o�+ro A97,R _ ___ ____ ____ __ _ ._ PTR HALL �It'a.J1 ' I HALL _Y___ eolT—�� , ENTRY PDR. ENTRY PORCH /� �� PDR , r ; � 000 > �a s-se a 31 1 I; �a�.a.�: GOV'D. MUD ROOM seer ENTRY ^` W 0 F I RST FLOOR PLAN ec Auer iia• r-o• A\ � � (n uvn+s ArreA.sees sP Y/ 0 s o U = --------------- CD t0 �yN m m STORAGE Q O a r CU Z= LL i GARAGE t___________7 c. O N �xm N.. ---------------i N L.L 0 0 .. ,. .. lob no.: w2I dale I APRs.2020 scale : AS NOTED t drawn: JA.L./EL.L. feV. o . A-2 o r ISSUED FOR REVIEW sbl: of I 1 S c E t� O l0 w � V A O c N r m N Ci r d t0 s H W e o ++ Y O t0 U ROOF DECK uozua � W � -- -- CI ❑ --------------------------------- -; H ---- -------------- 0 ❑ 000 Jf .lam LOFT ( C ❑ lo-a z roo BATH B 0 '�-lse Irarrt wu.. F�EDROOM IDROOM SS BEDROOM 6 C- N •_ w Lam+! ' xAr y , yamcaulu •_ (BEDROOM-B. ___ slave BATH 5 WIG. I ; UPPER HALL ', , 00 -. BALCONY HALL BATH 4 - _ -- ---- 0 _____ _ _ �WM°� ____ __ CEDAR y �. ___ _____________ _ _ - -;q _ __ ______ _ CLOSET __ _____ _________ _________ _ ___ LAU Y L� 0:6- ------------------ ro/sour W.I.G. a so Ywuleu+n .-- s . „ eym n • €Tin`^��r m% 9 auk E3 u ,p - �>g , R ---------------------------------------------------- ; sEAr �HALL U co SECOND FLOOR PLAN co„ as nuL , „ LIVIN9 AI@A.],M]5P ,, rwr f __ WIG co C `n a cc J4 =2 _o �-----------0--- �0 ai _ BATH 2 /R LL -BEDR OOM 2 -- --' -- O N (D V �+r .7 rt Ile GQ� O O W L 0 Q�Jv� ,I.0 wean `-__ _ job no.: w�l ❑ ❑ I' date t AMIL 2Ow �J scale : A9 NOTED 1"lwr drawn: J.Al./E.L.O. ' ,Je rev. = 2�9` C-��r Covh ( rev. 0 A-3 e ISSUED FOR REVIEW anc of I D •EBA PLV NOES $ 0 0 0 9tt4 oa o EM. T,e9.b• o �; ggKE 0liPLrpl •q POOL ., H C carf¢re Frtmr ww.9 io a ro•nlvx Tw lowa4rme.rooRe ro a T81A• m N -OM NPWIVp� Ped w Id9PV �FG0.MAlllwl m ea e•Aoero Of 7�a•TOP pEMMr Q wLLl � roa wee 4 M ro• o'a ya we,aalolm Amro `-a 6�/wK FPwl mt ws/ $IOr/.�L99110ey�4 p1 GITM PLAII � A eeuro¢wTxensA m/ I e r w wnwr eALVAraas e�/eLlal ,---; :- �•. B0.fl•9Y OG MeI Am•O'FFM GOW.9ti. � � ���.l�ll�u, • f lC BOLr9• L6'�1M[BOM M10 N0 � � • _____ � C nw ewuLa AwKa TEafl Pae raaw awn ___ M O suL ve.rostr cw waeuL. �oETN NOIE9 Mm r e w .I' ��n�ro a�N0�8Geemoena I �; omme r,re aTm wu(�eo/e� .� L i r.sr,�ee s m FcvmAnoa 0.\ - I - r 1 `o•caxc.wmr wVL I, OM N'A]•ILVL.MOflllb � � F w Txe R INe p, , Y 1Ne EPVeA D ' O9 m e FPOIIWN°rn">is t �} __fi ATO o emwnrtAL roTOA1bNltlRe _------___------------------------ ---' ___---, •H--- m o i0 0.M�M ;__ _-_ �� Lro________ _ - " P�nµS � 4 • .�. I�N11 CR iR0ID197iL —CP PAM• , eAa°n°diO1B o� 4 �I' �_____ - T��rneaP �noEr"x 4b a BATH/GHN6.