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HomeMy WebLinkAbout0005 RAMBLER ROAD - Health 5 RAMBLER ROAD sterv,ll 140 - 186 a c ° n m , s F1 �P t^rTtfp u 66 VP � n ° I a , d ° ° ° ° Wip ° 0 , ° , ° " rv, " ° e 'oc � " N ° n p r. " o- ° " ° Commonwealth of Massachusetts Title 5 Official Inspection orm Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 RAMBLER RD Property Address KURLAND Owner Owner's Name I' information is " required for OSTERVILLE MA 8-24-15 •- every paje. Cityrrown State Zip Code Date of Inspection r' 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 on the computer,use 1. Inspector: only the tab key to move your DOUGLAS A BROWN cursor-do not Name of Inspector use the return key. D.A.BROWN INC o IC—V Company Name ffi P.O. BOX 145 Company Address CENTERVILLE MA 02632 Citylrown State Zip Code 508-420-4534 S14297 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 8-24-15 Insp 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. �a S t5ins-3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 1 of 17 A Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '( 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information required foris OSTERVILLE MA 8-24-15 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 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 MET ALL MINIMUM PASSING REQUIREMENTS AT TIME OF INSPECTION. THERE WERE NO OBSERVATION PORTS ON THE S.A.S SO WE WERE NOT ABLE TO DETERMINE THE LEVEL OF PONDING OR STAINING. FUTURE PERFORMANCE UNDER THE SAME OR INCREASED USE CAN NOT BE DETERMINED BY THIS REPORT 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 RAMBLER RD Property Address KURLAND Owner Owners Name information is OSTERVILLE MA 8-24-15 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑_=NU.(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 '( 5 RAMBLER RD Property Address KURLAND Owner Owners Name information is required for OSTERVILLE MA 8-24-15 every 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 El ® 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 Qr cesspool El ® 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/day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 RAMBLER RD Property Address . KURLAND Owner Owner's Name information is required for OSTERVILLE MA 8-24-15 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: ❑ ® 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. !Sins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information is required for OSTERVILLE MA 8-24-15 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 ❑ Z 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): 4 Number of bedrooms(actual): 4 per assessing DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 440 t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 6 of 17 91OZ/11/8 t=bQsW900b00IL0=judduuzLdste-Anidstpyoi/2utssassd/sn•aigulsu ugjounnoi-AvAm//:duq Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r� 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information is required for OSTERVILLE MA. 8-24-15 every page. City/Town State Zip Code. Date of,inspection D. System Information Description: ACCORDING TO AS-BUILT CARD SYSTEM CONSISTS OF A 1500 GALLON TANK D-BOX AND A 4 BED S.A.S WITH INFILTRATORS 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 years usage(gpd)): Detail: SYSTEM NOT DESIGNED FOR GARBAGE GRINDER AVERAGE GPD----391 FOR 2013 2014 Sump pump? ❑ Yes ❑ No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ' ' ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3/13 rifle 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Z Jo Z aftm sp uD ljtng-sV i1utssassV Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information is required for OSTERVILLE MA 8-24-15 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: 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): t5ins-3113 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information is required for OSTERVILLE MA B-24-15 , every page. Citylrown state Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components,date installed (if known)and source of information: 1991 PER AS-BUILT Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑cast iron ❑40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 3 feet Material of construction: ®concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy'of certificate) ❑ Yes ❑ No Dimensions: 1500 PER AS-BUILT Sludge depth: MODERATE 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 "t 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information is required for OSTERVILLE MA B-24-15 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness LIGHT 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 were dimensions determined? SCOUR POLE 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 COULD USE PUMPING RECOMMEND INSTALLING RISERS TO BRING COVERS CLOSER TO GRADE 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page V of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 RAMBLER RD Property Address KURLAND Owner Owners Name information is required for OSTERVILLE MA 8-24-15 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑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 t5ins•3/13 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 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information is required for OSTERVILLE MA 8-24-15 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 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.): BOX WAS VIEWED BY CAMERA AND SHOWED NO SIGNS OF SURCHARGE OR FAILURE AT TIME OF INSPECTION 5 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: INFILTRATORS WERE DEEP, AS BUILT WAS NOT ACCURATE,AND THERE WERE NO INSPECTION PORTS t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information is required for OSTERVILLE MA 8-24-15 every page. City/Town State Zip Code Date of Inspection D. System Information (coot.) Type: ❑ leaching pits number: ® leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): S.A.S WAS NOT OPENED BECAUSE THE AS-BUILT CARD WAS NOT ACCURATE AND THERE WERE NO OBSERVATION PORTS 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 0 WA Subsurface Sewage Disposal System Form-Not for Voluntary Assessments r� 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information is required for OSTERVILLE _ MA 8-24-15 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.): y 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 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information is required for OSTERVILLE ' MA B-24-15 every page. City/Town 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 Offidal 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 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information is required for OSTERVILLE MA 8-24-15 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: GREATER THAN 5 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: You must describe how you established the high ground water elevation: INSTALLED NEIGHBORING SYSTEM THAT WAS AT A SIMILAR ELEVATION WITH NO GROUND WATER ENCOUNTERED Before filing this Inspection Report,please see Report Completeness Checklist on next page. 15ins•W3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 5 RAMBLER RD Property Address KURLAND Owner Owner's Name information is CISTERVILLE MA I 8-24-15 required for State Zip Code Date of Inspection every page. Cityrrown E. Report Completeness Checklist ® Inspection Summary:A, B, C, D,or E checked Z 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 Title 5 official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 t5ins•3/13 Assessing As-Built Cards Page 1 of 2 `JU VX -7 sr TOWN OF BARNSTABLE LOCATION '��+•L[-��A SEWAGE# VILLAGE2V 1 ASSESSOR'SS�MAP&LO? INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY )Sad LEACHING FACILITY:(typel1&& /4 Ize) NO.OF BEDROOMS- PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER q� DATE PERMIT ISSUED: 3 / �Rl DATE COMPLIANCE ISSUED- VARIANCE GRANTED: Yes No http://www.townofbamstable.us/Assessing/HMdisplay.asp?mappar=140186&seq=1 8/24/2015 Town of BAMs—table r# . Department of Regulatory Services i ,tgrAV A _]P: ublic aealth Division gate KAM ie y tee$ 200 Main Street,Hyannis MA 02601 �lfD r,N'[� ,J' '• t Date Scheduled ill 1 Time Fee Pd. Soil ,Siritability Assessment fop S w e Dispo r .