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0113 POND STREET - Health
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I I -- -------1 ] i BiDRROEaDBEi.DlERR&RqI wxFDeXELVEe, - I I t0, I� I •N�LLL] I W—D R A - _______ EEe WrusED BEVELE—EMIRWRDDDa ELecmr�.i'— i1 I t 1 1 .................. ............ ® `\� alai Low �._. I I, .......... F.EAI cn"XD—E...PUBrzLRM x".E caux,vnov. 1 ----------------------------------- p loo 1 I .I _ II I -' 113 POND STREET : - Duwwva Al®eamm OXSf REED A.MORRISON D-1'A— SECOND FLOOR PLAN D,�x: swt OSECOND FLOOR PLAN DmwR By: D 'marxDDPw+�— © A4 s ........ . 3 a .Eo --- -- ---1-- ------- ------- -------- ----------- � I y I I I I I I I I Ala .J6 I I I I OROOF PLAN 113 POND STREET I - i c l I ry I � i toxcncreeu9., � I i � ouv I I ; ---'� ` r�-------- - ----- I e5eo n.n�oReNsoN ' mdvea I : �...:-.rI I i it 0 i II I PLANS-GARAGE OBOOR PLAN 0 EE) AG1 01/07/2005 13:12 5084283115 SULLIVAN ENG INC PAGE 01 SENT BY: MATOLOTTI CONBT; 508A289399; JAN-4-05 12;43; PAGE 1/1 6 1 ' ..Town. of Barnstable ' Regulatory Services 1 u f Thomas F.Geller,Director Public Health Divisiou i Thomas McKsan,Director 200 Main Street,Dyannii,MA 02601 i Uftice: 509-862.4644 Fax: 308-790-6304 i Insd+ll+rr it Design er Cartil9caEion Farm l Date: x/z3lo y ' iu5�c�t +2 ?4 .2u Installer: AddrRRA: ~I FAZCM (ZOA Address: Os rev ..� On ��'��� �d!^ �4 was issued a pernit to Ltall a (date) (installer) / septic system at. ®� t5r� dSJ�r�'/used on desi+drawn by Avunn�r�T�c.t�.�ewTuon,s a ass CAr�u�-T+rv6 �n>�e dated esiper I ceati*that the septic system referenced above was installed 6bstali iall}�accordin to the design, which may include minor approved changes such laterl�l relocation oche distn"bution box and/or septic tank. 1 certify that the eopde system referenced above was install with jor changes.(i.e. greater than 10' lateral relocation of the SAS or any vertical rel ratio of auy companeat of the septic system)but in accordance Mth State &Local:Reg Ittiola Plan revision or certified as-ruilt by designer to follow. R ! su va�. (Installer's Signature C 1L3s O r,c 5 Pt!CA-O Z 1pature —5t - p axe ASEi ltITURN TO BARNSTABLE PTJAI:T(; AT.T CERTIFICATE O MI'LIAN OT BE I HIS z9odLan AA: RE F E T .BARN. AB[,F. 1 DIVISION. 1. i • Q:WEAW✓SepLIO) avgo®r Coeiticatioa Pone l ,. i TOWN OF BARNSTABLE OP 719010(p LOCATION AA e9 .S' SEWAGE # ' VILLAGE 9 l=4 i 4e-&L ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY ���� �`�I� - � 0 LEACHING FACILITY: (type) a SW C- (size) �3 y,�z q NO.OF BEDROOMS .� LTII,DER R OWNER Sg,A mom r PERMTTDATE: API -��/ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility), - Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet.of leaching facility) Feet Furnished by ` f 1.S :40 r \ 0 _ A � e 0"OL r No. d 'V 1 Fee ; TH9 COMMIONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 2pplication for Miqual *pgtem Con5truction Vermit Application for a Permit to Construct( /Repair( )Upgrade( )Abandon( ) gComplete System ❑Individual Components Location Address or Lot No. f?J �/) Owner's WAdVdr�l,�N �'7 C.+Assessor's Map/ParcelI ' VF+' Installer's Name,Address d Tel No. ! Designer's Name,Address and Tel.No. Type of Building: o Dwelling No.of Bedrooms Lot Size r D sq.ft. Garbage Grinder( ) Other Type of Building .9 No. of Persons Showers('aj) Cafeteria( ) Other Fixtures Design Flow x gallons per day. Calculated daily flow 1530 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank 1 U 0r1 Type of S.A.S. Description of Soil, Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued b s Boaz o Hea Signed Date f I III Application Approved by i Date p Application Disapproved for the following reasons Permit No. Ub q—d I Date Issued 3 r u I• +{s ��..>:. a'-..4.y .*. _ � .s_t`�L „y..►r--�,...-y.......-r.,�-'�+�.�,r.,� -wow ♦ a„i�!�u-,�+.w_j,,.-,..—r.n.li Fee ti f / THI= MhONWEALTH OF MASSACHUSETTS .: .4 Entered incomputer: y nZ �t PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS- Yes Zfpprication for Misspozal *pgtem,.Con5truction Permit Application for a Permit to Construct( .P(Repair( )Upg de( j Abandon( ) ®'Complete System ❑Individual Components ' 24 Location Address or Lot No. Owner's Name Ad ss and Tel`No. O c Assessor's Map/Parcel ar Installer's Name,Address d Tel No. M Designer's Name,Address and Tel.No,,.�, `7 7/ �3 Type of Building: o ' f Dwelling No.of Bedrooms Lot Size r D sq.ft. Garbage Grind 'O r Other Type of Building No.of Persons Showers('lj Cafeteria( ) Other Fixtures Design Flow I(U X gallons per day. Calculated daily flow �3 U gallons. Plan Date Number of sheets Revision Date Title ' Size of Septic Tank 50C� G"U Type of S.A.S. + Description of Soili f t °fi Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: -The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board-of Heal Signed `"��� Date Application Approved by ^ / n Date 7 j i i A t✓l Application Disapproved for the following reasons Permit No. ")I r(I LI-!)C,S Date.Issued 3 l t �t1 f -�� ��----- --- ------- ------�� THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance �'°MS (J/I/ THIS IS TO C-ER that the Qn-site Sewage Dispo al System Constructed( )Repaired( )Upgraded( ) Abandoned )by l�i� � at15n C9 c G has been constructed in accordance with the pr :'isi0:s of':'id- ar.0 the for Disposal System Coiiswuciion Permit Ni . '1.9�`1-(J cl S dated 3�/!t i Installer '"Yr4nl'-o Designer ((; The issuance of this pe t shall not be construed as a guarantee that the system 11 function as d si n d. Date � 31Ut-I, Inspector • t r 1 r` —---------- — _-- -----_—..