Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0231 SEA VIEW AVENUE - Health
L a View Avenue lle F -- 8 018 ADDRESS: 231 SEA VIEW AVE. OSTERVILLE REPORTS on RELEASE — HAZ.MAT. From : BENNETT O'REILLY, INC. DATE: QUARTERLY (3) MAR, JUN, & 2001 I NQTES DESIGN DATA Finish Grade I.Water Supply ForThis Lot is Municipal Water 9 Bedrooms D.9ilyFlow=990GPD f 2 Location of Utilities o Shown on This Plan Are Appro Thi Septic Tank•990 GPD x 200%=1980 GIRD t At Least 72 Hours Prior to An Excavation For This y Use 2000 Gallon Septic Tank � � a Filter Project The ConiractorShall Make The Required ; ' Notification to Dig Safe(I-888=344-7233) Leaching Area -� Fabric 'Compacte Fll ld .a The Contractor is Required to-Secure Appropriate Val)GPD/0.74=1338 SF Required sN N M Permits From Town Agencies For Construction Sidewall=2(12'+81')2=372 SF -1/8—I/2 . Defined by This Plan. Bottom Area=12 x 81'=972 SF pE�ti TC S T BIC) < 1 pea S1oM 4 Install Risers as Required to Within d'of 13"SF Total Provided AAYELR i0'/(i 3 3 Finished Grade. 1 5.All Structures Buried Four Feet or More or Subject Leaching Chamber Design DARK BROWN All Pipes to be Schedule 40.Use Leaching' to Vehicular Traffic to be H-20 Loading. 9-li00GaL Leaching Chambers In a SPNDY LOAM 19 Chamber 3/4~-1 1�2~ ` & Septic System to be Installed in Accordance With 17 x 81'Washed Stone Field as Shown t 1 9 Double Washed 310 CMR 15.00 Latest Revision And The Townof 81 LAYE?. IOYR 5�6 N YELLOW15V� BROWN Stone Barnstable Board of.Health Regulations 38, COpR$F SAND l7•5: 4-10 7. Al I Piping to be Sch.40 PVC. B2 LAYER IDYR 41(a 12 DARK yE LLDv11bk1 BRCWN NOTE:If Encountered Remove&Replace , CCAR SE SAND An Unsuitable Soils Within 5'of the ys C1 LAYER 10YR 5/8. CROSS SECTION OF CHAMBER Outer Perimeter of the System YEL.LDWISN DRY NOT TO SCALE. t COARSE SANS t�3' Wy At the Board of Health public hearing on November 20,2001 at 7:00pm CZ LAYER 'IOYR (pf(p r the Board voted after a review of the floor plans that this dwelling has aRowA�>Sti `f�LL.oW " 9 (nine)bedrooms per Title 5. FINE SAND E OF F.G. 25 F.G. 2Z SU gH NO WATER n n n . Ci11#L EL% .17' EL. 1-1.z 1 a 2000 Gallon - Top EL.2o-2: Septic Tank EL.2o. Bot.El. EL. i.a t. e' ` _ .�..- r`, „�•.: I Bedding as SITE PLAN IN Per Title 5 PROPOSED SEPTIC UPGRADE 2 Ci M MI AT DELVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM 231 SEAVIEW AVE Not to Scale OSTERVILLE, MA BY f SULLIVAN ENGINEERING 110(./o2 REVISED CHAMZaR INLET-S OSTERVII.LE, MA i SHEET 2 OF 2 'AOI��.D 11�20�01 RO ARO OF C c�gVIS10N II�Zlo/Oi FHHALT-}i COMMCNT5 t Commonwealth of Massachusetts o Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ° 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Robert Paolini use the return Name of Inspector key. Robert Paolini Septic Service Company Name 17 Playground Ln. Company Address Yarmouthport Ma. _ 02675 City/Town State Zip Code 508 362-3555 S 14454 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 16.000). The system: l 0 Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 2/3/2012 - 'J Ins ctor's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Bard of Health or DEP)within 30 days of completing this inspection. If the system is a shared systenTor has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit th report to the appropriate regional office of the DEP. The original should be sent to the systemgwner and copies sent to the buyer, if applicable, and the approving authority. i "a ****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 Officlal Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osteryille Ma. 02655 2/3/2012 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: R 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: The septic system is in proper working order at the present time. 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/Town 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 - Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments .�' 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 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 ❑ ❑x Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ 0 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 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ Z 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. ❑ 0 Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ❑x 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. ❑ 0 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.] ❑ ❑x The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ❑x The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•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 "¢ 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no" as to each of the following: Yes No ❑x ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ 0 Were any of the system components pumped out in the previous two weeks? N ❑ Has the system received normal flows in the previous two week period? ❑ 0 Have large volumes of water been introduced to the system recently or as part of this inspection? 0 El 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? p ❑ Was the site inspected for signs of break out? p ❑ Were all system components, excluding the SAS, located on site? ❑X ❑ 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? 0 ❑ 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: ❑x ❑ Existing information. For example, a plan at the Board of Health. El 0 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): 9 Number of bedrooms (actual): 9 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 990 t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth f Massachusetts onw eath o as - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ❑x No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes O No Laundry system inspected? 