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0096 OLDHAM ROAD - Health
96 OLDHAM.ROAD, OSTERVILLE A= 120 113 i DATEE : 6-/_11/02 -- PROPERTY ADDRESS ;96 Oldham Road` ----- --- -- 02655 - -- ------ ------ On the above date, 1 Inspected .-the .septic system at the above address, This system consists, of the following; k 1 . 1-1000 gallon septic tank`. 2 . 1-1000 gallon precast leaching pit. ( . VX101 Based on my Inspection' I certify• the- following con dIt-16ns;" ytio �6' 3. . _This is a Title Five •Septic-System ( 78 Code ) Fq�TB� ��O `4 ." The septic system is in proper working order ti4�AST at the present time . r 5 . Waste water is 37" below "the invert` rpipe of ° the leaching pit' S.I'G PN�AT U R E : . t - Name P . _Macomber Company ; s Joe h _ pP _ Macomber_& 'Son , *Inc , _ address Box 66 ; . --------------------.. __Centerville`, Ma`_ 02632-0'066 e . Phone :-- ' 508- 775-3338, , THIS CERTIFICATION ODES NOT, CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P° MACOMBER, & SON, INC," Tanks•Ceispools•Leachflelds Pumped & Installed. 4 Town-Sewer`Connectlons k. " P 0 Box'66 °Centerville• 'MA 02632.0066 ' 775.3338 775.6412 IiIIIII COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION V 4 TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 90 Oldham Road Osterville .Mass , Owner's Name: Lisa Blood Owner's Address: Same Date of Inspection: 6/11 /0 2 Name of Inspector: (please print)` Joseph P.Macomber Jr . Company Name: J.P .Macomber, & Son Inc . Mailing Address: Box 66 Centervill-e .Mass . 02632 Telephone Number: 50.8-775-3338 ' CERTIFICATION STATEMENT. I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Yy Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: 4~1/``'a� The system inspector shall ubmit a copy of this*inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner.shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. �r Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 96 Oldham Road s ervi e , ass . Owner:Lisa Blood Date of Inspection: 6 11 0 2 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D, A. stem Passes: I _have not ound any information}vhich indicates that any of the failure criteria described in 310 CMR 15.303"or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time B. System Conditionally Passes: A0 One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes,no or not determined(Y,N,ND),_in the for the following statements. If"not determined"please explain. _ZjL The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. 'A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate'of Compliance indicating that the tank is less than 20 years old is available. ND explain: /b 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 r obstruction is removed distribution box is leveled or replaced ND explain: N!7 The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND'explain: •a Page 3 of 1 I OFFICIAL, INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Propem• Address96 Oldham Road Osterville Mass . Owner:Lisa Bloo Date of Inspection: 6/ 11/02 C. Further Evaluation is Required by the Board of Health: A16 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. I. System will pass unless Board of Health determines in accordance with 310 CM'R 15.303(1)(b) that the system is not functioning in a,manner which will protect public health, safety and the environment: lid Cesspool or privy is within 50 feet of a surface water 4e Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment': 442 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.. ,e2d The system has a septic tank and SAS and the SAS is within a Zone I of a public water supple. . 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 10 feet but 50 eet or more from a private water supply %N,ell•'. Method used to determine distance "This s'\stem passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other ,failure criteria are triggered. A copy of the analysis must be attached to this form., 3. Other: ty 3 4 e Page 4 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 96 Oldham Road stervi e , ass . Owoer:LiSa Blood Date of Inspection: 6/11/02 D. System Failure Criteria applicable to all systems: You must indicate "yes" or"no" to each.of the following for all inspections: Yes ?�X/Back-up of sewage into faciliry or system.component due to overloaded or clogged SAS or cesspool Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet inven due to an overloaded or clogged SAS or cesspool H 1p, Aiquid depth-in cssfpo�l is less than 6"below inven ''A d or available volume is less than ay flow Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number — /of times pumped d. Any portion of the SAS, cesspool or privy is below high ground water elevation. Any ponion of cesspool or privy is within 100 feet of a surface water supply.or tributary to a surface water supply. Any ponion of a cesspool or privy is within a Zone., I of a public well. _ any ponion of a cesspool or privy is within 50 feet of a private water supply well. _ Any ponion 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. jTbis system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia , nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached_to this form.) ND (YesNo) The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15 )0). therefore the system fails. The system