------_--- No. 1r)!rLl `o '1(�' Fee lUo THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS- &ZpOar *pgtem Contruction Permit Permission is hereby granted to FJonstru t( )Repair( I)�U,pgr de( )Abandon( ) System located at e V t�" +��,o and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construc 'on must be completed within three years of the date of this >e t. p Date: I 1 � Approved by C IV" �J �` COMMONWEALTH OF MASSACHU SETTS c EXECUTIVE OFFICE OF ENVIRONMENTAL AFFA RS DEPARTMENT OF ENVIRONMENTAL PROTECTION OCT ONE WINTER STREET, BOSTON MA 02108 (617)292-55 10 1 [QO® 1rpe 4a 4 � . �]J,Tpl S r t ry FAILED INSPECTION ARGEO PAUL CELLUCCI DAVID B.STRUHS Governor Commissioner SUBSURFACE SEWAGE DISPOSAL SYSTEM_ INSPECTION FORM PART A CERTIFICATION Property Address: 113 Pond Street, Osterville, MA Name of Owner: Audrey Killion Address of Owner: Date of Inspection: October 19, 2000 Name of Inspector: (Please Print) James M. Ford I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000) Company Name: James M. Ford. Mailing Address: P.O. Box 49, Osterville, MA 02655-0049 Map: 118 Telephone Number: UN)862-9400 Parcel: 032 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: Passes . Conditionally Passes _ Needs Further Evaluat n By the Local Approving Authority ils Inspector's Signature: Date: October 23, 2000 The System Inspector shall submi py of this inspection report to the Approving Authority(Board'of Health or DEP)within thirty(30)days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. NOTES AND COMMENTS r t�(Y,^('ir • z r,..Y.M ^.'!§a•r t, ^..,. r.•t C^,_ : .P] .-1e i .µ revised 9/2/98 Page 1of11 Printed on Recycled Paper ry SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 113 Pond Street, Oster-Mle, MA Owner: Audrey Killion Date of Inspection: October 19, 2000 �': .. .... + INSPECTION SUMMARY: Check A, B, C, or D I 3 5� g i"A A. SYSTEM PASSES: �} I have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 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. Indicate yes, no,or not determined(Y,N,or ND). Describe basis of determination in all instances. If"not determined", explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the inspection;or the septic tank,whether or not metal, is cracked,structurally unsound,shows substantial infiltration or exfiltration,or tank failure is imminent. The system will pass inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. Sewage backup oi•breakout or"high;static water level observed in the distribution.box is due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if(with approval of the Board of Health) . . , 1. " ,. . I : - , 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 revised 9/2/98 Page 2of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION.(continued) Property Address: 113 Pond Street, OsteMlle, MA t.a=, , 1. + ,..;<::t .is°.s •' "`_ :sx;b3: k ... Owner: Audrey Killion s. �.!.kz •, _t Date of Inspection: October 19, 2000 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and the environment. 1) SYSTEM WELL PASS UNLESS BOARD OF HEALTH DETERMINES IN ACCORDANCE WITH 310 CMR15.303(1)(b) THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: — Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh. 2) SYSTEM WILL FAIL UNLESS THE BOARD OF HEALTH(AND PUBLIC WATER SUPPLIER,IF.ANY)DETERMINES THAT THE SYSTEM IS FUNCTIONING IN A MANNER THAT PROTECTS;THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT: ;JThe'system:has7a septic tank and:soil absorption system(SAS)and,the SAS is within 100 feet.to a surface water supply or. *t",r 1,tributary'tb a-surfacevater supply: rs e, r '5, The system has a septic tank and soil absorption system and the SAS is within a Zone 1 of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance (approidmation not valid). 3) OTHER n revised 9/2/98 Page 3ofli J SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 113 Pond Street, Osterville, MA ti Owner: Audrey Killion 4 „ Date of Inspection: October 19, 2000 D. SYSTEM FAILS: You must indicate either "Yes" or"No" as to each of the following: ✓ I have determined that one or more of the following failure'conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No ✓ Backup of sewage into facility or system component due to an overloaded or clogged SAS or cesspool. ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool., ✓ Liquid depth in cesspool is less than 6" below invert or available volume is less than 1/z day flow. ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ✓ Any portion of the Soil Absorption System,cesspool or privy is below the high groundwater elevation. ✓ Any portion of a cesspool or privy is within'100 feet of a surface water supply or tributary to a surface water supply. ✓ Any portion of a cesspool.or privy is.within a Zone 1-of a public well.f ' g ✓ Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis If the well has been analyzed to be acceptable,attach copy of well water analysis for coliform bacteria,volatile organic compounds,ammonia nitrogen and nitrate nitrogen. ✓ The system has a single cesspool and fails in the Town of Barnstable. E. LARGE SYSTEM FAILS: You must indicate either"Yes"or"No" as to each of the following: The following criteria apply to large systems in addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well The owner or operator of any such system shall upgrade the system in accordance with 310 CMR 15.304(2). Please consult the local regional office of the Department for further information. revised 9/2/98 Page 4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 113 Pond Street, Osterville, MA > '+' =hr�� ?_*:� >_ �'=w' ::• '., Owner: Audrey Killion Date of Inspection: October 19, 2000 u' t +" x.ie!! �X-; Check if the following have been done: You•must indicate either-'-Yes"or"No"as'to each of the•following + Yes No ✓ Pumping information was provided by the owner,occupant,or Board of Health. *✓ None of the system components have been pumped"for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. (*The house was vacant) n/a:y 'As built plans have beef'obtained and examined: Note if they are not available with N/A. ✓ _ The facility or dwelling was inspected for signs of sewage back-up. ✓ The system does not receive non-sanitary or industrial waste flow. ✓ _ The site was inspected for signs of breakout. ✓ _ All system components,excluding the Soil Absorption System, have been located on the site. _ , '.. SS `.., - .... •s• . . '� `. ....�s". Il?S4� :lf#.i�' f: ,+`..., t .'l e<a: .,7.