0 Yes ❑ No Seasonal use? 0 Yes ❑ No Water meter readings, if available last 2 ears usage d NA 9 ( Y 9 (gp ))� Detail: Sump pump? ❑ Yes Z No NA 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 Ift Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Robert Paolini Was system pumped as part of the inspection? ❑x Yes ❑ No If yes, volume pumped: 2000 gallons How was quantity pumped determined? Measured Reason for pumping: Maintenance Type of System: 0 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•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed(if known) and source of information: 2002 Were sewage odors detected when arriving at the site? ❑ Yes ❑x No Building Sewer(locate on site plan): 2' Depth below grade: feet Material of construction: ❑ cast iron O 40 PVC ❑other(explain): Distance from private water supply well or suction line: 10 + p pp y feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of leakage.System vented through the house vents. Septic Tank(locate on site plan): 2' Depth below grade: 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: 2000 gl. H2O Sludge depth: 5" t5ins-11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection F 0rm Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 37" Scum thickness 1" Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 11" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump tank every two years.Inlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound. 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 U0V Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-11/10 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 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 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 No 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 is level.Box has four outlet laterals.No evidence of solids carryover.No evidence of leakage. 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: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑x leaching chambers number: 9 ❑ 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.): Sandy dry soil.No signs of hydraulic failure.Chambers were dry at time of inspection. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 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.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 1 Map Page 1 of 2 Town of Barnstable Geographic Information System Parcel Viewer Custom Map Abutters Map Size Zoom Out .11A111j jIn �44 +V�, } P fik �V 3 y - •'�.-j5�. .rY'"-'��¢i�' f�,'�'ee°SF+�'<� f" � �\ ;� ''�aM'� r ;�,���'^ '6�' ?:t�, ��. S+�' ?m,�� i f � a. �� � -.'a:^.k+� ... ....'.' '...".cif � •cm! -... _._ _.... _,J 5 V1L... X 5 t il •:fit, � ��- 6Feet Set Scale 1" = 20J~ — Aerial Photos - ( MAP DISCLAIMER f nr+urinh4 7(/(11F_N)4r)T--of€k—.f.H. 64G 611 rint+te racenr. http://66.203.95.236/arcims/appgeoapp/map.aspx?propertylD=138018&mappar... 2/6/2012 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: FZ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells 11' Estimated depth to high ground water: feet Please indicate all methods used to determine the high ground water elevation: ❑x Obtained from system design plans on record 2001 If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑x Checked with local Board of Health-explain: As-Built ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. 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 Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 231 Seaview Ave. Property Address Susan Morrison Owner Owner's Name information is required for every Osterville Ma. 02655 2/3/2012 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Inspection Summary: A, B, C, D, or E checked ❑x 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 l d d i TOWN OF BARNSTABLE LOCATION c S FAMWLI ,Qllc SEWAGE # 0OL- MD, VILLAGE 057 lyl ell ASSESSOR'S MAP & LOT @ —0 INSTALLER'S NAME&PHONE NO. � � � SEPTIC TANK CAPACITY QO®O 6o;ol Ctlblo) 1 j LEACHING FACILITY: (type) 6'A j Cd/i3S �� (size) la X NO. OF BEDROOMS _ BUILDER OR OWNER v� :CECE' PERMITDATE< e� o7' ®/ COMPL DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by l is S8 " (931 i S --T 'TOWN OF BARNSTABLE LOCATION o��f` .SAii/ce✓ fi SEWAGE # Or7/- ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO.�V' ttcr-" go8'� �f SEPTIC TANK CAPACITY c�000 Cr/-a I 7 LEACHING FACILITY: (type) 5"06 W-C t/—4m 5 ��� (size) Job A(8r NO. OF BEDROOMS BUILDER OR OWNER VJQ,1 A10,e1,r33 PERMI7FDATE,4 it 9101 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well 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 Y 83 a n , vc �� �b _ No. e � � Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2ppYication for ]DigpoOal *p5tem Con!Wurtion Permit Application for a Permit to ConstcuoE{ )Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No.7_�5 J SecoV i F,_j okV e. Owner's Name,Address and Tel.No. 05�2N�11Q Susn-4\ Morrsok, Assessor's Map/Parcel 38 (AB e(Q00 E. W es�1m�n4,P_.r (r Fore-A. =l. (n0045 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. o�r�-�l - . -la.s ssaq ds\.er,,,1\e, nJA- 6Z-GS5 say-yzs 3�yy Type of Building: Dwelling No.of Bedrooms Lot Size A 15 ct(r 5 sq--fx. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 9 9S gallons per day. Calculated daily flow 110 gallons. Plan Date 5eA IZ, Z061 Number of sheets Z Revision Date 11 Zfol bl Title SNe 11�r\ PraQoSed 5e��<< U y� .e Size of Septic Tank Z000 GAS, Type of S.A.S. It-Sao G A. Lec khwr.a (hgnz`: �s i r\ r. iZx 81' Wasl\a 5 one re\r� Description of Soil;O-w A"er lo`IR 1. 