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HomeMy WebLinkAbout0959 SEA VIEW AVENUE - Health (2) 9-9119 SEA VIEW AVE 090-007 OSTERVILLE e, N g i 1 R p I 0 4 �.;.., ,� �_�..�,,,E � ,: ..� ., ;..�, ��,.w ®t+ a o ,�a ... � �5 -.:�_.:tee¢��a�mGay�ygEw r.s�^`.��,,,..F+ro�.: .,. 7q��." -.xt�r�.� •ac;"_.,��..--xer-< -^�v - ,- w Town of Barnstable , VE Regulatory Services Thomas F. Geiler,Director • saxxsrnsr.E, Public Health Division 163s. Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: /e z ay Sewage Permit# 260 Assessor's Map\Parcel Yn40 2 Designer: 5+�-12 c" A. W i I s c" , fee . Installer: R E H Cots true h&" Address: f3a-sk, Re I►"`S� Address: f 94, &ss< lrwacf g12 1'YL4�-� Sb�. �S�cr�ille �sS� ��ino��i On—Ns- Zc7U R r f1 Co.,jhvchPt, ZC"a was issued a permit to install a (date) (installer) septic system at 9s9 Se,* ycw Alycn use based on a design drawn by (address) S' hm 4, CJi/Pow Ac-, dated ZCX)`f (designer) *_ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) beat-in accordance with State & Local Regulations. Plan revision or certified as-built by des* er to follow. as ��4i O STEPHEN `y G� ALL`,N (lnsta&Ur Signatfire) WILSO^: No.W-216 l 0plAL esigner's Signature) (Affix Designers Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc fj7vin �od.L'� �`200 z-09, r Town of Barnstable �t►+E, � Regulatory Services Thomas F. Geiler,Director r • BARNSTABLE MASS. Public Health Division Thomas McKean,Director 200 Main Street Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: a 2 6 Sewage Permit# 26C4-3g$' Assessor's Map\Parcel M Designer: '7k✓&m A . w-,t-z&n 12.C. Installer: R s H Ccnsh-vchw, Tnr Address: Y3a xkr . Nwc 4 Ho l w.5 yt.,4 Address: ,91mcy,/i 4w On 8 S Z M RE Al 6msh-crc liM ?nc was issued a permit to install a (date) (installer) septic system at fJ«w *yyg w_ based on a design drawn by (address) �de ihw, �• Cc/i/sa►. z2t, dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or. certified as-built by designer to f low. STEPHEN L N G AL.LYN (stalfer',VXgna't_ure) WILSON 4 N.o.30216 "' /STERti� 4VAaC2 /?&- Fss/ONAI esigner's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doc .?GVZ-OFS�, AsBuilt Page 1 of 1 C`t r.. TOWN OF BARNSTABLE LOCATION q1,,0 ,craw;. Ug. SEWAGE#i '1 c10y—JTff VILLAGE_Q�Jef U1 jtL ASSESSOR'S MAP& LOT INSTALLER'S NAME&PHONE NO. I?f f/ (MS�ruC rcvt. SEPTIC TANK CAPACITY LEACHING FACMrTY: (type) FIOidC✓ ! (size). 117 �0 NO.OF BEDROOMS 3 LL-- BUILDER OR OWNER T� PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by aj 2-7 ` �17 - a3 36 3h 36 3 g y3' y 5 3 t - http://issgl2/intranet/propdata/prebuilt.aspx?mappar=090007&seq=1 5/6/2013 - No, P'C- %v Fee/00 i 0 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes ,PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS 0ppYication for �Bigozal *p5tem Construction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) Complete System ❑Individual Components e Location Address or Lot No. �S F S�.,rc.w,/ vU�. Owner's ,Address No. Assessor's Map/Parcel a •!r' C(ylJ9 A,A aa� Installer's Name,Add re s,and Tel.No. �� Designer's Name,Address and Tel.No. JC o ► D R,j tvC ' Type of Building: 4 C r 4e Dwelling No.of Bedrooms Lot Size -sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets- Revision Date - Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) � nn Date last inspected: Agreement: The undersigned agrees to a nstruction and mainte ante of the afore described on-site sewage disposal system in accordance with the pro ons of Title 5 o n ironmen 1 ode and not to place the system in operation until a Certifi- cate of Compliance has d f Si ed Date Application Approved b Date ' Application Disapproved for the following reasons Permit No. Date Issued ---------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (fompliance THIS IS TO r at�O Se ge Di osal System nstructed (� )Repaired( )Upgraded( ) Abandoned( )by ��7 X 7 (� \2 at ge A Li has been constructel in accordance with the provisi s of i M5d the f Dispal System Construction Permit No. datedInstaller fir° e�-,n N Designer .j The issuance of t 's p rmit shall not be construed as a guarantee that the sys e wi l f nction a designed. Date !