`"'b.� .s>m n/4 sarn/L aev/avM xmes I� ♦3) rx we rc•eouo Psl A v____________________ _____I e'a r-T w• N •� • ° P ro e e'a• or roan wr r T S �,AmrAr9� PPOInG9 oa I'. �Pqqawr I .cTnra, -5@ 911e.LRPK eElaeAL rom . :.. ... -.. ..... ... � _•-_,�.s.-_� g � �,a4 W d 'rrole""+o"el w ems' wni re4�ImIM�.es rj �1 e'oOemw°�NPeuO°�w a % a®aYor.. 1 �f wwwn cAs1w, 1xi�A�FeAo cA4W w le•�uT• �'a �}�a erolE arAwro ruu u rxlsrow`c�'d�u x�oslxenw�s IalEo) N r , w+ V O d ' lew• nun`nu.¢ac. �/ N 'O FOUNDATION PLAN re�L� w N y FLOOR - PLAN 9LALE. I/4'• 1 O ` - WLOPUe AIO 1N119Y'AIDc'L0.90ItM•.` ALL PVL --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- LFF r � M-3 ® ® AL.exnlue w Irc.exnnea w - -ere 3 y5e e- . YE„tD LLW�9 FEA•.fv Lome -R g�,3a3� �s s I@niATL,.BIE x�e •❑ IQIMTLME xlaxe Ni -N is 9Zoac y 6 ;b E.eoec __________________L� , _________________________________________________� fie$'"'• ____ _- --------------------------------I ---------------------------------------------------- ________________________________________________-______. SOUTHEAST ELEVATION NORTHEAST ELEVATI ON NORTHEE5T ELEVATI ON SOUTHWEST ELEVATION V f0 9LALE. I/4' •I -O' 9LALE. I/4•• I -O 9LALE. cc (D N n m CU p� pv U p C A I A W H O - ,I m cu m a) TwT WoeE TwT woeE Y �U) TUO N.VIE®•b'OL. ]wG wnA9•b'LL. aAn yTx10 W — —..,—'— — — — — — — Co Z U) N p rn Two L16..UGfl•m•oL. Two as.,ulsis•1e•oc. co 1� Tw0•'a.ATl9r9•b ]wO RLLP •N'OL. O N //�fW�, C CC � to > > -_ .--rruelt_Anee B Q O CD LL T%4 wuL.lr�m room ro , r�Two a W BATH/ FxosloE r AxvArE ro ccec.n•LL BATH/ GHN6. CHN6. KITCHEN !�n�T�x'®'�' �' caGnere 9t/a iocee•cLxcne,e ? ? As�m�avl��re. job no.: Ivsl Aooa P9)ox a wL vvwe wrauai ova e•weuaa�om ea4va cwane I.�ap..�s�Oalpe�vAnoro I LO'PALRV ro49%M.Vt ORt'OBWiT PO�OfIINe B80M%AD9nUP � dale 2 SEPTEMBER 2020 iLP d'YM_ " _ TwO W.J015fl•le'OL. $ scale A9 NOTED ..,.:. ...,..".. . ........... .. 9 55 A Fl drawn: JAL./E.LL. wv rri r✓.er 10'earJER FNasr N41 Twf IEMet TM IEADEi rev. OTNIb N Its } - rev. SECTION A SECTION B CEILING FRAMING PLAN ROOF FRAMING PLAN A 10 5—LE.I/4' I'-O' 9LE. 1/4• • 1•-O' 9LALE. 1/4'• 1--O 9G AL, 1/4•• I'-O' ISSUED FOR CONSTRUCTION sne 10 of 16 _DIRECTIONS: ASSESSORS REF.: - From Hyannis - Follow Main Street to the West Map 073, Parcel 033 ' End Rotary, Take third exit onto Scudder Ave. Turn right onto Smith Street and continue on Narrows 1 ' - - Cotuit to Croigville Beach Road. Turn left onto South - -__ EBB --- Main Street and continue over the bridge to OVERLAY - - -- ' ............ _w - Osterville. Turn left onto West Bay Road and AP Aquifer Protection District� FLoo y - q \ \ continue on Bridge St. On Oyster Harbors � � continue on Oyster Way, turn right onto Grand w \ .� Island Dr. and right onto North Bay Road #248 q . is on the left. FLOOD ZONE.Zone AE El e v. 12 & X (Min Flood Hazard) Community Panel No. a a rz t �. �. #250001 CO543J July 16, 2014 ��� Finish Grade 3 Max. ; 11 . - LOCATION MAP: \ \ .,.-. __ _ �...,, `• \ _ � 9" Min Compacted Filter Scale: 1 = 2000 f Fill ` ` ~ Fabric Ili ` An d/Or `�. . Pea Stone A 3' H-20 3/4 - 1 1/2' • _ __ ZONE LEACHING Double washed CHAMBER RF-1 Area (min.) 87,120 SF (RPOD) f 10" Frontage (min) 20 �- 12' 10" -•-� Width (min) 125' Setbacks: .................... ....CROSS SECTION OF CHAMBER Fran t 30' 1 \ �`• _ Side 15' . NOT TO SCALE Rear 15' \ ! Beach _ I Grass Lot- .2 ` i i � ``ti ,� �., .•.. 78,860sft to MLW - , \ 1.81 f_Acres ~ f' REFERENCES: \ I \ \\ : 1;' `\ -- '' / / Deed: Bk. 12749 Pg.178 rf Plan: Bk. 321 Pg. 4 t _ Beach ��oti• `\ Grass Q; / 1 _ \ Beach `� i l6 Grass \, LOT COVERAGE: 712212020 Bulkhead j� \ ' _.. ail�f CBIDH Lot Area (Upland): 52,190fsf J- i -== §240-9 Nonconforminglot. DESIGNDATA g Y1 1 / ` r -- x�tm� Fen e df --- H. Developed Lot Protection single ` j i i r J / /� t I ...._ `� 1 ^ �_ _ 8_ -- - (1) As of Right -7 Bedroom 110 GPD . J j o f @ v� fr'/f p & Town \ \ ` \ ' f� j (b) Lot Coverage No Garbage Grinder r'� ✓ State / \ \ \ CB. sk sr \ r f Defi ition `� t ' c 1. Lot coverage not to Exceed 20% Total Dail Flow-770 GPD •� g Y � � i \ Fn?3• / 1 Use a 2000 Gal Septic Tank X_ ��\ ` i / f `� " Building 4768 ! 1 Decks 809 o ' / /N ! / 1$- l f / \ \��\L ��. Garden / o LEACHING AREA �!� / / ' 1`� I I o. Pool 1145 770 GPD/0.74(LTAR)=1040.5 SF Required / T4 / / � ! , \' \ `� cf I I \ \ I I Cabana 224 Sidewall=2(12.83'+59'2'=287.3 SF 50' � ) _ \ Bert�hm rk: i / l Total 6,946sf (13.3q) Bottom Area=(12.83 x 255=757.0 SF e `� 1 `� `• I\ Total Provided=1044.3 SF(772.8 GPD) ' o \\ Top f CB/dh f d ' 7 Z �o �\ \ 1 1 1� �� G'ro�e�P�, ( ......; I I 2. Floor Area Ratio Shall not exceed '� a `ti El.-1 fJ.20'`(NAVD 8) , ,., ath l r i g LEACHING CHAMBER DESIGN ^ o \ \ 1 ;- . I / �` 0.30 or the existing floor area ratio. Q o \ \ -- '�` �, ' PP y cB/DH To be supplied b Architect All Pipes to be Schedule 40. Use ,� ti \ \ \ 1 1 - �:. /Fn d 6-500 Gal.Leaching Chambers in a Q(Z c \ \ \ -- -' - - - f 0Arbor y 12.83'x 59''Double Washed k� \ fix' . . ...................................._ ........... \ _ _ t.... ..