�;.fi•ah � ✓ _ The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for conditions of baffles or tees, material of construction,rdimeiisions;'depth of.liquid;;depth.of,sludge;depth of scum: The size and location of the Soil Absorption System on the site has been determined based on: if, ✓ Existing information. For example,Plan at B.O.H. ' Determined in the field(if any of the'failure criteria related to Pait C is at issue,approximation of distance is unacceptable) [15.302(3)(b)l• f ✓ _ The facility owner(and occupants, if different from owner)were provided with information on the proper maintenance of SubSurface Disposal Systems. revised 9/2/98 Page 5of11 i . SUBSURFACE SEWAGE. DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 113 Pond Street, OsterMle, MA Owner: Audrey Killion Date of Inspection: October 19, 2000 FLOW CONDITIONS ., .. RESIDENTIAL• Design flow: n/a g.p.d./bedroom. Number of bedrooms(design): n/a Number of bedrooms(actual): 3 Total DESIGN flow n/a Number of current residents: 0 Garbage grinder(yes or no): No Laundry(separate system)(yes or no): No laundry; If yes, separate inspection required Laundry system inspected(yes or no): Yes Seasonal use(yes or no): n/a Water meter readings, if available(last two year's usage(gpd): 1999-16,000 gals.:1998-21.000 gals. Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL: Type of establishment: Design flow: wd(Based on 15.203) Basis of design flow 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) a _.._.. `,: Last date of occupancy: GENERAL INFORMATION PUMPING RECORDS and source of information: Pumped on Aug. 9195-per treatment plant. System pumped as part of inspection(yes or no): No If yes,volume pumped: gallons Reason for pumping: TYPE OF SYSTEM Septic tank/distribution box/soil absorption system ✓ Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) I/A Technology etc. Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other ...APPROXIMATE AGE,of all components,date installed(if known).and source of information: Approx 1920s-original with house. Sewage odors.detected when arriving at the site:,_(yes or no) No revised 9/2/98 Page 6of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 113 Pond Street, Osterville, MA Owner: Audrey Killion Date of Inspection: October 19, 2000 BUILDING SEWER: _ ��4 (Locate on site plan) Depth below grade: Material of construction: _cast iron _40 PVC _other(explain) Distance from private water supply well or suction line Diameter Comments: (condition of joints,venting,evidence of leakage,etc.) SEPTIC TANK: None (locate on site plan) Y Depth below grade: Material of construction: concrete metal _Fiberglass _Polyethylene _other(explain) If tank is metal, list age_ Is age confirmed by Certificate of Compliance_(Yes/No) Dimensions: Sludge depth: Distance from top of sludge to bottom of outlet tee or baffle: -.Scum thickness: 3.- Distance from top of scum to top of outlet tee or baffle: _......,.__.._.._ ----- .�_. . Distance from bottom of scum to bottom of outlet tee or baffle: How dimensions were determined: 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.) GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete _metal _Fiberglass _Polyethylene _other(explain) Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments: , (recommendation for pumping,condition of inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence.of.leakage,etc•:),- revised 9/2/98 Page 7of11 / u SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 113 Pond Street, Osterville, MA Owner: Audrey Killion Date of Inspection: October 19, 2000 TIGHT OR HOLDING TANK: None (Tank must be pumped prior to,or at time,.of inspection) (locate on site plan) Depth below grade: Material of construction: _concrete _metal Fiberglass _Polyethylene _other(explain) Dimensions: Capacity: gallons Design flow: gallons/day Alarm present: Alarm level: Alarm in working order: Yes_ No Date of previous pumping: Comments: (condition of inlet tee, condition of alarm and float switches,etc.) DISTRIBUTION BOX: None ? (locate on site plan) Depth of liquid level above outlet invert: Comments: (note if level and distribution is equal,evidence of solids carryover,evidence of leakage into or out of box,etc.) PUMP CHAMBER: None (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.) revised 9/2/98 Page 8of11 I ` SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 113 Pond Street, Osterville, MA «', ,''.r , r'. a=+ '.-.Z 1 re W, r r ;:,-•i', Owner: Audrey Killion Date of Inspection: October 19, 2000 SOIL ABSORPTION SYSTEM(SAS): None. (locate on site plan, if possible;excavation not required, location:may be approximated by non-iritrusive.methods) If not located,explain: , Type: leaching pits, number: leaching chambers, number: leaching galleries, number:. leaching trenches,number, length: leaching fields, number,dimensions: overflow cesspool, number: Alternative system: Name of Technology: Comments: (note condition of soil, signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,etc.) CESSPOOLS: ✓ (locate on site plan) Io ''r'Ai Number and configuration: I main Depth-top of liquid to inlet invert: 7' Depth of solids layer: 3" ; Depth of scum layer: 0" Dimensions of cesspool: 4'W x 7'T x 9'bottom to grade Materials of construction: Block Indication of groundwater: None 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.) 1 The cesspool was dry. Roots were growing on the inside of the cesspool. The cover was to grade. PRIVY: None (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.) M revised 9/2/98 Page 9of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 113 Pond Street, OsteMlle, MA Owner: Audrey Killion Date of Inspection: October 19, 2000 Map: 118 Parcel. 032 SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) 3ACk B i t f t t 11, revised 9/2/98 Page 10of11 SUBSURFACE SEWAGE -DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 113 Pond Street, Osterville, MA i F F, 3 :.L' �<;�:;y it Owner: Audrey Killion Date of Inspection: October 19, 2000 NRCS Report name Soil Type ,.r' ;• . . Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep SITE EXAM Slope . Surface water Check Cellar . Shallow wells Estimated Depth to Groundwater Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed Site(Abutting property,observation hole, basement sump etc.) { Determined from local conditions ✓ Checked with local Board of Health i Checked FEMA Maps s Checked pumping records Check local excavators, installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) The bottom of the cesspool to grade was approximately 9'. Using the Barnstable topographic map and the Cape Cod Commission water contours map, the maps were showing approximately 30' +/-to groundwater at this site. This report has been prepared and the system inspected and failed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection and/or this report. revised 9/2/98 Page 11of11 N/F N/F N/F A Amoral Matthew do Mauro Dagher Edward Cronin &Marla 27117/321 24654/81 NAr Joseph.tf#t67165 33.98' Linda Everett 28317/70 2 180.00' 213.98' Proposed S720'44'E 1 Proposed Pool t3.6' 3 Proposed 29.2' Equipment Enclosure I Pool h Fence 1 IIF N J Snow Living Lust . — 1 � 29897/60 I h #113 11 70.6' I /lb- 3 2 Sty w/f I b Dwelling Lawn o--- h n Stohe Wall ti p110 10 1 p �9ti,►I; i oantd .. i 1 a . I I ASSESSORS REF.: o I Stone I Drive I 1 Map 118, Parcel 32 w 1 I , OVERLAY DISTRICT: x I ° I I,••.,i,,ti i v •I AP — Aquifer Protection District .... Approx Septic 1 As Per BOH FLOOD ZONE. Card Zone X (not a flood zone) I I to FEMA Map I Parcel Area �Nq #25001 C0544J W I 36,804±SF 1 Effective July 16, 2014 to ZONE: RC Area (min.) 87,120 SF (RPOD) \pop, Frontage (min) 20' Width (min) 100' Setbacks: -0 Front 20' �158�°�500E �� Side 1 . e t��M OF 64 j��` r \3 '401) P RICHARD public R• •(50 Wide VHEUREUV o No. 34312 ��0 000 -- — P J@ P L�Na I certify that the structures shown hereon conform to the setback requirements of the PLAN SHOWING PROPOSED POOL Zoning Bylaws of the town AT 113 POND STREET of Barnstable. BARNSTABLE 1 (Osterville) NOTES.- MASS, DATE:23/MAR/17 SCALE: 1"=40' 1.) The structures shown were located on the ground 0 10 20 30 40 60 80 FEET by conventional survey methods on or between 101JAN105 and 16/MAR/17. I PREPARED FOR: 2.) The property information shown hereon was Dorrit Kingsbury& James Henning compiled from available record information and 193 Parker Road does not represent an actual on the ground survey. Osterville MA 02655 3.) This plan is not for recording and is not PREPARED BY: CapeSurv to be used for construction layout or deed description purposes. 23 West Bay Road, Suite G Osterville MA 02655 DWG #: C614_7gl cppl FIELD BY. WHK/ASK (508) 420-3994 / 420-3995fox Commonwealth of Massachusetts W Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form Not for Voluntary Assessments 113 Pond st Property Address Reed Morrison Owner Owner's Name ►+ information is required for every OSterVllle Ma 02655 10/25/16 page. City/Town State Zip Code . Date of Inspection IV •M V Inspection results must be submitted on this form. Inspection forms may not be altered iHny way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information ��# /,7100� on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael DiBuono use the return Name of Inspector key. DiBuono Sewer and Drain rab Company Name 8 Johns path Company Address �atar� S Yarmouth Ma _ 02664 City/Town State Zip Code 508-364-9587 S103522 ., _ 'Telephone Number 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 Evaluation by the Local Approving Authority 10/27/16 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP) within 30 days of completing this inspection. If the system 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 orr� Commonwealth of Massachusetts u- Title 5 official Inspection Form — - — Subsurface Sewage Disposal System Form - Not for VoluntaryAssessments 113 Pond st Property Address _ Reed Morrison Owner Owner's Name information is required for every Osterville _ Ma 02655 10/25/16 r�e page. City/Town State Zip Code Date of Inspection B. Certification (coat.) 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: System contains a 1500 GI septic tank as well as a concrete distribution box and two 500 GI leaching chambers. 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): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts MEW Title 5, Official Inspection Form _ Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 113 Pond st Property Address Reed Morrison Owner Owner's Name information is required for every Osterville Ma 02655 _ 10/25/16 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 breakout 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 t5ins•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 113 Pond st Property Address Reed Morrison_ Owner Owner's Name information is required for every Osterville Ma 02655 10/25/16 page. City/Town 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 'h day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 113 Pond st Property Address Reed Morrison Owner Owner's Name information is Osterville Ma 02655 10/25/16 required for every. _ page. City[Town 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: ❑ M 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. ❑ ® 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 water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA) or a,mapped Zone II of a public water supply well 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 U - Title 5 Official Inspection Form Subsurface'Sewage Disposal System Form - Not for Voluntary Assessments 113 Pond st Property Address Reed Morrison Owner Owner's Name information is required for every Osterville Ma 02655 10/25/16 page. City/Town State Zip Code Date of Inspection C. Checklist 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 11 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 I Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments e 113 Pond st Property Address Reed Morrison Owner Owner's Name — information is required for every Osterville Ma 02655 10/25/16 page. City/Town State Zip Code Date of Inspection D. System Information Description: System contains a 1500 GI septic tank as well as a concrete distribution box and two 500 GI leaching chambers. Number of current residents: Does.residence have a garbage grinder.? ® Yes ❑ No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonaluse? ® Yes ❑ No Water meter readings, if available last 2 ears usage d 238 Gpd 9 ( Y 9 (gP )): Detail: Sump pump? -------------- ❑ Yes ❑ No Last date of occupancy: Dare Commercial/Industrial Flow Conditions: Typet'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: -----------------.