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Home My WebLink About0195 POND STREET - Health 195 POND ST. OSTERVILLE f A = 118 039 AsBuilt Page 1 of 1 TOWN OF BARNSTABLE LOCATION 1(15 QO/l S'T SMOME#! -Ln s P VILLAGE Q'Z>T4(J�kk ASSESSOR'S MAP �&PARCEL INSPMEER'S NAME&PHONE NO. �� k_( 'tJor1►1t l �la�-1?�9 SEPTIC TANK CAPACITY 1500 a7; LEACHING FACILITY:(type) r9d Tr.VrAg V.y jr,p,Lka(s -) NO.OF BEDROOMSn OWNER- lccX��'C O\0.G PERMIT DATE: CaM=NeE DATE:7 e 5P J0 Ian?I b 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 �iMO .•r 7• '20' PerfI ♦/\/�J\J\i r i i i!\i i/ ! ! ! ! ! / / ! / , 63 ! J / l ! ! ! ! ! ! ! ! ! ! / / / / I / I / / / / ! / I I / I / I I / I / http://issgl2/intranet/propdata/prebuilt.aspx?mappar=118039&seq=2 5/17/2013 LOCATION r SEWAGE PERMIT N0. aS''691 I95 19v,�a s7rce-7' VILLAGE A & B CESSPOOL SERVICE 128 BISHOPS TERRACE, HYANNIS, MA 02601 BUILDER OR OWNER DATE PERMIT ISSUED 6 DATE COMPLIANCE ISSUED 6- � '�� .�r�.� 'I < s � c�� ' 7 �� , �p� � !s„ r, �. .�" � � i �' ��, � �_ _ � �. �, TOWN OF BARNSTABLE j LO)CA-TION SEWAGE # o ✓ if/ � LLAGE S' ��,�i ,��,, ASSESSOR'S MAP & LOT' 'i'�'� INSTALLER'S NAME&PHONE NO ��,Yi�✓ �A .7e 1 p�, se g� :�p�� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) IZ'X9 NO.OF BEDROOMS BUILDER OR OWNER Jr✓bltr /11p � PERMITDATE: G�,;,6-h COMPLIANCE DATE: ICE I' 01 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,) how da Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet Rf leachin .t acility /!�{ Feet 1q, Furni"shed by 5,4L id h is T To I r TO � 70 ti!= 73`s 3011, I No. e�w � 4 Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYication for Miquar 6p.5tem Con5truction Vertu Application for a Permit to Construct( Repair( )Upgrade)Abandon( ) O Complete System ❑Individual Components Location Address or Lot No. 1Q4_ a old 5 ' 6 6 7e r y'l e. Owner's Name,Address and Tel.No. 4LJ Assessor's Map/Parcel Installer's Nam ,Add ess,and Tel.No. 7 Designer's Name,Address and Tel.No. C � ��t��87 _ Type of Building: Dwelling No.of Bedrooms 3 Lot Size 3 40 sq. ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow '760 gallons. Plan Date G.. ;,5 01 Number of sheets I Revision Date Title Size of Septic Tank Od Qu Type of S.A.S. _l Description of Soil ��. o f?o u v e 4 "I L�` b�X t x-2 c► x �2x2 � Nature of Repairs or Alterations(Answer when applicable) r Jgw r^� 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 y this Bo�ofalth. Signed Date Application Approved b Date Application Disapproved for the following reasons Permit No. s��1 �e"O f Date Issued -5 � ' No. ' ��' ! / Q _ N Fee ./ " THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS v 01ppYication for Oie;poM *patent Cori%truction Permit Application for a Permit to Construct( 4Repair( )Upgrade(�)Abandon( ) ❑Complete System El Individual Components Location Address or Lot No. /Q5 P.,d s7- Q 5 7,r u,/Ie Owner's Name,Address and Tel.No. _ Assessor's Map/Parcel Installer's Nam/e�,Address,and Tel.No. Designer's Name,Address and Tel.No. la s 5 5 y5 Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) 'e Other Fixtures Design Flow #V Y gallons per day. Calculated daily flow g30 gallons. Plan Date G/a 3_/�/ Number of sheets / Revision Date Title Size of Septic Tank /-, d o Cs�. L Type of S.A.S. 40k C) lt��r-\V, Description of Soil r 5 e 11 6/ Nature of Repairs.or Alterations(Answer when applicable) Sys ye'.I1 y 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 Health. I Signed 6I 4f t- Date / -4 Application Approved b',,}, Date Application Disapproved for the following reasons Permit No. ! +��1' f^ Date Issued { - --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance - THIS IS TO CER that the On-sit Sewage Disposal System Constructed( )Repaired ( )Upgraded Abandoned( )by d tv t 4 at ro' " �Ji _ has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.gjtO1- k/ dated 44 - .V";T P7 Installer "6 h / r Designer The issuance of this permit shall not be construed as-'a' a guarantee that the system will function as designed. (� Date Inspector f } No. X_ 000/' 41111, Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS 1=i!6pool 6p.5tem Construction Permit s Permission is hereby granted to Cons ct( )Repair(�)U grade( )/AJbando ) System located at II?A� �� /r'{ Ile 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:Construction must be completed within three years of the date of this t. �� Date: �/ �� Approved !