Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0081 SAND POINT - Health
:1 SAND POINT Usterville M A073 - 015 - 001 �I 1' i t. No. Fee THE COMMONWEALTH OF MASSACHUSETTS in com uter: Yes r PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSET appYitation for Vsposal *pstem Construction i3ermit Application for a Permit to Construct X) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ek S kf4�) FT Owner's Name,Address,and Tel.No. 9n;S_AZa-S34" OS%EV_,4 I LE %i A e— P1 St-\ L\_C. Assessor's Map/Parcel C>'l c t�Q LL..er Sr �O � 62 k 9 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 4 ZS-34 3 Z4 1B/ Rtj L .� ^(� l^i 5'I l� Type of Building: Dwelling No.of Bedrooms 3 Lot Size b\ sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided ?J,ArT gpd Plan Date FEP> L(, �Zol A Number of sheets115 Revision Date 67 152 1 Title 5' ?L (2p Ejo tMPQ.t�UEWt $ `c 6 �P�Fv. Size of Septic Tank Type of S.A.S. \'L 32. yL.CON.l �= v e Description of Soil D^ 9 F't L L— we p l Rao'."o W FF jge a C��\�� OkOta VM QC-0 ` PtlLU Vu,Ae I i't.aLL�QV OQNA C-C LLz Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and intenance of the afore ed p�site sewage disposal system in accordance with the provisions of Title 5 of the Environme Code o place the system in operation until a Certificate of Compliance has been issued b is Board of Hea i e n Date Application Approved bykzz�?w &M Date Application Disapproved by Date for the following reasons Permit No. J Date Issued r=No. jF� �` Fee THE COMMONWEALTH,'- 'F MASSACHUSETTS in com uteri PUBLIC HEALTH DIVISION -JOWN.OF BARN ABLE, MASSACHUSET Yes 01pplication for Bistlo86pstellY tOIIStCULti01T Prltiit Application for a Permit to Construct 14) Repair( ) Upgrade( ) Abedon(' ) ❑Complete System ❑Individual Components Location Address or Lof No. Q�� A�� �T Owner's Name,Address,and Tel.No. ,-QZQ� 3gt . . . Assessor's Map/Parcel C> ej )a Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. 42e,- 334 Type of Building: F�c emirs Dwelling No.of Bedrooms Lot Size �\ sq.ft. Garbage Grinder.( Other Type of Building No.of Persons Showers( ) Cafeteria( ) A Other Fixtures Design Flow(min.required) 2i3(� gpd Design flow provided jg�[ gpd Plan Date° 'VGo:> L 201!�A Number of sheets Revision Revision Date 67 b2 Title S c -' O v� �oV E vtJ� t G 5 t Size of Septic Tank k-15t�)O Type of S.A.S. \Z A 32 5o,2 Description of Soil D- g t t_ 9��-, `G..B�� `Q WF- iA Tl 17 \k y'41G1,,\ \-M 11. L1-x\,L0G%y1 C-<cLZ Nature of Repairs or Alterations(Answer when applicable) Date.last inspected: Agreement: The undersigned agrees to ensure the construction and �off d on-site sewage disposal system in accordance with the provisions of Title 5 of the Environme Codesystem in operation until a Certificate of Compliance has.been issued b his Board of Health. i ed t Date Application Approved by` Date Application Disapproved I Date for the following reasons Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS - Certificate of Compliance THIS IS TO CERTIFY,tha he On iiI Sewage Disposal s stem Constructed O Repaired( ) Upgraded( ) Abandoned( )by (n /��, at A S A 1�,i�� �p >y l� ZV t t t✓ has been cons cte accoFf-0 4 with the provisions of Title 5 and the for Disposal System Construction Permit No r Installer Designer f #bedrooms 1'� Approved des'gn,�ow gpd The issuance of this pefinit 1 not be construed as a guarantee that the system nction as designed. [+, C ' r ) � t J Date sh Inspector f 1l - - 4 - /- - - - - ---------------------------------------------------------------- -- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal 6pstem Construction permit Permission is hereby granted to Construct(K) Repair( ) Upgrade( ) Abandon( ` ) System located at e I and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must belcompi6tedrithin three years of the date of this permit. I Date Approved by Town of Bamstable Regulatory Services Thomas F. Geller,Director Public lealth Division Thomas McKean, Duector 200 Maio Street, Hyannis,MA 02601 Office: 508-862.4644 Fax: O Q4 r Date. 2 . `moo r'arm�it#9.01 2j� Aikssor s�si�tl a1"r:et t 911a A Rai=C. e ' a oar Form 1 I, Desrer: Installer: : E- Address: 6 } Address: P, 6 k On .r I issued a pemmit to in Wl septic system at based on a design drawn by Al Ail t daod omopv I tit tho a tee r ric+ed abo�re :i n taped:substan all. ,"rd` to oearify p sys ,.. tha .J wl�icli may xaclu�de au�uaor.ap ued ebanges such.as lateral relocation ofih, . distributxo box 4ndl4r nap#c tanl . S�ut (if required) was inspected and the :soils Were bUnd'saiisfiMM I certify that the S.quo . stern referen*ct~d above was utst fled with.maiar cho .ges.(c.+a, greater than 10' lateral re ocation of the'SAS or any Vertical relocation.of any component of the soptie stet )'but ist.1=0'r4mce. State:& Local Pwgwafions. iah revision or was its certifi gner ed a� t by'des� to follow. Stripout1(if.irequu�d)::.._. p and-the,soils were f4_ Si 't e. finer s i (A x estgner s Stamp Here TE E &N-NOT An UMA . w . q:bffice fonnaWesignerctrci9cedon rom+.aoc - . . d, TO OF B STABLE (7 001 LOCATION SEWAGEglq LS VILLAG4,1 r ASSESSOR'S MAP&PA INSTALLER'S yNAME&PHONE NO. r 6� SNc,,E C�A CMCITY �1 LEACHING FACILITY:(type (size) NO.OF BEDROOMS OWNER ®� PERMIT DATE: C\- 6 COMPLIANCE DATE: bob I- Separationn 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 VI Vl N t I e TOWN OF BARNSTABLE LOCATION SA/1� POI A—r SEWAGE# V4 ILLAGE QST(vdk ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. SEPTIC TANK CAPACITY Sra LEACHING FACILITY:(type) 3 106o 13'4fy1Rc! (size) NO.OF BEDRO.O—MS�) 3 (� OWNER .�Oi A Pa PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) 11 Feet FURNISHED BY A SOe0-w �0/c W w o J� VN ` (W V rE ` Sullivan Engineering Inc. 7 Parker Road, P.O. Box 659 Osterville,MA 02655 Peter Sullivan P.E.Mass Registration No.29733 phone 508-428-3344 fax 508-428-9617 December 18, 2014 Health Division Town of Barnstable 200 Main Street Hyannis MA 02601 Re: 81 Sand Point Road, Oyster Harbors Disposal Works Construction Permit No. 2014-216 t Dear Health Division, Please find attached revised plans 81 Sand point Road. The house foundation grew so we had to adjust the geometry of the leaching field. The revised plan date is 12/17/14 I trust that this meets your present needs. - Very truly yours Peter Sullivan PE Sullivan Engineering, Inc. cc: Will Saltonstall, Attorney Paul Losordo (via e-mail) Donna Miorandi BoH (via e-mail) na s' em+l UJ Members of American Society of Civil Engineers and Boston Society of Civil Engineers Section THE COMMONWEALTH'OF~MASSACHUSETTS Fpteradincom uteri j PUBLIC HEALTH DIVISION-TOWN OF-BARNSTABLE,MASSACHUSETTS ` Yes Iitatiu�t fur is�� � vusat &p�tem 4�ultstru�rt[utt-�PCIItIt All for a Permit to Construct =Repair(::) tipgrada( )'Abandon( )' �]Com lete S stem. P . y ❑Individual Cornponents ocatioitAddressorLotNo. �T OwiiersNatiic'Addreis,'an(ITe1 No_: Z Assessor,'s MapJParcel Cj Installer's Nome,:Address,and Tel No, Designer's Name,Address;and Tel.Nca: '32t3 :33Q G� ' 2iL.ClT 'Cr'ni, _,rs , .� Tytpe of Bvlldang: Pcc2� pwallmg No.of Bedrooms Lot Sines �t Sq.