© Performed By:, t%l 1� Witnessed By: j LOCATION & GENERAL•INFORMATION Location Address V n�(n ' _ Owner's Name �s i 1 I IG I Address Q? ' Assessor's Map/P4Ccel: Engineer's Name tu/t&4tf , •S NEWCONS1RUt jON REPAIR Telephone# '0�� Land Use Slopes('Yo) '_/ y Surface Stones �Q�(°. Distances from: Open Water Body>*Z o f[ Possible Wet Area�L'00 ft Drinking Water Well 2 �� ft ; brainage Way > 0L) ft Property Line ft Other ft SKETCH:(Street name,dimensiods of lot,exact locations of test holes&perc tests,locale wetlands in proximity to holes) 9- c� 3 :o /•'� 1 j • t l - Parent material(geologic)6� Depth to Bedrock Depth to Groundwatdr: Standing Water in Hole:' i Weeping from Pit Face Estimated Seasonal Nigh Groundwater i DtTERMINATION FOR SEASONAL HIGH WATER TALE Method Used: In. Depth 10 soli MOttlgs: Jn. Depth Clbserved standing in obs.hole: i prdundwater Adjustment Depth to weeping from side of obs.hole: _ A {aetor-, �,._ A�1•C�roundwaterLevel,,s• Index Well# Reading Date: Index Well level — - PERCOLATION TEST . n�tp-- -- 'Pl►ise Observation ` I Tithe at 9" .--- Hole# Time at 61' ' Depth of Pere Time(991-611) start Pre-soak Time.@ � �� � • End Pre-soak Rate MinJlnch Site Suitability As sessment.• Site Passed � Site Failed%_____— Additional Testing Needed(Y/N) Original,Public he'�lth Division Observation Hole Data To Be Completed on Back— . o i' ***If percola#6n test is to be conducted within 100' of wetland,,you must first notify the ` Barnstable Conservation Division at least one (1)week prior to beginning. U DEEP OBSERVATION HOLE LOG , Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel • ncl I Soo 2 `�1 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure.Stones,Boulders. Consistenc %-Gravel) DEEP OBSERVATION HOLE LOG Hole# 27 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel IPA DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consisten ra I �> wJ Flood Insurance Rate May: Above 500 year flood boundary No— 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 perviou material exist.in all areas observed throughout the area proposed for the soil absorption system? S If not,what is the depth of naturally occurring pe vious material? Certification I certify that on (date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with the required r • i ,expertisl and experience described in 3.10 CMR 15.017. Signature Date -`I 1 Q:\SEPTIC\PERCFORM.DOC - t AsBuilt Page 1 of i -Ws�/TOWNQOFQBARNSTABLE c� LOCATION��''1/4_ SEWAGE # VILLAGE 1� ASSESSOR'S MAP 6i LOT INSTALLER'S NAME & PHONE NO. bye- Ae, SEPTIC TANK CAPACITY LEACHING FACILITY:(type)//qq&npA hCCJ *ize) NO. OF BEDROOMS_ PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER rhl 'A-4p/ DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 1 Y http://issgl2/intranet/propdata/prebuilt.aspx?mappar=140186&seq=1 6/13/2013 I .. t I y;�• 1 I � i I Ii --'k- , I � •- � ° � -gib. �-i�; ��/'x�, 3 . - '4 h I31 - I � NP L I i N � Z • l ,j7 ,pppp;l cLwK AI60 �. COPYRIGHT ,.,. ... DATE B 1 ,,, TITLE arU� �.... NORTHSIDE . .......<.a.,.,... i SCALE „� , „ DESIGN ~,"°"""'"' �.... PROJECT SHEET i I �• 'F .TIXi qt7/�i'Z.,.���'/4T�^� '`��urucbTM,s=u.,.n rmw�wA mova, a �e i��esuio REVISIONSy :VL' lid. i TOWN OF BARNSTABLE LOCATIONcy ^ SEWAGE # " ViI,Lp GE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY f � LEACHING FACILITY:(type)z&fi o,d*ize) 3 NO. OF BEDROOMS ZI PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER • A "Ion DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED. VARIANCE GRANTED: Yes No ._ �� � � �_ 7'6 I � a No....��1--'---7f- Fes$.... -,�?,G1.........._ THE COMMONWEALTH,OF MASSACHUSETTS 'BOARD - OF HEALTH TOWN OF BARNSTABLE ` Applira#ion for Uisgosal Marks Tnntrnrtinn r-rmit Application is hereby made for a Permit to Construct ( or Repair ('.-/an "Individual Sewage Disposal System at ............ . - - -........................................ Lyon i Ad or Lot No. ess F • ...... ----------------- ----------- . -----------------•-----------. Addr ... Installer Address _Type of Building' Size Lot.............................Sq. feet U Dwelling—No. of Bedrooms________________________________________Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons____________________________ Showers — Cafeteria Q' Other fixtures ------------------------------ W Design Flow .. __________________gallons per person per day. Total dail flow............. _ .................gallons. W Septic Tank . capacity_15V4r allons Length___:_ ____ Width______ _______ Diameter._.