+.._ .. __.__.. J o� Stone Field as Shown. ` N 111 MITIGATION CALCULATIONS T_ P 6#c T 1 -- - 1�ath i'•., 1 I 0-50' Buffer PERC TEST: 20-72 ` " �` \ i', Limit I No Work Proposed PERFORMED BY.CHARLES ROWLAND,PE- SULLIVAN ENGINEERING CB/D�l ' \ ! ~`:�"� ./ m: / / � ) / 50-100' Buffer, &CONSULTING,INC. Fnd l \ \ \ ??� I rH-s �P�sed / i f / // `•. / / / i / Existing Proposed SOIL EVALUATOR NO.13586 \ i '; _ J / Existing Drawdown f r r� / `• , Patio 710sf Pool/Spo 190sf WITNESSED BY:DONNALD DESMARAIS,R.S.-TOWN OF BARNSTABLE \ cv ' I / Pool Patio \ Pool 680sf April 21,2020 ` a to be removed \ ,� /............... SITE PASSED / Wall 46sf Total 1436sf � 1436sf-190sf=1246sf Horoscope Reduction TEST HOLE- 1 EL.33.5 TEST HOLE-2 EL.33s / \ \ 1 Existing Pool \ / Lawn /� / ,�, AiAYER 10YR 413........ A.LAYER lOYR 4/3. \ \ \ \ \ ; to be Removed \ j /' °\\ 1 j S oared I No Mitigation Required .BROWN ... .... :BROWN.... \ \ / p - 6„•.............SANDY-LOAM 33.0 6,� SANDYLOAM.... 33.0 Existing Wall \ \ f ° o �P r , .Bw-LAYER.I0YR.4/6...... \ ` ` ` } t / / , I ; ool Fence NAVD ...BwLAYER10YR4/6. ...... to be \ r 1\ Q 100 duffer / c\� Proposed DARK.YELLOW BROWNISH DARK.YELLOW BROWNISH..... Removed \ \', .......... .. ....... "�t c 38 ..............LOAMYSAND. .. ....... 30.3 36 ...... LOAMY SAND............. 30.5 7 \ \ � \ \ �\ �� / ti I / C LAYER 2.5Y5/4 PERC TEST a�o \ Proposed / LIGHT OLIVE BROWN 25 GALLONS GONE IN 4 MIN.40 SEC. s,c• \ \ \� / O'x42'`Pool .................. � 132' MEDIUM SAND 22.5 PERC RATE<2 MIN/IN(LTAR=0.74) ��� \ \ \ \Spate �' R 0,106 NO GROUNDWATER ENCOUNTERED 42" C LAYER 2.SY 5/4 30.0 ofi� \ / x / ......... \• o►I . �. • \, •• / �� `'1� LIGHT OLIVE BROWN i,�� \ ✓ �\ / ?°'' x W / { ` ` \ ML W\ 132' MEDIUM SAND 22.5 E - �` �ij r ` 'i o\DTck \; NO GROUNDWATER ENCOUNTERED �S'yo� ��\ ati-- ?roposed 1 A v � %7A- r Patio n \ ✓ � \�\ �'� � \ DATUM Set�c Not to Scale TEST HOLE-3 EL.34.5 TEST HOLE- 4 EL.34.s . -- - - / � E �°� stC`' \ y -� ( 1 � \ � � � Datum Reference by FILL. FILL.................•.. b �o� Pr Deck --- f O os i to t ove .'� ,' �~ � p � ,,c�, , ( i ( ! Buzzards .Bay interactive GRAVELDRTirE/.HARDNER GRAVEL DRIVE/.HARDNER �, Cabana` �t / -' \�Tnnk r3r'e/ ^� Tidal Datum Viewer . .... .... .. ...... �\ y- ' / / -^ \ J 42" ..SAND LASPHALT:..... 31.0 8" SAND LASPHALT.... 