(}; Garbage hrander( �� Othei . Type ofBuddrng , No.of Persons_... _ Showers(;").Cafeteria Other Fixtures 3 Design°Flow(min,required) gpd "Design flnw.provided Plan Tlate�E — gPd 1t, ZJI Number of sheats. t, Revision Date j`t $ize of Septic Tank T of S.A.S. �} �. . =D senption of SoQ" (? ✓��� t L t_. �i r- '�, "� t(3 ��(� , tat-L.tl"l 64�.. or: erations,(Answer when applicable) —< Ua(e last inspected Ag�cemenE §§ The undersa(rted agrees to ensure the construction and maintenance of the,afore described on-stte.sevJage disposal aysiem in acchrdance:with the provisions of'lYtle S of the t;nvirotvnental Code and not to place the systarn in'oparation:untiLa Certificate of " LL 1.: Coi�ipiiance has been issued b its Board a Date - Application Approved by D'atc Application Disapproved by — for the following reasons _, ..., Date " PenntWo Date Issued TT' nnTMONWEALTH OFMASSACt(iTSE STABLE,;MASSACHUSETTS ertifizate of Gulp ancc '. cage Disposal system"Constructed(i�) Repaired( ) Upgraded( ) �Q�_ has been'const' e a acc`dj r ern Gonstruetioa Pennit.No� Y i Dasigner, Ap77777777 proved design Clow r a ��11AAA uarantea tlint the sq ier�a will function as desip�n Inspector 4 � Fee YWEALTH OF 1"SSA MUSETTS r a AON-BAKNSTAE3I,E,MAS5AC1ILiSFTTS J IpO � pte11Futt' tfttCtlA�lterntit a Peunssiop is�hereby granted to Construct a y In R �U , .. Re air( ),. Upgrade( ) Abandon'( ) i (K.' S ste" located at 8�' and as described m the:above Application lor`>ltsposal System Constnaciion Permit.•The applicant recognized his/her duty to comply with, Title and the foltowuig,Iocal provisions or special conditions. @rovied:Canstitictian must be completed within three years of the date of this permit. Data Approved.b} . Y d T wn of Barnstable: P# Department of Regulatory Services * �"ublic Health Division Date / searisreau. >; II 7, '.q 200 Main Street Hyannis MA 02601 4., z r .� x ,1 ':,.,� .,; *I -," .'4 1 �;c. _.P�. h�i 4t ,�,,�,,.��� I,_,,�iIT,��:.II;!11.'.,,,I1'I,"I f.�III'_,����,,�I.. Date ScheduledV Ttme Fee Pd. �'®d ��,�-". I.II'.. I;l1,�",,t��1�I.. t; r Soil S itabalzt ��lssessment for Se a p ` tI r �� ! t nip, �— i�;z f Ii r Performed By vi�i v O Ir uu6a VGc�%VQ6`1„9 Witnessed By a,.-v t :!j u:, - a: L OCATION& GENERAL INFORMATION , t—,`" }, Location jAddress i � A 1_1 Zy). i , , Owner's Name �N6 c-I S H �,Z , f �r_ p )} Assessor's Map/Patcel �Z 1 S, ,:Q I . Engineer's Name v�i_t V µ n-k iG 1 w C t �^ �4 `,r 1 �I ;. 1 1,i,1 , �t7-� NEW CONSTRUCTION,1 REPAIR"I'a ''x'i};;y r Telephone#,, ,. 21 .` i 5r -e "; �, IYi, { 1 i. 4j�.;., -,��'��. �'r�.Cfnl� F�a!j�'. :i 3 ' i , Land Use __a /1�l ' I 't s =11 Slopes(%)`foc`!a $[s.�+vd�It rfaceStories Ns 1 } i ''. t1 Ir I"x !'! �'^► �- tl iI r'x ..', '1} E I �',� ` ! % "I .r -11 Distances ftom,.Open Water R I (3 x�ft "Possible Wet Area(W. (tdt��Dunking Water Well I I'I ft 3 I. ! a 4 5 � t?S t r" k� i 1 �. ;} Drainage W y 11 /V I 'ft 'Property Lme �S ft Otlier«. i ft a � i r i i N } 4'i y � : r i, I p } SKETCH (St<eet name 1 dimensions of lot exact locations of test hobs&perc tests locate vVetlands m proximity to hole's), i I' , f `I �f ai ! ' Y d ' >� l� !f I C s , 1 1 G yy _' I{ Id t 1 v , II h a 1 ! i, 4' i �ilt I i �': , - i�I s -�" I.,�, .r�.I;-I�.,�.tr ,�,k"F�,�,�.,',6:.::"��.'`�,,:.f--1, I' J T i r 1 p t� 1 1 t 7 s � :ff �'1. I {! {' xt f . .i31 Ir ! � �L q�, f i t,,;.��;;";1,",::.r,-,-�;-LL"..�,-:�,,1-,::�,�:-�h,,:1..1-�t,,�-,-_,'I,�n�:",,.","_0,�','_,�_,"�,;.:-�,I,."--.',��,—,-t,:,.�,1�.,I,,�i,1`,,��'�,.L'"I;;,.,,j",,,-I"�,,.I1;,,:,I��.,f._,I:.' I, ,1;. i 1y I 11pt ul 4 ,• M.?C,� f ° —; u ,,t,; ,_n zr� liil 4 `-� S r s t , �/� r l•^/IL t r a� ,,, f I t t II a a,z x'>i ,f's. � i� ! , r f i } t.,.� ki. ''- r lj ,`J J'- I i.,, I s 5 ,�I '�' j z �iC � a a, t ,�i1 L.rj.. C—: I - �. r ; { t :I + �, w , q. gg ;, } Y Li i' '2 }S t" i ' 4 1 � �� r r 'r fil� l 1 r'1 '1 11 f Et II sl W ! s a, , - t t a .y r, ll '+ t J, �' i i [Ri rt i i h ( } 1 C _ i _ lli r 4 �I �' { t i i R i ;i I i� i - 3 1' y '4 4 'I{ fS i 3' #r` I s r i ' I y 4Et { 3 } . I Y i �: t i }7 r AV I 1 is r ,si ( f { ¢ 1,fi 7 3 �I� J ! t ( r k f` 1' t 3 _r,, t it X _ i y ' j I( tj ! ^ f f I , 1 i I p r �1 r t =d < A' s I 1 1 "h h I a 4 t� � 41 9 _� $ �:� ♦ A a t i t!. t � Parent triatenal(g logic)i I I �' }, c "1 I rF f g r 41 } , a ' DeptR to Ck } �� "r� 4 s c `" '�, �!r 114 !f , �I r ! II l,� �i , . r '.I { t rl �� I .is r _ <z § rt it,?i i.� �,�' ! ` r " s Depth to Groundwater Stand g Water`m Hole "ga5r Weeping from Pit Face N L — f rx 1 I u' Estunated Seasonal High Gr� nawater; -1 , - _= r ,t t i I� I r } a } vi t 1 4,��tr. dal ��,�a' .i,L. ! a 4 i _11� Y►J�`�f��(�C�i SloI� S)ii�, :: 2 �4,I rE av j DETE NAfiIO 'FOR SEASONAL HIGH WATER TABLE M, I, ,d sedl i i , �lilIC i { 1 ' in s Depth ;Observgd� dmg,m obs h 1.1 t , - an Depth to soil mottles �,)� �in . Depth!to wee ih bm'side of obs� le �ry i!'s i ��;I`` in ,i Groundwater Ad ustrnent= , I ft " Index Well# 1 "::I `1'Rlea l jjba.i"I s I' Index Well level` $'1!M factor 'I AdI,Groundwater Level � - I t.11 .IC4I.. tl ( .il.[ °-� �I�I�1., ,xr;, �k�. I�4 91.II .k I i t ( PE COLATION TEST bate Trine ObservaYfon I r i {t { ' I� e t a -�r { Hole# '_ {i' Z , a ; Ttme1 at 9 ' # .t d:',1 Dth of Perc f ! ' �' '� r ��1 Time at 6 i �1 1 �' E y Start Pre soak T el@ I� °# i l ' t_ }4 Tune(9 6 ) i � r End PIe SOa1C{ rr ¢ "i ' !a I 1�!%iy;�� " r . !t a n i 7x w I ,{ i l l 4 r ,f I (� 11_I i t i IF i }!1, 1 �3 Ratelltin/InohArai "i ,�i�E 1i M���I ��. } =� ��. �� /,', Site Suitability Assessment)'x to Passed �! Site Failed Additional Testing Needed(Y/I� i. Tl t I or,gmai Public Health Division 1 , 1_ 1I Observation Hole Data To Be Completed on Back -- 3 ('., ! "4.1, ***If ercolahon,,a is.to be con'I'dII .within'.100'of wetland,you must first not>fy the :., rr: 11.s- I ,, I , Barnstable Conservation Div►siol at least one(1)week prior to beginning. Y ! 1 - x , Q ISEPTIC\PERCFORM DOC 4 k s . . f'n. { , If i }{ A { ! I �_ j { . „" a .. ,,., . tI `' --DEEP OBSER 4'171ONHOLE LOG Hole# Depth from Soil Horizon Soil"Texture. - Sod Color: ,-Soil, � Other Surface(m) " (USDA) , (Mansell) Mottling'>(Structure,Stones,Boulders. F.�_ t Consis enc %Gravel . . , Z�-�Zv L� .� _z, \ �� � a 1� � b e' I f i ;. II a ` DEEF11 BSERVATI�(?NHOLE LOG Mole# _ Depth from Soil Ho' n Soi�Texture Sod Color Sod ', Other Surface(m) ) ,` (USDA)#',' (Ivlunsell) Mottt�ng (Structure Stones Boulders f �, '. - ,:'. . I Consistency i:%GraveD ` �i_�y r e" { ) F11.i! - A i S• d } $ e r ¢ y . q , 33 ©, , � 1 ' � , ' �ti: 1 r'� d h 'b ; F ;-. i {{I P t{{ fU 1 H o ,: { _ Isi s I{ LI , t - 1 .i t - f.." , f .t r1 `^� a aI �'�' -., ., .. t DEEP,, BSERVIbN HOLE LOG Hole# � Depth from , So>l Hoiwn , Soi Texture Soil Colon Sod Other Surface(m) 1 .`._ 4 ' r l '` (USDA) (Munselt); Mottling R,(Structure,Stones,Boulders.f ` ( i, '" " Consistency.%Gravel) �� P ! �, � i� ti" ',.�. I 4' I In'. ,� i �, S 1- :::I. j i i -J� . k 1 . i` f I :a ' ' 3®_ Z® ;. 3 i `.; E f� , ' I ' A j ;. ,k - t I t "�{;t � ,l 1. Ir i r - f. i y y� k , "A � ,i {I } II 9 , .. till...-h.F I P,II I E.I I i 1 ,.d I f� [ .. .`DEEPI(I$SERV TION HOLE LO,G Mole# -� Depth from _ Soil,He �zon 'I Soy' Texture' Soil Color ,Soil . ther r Surface.(in) - ,, , (USDA) (Mansell) Mottling ,(Strocture Stones,Boulders 11, 1 , "' .. ,h\ p, .,{ "1 f ,.:nH Consistency!''%Gravely 1 I l I_3i ' IgtI + i ., f ,",� ;, `'� k 4 e I I { { � r+ II ,. ,i..i, ,I, . .. , � s 1' r, P " �� I� t III i i I• it ' I F 1 g. �*' S -' C ` H111 ; :: � tl... } .i ti "' 1 `'P nr '.r I{ ' 1 ,1 t 7 II a� I I;t,;e r I E 1 3, If. € k yE i i 1 v I t't1 1 ,i,iHI �,-,4, r�II I t t } ixt I Ih ,S , tit F t i �I; 1< i Flood-IfisUraIICe�Rat� a fl l �� 1 j jr #td ' ? } �� F �� i ( I l,f�I �1 }Ii;jF I .j �t SI 4 r� I 1 �" , Above,50Qy' j odboiindary [j�L Yes et�`u� �9 JJ� ;i G {I b -Fes Wittirt'1500ye1,b 1 dary,I{ No ,; Yes i/s SdQ�Ir�r I} � T z I ,1 I'I :I', r� '' :° i� II Wrth�n 100 year fl od boundary N� I ��I 1 j Yes l!