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HomeMy WebLinkAbout0340 PARKER ROAD - Health 340 Parker Road A = 115--032 Osterville -7"[17.78 cm] 78"[198.07 cm] T EQUIPMENT ACCESS ur----------------- rn 60"[152.54 cm] 168"[426.58 cm] `D I DRAINS v N O 0 pO 64'[162.43 c ] 0 —OPTIONAL0_`. � ° /,� KEY PADS T 49"[124.33 cm] HYDRAULIC TREADMILL 0-A 50"[127 cm] 45 WATER .5"[116 cm] OPTIONAL DEPTH N WATER DEPTH HYDRAULIC G SWIM r' CURRENT GENERATOR 00 o O O 228"[579.12 cm] 78"[198.07 cm] 55"[139.63 cm] 78"[198.25 cm] SKIRTING PANEL SKIRTING PANEL SKIRTING PANEL APPRO LOCATION OF ELEC *OPTIONAL STUB U (SEE EP-18.4.1) ENHANCED LED LIGHTING 'R ® ® 21' 53.34 o°o ] w I TYP T T I 50"[127 cm] I o v Q I W WIREATER I �* N a 0- DEPTH I HARNESSES c) m Z I o ® I CONNECTION FOR j rn fc? Y I OPTIONAL MASSAGE I to ° WAND ATTACHMENT 0 0' HORIZONTAL 228"[579.12 cm] STRINGERS VERTICAL RIBS J Q 2 O C) z.a I l z.a � Z Q a E^� u E Li u O I I I v �O I 2.6 10 126"[320.05 cm] 211.[60.96 c ] 9"[73.66 c �" 2 "[60.96 cm] 2 "[60.96 cm] / *24" PERIMETER ACCESS IS REQUIRED FOR ENHANCED LIGHTING OPTION DETAIL NUMBER: ENDLESS POOLS* 19 FT SPA EP-18.0.4 SWIMMING MACHINES 1601 Dutton Mill Road,Aston PA 19014 www.endlesspools.com swim@endlesspools.com 800-732-8660 SPA SERIES DETAILS REV 2016/03/29 Dct, 1. 2013 9:31AM Fraser, No. 3412 P. 2 S `1 Fdl 3 '10 Porker /50 05 fed v "!I � 9 r j r 1 � 7'A-ri IT d Cr r E � Massachusetts -Department of Public Safety Board of Building Regulations and Standards ConstRIitictin Su er%kor r r S License: CS-097991 r, 71. JORDAN T RACE' ' � � "� c c� PO BOX 149 fi Ay �3- C. 6 -- Monument Beach~1VIAi02553 r � Expiration Commissioner 03/05/2015 ol Ci f c t/� i s i bz :b W ' � 001 `. 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'"arA �-y�,p}« ' _ :'a�S- .��yL-�';-� �'"�` , r - �r r;`,t a s1 ... �} x•1.3F1'�6 8�."`u�p g � "*t�L 'r* .���(ih�,"*7`,S" �°�"Y *`t'Ex„ •�fj�X'":iY�r � _ .+t���'►1 �;�� .� y s*°. `C d-..1 "r �• 3�1��yb 4 '� t�,y« . r 4 Commonwealth of Massachusetts Title 5 Official Inspection Form 7 Subsurface Sewage Disposal System Form -Y Not for Volunt ary y Assessments 340 Parker Road Z Property Address C John Williams1 Owner �.: information is Owner's Name _ required for every Osterville MA 02655 7/21/2016 _ page. CitylTown State Zi Code 1� . P 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 A. General Information filling out forms I %1p9 L on the computer, use only the tab 1. Inspector: key to move your cursor-do not James Ford use the return key. Name of Inspector Ford Septic Services, LLC rah Company Name P.O. Box 49 Company Address Osterville CitylTown MA 02655State 508-862-9400 Zip Code Telephone Number S12482 License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that`the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further luation by the Local Approving Authority 8/8/16 Inspect 's Slgna Date The s m inspector shall submit a copy of this inspection report to the Approving Authority(Board of Healt or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if_applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time:This inspection does not address how the system will perform in the future under the same or different conditions of use. . t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of inspection- B. Certification (Cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. 