__._.__..____Depth__ xDisposal 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 ( ) Percolation Test Results Performed by--•---------•-••-----•-------••--•------••••-------••------•--------•--•. Date...................-.................... aTest Pit No. 1________________minutes per inch Depth of Test Pit..................... Depth to ground water_________,............ Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ C4' -------------------------- •-- •- 0 Description of Soil..........4_::2M -'_ .1 ...._._..-•-----------------------------------------------------------------------------------------•••- W UNature of Repairs or Alterations—Answer when applicable................................................................................................ -•---------=-----------------•--•--...-------------=-------•--------•---•--•---..__.......:--------------.....-------------------------•-------•-----------------------------...._....•••---•-•-••_..._. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance s been issued by th oard of health. Signed ---------- --- - --- ------------ = ------- �. Date Application Approved By ------ _- ..(-��\ �.----7^�,1. Cy� V.. � Date Application Disapproved for the following reasons- ----------------------------------------- ---------------......................................................... ---------------------- ------- .-.-... .-y--/----'---'-'�-/----'-----------'----...--..--------"---------------- Date Permit No- --_1 [.. �= / ---------------------------------- Issued ..--------------------- - Date No.. �e/_-_ 7/ FEB.. _..._._ ,THE COMMONWEALTH OF MASSACHUSETTS _ r BOARD OF HEALTH /Q O TOWN OF BARNSTABLE - A Appliratilan for Disposal Works Tniistrnrtion Frrutit Application is hereby made for a Permit to Construct ( or Repair an Individual Sewage Disposal .ysten at• ZD, - - ...................................... ._� Loci iozl-Ad ............................................... -------------------------------------•-..or Lot No. Address ......................................... .................................•-=..... Installer Address dType of Building `` Size Lot-------------------..........Sq. feet U Dwelling—No. of,Bedrooms................................... ......Expansion Attic ( ) Garbage Grinder ( ) pa,, Other=Type of Building ............................ No. of persons--_..____.__.---_-___--_-- Showers ( ) — Caf t ria ( ) Otherfixtures -----•------------------------------------------------.-••-•••-••••••--••--•••••-•-•-•------••--••-•••••••--•---......................-• .......... W Design Flow............ ..................gallons per person per day. Total daily flow............ v_/�.................gallons. WSeptic Tank—Liquid capacity./,;gallons Length.._.4 -� Width...._lii..... 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 ( ) HI Percolation Test Results Performed by.....................................................................----- Date........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit-____.-•_--_-...__.. Depth to ground water........................ Gil Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...............-........ P4 ........................... . 1 k of Soil... = - 1------------------------- Description �l��a ,�,, U'Q... �-'�Qr ----------------------------------------------------------------------- W ----------------------------------------------------- •-----••••--•••--•--••---•---••••-•-•-•••-•••---•-------•••---•-----------••••-•--•-----•---•-•-•••---•••••-•••••-••-•-••--•••--••••-••--•-----•- UNature of Repairs or Alterations—Answer when applicable.....................•..____._..____.........................._....................._........... •-------•--•----------------------------------------•-----••------------------------...---.....---------•-----•-•----------------------------------------------------------•--•-•-•-••--•---.........