----- _._____._-._-__ t5ins•3113 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 Y 113 Pond st Property Address Reed Morrison Owner Owner's Name information is Osterville Ma 02655 10/25/16 required for.every __. page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other (describe below): General Information Pumping Records: Source of information: Never pumped Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspocl ❑ 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 p ' ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other (describe): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 113 Pond st Property Address Reed Morrison ' Owner Owner's Name -- information is required for every Osterville Ma 02655 _ 10/25/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components,date installed (if known) and source of information: 10 Were sewage odors detected when arriving at the site? ❑ Yes ❑ No Building Sewer (locate on site.plan): Depth below grade: 2 -- - ---- feet Material of construction: ® cast iron ® 40 PVC ❑ other(explain): -- -- ----=-- ---------- Distance from private water supply well or suction line: feet . Comments (on condition of joints, venting, evidence of leakage,.etc.):, System is vented at the roof Septic Tank (locate on site plan): Depth below grade: 1.5 feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) 1500 If,tank.is metal, list age: --- -- — -- ---- years Is age confirmed by a`Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No . Dimensions: Sludge depth: t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 113 Pond st Property Address Reed Morrison Owner Owner's Name information is required for every Osterville Ma 02655 10/25/16 page. City/Town 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 24 Scum thickness 3„ Distance from top of scum to top of outlet tee or baffle 42" Distance from bottom of scum to bottom of outlet tee or baffle 1" Sludge stick How were dimensions determined? Tape Measure Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert; evidence of leakage, etc.): No evidence of Ieaking,Tees and or baffles in place at time of inspection Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ pol eth lene y y 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 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 113 Pond st Property Address ----- Reed Morrison Owner Owner's Name — — - --- --- information is required for every Osterville Ma _ 0265_5 _ 10/25/16 _ page. City/Town 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.): Tees are in place and levels are normal. Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: -=- ----- -----------_ -.--- Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: ---- --- Capacity -- — gallons Design Flow: _ -._ - ----- gallons per day 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.): t _ 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. Commonwealth of Massachusetts W Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments e% 113 Pond st Property Address Reed Morrison Owner Owner's Name information is Cisterville Ma 02655 10/25/16 required for every 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 Level and at normal level Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): 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: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora' Subsurface Sewage Disposal System Form - Not for Voluntary Assessments • 113 Pond st Property Address Reed Morrison Owner Owner's Name — information is required for every Osterville Ma 02655 _ 10/25/16 page. City/Town State Zip Code Date of Inspection D..System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 2 500 gl ❑ 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.): No signs of failure system is like new Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth —top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction _ Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ° aa 113 Pond st Property Address Reed Morrison Owner Owner's Name information is required for every Osterville _ Ma 02655 10/25/16 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of pondingi condition of vegetation, etc.)-. No ponding no break out 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.): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 113 Pond st Property Address Reed Morrison Owner Owner's Name --- information is required for every Osterville Ma_ 02655 _ 10/25/16 _ page. Citylrown State Zip Code 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. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts .� Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 113 Pond st o Property Address Reed Morrison Owner Owner's Name information is required for every Oster_ville _ __ Ma 02655 10/25/16 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 ground water: 10+ ft 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: 2/11/04 Date i ❑ Observed.site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health - explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database -explain: You must describe how you established the high ground water elevation: Test hole data on plan Before filing this Inspection Report, please see Report Completeness Checklist on next page. 15ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 i � �� �.�' �I ifs♦'�u a�..11�....�,:,�, k . f, t> yr) �•s � y 5 r TOWN OF BARNSTABLE l SEWAGE VILLAGE f"': i .:•z'" t,'i''�i,S '. ASSESSOR'S MAP&LOT J � F INSTALLER'S NAME&PHONE NO. 1-30,ti.:__[ SE•I-'I1C TANK CAPACITY LEACHING.FACILITY: (type) .S'Z:1,.5 h.