3 l4-�8�� 1 l tiypr 104R5i i4-45" 3Z Lamer- lo`IR41(Q 45-S6" 0- 1 -C-s2 r IMR5b, S(o-IZO" CZ "-er 104 2 l01(0 — 60 (. ALNEV- Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by,gus Board ofAHealth. Signed . Irla1r, Date—OAA/V Application Approved by Date I Application Disapproved for the following reasons Permit No. fY1�-��c�- Date Issued • +.<.... •`.....L—...wr 4 �r ��"d �--`� .LI 4. �..w s r ♦ • f(,"��'Y tY! + • • 1 - 1•', ' � . - - t"`---'�• Fee 1 t+p� .. THEkCOMMONWEALTV OF MASSACHUSETTS Entered in computer: L T- UBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASS`ACHUSETTS` Yes application for ]Digozaf *p!tem Construction ermit Application for a Permit to Construct-(y)Repair( )Upgrade( )Abandon( ) Complet System" MI Individual Components Location Address or Lot No.7_11 Ser v i e,j -kV e. Owner's Name,Address and Tel.No. Assessor's Map/Parcel (o00 �. \d rAm%05A e r 13� O18 Cc e ForesA, ZC. (0045 Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. s;cr S��\�va r` Cr,9��eer;^5 Pwr"fie r ?\.A. ''r.0, Z o r< 65 9 �fa8-ss0 j OS�e,, '1\e, mA- 0?,GS5 Sod-419-3sL11-1 Type of Building: �± DwellingNo.of Bedrooms Lot Size •ys c,"� sit. Garbage Grinder 44 Other Type of Building s. No.of Persons Showers(' ) Cafeteria( ) Oilier Fixtures Design Flow yS gallons per day. Calculated daily flow 9 4 C gallons. Plan Date Se A. ►Z, ZOO I Number of sheets Z Revision Date 11IZ(I t11 Title SAC t I q n Q P�AA- Size of Septic Tank Z000 GAL Type of S.A.S. `l- SOO �tiL• ler,��n�h� (h�,mb e�S i r\ e. IZX 81 (�asl�r�d 5 anf rF1r� Description of Soil 0-•14 ALrcuer Id`IR 3�3 . 14-38 �� L•5yar Ib\IKS' 38-45" 81 L"e, Ing41lo 4S-S6" Q I U,4tr IWSIB. SC,-120" CZ LA .P ICN& AD Wh1eqL_ Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by is Board o ealth. •-w _. Signed, : . .tt Date'Ahf' 3 Application Approved by <<_ el Date I �. Application Disapproved for the following reasons 1 Permit No. C���t;� - c�- Date Issued I 7 U -.. . - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-sit Sewage Disposal System Constructed(X)Repaired( )Upgraded( ) Abandoned( )by �G'c K.c co�,1 1 at Z31 Se4 V�e O Av P t 05 If-r L d : has been constructed in acco dance with the provisions of Title 5 and the for Disposal System Construction Permit No.�(�\- 7�Z dated I I 7 �U InstallerF111-e Mc c�l 1: �c r Designer The issuance ol th4permit shall not be construed as a guarantee that the syst m ill.function as!;i gned. . Date b Inspector _ _ - . — No. ���`�- ---- --------------------Fee /l�V THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS Miopoat 6pelem Construction Vermit `Permission is hereby granted to Construct y)Repair( )Upgrade( )Abandon( ) System located at Z 11 Se S V i�� Ao I Q-S Y N'I!� and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this t. Date: t) I / 3142 0 Approved by • �/= PAPOZ 1,-61tb Z10LY COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL:PROTECTION FAILED-INSPECTION TITLE 5 - OFFICIAL INSPECTION FORM—NOT FOR YOLUNTARY.ASSESSMENTS SUBSURFACE SEWAGE DISPOSALy SYSTEM FORM PART-A" CERTIFICATION Property Address: c J) Owner's Name: Owner's Address: - Date of Inspection: Name of Inspector: lease print r Company Name: Mailing Address: 0. 27 A- 0-X0 f Telephone Number: (� CERTIFICATION STATEMENT I certify thatI'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 Citionall Passes . ' Fu r Evaluationby the Local Approving Authority';Xs ails Inspector's Signature—' tuaie: The system inspector shal sulfmit 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. Notes and Comments r ****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 perfoi-in in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 o Page 2 of l l OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ;jPARTI A { CERTIFICATION (ccoo inued) IM Property Address: 03 Owner: Date of Inspections 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: 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 septi.c'tank is metal and over 2.0 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: y 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 Rage 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL; SYSTEM INSPECTION FORM ' PART A _ a CERTIFICATION(continued) Property Address: Owner• r ' Date of Inspection: 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 15.30.3(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 r F 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 l of a public'water supply. The system has a septic tank and SAS and the SAS is within'50 feet ofa private water supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a. private water supply well**. Method used to determine distance **This.system passes if the well water analysis,performed at a DEP certified laboratory,for coliform bacteria 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.oche► failure criteria are.triggered.A copy of the analysis must be attached to this form. I 3. Other: y 3 Page 4 of 11 OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) 3 Property Address: % Owner:Q4W4 el Date of Inspection: bQ D. System Failure Criteria applicable to all systems:. You must indicate"yes"or"no"to each of the following for all inspections: Yes No s 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 V 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'/2 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.] e5 (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 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• 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 L 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 Secti" on 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 INSPECTIONYORM PART B CHECKLIST Property Address: �J Owner: - Date of Inspect on: %//C;)9/0o 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'? . y _ 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? t/_ Were as built plans of the system obtained and examined?