••. M Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental 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 .......... A -=----- P - -----{ � 1 J 1 4 Da .' Application Approved By -------------------- --- ----- -- - - Application Disapproved for the following reasons- ------------------------------- ------------------------ --------------------------------------------------------------------- ............................. --------------........................................................-------------------------------..................... --------------------------- ---------- -------------6...------- --------- Permit No. ------ ^ " 1--------------- .................. Issued ............................. Dace THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE (gQrtifirate of V l!���ontlattanre THIS4S TO CERTI Y, That the Individual Sewage Disposal System constructed ( ) or Repaired by /� Installer has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ...... .-. -Z5. 3............. dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATIS FACTORY. DATE. .....................................f --------------------- ------- Inspector .---...------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Uio1rn11a La ku Tuntrudilan rrmt Permission is hereby granted �� •.•.•-••--- ........ to Construct ( ) or Repair �) an ndividual Sewage Disposal System atNo...........�-...... �����+�.....I/ .....-••..............(f m�--�°a���--------•-••-------•------•-----.....---•--••-•-•-•----------.........--•-•- % Street as shown on the application for Disposal Works Construction Permit No./(/;)P-z��.�.._ Dated.......................................... •----•------------------•-•--.. . J................................................... _ �/'�/� Board of Health DATE....................•-•-•-------•-••---........................---•-•-•-----.... L/ r FORM 3850E HOBBS Q WARREN,INC..PUBLISHERS 4 � " Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 page. City/Town State Zip Code Date of Inspection r 14 — .t Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information - on the computer, use only the tab key to move your 1. Inspector: cursor-do not Chad Hathaway use the return Name of Inspector key. H.P.S. Company Name P.O.Box 151 Company Address Forestdale Ma 02644 City/Town State Zip Code 774-274-2581 12866 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this a ss and tl theo information reported below is true, accurate and complete as of the time of th pection.t rr he inectio was performed based on my training and experience in the proper function an aintenar�of Wite sewage disposal systems. I am a DEP approved system inspector pursuat'T_ Section 11 5.34ftf Title 5(310 CMR 15.000).The system: "o ® Passes ❑ Conditionally Passes ❑ F ils FZ3 ca ❑ Needs Further Evaluation by the Local Approving Authority o ;- 7/9/13 Inspector's Sign re 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•11/10 Title 5 Official Inspection Form:Subsurtace Sewage Disposal System Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments G 0 y`e Rambler 5 Rd. ,M Property Address P Y Birmingham Family Trust 9 y Owner Owner's Name information is required for every Osterville Ma 7/9/13 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: ® 1 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 in good cond. tees in place Dbox clear of carry overs and level no leaks no signs of ever being over full. Dbox was camera inspected due to not being able to locate with as built measurements 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osteryille Ma 7/9/13 . page. Citylrown 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 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•11/10 Title 5 Official Inspection,Form:Subsurface Sewage Disposal System Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments M , 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 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 day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 page. CityrFown 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. l5ins•11/10 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 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 page. Cityrrown 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): 4 — Number of bedrooms (actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 page. Cityrrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required]: ❑ Yes Z. No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑. Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Detail:. Sump pump? ❑ Yes ® No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 page. CityrTown 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 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): l5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 ssachusetts Commonwealth of Ma W Title 5 Official Inspection Form . Subsurface Sewage Disposal System Form Not for Voluntary Assessments GSM 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 page. City(rown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 1991 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 2' Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line. 30t feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 2.5 feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500.gal Sludge depth: 2" 15ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts . W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 32 2,. Scum thickness Distance from top of scum to top of outlet tee or baffle 13" 511 Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? sludge judge tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap(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-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts 4 v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments wM 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 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 ❑ Nb Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-1 Ill 0 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 page. CityrFown 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 o 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.): level no carry overs and no cracks or leaks 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: no inspection port on as built inspected through Dbox t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 47H 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: — ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: Tx 36' ❑ 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.): 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 ' Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Cisterville Ma 7/9/13 page. Cityrrown 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.): t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 f Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for.Voluntary Assessments 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 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 f 3 1 �) L1u - �3> Co? 39 s� t5ins•11/10 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 5 Rambler Rd. Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 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: 12'+ 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: You must describe how you established the high ground water elevation: Online topo maps Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 " Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments w 5 Rambler Rd. - Property Address Birmingham Family Trust Owner Owner's Name information is required for every Osterville Ma 7/9/13 page. Cityrrown 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 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 El I ] SO III � p TOWN OF BARNSTABLE BOARD OF HEALTH C ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION J r Date 0— � Time: In Out Owner 7ltL, Tenant l Address Address Compli ce Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 40V --- 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of-Service ` 11. Space and Use _ 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 7fo 17. Temporary Housing 18. Driveway Width ^� Cj C� I y� 150 1 Sv 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here �� TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II:MINIMUM STANDARDS FOR HUMAN HABITATION Date