owner should contact the Boon _ Health to determine what will be necessary to correct the failure. E Large Systems: To be considered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000, gpd You must indicate either"yes" or"no" to each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no �O the.system is within 400 feet of a surface drULking water supply 2Lhe system is within 200 feet of a tributary to a surface drirdcirig water,'supply —� `he system is located in a nitrogen sensitive area (Interim Wellhead FToteciion Area — IWPA) or a mappec Zone II of a public water supply well r !f you have answered "yes" to any question in Section E the system is considered a significant threat, or answered es" to Section D above the large system has failed. The owner or operator of any large system considered a s:gnifcant threat under Section E or failed tinder Section D shall upgrade the system in accordance with )10•CMR The system gwner should contact the appropriate regional office of the Department. 4 Page 5 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:96 Oldham Road Ostervi e, ass . Owner: Lisa Blood Date of Inspection 6/,11/Q 2 9 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No > Pumping information was provided by the owner, occupant,or Board of Health Were any of the system components pumped out in the previous two weeks,? _ Has the system received normal flows in the previous two week period? /Have large volumes of water been introduced to the system recently or as part of this inspection ? Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back 6p? Was the site inspected for signs of break out? ' Were all system components 114cluding the SAS, located on site J _ Were the septic tank manholes uncovered,opened, and the interior of the tank.inspected for the condition of the baffles or tees,material of construction, dimensions,depth of liquid, depth of sludge and depth of scum ? Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes YExisting information. For example,a plan at the Board of Health. Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)] 5 f : Page 6 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 96 Oldham Road stervi e , ass . Owner: Lisa Blood Date of Inspection: 6 11 02 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms): dd? Number of current residents: .S'- Does residence have a garbage grinder(yes or no):&LO Is laundry on a separate sewage system es or no):4A [if yes separate inspection required] Laundry system inspected(yes or no): /.S Seasonal use: (yes or no): A)19 Water meter readings, ifavailable(last 2 years usage (gpd)):2000-54 , 000 gallons=147 4 95 GPD Sump pump(yes orno): Q 2001-53 , 00.0 gallons-145 . 21 GPD Last date of occupancy: COMM ERCIALX0USTRIA L Type of establishment: AA Design flow(based on 310 CMR 15,203): Y14 gpd Basis of design flow(seats/persons/sgft,etc.):: Grease trap present (yes or no): Industrial waste holding tank present(yes or no): Non-sanitary waste discharged to the Title 5 system (yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): /jffZ GENERAL INFORMATION Pumping Records n Source of information: 1"dyVl► (�` G I411W 1 Was system pumped as pan of the inspection(yes or no): If yes, volume pumped:__gallons -• How was quantity pumped determined? .lfyt Reason for pumping: OF SYSTEM Sptic tank, distribution box, soil absorption system nJD Single cesspool Zh�Overflow cesspool DPrivy Shared system(yes or no)(if yes, attach previous inspection records, if any) AJOInnovative/Alternative technology. Attach a copy of the current operation and maintenance contract (to be obtained from system owner) Tight tank ,4y Attach a copy of the DEP approval NPR Other(describe): Aipl \ r Approximate �12e of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site(yes or no): 6 Page 7 of 1 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 96 Oldham Road stervi e ,Mass .. Owner:Lisa Blood Date of Inspection: 6 11 02 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction:AJ119cast iron Y0 PVCiVO other(explain): Distance from private water supply well or suction line:lG'f Comments(on condition of joints, venting,evidence of leakage,etc.): Joints appear tight . No evidence of leakage System is vented through the house vents . SEPTIC TANK:Zlocate on site plan) /0499 4 $J Depth below grade: Material of construction:—J—/Concrete'Aimetal&1,0 fiberglass,tl_polyethylene �other(explain) All If tank is metal list age:gM Is age confirmed by a Certificate of Compliance(yes or no)�(attach a copy of certificate) Dimensions: F -),W Sludge depth. r,�t�D . 