(If they were not available note as.N/A) V _ Was the facility or dwelling-inspected for signs of sewage back up 1'_ Was the site inspected for signs of break out? ' r _ Were all system components,excluding the SAS, located on site V11 — 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 �o 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 5 e •: Page 6 of 11 OFFICIAL INSPECTION,FORM—NOT FOR VOLUNTARY'ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: Owner: Date of Inspection-: 150 FLOW CONDITIONS RESIDENTIAL , Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.20�or example: 1.10 gpd x#of bedrooms): (,q�gs� Number of current residents: Does residence have a garbage grinder(yes or no)/,Z49" - Is laundry on a separate sewage system(yes or no)/ if yes separate-inspection required] Laundry system inspected(yes or no)-/7V�- �� Seasonal use:(yes or no); Water meter readings,if available(last 2 years usage(b'Pd)): . Sump pump(yes an Last date of occupancy: ' COMMERCIAL/INDUSTRIAL//T_e Type of establishment: Design flow(based on 310 CMR 15.203): Qpd 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: Was system pumped as part of the inspecti (yes or no): If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: 4. .- TYPE OF SYSTEM y A _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): proximate age or All components,date installed(if known and sour a of informs ion: Were sewage odors detected when arriving at the site(yes or no): �— 6 Page 7 of I 1 OFFICIAL,INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART SYSTEM INFORMATI.ON(continued) Property Address: Owner. Date of Inspection: BUILDING SEWER(locate on,site plan) .111T16— 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:l✓ (locate on site plan) Depth below grade: 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: Sludge depth: .. Distance from top of sludge to bottom of outlet tee or baffle: 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: How were dimensions determined: Comments(on pumping recommendations, inlet and'outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert,evidence of eakage,etc.): . w Al I 7, Z&zaZT CREASE TRAirA&(locate bn s"ite plan) Depth below grade:_ Material of construction:_concrete_metal_fiberglass___polyethylene_other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from,bottom of scum to bottom of outlet tee or baffle: Date of last.pumping: Comments(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 8of11 OFFICIAL INSPECTION FORM.-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL-SYSTEM INSPECTION FORM PART C: . SYSTEM INFORMATION(continued) Property Address: Owner: Date of lnspe tion: ICO TIGHT or HOLDING TANK 4&ank 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: Comments(note if box is level and distribution to outlets equal;any evidence of solids carryover,any evidence of leakage into or out of box,'etc.): PUMP CHAMB1 R%�ocate on site-plan) Pumps in working order(yes or no): Alarms in working order(yes cr no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 a OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION.FORM PART C :F SYSTEM INFORMATION(continued) Property AddressL C ` Owner: XL C2 Date of Inspection-: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: x .; Type s y leaching pits,number: l 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, et .): CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) s . Number and configuration: Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: ` Materials of construction: t Indication of groundwater inflow(yes or no): a 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.): 9 r Page 10 of 1 I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION.(continued) , Property Address:?,,g J ` Owner: ' Date of Ins cti P on: 2 OG 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. _C©© ar 10' �'`�' f cpr 10 OFFICIAL INSPECTION FORM—NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: ��-?/ Owner: Date of Asption: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water Zf 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: G' r 11 11-27-2000 03:06PiM CENT OST FIREDEPT 5087902385 P.02 Make application to local Fire(Department. A- ` /'�g 0/� Fire Department retains original application and issues duplicate as Permit. SlIx APPLICATION and PERMIT Fee: . f for storage tank removal an!transportation to approved tank disposal yard in accordance with the provisions of M.G.L.Chapter 148,Section 38A,527.CMA 9.00, application is hereby made by: Tank OwnerName(pteaseprint) Mope Burke X n� o• Address _ 242 seaview Avenue Ostervilie, MA 02655 Removal • • Company Name >~ny i r o-Safe Co.or individual Enviro-Safe FM Address P•0 'BOX 810, E.Sandwich, MA Address P Signature(it to ) Signature(if applyingjor permit) G.iFCI Certified Other 0 lFCl Certified 0 lSP# Other Tank location 231 Seaview Avenue Osterville sm•r AWMIS aly Tank Capacity(gallons) '2 7 5 gallons Substance Last Stored heating o i 1 j Tank Dimensi arpete x length) Remarks: Firm transporting waste Enviro=Sate State Uc.# 329 MA Hazardous wastemanifest# MAK846567 ' E,p,A,# MAD985269323 Approved tank disposal yard Turner Salvage Tankyard 002 f Type of inert gas Tank yard address 235 Commercial Street Lynn, MA i . 