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): l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 I • Commonwealth of Massachusetts H v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) 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 ❑ ® 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 '/z day flow t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 I Commonwealth of Massachusetts t Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 340 Parker Road Property Address Owner John Williams 's information is Owner Name required for every Osterville MA page. City/I own 026_ 55 _ 7/21/2016 State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for 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 2000gpd- 10,000gpd. El ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking watersupply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not fo r VoluntaryAssessments nts 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 Cit 7/21/2016 page. y/Town C. Checklist State Zip Code Date of Inspection 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 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)] D. System Information Residential Flow Conditions: Number of bedrooms n/a 5 (design): Number of bedrooms (actual):. DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550 15ins,1113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 3 Does residence have a garbage grinder? r ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection information in this report.) ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail unavailable Sump pump? ❑ Yes ® No Last date of occupancy: currently Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: l5ins•3/13.. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville page. CitylTown MA 02655 7/21/2016 State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: currently Date Other(describe below): General Information Pumping Records: Source of information: unknown Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1000 gallons How was quantity pumped determined? Reason for pumping: maintenance 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): l5ins•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: system installed -unknown Were sewage odors detected when arriving at the site? ❑ Yes ® No 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.): Septic Tank(locate on site plan): Depth below grade: 12" feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ® other(explain) If tank is metal, list age: years _ Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gal. Sludge depth: 2 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection For Subsurface Sewage Disposal System Form - Not for Voluntary Assessments a,••'•y 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank (cont.) Distance from top of sludge to bottom of outlet tee or baffle 22 Scum thickness 6 Distance from top of scum to top of outlet tee or baffle 6 Distance from bottom of scum to bottom of outlet tee or baffle 12 How were dimensions determined? 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.): The tees were present and there were no signs of leakage. Grease Trap(locate on site plan): Depth below grade: n/a feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene El 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 I5iris•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 9 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene El other(explain): N/a Dimensions: Capacity: gallons Design Flow: gallons per day 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 t5ins 3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert n/a 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.): 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. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: l5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 I Commonwealth of Massachusetts - Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments G 340 Pa rker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ® leaching pits number: 1-1000 gal. ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The leach pit had 1' of water on the bottom. The scum line was at the same level. There was no sign of failure.The cover is 3" below grade Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration n/a 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurace Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official 4 al Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding; condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/a. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 14 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - i Not for Volunta ry Assessment s 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State ZipCode Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately r O A as 36 t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments i M a 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high groundwater: 17'+/- 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: Date ® Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: Topo and water contours map. ❑ Checkedwith local excavators, installers-(attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: see above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 ' Commonwealth of Massachusetts U m Title 5 Official Inspection Form m Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 340 Parker Road Property Address John Williams Owner Owner's Name information is required for every Osterville MA 02655 7/21/2016 page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked i® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins• /1 3 3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE RA(b UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS L ' ASSESSORS MAP NO. 115 , PARCEL NO. ADDRESS; VILLAGE ®�E�G� CONTACT PERSON CIAO L 42�1��ONE NUMBER LOCATION OF TANKS:.. CAPACITY: ..TYPE- OF. FUEL. A' TYPE: LEAK OR CHEMICAL: DETECTION SYSTEM! OF 'Acge . s o m r=l �otrs -/998% 057 HAVe i�s-rep A&10 P-C-Mo 1 9 q��__ -ro Lo pce�r� uQnd. k6momi DATE OF PURCHASE OF EACH: 1. 2. 3. 4. 5. DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. d y TANS `/ IN &CK nnok-1 -6 cK -WOP DbO l2. 14 BANK C�F- Trust Division 31 March 1988 Board of Health Town of Barnstable 367 Main Street P. 0. Box 534 Hyannis,. MA 02601 Re: 340 Parker Road, Osterville, MA 02655 Gentlemen: _ Please find enclosed Registration Card for the underground tank on the above-captioned property. We are co-owners with occupant, Mary B. Williams. We have completed same with the information available to us and should you have any further questions, please cont-act .us he.1 at the P We understand that the valve tag must be attached by May 31, 1988 and trust that you may be able to proceed with the necessary steps to accomplish this. r. Thank you and should you have any questions, please contact me at 973-1752. Sincerely, Clara V. Sarno closure Trust Real Estate Dept. S15-TRU cc: Mrs. John B. Williams, Jr. 28 State Street, Boston, Massachusetts 02109 (617) 742-4000 TOWN OF BARNSTABLE. . Pao ��* ' �' • . ' OFFICE OF awer►azR � ' . .. BOARD OF HEALTH . 4°be 1679• 3e7 MAIN STREET of�11Y M• i, HYANNIS. MASS.oisoi February, 1988 Dear Underground Tank Owner: You are now reg0xed by the "Health Regulation Regarding Fuel and Chemical Storage Systems" published in the December . • 17 , •1987 issue of the Barnstable Patriot, to register your underground tar_k° with the Board of Health. Please complete the enclosed Registration card. Include any evidence of the date of� purchase and installation, a copy of the permit from the Fire Chief, and a sketch map showing the location of such tanks on the property. Upon completion- of the Registration