33.8 CLAYER 2 SY 5/4 . ... Bw LAYER L0YR.4/6.... - ......... ..... LIGHT OLIVE BROWN ..... ... DARK.YELLOEV BROW1ViSH..... / 132" .....:....MEDIUM SAND 23.5 28' ...... LOAMYSAND 32.2 ` NO GROUNDWATER ENCOUNTERED PERC TEST p� \ \ / ' Exis tin g Dwelling 32�' 25 GALLONS GONE IN4MIN.20SEC. emu, \ \� 'Under Construction PERC RATE<2 MIN/IN(LTAR=0.74) 44" C LAYER 2.5Y5/4 30.8 LIGHT OLIVE BROWN Proposed TEST HOLE- S EL.15.3 132 MEDIUM SAND 23.5 1500 Gal H-20 2 Compartment Tank I _., . d_... .., �' I _ Y. ALIIYFR.iDYR4/3. NO GROUNDWATER ENCOUNTERED 1000 Gallon Septic Tank Basement Jete e 500 Gallon Pump Chamber �i,, Bathroom G° °nG BROWN................ P '�• / Ejector Pump E� 6" ........ .SANDYLOAM 14.8 rr - - f ... ,,....'..0 LAYER 2.5Y 5/4 L�GHTO.LIIYEBROWi ........... oo.I 7S�� MEDIUM SAND....... ..... 8.8 "- / NO GROUNDWATER ENCOUNTERED $ 2e \ (: c� 31.0' yd / l Proposed TH Proposed Dr' way D-Box 000 Gal H-2 7 H-20 Septic Tan �\ 32 r 0 3/4„ Crushed Stone l 10 5' �.... / Benchmark: 6-500 Gallon r. \ \ x - } O 11 H-20 12.8' \ \ , \e j . t o J ~ Tag Bolt on Hydrant 33 Chambers \ tJ t j ( / / E1.=27.0 (NAVD88) ' Vent i X \.\ 59.0' - i -s I \ SAS Detail View - E 1' f \ Speed Bumps LEGEND: Scale 1 " = 10' -4 1 CDT Cedar Tree F.G. EL. 23.1' Max. - Vent ? Propane Tank Pool Cabana FF El. 21.5 to be Removed �B•9 j �\ Jett`e (� HT Holly Tree Department Approved \ p� > o VVV"' DT Deciduous Tree Effluent Tee Filter on •F° / ° V� 1500 Gallon the Outlet °,e EL. 20.1 2 Comportmen c 0�1� / ` � CT Coniferous Tree H-20 Tank `, Utility Pole 2q pitch Min %' / \del Plan View -E- Electric Cabana EL. 19.5 at 40 p -G- Gas Installer To Confirm Prior EL. 19.2 72tPVC Sch. O: L� Scale 1 " = 20' D> Wetland Flag 1000 Gallon To Any Work Septic Tank f / Light Post FL. 14.45 El CB/DH OHW- Overhead Wires 25 Elevation Contour 500 Gallon W Water.Line SEPTIC NOTES Pump Chamber -Pro W- Proposed Water Line 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours DE VEL OPED PROFILE OF S YS T EM Prior to Any Excavation For This Project the Contractor Shall Make the Required Notification to Dig Safe(1-888-344-7233)and contact Sullivan Engineering&Consulting Inc.(508-428-3344). NOT TO SCALE 2.The Contractor is Required to Secure Appropriate Permits From Town Agencies For Construction Defined by This Plan. 3.Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shall Be Constructed of Class 150 Pressure Pipe and Shall be Water Tested to Assure Watertightness. In General,Water Lines Shall be Constructed in Vent Coordination With COMM Water,and Shall be in Accordance See Note 6 (typ.) With 248 CAR 1.00-7.00&310 CAR 15.00. Pro F.F. El. 34.0 15' 4.A Minimum of9"ofCover is Required for All Components. F.G. EL. 32.2* - *Final