1920 City or Town Centerville0 FDID# Permit# Date of(slue November 8, 2000 ate of expiration . November 22, 2000 . Dig safe approval number 2000460 Safe Fr - 0.372-4844 Signature!Title Of officer granting permit V 114 4 , ------- After removal(s)send Form FP•290R signed by Local Fire Dept.to UST Regulatory Compliance Unit.One Ashburton Place. Room 1310.Boston.MA 02106.1618, TOTAL P.02 ,,r - ° r x -� . _. �J e� COMMONWEALTH OF MASSAC1 USETT Fly EXECUTIVE OFFICE OF ENVIRONMENT d DEPARTMENT OF ENVIRONMENTAL PROTECTION ,y= 20 RIVERSIDE DRIVE, LAKEVILLE, MA 02347 508-946-2700 ARGEO PAUL CELLUCCI R Itd C F!v D BOB DURAND Governor Secretary JANE SWIFr APR 1 ry LAUREN A.LISS Lieutenant Governor I 2 0� Commissioner TOVviv U, URGENT LEGAL MATTER:PROMPT ACTION NECESSARY CERTIFIED MAIL:RETURN RECEIPT REOUESTED April 12,2001 Hope Burke RE: OSTERVILLE(BARNSTABLE) c/o Joseph Burke,Power of Attorney for Hope Burke . BWSC 21 Custom House Road Burke Residence Boston,MA 02110 231 Seaview Avenue . RTN#4-16146 NOTICE OF RESPONSIBILITY M.G.L. c.21E,310 CMR 40.0000 ATTENTION:Joseph Burke On March 27, 2001 the Department of Environmental Protection (the "Department") received a Release Notification Form ("RNF") which indicates that a release of oil and/or hazardous material has occurred at the location referenced above. The Massachusetts Oil and Hazardous Material Release Prevention and Response Act, M.G.L. c.21E, and the Massachusetts Contingency Plan (the "MCP"), 310 CMR 40.0000, require the performance of response actions to prevent harm to health, safety, public welfare and the environment which may result from this release and/or threat of release and govern the conduct of such actions. The purpose of this notice is to inform you of your legal responsibilities under State law for assessing and/or remediating the release at this property. For purposes of this Notice of Responsibility, the terms and phrases used herein shall have the meaning ascribed to such terms and phrases by the MCP unless the context clearly indicates otherwise. The Department has reason to believe that the release and/or threat of release which has been reported is or may be a disposal site as defined by the M.C.P. The Department also has reason to believe that you (as used in this letter, "you" refers to Hope Burke) are a Potentially Responsible Party(a "PRP") with liability under M.G.L. c.21E §5, for response action costs. This liability is "strict", meaning that it is not based on fault, but solely on your status as owner, operator, generator, transporter; disposer or other person specified in M.G.L. c.21E §5. This liability is also "joint and several", meaning that you may be liable for all response action costs incurred at a disposal site regardless of the existence of any other liable parties. This information is available in alternate format by calling our ADA Coordinator at(617)574-6872. DEP on the World Wide Web: http:/ANm.magnet.state.ma.us/dep C* Printed on Recycled Paper I S!14 The Department encourages parties with liabilities under M.G.L. c.21E to take prompt and appropriate actions in response to releases and threats of release of oil and/or hazardous materials.By taking prompt action, you may significantly lower your assessment and cleanup costs and/or avoid liability for costs incurred by the Department in taking such actions. You may also avoid the imposition of,the amount of or reduce certain permit and/or annual compliance assurance fees payable under 310 CMR 4.00. Please refer to M.G.L. c.21E for a complete description of potential liability. For your convenience, a summary of liability under M.G.L.c.21E is attached to this notice. You should be aware that you may have claims against third parties for damages, including claims for contribution or reimbursement for the costs of cleanup. Such claims do not exist indefinitely but are governed by laws which establish the time allowed for bringing litigation. The Department encourages you to take any action necessary to protect any such claims you may have against third parties. SITE INFORMATION Information on file with the Department indicates the following contaminant was detected in a soil sample collected from the site at a concentration which exceeded the Reportable Concentrations for Soil Category 1 per 310 CMR 40.1600. CHEMICAL CONCENTRATION RCS-1 #2 Fuel Oil 12,000 mg/Kg 1,00o mg/Kg Specific approval is required from the Department for the implementation of all Immediate Response Actions ("IRA"), and Release Abatement Measures (RAMs) pursuant to 310 CMR 40.0420 and 310 CMR 40.0443, respectively. Assessment activities, the construction of a fence and/or the posting of signs are actions that are exempt from this approval requirement. This site shall not be deemed to have had all the necessary and required response actions taken unless and until all substantial hazards presented by the release and/or threat of release have been eliminated and a level of No Significant Risk exists or has been achieved-in compliance with M.G.L. c.21E and the MCP. Unless otherwise provided by the Department, potentially responsible parties ("PRP's") have one year from the initial date of notification to the Department of a release or threat of a release,pursuant to 310 CMR 40.0300, or from the date the Department issues a Notice of Responsibility,whichever occurs earlier, to file with the Department one of the following submittals: (1) a completed Tier Classification Submittal; (2) a Response Action Outcome Statement or, if applicable, (3) a Downgradient Property Status. The deadline for either of the first two submittals for this disposal site is March 27, 2002. If required by the MCP, a completed Tier I Permit Application must also accompany a Tier Classification Submittal. The MCP requires that a fee of$750.00 be submitted to the Department when a Response Action Outcome ("RAO")statement if filed greater than 120 days from the date of notification. You must employ or engage a Licensed Site Professional ("LSP")to manage, supervise or actually perform the necessary response actions at this site. The Department has David C. Bennett of Bennett & O'Reilly,Inc. listed as the LSP-of-Record. 