� o y Inspector lk / Entered in computer: THE COMMONWEALTH OF MASSACHUSETTS , p Yes' `F. p Y. PUBL C HEALTH DIVISION - TOWN,OF BARNSTABLE., MASSACHUSETTS ` K- 4 4�_. ca.tton for W9poof *pgtem Cone;truction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. qi /3 � S�o�te-rw✓ n� O/wn�e/yr'�s�N(/y�)a�me,Ad•�d/res�s an el�.r'No�. rty ZO/V/�/A Assessor's Map/Parcel (!99 Zewl- Installer's Name,Add re s,and.Tel.No. Designer's Name,Address and Tel.JNo. 'k Type:of Building: 4 C r e 4:Dwelling No.of Bedrooms Lot Size .,7 S sq.ft. Garbage Grinder( ) Other . Type of Building No. of Persons Showers( ) Cafeteria( ) Other-Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets- ' Revision Date Title Size of Septic Tank Type of S.A.S. ... Description of Soil Nature of Repairs or Alterations(Answer when applicable) r Date last inspected: Agreement; The undersigned agrees to ensure-t11�a struction and maintenance of the afore described on-site sewage disposal system �., in accordance with the provisions of Title 5 o n ironment l ode and not to place the system in operation until a Certifi- cate of Compliance has%;e/ej is ued-kry-this o d fI a e J Si . ed Date 4 7 Application Approved bb Date Application Disapproved for the following reasons Permit No. Date Issued I . Tti THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compitance THIS IS TO QEPCT'IF- , at O e Sew ge Di �a� System nstructed(� ) Repaired ( )Upgraded( ) Abandoned( )by ��! eC_ at c1 ,e s4 a , e w Apae has been constructe in accordance with the provis s ofi}le 5 d the fo Dispo al System Construction Permit No. ti 0, �� dated U l� f� ( ; �f ANC— Designer .' _ Installer n.al S r v c �o� 'SO � The issuance of t/is p•rm ,eit shall not be construed as a guarantee that the sys wiV nction a designeepd. Date / ��`� Inspector . t� - a No. Fee . THE COMMONWEALTH OF MASSACHUSETTS i PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS ltgogal *p5tem Conmructton 30ermtt, Permission is hereby granted to Construct O Repair( )Upgrade( )Abandon( ) System6cated at 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: Constructi I n'in Ist be completed within three years of the d toe of this pe i . � r PP ` Date: A roved y a I TOWN OF BARNSTABL•E LOCATION e SEWAGE # VII.LAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY I 56-L • LEACHING FACILITY: (type) �® (size) NO.OF BEDROOMS 3 BUILDER OR OWNER T v COMPLIANCE DATE: L PERMIT DATE:, Separation Distance Between the: Feet Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Private Water Supply Well and 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 Feet within 300 feet of leaching facility) i Furnished by QJ V N F, NMI -r- a� No. �� ' Fee 'THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION ;TOWN OF BARNSTABLE., MASSACHUSETTS Rpplication for Mioogar *pgtet� Congtruction Permit Application for a Permit to Construct( 5`)Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. eA, ��,t e��tJ Own ame, dress and Te No. �C Ali A., Assessor's Map/Parcel 6,10 V , `�� `,.o Ins Ad and1YT .,No. Designer's Name,Address and Tel.No. Q �t9 v r o `v ANC , Type of Building: Dwelling No.of Bedrooms�_ Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 40 gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank C�,?Do Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agr