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,; c✓v Distance from bottom of scum to bottom of outlet tee or baffle: s How were dimensions determined: �74lSCl/"La� Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of.leakage, etc.): :'Pump the septic tank every 2-3 years ,Inlet & outlet tees are in place The tank is structurally sound and chnwR no evidence of leakage . GREASE TRAP4&Vlocate on site plan) Depth below grade: Alh Material of construction:eWconcrete.t/'fl meta k_fiberglass.1//APolyethylene.0^A other (explain): Dimensions: iQ Scum thickness: Allf 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: JA Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease trap is not present , 7 Page 8ofII OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address:96 Oldham Road . stervi e , ass . Owner: Lisa Blood Date of Inspection: 6/11/02. TIGHT or HOLDING TANK, ✓e,(tank must be pumped at time of inspect ion)(locate on site plan) Depth below grade Material of construction: 10 concrete metal jAfiberglass e,4 polyethylene4 L-other(explain): Dimensions: Capacity: AM gallons Design Flow: ,{14 gallons/day Alarm present (yes or no): _,I& Alarm level: " Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): Tight or holding tanks are not present DISTRIBUTION BOX:Zif present must be opened)(locate on site plan) Depth of liquid level above outlet invert: _ Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Distribution box is under the deckBox has one lateral . No evidence of solids carry over No evidence of leakage into or out o of the box . PUMP CHAMBER4j,.,.�(locate on site plan) Pumps in working order(yes or no) Alarms in working order(yes or no): Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber J.s not present • _ 8 . Page 9 of 1 1 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 96 Oldham Road stervi e ,Mass . Owner: Lisa Blood Date of Inspection:6 11 02 SOIL ABSORPTION SYSTEM (SAS): locate on site plan, excavation not required) 1-1000 gallon precast leaching pit .Packed in 12" stone . If SAS not located explain why: , Located ; See Page 10 TYP e o,' leachingits, number: Pl A/ leaching chambers,number: leaching galleries,number: "leaching trenches,number, length: leaching fields,number,dimensions: Alboverflow cesspool, number: d ,�. At2' innovative/alternative system Type/name of technology::a& Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): Loamy sand to boney sand to fine sand . No signs of -hydraulic failure or ponding . Soils are dry . Vegetation is normal . CESSPOOL%d &(cesspool'must be pumped as part of inspect ion)(locate on site plan) Number and configuration: Q Depth—top of liquid to inlet invert: Depth of solids layer: 1)4 Depth of scum laver: Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes or no): Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Cesspools are not present. PRIVY 'f_ (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.): Privy is not Present 9 Pal( 10 or I i OFFICLA1- INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION pop1M PART C _ SYSTEM INF0RMATI0N (conHnucd) Prcptrr) ,,dart,,: 96 Oldham Road stervi e , . Ow0cr: Ij sa blood DIIt' o! Insptc600: f/11 /02 SKETCH OF SEWACE DISPOSAL SYSTEM PTo.ioc c Ikctch of the tcwttc dilpolcl lyltcm including tics to at Icut two Pcrmtncni rcrcrcncc IcnCmarks or Ocncrrnukt. l ocuc cll wcIII within 100 (m. Loct,tc wh<rc public w"cr supply cntcrs the bvil4in;. "Pic) � S 3 J _ r Page 11 of 1 1 ' V" N — TAR ASSESSMENTS OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 96 Oldham Road stervi e , ass . Owner: Lisa B o o Date of Inspection: 6 11 0 2 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: 44 Obtained from system design plans on record - If checked, date of design plan reviewed: 40 IU Qbserved site(abutting prope bservation hole within 150 feet of SAS) ,00 Checked with local Board of Health-explain: ,t1fl Checked with local excavators, installers-(attach documentation) Accessed USGS database-explain:/: You must describe how you established the higgh gground water elevation: Jsed ; Gahrety & miller Model . 12/16/y4 Ground water elevations above sea level - Jsed ; USGS ; Observation well data . June 1992 Jsed ; USGS ; Technigal , bulletin 92-000-1 Plate #2 Annual Ranges of I up ofr uno ground water elevations . January 1992 Leaching n Pit Groundwater: Feet Below Bottom of Pit High g Groundwater Adjustment 1.8 ft per Frimpter Method Therefore, the vertical separation distance between the bottom of the leaching pit and the . . adjusted groundwater table i s 1��feet. t 11 rrnr+ -nirr�Tr-trnrmrnrnrrrnrt.r.n.rr. r:-.�r+ernr:+rrmem rrr+�nu r+a�r�eavnm « ,. �1 t- Barnstable I'OWN OF WARD OF HEALTH 1 Sl1I)Sl1RFACF SEWAGE DISPOSAL SYSTF,M INSPECTION FORM - PART D .- CERTIFICATION rr�-r•••. .-r. r.--.--n.r.rm•rt:rn rsrrrtmrrt-.+-n-'-•n�,nw- nnvr-','n+i++e+nrr n*vmnn►w-rrr� e�nn —TYPE OR PRINT CLEARGI'— PROPERTY INSPECTED STREET ADDRESS96 Old Ham Road Osterville ,Mass . ASSESSORS MAP , DLOCK AND PARCEL # 120-113 OWNER' s NAME Lisa Blood PART D - -CERTIFICATION I NAME OF INSPECTOR Joseph P.Macomber Jr . COMPANY NAME J.P.Macomber: & Son Inc..r ------------ COMPANY ADDRESS Box 66 Centerville ,Mass . 02632 Street Town or Clty Stat• COMPANY TELEPHONE ( 508 1 775 _ 3338 ciP FAX ( 508 ) 790 _ 1578 R CERTIFICATION STATEMENT I certify that I have personally inspected the sewage . disposa7 this address and that the in system at formation reported 'is true , accurate , and omplete as of the time of .inspection , The inspection was recommendations re ardirl performed and any g g u pgrade , maintenance , ,and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems , Check one : System PASSED rJ The inspection which I have conducted has not found -any information which indicates that the system fails - to adequately protect public heal Lli or ` Llre 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 con�ucted .has found that the system fails to Protect the hublic health and the environment in accordance with Title 5 , 3.10 CMR 15 , 303, and as specifically noted on PART C - FAILURE CRITERIA ,of this inspection form , I1 Inspector 5ignattre 1. Date r ✓d. ne copy of this tification must be provided to the OWNER, the BUYER ( where aPl?l icable ) and the DOARD OF )JEALTI(, * If the inspection FAILED, the owner or "operator shall upgrade wir,hin one year of he ayste the date of the inspection , unless allowed ortrequiredm otherwise as provided in 3.10 cPIR 16 , 305 , partd ,doc r_? TOWN OF BAP.NSTABLE ,Y« c.LOCATION SEWAGE # " VILLAGE �� � � '�� t ASSESSOR'S MAP & LOT 7- INSTALLER'S NAME_&PHONE SEPTIC TANK CAPACITY LEACHING FACILITY: (type) /�'����� (size) Zg NO.OF BEDROOMS BUILDER OR OWNER L,�l PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leac 'ng Facility (If any wetlands exist within 300 feet of a ) Feet Furnished by 1. FjD c 1 e:,r. Fo 5-1 r AGE PERMIT NO. L 3 7 VILLAGE INSTA LLER'S NAME A ADDRESS B U I L DE R OR OWNER � e DATE PERMIT ISSUED DAT E C 0 M P L I A N C E ISSUED J .., a. r. �� �� i�.� �� l l � - � � 3 Commonwealth of Massachusetts Executive of Environmental Affairs DEP� Department of Environmental Protection9 # CO SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A �► CERTIFICATION k r I h k r Property Address: 96 0 d am Road. Osille M a.e v Address of Owner: Mr Lawrence & P. Hibbett (if different) 9 Caitlyn Circle, Marstons Mills Ma. Date of Inspection: 04/17/96 Name of Inspector: Michael DeDecko Company Name, Address and Telephone number: Atlantic Environmental P.o B ox 2384 - M ashpee M a 02649. Tel : (508) 4771420 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. The system -X-- Passes Conditionally Passes ---- Needs further evaluation by the local Approving Authority ..-- Fails Inspector 's Signature: 1 D ate: 04/19/96 ' w The system Inspector shall submit a copy of this inspection report to the Approving Authority within thirty (30) days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office or the Department of Environmental Protection. The original should be sent to the system owner and copy sent to the buyer, if applicable and the approving authority. "t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 96 Oldham Road, 0sterville Ma. Owners: L. Hibbetk Date of Inspection: 04/17/96 INSPECTION SUMMARY: Check A,B, C, or D A) SYSTEM PASSES: --x-- I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CM 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 completion of the replacement or repair,passes inspection. Indicate yes,no, or not determinate (Y,N, or ND). Describe basis of determination in all instances. If"not determinated", 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 septic tank is replaced with a conforming septic tank as approved by the Board of Health. ---- Sewage backup 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). ----- broken pipe(s)are replaced ---- obstruction is removed ---- distribution box is levelled or replaced ---- The system required pumping more than four times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ----- broken pipe(s)are replaced ----- obstruction is removed SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 96 Oldham Road, Osterville Ma. Owner : L. Hibbetk Date of Inspection: 04/17/96 C) FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: ---- Conditions exist which require further evaluation by the Board of Health in order to de- termine if the system is failing to protect the public health, safety and the environ- ment. 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 of water ---- Cesspool or privy is within 50 feet of a bordering vegetated wetland or a small marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH (AND PUBLIC WATER SUPPLIER, IFAPPROPRIATE) DETERMINES THAT THE SYSTEM IS FUNC- TIONING IN A MANNER THAT PROTECT THE PUBLIC HEALTH AND SAFETY AND THE 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 within 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 analy- sis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate notrogen 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 CM 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to cor- rect the failure. --- Backup of sewage into facility or system component due to an overloaded or or clogged SAS or cesspool. " r .SUBSURFACE SEWAGE DISPOSAL SYST M E INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 96 Oldham Road, Osterville Ma Owner: L. Hibbett Date of Inspection: 04/17/96 D)SYSTEM FAILS (continued) -- Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool --- Static liquid level in the distribution box above outlet invert due to an over- loaded or clogged SAS or cesspool. --- Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/2 day flow. --- Required pumping more than 4 times in the fast year NO T due to clogged or obstructed pipe(s).. number of times pumped --- Any portion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation. --- Any portion of cesspool or privy is within 100 feet of a surface water supply ortributary to a surface water supply. ---Any portion of a cesspool or privy is within'a Zone I of a public well --- Any portion of a cesspool or privy is within 50 feet of a private water supply well --- Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality ana- lysis. 