-- r ` 5/25/01 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. PERCOLATION TEST AND SOIL EVALUATION EXEMPTION FORM I, Jof7/(/ L✓L, le , hereby certify that the engineered plan signed by me dated S-o , concerning the property located at meets all of the following criteria: Je This failed system is connected to a residential dwelling only. There are no commercial or business uses associated with the dwelling. • The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. The applicant may use historical data to conclude this fact or may conduct preliminary tests at the site without a health agent present. • There is no increase in flow and/or.change in use proposed • There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than fourteen (14) feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] Please complete the following: A) Top of Ground Surface Elevation (using GIS information) B) G.W. Elevation 3, - + adjustment for high G.W. A15 DIFFERENCE BETWEEN A and B SIGNED : DATE: S NOTICE Based upon the above information, a repair permit will be issued for bedrooms maximum. No additional bedrooms are authorized in the future without engineered septic system plans. q:health folder:percexmp or c a JI yy /� /16 o�OW 1 � ` rs /k .0 J y x . h . z TOWN OF BARNSTABLE OCATION I 5� ed- o SM=GE# 1^51 VILLAGE CY2>T-etJS1LQ ASSESSOR'S MAP �&PARCEL �'S NAME&PHONE NO. n`_r i C-�Li�ad1 �'fa�� 171. SEPTIC TANK CAPACITY 1500 9 cv� O k,/ LEACHING FACILITY.(type) C9Qo Tv...,,,r �`�AIrn'"`(s ze) NO. OF BEDROOMS :!> OWNER C—I- AC 0A0LC PERMIT DATE: C DATE: _i-,,SP iG fda l/o 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 �iM� v�ixe.�ray...... . .. \ 4 \ 4 \ \ 4 \ 4 4 • 4 4 - -20' F rfffJfFfrFJfF 63 .... .. .......... f r r f f f J f f ! / / / f f / f •.. •. • f f f r / f f f / / / 1 J J f f f ' \ 1 \ \ k \ 4 4 \ f f F F 14 f i r t ! t r FtrhJ\rh ! f\ f ....... . \F\f\f\f\ 4f\ F\ \ 4 1l4f4F♦ .... ..... t \ ♦ h \ \ 4 \ t \ t ♦ 4 \ \ t \ t . \ 4 1 t 1 \ \ t 4 \ t t \ ♦ \ \ 1 1 """""""' frFfFrrfflrFfrrfF 73 h h \ \ k \ k 4 h k h \ h t \ h t ♦ \ h \ 4 \ \ 1 4 4 \+\ l 4 4 \ \ h \ 4 \ ♦ 4 \ \ , \ t \ 4 4 ♦ k rt. 4 4 h 4 4 ♦ \ h 4 \ ♦ \ \ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 195 Pond Street Property Address - Federal Home Loan Mort a e Cor . Owner .Owner's Name information is required for Osterville _ MA 02655 October 22 2010 every page. City/rown State ZipCode Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any -way. Please see completeness checklist at the end of the form. important:When filling out A. General Information forms the computer,use 1, Inspector: ti only the tab key to move your Patrick M. O'Connell cursor-do not Name of Inspector use the return P key. Septic Inspection Services Co Company Name II m 189.Cammett Road Company Address Marstons Mills MA 02648 'd71 Cit /Town Y 508.428.1779 State Zip Code S1 12855 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 G---- �7 October 22, 2010 Job# 10-257 In ector'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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Di at System•P/g-11 0 7 Commonwealth of Massachusetts UTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 195 Pond Street Property Address Federal Home Loan Mortgage Corp Owner Owner's Name information is Osterville MA 02655 October 22, 2010 required for every page. Cityrrown 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: Tank is not in need of pumping at this time, leaching system shows no evidence of surcharge or saturation. 