Foundation Grading To Be Min. S.All Structures Buried Three Feet or More or Subject Coordinated With Landsca e Plan F.G. EL. 32f to Vehicular Traffic to be H-20 Loading.It is the Engineer's Complies ' Recommendation that H-20 Always be Used. 3.75 With 6.Install Watertight Risers and Covers to Grade over Septic Tank Inlet,Outlet, Flow Equilizers Breakout D-Box and Within 6"ofFinished Grade Over One Leaching Chamber. EL. 31.25 � As Required All covers are to be maximum 18"for concrete or 24"Cast Iron. Installer To i OF EL. 29.7 2000 Gallon 7.Septic System to be Installed in Accordance With 310 CMR 15.00& A� Itlq Con firm Prior S Septic Tank EL 29.45 Top29.30 248 CAM 1.00-7.00 Latest Revision and the Town ofBamstable r r 4�,y To Any Work H-20 Required 9.1 H-20 Board ofHealtb Regulations. I T U See Note 5 D-Box EL. 28.94 A8.All Piping to be Sch.40 PVC. ` ( ) IL 9.D-Box Shall Have a Minimum Inside Dimension of 12",and a Minimum -' 28.30 H-20 � . 599 �-' Leaching Sumpof6". `\ To Be Installed On Chamber 10. The Separation Distance Between the Septic Tank Inlets and y�� a /SSER�� 4`u y Stable Compacted Bose Bot. EL. 26.30 Outlets Shall be No Less than the Liquid Depth.Inlet Tees Shall Extend `�SSIONA L a Minimum of 10"Below the Flow Line.Outlet Tees Shall Extend 14" Bed ding,"T"s, Inspection Port, tf: Encaunt.ered Remove:& Replace Below the Flow Line,and Shall be Equipped With a Gas Baflle. DEVELOPED PROFILE OF Or- & Baffels :::All: :Un:5uitable::Sb�/s .Withrn 5'::of .: `n as Per Title 5 the Outer .Perimeter of.:The System NOT TO SCALE EL. 8.8 Revision: Add septic tank and pump to Cabana 912812020 No Groundwater - Per Test Hole 5 Revision: Add proposed Pool, Spa, Patio & Cabana 712212020 TITLE PREPARED BY.• PREPARED FOR: NOTES: Site Plan 1) The structures shown were located on the ground 0� Proposed Improvements Engineering & Mark E. & Down C. Don o van by conventional survey method or RTK GPS on Z AtConsulting, � 398 For .reach Road 10/15/2019. y ' Inc. Westwood MA 02090 2) The property line information shown hereon was ZTV North L./ay Road compiled from available record information. (508)428-3344• P.O. Box 659.711 Main Street, Osterville, MA 02655 3) The datum used is NAVD 1988 based on RTK GPS BarnstablepysterHarbors) Mass. seci@sullivanengin.com•www.suilivanengin.coni Bench Mark supplied by Sullivan Engineering & O Consulting, Inc. 'Tl Draft: ASL Field: JOD/CTR,/WHK 20 " 0 10 20 40 80 DATE: SCALE: Review: CTR Comp./Review: CTR/JOD April 21, 2020 1 = 20 Project: Donovan Project#• 3900024 1