✓ a r'i 1 'f1 I I1 O 11, ii tI f 1 , "� 1 " € _ {��� { jI�'�I II t� ;I. 1•- IIII C i3 § x 1 � I P De tli'of Natarall c urrin EPery us Material } '. „ • > ; ' II l" Does at least fourlfeet b naturallI Oc rring pervious material exist in all areas observed throughoutethe area 'io osed for the s 1 abso[Ption. stem?.' 1 i; ,. �- fn' ri i,11 JI1 .J I ,; —" �� } 1 4 L' If not,what is the depth of naturally� �urnhg pervious materiah g r „Ili ' a R or ,Certification- , G., i L , I { b , 1 certify that1on ;6 i 1 (lddte)I have passed the soil'e taluator examination approved by the ',I lli Department of Enviro 1 I elntal Pro�ecti�n.and that the.a above analysis was performed by me"consistent with the required training 1 e ,rtise and experience described m 310 CMR 15 017.'_ Signature I {; Date I e ,'s r k "I, t s -:' ,1 r Q:\SEPTIC\PERCFORM!DOC �� � _i , I r " 1 5 I S� `4 t _' ,I k 9.ti I I I i COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION U� TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION f Property Address: 81 Sand Point Osterville, AM 02655 _ Owner's Name: John Fish, 579 Owner's Address:. Date of Inspection: Mav 24, 2007 Name of Inspector:(Please Print) James M. Ford Company Name: James M.Ford Mailing Address: P.O.Box 49: Osterville,MA 02655-0049' Telephone Number: (508)862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the.time of the inspection. The inspection was performed based on my training andexperience 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: r•� —; ✓ Passes �-- Conditionally Passes ` eds Further Evaluation by the Local Approving' 'thority r ? a is Inspector's Signature:Signature: Date: Mav30.. cm The system inspector shall sub ' a.copy of this inspection report to the.Approving Authority.(Bo d of Hew& rrn 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 regiona office of the DEP. The original should be.sent to the system owner and copies sent to the buyer;if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. I Title 5 Inspection Form 6/15/2000 page.1 Page 2 of 11 v OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A . CERTIFICATION (continued) Property Address: 81 Sand Point Osterville. MA Owner: John Fish Date of Inspection: May 24 2007 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D 3 A. System Passes: I have not.found any information which indicates that any of the failure.criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system,upon completion of the replacement or repair, as approved by the Board of Health;will pass. Answer yes,no or not determined(Y,N,ND)in the 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. ' ND explain: 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 obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced ' obstruction is removed ND explain: 2 i Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 81 Sand Point Osterville, MA Owner: John Fish Date of Inspection: May24, 2007 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 CAM 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 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 aseptic 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 and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 81 Sand Point Ostmille. kM Owner: John Fish Date of Inspection: May24 2.007 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No _ ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool.is less than 6"below invert or available volume is less than %Z day flow ✓ 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from.that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)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 System:. To be considered a large system the system must serve a facility with a design now of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No 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. 4 Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 81 Sand Point P Y Osterville. MA ' Owner: John Fish Date of Inspection: May 24, 2007 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? P ✓ _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? ✓ _ Was the facility owner(and occupants.if different from owner)provided with information on-the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: Yes No ✓ _ 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(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 81 Sand Point ! Osterville. MA Owner: John Fish Date of Inspection: May 24, 2007 FLOW CONDITIONS, RESIDENTIAL 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 gpd Number of current residents: 0 Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system(yes or no): No [if yes separate inspection required] Laundry system inspected(yes.or no): No Seasonal use(yes or no): No Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc..): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to.the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Unavailable Was system pumped as part of the inspection(yes or no): 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) Tight Tank Attach a copy of.the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information` Installed in May 1988-per as-built card . Were sewage odors detected when arriving at the site(yes or no): No 6 ,a 1 Page 7 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 81 Sand Point Osterville, MA Owner: John Fish Date of Inspection: May 24, 2007 BUILDING SEWER(locate on site plan) . Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 4.5' Material of construction: ✓ concrete _metal _fiberglass polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1500 gal. Sludge depth: -- Distance from top of sludge to bottom of outlet tee or baffle`. -- Scum thickness: Pt 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: Measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related.to outlet invert,evidence of leakage,etc.). Tees were present. A riser was installed on the inlet side of the tank. The cover is now 3"below grade. GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete metal _fiberglass _polyethylene _other (explain): ri Dimensions: Scum thickness: Distance from top of scum to top of outlet tee.or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recommendations, inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): I 7 Page 8 of 11 OFFICIAL INSPECTION FORM-.NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 81 Sand Point Osterville, MA Owner: John Fish Date of Inspection: } May'24. 2007 TIGHT or HOLDING TANK: None (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Even Commnents(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.): The D-box was level. No solids were present. A riser was installed and the cover is now 3"below grade. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alanns in working order(yes or no). Comments(note condition of pump.chamber,condition of pumps and appurtenances,etc.): P f • Page 9 of 11 V OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 81 Sand Point Osterville, MA Owner: John Fish Date of Inspection: May 24, 2007 SOIL ABSORPTION SYSTEM{SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain.why: Type leaching pits,number: ✓ leaching chambers,number: 3 flow diffusors w/2'stone(per design plans) leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool;number: Innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): The flow diffusors were dry and clean. There did not appear to be any signs offailure. A video camera was used for the inspection. The bottom to grade was S'.. CESSPOOLS: None (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 or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSALSYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 81 Sand Point Osterville.kM Owner: John Fish Date of Inspection: Mav 24, 2007 . SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 1.00 feet. Locate where public water supply enters the building. I-A a r 3 a� 30 10 Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) ` Property Address: . 