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-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 i Commonwealth of Massachusetts UTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is required for Osterville MA 02655 October 22, 2010 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) '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 theBoard 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-09/08 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 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is Osterville MA 02655 October 22, 2010 required for every page. Citylrown 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 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 day flow t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is required for Osterville = MA 02655 October 22, 2010 every page. Citylrown 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. ❑ ® 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•09108 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 for Voluntary Assessments 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is Osterville MA 02655 October 22, 2010 required for every page. Citylrown 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 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 (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments "( 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is Osterville MA 02655 October 22, 2010 required for every page. Cityfrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?[if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No ,000 gal. Water meter readings, if available (last 2 years usage (gpd)): 53 53 gpd. Detail: Sump pump? ❑ Yes ® No Last date of occupancy: UnknownDate 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: t5ins•09108 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 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is required for Osterville MA 02655 October 22, 2010 every page. Cityrrown 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: None available 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 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): Istria•09a Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 J Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is required for Osterville MA 02655 October 22, 2010 every 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: Installed 10/5/01 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: t ®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): 8" Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑ fiberglass 0 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: 1500 gal. Sludge depth: 3" Lisin. = 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 't 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is required for Osterville MA 02655 October 22, 2010 every 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 30" Scum thickness 2" 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? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is not in need of pumping at this time, liquid level was found at bottom of outlet invert. Tees were intact and clear. Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: . Date t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 J Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 195 Pond Street Property Address Federal Home Loan Mortgage Corp. . Owner Owner's Name information is required for OSterville MA 02655 October 22 2010 every 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.): 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.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No 15ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �Y 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is required for Osterville MA 02655 October 22 2010 every page. Cityfrown 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 0" Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): No solids or high stains present. Liquid level was found at bottom of both outlet pipes. 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.