u ti and maintena e the afore described on-site sewage disposal system in accordance with th rovisions of Title 5 t vi on tal Coe nd not to place the system in operation until a Certifi- cate of Compliance h s b 'ssue o e S' Date Application Approve Date Application Disapproved for the following reasons Permit No. Date Issued 10-14 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CE th, /fie si�e age Di posal System Constructed( ) Repaired ( ) Upgraded( ) Abandoned( )by '` %b eV C j/i`%l C�' 0 (-, =tU at .Se-al C/r e(V 4 uEo has been construct dYiaccordance with the provisi f T le 5 and thee,foorr Disp al System Construction Permit No. Q— -7dated Installer ��C" 0 r',JCT i a a, Designer & ' a The issuance of t 's pert t shall not be construed as a guarantee that the sy e will nction as d signed. Date Inspector _ C� -'� i �� Fee �.S Or 1 Entered in com titer: THE COMMONWEALTH OF MASS�ACHUSEtts x p ' Yes _ `PUBLIC HEALTH DIVISION .-TOW, OF BARNSTABLE, MASSACHUSETTS ^.y 2pplication for Miqogaf * gtem-�vngtructiott Permit- Application for a Permit to Construct( �`)Repair( )Upgrade( )Abandon( , )­E]ComplAtt`e System ❑Individual Components Location Address or Lot No. GC. � Ow ame, dress and Tell No. D � ""��C.i �C.9 ill 1U Assessor's Map/Parcel_jns taller . Ads ,an Tie.No. r rOG Designer's Name,Address and Tel.No C O ,v S d r 9o77` Type of Building: Dwelling No.of Bedrooms !f7 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures / Design Flow © gallons per d�;Calculated daily flow ' gallons. ' Plan Date Number of sheets Revision Date 1/ Title *` Size of Septic Tank C ,20©0 Type of S.A.S. Description of Soil ^ i Nature of Repairs or Alterations(Answer when applicable) Date last inspected:, ? Agreement: The undersigned agrees o ensure e-ee ti and maintena'}ce f the afore described on-site sewage disposal system in accordance with th provisions of Title 5 t vi on tal Code nd not to place the system in operation until a Certifi- cate of Compliance has been ssued=b athis Bo e th. Signe \ Date d ; Application Approve&,b_y Date d j Application Disapproved for the following reasons r v t r, Permit No. 1-�4-0�Dq Date Issued 1, lo THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance , THIS IS TO CE�,/Kr�-si,Sewag posal Syst Constructed ( �) Repaired ( )Upgraded( ) i Abandoned )by J Oat S ���v C 1 D Ica C- at Ss� SE'a y r e w f7✓e -.has been construct d • acc rdance with the provisions f • le 5 and e r Dis sal System Construction Permit No. � �� 3 g 7 dated �� l� Installer /` �60�5 v (✓���a lu--7;u q—Designer 'V The issuance ofit pe shall not be construed as a guarantee that tie sy rteiwill unction as&sid. Date Ins ector ——— No �.J.�""� 6 / ---------------------- Fee THE COMMONWEALTH OF MASSACHUSETTS 1 PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Di.5po.5al *pgtem Cougtruction Permit Permission is hereby gra ted t Cons uct(k )Re air(�)U}grade( )Abandon( ) System located at � E4� C _ 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 m,st be completed within three years of the date of this,permit. Date: �5 � Approved by- TOWN OF BARNSTABLE � LOCATION .. � Sea 0 /eLO U R— SEWAGE # _Jbo c�_3� 7 VILLAGE ASSESSOR'S MAP & LOT 0161 INSTALLER'S NAME&PHONE NO._1? � �OY/S7i'r.�L O✓t i SEPTIC TANK CAPACITY "' LEACHING FACII.ITY..(type). >'1o&1P,,- j*SP S — (size ) NO.OF BEDROOMS BUILDER OR OWNER C•l-1 • /l�cru�o n ' PERMITDATE:9/0,C,/O V COMPLIANCE DATE: 12A1 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within.200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by i G+� �J Y _ "F-2 - �, No. Fee BOARD OF HEALTH TOWN OF BARNSTABLE 0pplicationffirlVell Congtructionpermit Application is hereby made for a permit to Construct (X), Alter or Repair )an individual Well at: _20 _6,5 _g�o, ik,,g Me- Location — Address Assessors Map and Parcel Mc4oy--"C"" — N4?