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. k r _ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 96 Oldham Road, 0skerville Ma. Owner: L. Hibbetk Date of Inspection : 04/17/96 E) LARGE SYSTEM FAILS: The following criteria apply to large systems in addition to the criteria above : The design flow of system is 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 --- 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 I I of a public water supply well. The owner or operator of any such system shall bring the system and facility into full compli- ance with the groundwater treatment program requirements of 314 CM 5.00 and 6.00. Please, consult the local regional office of the Department for further information. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 96 Oldham Road,Osterville Ma Owner: L. Hibbett Date of Inspection: 04/17/96 Check if the following have been done -x Pumping information was requested of the owner , occupant and Board of Health. --x None of the system components have been pumped for at least two weeks and the system'has been receiving normal flow rates during the period. Large volumes of water have not been introduced into the system recently or as part of this inspection. --x As built plans have been obtained and examined. Note if they are not.available with NIA. --x The facility or dwelling was inspected for signs of sewage back-up. --x The system does not receive non-sanitary or-industrial waste flow. --x The site was inspected for signs of breakout. -x All system components, excluding the Soil Absorption System, have been located on the site. ---x The septic tank manholes were uncovered, opened and the interior of the sep- tic tank was inspected for conditions of baffles or tees, material of construe- tion, dimensions,depth of liquid,depth of sludge,depth of.scum. ---x The size and location of the Soil Absorption System on the site has been deter- mined based on existing information or approximated by non-intrusive methods ---x The facility owners 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 Property Address: 96 O ldham R oad, O sterville M a Owner: L. Hibbetk Date of Inspection: 04/176/96 RESIDENTIAL: Design flow: 330 gallons Number of bedrooms : a 3 Number of current residents:o Garbage grinder(yes or no) : oa Laundry connected to system (yes or no):`1e-S Seasonal use (yes or no) : Nd Water meter readings, if available: Last date of occupancy: p1'kc s. COMMERCIAL/INDUSTRIAL. Type of establishment: Design flow : gallons/day Grease trap present: (yes or no) Industrial waste holding tank present (yes or no) Non-sanitary waste discharged to the Title 5 system (yes or no) Water meter readings, if available Last date of occupancy Other: (Describe) .....................................:...:.......................... Last date of occupancy: GENERAL INFORMATION /PUMPING RECORDS and source of information 4„t �r gym.... ? ....�!cc�•r?tt :�Y............... System pumped as part of inspection(yes or no):....k?.O........... if yes,volume pomped : .................... gallons Reason for pumping:............................................................................................................. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 96 Oldham Road, O sterville Ma. Owner: L. Hibbetk Date of inspection: 04/176/96 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) --- Other (explain)............................,..:........................................................... APPROXIMATE AGE of all components, date installed (if known) and source of information. ................................................................................................................................................ ................................ Sewage odors detected when arriving at the site: (yes or no)....Q0..... SEPTIC TANK : . . ....... (locate on site plan Depth below grade: ..3...... Material of construction: .:.15. concrete .......... metal ........ FRP ........ other (explain) .................................................................................................. ... . . Dimensions: 5.n.$. ..... Sludge depth:...I............ Distance from top of sludge to bottom of outlet tee or baffle:........ ......... ........ Scum thickness :....O.`.............. Distance from top of scum to top of outlet tee or baffle: .......................... Distance from bottom of scum to bottom of outlet tree or baffle :....Is................. Comments (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert,structural integrity, evidence of leakage, etc.)...................... oA Ullr.. :� .�.►?�4.� :�.:a,. : Cll?:l ���. r�.T���:�:m,:;...t°� �lS���YA `.... ................ V i G' i SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 96 Oldham Road, Osterville Ma. Owner: L. Hibbett Date of inspection: OV17/96 r GREASE TRAP : (locate on site plan) D epth below grade: ::....:........ Material of construction: ........concrete.........metal........FRP........other(explain).... .............................................................................................:...........I................. Dimensions:.............. Scum thickness:......................... Distance from top of scum to top of outlet tee or baffle:....................................... Distance from bottom 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, etc.)........................ ................................................................................................................................................ ................................................................................................................................................ TIGHT OR HOLDING TANKS:...PO..... . (locate on site plan) Depth below grade:............... Material of construction:........concrete........metal.........FRP..........other (explain).......... ........................................ Dimensions:............................ Capacity:....................gallons Design flow:...............gallons/day Alarm level:.............................. Comments: (condition of inlet tee, condition of alarm and float switches,etc.) ................................................................................................................................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 96 Oldham R oad, 0 sterville M a. Owner: L. H ibbetk Date of inspection: 04/1 T196 DISTRIBUTION BOX:..16. (locate on site plan) Depth of liquid level above outlet invert:... Comment: (note if level and distribution equal evidence of solids carryover, evidence of leakage into or Qut of box, etc.)..7 ............................................. PUMP CHAMBER:....K)D.. (locate on the site) Pumps in working order: (yes or no)............... Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.).................... ................................................................................................................................................ SOIL ABSORPTION SYSTEM (SAS):... 5......... (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: ..1. . '..k..e.� leaching chambers, number:......... leaching galleries, number:........... leaching trenches, number ,length:..................... leaching fields, number, dimensions:................... overflow cesspool, number:.......... Comments: (note condition of soil , signs of hydraulic failure, level of ponding, con ition f vegetation, .. 131!� _►.^! c...\,t Q! �:..Ca1??.l Ail , .. .: 9!Yl....M0 RYYIolQ .......................... I A A� SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PAR T C SYSTEM INFORMATION (continued) Property address: 96 Oldham Road,O sterville Ma. Owner: L. H ibbetk Date of inspection: 0411.7/96 CESSPOOLS:........ (locate on site plan) Number and configuration: ......... Depth-top of liquid to inlet invert: ...................... Depth of solids layer: ............................................... Depth of scum layer: Dimensions of cesspool: ...................... Materials of construction: ..................... Indicator of ground water: ............:........ inflow (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.) PRIVY : (locate on the site) Material of construction: ................................... Dimensions: .... Depth of solids: ................ Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.). ................................................................................................................................................ SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address : 96 Oldham R oad, 0 sterville M a. Owner: L. Hibbetk Date of inspection: 04/17/96 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate at wells within 100'. DEPTH TO GROUNDWATER: Depth to groundwater: 1.1 3...feet Method of dekermi�akion or approximakive: No..... ..o.�.\.w...... Fizs... ... THE COMMONWEALTH.OF MASSACHUSETTS BOAR® OF HEAL A I /� ,r d f . �,Q • ......OF.....18AR ta �Y. ......................... Apptiration for DispatiFal Works Tomtrurtinn Frrinit Application is hereby made for a Permit to Construct ()() or Repair ( ) an Individual Sewage Disposal System at . a. .._.: 37 00 ......_ ..... s 1 :.... .�._. ........ ....... ............... ' �^Location- ddress - or t o ll�. .cllrr 0� riz ..lZe& ) t /y -- ' dy, .�r� r. ... ............. Owner Address . . .. ............................... ......................................... --...-.---..-.-.-..-.-..-.----------.------ Installer Address / �� Type of Building Size Lot__/s7}......... ....Sq. feet U Dwelling—No. 'of Bedrooms............ ....Expansion is ( ) Garbage Grinder ( ).-, 4 04 Other—Type of Building ............................ No. of persons............................ Showers (f ) — Cafeteria ( ) a, Other fixtures ------------------•--••••--•--..............•- w Design Flow............................................gallons per person per day. Total daily flow........._...................................gallons. W Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total-Length.....................Total leaching area....................sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area.;.... sq. ft. Other Distribution box ( ) Dosing tag (// ) s V ���X'Percolation Test Results Performed 'by_____________ 2.C1 - .....ir/_ O "� ....._... Date... ....•.......................... aTest Pit No. 1.4....._......minutes per inch Depth of Test Pit.................... Depth to ground water........................ Test Pit No. 2.�... minutes per inch Depth of Test Pit.................•.. Depth to ground ax ......... 1_ � water........................ ............... ........... •.......... -•--•-- --------------------- 0 Description of Soil---0--... ----- 4...... _ (...