3 If you have any questions relative to this Notice, please contact Andrew L. Jones at the letterhead address or at .(508) 946-2785. All future communications regarding this release must reference the following Release Tracking Number: 4-16146. Very truly yours, Richard F.Packard,Chief Emergency Response/Release Notification Section P/ALJ/cb CERTIFIED MAIL NO.7099 3220 0002 0275 7227 RETURN RECEIPT1REQUESTED - Attachments: Summary of Liability under M.G.L.c.21E cc: Board of Health P.O.Box 534 Hyannis,MA 02601 Board of Selectmen 367 Main Street Hyannis,MA 02601 Centerville/Osterville Fire Dept. Falmouth Road Centerville,MA 02632 Bennett&OReilly,Inc. 1573 Main Street P.O.Box 1667 Brewster,MA 02631 ATTN:David C.Bennett,LSP DEP-SERO ATTN: Data Entry llCATION SEWAGE PE MIT NO. VI'tLKGE I N S T A LLER'S NAME ' & ADDRESS ,49�+ .4 -1 75, LZI64 -15"9q `e`1 4 S Are k 8 UILDE R OR OWNER DATE PERMIT ISSUED 7 DAT E COMPLIANCE ISSUED _ a Vx` r r _ 77 No..---.------�. b�.... ✓r1� / I o\ F>cs ....... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Appliration for Disposal Works Tonstrnrtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( _Individual Sewage Disposal System at: ...• ......... ------- ---------- - ocation-Address ..... .......� .....'. -- ......�-�..................... ---------------•-----•---•---- •^-•._ Owner Address � 1 or 7 a Ins-- -----------V........................... ................. ! ............. ta er Address � Type of Building Size Lot............................Sq. feet ,., Dwelling—No. of Bedrooms___._____________________________Expansion Attic ( ) Garbage Grinder ( ) '4 Other—T e of Building No. of persons............................ Showers — Cafeteria Q' Other fixtures -------------------------------- . W Design Flow............................................gallons per person per day. Total daily flow.............................................gallons. WSeptic Tank—Liquid capacity.............gallons Length................ Width................ Diameter__-------_------ Depth................ 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 ( ) 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........................ n+' --------------------------------------•--•------------............---------...--••••-••-•-••..._........------------------------•-•--•............•....---- ODescription of Soil......................................................................................................................................................................... x ------------------------ --- .----------------------------........ .- -------------------------•----- x ------------------------------------- ---------- -------------------------------------------------------- ....... U Natur of Repairs or Alter tuns Answer when appli 1 ___ _ &.............7............................... ..._ ��.G'A�.. ..._.. ---- ....................---- = Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITL U 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b5p,issued by the board of he4l igned- ``! -------- - r --- Date ApplicationApproved By.................................................................................................. ---------------------------------------- Date Application Disapproved for the following reasons:................................................................................................................ --------------------------------------------------------------------,� .---------•--------------------..---------------------------------------....�..-------� 4�---------------------------•-••-•- Date {- r _ Permit No......................................................... Issued--. Date T 7- 7 1 No... FEz ....... .................. .. . .. ... THE COMMONWEALTH MASSACHUSETTS BOARD OF HEALTH 0 F..: ................................. ..........................Avvfiration for Uisp a.l 10orkfi Tom4rurtion Famit Applicati6n is hereby made for a Permit to.Construct or Repair ( )An Individual Sewage Disposal System at* a—ZO-0 * .... ... ......... ............ ............ . ................ .... ocation-Address. ................................... ..........................................or.Lot I No.Acv,-----444ftc ..... .. ......... -- ------ -------- .......... ............................................... 4.0n -------------------------- ......... ............ �ress .......... . .. ... . ....... .................... ...... ------------......... ................... ......................................................................... Instiller r Address Type of Building Size Lot________________ Sq. feet U 0-4 Dwelling—No. of Bedrooms........... ...........................Ex0ansion Attic Garbage Grinder ( ) Other—Type of Building, .................. No. of persons- Cafeteria ( ) ------------------------ Show6ps Other fixtures ...............1�1 ........................................................ ...................................... Design Flow______ ..-:_,jallons per person per day. Total'.daily flow____._. ............gallons. ..,_................ 