— 0-5tk-(4iktL -N\A Owner oea -t 0\4 ---------- A-- dd ess al'4 2\� A— . --------- L - ----0'r \5 "Ty\ Installer briller Address Type of Building v/ Dwelling—-------------------------------------- Other - Type of Building No. of Persons--------- ---------- � i 2Q;� G,P 1� Type of Well IT LAI I - —.— apacty Purpose of Well---A!-'(ivin- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to place the well in operation 4until ertificate of Co�r"lia ce has been issued ued by the Board of Health. J7 S date Application Approved By A6 date Application Disapproved for the following reasons: date Permit No. +0 L l Issued date BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of Compliance THIS IS TO CERTIFY, That the Individual Well Constructed 06, Altered or Repaired OQ 0--NN- Installer a t 5c� 5e-(N has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. Dated THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE------------------ Inspector——------—-------------------- No. - -- --- Fee- t BOARD OF HEALTH TOWN OF BARNSTABLE v 0pp[icatiohArVell Con5tructionpermit Application is hereby made for a permit to Construct (V, Alter ( ), or Repair ( )an individual Well at: i *, Location'—,,Address Assessors Map and Parcel Po:'Ao\ _mo_ldr 'o. u- — ��ea View Abe. Os�evv i lL (VGA oz655 Owner Address — �rnor� a\� h��\�i -�l�o �C.Smor��_ �.0• i���t_21 -�r�to, Installer — riller Address Type of Building Dwelling ----- --------- - Other - Type of Building---- -------- No. of Persons-___ of Well -L�-I-��=� -� �= - Capacity PM _-- Purpose of Well r i --------- Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until a/Cnertificate-.of Compliance has been issued by the Board of Health. +� I date Application Approved By— - ----— L L - date Application Disapproved for the following reasons:-------- - - ------- ---------- date_ Permit No. --- - Issued--- I --� --— --------- date A�-'-;':;,� ..:;.`_..fi=_x-'�.-,. ,^.-w .�.. =;.-�• �.- t ;,;N-�x _ ._H� _. '-'��t .ti .�.t..�.•...,.�� ,.r ......�..t..ra:.' BOARD OF HEALTH TOWN OF BARNSTABLE C ertif irate Of Compriance THIS IS TO CERTIFY, That the Individual Well Constructed OO, Altered ( ), or Repaired ( ) Installer at has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the-application for Well Construction Permit No. -----------Dated---- ----- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. - DATE-------- _ _ Inspector----------------- -- — ---- BOARD OF HEALTH TOWN OF BARNSTABLE Ive[I construct ion permit No. ! ' i�— 3 Fee- CJ — Permission is hereby granted 00 t A\\`A n to Construct ( ✓), Alter ( ), or Repair_( ) an Individual Well at: Me_ -------------------------------- street as shown on the application for a Well Construction Permit No.-- -- a ed-- ---- ------------------------------- DATE Board of Health —������t ----- No.----------------- Fee— ------------ BOARD OF HEALTH TOWN OF BARNSTABLE cc"? Zpplicat ion ArVeil Con5truct ion Permit Application is hereby made for a permit tq Construct ()(), Alter ( ), or Repair ( )an individual Well at: Location — Address Assessors Map and Parcel Owner Address Installer — Driller Address Type of Building / Dwelling ----—— —--- — Other - Type of Building-- ----,----©-�� No. of Persons--------------- �� ---------- Type of Well�_�1 4rk 0�� t ���i-11,E-1`C' Capacity ZC) �- C';P i'" Purpose of Well---- Agreement:The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The Town of Barnstable Board of Healt Private Well Protection Regulation — The undersigned further agrees not to place the well in operation until ertificate f pliance has been issued by the Board of Health. 