-,. (size) NO. OF-BEDROOMS 1RllI DER QR OWNER . -- PERMITDATI :•_ %/ �:?<{ COMYLIANCF, DATE: Separation Distance Between the; , Maximum-Adjusted Groundwater'Fable and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet I 1 Edge of Wetland and Leaching Facility(If any wethutds exist within 300 feet of leactung facility) Feet j Furnished by . i Commonwealth of Massachusetts Title 5 Official Inspection' Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 113 Pond st Property Address ------------- ----- __ Reed Morrison Owner Owner's Name ------ --- ---- — information is ---— ------ required for every Osterville Ma_ 02655 10/25/16 page. Citylfown State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked ❑ 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 I F t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Town of Barnstable P# b b Department of Health,Safety,and Environmental Services �tt+f► Public Health Division Date 367 Main Street,Hyannis MA 02601 + eAaxareat.e. �r Musa l Date Scheduled d Time Fee Pd. O�a lf4 IAA� Soil Suitability Assessment for Sewage Disposal Performed By: ��� y S��C Witnessed BY: IJ ONN I OCA ON & GENERAL INFORIVIA'TION lam. Location Address 3 N I � Owner's Name R��� M D�J.So�W. Lot' 3� oSrt�vJL�� ► 93 A-P-) Z> Address o5—FE4v)L"� Assessor's Map/Parcel: A J Q C 3 Z Engineer's Name NEW CONSTRUCTION REPAIR Telephone# ��$ ' � OZo Land Use V) C LL� Slopes(%) c- b Surface Stones Distances from: Open Water Body< OW ft Possible Wet Area Jy , h} ft Drinking Water Well �N. It t Drainage Way JY , A— ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) -t•r c -? Parent material(geologic) +y V T—\^/#5 r7 / Depth to Bedrock Depth to Groundwater: Standing Water in Hole: /t' 0 >✓ Weeping from Pit Face (y )J Estimated Seasonal High Groundwater . � TFtt.�INATION 'OR SFASl�A ,HTOT 'wA 'ER 'AB]G .. .............:......:::::.:.:.........::...........:...:.:........................................ Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well#__-. ._ Reading Date:,_—-._-_ Index Well level ___ Adj.factor^_ Adj.Groundwater Level PERCOLATION TEST > ` >.:`D. to Observation ' Hole# I Time at 9" rr _ Depth of Pere `� Time at 6" Start Pre-soak Time @ Time{9"-6") End Pre-soak Z 0 0% Rate Min./Inch 2 m /7,W Site Suitability Assessment: Site Passed V Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data To Be Completed on Back ; j Copy: Applicant JI - p d IILLP � T � EO Hoole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(im (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,°° ravel 1 EEP 0$SERVATION HOLE LOB Hole# :.. - Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.°o ravel L D N) SL DEEP;OBSERVATION MOLE LOG Hoke# __. . Depth from Soil Ho I.rizon Soil Texture Soil Color Soil Other Surface(m.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,° ravel PEEP;OBSERVATION HOLE LOG Hote# .. Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel I Flood Insurance Rate Map: / Above 500 year flood boundary No V Yes Within 500 year boundary No Yes Within 100 year flood boundary No Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? Certification (� I certify that on �I (date)I have passed the soil evaluator examination approved by the Department of EnvironmLntallPProtection and that the above analysis was performed by me consistent with the required traim , pnd ex erfe%eescribed in 310 CMR 15.017. Signature Date))11c)-3U C� No. ° Fee ' --�/ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes J PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pplicatfon for Migaaf *pgtem Com;tructiou i3ermit Application for a Permit to Construct( X)Repair( )Upgrade( )Abandon( ) ®Complete System ❑Individual Components Location Address or Lot No. 113 Pond Street Owner's Name,Address and Tel.No. (508) 428-8379 Osterville, MA 02655 Reed A. Morrison Assessor'sMap/Pazcel Map 118, Parcel 032 193 Parker Road, Osterville, MA 02655 Installer's Name,Address,and Tel.No. (508) 457-0109 Designer's Name,Address and Tel.No. (508) 888-4029 Weber Construction Inc. Advanced Technical Solutions 12 Vintro Court, E. Falmouth, MA 02536 Box 99, E. Sandwich, MA 02537 Type of Building: Dwelling No.bf Bedrooms 3 Lot Size 36,800 sq. ft. Garbage Grinder( ) Other Typ of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 1 0 gallons per day. Calculated daily flow 330 gallons. Plan Date 11-15 00 Number of sheets 1 Revision Date Title "Sew ge S ste esi n for Reed A. Morrison" Size of SjSil Tank 1,500 Ga s Type of S.A.S. Description of H E #I: 0"-8", 0-A, Loam, `,0 YR 4/3; 8"-25", B, Loamy Sand, 10 YR 6/4; "-120" d. Sand & Gra el, 10 YR 5/2. HOLE ��2.: 0"-8", 0-A, Loam, 10 YR 4/3; 8"-24" B. amv Sand 10 Y 6 4. 24"-120" C Med. Sand & Gravel, 10 YR 5/2. Nature of Re irs or Alterations(A wer when applicable) Date last inspected: Agreement: The undersigned agrees to enthe /ctionmainte nce of the afore described on-site ewage disposal system in accordance with the provisions of Title 5 of the Environmental ode and not to place the s operation until a Certifi- cate of Compliance has been issue th' oar of a h. Signed - Da 12-4-00 Application Approved by Date -r Application Disapproved for the following reasons Permit No. 7 ® 3 Da Is d THE COMMONWEALTH OF MAS CHUSETTS �.s�r BARNSTABLE, MASSA USETTS Cer�Se "rate of mptiance /n - O C TIFY, that the On- ' wage Dispos c ed( Repaired( )Upgraded( ) Aby - at f ST— has been constructed in accordance with the provisions Title 5 and or Disposal System Constructi ermit No. �� 7 13 dated /Z -S-�yY� Installer signer The issuance of tlkRpFA6halI no cons ed as a guar ee that the system will function as designed. Date Inspector Fee E COMMONWEALTH OF MASSACHUSETTS PU LIC HEALTH DIVISION/BARSTABLES MASSACHUSETTS i� at �5t7) doq� ernYit Permission truct Repalde( ) System located at and as described in the above Application for Disposal System onstr cti r T is t recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: Approved by ..-+i^. .. .f _ ; ..t�. l .J , .. ,.r.._. ,Y f ...`y vta•v���+r,.�ti..