--•--I-----lZ-----�G.. ... �6 ------------------ w UNature of Repairs or Alterations—Answer when applicable............................................................................................... ---------------------------------------------------- Agreement: .The undersigned agrees to, install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT!- 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i§sjaed by the board of li 1 / p igned k� •-- 1. `_--......_ p. Date Application Approved By....'........ , .. :.. . f t/j/�. ...... /.. �i ..�� ��------ Application Disapproved for the following reasons:..................................... -•••••...................••.••••. ............--------Date•-•••••....... .......-•.......................•----........._...----•------............-•------•---------•-------......---------------------------------•-----...---------------------------------------------•-•-•--- Date PermitNo......................................................... Issued........................................................ Date NoC THE COMMONWEALTH OF MASSACHUSETTS h BOARD OF HEAL Aliptira tion for Disposal Works Tonstrurtinn Prrutit Application is hereby made for a Permit to Construct (ray) or Repair ( ) an Individual Sewage Disposal System at " `Location- dress �-- C"1 s jee r s# 19 .:... co ....�°---------.'A y� Owner Address --------------------------------------•--------- -................................................................................................. Installer Addressjv�o d Type of Building Size Lot ........� _..O....Sq. feet U Dwelling—No. of Bedrooms.............. ...........................Expansion AVC ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of-persons............................ Showers Cafeteria ( ) Otherfixtures -------------------------------------------------------------------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—No..................... Width.................... Total Length..................... Total leaching area....................sq. ft. Seepage Pit No-_------------------ Diameter.................... Depth below inlet.................... Total leaching area........... q. ft. Z Other Distribution box ( ) Dosing tank ( ) y �- . W Percolation Test Rests Performed bY------------- --- --• - •--- -----•----------------------.... Date.................................... Test Pit No. 1._.'__. -._minutes per inch Depth of Test Pit.................... Depth to ground water........................ LT4 ? Test Pit No. 2.. _Minutes per inch Depth of Test Pit.................... Depth to ground water........................ t O Description of Soil... _�_ _y_. .1 !. . ---UA _l /_..----- --�-�.................. .-'.. ...........-------- x W UNature of Repairs or Alterations—Answer when applicable.........:..................................................................................... --------------------------------------------------------------------------------------------------------••-----------------------------------------------......-----------------....----•-•-------.----- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITS 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be n i slaed by the board o h alig. IIa��'"��4 '..Y 0 �i"r•�c-¢. �}. ate Application Approved By.............. v-- - �---.. G(J �.............. ------1--�--/�---.--�-�--....._._ Date Application Disapproved for the following reasons-------------------------------------------------------------------------------------------• --•--.........---- -•-••-•...........................•--•--......------•-----........-•-•-•--------------•-------------••-------•-------•-•-••--••-••-•------•--•--------................................................. Date Permit No----------------•-•---•-.. • •-•---------... Issued---...----•-----------------------•-•-----...... ------ ------- Date.................................................-•---- THE COMMONWEALTH OF MASSACHUSETTS .--- BOARD OF HEALTH t.. .�� .............OF....... .............. .... .................. . Trrtifiratr of TompliFaurr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (.) or Repaired ( ) by....... - ` .. �.r: / : ................ ....... ....j -----------------... - ---------------.-----.--------------------------------------------------- staller Lo has been installed in accordance with the provisions ofrip r of The State S anitary Co e as escr&-d in the application for Disposal Works Construction Permit No _.. 1/............... dated....... `_ ............................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL /FUNCTION SATISFACTORY. � DATE olg .... Inspecto THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......� p.J ../ ....OF......... /='.!`•<r ±.:.. ....... .........: No......................... FEE... d........... Disposal Ifork utrudion rrutit Permission is hereby granted...M�!1; �=.....------------------------------------------------------------------------------ -- to Const &ts(-6 p� epair �jan ndividual Sowfi e Di�ps�l tSystem at No... -...I.........------...!t—.y...G': 1... 5"�_��'_�...�.�. ��--------------•----------------- Street p as shown on the application for Disposal Works Construction Per No..f Dated......./................................. DATE................................................................................ Board of Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS Al Ft✓4'"�v ,. Yf~�ti r.'� .... q _� .._ ..._..,._,.._.._.__,__•^/,—._...........__.` L— r Y. 41, y } �`• Y , I „ti r e �' fir. f}r r•�° r' ? ' li.7 .a # r.>j .cat rnm �_ - ! c:.�4'l�/� VS/67 A/ Y h� �'.�- �I �;� � of . , 6ti t4 �d7 i, �.. �+ �• 5;••+' �',Y" t�vt t1 �. tz + • '" k "� i„ Y , ik' :> f�✓/E' ='!?-p+'.`C y'Y� a `� z5 r* h f Iwg �' c s,. 4a �^ r y i��"l W �T - :z i y� - �h� '0 � �•" � - { (`/'� � I j t JAB r, !1 .,,4 ` t '`~ -1.` J.�.-,1._,r.`..___..._'_._-! , \I .• `L' fug .x,' e y' ii � I t ref "j Gell, ;,Ui F , , t, c� } BJNIKIS ; y Nn 4c` 7. sSONAL�N6 LEGEND EXOSTONB SPOT ELEVATION 00 CERTIFIED PLOT 'PLAN EXISTING CONTOUR -- ' ® — - — FINISHED SPOT ELEVATION. L._D � s- � FINISHED CONTOUR 0 — "A ROVED = BOARD OF -HEALTH ON . N GATE AGENT SCALE: 3 ®ATE g NE'EROAIG CO. l�l F, // � ; -- . CLIENT ' I CERTIFY TKAT THE PROFSO89D , EBiSTERE RE(31STERE® JOB N®.N� �r t ,► BUIL®INO SHOWN ON T0I1�'I PL At,Irt'': ;. N k CIVIL L Y CONFORMS TO THE ZONING LA*i u ENGINEER SURVEYOR DR.BY `�_ e r OF BARNSTIS ASS 33 M0. MAIN ST.. 712 MAIN ST. CH. BY SO. YARMOUTH, AMASS. 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'•''4 � r t .I I:y,/�YGjUP �9 r r o CZ4EAA1 -TA NO o r. • CoMeo AL W 1C rA/V1C >5�0�-�D s�I!/E ® N ° ° o o ° ®o WASN.E® .SpdNE A --o y. ®07 OR E4J t/ 0D A O © o ® ® D o 0 6 o 0-to o; a ® o 'o a "® 1p oVV"Tr AT BD4DoWep 2 7,O .,mr �. XSC7 M V ®. ' w .TC/51LL'� a ffo" N&WR 3 't P j �/MlN.$�/®Oa0 `� �T.^1,n/ T®�.�t di a ® ���✓ .144V 6014 7ESt O/ slr,02; /f50AI *�w L,!'ACNINO P0� __ ,��L�Q� 9P,0 '' _.�LF1/ T-L.®j'S®DI: 7'ES y' Saw -qDRv ARM PDT 007 rOM A4KCVIAIO..POR I-.1I F5— Sol. Ar- t 7�7P�L Y�Il S ��•� a G^ ��D®M Q4r4ff girach► z 6 RVOLAWON / r e - ' T. �/M -'k v , g may^ r „ '�ssq � Y.. 'l.:�,.. ,.i• . '•'�� '*. �G ,D'.U3�� �.:a+a �''§s. '`1 v'li.:�.. tea;t � �' ��7 -��� :y,. �d/lT-.'�'�"f /�.:..•.• s � .. k .prf :` f'4 .�,•, F "�i.7 ��./,„4 �`,t i:YS �-n.� }�y'y. zap-�V. s -�F ..��w/. ..8a /�+'' A - t ` ak P- 7pt- tjjm l Ko, ., � mow•. 3 w�.'_z� _ � 4J a�_ =wk No;`22162 < xr � • •• a >g= - {r,, � +�..• „<.t. - ,5±�„ -4'S�,-+i r,( a a-» Sti�,i _,r.. x ;4�i. <,r=� ��� - .4 us w :-.- 1.. �...- .,r. ,g`y y. a.....-; "ti..'•..:3 .x':�s�c, 'Y;' e� �.1..,.Po • r :..'.+.f -P'`S y.J,:('1$'"1':[•s .^ � �� .' J� _n..-.+i';}..,.. „`.4 [[.. :...�}. '^"ci 6 � - F _ 3' �. .fir .. ,� ..:; ��r.�� �„��-',`"• �" �� .�, mk '-�4o i'ice' ._'?; r . j. �.•' • i 1.•.: .''Y°zo a ,5:0• _ � a��3 6 � � SAC' ® ---wttatrnw �GFVfik.ULE= —... I �� l.. D yJ111�j' �p-fyp__q.N "ANDfiR'S EH (-171L..fiQ��_.__. r p Val I —HaiF- 'D I rm� c _ CIO I 0 W P. .- .. N _:. cD:' _ •p'b - MIN. - � a Q I .10TIUMM - _ A� d I M - PM ' FAAT2:u�. - • =gyp:QpOL�1-- j .. .. " Irraf� 9P. oo EXit'QN-t'---unlSF I` New Addition __ . \\\ i 4 l�y�'� q I W A2ESiYP-4El \ ' I !6 Oldham Road I. 1j bP -,i 'l9_ Pot:;'a O�_x1-=7¢' y _Ei2?i"Ar2Y'f5_'�aW � �^ y Osterville. MA 02655 _ _ .P`b / -— General Notes: _ (660 or., / - ! 1.All work to be performed in accordance with Massachusetts State Building Code,780 CMR, � UP 11 • .91p �/. ! Eighth Edition,IBC 1009,and applicable codes included by refemace.Framing to be in 4 , accordance with the American Wood Council Wood Frame Construction Manuel,110 WH -'"t:tF.C.LRtG_f316• -- - - t Qz Zone.All wodc to be as approved or directed by local authorities having jurisdiction. � - . 2.Contractor to secure all permits,and to mange for inspections by local authorities having --_- �IT) jurisdiction,asmeybe required. (.LZITIU._$ E _ _---_1Y1A�L- .'I•=90' 3.Work to be left in clean condition,ready Cor use and occupancy.All debris m be disposed off yteiygs: '. ' site in a legal tinlncer. ; _ _ AIldrejS R.StlirUS .. . . ' Architect tiIE$.S�T.E.•. - - 85 River View taae,Ceuta vUK MA 02632-Telephone:(508)790-0920 - RTC9�TbiCAFH-4LQ'1`��..tlD) 4.Contractor to iremll plumbing,electrical,heating and venting systems as mgrdred,per I Instal new smoke and carbon monoxide detectors,Pat codC• loor Plans New Addition Al --.. 96 Oldham Road,Oster lle.MA 0205:..' T --mw=Imp IrVnK k4'--.0'`_ —�xEvr-6:oof o" -evrrnx r—um7bE-_ pE`CSu . . .. - -ccarror-annc�crcaQ]Fy _ • _crHou3F.=-aJiYy.dc_.._ \ 8� I f Y y tq�ux—r re_. _ I �te�rnirtz M&SMi SPA"LVENT,.�Y -- 4°K IL" —ve¢r—cirnmar.- i Ct_&ILL£YLHf+.-BAx6:NCYR ... _ t -Fg_t' — �"�AZti71T177N - _I�sA_ .. I' MEW wo 1' RT fY6YlOh1ll __— zrr E�(� IrT� Tc77s�Ps �4�_1 i p Andrejs R. Architect 85 River Yew Ian-,Caue Ml,R MA 02632-Tdephene:(508)7904920 Elevations . I I'New Addition - '.._96 OldLnm-Road,Oste�villy_MA 02655,j V 1 ?l Yue_stEo7T AIA�FS�R3�jeYc*�=�rEE"`-ta�rcw - : I �.� a • =x�u�a _ ✓UI� � w� g , U , . -..-��Vr-VElIT ----. .'.: ���: .. •��-Y74IIff-YY.I'1�1�=_7/.fNDIT1IIF� _ _ � - - �,ysx -__wautssAev ---- R§ =fWIB&.WRAP.:6.OIe IC.• o- ... __ ,i. .� .. I _ ru;'gaDRp::ovNb vPL1�N Q6:( ._,FtZhN1 NiG� PO.OFf CE]Llu�. F�h4�tIN.G..... .._.:._. _(ON,.FK&W164G:.:,.. --- „ LA - .. • -. - .. - - � �-�p�p�--�,�y��y�n/-/� ' - �-1 t-PDL'Ytf41^!1-r�E•-VgPdA-'la'ig�rRP _-__.. I' " A o�a e a � a. a "•�i o o O >o m e e.° ._._. - - ._516N1--s�=O.-X��"" h y ! � _ --- mom'•,—Pst v' Qe� .. 4 1 Andrejs R Strips Architect 95 Rfver view[.sne,cenleMft NIA 0202- hove:5os 790-MO Section and Framing Plans New Addition L'✓... 96 Qtdhem Road OsWvtHe,b4A-02655 As mnp _54;13 A,,?s