1:4 Septic Tank—Liqui&:cap acity------,.-"gallons Length................ Width...^ _:---------- Di4 etet............... ................ Disposal Trench—No................... Width'.-_ Length........_ .. Total leaching area_n_,. ......... sq ft. Seepage Pit No---------------------- I b4o"w inlet.................... Total leaching area............... sq- fits Z Other Distribution box Dosing tank Percolation Test Results Performed.by. ------------ ......... ...........L....... Date__. --------------------- aj Test Pit No. I----------------minutes per inch lep th?bf-lest Pit' .... ...� -Depth to,.groud,*.w.ter_".... .t,D ......_............ Test Pit No. 2................minutes per inch '6epth of Test Pit.................... Deptfi to ground water____._.............._... .................................... --------------------- ............................................................................ 0 Description of`Soil. ................_. ...................... ................................................................................................. n-;----------- ---- ........................................................................... ................................ U ----------------------- ----------------------------------------- -------------- .. . Z.............---- . ... .... ........... . ............... T 4' Answer whe n appl i Natult of Repairs, or Altelaff U ------ ----- - ----- ------ . `17..... ...... - I ... ................ ..... ....... ....... ................. .......................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLITIE 5 of the State Sanitary Code—The undersigned furtler agrees not to place the sysiem in operation until.a Certificate of Compliance has b issued b)&the boa; �f 11 —17- .... ............P----- Signed.,!�?_Ilf ---I......W6112. ...ve........ Date ApplicationApproved By................................................................................................... ........................................ Date f 0110ZVj Application Disapproved for the ng reasons:.................................................................. .................................... .................................. ......... to ....................................... 7--------------------...................V, ----------------------------------------- Date Permit No. ................. ......... Issued-. Date THE COMMONWEALTH�OFe4 HVSETTS -A- BOARD OF H ALTH ........OF.................................................. ................................... TA C TIFY, T at th , ndividdal'.Sewage Disposal System constructed ( -).-.or Repaired 27 by ........ ...... ... ... ...........IS------.... .................................. ..... W111111*11111*11111 ---- ----- ------at..... ..... . .. ......4. ................... T ilia in the State Sanitary r—de d i d " 'e7 ..... -------- ------------------ ------- ------ ------------------------------------*------------ has been installed in aq.Fordance with the provisions Of TA application for Disposal Works Construction Nrmit�Nokv- ...67 4............. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM-WILL FUKC.TION SATISFACTORY. - ---- ----- ............DATE_.. ...... 'Inspector-.��7........---------------7 -------------------- 7.....oe... ...........17------------------------- THE� Cq,MMONIVEALTH OF MASSACHUSETTS,,, BOAR OF'--*jjE<HTr ., W.................. . ...... ......... OF ........................ .............................. No......................... FEE. ......__ Rap r T v t W ft'l W#t 'Vrrmit Permission is hereby granted.....70 ------ ------------------------- .............---------- to vi U ConstrucL.� (�r p or/,Re air n Indi' id osal% at No......4' .................................... .............................................................................. Street >n .... .... as shown on the application for Disposal Works Consirooion 1 t VINI .....A... Dated.._. .............. ............................... 04, Board of Heal DATE--- -- ..................................... ............................ FORM 1255 HOBBS & WARREN.-INC., PUBLISHERS,," CENTERVILLE-OSTERVILLE-MARSTORS MILLS FIRE DISTRICT 1875 ROUTE 28 CE><,7TERVILLE, MA 02632 i (508) 790-2380/FAXO(508) 790-2385 OMIHAZARDOUS MATERIAL RELEASE FORM F.A.# AAA:; LOCATION: ADDRESS OF RELEASE: DATE OF RELEASE PRODUCT RELEASED: ; ,�.t ESTIMATED QUANTITY: -t3•ntcrtmart-- CORRECTIVE ACTION TAKEN BY RESPONSIBLE PARTY NOTIFICATIONS: r FIRE DEPARTMENT: YES( NO( ) DATE:- ri 0. rAR TIME •. t i =' NATIONAL RESPONSE CENTER YES( ) N0( -D'AT� TIME DEPT.OF ENVIRONMENTAL PROTECTION YE ) NO( ) DATE:_,-,t.,-TIME: OIL SPILL COORDINATOR: YES( ) NO(` DATE: `' ' TIME:tc.. r TOW(d BOARD OF HEALTH: YES NO( DATE: TIME: TOWN HARBORMASTER: YES NO(� DATE:`"`�, IME `�iJ"` ' OTHER AGENCIES- and l ac s erea1 r sp COMMENTS: _ � '• s-c_ n-_r__--? --• !�a ru w �niWerr�rail 6�e�n� e�r}e 1-�arvacent ,.J -- _ --1 t.-l_._._--.__—�_]__-- -_ _----o -_ ---- � •0s e-_ 'o.n (���rie—ri�:L�L. TTio �1: i�tL'L':r' obvious .:.a r::-'La::b r--;s:r:=-.,•f—}O holes Roma i—r_n�+=r�nr��i P-rr Le_ L�ib• lob i� n ; �1�Mleier 4�.er i --.r..`.`uriil -b r r �•J g ir•M-4-mr49 baa: St.'ure : .: h - -- ------ ------ - --r------- -----.--- --.- s -_ ------- 9 r-�Pfl i�Plt �-1Pf3e71--�1^lfilq$�F+119 t 4 t REPORTED BY: DATE- Martin MacNeely, FPO 12/4/00 WHITE COPY-FIRE DEPARTMENT YELLOW COPY-A.E.P. PINK COPY-BOARD OF HEALTH C-Q-MM FORM #58 f I. EX IS TING HOUSE IRF I ;i ® � !'