��4�i.. ^ti,rN`ier. No. � " tom. '"" Fee / THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION TOWN OF BARNSTABLE, MASSACHUSETTS Application for Ztghal *proem Cow6tructton J)ermit Application for a Permit to Construct( X)Repair( )Upgrade( )Abandon( ) ®Complete System ❑Individual Components Location Address or Lot No. 113 Pond Street Owner's Name,Address and Tel.No. (508) 428-8379 Ostergille, MA 02655 Reed A. Morrison Assessor'sMap/Pazcel Map 118, Parcel 032 193 Parker Road, Osterville, MA 02655 Installer's,Name,Address,and Tel.No. (508) 457-0109 Designer's Name,Address and Tel.No. (508) 888-4029 Weber Construction Inc. Advanced Technical Solutions 12 Vintro Court, E. Falmouth, MA 02536 Box 99, E. Sandwich, MA 02537 Type of Building: Dwell�i,ng No.if Bedrooms 3 Lot Size,P6' 800 sq.ft. Garbage Grinder( ) Other Typ of Building No..of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow i 0 111'gallons per day. Calculated daily flow 330 gallons. Plan Date 11-15100 Number of sheets 1 Revision Date Title "Sew ge System4esign for Reed A. Morrison" Size of Septi Tank 1,500 Ga Type of S.A.S. Description of S,it H E #1: 0"-8", —A, Loam, 0 YR 4/3; 8"-25", B, Loamy Sand,, 10 YR 6/4; 25"-120", d..sSand & Gra el, 10 YR 5/2.1 HOLE #2: 0"-8", O—A, Loam, 10 YR X/3; 8"-24" B, amv Sand 10 Y 6/4. 24"-120", IC, Med. Sand & Gravel, 10 YR 5/2.f � Na re of Re 'rs or Alterations(A saver when applicable) sa2w'lbate last inspected: Agreement: The undersigned agrees to ens the co ction and mainte ance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental ode and not to place the syst operation until a Certifi- cate of Compliance has been issued b thhiiissue'oar f e Ith. V Signed .� Da 12-4-00 Applicatioir'Approved by Kwn Date Application Disapproved for the following reasons .��a _ � ' i Permit No. 3 Da a Issu d --------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABL'E, MASSA HUSETTS", Cert 'rate of ` Yta tce d>.f S IS TO C RTIFYthat the On- •te Sewa e Des.no" S�.stem-Gans ed Re aired U raded / g. P , ( P ( ) Pb ( ) -"Abaoned(' )by t at t / S S l"� +� '; has been'constructed in accordance with the provisions f Title 5 and or Disposal System Construct tl Permit No. n - J dated / 2 - S� Installer signer,,' The issuance of this UmyKslall no a cnso ed as a guar tee that the system will function as designed. Date Inspector t � -----�---------------------- No. Fee l �• T iE COMMONWEALTH OF MASSACHUSETTS PU LIC HEALTH DIVISION - BAR STABLE, MASSACHUSETTS t/gar to ott5truct" tt Permit-' Perrrussion is y-giant d 6 }astru%"l Repair Upgrade( ) ando ) System located at l/ �/Gyr, and as described in the above Application for Disposal System/onstr`ction PAt. Th p t recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. , Provided: Construction must be completed within three years of the date of this permit. Date: Approved by - - x CRAWLSPACE - - _ E no2.8.,DOORBASEMENT �4 z1. GYM L)2'6"DOOR � � � CONDITIONED SPACEO a24"DEEP SHELVES - ..HW _ .. WLSPAYE $.-- III`�� 4 EXISTING GIRT ABOVE-CRO - .. iv - - --- e--------.-e-- - - CR'AWLSPACE 4,-6„ iI 7'4" - n MIRRORED WALL ° HW HALL k w -.WINE .. HVAC �LTb—$�:1 CELLAR` LU HALL. OR CRAWLSPACE BASEMENT PLAN THE ERRORSIOR OMISSIONS ARE FGNER SHALL BE IOUND ONFIED IF Y SCALE : DRAWING NO:: COTUIT BAY DESIGN. ,LLc .NEW REMODELING FOR: - CONSTRUCTION. THE WILDING STMTCONTR i 4•°' " WILL BERESIPONSIBLEBFORIT„E CONTENTT� 1/4"=-11-01, 43 BREWSTER ROAD NT„ESE DRAWINGS IF CONSTRUCTION K I N G S B U RY/H E N N i N G R E S I C�E N C E COMMENCES WITHOUT NOTIFYING THE MASH PEE MA. 02649 THESE DRAWINGS ERRORS SOLELY OMISSIONS. DATE THESE DRAWINGS ARE SOLELY FOR THE USE ' PH. (5C08$)274-1166 OFT OWNER NOTED.ANY OTHER USE OF • TE FAX (508) 539 9402 COTHESENTOFT EDESIGNERUNS REQUIRES ERTH- 4/18/2017 IA 1 113 POND STREET OSTERVILLE MA 02655 . CDNSENTDFT„E DESIGNER UNOERTHE ' • ARCHITECTURAL COPYRIGHT PROTECTION ACT OF IND. _ p r t 1 LEGEND a EW2X4WALLCON8TRWWN I NEW2%8WALLCONfiTRUCION ` NEW MASONRY CONSTRUCTION $ SMOKE DETECTOR NOTES ------------- ----__-_ -____--____----T-----__--__- -----------r-------------- r-_-- -----'�----------- -J-L- LJ- -----�--- ----�'L-------- -----___- , I A. FORGENERAL ROOM FINISHES SEE THE ROOM 1 P I ESMOKE DRAWING SAA26 REQUIRED, B. PIN IMMEDIATE VICINITY OFDETECTORS ALL BEDROOMS , I I I 1 N AULBEOROOMS I I I I i N EACH STORY INCLUDING THE BASEMENT I a i R AREA . 1 ! RECESS STUDSB VI S C• ACCOMMODATE FLUSH WTALLPA El8 , t "Inl --- ----- II 1 I ............................e.................................r......,. MATERIALS NOT A... E9 tr nlf 3 I l i y �••.� o t 1°c- 4: r T 1, ^; i 1 161 SINK ONEFfER 16. WATER CLOSET E I ( - --------T" ..`• T >•t Ff•' I 15.6 SHOWERS .... _ ..._-........ _ 1 18.7 TELEVISION . - j I _ 16.8 STERLR7 EQUIPMENT - CABINETRY DESCRIPTIONS i I 1 ` I-___- 1 I r '� f �:• S 1'. x; I CLOTHES CLOSET.(2yHANOING RODS. 0202 STORAGE 0.05ET.CLEAR BIRCH FIXED SHELVES. Cm j ; i ; __ __-____ 1 201 •�� NOT USED b � HA ��$ 4 I I I C204 SEDROOM2 EDRO ® DMI NOT USED II08 E 1 1 2: ETE i MOKE - � eMOICE I 1 I LINEEN CLOSET,CLEAR BIRCH CABNET INTERIOR. r Cro OR ! I 1 I PAINED DOORS AND EXTERIOR.ADJUSTABLE _ T'4LF� SHELVES. I I i i C208 MEDICINE CABINET.CLEAR BIRCH INTERIOR re P 1 I BEVELED-EDGE MIRROR DOOR,ELECTRICAL OUTLET. 1 1 1 E I 1 1 MEDICINE CABINET.CLEAR BIRCH INTERIOR, x 1 BEVELEO•EDOEMIRROR DOOR,ELECTRICAL OUTLET. 208 CLEAR CABINET INTERIOR,PAINTED DRAWER FACER AND 1 1 I i `• 1 j l AND E EXTERIOR,PLASTIC LAMINATE COUMEFROP. O�^l�•P`LOW ---------------•---------------- -----�------ -------�----=--- +r-------- --------------- 00 113 POND STREET V 1113fit" d SwIr 1 Drravlrfe02655 +�n ------------------___-- Jr' aED,.,4� 9 REED A.MORRiSON/ v - S � / rcmner lN�O����& CD No. 8097 S ��� BOSTON, 1 Q MASS `� F'�l Ty ASS�� onerv36a 2633 �P 0 Mom. $08426.079 . RF(:ClNll FLOOR PLAN Ir.1a as-t a-a ' a-a a-+a- -i LC-:ter= i=a - t, ti d iY lt �``x• `' \ �`s :� i{E'- _.t� fi- 'y' -ty..,.s -'i-- -.w a ��` �'a'rh����zu-'ter i7 �; �73 � {�-'•dS ash F i;�r•c� '",s } `{�t,.., �},.s1 �S,�jr<x �,"•s�-'n a rf _- - © I" .* t` 3 y�, 'J +rS fit-i 'Y°`. �`` -4 ram•_` S F t•: / < 2.'� 4 k L 3-+t.. i' � � Y C'Yw.M.