81 Sand Point Osterville, MA Owner: John Fish Date of Inspection: Mav 24 2007 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design,plans on record-If checked,date of design plan reviewed: ✓ 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: On last inspection hand augered down on the lowest elevation and water was observed at 9'below grade on incoming tide. There is no high groundwater adiustmenYlor this site This report has been prepared only for the septic system and components described herein. This septic system has been inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the septic system, the inspection, this report and/or any components of the septic system which have not been located and inspected. 11 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION CEN EI TITLE 5 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTA Y �SS S SUBSURFACE SEWAGE DISPOSAL SYSTE8 PART A CERTIFICATION Property Address: 81 Sand Point Osterville, MA 02655 Owner's Name: Bob Vila Owner's Address: Same Date of Inspection: July 5, 2001 Name of Inspector: (Please Print) James M. Ford Company Name: James M. Ford- Mailing Address: P.O. Box 49 Map: 073 Osterville,MA 02655-0049 Parcel: 015 Telephone-Number:. (508) 862-9400 CERT MCATION STATEMENT I certify that I have personally inspected the;sewage disposal system at this address.and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title.S(310 CMR 15.000). The system: ✓ Passes Conditionally Passes Nee4Cfurther Evaluation by the Local Approving Authority Fail Inspector's Signature: Date: July 6, 2001 I The system inspector shall sub 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: s Notes:arid'Comments _ ****This report,only describes conditions'at the'time of inspection and under the conditions of use at that time. This inspection does not address1ow the system.will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 • i Page 2 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property,Address: 81 Sand Point Osterville, MA Owner. `; ,�F; Bob Vila _. Date of Inspection: July S, 2001 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system,upon;completion of the replacement.or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"notdetermined",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. ND explain: 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 obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(sy.' The system will .._....__.... .__pass ins ection if with a roval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 81 Sand Point Osterville, MA Owner: Bob Vila i Date of Inspection: July S, 2001 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 2. System will fail unless the Board of Health(and Public Water Suppher,if any),determines that the' ,.,system is functioning ty in a manner that protects the public health,,safe 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 I of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supplywell. _ 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 systeir,passes if the well water analysis,perfo►-med at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: j N Page 4 of 11 OFFICIAL INSPECTION FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ;CERTIFICATION (continued) Property Address: 81 Sand Point Osterville, AM Owner: Bob Vila Date of Inspection: July 5, 2001 D. System Failure Criteria applicable to all systems: You must indicate either"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 cesspool is less than 6"below invert or available volume is less than '/Z da ✓ Liquid depth in cessp Y flow ✓ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped ✓ Any portion of the 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 Lof 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 coliform bacteria,and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] No (Yes/No)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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd- You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No 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. 4 f Page 5 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART B ::CHECKLIST Property Address: 81 Sand Point Y ' - Osterville, MA Owner: Bob Vila Date of Inspection: July S, 2001 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 backup ✓. Wasahe site.inspected-for sigh's 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:' Yes No ✓ 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(3)(b)]. 5 Page 6 of l l OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 81 Sand Point , Osterville. AM Owner: Bob Vila Date of Inspection: July 5, 2001 FLOW CONDITIONS RESIDENTIAL 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 Number of current residents: 0 Does residence have a garbage grinder(yes or no): n/a Is laundry on a separate sewage system(yes or no): No [if;es separate inspection required] - Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Approx. 2 years aJ;o COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of,design flow(seats1versons/sgft;etc). Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: None on file-per treatment plant Was system pumped as part of the inspection(yes or no): 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) j Tight Tank Attach a copy of the DEP approval < Other.(describe): ; Approximate age of all components,date installed(if known).and source of information: Apr. 5188-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM-INSPECTION FORM Y '= PART C SYSTEM INFORMATION (continued) Property Address: 81 Sand Point Osterville. MA Owner: Bob Vila Date of Inspection: July 5, 2001 WELDING SEWER(locate on site plan) ' Depth below grade: Materials of construction: _cast iron _40 PVC other(explain): Distance from private:eater supply'well or on h sucti :ne;' Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: S' Material of construction: ✓ concrete metal ,_fiberglass._polyethylene ' _other(explain) If tank is metal list age:............ Is.age.confirmed.by.a..Certificate of Compliance-.(yes'of':no):'� - (attach-:a^copy.of certificate) Dimensions: 1500 Qa1. _:;t. , Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle:.. 30" . Scum thickness: S" Distance from top of scum to top of outlet tee or baffle: 10" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: Measuring stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): The tees were present The liquid level was even with the outlet invert. Recommend installing risers to bring covers within 6"ofgrade The cover was 30"below grade GREASE TRAP: None (locate on site plan) Depth below grade: Material of construction: _concrete metal fiberglass _polyethylene _other (explain): Dimensions: Scum thickness: Distance from top ofscum to top'ofoutlettee or baffle:,,, ... .... . t. . Distance from bottom of scum to bottom of outlet tee or baffle: .