� EXIS`�`� 1 • 1. i ujj SOUTH EL EVATIOi%l WEST EL EVATIGN i T EY.ISTINP - 1 I J� HOUSE FLUI I o =y t l 1 _ 1 T MCPPISON RESIDENCE ez- F,4 ON T E L E VA T i O,^l _ 8-b oz EAST EL ':i.y i 1 "P•1 -__-,_-- ELEVATIONS c , St,. VIEW / AVL. mow�a i � L-X tSTjNC� • _ B'- o" I B'-o" � y'-s'Iz C X ISTIN� _ _ S'-1'�' b'- 6" o'_ o%ae e� It�8 N4 OI�S�, ,�C U S i .1 6o B2 608'3 I �o SZ iCVSTO�-. CVSTbn � ; mi P l(JFA-_ / ' -a� , �• i 9' o. 4 0'� � 6'Iz' b z" - O FAM 1)_� IZ I im 2 1 ` �� rl 4 U C l l_L�j' i I --- — ---- nI - \a M _' s� o � 1 1 I �' ' 1 I I � I _ Q���oO[^'1�(� � 9E a ��1/ __ _. • goI: Lq.—, Q� 2941 L I I `/ j I I • - . __ I P6 3353 3353 I RPISCN RESIDENCE F L C C R P L A'NSa ' .. 23l Sty VIEV! AVE. P w,q,.2 s P ' Laoe: o-.o o o T�'s,.a cL o-o'• o 0 �; � � TOP av0 FL.^ -'1•IL :c , T.O.W.: -IIY9•�------ �O n33ro .. a PEe_•c allM pVwoy) Bogen a �e.sT_ -I-e'/gc .. J I' .� ; �ToP on crca n-1'_9�g.• � P it Tbo lo^ 10• ' I'I-O� +z8 -•@AIL. i M' a � ... ` 250 %7, C.. 77 TVP\GAL r FIOOZ Ij �—I i I * I I I � 1 _ I ly Sze 1 Ib-4St^ I II-lot __� .� I T.a.W _.I.>ZyB.. 2-6•. I .. i Ic Lvl. -�. • I y i w' - . . , I' I - __ e 1 - I 7-1 II I I I a " rl 'Q , _ � N _ _O , lCt/�j 2 I6 .T. 16� .G. �I i O � I 1 - - - � " O i I� T;o.w. -1'_Z'y8•• I i i m .. IS' FLOOP FPA;)_1i1N_G_ ._P.. L'_- rl FOUNDATION PL AN MOP,P/SON P ES I DENC E • e 6'aa FPAMINC- 'PLANS . 23/ SEA VIEW AVE. AW= •� ' 2%8 P.T; ib• .G. .: Z 8 v. lea ,_ _. _ i I N• I i 9lL B.C.2 LSO 12.-p:G. 1 _ I 5,14 Z. 3"zx 4"L* -S LT 7 _ ,� .. 1t•_iO'Iv _ 2x a. e3 I r( i '.�>- 16'� 1C. i RI eE o.G. ..4 SYcx G•L t 5�4�% 9"L• _ I i PO_ ; `I 1 t - Zxl RT_R -io" _' I. I ;9II2. 3 - IRn�Ees Ib O.L _— i -v _ I• v - ' • I ( I — LLH�T I I 16 -J R- C�r= r R!'nAE PLAN -? - - -2ND FLOOR O FRAIVE —R -- .. — _ ti10RR;SON PEES;DENCE FRAMING PLANS 2,31 SEA VIEW AVE. °A��-°•^ - 2Y 12 Rrob>__ l>i CD% Snf PTHrNb �$Jb FEsr • IQ' ¢.C. I�gFECTroN ' f TOP O¢ e,O bE 2J�-B•' � oc I PPoeEi v T �O • - d-2xb-HeaD¢q . •. �E 6+tiTINb NOOSF C%i5TtN 4, NOUSE f TOP oP SYO pt 1a-11 � � - _ _ _ - _ -.._ � �'T00 psVw apO(t,l Ycr.� 5•!4•+'9�i1 t.v.c. _ - SNOS Ib O.G. - 3-2xb r+<A Oey ZHp.FZ. 9�IZ 8L�2. 7.$O SE¢IES r!Z GOr SHE ATnrn(• I I i IV t .6" O.G. r 16'PO4 0ae¢r EiL --- 2x9 SHT PaeTTION� -.`TYP _ . Ib�� i r , Ts� JUM MEN 'R-19 F.v.=MSVL-IT.rp� _ ers•st_Tzea�eq./ __ --_ �r j 1ST 1. II%g" d.CS 25o SER.ES Ibo.L. DYST cpucE '1 - .I _ oYG FOYuowr-.o E�f- 1 I I ASPv>lr Db,NP ee 4 T 10 �,LL aEnO= � - � REr .Ha w+LL 1 • �I ! .. I e.zei" 7��/j � . PEAR SECTICN L E FT SEC TICIII ! Lx ro RAFrE qi • I - �B•�CO< SHESTkrNC I ! �.' ,Ly�G HOIIDF vrvulES 5•••� 1 I 1- I rZ'S0 F.b Sr�SVL-TYP _ i I R-�O G.6-rvzYL-TYP. W—e In T IS S G l0 � - " O.G. -TYP. -.. ., SUFc.T vzvT-TVP. i _ - .. _ - - .., .. rZ•:. I� , r i I ! • Ibp W.C.54rn16',ES _ I T66 .. .• � ,. �9'!L'E+.c.i. zso sEc-Ics �e o.a. � o (c YCD FRONT F az•�.C2 :.b seelE e�so ZuzQ. _I SECTION an Pl q IYe I e 3'p T,A6. (vsVS.D� - T. PYwdJO -ILo; ! J�,Q��J,' T Vw _-..r..._ _ r ZR b Pr,s w e I I rlr ,L _ ._.I_ IIr— 1 d 11 _.i. R-21 P,b.L»sul -Try. ;/g••6C.Z Z_o I.-19 Suwl Ib'C LS VCT I lo" GONG FO'✓NDPTIOV ----- I j ' I v'I y 45 P4 p� pvw�prr<O^�p IH(a �; �vtw H ARIGHT SECTION :UORRISON RESIDENCE IL I � C-oOT Hb ----- 1 S E C T I O N S 23i SEA VIELY AVE A Yr�S.Y . Sr-o• rSREA.KFAST ID I N I N G` LIVING ❑ o' m I KITCHEN L�l h Q COVERED .. - FOYER / a PORCH _ PANTRY 1 W ° SU PIROOp'l POTTIN SHE LAUNDRY • i __ � i P0T/DER CCVERED PORCH - I _ �29' -6-s F/PST FLOOP PLAN MOPPISON PESIDENCE ./9^ 1 wvm n. n R3L ' 86ec EXISTING CONDITIONS 231 SEA VIEW AVE T BATH MASTER._. S'JI TE' BEDROOM I VV C C. O - m \ M,STR_._....__BATH_ b' - _ / —r -- - - - - .. C F F I C E ''ALL BEDROOM BEDROOM BATH f DN � BEDP.OGM BATH C. h I , N _ orIi BEDROOM BEDROOM f � SECOND FLOOR PLAN MORRISON RESOENCE EXIST INC CO3,lVD1TIONS 231 SEA V1E!A' AVE °^ i Directions to Site: From Hyannis—Take Route 28 toward OsteMlle; Take a left onto Osteiville West Fn / /° Barnstable Road and.follow to end; Take a left onto Main Street and follow into the village of Osterville / / /° �' ^'�� ��J ~• °' staying right at the fork on Wianno Ave. and follow to end; Take a right onto Sea View Ave.and house is ° / \? °/ on the left#231. V V e / .A ' IeW e a aA/ \ ool / / ,Zp"E / Lem of P ,. 33.93 g o / /$A _ LOCUS PLAN on i q" Scale: 1:12,000 L Fce // / O ® I "25 18 � Assessors Map 138 /r^O 9 O TH+-4 // I I / / 1 ° n Parcel 018 // = Groundwater Protection Zone:AP N O a- / 1 c Z Flood Zones: VI 1, C 29.4' cam Zoning:RF-1 Setbacks: / L°"„ � Front: 30' STING SYSTEM TO BE / °s Side: 15' /Zoe NOTE: F ABANDONED OR REMOVED., / 1 f ° 1 Rear: 15' 231 P�10 I \ s Z� / �'' 2 Sty W/F \ ?3` \ I `-• Dwelling \ Lawn \ / ce 1 I Pod ►►/concrete Apron \ co Lawn to 7- 00, fence r� i Ul o SIZE° LOT / Lawn / coos 6�k ,y� 20� / / fI � Top of •+ •�'' -15� ..�• " 100, /� /1// lY / So r do S /► G11 L.01 G3 p y 000 /Z/ Seaun •-' "- .-. / / /.00, � / /gyp — ' "oSO UcKe 0 0 _ _ _ -- Nant RFV�SED CHAMBER SNIT AOOav II /2o/ol SCAJZO or Rtv 1 910N I I 2 L I01 PR LTN Ttle: PREPARED BY PREPARED FOR: Notee/Revislon: SITE PLANCapeSurvThe property line information shown was compiled Sullivan Engineering, Inc. SUSAN MORRISON from available record information and does not PROPOSED SEPTIC UPGRADE CD Po Box 659 7 Parker Road 600 EAST WESTMINSTER represent- an on the ground survey. AT Osterville, MA 02655 Osterville MA 02655 231 SEA VIEW �' IEW AVE 428-3344 508 428-3115 fax (508)420-3994 (508)420-3995 fax LAKE FOREST, IL 60045 (508) ( ) The topography and detail shown was obtained o OSTERVILLE, MA by conventional survey methods. -h 20 0 10 20 40 8o Field: MDHIW4K Draft: RRL The datum used is NGVD '29, N Date: Scale: Comp.: MDH/RRL Review. September 12, 2001 1 "=20' Prod # c-4s2 Drawing ,# c4s2g