7� date Application Approved B --— ----—— �' /t Z Y PP PP date Application Disapproved for the following reasons: ----------- -- ---- -------- / ------ date Permit No. Dec � --Q�'a� -- Issued--- ` -- -- —- date BOARD OF HEALTH TOWN OF BARNSTABLE C ertif icate ®f Compliance THIS I TO CERTIFY, That the Individual Well Constructed (-; Altered ( ), or Repaired ( ) by—— Instd1ler at----_ ---------------- has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -------------------Dated---------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE--------------- —- — Inspector-------- - -- -- —- --- No. ;Z�t-/ —C7 Y �-- Fee '4�----- — --- ----- ----------- q BOARD .OF HEALTH TOWN OF BARNSTABLE 6 ���Citation,�'or�eCY �on�truction�ertnit ._ ���, Application is hereby made for a permit to Construct (X), Alter ( ), or Repair ( )an individual Well at: q5 'IeW tA�e� J�►1� _ - k,T_ 6 - 2z,- __ --- Location'—-Address Assessors Map and Parcel n C _� RR Cff L5A lfln} FW C, Q9M,(gi§ o-- 61Q-- - -- - Owner Address V 1V3 O_r_learm 1W Uz.653 QQSrne�•d WQ\\'(- i:i�i�°�_�ovr�o�s'D�sl�n� ---------------------------------- - ---------- Installer — driller Address Type of Building Dwelling— ---- - -- - - - - Other - Type of,Building-------__-_____:__ No. of Persons----------------------- Type of i Well IYC �- -p-—m acitY Purpose —--- -—— of Well---l_tr� Agreement: The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The } Town of Barnstable Board of Health Private Well Protection Regulation - The undersigned further agrees not to place the well in operation until i ertificate f C�' pliance has been issued by the Board of Health. / — date 17 &_.4 Application Approved By, —__—_--_—___— � 1 date Application Disapproved for the following reasons: --- ----- -- -- ------- --- ----- ---------------date J I i Permit Nod. W `'� _ y 'a.._ __ Issued--- -r_1-7 ! — i* date a BOARD OF HEALTH TOWN OF BARNSTABLE Certificate Of COMPliante THIS IS TO CERTIFY, That the Individual Well Constructed (W); Altered (` ), or Repaired ( ) has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection Regulation as described in the application for Well Construction Permit No. -------------Dated---- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL SYSTEM WILL FUNCTION SATISFACTORY. DATE- ---- --- -- - —-- Inspector-- - - - - --- ----------- BOARD OF HEALTH i TOWN OF BARNSTABLE Melt Con5tructionPermit No. - -- Fee — Permission is hereby granted ,_' to Construct ( v)!Alter ( ), or Repair ( ) an Individual Well at: No 04 IL / street as shown n the application for a Well"Construction Permit No.__— -- Datied- —_ -- — --- -- - Board of Health DATE Massachusetts Department of\Environmental Management / Office of Water Resources 135533 TYPE OR PRINT ONLY Well Completion Report 1. WELL LOCATION GPS(OPTIONAL) LATITUDE - LONGITUJDE t+ p v,' i Address at Well Location: ��� . a V eW Avg Property Owner. 1 ��'`lQ. tv\A��+o� 'moo' a Subdivision Name:. C. l3Zz Mailing Address: °�501 So _VIe Avc.- F_ City/Town.. _O S "Z t t c` - Ciry�Fown'=' Assessors Map'-,--�--© Assessors Lot#:' NOTE:_Assessors Map and,Cot#Lmandaforyif no street address a,aitable ,I Board`of Health pecmit'obtained:- Yes LI :: Not Required.❑ Permit Nurnber Dae'Issued + f l 2 WORK PERFORMED '3:PROPOSED`USE 4.DRILLING:`NIETHOD 4 New Well ElAbandon ❑ Domestic [9 Irrigation ❑ CableAuger ❑ Deepen ❑ Recondition ❑ Monitoring ❑ Municipal ❑ Air Hammer`� 0 Direct Push ElReplace El Other ❑ Industrial ❑ Other El Mud Rota" ❑ Other 5.WELL LOG cc Unconsolidated Consolidated 6. SITE SKETCH(uae permanent landmarks with distances) W Permeability _� >co � ; From (ft) To (ft) High Low U `� C7 m Other Rock Type ' c k ,: � o -7_3 , I -V4\jr, 8.7,•WELL CONSTRUCTION CASI NG, From (ft) To (ft) ;>i' Casing-T y` a an'd Material Size:O D. (in) ,Well'Seal'.Type T.otal_Depth Drilled p " t Date Drill' Complete U" 3 �: SC � ��VG ,r PI{Z.E ADA-MK 9. SCREEN r From (ft) To (ft) Slot Size Screen Type and Material Screen Diameter —31 -35 .01 z STAIR STEEL- 11" 10;'FILTER PACK/GROUT!ABANflONMENTMATERIAL 11.ADdITlO1AL WELL INFORMATION, .