__ _. „x , Date of last pumping Comments(on pumping recommendations,,.inlet and outlet tee or,baffle condition,structural integrity;liquid,levels as related to outlet invert,evidence of leakage,etc.): 7 Page 8 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 81 Sand Point _....._--..._.... Osterville, AM Owner: Bob Vila Date of Inspection: July 5, 2001 TIGHT or HOLDING TANK: None (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): _:DISTRIBUTION_ BOX:,. ✓ . (if present must bp opened)(locate,on site plan) Depth of liquid level above outlet invert: Even - 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.): The D-box was level and there were no signs of leakage or solids. There were no signs of back-up or failure from the leach field The outlet invert was approximately 4'6"below grade Recommend installing risers. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 Page 9 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C `''"''"`"'-' SYSTEM'INFORIVITATION (continued) Property Address: 81 Sand Point __ `- _-... .L?:.. ..i.e__ - '' "•" '" Osterville, MA _..__. _.. . Owner: Bob Vila ..,... t Date of Inspection: July S, 2001 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: , Tyler leaching pits,number: ✓ leaching chambers,number: 3-flow diffusors with 2'stone(per design plans) leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: _. .__w .. .. ...- overflow cesspool,number: - - Innovative/alternative system-- Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): The flow diffusors were located but not duQ'ut% -There werefno`sizns`of failure..inahe.D b'ox.9 The'bottom76"1 Bade was approximately 5'5" CESSPOOLS: None (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: r Indication of groundwater inflow(yes or no): Comments (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (locate on site plan) Materials of construction_ : Dimensions: Depth of solids: Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C ,,SYSTEM-INFORMATION (continued) Property Address: 81 Sand Point 1 Osterville, MA Owner: Bob Vila Date of Inspection: July 5, 2001 Map: 073 Parcel: 015 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. �ronT . ga- ;n c� A3- as c� 0 0 3 10 Page 11 of 11 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ,.:t ''W PART C SYSTEM INFORMAThON (continued) Property Address: 81 Sand Point Osterville. MA Owner: Bob Vila Date of Inspection: July S, 2001 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indicate (check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked, date of design plan reviewed: ✓ 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: The bottom of the flow diffusors to grade was approximately 5'5" Hand angered down to groundwater at a lower elevation on the lot Water was observed at 9'below grade on the incoming tide. There is no high grouti&ater adjustment for this site. F This report has been prepared and the system inspected and passed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied, relating to the system, the inspection andlor this report. 11 f l� J: THE COMMONWEALTH OF MASSACHUSETTS r-, BOARD OF HEALTH QLU.i�I----------------- OF.....I?�NZJA.S`� &---............................ Appliration flax Disposal Works Tonstrartinn 1hrmit Application is hereby. made for a Permit to Construct ( 16<or Repair ( ) an Individual Sewage Disposal System at, 0'I ' ( 149 f • ... .................................. --•- ---............ Location•Address / or Lot No. ..... ..... I Q....S?l�.i�A1.._.._.14 413(................... ............................................................:.---.............-----............-- Owner Address W Installer Address Type of Building Size Lot...........................-�ct--feet Dwelling—No. of Bedrooms___...`.Z..�S ...l._�' 1-..Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures .................................................... W Design Flow....................5.!C..............._.gallons per person per day. Total daily flow......................... -®.....gallons. W Septic Tank—Liquid capacity`.50.gallons Length................ Width......q-------- Diameter................ Depth................ x Disposal Trench—No. .....1............. Width....I ......... Total Length.....k.CP....... Total leaching area....f.(23!..sq. ft. . Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( Vr Dosing tank ( ) r Percolation Test Results Performed by.._-BA)CT§PZm.. ...Q.&........................... Date......11.1_Z���............ aTest Pit No. I.....�L......minutes per inch Depth of Test Pit......i Q....... Depth to ground water......4'-t.l........_. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...................... a ........................................................ -••..............•••-••---•---------•---••-•-•-••-•--••••-•••---•--•-...............-•-••_..... 0 Description of Soil..............................................•--•-----•---••---.... -- x U •••••-•------•-•••-••.............•••-•-••-•••L .!�------ ....------ .. M...... ..................... ......................................................... ...............---..............-•••••..............-...... ..............-.............. .......................-••---............................................................. UNature of Repairs or Alterations—Answer when applicable-.--..................................M.....................M.................................. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'JIliE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beeA�ssueby bo ealth. Slgned---•-- '. . .......•--.....-- ---�--Date ..._».... �I Application Approved By.......... ................................ -----•-•- ... Date Application Disapproved for the following reasons:...........-..................................................-..................................-................ .................................................-.............................................. ......------------------------------------------------------------------------ ...................... Date PermitNo......... ��-^--J].......................... Issued_.............---.....................................,,.;w"' .._. Date S 1 THE COMMONWEALTH OF MASSACHUSETTS FRic BOARD OF HEALTH .................OF. ApplirFation for Disposal Works Con rttr#iu t r (rraati# Application is hereby made for a Permit to Construct ( �or Repair ( } a,n Individual Sewage Disposal System at: .Location-Address - or Lot No. Owner Address W a •••....•---•--•-••-•••••••••••••-•...........•--•-•...•---•••••--•...........................•... ••••-•••••---•------•••.....................••••••................._...._.................••-••••. Installer Address i d Type of Building Size Lot.....................-..-:-.=�eet ; Dwelling—No. of Bedrooms.•...�.".�SE.....................Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type of Building ............................ No. of ersons._:'........................ Showers — Cafeteria Q' Other fixtures t1l .----••...................•--•-. - .. --------- W Design Flow....................5.i_................gallons per person per d. y. Total daily flow.........................13.v.....gallons. WSeptic Tank—Liquid capacity 1.•5`-1-j-0--gallons Length................ Width_-----r........ Diameter................ Depth................ x Disposal Trench—No..................... Width---.. ..........Total Length......-.�r->-'-....... Total leaching area....h��-.�..sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area................:.sq. ft. Z Other Distribution box ( f/')� -" Dosing tank ( ) ~" Percolation Test Results Performed by._.....................................'