h L11 fo Time: In Out Approved;_ �1�-'�zlq Olt Owner IIAVW10 � ALA-JbV Tenant 6c&ff Address q �j e 0�1 `� i Address Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities D ®v\� 4. Water Supply ?41 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents - 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal v - 17.Temporary Housing 18. Driveway Width ,s c-) ►-- 23O.Z3J 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allow m Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here LZ L r TOWN OF BARNSTABLE BOARD OF HEALTH r - ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date JJ �� Time: In Out Owner WNW 721WW4114M Tenant Address J 11 ffimm Avc Address 5- 9AM OL,!!5-1a 19I> Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities ! S o 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural / Elements V 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal L ` �- GAS �� -3 �e 16. Sewage Disposal 17. Temporary Housing N� 18. Driveway Width 19. Number of Tenants Observed j4 PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms l Number of Vehicles Allowed max) Number of Persons Allowed (max) Person(s) Interviewed WOO- P Inspector If Public Building such as Store or Hotel/Motel specify here NOTES: PRELIMINARY DRAWING 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS " FOR.DESIGN REVIEW &DIMENSIONS IN THE FIELD EXIST. 2.) CONTRACTOR TO.VERIFY ALL INTERIOR.&EXTERIOR MATERIALS, DECK DETAILS,&FIN18HES,IN THE FIELD.WITH OWNER 20'-6 12'-s 23.1 3.) ROUGH OPENING HEAD HEIGHT OF WINDOWS AT a'-svr' 3'-91rs° FIRST FLOOR.TO BE 6'-8"ABOVE SUBFLOOR 4.) ALL CONSTRUCTION TO CONFORM TO 780.CMR MASSACHUSETTS 2'-1 3r4" 2'-8112" 2'-3 V2" 2'-8 1/2" 1,2'-6314" STATE BUILDING CODE,.8TH EDITION AMENDEMENT&I.RC2009 H ----- H 5.) 110 MPH EXPOSURE B WIND ZONE, 1.50 ASPECT RATIO 6.) ALL LVL LUMBER/BEAMS TO BE 1.9e.1/480 LOAD Y 7.) FOLLOW ALL MANUFACTURER'S SPECIFICATIONS FOR INSTALLATION\ �+ 4 OF ALL SIMPSON COMPONENTS s 8.) ALL CONCRETE USED FOR FOUNDATION WALLS,FOOTINGS&SLABSTO BE 3000 PSI. J -` --- 9.) VERIFY ALL PLUMBING.&ELECTRICAL DETAILS W/OWNERS ON THE SITE " ` x//��/ MARVIN CUSTOM DURING FRAMING CONSTRUCTION I- 3 a > ROUGHOR OPENING" EXIST. a lJ. O ROUGH OPENING 10.)TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO.2 GRADE FAMILY d N c � U'I dl ug .12'-0., 11.)THIS SITE IS IN THE 110 MPH WIND BORNE DEBRIS AREA,EXPOSURE"B" ROOMv EXIST. &WITHIRONE`MILE OF CAPE COD BAY PER STATE OF : x MASSACHUSETTS WIND SPEED MAPS aai a o DINING. F 12. GLAZING PROTECTION PER 780 CMR 5301.2.1.2 TO BE PLYWOOD PANELS ` VERIFY ALL WIND BORNE DEBRIS PROTECTION REQUIREMENTS N ' W W/OWNERS PRIOR TO START OF CONSTRUCTION z III 111 NEW 4 x 6 I'SL- WINDOW SCHEDULE _ _ POST UNDER END OF BEAM r_______________ TYPE MANUFACTURER'S UNIT ROUGH OPENING REMARKS i i UP I(s1L.i1L. 19/y"ull��g^o� E D A MARVIN.CUSTOM " 2'-0"x 3'-0" OVAL B INTERGITY ITDH3240 2'-8 1/2"x T 4 1/4" DOUBLEHUNG. � cZ��uli_ i9/v Rr4 REF o^ USE S MPSON HID XI ST. 'D I C INTEGRITY ITDH3264 2'-8 1/2"x 5'-4 1/4" DOUBLEHUN61 4 ii HANGER TO FASTEN \ —J-__—___—J___—___ < „ •� -8E7{Ms,'S1GE-rNER----- ,, MATH D INTEGRITY ITDH3252 2'-8 1/2"x 4'-4 1/4" CASEMENT. ' " L—._J I I { HC141 t-Z BR- �i L——.� I I----\-- _E._...INTEGRITY.IAWN2923 2'-5"x 1'-14 5/8" AWNING �--- r t�uytw i w F INTEGRITY ITDH3456 3W 8'-5 "1/2"x 4'-8 1/4" DOUBLEHUNG ;u _ <..IL_ EXIST.2 x 8's -I EXIST.2 x G INTEGRITY ITDH2656 2'-2 1/2"x 4'-8 1/4" DOUBLEHUNG u_______ J ��oD .. I o.c. H INTEGRITY ITDH3260 2W 5'-4"x 4'-8 1/4" DOUBLEHUNG A _ J---=�T i L___ . A J INTEGRITY ITDH3260 2'-8 1/2"x 4'-8. 1/4 DOUBLEHUNG A2 w1� I I I 1 NEW BEAM" / NEW BEAM J II 1 ABOVE / ABOVE K MARVIN CUSTOM COTTAGE 2'-2 1/2"x T-8 1/4" DOUBLEHUNG 1ru i' ; C21?