• Developed? 120 Yes ❑ No From (ft) To (ft) Material Description Purpose Fracture . °. `�. Enhancement? L❑ Yes No Method Disinfected? C?§ Yes. ❑ No 12. WELL TEST DATA(PRODUCTION WELLS) � r� ``� � � 13.STATIC WATER LEVEL(ALL WELLS) _ Yield ``Tune Pumped Drawdown to Time Recovery to Depth Below Date Method (GP,M) (hm,8 min) (Ft. BGS) - (hrs & min) (Ft. BGS) Date Measured Ground Surface (FT) �eI Zqo� !'UrnP f(�an�c 2NKS 012-1 Fb%4 14. PERMANENT PUMP(IF AVAILABLE) 15:NAMEJADDRfSS OF PUMP INSTALLATION COMPANY Pump Description -- Horsepower Pump Intake Depth .(ft) Nominal Pump Capacity— (gpm) t § 16. COMMENTS . 1 ; 17. WELL DRILLER'S STATEMENT This well was drilled and/oi abandoned under my supervision, according to applicable rules 1 �� a and regulations, and this re is co to and core the-best of my knowledge. # Y Driller: � -`�"S '"`f mOin°� Supervising Driller Signature: GU� Registration #: I o `Jest �rin I►�� 1 Firm: Date: t !?1© Rig Permit#: I I g I I NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion. «^ y y BOARD OF HEALTH COPY Jl f EATT7R0TECHL.4I30R4T0RIES,INC � ! 16LA CERT.IATO.:AgL4 063 8,jarr S hastian Dace-Unit#12 Sandwich ALL 02563 508(888-6460) 1-800 339-6460 FAX(508)888-6446 CLIENT. Desmond Well Drilling LOCATION: 959 Seaview Ave ADDRESS: (Russ Botelho& Osterville MA CH Newton) Carriage House LIDT' `3'4Z COLLECTED BY. Desmond Well Drilling SAMPLE DATE: 10/29/2004 SAMPLE TIME: 10:30 WATER SAMPLE TYPE: New Irrigation Well DATE RECEIVED: 10/29/2004 LAD I.D. #. 0410439 WELL SPECS.: 4"Sch 40 Well RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Analyzed Limits Coliform bacteria /100ml 0 0 9222 B 10/29/2004 pH pH units 6.5-8.5 5.78 4500 H+ 10/29/2004 Conductance umhos/cm 500 138 120.1 10/29/2004 Nitrate-N mg/L 10.0 2.91 300.0 10/29/2004 Nitrite-N mg/L 1.00 <0.004 300.0 10/29/2004 Sodium mg/L 20.0 22.9 200.7 11/1/2004 Iron mg/L 0.3 <0.1 200.7 11/1/2004 Manganese mg/L 0.05 0.049 200.7 11/1/2004 COMMENTS: Low pH indicates high corrosive characteristics. Sodium level is not a health hazard. WATER MEETS EPA STANDARDS AND/S SUITABLE FOR DRINKING PURPOSES - FOR PARAMETERS TESTED. < = Less than >=Greater than TNTC=Too numerous to count S ,� Date —&I* Rod6ld J. Saari Laboratory Di r t®r Massachusetts Department of Environmental Management Office of Water Resources 135532 TYPE OR PRINT ONLY Well Completion Report 1.WELL LOCATION GPS (OPTIONAL) LATITUDE`a ` ` LONGITUDE r Address at Well Location: 5°l Sea qi e w R\I e vwL Property Owner: Subdivision Name:SOT Mailing Address: Cw5 Su,vleW AUK- City[Town: City/Town: Assessors Map OW Assessors Lot#: NOTE: Assessors Map and Lot# mandatory if 2te street•addr ss available Board of Health permit obtained: Yes D7 Not Required El Permit Number)42M-0q_L ass ed`R i- 64 - 2. WORK PERFORMED 3:PROPOSEo USE=_ e ,s;' , .' 4. DRILLING,METHOD © New Well ❑ Abandon ❑ Domestic l Irrigation ❑ Cable A;Auger ❑ Deepen ❑ Recondition ❑ Monitoring ❑ Municipal ❑ Air Hammer Q Direct Push ❑ Replace ❑ Other ElIndustrial ElOther ❑ Mud:Rota ,❑ Other 5.WELL LOG Cc Unconsolidated Consolidated 6. SITE SKETCH (use permanent landmarks with distances) W Permeability - From (ft) To (ft) > High Low C7 m Other Rock.Type o -3 L x X X r--.W-L y 7.WELL CONSTRUCTION 8. CASING J Total Depth Drilled - '2 From (ft) To-(ft) Casing Type and Material Size O.D. (in) - -Well Seal Type Date Drillin? Complete � - 28 C ,, Pvc L-tI PrL.EsS ADAPTEK 110� AAZC\(Otf 9. SCREEN e _. From (ft) To (ft) Slot Size ScreifiZ pe and Material Screen Diameter -L% -'32, ,042- S-TN1NLES' , S- FE L 10. FILTER PACK/GROUT/ABANDONMENT`MATERIAL 9 T 11."ADDITIONAL WELL:INFORMATION Developed? L� Yes ❑ No From (ft) To (ft) Material Description Purpose Fracture Enhancement? ❑ Yes ^ No Method Disinfected? Q�Yes ❑ No 12.WELL TEST DATA(PRODUCTION WELLS) ',:° 13. STATIC WATER LEVEL(ALL WELLS) .