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: l5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is Osterville MA 02655 October 22 2010 required for , every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 4 Infiltrators ❑ leaching galleries number: ® leaching trenches number, length: 1 @ 20' ❑ 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.): Leaching system was probed with no signs of saturation found. SAS showed no signs of surcharge into d-box. 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments "t 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is required for Osterville MA 02655 October 22, 2010 . every 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.): l5ins-09/08 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 'Y 195 Pond Street , Property Address Federal Home Loan Mortgage_Corp. _-- Owner Owner's Name -- - information is Ostetville required for __ __ MA _ 02655 October 22, 2010 every page. Cityfrown 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 ,Pond;Street Water . Service :: . . ........:. ....•...... 20' PerfPipe :............... % /%/%/ /%/%/%/%!%, /%/%/%/ /%/ J / /%/%/%I ! / / /%/ ... ... /%/%/ / / / ! / / / L / / / / / / / / / / ! / I / / / ! .... .. \ \ \ \ \ , \ \ \% \% \% \ \ \ \ \% \ \ ...... V. % / / 73 .... \/\! \/% \ e:':';':'; Commonwealth of Massachusetts Title 5 Official Inspection Form UVSubsurface Sewage Disposal System Form -Not for Voluntary Assessments- 195 Pond Street Property Address 7 _ Federal Home Loan Mortgage Corp. r Owner Owner's Name information is Osterville MA 02655 October 22 2010 required for _ , every page. Cityfrown 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: 20 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: ❑ Checked with local excavators, installers -(attach documentation) ® Accessed USGS database-explain: USGS topo maps and town GIS. You must describe how.you established the high ground water elevation: Town groundwater contour map shows water at el. 5 and topo map shows property at el. 30. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 n 4 , Commonwealth of Massachusetts _ r Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 195 Pond Street Property Address Federal Home Loan Mortgage Corp. Owner Owner's Name information is required for Osterville MA 02655 October 22 2010 _ every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, 8, 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 t5ins•01W Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 I� CERTIFICATE OF ANALYSIS Page: 1 :U 9' Barnstable County Health Laboratory. Report Prepared For: Report Dated: 1/29/2007 John Whiteley Order No..: G0739369 <195 Pond Street Ostervitle, MA`0265 Laboratory ID#: 0739369-01 Description: Water-New Main Sample#: RME 43 Sampling Location: Rue Michel,Barnstable,MA Collected: 1/22/2007 Collected by: John Whitele End Received: 1/22/2007 Test Parameters ITEM RESULT UNITS -RL MCL Method# Tested Total Coliform 0(28) CFU/100mL 0 0 MF-SM 9222B 1/22/2007 Laboratory ID#. 0739369-02 Description. Water-New Main Sample#: RMB#3 Sampling Location: Rue Michel,Barnstable,MA Collected: 1/22/2007 Collected by: John Whitele Beginning Received: 1/22/2007 Test Parameters ITEM RESULT UNITS RL MCL Method# Tested Total Coliform 0(49) CFU/IOOmL 0 0 MF-SM 9222B 1/22/2007 Approved. BY' -- —. — — �-- hector) /3l h MCL=Maximum Contaminant Level RL = Reporting Limit Superior Court House, PO. Box 427, Barnstable, MA 02630 Ph:.508-375-6605 °z LOCATION '/ �,e �S SEWAGE # /J�J. �r VILLAGE_ : S e0 �-�� - ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. e Ce' T i SEPTIC TANK CAPACITY f I j LEACHING FACILITY: (type) 0hdm, l t"J+- 5�*:v- (size) 491911 -5 a NO. OF BEDROOMS BUILDER OR OWNER /r 14AI PERMIT DATE: /fib`, y/• COMPLIANCE DATE: Separation Distance Between the. Maximum Adjusted Groundwater Table and Bottom.of Leaching Facility Feet ` Private Water Supply Well and Leaching Facility (1f any wells exist on site orwithin 200 feet of le.aching..facility). Feet i Edge of Wetland and_Leaching Facility(If any wetlands exist �/ within 300 feet f leachin acility �1 Feet ' Furnished by _ �Ae VIE i f S s of a s - 07,5 -tt f - o IL EIL ast(��°aplc� rNS w, 1 40% N o. Aft THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....Town........................OF...........Bar-n-stable---------------------.....