�-� ' � ��'• ................... ! 7—t�?-7_________... ..-•-•• Date•••••.d.............. . Test Pit No. 1.....�-=......minutes per inch Depth of Test Pit.......4 ... Depth to ground water.._._.° �. a...___.. f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..................... a ........................-.................................................................................................................................... ODescription of Soil..................................................................................................................................................................... .. c� -------------------------------------- •----------------------------------------- -....------------.--.-•--•--•--------------•-------.--------------------•-• ...... 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 TITiZ 5 of the State Sanitary Code— T e unde igned further agrees not to place the system in operation until a Certificate of Compliance has b�ii issw,ed y the health. Signed................ ...... ........................................................ ................................ Date Application Approved B Wit. 11................................... r� Date Application Disapproved for the following reasons:................................................................................................................ -•..............•••••-•-•--•-•••----•-•••........••--•••-•••---•-•••••••••----•-•-•••---...---•••••-•-•--.....-•••-••--••••-•••••--•-•••-•--••--•••••--•--•--•-••-••--•-•-••••-••••......---•--...._.._.. Date -•----------. Permit No......5�.�...��-------------------------•--. Issued.------------------------•-•- ---... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH __- l.il .}# .........OF.... ' `� .. r. 1t��i.. "J,c. Trr#if irat a of TontpliFanrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ' ) or Repaired ( ) by. R ......... Installer ...............•........... .�.. �Io at............................•-.••-• •••......•••. = 1 ................................................... has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.... ?S.":_./f................. dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE....................... 1..�1�.:-_:.L ................................ Inspector............... ................................................. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH D �l� ?4.1.1 +........OF.......... No0 x .4. ..►. .3..s.1 �� €�...................... ......................... Disposal Works T-PaInstrudion Uprrutit Permission is hereby granted................•-------.......•...........-•-.•-•------••-........--••--•-•-•-•••..............................•••••.............•--••-...... to Construct (V) or Repair ( ) an Individual)SOWage Disposal System at No...................�C. .....lei. ........c r .......L CI 1 r:'••-- 1-- �•'I:r t r qr r¢ , Street 5v as shown on the application for Disposal Works Construction Permit NO-&.......... Dated.......................................... ....................................... ........----.....----••-•-- x�.- -- and o Health DATE...............................................:..........................•••••• FORM 1255 HOSES & WARREN, INC., PUBLISHERS -C' TON VA OF BA.%N TABLE -1 L&CATION SA►�C D i n� SEWAGE # VILLAGE OS,EfVtl� ASSESSOR'S MAP & LOT 3 INSTALLER'S NAME&PHONE NO. A o 1 Fe- SEPTIC TANK CAPACITY t50D Go) LEACHING FACILITY: (type)3' Y%�dw %1�' USS��S (size)a ST'0^1— tax 1110 NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: / COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of JeachZ facili� lel r l Feet Furnished by., S �- S Ti(a-j J Y OrC d i ci lJ v t4 �T C -- - �� TOWN OF BARNSTABLE LOCATION �m�� . SEWAGE # 9(3// VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. hmz CO'AK't-, -3j76 SEPTIC TANK CAPACITY LEACHING FACILITY:(type) FQ-5 (size) X/j NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER &&/ T BUILDER OR OWNER dB IL�9 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No �' r- a�T <r� cry^ o\� �_ �� ti -:'.2013',13-22 Sand Ro;nt !taster Flan'•,13-22 Grawrnp\Guest House''.SD VI-New Guest House-(larch 2.8-aec . I � y _ - n m z - 'I I'M I oz I % - _ ! - I .. - ------------- .. :• I \ X D ' -- - I i O A ___• LD3iJa -m --- ------- a % _ Q - - - D A .. .. • m :. a o A E, - N . . I Is A - z m. A ,m ro .. - < "D J N X = i j - I eve leNax. I, r 'm I Il El :I Fin I I .I 1 I D -1 -'-- D In m _ 1A I I.. I I - I I A 3 II II - _ —r--- In ------ _______ ______ ____ --- ----- II = aA do6= II. .m e a v W - _ D �A �m 0 A C " I •a m m m m °y ©2014 Saltonetall Architects. These drawings are- - �'+. D 5 S 5 5 copyright protected. These CARD documents are - - �' _ z z E O la 0 to !�. recorded on,or can be transmitted as.electronic -SAND" POINT MASTER PLAN - - - p r1.m z z z z media.They am therefore subject to undetectable - 'p �1 m- alteration or erasure,either Intentional or unintentional ,n due.to,among other caused:transmission,conversion, ��--��_/7 CQ,�, ,,,.1.. /�` Lt +- - •S = media degradation,software error,or human - �+- r-+•1 Lem n -` - JaI��Il A Ql Ut�.`t3 .. • m m alteration.Accordingly,Saltonstall Architects shall not I ' `ND O�'N'�'� �O D - -- r x be held liable for any claims,losses,damages,or costs N arising out of any such alteration or 8 380 W..h—Street Merlon,MA 02r38 �. unauthorized re-use or modification cur these OSTERVILLE, MA 1�• m 0 908-140-104) 1.506-748-2330 CADD documents. - - s...ntonamlwms•c—m - ZA2013-.I3-22 'arid Point-r1a5ter F'tanV3-22 Drawin s"Guest Hoes.`•.,C v1_Mw C uest House'-March 28.aec. . A D - r - • O O n - 2 20 - .. - ... -Q O D I . X = 70 KXeeOALL O- R O C oftu. _ 50 ° Xm IL' Li o o --- -------- -- -, m r ---------------- z. 6'-emu 7i° n C KXSEMLL C KIffEe . O ' z bon i O -.�. z ..ai > ©2014 Soltonstall Architects. These drawings are - - a� z E 5 to , 5 copyright protected.' Thera CADD documentselct am SAND POINT MASTER P L A N z z r 0 0 0. f0 recorded on,or can be transmitted ae,electronic o o n m i z z z media..They are therefore.subject to undetectable ■ m m alteration or erasure,either intentional or unintentional c� • �� due to,among other caused:transmission,conversion,. - Ja�I�n$�II _A_�6p�„/,. W a n media degradation,software error,or human Ja Archbots 9 S = alteration,Accordingly,Saltonstag Architects shall not � �81 S'A N D -:P O INN T R.O A D ■ - E`F be held liable for any claims,losses,damages,or costs arising out of any.such alteration or 3e0 wean Slraat Mrnen,MA 0273e I y m onauthor zed re use or modification of there OSTERYILLS, M >e0e-� �1 4e roes r.sae n »e 20 CADD documents. - .s...mta,naima,nert.rem ' -c-?�sT�t r•3vTtO�,.� Pia � I y� IZ` $ 3 I ��►.It TO SC 3�TU'�Gz�,aSti I ' VO ► 4' I� 4' t 4( i I � i 2g5s 14 \\ or ( � 1 ISH t � ` l� �Tom'-- "'� '".� ,,� � � �� "•-.. `'�..�� � `. � G T� FN� - fl,s , F`_ Azvt�rsSt , ` Vz"oat, \0 s y y r I r . s.. P f 1 � + 1 � •1� .tC/ fc� •'� / ato X 3�b E�w -�1� :� � ,t U t� S�'1G�1JK. '. 3k t I O x• 1�5or6--_ �495Cz�i. Q , . _ _ 3 L t=-- C_t l rr L'� -L�5 z 1(o k i 2X ��F— �c.l. t( 1�-t,�2-t\2 r,oN \ �h.`,A `4" \ �N</ C►t��1 . o �-T-sa�il to cIr Ile A' /y Y � _ -To N `- : � Piz opvsv� sox l4AT Tt�ti= t� e�C.e.i N(� S}{G�IKI ! � C.. rLT 1�`( 'Top eF Cam 'RCUwt5 i� �Z�a►.l AMP `t5 �! -4`n�� 6�'���N A?a� ��I / �"� ' �� • .t;, \ \�\ \\, �� / EL IS',� NGUt� 6�'r`"r'S�GK R�G?U t��NtE"1.rG'j aF'�E�"a'vc[1.1� • .� , � � � A. NcI. 2 t3a -mot `:R �k ,s x Pf 67'7 2 -:WC=_14, cr Fiji)-IS•S 5A 4 Sc ?V c- S Ssok. (600441- 6 tNY �• SCE C.