{ Yield Time Pumped Drawdown to Time Recovery to Depth Below _ Date Method (GPM (h'rs,&min) (Ft. BGS) (hrs& min) (Ft. BGS) Date Measured Ground Surface (FT) I0� qo PuvrP TA"P Cl`� \Z�N12S I3 (mm�p - )o lv Z1164 14. PERMANENT PUMP (IF AVAILABLE) a = '- 15.NAME/ADDRESS OF PUMP INSTALLATION COMPANY Pump Description ,�� Horsepower Pump Intake Depth 4 (ft) Nominal Pump Capacity (gpm) 16. COMMENTS 17. WELL DRILLER'S STATEMENT This well was drilled and/or aba oned under-my supervision, according to applicable rules ��. and regulations, and this rep( complete�an/d corre t to the best of my knowledge. Driller: hog�" .J` jvn6r1 Supervising Driller Signature: �'�/-� ^registration #:I ` Firm: �V�t� �� t� t��� Date: I l f z/ o` Rig Permit#: NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion. BOARD OF HEALTH COPY ENVIROTECHI-ABORT TORTES,71VC L/ JL4 CERT.A-O.:Af-AL4 063 8 jan Sebastian Diire-Unit#12 Sandsc4ch 11L1 02_563 508(888-6460) 1-800-339-6460 FAX(508)888-6446 CLIENT. Desmond Well Drilling LOCATION., 959 Seaview Ave ADDRESS: (Russ Botelho& Osterville MA CH Newton) Garage L �L c COLLECTED BY: Desmond Well Drilling SAMPLE DATE: 10/29/2004 SAMPLE TIME: 12:30 WATER SAMPLE TYPE: New Irrigation Well DATE RECEIVED: 10/29/2004 LAB I.D. #: 0410438 WELL SPECS.: 4"Sch 40 Well RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Analyzed Limits Coliform bacteria /i00ml 0 0 9222 B 10/29/2004 pH pH units 6.5-8.5 5.81 4500 H+ 10/29/2004 Conductance umhos/cm 500 264 120.1 10/29/2004 Nitrate-N mg/L 10.0 3.69 300.0 10/29/2004 Nitrite-N mg/L 1.00 < 0.004 300.0 10/29/2004 Sodium mg/L 20.0 13.2 200.7 11/1/2004 Iron mg/L 0.3 <0.1 200.7 11/1/2004 Manganese mg/L 0.05 0.016 200.7 11/1/2004 COMMENTS: Low pH indicates high corrosive characteristics. WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. < = Less than > =Greater than TNTC=Too numerous to count Date Ronald J. Saari Laboratory Dir for No. 0003_. 1 ..; �i1✓t�( b Ua w. i� '��� ��i_Fee 1 . THE CO0ONWEALT OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 3pprication for 0i.5po.5al bpztemc Construction Permit Application for a Permit to Construct( . )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. tC 4c Owner's Name,Address and Tel.No. Assessor's Map/Parcel r D U 003 PdAl- a h1) Trc c�-- Installer's Name,Address,and Tel.No. Designer's Name,Address and fel.No. Type of Building: Dwelling No.of Bedrooms Lot Sized 4�Gsq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow G O gallons per day. Calculated daily flow gallons. Plan Date ca_3 Number of sheets Revision Date Title Size of Septic Tank / U Type of S.A.S. lezj.nt, L4anwCd Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees t._ensure-the.00n c on and maintenance of the afore described on-site sewage disposal system in accordance with the pr isions of Title viron a Code_a d not to place the system in operation until a erti t- cate of Compliance has been ' ued s ar th. Sign/ed _ Date i I /u 3 Application Approved'by Date '4 —v M Application Disapproved for the following reasons Permit No. D — Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( ) Abandoned( by at*0 s";ua Ajc, Q&rj.11 e, has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. �03' A dated ' Installer = Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector s No. Q` Fee