----.-...._.......... Allpfiration for %Vviial Works Tonotrurtion Prrutit Application is hereby made for a Permit to Construct or Repair an Individual Sewage Disposal System at: ........1J9.5_.P.o-rLd-..,S.t_r.e_et------ 0245. 5----------------------------------------- ------------------ ------------ Location-Address or Lot No. ....... ------------------------------------------- ...1.95---PQnd---- 55 'j;n,r Address ........4_0...0 ................................. .........1,28---Bj� h.Q-pa... Na-. 02601 Installer Address Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms----- ................................Expansion Attic Garbage Grinder 04 Other—Type of Building ----------------------------- No. of persons............................ Showers ( ) — Cafeteria Otherfixtures ........... .................................................................................. ...................................................... Design Flow.................................'.._.._.__gallons per person per day. Total daily flow............................................gallons. 1:4 Septic Tank—Liquid capacity,...........gallons Length................ Width....._..___..... Diameter__._________---. Depth_....__......._. xDisposal Trench—No. ................4... Width..............._.... Total Length....._......._...... Total leaching area....................sq. f t. Seepage Pit No____________________• Diameter............___..__. Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) 04 Percolation Test Results Performed by...,.!.................................................................... Date........................................ P4 Test Pit No. I................minutes per inch Depth of Test Pit___._...........__.. Depth to ground water.._.................___. �--4 �r4 'test Pit No. 2................minutes per inch' Dlepth of Test Pit___.............._.. Depth to ground water____._..._......._..____ P4 ............................................................................................................................................................ . 0 Description of Soil........................................................................................................................................................................ W ......................................................................................................................................................................................................... ...................................................I.................................................................................................................................................... U Nature of Repairs or Alterations—Answer when.applicable------1000--- stone_ P9,Cked over flow --------- . ................................. ....................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code—The �pth undersigned f undersigned agrees no o place the system in operation until a Certificate of Compliance has been issued b, e boa al Signed.. .................... . ............... Dale ... ...... ..... .. .. . . ... .......... .................... Application Approved By........ I .................... Date fo Application Disapproved for t e ollowing reasons:............................................................................................................... .. ................. ..................................................... ................................................................................................................................................. Date PermitNo......................................................... IssuedL....................................................... Date ------ ------------------------- a No......................... Fizz......................