� l ''=='LD l�oU 1Z lie'7 r x ta,5 12�u• l2 (Ia/P? LANDSCAPE 06TA(LS F- +Z,p ) 1 NV 1 tiY t NY -T'rai.a� I My -; y -` 12fZq,, SC-PnC Moe? l� N, Ct �1 l .rr��.�.• 1Z.c�tST�.+L-�I� �/3�1�� Sr1�L�'�c;.fy +��; To SAve 18"oAtc.. 4-1 5. - G I V i I. L>JG t QS \-41Eu. —7J�c!- 8� ti4� �=- 1.2 --- us► CIVD a a. -TIC) afl 2 3T L \ki 'r>►l7 Ft,..►S50 e,S 6F-7 t2 $ 3 s N 1L To 3 E g 1ama Gash 1� I, i 1(D` • I I �p GL -3 d r� i I L G7 ry ti� IL m Ll v44� } . - N REUXAT � L oS NOD ji4. C n Q t f r tl a` `'�, '` c� V l�.�tUC` tc� -1 3x atb X - 330 Ezr"•'D AD Ly Sic—W,&i . . 3x I I o K. +sow- w h r t- Lt��1 E(_:Z) -J6 F- (fl X I Z)(,1.5• �� I /l \ ' a +a m W n\ ,�, :r� r ;��. �' � ;.s 1 S r v,./ALt,._ C1 Cps-1(a-�t2-r\Z�xt•S= St= � to V)-N* y� J� \ `�� r' ,; '°•S �t�-i-sue 1 Ca �:�Z= 1925 _ i \ = ram TA14 L, P¢OP0,5 I Q , N i �,, t, I�QapvS 1,� � � � � � x _ � ) G..�2-ri'F`( 'Tt�AT Tt4•E �.ti��C.c-�N� 5}{v�lhl CF CG�I ��YJIe'� ���Z�s.1 �'t''rPt-�5 iT{-�"Ct�� •6t'DU1_tN5; A�1-k) ��� /` --________ i %\ ,\`a 4 EL= 1�,� N�.v� 6�`"2�� R�QL�+�.�Nt�� �F�•E�-a.ut-1 � 6 � � • 2 \. - � L7F $A 21J5T✓a 3l..c. r�tiR7 15 1SCSC' I � nb'oAot- � -4,� . ( _ '`''�•_,� k 1txe-'�`r7 �l+T�•t Ir.1`"C'-F•�� �►..�'V`!�-+`acts. y � �1 i env 2. i�i e, ��T Ei -1�csr lrsvYt?; I o� "0 a i 1 CAl ^' " r. \� igrY ?. C- 1• 14- _ t P-6'7 rl 2_ F_D = 1s' �, --- a �►.n, tSS c� �c) 1-l'D 1° iNY �•• �C,'� L ( `L1� I�oU to.S IZ�V. 12 �►a/O'l LADXAPF- DeTmLS E RQ/• IgZg6l SGFPC. MOVED to N, s Ci ,a „�, TZ�L l ST✓=t���� L/\ To SAvr 18„o Atic. R+.IA I �Q rA-sTyP \ Beach _ .P r- .� yr, /b � _ d -15 .._._�,-..,-.�,_,y,-, s- I • ,'^ ' - .... ._ _ .•'• ..` ------- a `\ [ _ -- t 71 00 ESOM - _ R t v r \ t t t - 6 +ram •r \ j(\ ,\ M Y Y y Y 0 Y B�Ir'hER Y Y � a Pot;o � Rom,, .:.• '`•: `•t r,•, :,,; \•: �• .`• `,. �.,; `' : . : . , `. \ y k �, AREA � l Location Map Y Lawn a 1t 1 =2000f 'S\ W N. �° \ \3 ASSESSORS REF.: Y # :j : \ Map 73, Parcels 15-1, 15-2, & 16 / Y Y 86 1 1 •l j Y , �� 2 Sty W/F ��y t, j 1 ° Y ` e y' Dwelling t ' f �W Y y., y PROPOSI�D Qt �\ ` "-� °ao ASSESSORS ,`,: is , 'E:�:1:�.V SV% 1 Sfy W�F Dock 't�` \ `\ \ Y v - 1 Q " ' �`'� °y 1. (• F t.. / Beach House 7 , - Y , t t J ` '`��P,S �' fi "'C' i \ `ONE \ o Y y \ 81 t � _ \ r i 1 F=7.8•NOD J (: j j { RF-1 Dwelling PR POSED ,�%' Q �\�� 0� /, �f �, i,. !' I I ` arawolk Area min. 87,120 SF RPOD} o y' TO BE �q�O ``. �� \ i'J: ypq (min.) ( / , Y REM \ ,� /i .� ~I / i < �: r . jgtce Fron to e (min) 20 REMOVED ,�/ S .. ` A � 0t�oi.° LOW? i''.i/.��!:1.�: i � Width (min) 125' \ 1 y Y w ,REQUI ED \\ d� Q°o ' Q };v ; .f 11` 'f t : ' ' : . AL � Setbacks: t09 Y y ,� y Q A Front 30' N Y ` c�w ROPOSED o s ,� \ �' �' r m I :r ,r °[t :�' J' . : • ; , Side 15' Y DWELUNG • - Y\ N 34$' 9 'i \ Q /•j `,Q.i Rear 15 l a C, \ ► � ~` \ 0• 1 � ._ � � - OVERLAY • - J o, � ;� ` ��. �. q�� . � � .;.f � ./. �. � . ' :,: ; . . . . . ,,y. . . . . o� O FLOOD BONE. Y\ _•=-r ~- /' /,9 ~ 9 `�\ Gtiq o ! i 'f !:I r ! r , 1. ✓: : • AP Aquifer Protection District Zones: C , A11, & A13 (see plan) \�\ ' /! ''1 1 '• i %: �' Estuarine Watershed Overlay Community Panel No. -- — — -- _ i o t o, SEPTI \ _ `� �:1•t ` : : : ' #250001 0008 D p , , , try �• •! r,. 1 .�)1:1: Jury 2 1992 DIRECTIONS: "o � yip^ // ,.v. � 1 • � ,1. �!. o' ;� . \ / / , ' ! 1. ,1� f..% t � •,. x y o�° 9 f off- i N / \� t f 1 t !f` f/ / ,� From Hyannis:On Main st. headed West: At Rottery take second exit onto West Main St. Turn oT Op ` ' Y i �\ \� \ or yUD-BOX; Chri en Realty Trust ____ ti �('' r` 7 f Left onto Pine St. and continue into Osterville. t It w "1; ' • / Take a left onto Parker Rd. and first right onto ohn F Fish Tr t t f >�•,` / \,,/ `` ` �XlST1NG 1� 4a�t� y Y / j , - West Bay Rd. Turn Left onto Bridge St. and ' SEk�IlC ; r continue post gate house. Turn right onto North It rl Lawn h/A M 1 1 Bo Road and slight right onto Sand Point. `. Lawn r0 BE l f /,ijr 1 ll i Y 9 9 N / l \ t r one / Q, 1 •\ 1H-s REMOVED ` ./ ' /t / /i - AREA' i ! I rllii J ' �AL / Sites are at the end. 1.01 ACRES // /\,, —2 ,I y Y x— / / ., 1,.. / k Met ^^' 'y "``- •. \ � Of �� � t �• �^ a ` z '.?.•� ,— �. / / +•� t _ __ i // ,�0!f!� eit� pit, o, to Of Oi / K'ak �O / `1 w O i 5\�� ✓�J Lawn ,� t ~ /dv �0 wnl 1 =; 27.7 � v• �y� \ -.� a " --Tg1YK _ _ ' ' A.G:�A1F0 /' / 6 Island IN W''" - 2 St W F `0 �� y1 y / / MAG L S / Dwelling / l z ``_ o FF EI=15.6' Lawn f/ i .- . 5.13 50 BENCH MARK �/!I �'f 5x4 ^ LOT AREA • f AL F r,i Lawn 1.41 ACRES / J f f. % h�\ PER ASSESSORS <<G i l.. ! /0 4xri:If �W AP t �/ r It V. 24 PETER t 1 RESOtRCE: �;,: �. .: / / '•,9m SULUVAN ; Chris'en R T.rut• ~ , ' a ENHANCEMENT . . ` John F Fish : . RESOURCE . �•` . ' ` ' �, " 1 AREA, :/ - _• �, /' . 23 -•/, •Soitmorsh• 'ENHANCEMENT' ' 3 " 'h - \ • ,AREA' . •� / �� r _► i Unregistered w / { a . Lot ' t : ' . : . . : . , . • . , . .1. • : 94Registered `�--- _ • . . � • . f 1 Approximate M High Water Legen(,�: h ' ;� : ' : : : _- -_ _ _ __ __ : : --" '-- --- REVISION: Change BLD at #81 & Change Leachfield to meet fdn setback 12117114 -- - --- REVISION: Add Proposed Septic Work 07102114 REVISION: Reduce Pool Potio Size Per Conservation 04/10/14 • Deciduous Tr e " i ; , �` NOTES: PREPARED BY.• PREPARED FOR: TITLE: Site Plan ' CapeSurvProposed Improvements ` \ 1.) The property line information shown was + Coniferous ree a ��° . � `�r •'"A ° \ � compiled from available .record information. Sullivan Engineering, Inc. - _' _.. John Fish M -o- Sign o ; �� PO Box 659 Light Post t, ` 2.) The topographic information was obtained Osterville, 7 Parker Road At g MA 02655 Osterville MA 02655 65 All ertOn St O from an on the ground survey performed on O Guy o / / / / (508)428-3344 (508)428-9617 fox (508) 420-3994 420-3995fax Boston MA 02119 8 ••86 Sand Pont ` V <>- Utility Pole ` , NI or between 31 JAN 01 and 11 OCT 13. / El CB DH 1 I Asemeno T Dodge 3.) The datum used is NGVD 29, a fixed mean Bamstable (Oyster � MaSS. ~ OHW— Overhead Wires \ .g � sea level datum. Draft: JOD Review: RRL 20 0 10 20 40 so Harbors) 25- - Elevation` Contour ° A SC L — � Review.: PS Job # C-310.3 D TE S Underground Utility LirTe • A E: Z �\ Draft: 22036 Drawin C310_3BGi ex2 February/ 4, 2014, 1 n 20r g #` J F 1 1 i e SEPTIC NOTES 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours / Prior to Any Excavation For This Project the Contractor Shall Make j the Required Notification to Dig Safe(I-888-344-7233, ' 2.The Contractor is Required to Seam Appropriate Pamirs From Town i itR Agencies For Construction Defined by This Plan. 3.Wherever Sewer Lines Must Cross Water Supply hoes Both Lines Shall Be Constructed.of Class 150 Prassurs Pipe and Shall be Water Tested to %+ AaaueWowtiapmas.InGeneral,Water Lines Shall be Constructed in t Vent - Final Locotation to be Coordination With COMM Water,and Shall be in Accordance t� Determined at Time of Installation so With248CMR1.00-7AOdt310CMR15.00. as to be as Inconspicuous as Possible 4.AMinimuof9"ofCoverisRaryiredforAllComponents r m S.All Structures Buried Thee Feet or Mau or Subject a Vehicular Traffic to be H-20 Loading.It is the Engineer's Recommendation that W20 Always be used See Note 6 (typ.) 6.Install watertight Risers and covers a Within 6"of Finished Grade ! DESIGN DATA �, Garage Slab Clean out Within Landscaped Areas,or a Grade within priveway over septic Single Family EL. 10.6 F.G. EL. 10.50 Tank inlets,Compartment walls,and outlets,D-Boxs,aid t Leeching f j -3 Bedroom 110 GPD --- F.G. EL. 10.00 Chamber Per System { F.G. EL. 9.00 No Garbs Grinder 7.Septic System a be Instaited in Accomlattce With 310 