-v g I_____._ N I C.' 1.CONTRACTOR TO VERIFY ALL WINDOWS WITH OWNER AND ROUGH OPENINGS N m�„ I I f1I DN. ILL WITH WINDOW MANUFACTURER PRIOR TO ORDERING OF WINDOWS ~ I' 2.MARVIN INTEGRITY OR MARVIN CUSTOM WINDOWS SPECIFIED.VERIFY ALL EXIST. NEW 2.8'x68" DETAILS W/OWNERS GARAGE FIRE isulTeo y--�I----i - --- NEWSTEPS DOOR =- .7 -- --- REMOD. " ® ISLAND Oo LIVING v Oo u II 0.0 " . A RANGE - - -. ' - NEW4x6 - - POST UNDER EXPANDED . END OF BEAM C. FIRST FLOOR PLAN e KITCHEN (VERIFY KITCHEN LAYOUT W/OWNER) ,tY'F8 sDOOR II NEW BEAM LEGEND: a= SINK I DW I SINK I ABOVE McKENZIE - 0 EXISTING WALLS. TO BE REMOVED � q/Zyt B B c c NEW CONSTRUCTION Fss'IONALEao 20'-6" 3'-6" THE DESIGNERSHALL BERE IFIEDFOUND IF ANY SCALE :. DRAWING NO.. ERRORS OR OMISSIONS ARE FOUND ON �.I THESE DRAWINGS PRIOR TO START OF CONSTRUCTION.THE BUILDING CONTRACTOR II 1 11 N LLc REMODELING FO`R: _ COTIJIT BAY DESIG NEW NMLLBERESPDN9IBLEFORTHEDDNTENT 1/4 1 -0 EK 43 BREWSTER ROAD - COMMENCES CONSTRUCTION COMMENCES WITHOUT NOTIFYING THE 9 RESIDENCE DESIGNER OF ANY ERRORS OR OMISSIONS. EE MA. 0264 AN THESE ORANMNGSARDS MY THE USE MASHP N.D/YETMDATE :. LA K U ROF THE OWNER NOTED.ANY OTHER USE OF PH. 508) 274-1166 THESE DRAWINGS REQUIRES THE WRITTEN CONSENT F THE DESIGNER UNDER THE S O 1 9/20/20.1 1 HIT T COPYRIGHT PROTECTION. 3 ARC EC URA CO 5 8 539-9402 FAx o D OSTE LE MA A c > 5 RAMBLER ROAD RVIL CT OF 1990 • WING P RELIMINARY .DRA FOR DESIGN REVIEW EXIST. .. .. Lg K D K S.F. BEDROOM ELEVATION .24'-0,. EXIST. EXIST. BEDROOM CRAWLSPACE - - 2x8JOISTS - . - NEW BEAM NEW'BEAM 2 - . Imp ' 'I .. - cp EXIST. EXPAND. I I GARAGE KITCHEN _ I NEWS-1 3/4 x 9 1/2 LVL GIRT " .. `x I 2 x:8 JOISTS 16'o`a EXIST.3-2X4 GIRT A :I43s 4"x W"u%vll w I A.. X C�aGa e-rE ... EXIST.2 x B's ------NEW 3 1/2"DIA.. . . . I=o EXIST. I T.2 x °C - STEEL LALLY COLUMN - 6'-7.1/ - 6'-7 1/2" —,— EXIST.CONC. .. +- BLOCK FOUND. '� WALLS" EXIST. EXIST. I I I e I BASEMENT BASEMENT --� --- ¢ NEW 30"x30"x 12' • - - I I. I CONCRETE FOOTING .. W� � I �I J -... N .. N L L BUILDING SECTION @. KITCHEN co LJ 4-AOF Cuv Y Caaour GeLLs UNo6R AND �s r o NIARK A. - AOSAC.E.tsc 32'-0" McnEidZIE ��T°. - FOUNDATION PLAN F��I�T� x �� eF' A THE DESIGNER SHALL.BE NOTIFIED IFANY SCALE . �RAW�NGNO. ERRORS OR OMISSIONS ARE FOUND ON - �� COTUIT.BAY.DESIGN, LLC NEW REMODELING FOR: CONSTRUCT NON. THE BR TO START OF DINGCNTR ,1 [7 �/�� "LLBE RESPONSIBLE FOR ITHE CONTENT TOR 1/4" _ 11-O" 43'BREWSTE�R/� ROAD IN THESE DRAWINGS IF CONSTRUCTION MASHPEE M/"A. 02649 COMMENCES OF B MY ITHOUT OR THE 1 GG KURLAND/YETMAN RESIDENCE THESES WNGY ERRORS DR OMISSIONS. DATE . 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Iteration reproduction or disldhu- ,y�..-._ s " " 5 Rambler Road tion of 11asa plane wllhoui[the %--r 6 school street t 508.420.5335 f 508.Q0,5304 ° I -p " press written consent of Aron, ASS 0 C I A T E S.� info@ archRechassodates.com m OsterVille Massachusetts Tech Asoculealnc.,iaaninbine- h z; cotuit, ma ozsas ainf chitedlassodates.cam ment of that acL Acy,Wars,am U m ions ar diacrepp rt ea on lheae aa� drawing,shall be b ougght to the p ltenti n of Archi-4e T Assoc., m u u Foundation Plan Details rn�.iori,or inning work.Dlm- �,• 'o > tole used,do net arch i t e c t u r a l design architech associates.com A sole drawings a. 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OOI@LEiLN&-ITVH 3056 -__�_ 3' \ 10'-6' 4'-0' KO 2-0 2 x 4-B va rL " KID 2/2) z � _ D �2 — A, o A { Nag P r ; _ r N � r OR - u 5INIP50N DOOR- y 3_bXl KET SERI .n ro LAS FIR1 A 3 - RD.;5-DOOR d D r y r � a r 8'-III/4' _;�°}tk�_N' WJBLE-FLN6-ITo.3051, / — --!J, R.O: CD ------ - ---- -- .- .---- ------- _ ...-- ---- --- - ..; _ mSu oZ� mg °� =r �� P5 _y y N r g yya� Gu i ___(j _ lIIfiNN 1� 'n L : Z. .. _ , ---- N ------------- �P- O r-110 N °NTn D51ACU cs U I I I Va C O O t") O a sn ti C P O Z m Q Additions &Alterations to the Archi-Tech Associates,Inc.hereby spressl reserves the copyrigh!of . .. .. .. — c these:tea Works C yF the N Kurland-Yetman Residence archilectua�°ofer'Copyright ® V A C S I T B C H Protection Acl-of 1990. a A D Ilenlion odu<6on,or�istribpu- N w 5 Rambler Road jinn of t6serplans nlhout the uuu" , 6 school street t 508.420.5335 t 508.420.5304 p N Yp written consent 01 Archi �> o b Osterville, Massachusetts TecA As ocutes,Ins,is an infringe- 7 ` : $ = ASS 0 C I A T E S A cotuit, me 020 Y info@architechassodates.com menl of That e.L Any errors 3 m ions or discre ancsea on yhese ■,w`v` m drawings shall to brought to the Oj • p A Ienti,n of Archi-Teo Aa oa u o First Floor Plan a°�.'eri°r 1Bbegb;lug work.not arch c h i t e c t u r a I design s i n architechassociates.com e a to ed.do not a A aaal.Na angs ;c 9 -