card, you may be issued a brass valve tag by the Board of Health. This valve tag shall be picked up by you or your representative at the Health ,Department located it -the Barnstable Town Hall. The tag shall then be. attached to the filler pipe of the underground tank. Please return completed Registration card to the Health Department as . soon as possible. You are required to comply with this regulation by May 31 , 1988. After -this date, if you do not have an attached valve tag, you will not be able to receive any fuel oil from your supplier. Very Truly Yours,, Thomas A. McKean Acting Director of Publio 'Health �c�u 0 30 r. b TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS ASSESSORS MAP NO. PARCEL 'NO. 'IR1115 032 ADDRESS; 340 Parker. Road, •Osterville, MA 02655 VILLAGE. . .OSTERVIIZ8[ ,.TOWN OF BARNSTABLE 14AME; Mary B....Willlams and, Bank .of New._England, NA Tr._ u/w Charles N. Borden _ Clara Sarno, Tr. Real Estate 617/973-1752 CONTACT PERSON PHONE NUMBER LOCATION OF TANKS: CAPACITY: TYPE OF FUEL AGE: TYPE: LEAK OR CHEMICAL: Prior . DETECTION _ YsTFM: See map on reverse side 500 '42 noel 1972 Ifs/A F This property purchased by tliese owners 11/29/72; tanks were already underground. DATE OF PURCHASE OF EACH: 1. 2. 3. 4. 5. DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS - PLEASE PR V K OWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. 0 IDEA SKETCH SHOWING 1 . r TOWN OF BARNSTABLE UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS ASSESSORS MAP NO. PARCEL NO. rR1115 032 ADDRESS: 340 ;Parker Road, Osterville, MA 02655 VILLAGE- .OSTERVILLE� TOWN OF BARNSTABLE NAME! Mary B.__Williams and Bank of New_England, NA Tr._ u/w Charles N. Borden CONTACT PERSON Clara Sarno, Tr. Real Estate PHONE NUMBER 617/973-1752 LOCATION OF TANKS: CAPACITY: ..TYPE OF FUEL AGE: TYPE: LEAK OR CHEMICAL: )Prior DETECTION see map e on reverse side 500 �42 Vul 1972 �YASTFri This property purchased by these owners 11/29/72; tanks were already underground. DATE OF PURCHASE OF EACH: 1 . 2. 3. 4. 5. _ DATE OF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS CARD. _........ __ ................-......... .,..,..,.....,_ _----- --- ... _.._...___.. .._..._ -- ... __ . a y e 3 m 9 0 Y � f---�- � - jl t� - y J a ! � fF '� K ; i � S i . i it t 1 d :f 3 L J j ]�t 3 �a A I s � ,w I � r a I rJ y i r. TOWN OF BARNSTABLE LOCATION 3 yU Parker .RA SEWAGE# VILLAGE 05 le(yJ de_ ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY 1600 t,J o A LEACHING FACILITY.(type) I_Pa c t.,4,S o I f (size) NO.OF BEDROOMS OWNER So i n LJ• I aw,S PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY Ci/7// 3 -TosePL-t Abe-kto Sq - 9-0 9 G As buc,1 t tole Z. 9eff1C sx ems 390 Parker t A- Osie(O(e, MA A -E = 37 m A_ 0 : 21 Iv`� - E - 59, � „ 3 6' A- r - " - S 7� y 1>0 0 D61 ,l 3C 6 " rn 35 N '�`• =� O _ _ _-•-i ------------- - - C _ r I O � ` j sr i . P . •, T � t 3 I - r ' , rn r 1 ' rn -------------- a -----------_-- - ---..... ' r Elk {{ p _......., I rn A — i.. 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PISCITELLI E JUDY L. BELL ENGINEERING & �`{, �z - DEED BK. 26296 PG. 300 e} ` \?-__ PARCEL 116-075-003 SURVEYING 27, e ` S Registered Professional Engineers \��1 o�tiPti � and Land Surveyors ' ' } , ��_ 78 North Street 3rd Floor N , ' �' \ k �37.0 `� `�2`�, Locus Map Scale 1 -Z000 Hyannis, Massachusetts 02601 GENERAL MOTES: Phone - 508 - 7502 1 S ' Fax - (508) 771-7622 - 25- O i ��� ____- _- 6 f 1. THE INTENT OF THIS PLAN IS TO DETAIL EXISTING SITE CONDITIONS AT 340 PARKER ROAD x 30. 