CMR 15.00 Qc , 8e <r„__.._ 248 CMR I.00-7.00 Latest Revision andthe Town of Bamsmble Total Daily Flow=330 GPD T. Board of Health Regulations. s.All Piping a be Sch.40 PVC. $ Use a 1500 Gal Septic Tank Flow Equilizers 9.The Septic Tank for O6 Shall be a 245W Gallon,with 2 Compartments f ; f As Required LEACHING AREA Installer to Confirm 5 The First Com padmant Shall Have a Volume of Not Less Tlwn l 1,540 Gallons and the Sexxud ofNot Las drum 770 Galin. � Prior to Work E 1500 Gallon t \ H-20 8 0 H-20 l 330 GPD!0.74(LTAR)=446 SF Required Septic Tank E 0-Box 3 The Coropartmars Shall be Interconnected by a Minimum CO � � SidewaU 84.8X0.96 81.4 SF Veined Lweted U Pipe. 10.D-Box Shall Have a Minimum Inside Dimension of 12",and a MinimumSumpof4r. Bottom EL, Flow Diffu$or 11.The Separation Distance Between the septic Tank Inlets and 81.4+369=e450.4 SF Total Provided Outlets Shall be No Las than the Liquid Depth.Intel Tea Shall Extend a Minimum of IW Below the Flow Lime.Outlet Tea Shall Extend le®#81, h ' 24" 2,and 29" #86 Below the Flow Line and Shall be Beectio "Po ® Enav LEACHING CHAMBER DESIGN inspection Part. 1f En�Cauntergd Remove & Replace with Goa Batiks. . t Installed All Pipes to be Schedule 40. UseStableo $eompac e On oslnsurtgble Sgtls Withln 5'.of& Baffels as Per Title 5 The.:: t Pelgeter of. fie S)!stgm Groundwater 3 Concrete Flow Diffusers in a Per Test Hole 3 12'x 32'Double Washed Stone Field as Shown. Monitoring Well s sf DEVELOPED PROFILE OF SYSTEM NOT TO SCALE #82 1 PERC TEST: 14,347 PERFORMED BY:JOHN ODEA,P.E.-SULLIVAN ENGINEERING j SOiL EVALUATOR N0-2911 I WITNESSED BY:DONNA MIORANDI,RS-TOWN OF BARNSTABLE o ri } MAY 2,2014 Finish Grade TEST HOLE- I TEST HOLE-2 TEST HOLE-3 TEST HOLE 4 I I! { Fa1 ter bric _ EL i 1.8 EL.t 18 EL.10.5 EL.10.5 N { -"-'-^ Compacted Fill AND/OR DESIGN DATA FILL FILL FILL FILI 1/8" - 1/2" -IL0 11.0 9 tO Pea Stone $1ngIC Family H LAYER t0YR4/6, ... B LAYER 10YR4l6 B LAYER iOYR4/6 B LAYER.l0YR4/6. ® C2 12 VARIANCES REQUIRED DARK YELLOWISH BROWN DARK YELLOwM BROWN DARK.YELLOWISH BROWN. DARKYELLOWIISHBROwN. 3/4-5 Bedroom Q 110 GPD • Double washed IOAMYSANA LOAMY SAND: . 9 t LOAMY SAND . .. 8.0 LOAMYSAND. 7, 4' 15.104 Percolation Testing-No Pere Test Information Available No Garbage Grinder L 23Y C LAYER 2.5Y 6/4 C LAYER 23Y 6/4 LAYER 2.5Y 0/4 And Limited Area to Perform One Now. Total Daily Flow=550 GPO LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN w Seeking Permission for Engineer's Certification Relocate Existing 2,000 Gal Septic Tank _ At Time Of Install. � MEDIUM SAND MEDIUM SAND MEDIUM SAND MEDIUM p � 7.7 15.211 Setback to Coastal Bank-50'R ired or Replace with I500 Gal Septic Tank 25 GALLONS GONE IN 7 MIN.B 25 GALLONS GONE IN 6 MIN. i PERC RATE<2 WM(LTAR-0.74) PERC RATE<2 MRJ/W(LTAR-0,74) CROSS SECTION OF FLOW DIFFUSOR 27.7'Provided LEACHING AREA 15.221(7)Depth of Components-36"Allowable NOT �s 48„Proposed 550 GPD/0.74(-TAR)-743 SF Required 120.1 1 8 GROUNDWATER GROUNDWATER GROUNDWATER EL 1.5 rYD 1 TO SCALE T.O.B.360-1 Setback to Coastal Bank-I00'Required Sidewall-2(8'+61'-6"�CZ'=278 SF ENCOMn= -1 5--1 0' MONITORED THRU 27.7'Provided Bottom Area=(8'x 61'-6")=492 SF MAY FULL MOON CYCLE 770 SF Total Provided SITE PASSED LEACHING CHAMBER DESIGN All Pipes to be Schedule 40. Use i--- - 7-500 Gal Concrete Chambers in an 8'x 61'-e Double Washed Stone Field as Shown. Vent - Final Locotation to be Determined at Time of installation so as to be as.Inconspicuous as Possible DESIGN DATA Provide see Note 6 (typ.) Single Family F.F. EL. 23.60 Clean out F.G. EL. 21.75 F.G. EL. 19.50 See Note 6 (typ.) -7 Bedroom @ 110 GPD F.G. EL. 16.25 F.G. EL. 14.50 Providesome No Garbage Grinder Flow Equilizers F.F. EL. 15.60 Clean out g I/- As Required F.G. EL. to Total Daily Flow=770 GPD 2500 Gallon F.G. El. 14 Use a 2500 Gal 2 Compartment Septic Tank EL. 18.25 Flow Equilizers peitm Installer to Confirm EL H-20 EL. 10.30 �/" As Required (Multiple Kitchen Areas) Prior to Work 2 Compartment 1 5 EL. H-20 Tap EL. 13.25 Installer to Confirm EL Relocate or Replace Septic Tank D-Box 1 3 Prior to Work Existing (SEE NOTE 9) 5 Too EL. 10.00 H-20 To Be Installed On EL. s.3o 2000 o E D-Eo LEACHING AREA � / EL. cnamtier Crawl Slab Septic Tank Stable ompac e EL H-20 770 GPD/0.74(LTAR)=1040.5 SF Required . teocbrng Sidewall=2(12'-10"+59')X2'-287.3 SF Bedding,"r"s, To Be installed On f Chamber Inspection Port, if fn.....-erect Remove & Reptaoe: Stable pac ose _ Bottom Area=0X-10"x 59')=756.6 SF & Baffels �A11 llnsu/toble Sor7s.Within:5' of o Bedding,"T"s, 1044.2 SF Total Provided as Per Title 5 The Outer Partmeter:of fie.`.$ysterri ^vi Inspection Port, it Enaauntered Remove & Replace & Baffels Alr&t suttobte Sobs 144Yhrn 5. of.:: ep EL 5.2 as Per Title 5 the Outer Peritnetef.'O The System LEACHING CHAMBER DESIGN No Groundwater P Test o, All Pipes to be Schedule 40. Use Per es 3 No Groundwater 6 Concrete Chambers in a DEVELOPED PROFILE OF SYSTEM EL. 1.5 � ENGINEER TO VERIFY Per Py 14,347 12'-10"x 59'Double Washed Stone Field as Shown. Groundwater DEVELOPED PROFILE OF TANK SOIL CONDITIONSFNSTA AT NOT To SCALE r TIME OF INSTALL EL. 1.5 Per P,fl 14,347 PATER NOT TO SCALE Groundwater €0. 29V 33 Per PI 14,347 273� v PERC TEST: 14,346 . . � ,w� ,.•� ," L PERFORMED BY:JOHN ODEA,P.E.-SULLIVAN ENGINEERING SOIL EVALUATOR N0.2911 TEST HOLE-I Finish Grade WITNESSED BY:DONNA MIORANDI,RS-TOWN OP BARNSTABLE MAY 2,2014 Finish Grade EL.13.5 3' Mox. { 3' Max. ALAYER 9" Min 9" Min Compacted Fill Filter TEST HOLE-I TEST HOLE-2 TEST HOLE-3 TEST HOLE-4 Compacted FRI Filter SANDY LOAM t .8 Fabric EL.17.0 EL.17.5 EL.16 2 EL.17.0 Fabric 2'111M / / LOAM LOAM LOAM LOAM 1/8,a/0/2" PLAYER And/Or LOAMY SAND . Peo Stone ". B LAYER IOYR4/6 1 .2 . ... 1 .8 14.7 Pea Stone " . 12.3 3' B hAYER.dOYR 4/6. - Ci LAYER 3/4" - 1 1/2" DARK YELLOWISH BROWN FILL. DARK YELLOWISH BROWN. FILL, 3/4" - 1 1/2" LEACHING Double Washed LOAMY SAND 4 1 .9 LOAM SAND LEACHING Double washed MEDIUM SANDY GRAVEL g CHAMBER • B.CAYER 1@YR�6 CHAMBER 13.7 Stone B.LAYER 10YR4/b Stone DARK YELLOWISH BROWN , C2LAYER 4: .2 " LOAMY-SAND. 13.0 13.7 ". DARK YELLOWISH DROWN 2.6 D I 4' - 10" ( LAYER 2 SY 6!4 LAYER 2.SY&4 YER 2.5Y 6/4 C LAYER .S 4 (_ ' 4' -- 10" I MED SAND 8, LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN LIGHT YELLOWISH BROWN �- 12' - 10' r MEDIUM SAND MEDIUM SAND MEDIUM SAND MEDIUM SAND 25 GALLONS GONE IN 7 MIN. 25 GALLONS GONE 1N 7 MIN. CROSS SECTION OF CHAMBER , + PERC RATS<2MBJ/IN(LTAR-0.74) 12" 5 t " PERC RATE<2MOM(LTAR-074) 5. , o• CROSS SECTION OF CHAMBER NOT TO SCALE NOT TO SCALE SITE PASSED REVISION: Change Proposed Septic Layout & Calculations ® 81 Sand Point 12117114 REVISION: Add Proposed Septic Work 07102114 REVISION: Reduce Pool Patio Size Per Conservation 04110/14 NOTES: PREPARED BY.. PREPARED FOR: TITLE Site Plan 1.) The property Line information shown was CapeSurav Proposed �mprOvements compiled from available record information. Sullivan Engineering, Inc. John Fish M 2. The topographic information was obtained PO Box 659. 7 Parker Road At LL ) Osterville, MA 02655 Osterville MA '02655 65 All erton St O from on on the ground survey performed on i a or between 311JANIOI and 111OCT113. (508)428-3344 (508)428-9617 fax (508) 420-3994 / 420-3995fax BOSLOCi MA 02 9 8 / -86 Sand Point 20 0 10 20 40 Bamstable (Oyster ) Mass.3-) The datum used is NGVD '29, a fixed mean Draft: JOD Review: RRL HQrbOI'SLLJ sea level datum. 80LLJ Review.: PS Job A C-310.3 DATE: SCALE: rr r Draft: 22036 Drawing # C310-3BG1 ex2 February 4, 2014,f 1 =20