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .own.........................OF.........Barnstable-------------.-...----------------------------- Appliratiou for Disposal Works Tonotrnrtiun rrntit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: .......}195--Pond--- �PE@�¢¢.. ((��' �rV �}:L._ a*...�� j��---------••---------------------or.Lot- John tltit,, Location-Ad'dress or Lot No. .......Joh 2--iPiilte'le -- Owner------------------------------------------ .....1}_P-011&---Sty'QrGtA,Q ervil3e...M&v...42655 a ....... &B...Ee speed-- r e e-------------•-------------------- ........128...B�.ahepq...T-p raee-Ryenn o f---Ma, 02601 M nstal er ress UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ---------- ...........................................I....... ------------------------------------------------------•--•••......-••--•-••--••-------- W Design Flow............................................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid*capacity............gallons Length................ Width................ Diameter.........--..--. Depth................ x Disposal Trench—No. ............:....... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No:.................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P4 ------•---•-------------------------------------•--------------....---------.........----•-•..--..-•......................................................... 0 Description of Soil.....................................................................-------•----------------------------------------------------------------------------......•..... U ...........................................................................................................................---........................................................................ x •--•••••---•--------------------•----------•--------------------•--•----------------•-•-----••-•-•-------------------•-------------•---------•---•--•-••-•--•-----•------------•---••-•---.....---...--- U Nature of Repairs or Alterations—Answer when applicable..... 0 -.-�a1].Q21___50212--•�caGkGd_.OVBT...f4)OW ----•----------=--------------------------••--.......-----...---------------•-----------•------•-•----------------------------------------------------•-----------------------------•-•----•........... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT1Z 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed...................................................................................... ................................ Date ApplicationApproved By.................................................................................................. Date Application Disapproved for the following reasons-------------------------------------------------------------------------------------------------------------••-- -••-•-•-•-•---------•-•-••......-----•.............•---•-••.......•-•-•-..........•------•...•--•---•••-------•--....•-••-----•-••-•--•-•--•----------••••-•------------••-............................ Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..............mown...............OF.........Barns tabl e............................................ Trrtifiratr of T.antpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( X) by......._4-&B...lamesspo-oJ_.SP_r.vJx-e---------•-------•-----------------------------------•-----------------------.---------------.---------------.--------------------- Instal ler at----------1-95--Pand---St..reet...4ateruilla,---Ma.,..--fly 5---------------------------------------•---------------------.....---------------- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated-_-.------.--.----.------_---------.--..----_--. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONS RU D AS A GUAR HTEE THAT THE SYSTEMWILL FUNC ION ATISFACTORY. DATE... 44J__ .Z ------------------------------ inspector............. ................... THE COMMONWEALTH OF MASSACHU TTS BOARD OF HEALTH ........Town......................O F...Barnstable....-----...---. ................................ No......................... FEE........................ Disposal AlVorks TD[n#ra " n frrnfit Permissi6ia!is hereby granted.............. - c .......-�1�.�pv .....-------•-------------•------...........----...............-•---•... to Const uct ( ) or Repaig( ) an Individual Sewage Dim at No........ ----•-•----------..PQAd...S.tre.et......Qstervil.le.,---Ma-, 02.6-rj-5. Street as shown on the application for Disposal Works Construction Permit No..................... Dated......................._......_........... .................•-----------....-•--••-•---••-------••-------•- DATE_ _---_-- Board of Health FORM 1255 A. M. SULKIN, INC.. BOSTON BOOK PAGE 1 esrt7fy to th8 best of my professional 1 heraby certify that this plan was knawfedge. Informotfon, and belle!, that prepared In accordance w th the rules ASSESSORS REF: the Praparty tines show» hereon are the and retfgulatims: of the uOssochuselt9 fines dhdding existl+e9 awnershlPS, end the Regkstrfea of deeds as amended to May ft8, Portal 39 fines of streets and ways shown are January f. 20GZ£ �� those of Public or private streets or says QVERZ.AY DISTRICT. already estabfiehed, and no new dde* for �" ion { drvlaFan of edsting ownership or far now � 'ViF,;o-WeNhead Protection DFstrkt E wayy are show+ e Lot-fin of FLOOR ZONE. , Me abort certifkotlan Fe intdided to 4*1 uecuo meet Registry Of Deeds requirements and pp 341"p. Zone 0 fs not o cerURaotfen to the title or y a i pe Ishtp of the Props ty shown. ", mu0001 00 Q a wn i ":• July 2, 1992 Location M P For Registry Use I b ZONERC�RPOD) Atop(min)87,120 SF 1 of Wumm Realty Trvet Fronts a m&(10 20' V t�s M7M 0 k QIMK L IHJ"M• ft N2 f• Width [yam,rt) f I298J/234 pis! SatbaCK3: E x Fame 124:01' Front 20' t Stecicoda fence '5"✓= T09.40' F� Side 10' 170.82' Rear 10' Ad c v moo- REFERENCES: Pfau Book ��6 Fr7irvo0 4�} w Stpf9f 5Q907.*SF ;--- 210 aesMAPD�oed Book 2&38Jt8 !yamf 1.t7Ac F9214f146 `w pa�qto S v e ��u,S'b R.MSIO re Road sound �S "me r/bRmere ._J lae7 to�+ut �TrJ ` 2 SI tirjl bl 15�15 �Ji / 0 �- gon8�omd Paa45Troft e, , a t+ �CIGN� IDI�1 l �'1�A5 2 K1T�N1J ('I�. � s Qo�'� trterirrw. e148 CfiVhII a =tin �c av MI Ad 3R6' s• /// 'moo• Fnd Fad % � � •� � 5a ' Fad Jd ,"'" nd L-F20.g8• ra -et•t N 270.04 L�172 78t7 1'a r+t •p. , e 40 Ur Uff r s BRB S2729'40"yf Poremm+t Fd e ° r �e ✓^ , �.-. y`-� 1e�u � ;-✓d Y teTrRefa IM pond (i997 Tor»L%-1-FR 210/81j ............_.......,.. ..................... eRer Fled f �•..�_� Titter PREPARED BY: PREPAM FOR ttates/Rerlsiarr Plan Of Laird At CapeSu�V 1.) fie structures shown were located an the QQ Pond p y� y� .s ground by cemrantiarlol surveyfrtg mottmde an or 1�J� P1/l Ili Street In l Rou�%►`A Lorraine Stone between 31fJAN/tT and 10/FE8/1f. 7 Porker Rood L) All rneosaremente to dweMq are to Barnstable { Mass �t/>k 0- COPS" ¢omerboard� Ostervfile S08 420--3994/420-39951or � werw eoAesvry eon► V 1 30 p SS 30 tDD 120 Date: Scale: e r Fw*#HMALL Reviser RRL February 9, 2Di I m � comy/braft:RRt Drowing C5139_1 1 1 f c. t NA96 A* Pt lash 1- Gb r�.� , MAX W I � FA Y ii fllrllN a. r11L' �}1`lj►�. I f � LkVI� m Gl o-` w i {ZbD►t ( D w �ro ( Ki'tulErJ w� "' }. fal ��f w z: a. 195 Pond Street Phased Construction Plan Total Total Total ,Total •' I � Bdrrns Bdrou SF SF A.Existing tin Construction: 3 1 1280' 1 Porch 112., Z �� I B.Phase 1: 1. RenoCe I srt�g n/a n/a n/a n//aJ�- 2. Conv r e t -1 1 no chg no chgBath {VVV/ i ,. ! V.✓Pi'. �.-'__ 2 2 1280 122 Phase 2: L Convert existing Parch to Kitchen. no chg no chg 112 -112 2 2 1392 0 w. > D.Phase 3: i RIIIA ' GhfE� 1. Demolish i riginalKitchenaddition. -240 2. Add Fami y Rocco. 