�} '� ire �.s ,»I�4 - ti`"` �+• .� *_ t ,} %a•3 s ,� � �. at f IEH�, r t' C y N �f-tt- t i I�, Y 1 x..�c` - F`E`,f�Yv }. r c 1- Y- -}�.. m- .s•c •'•,< � s r x��./ .'#�`•� .a v � 4�n• F a- -h=.t}v}--`^"•.rs.�i �--.i;i�'% �i� K ;' - ..7 k,G Y t l `'tl x�' s° J Via-{[• Q ''r r"Fkeb-----_• ,. i .................... ................................ 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I+.k,:.t _ i i t ! 1 ' E I t3 • : t :.._...ra; ; i,T�___."._�..-...«....� »......_.._._.. ..._......___ _.._....__....______'_•__«"_»._...__..-..".._"__.._l1� � i i ' E I - :,tics,_ p:..« .....«.._____-•__ «. t J --------- .............. -�... ..._«........._......_....«--"'-"-'^.__.._._..__....._----------^-._- _._�___.__._..�.._____^_--" ^ -;..F•ti,: 1 1 _='S2: iT v ": fir x't'` t.k-.{�-.:ie!'t_`r..":�-'.r,;aK,•:.•.;^,g'-- �e.. _...._... i C �< ®► ��1N;0� ,��tit ��<4 � F, �,a �, O 0 " 17 ip O ,1 N� � 't`r USAv ETTS ti 75 OJ�� bbb5b m7a n. D P > o>� $om =�z;�� x g>� � z•a+x� �41� _�� YY 5 �'gm>35io a ts 31 to x $ � zmQQ� [n $ g _ 85 � i" �fsTFSg55}g '� � � mmyF 'a i m > _ aiifS4 �—y;� '� an� '^ rn 6 �' r�sPx '?�q'- ro azzDox A i p abT�m?R P v i°��Fi �7J ASP t� f - Is�9@J�36INI 0 In�_.oP 5 is L 3 i - • t sr FLOoK - p _ _ . .. RE MoVt r EL. 39,E - 3a.0 MATERIALS 5 AROUND,9-1 rA.GR, EL EKI STING GR. EL SY5TFrI� T c�E PDX -a SLOPE- SAKI i ACCESS /' 9 Mt►t -Co�6 �.. �— 6 M 14 3 M Ax c ov c� _ 2 l-EV El� - - _-ST ACC ES 5 z pfAST NE - . GAL 3J_0 34.1 p C: CQNC_ 33.$ N �a -- I-1 ) SENT Ic TANK3.3 0,��' - •a,,, - - EL- 3 �.O d 1 _ : —6"cau9>1�Sr E wR raMt'AcTtP 3A'! of Ya -t - - _. ._ �_ wmnfjt j STowE - z :, LOG U 5 r o mi"_ :: 2 --- 5 1 J- 1 t 13 , y /NLEr TEL DElrik, -IQ B IELO\n/ v EL 25 0 1V OTES: : /. DISP03AL SN/STEM -rm cat: C8K5TKUCTED ]K Y R I CT ACCDRDANCE : o►- COI II I. or MASS . T.NVIRON. COiJI. TtTLC . PROF L y> DISPOSAL SX STE 1`r1 E!,. SURUGY DATA-FRo,�n-".�51.1.t D1V 1=S:l_O�N _Y1_ N- of LAND �OCATLD IN or BARN S TAB I-1 C US7ERViLLE- ,MA5S- w ME�FORD ENG'G. It �j./ T o 5�A LC� SURVE MED SRID MA,)DA,�:1�D /3U6U5 T'16, 2 D00. . S 72 2 3. ASSESSORS Mi�P I19 Pc_ 3Z: � 36 z13,9%' _ - 3 ' 4. T3E.NCH MAP, Fe, - C. B ., FRONT LEFT C0RNERoI- L3"T, ELV. - 362 . J3 POND. cST ►� � 5_ MEALTHN AGENT MAY REQUIRE DEED RESTRICTION oN +, ►� M NU Iv113I: R of 6EDROOMS. - : m ,G USE Z 5' a`xZ' : P_ C_ COX/C LEMI-1 C1-?AMBERS: w,rr] 4'a3J "To h � v MAR HQ Pc- 32 t . 1 '/2" 0 t 01'�,Lti WASP- ED ST-b NE. \A vvt-i E" or-PEASTM� A opi TOP. PoRCN �; 7. PUT-•T•' s 'AQ� GJAS P--AFF Lf_S ►Iq S EPT I C TAN K PER TITLE Y_ i srm 36 -k , f POW) 3�1- Sill a 14 Da F 00 Z n � - a m 1 155 f + "' _�- goo, ; :: - ►-IEAL T I-1 f� ENT h�PR4VAL` f�/ETC a ;SHOP, 2 - 1 � - TE•5t Pi £ Pc►�C.TEST ., - i ST�` - - . BM- 2 - EXf�TtJdG ae��I ti PY 1 �f C o ` t,. cJ 35. -35.o ozlr� �Ia 3 6• _ LOAM Ze 'J ¢7 _. - cn 00 xaPPv � 51NIGLE FAMIL`/ DWELL-ING W-/3 13EDR60,M5 5c_ I- E o I•„ zF , ;_ E4f�L : m Ia - D ISP0 S,NL_ ., . . lib G RBf�G 5 E\A/ 26515 AGE DAIU FLOW ` '= II a X 3 = 330 G.f�.l�, o Mc fl, cc.�arf SYSTEM DESI 6N_ SEPTI"CTANK CVat. REQ' DJ SA ND � aR R E E D A. LE�E�ID 19 3 PAR K�T< R(:)AD , 1 , 5C31 GAL. TtiI`\ K - O .Y.. ff O 5TER °✓ ILLCI"1A D2.G55 LE.ACIAING J-\REA CS. A ,S.� . _ �2 R SC . 1 13 pbg. S T] LET. CON E_ L. C.`+ 4' STONE . to _ , _ -r�= IV E DCPTM z . �' C-xlsnN& C mTOUR W H S S E S S QR 3 M A P ! 18 �� �Z C ECT Y. z xL t b x .;4 r - Paw cz\✓gy C7. 5TE RV i L 1.I"-. V ) L LA GEE i Li-x j �,x Q_ 7� - y z i - c ADVANCED TECH . 30LU-TI ON S FIr�M �oNL rfo>�zo -25,0 CONSUL-f CI�1G'�. -SAND, -- 5.O— �foJ)� T O T r-� L CA; ACITy � 34! GALS. ' � - _ MA - ... Ll: l 0 30 00 -� s`IOLLER..,`jCAV, DATCo I I I S-M 0W G. I H 5OG- G i ` Isr FLOOR . 16p o r H �L� - - R[ MoVt - nP l.CJir 3a.o MATE r 1- S 5 7AZOVNA - z �o w� 1►.1.Gf� L 38,0 Ex1STINGGR. �t � -a° % SLOPESAM vN PA D- Q ACCESS 'w/l,v 6 ,9�f�R. X ' � _ : 9 r/►i►1_co�� Z+• 6 M1d-.�3 MA Co Cr� 2 LEV EL r. - .. _ A E 51��1 z 500 - G L 31.0 34.1 P c, ccwc- 33.8 5c?T t C_ TAM►< 04 ) o Q 3 3.3 c-�,, •a,,o _ _. _ 6�y 5'F ASBq�FIL 33.5, oof..00 Z w ^� J 3.0 o L EL-_ L.O - - - '•c ��STONE �,R caMPAc'SEa 6 R09 - - W ILSr1rD S�oNE _ - - rL d G U 5 _. _ 20 ra�>J - - �r: k DeTrN o 9�+ U — Nc�' Ttt De�t�a, - (o f- O F3 Cl off,✓ :tAl w 3 _ _ du�+xT'T£E " J 4" EL 25.E W OTES l: (�ISPDSAL SYSTEM Tm L'�t C�IVSTRUCTED Iri STRI CT ACCDRDt11\tCE o� G Olvl lvl_. _ E N pp _ - a NIASS VIRON _C l__ TITLCy hRdF-1 LE O DISP OSAL- S`� STE N\ Z. SURVEY DATA XRoy\ '-6_uBbiv ► g� LAN:-PZJ�N of LAND LDCATt_Z iN -- -- (Norro scALz) BARN S TAB LE C D=5-T-ER7Vi _E��M ASS. i5v ME-UFORD EN G`G. t s 7z� 2�, SURVP V MEDFDRD' MA.,D/a� 1cD AU6U5T ) 6, zfl00. 44 t QT: S' MT�1P I J 9 Pc 3Z. • 38 ziS,98� 3. IaSSESS q, T3E.NCH MJXFK. - C. R FRONT LEFT- CORNERoi LOY ELV `,S&Z . J3 P QA/D c5T 5. HEALTM AGEN T MAY REQUIRE DEED RESTRIMON oN NUMBER of EF-ORDflMS. - - �, _.. _ h v Co. US1= " Z- 5'x S"aZ P. C, CONG: LEACH CHAKtERS w''I MAP llg Pc_ 2 � . I rye/r fDflUT3Lti :WASI-IED-S ► b)JE. \Ai-Tw Z" or-FEASTON't- on,TOP. 26 PORCH �, 7. PUT,•T- s Avm:1 , GAS..FlAIFF LU 14 SEPT I C TAN V PEx TITLE Y_ r=X.V-4u 3.1- fJ 6 � ' ST11 / I 1 1.9 : .v ej 1 .n Q - I ,4 N 'w o R)< 9e,�° - ' HEALTH M ENT I\PPROVIkL D/I\TC Flop - 2 4c T�E5rP,T £ Pc-pc TEST X I r 69 „_ 35.0 CA ' /LLAf .3 -D 2 , C �� 34 LnAM 34.Z i 4tt1Vv$U P E S / .T � P / _ VX DE5161 � E � �. \ 3INIGLE FAMIL/ DWELLLING W/3 BED R00MS SCALE o I n, i;'s TARRY ' tom./ I�b G AR 'DISPOSAL ;� LANTFRY. 1R. DAILI FLCIW = I a x. 3 330 0.1? ID, 5EWIA � SYSTEM DPSl 6N S�. PT1 C TANK CVaL. REQ' DJ 40 �� o o FbR f 3 t C7.P. y�. . 0 = G u G/aL5. RELD A_ ��1Of RlSDN 0o I,ScQa 5AL. Tl'\ I\IK - O .Y� LE�END 193' PARKT_R- RQAD - -2 PROPOSE-0 _ O STERV ILLC MA 3 �55 ' ts,x x P. C. J 13 PZ)t�1D STrC-CONCH �. C_ t4., STONE �.>_T. - :` low _ .. CX COt' otJ CT=rECTIVE DE A Z , p R IN 5SESSOR S )\/\A P 113 ? L U``ilN G T. =; t�T'Y: ZxL`+AtZb ? k 0.7 l l'�, Pew �JAy DSTE;R'VILLF_ VJLLA GC ,4 _ © - _ 1 _ C. z5•Q— �o�l� ADVANCED TECH . SOLU-TI C)N S —25,u TOT r�L CA�ACITV 3�J I GALS. Q . TESTED: to-3o-oo CoNSVL7 ENG'I , E .SAND, MA � " 1�v�L>;1Z ,1_6AY. DEaTEa ! I - I S-M 1DW e o I l l5CC