200t 5011 LOCUS AREA IS COMPRISED OF: www.baxter-nye.com Z PER CURRENT ASSESSOR'S RECORDS: <90 ' _ ~ e} \\ r \ 4' r ®\ _ - ��- _ OWNER: ESTATE OF MARL' B. WILLIAMS, ET. AL } ` --�- / \ \ ` f ---/ �"�s/'' CERTIFICATE '57133 a J t � \ ` x,28.4Nc cR EL e l RECORD PLAN: LAND COURT PLAN 7686C LOT 1 _ _ -- _ o oRi ;� - ASSESSOR'S MAP. 115 � � �- 24 - - --��` �_ �� o i W, -�_ W ��\ � � o - --- 28X27.9 '� PARCEL• 032 O �o�' �ERti/ w f "-X2'.0 P - 3. PROJECT BENCHMARK:AS SHOWN ON THIS PLAN w O / i �t qTE) �, AC W d r+ ❑ 28 w �r N EXISTING -'�• ..... 4. ZONING INFORMATION: -�-�' 100' BUFFER OFM4 STAMP '� �, GARAGE s TO B V W ZONING DISTRICT : SPLIT RC, RF-1PC � � _', �t t ; i f 3 �i �� ' `J �° CURRENT MINIMUM ZONNG REQUIREMENTS: �� gNANE J I23 Aa --�I e� O� �`, "� . i �t 0, r d� x 25.8 �-J s� - RC RF 1 M N/F WALTER NASON LENS, JR. CUD MMIN. LOT IN. LOT AREA 20' 87,120 AMA ��aN7� } '} O '} i '`� j �\ i ' / / ,f x r2.8 MIN. LOT WI FRONTAGE = 100' 125' ,qo� sop`a - DEED BK. 13256 PG. 77 PARCEL 115-023 FRONT YARD = 20' 30' C��� SU�v��® 1 v �} - 26,' it SIDE & REAR YARD = 10/10 15/15 I I' '� e U e ! SILL EL. 29.77 ' ' / �� s \_✓ OVERLAY DISTRICTS. RPOD, SWEP EXISTING? AC M r -- �P,_ / �-k 21.VQ ` \ /W�7 (( DWELLI G y ` -'` \,xl20 5 p 5. A TITLE SEARCH HAS NOT BEEN PERFORMED FOR THIS SITE• THERE MAY e l 340 - > ,� fBE ee ee TI M B f��, / - r r- �, x 4 �` ETC NOT DEPICTED IF DETERMINED TO BE NECESSARY A TITLE SEARCH O `� ' 1 s e e _-1{J." _ L`A�ai),9CAPE` -- �� �/ 7�?4 CONSULTANT } e 1 56.6' Y ,� ,, e ,' , 2�- 2 ��� ENGINEERING do SSMI BE U�RVEIINGED BY OTHERS AND SUPPLIED TO BAXTER NYE - e , x 2fi.3 e c> ---0 ,- �� �� 50 BUFFER '� 1 �\ \ o ��`.- _ - / e 18 4 `�� t` TO B.V.W. l } G , ti` �� APpL x ATE ,. pip gppl�OA_ , •, `.\i 6. THE PROPERTY LINE RfORMATION SHOWN IS BASED ON CURRENT AVAILABLE r �� �� �- G �` �� �� _ ExISTINc SeTIe ' e,- r- , �\} o RECORD INFORMATION CONSISTING OF PLANS AND DEEDS. THE EXISTING FEATURES 1 '21,-__ _ J' O }} �e �\\ `\ G �`\_�-�, \\\ 01L , _ - '- _ ''x21.7 - -PARCEt 1 l5032 s, ,�' SHOWN HEREON WERE OBTAINED FROM AN ON THE GROUND FIELD SURVEY ' LVE ' _ V PERFORMED BY BAXIER NYE ENGINEERING & SURVEYING ON FEBRUARY 14, 2017. }� e� _49,89a±'�S.F._(UL"AND)� r r 15''� ^X ` 3 4.2 7. COMMUNITY PANEL NUMBER 250001 0757 J, EFFECTIVE DATE 07 16 2014 s , '2,219-t'�.F_.,�Y ETLAND) / / ��. 3.9 '�r ��� r} �Q// O� rr r'f J f 2 '-5- 4( �S.F. �TOTAL ,1 �� � � �' / �� ° THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONE X (UN-SHADED) CONSULTANT _ -' , LU _ _ p E w ,-'X 15.6. ,,-'' --- /' `_ PER MASS GIS OWNER AS OF 02/16/17: J - T[f� -O ` x , 7 3 N AN AC E C EA OF CRITICAL ENVIRONMENTAL CO 15� ,�'` 'r �$-___ '` - /�� /`� _x SITE DOES NOT APPEAR TO BE WITHIN . . . (AR CON"). O }tom 'r 2d ,��''l 'J �' ' , '` • . �, ,__- by SITE DOES NOT APPEAR TO BE WITHIN AN AREA OF ESTIMATED HABITAT OF RARE WILDLIFE AS / 10 x 20.2 I� ' -r0pC0 x^�', f /� ' �, MAPPED ON MASS GIS OWNER PER NHESP "ESTIMATED HABfTATS OF RARE WILDLIFE" FOR USE WITH 1 F' '/ n x-�9 1� ''�x 17i6' TIMB�W{�L'L ��- ?� �,' X 1©`� ,�' �i ,' " 2o.s6/ THE MA WETLANDS PROTECTION ACT REGULATIONS (310 CMR 10). 5.8 / 3.7 PREPARED FOR : 1� �, SITE DOES NOT APPEAR TO CONTAIN A CERTIFIED VERNAL POOL AS MAPPED ON MASS GIS OWNER OSr - s �j� Fo / - ' ,' e!?y/ /` 4 �a�` PER NHESP 'CERTIFIED VERNAL POOLS." Fraser COI1Strl.IGIO11 �� r RAIL � � ,_ � � � -vo ,x 12 � � , p Apo '/p-__ 31�0-ti,�� //f �,/ -_-® -'f. ��GCP� A PORTION OF THIS SITE APPEARS TO BE WITHIN A PRIORITY HABITAT AS MAPPED ON MASS CIS 31 BOwdin Road 73.5 -• // x 10.5 __ ''� ,�'• �'8 �� OLIVER PER NHESP "PRIORITY MWATS OF RARE SPECIES" FOR SPECIES UNDER THE MaS I1 nnP.P. MA. 0264 9 �'I'i > i MASSACHUSETTS ENDANGERED SPECIESACT REGULATIONS CM N E TIONS (321 R 10). � •J�c� '� X1.