335 .yy' "l I 3. Add Master Bedroom and Master Bath. 1 1 4340-0 3 3 1921 0 .. E.Phase 4: 1. Convert first floor Living Room to Study. no chg no chg no chg no chg V✓ 3 3 1921 0 E.Phase S: Renovate existing second floor Bedrooms#2 no chg no chg no chg no chg 1 W I J and#3. 3 3 1921 0 F.Summary of Changes: 1. Change in residence footprint in SF. S29 1 " " 2. Change in number of Bedrooms. none ,. 3. Change In number of Bathrooms. 2 r(NA - • II 6�t5-U�bA SNOW IJ�� rl o�y� ��ary•�1 �{1H� //�j1 — /7�J/�� SCALE I 15 p�(b DA��BY:"bg�:e -vt 0A BY DATE: I✓ REviSED " 111 PL.rQ�"5 DRAMUMEER Qy Fwv / IN � Euz � �' u , is ,Z,•• � zr . Z o z TA d h Y IA 41 00 .� 00 y' kA Z i S m3 � 33. w �\ • -w. 4t r� 0 i J !Y L _,; . �• ate. ,i , . . ; A ha C4 ,Q�� , c � r t;. a , _ s - pow _ = _ 41Y n A s s : s � o Ok x s' s �1• r Ql AN B PAG • r car#Ffy to The beat of my profesaknot I hemby cortlfy that thh pion was kno ledge, Jnlwmattm and beI that prepaid to acrordonee with the rules - ASSESSORS REF:the pr+vperty lklsa shown Woo ore the and lkns of the tuvss4chusatts Ihaa vldln *W51109 owneraNPS. and the Rely of Doods as amended to Addp tt8, Aoreat 39 firm of streets *ad woye shown am January 1. 20M + thauro of plrb►fc or private atroats orways _ VERLAY DISTRICT: r� a#rrcdy estnbtlei+04 and no now 061 !or ,� d3vJs of axlstbp ownership or four new - .�" � MOWtoG�lrB �• wo�+rs ara ehow�r,. ,•::�, - N.aN wd Prvteacti - -- } + R 6i mo above eertrticotkn is tat�;ded to �"Ariaw • FL Q CANE: •� most Ret�rryy of Ooeds requirements cod Nit �i•1ltt to not a certMkotian to the tllle or .: „ Zone G ow+tvral v!' the grape ty shown. Community f' t No. #260001 0016 A .. Location hfap For Registry Use r �� J ZONE: RC (RPOO) Arse (min) 87,120 SF J wow #tjY1��iit ire - Front mA 2W C8 ,1a ae 0 de I W3/ft34 , . e! !� ZINN fi7�n) f 4 S�rtbactca: ind f+n�+a N 7 "5 N2 '� f a t2#.4t End &vet 20' 17+R8Z' too.{� Side 10 • � �� Rsar tv a'' 04a• ,� �. ��• REFERENCES: & nrroad Plan SWlc 4"196 atawtar dot 1 w-: 134/vf I PY WA ie°sAP 1.1 MAc Oared Boots 26MI18 �V. 1304j148 N`' '�� 'saga `'' o, o Bi+Re � e�.ta�re nooar eo�d W MAW - COW104 ftund rllte M? so - slope tv t Dwta r map +rod d Road Shaft UW Ror rod And Fod All" CCOAM r )f If •' Z'PO�t?4' ��..� KillMU�e•/^-�� / , ��•�.!' P1� .n .� '* AtN1 �1 BrtB S27'29'40"'1Y po,rerra�st o FiEal fix'- Cg/t /f7d .. .. ... ... S,tre e t =llafd Rd Pond — $ / . .. . ............. dO �"""�. � Fed 1� 1q - Tltle: PREPARED B%: AMPARED FOR. Note evlsloh: Plan �Y Lard ACapeSury 1.) The otn,+cturee shown were locorted n the ground by con++er+#lortot srrrwylrtQ mends on or 195 Pond Street InRob�erf�& Lorraine Storrs b�twea�r 3tjJUNjlt and ZO/JFE1Bj�f. 7.Porker Read 2) All meosw'err+tnlo to dwelllsQ are to �+ 09tonft MA 02055 cornrrboarft l (Qsterv�llaj Maaa $00 420-3094 420-3993faxtyww. essumconB n to4ap �. 30 0 IS 30 so 120. Dala��bl�1 � $Col t a �r Flatd: t1fitK/1 U Re�tarw. fin Com ft: RRt 8roq C569_? f w ' • w�w.ww•n.r•wr•r�.r� •ww•uwuw...�S � �.. w.w • s I .� A M y� UP 7, 111 Al 1VVWN I �I I L`T Q A P)N Irk D SON . r t�aSE'T G f- r.. � I ( w w � W oa a I 14 w t 195 Pond Street Phased Construction Plan Total Total Total Total ; Bdrms Bdrms SF SF A. Existing Construction: 3 1 1280' Porch 112 , ' g f.� B. Phase 1: ° 1. Renovate existing first floor bathroom. n/a n/a n/a n//a n I 2. Convert existing 2nd floor Bedroom#1 to -1 1 no chg no chg Bathroom. i j _ 2 2 1280 112 W Q C. Phase 2: t 1. Convert ex Porch to Kitchen. o chg no chg 112 -112 existing Por n j 2 2 1392 0 W i i D. Phase 3: 1. Demolish original Kitchen addition. -240 W 2. Add Family Room. 335 M 1r'��, 3. Add Master Bedroom and Master Bath. 1 1 434 i 'J I 3 3 1921 0 r- v_ E. Phase 4: 1. Convert first floor Living Room to Study. no chg no chg no chg no chg I I . e v✓ I I 3 3 1921 0 E. Phase 5: ; ._ 1. Renovate existing second floor Bedrooms#2 no chg no chg no chg no chg -� and#3. J 3 3 1921 0 . F: Summary of Changes: 1. Change in residence footprint in SF. 529 r..-..... 2. Change in number of Bedrooms. none 3. Change in number of Bathrooms. 2 _ l �5pbD asTav► - SCALE: APPROVED BY: DRAWN BY DATE: ' ✓ REVISED DRAWING NUMBER p