�3 '�, ��,' �` �c ,�0 �,'�/�, �,� /�9 �� ��`L SITE PROTECTION CTION AREA.APPEAR TO BE WITHIN A STATE APPROVED ZONE II GROUNDWATER RECHARGE J0�• _ - _ - -�� - - - e A PORTION OF THIS SITE APPEARS TO BE WITHIN A ZONE OF CONTRIBUTION TO A SALTWATER CB H FND - --x- -2� x 9'/ ' G� , ESTUARY (BARNSTABLE B.O.H. REG. 360-45). N/F ALESSANDRA PRIZIREMBEL ANGELI ®u ¢ S���P 3. ��� CERTIFICATE 179229 9 - - x 6. ' �` 9. UTLLfII' INFORMATION SHOWN HEREIN: PARCEL 115-031S - 6 ' ' �� G' PROJECT TITLE 9 9 '� 1'k,y -' 1 4 i1E C THE CONTRACTOR SHALI. CONTACT DIG SAFE (AT 1-888-DIG-SAFE) AND UTILITY COMPANIES TO LOCATE 9 v R s Q , N 7 THE LOCATION OF ALL EXISTING UTILITIES, AT LEAST 72 HOURS PRIOR TO THE START OF 735,40 , WN IN AN APPROXIMATE WATRUCTION DY ONLY NOT UNDERGROUND If LIMITED TOREME SHOWN HEREIN AND HAVE BEENES CONDUITS AND LINES ARE 340 Parker Road 0� 44,E ' 8 `��`��\ RESEARCHED BASED ON THE AVAILABLE UTILITY RECORDS NOTED HEREON. THE CONTRACTOR AGREES TO '�? v - BE FULLY RESPONSIBLE FOR ANY AND ALL DAMAGES WHICH MIGHT BE OCCASIONED BY THE OStervllle, MA CONTRACTOR'S FAILURE TO LOCATE SAID INFRASTRUCTURE AND UTILITIES EXACTLY. IF FIELD CONDITIONS { e DIFFER FROM PLAN INFORMATION, THE CONTRACTOR SHALL NOTIFY THE ENGINEER IMMEDIATELY FOR POSSIBLE REDESIGN. e SOURCE INFORMATION FROM PLANS HAS BEEN COMBINED WITH OBSERVED EVIDENCE OF UTILITIES TO DEVELOP A VIEW OF THOSE UNDERGROUND UTILITIES. HOWEVER, LACKING EXCAVATION, THE EXACT LOCATION OF UNDERGROUND FEATURES CANNOT BE ACCURATELY, COMPLETELY AND RELIABLY DEPICTED. WHERE ADDITIONAL OR MORE DETAILED INFORMATION IS REQUIRED, THE CLIENT IS ADVISED THAT EXCAVATION MAY BE NECESSARY. ZONINGTABLE APPROXIMATE EXISTING SEPTIC SYSTEM INFORMATION OBTAINED FROM SEPTIC SYSTEM INSPECTION REPORT BY JOSEPH AGRILLO, JAI. INC. 09/07/13 ON FILE AT BOARD OF HEALTH, EXACT ZONING DISTRICT: SPLIT RC, RF-1 PROPOSED USE: SINGLE FAMILY DWEILING LOCATION TO BE VERIFIED AS NECESSARY. OVERLAY DISTRICTS: APD RESIDENTIAL: RC TOWN WATER SERVICE SHOWN AS APPROXIMATE LOCATION ON THIS PLAN FROM WATER RESIDENTIAL STRUCTURES FOOTPRINTS =4,402±SF DEPARTMENT SKETCH 0-988-T HATED 09 21 ALLOWED USE: RESIDENTIAL EXIST ABANDONED COVERAGE =-324t SF / /95. PROPOSED ADDITIONS & STEPS = 668t SF GAS SERVICE SHOWN AS APPROXIMATE ON PLAN PER NATIONAL GRID MAPPING do FIELD LOCATED EXIST USE:SINGLE FAMILY DWELLING METER. EXIST TOTAL BUILDING AREA=4,402t SF PROP TOTAL SITE STRUCTURES FOOTPRINT=4,746t SF EXIST COVERAGE UTILI�YIC LINE SHOWW AS APPROXIMATE ON THIS POLE RISER AND FIELD LOCATED METER PLAN INDICATING UNDERGROUND SERVICE FROM TO BE ABANDONDED=324t SF a 0 TOTAL PARCEL AREA: 52,140 t S.F. N O S Y DATE DESCRIPTION M REQUIRED/ALLOWED RC REQUIRED ALLOWED RF-1 PROVIDED o; SHEET TITLE � ZONING LOT LOT AREA: 87,120 SF 87,120 SF 52,140 SF ** Ln Proposed Site Plan 3 FRONTAGE: 20 FT 20 FT 200 FT BUILDING SETBACKS: o FRONT SETBACK 20 FT 30 FT 56.6 FT SHEET N O 0 C> SIDE/REAR SETBACK 10 / 10 FT 15 / 15 FT 37.5 FT (EXISTING) Dmimo N 70.9 FT (PROPOSED o MAX. BLDG. HEIGHT' 30 FT 30 FT - DATE : MAY 03, 2017 OR 2.5 STORIES OR 2.5 STORIES S 20 0 20 40 ** PRE-EXISTING NON-CONFORMING o SCALE IN FEET 9 SCALE : 1"=20" o DRAWN BY: OF CHECKED BY: MWE N JOB N O: 2017-007 FILE: 2017-007 DM.d 0 N MASTER BEDROOM II5 f� PLAYROOM CL05 ,I „ r v HALL r MA5TER BATHROOM ofl L I: CILOS --........ i i i BEDROOM 2 HALL BEDROOM 3 I BEDROOM 4 i STORA6E , DECK ---.- - -- I i i , I GLOSCLO5 CLOSIla - I I UP HALL SCREEN PORCH BATH 1 i MtTll I , II ON O LIVINS ROOM I I I it pN El , BATH i � .I KITCHEN EXI5TING FINISHED BA5EMENT AREA SITTING Roots BATH 5CALE: 1/4"=P-O' , I HALL 0- Ii -O 00 1 .......... .._:._..... .:....._ ............ ._._...._.... _......... ..... ....... ..._.............. -7 MUD ROOM u , I OFFICE i ENTRY PORCH .._ � I FAMILY ROOM t l 031 Ll I -EX I5TING 5EGOND FLOOR PLAN EXI T ! NG FIRST FLOOR PLAN SCALE: 1/4"=I'-O" SCALE: 1/4",I-O"_