r� THE'G'�MMONWEALTWOF MASSACHUSE�TS m +�. Entered in computer: ✓ Yes ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 3pprtcatiort for �Di�/ogar *pztem Con.5truction Permit / Application for a Permit to Construct( . )Repair,( 'j Upgrade( )Abandon( ) El Complete System O Individual Components Location Address or Lot-No, y5� SGL` tCiJi do Owner's Name,Address and Tel.No. Assessor's Map/ParceJ Installer's Name,Address,and Tel.jNo. Designer's Name,Address and Tel.No. Sl c CJ Type of Building: // r Dwelling No.of Bedrooms to Lot Size J lit�rLsq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date !o o Number of sheets Revision Date Title Size of Septic Tank /.'f( rJ Type of S.A.S. l to '.n4 644^s ces ' Description of Soil, Nature of Repairs or Alterations(Answer when applicable) r Date last inspected: Agreement: ` The undersigned agrees to,ensure-the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of�ffie'gnv_ onmental`Co—de ''and not to place the system in operation until a Certifi- cate of Compliance has beemissued.bythis Boar _of Health. � Signed "" _ Date Application Approved'by / 1 w Date (f "Application Disapproved for the following reasons Permit No. c)2 — Date Issued S-,�S`0 3 / THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance tj. p " x " THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed(ry' )Repaired`( jUpgraded( ) Abandoned( )by at is .Se,4c,j AJ t, nc-rut!•II f has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. -2LW I, A dated Installer Designer = M ?1 The issuance of�.this permit shall not be construed as a guarantee that the system will function.as£.designed4 Date C I f .% -t 1. i i Inspector _ No. 9UV 3—Wlb --------�Y} , Fee /0v THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Mizpo.�af *pgtem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( )Abandon( ) System located at $�9 J.raJ A J t 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 permit./ Date: `u Approved b �/`�• f` � PP Y �'raa�smial seer . To: - �Board-of-Health. _.__. r-- AIGL 1200 Main Street 1 Hyannis,Mi 02601 Attn: Saw. W ba t*r— From: Stephen A. Wilson, P.E. Subject: P- Date: 3 •zia. t33 We are sending you ®Attached ❑Under Separate Cover The following documents: El Prints❑Order of Conditions❑Variance,Approval. Recording Slip,❑ Septic System Permit ❑ Other` DATE QUANTITY DESCRIPTION a•Lf•ar3 Stec ? J These items are transmitted as checked below: ❑ For Your Use ❑ As Requested For Your Files ❑ For Review and Comment ❑ For Recording ❑ As Required . . _ Other: Additional Distribution (,e File No. 2 c�w.--c9!j Baxter,Nye&Hohngren Inc. Phone:508428-9131,ext.13 812 Main Street Fax: 508428-3750 Osterville,Massachusetts 02655 E-Mail: swilson@jkholmgren.com Transmittal Ldterldoc i a CL Z7, —p } _ �`.+, — — Z LSA ' .•� as `' .° �' '- = o'n � _ � �D ,5` .?^� i ;2:^ _Li;i 7/-'-`�� - .- < N �' i > T .. n. Z. cr - - O w- 7AK `--' - r- ,1\`q. :c i2.= C t %: '� •�:' 'V3 y n a C GARDEN _ D!2: LAWN EA (m 'DH w TD -> j o. — .� 1 i i•.' ?c WOODED _ �. LAWN t—o o aq SSPQ 1 ,4 ii.7 - _ 26.0• 'i — v. _ ':. .. -tom`' _. ass• uESSPO J _ t — tx a. LSA \ i CD II9 2. EXIST!N0.WOOO.FRAME --- 1 'A . co 'y:.a ! O= \ -LA';WN N 3 59 C \\. \ _ - �POR CH . .. .r �..• — rr... J�e _. . vcn n — _ C.'`i .•T co `'S _ — - EAf FLOOD EL 7�2_0' x 2, n:- o N - .0.- .j Q o 12.2 cn -1500• < ,n 1 t .� f� G BRUSH n 16 _ b _ .' w o p a 7BR SH fc, a� -„• - - r 6.16 l w YR VEL C 'COAST /U/g7v%UG''•CCT c5-0&A/,o .., �► .. . . . � . . . I .. � . I I I I I . - � I � . . I I . . .. - . . I ., . I . . . I I - - . - 11 I . . . .1 1 . -I . . I.1,. .. 1. I � - '. .. . 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Surfncg(In)._ , "(USDA) _ (Munsell) Moilling•. (Structure,Stones 3oulJeres :e. _ C ° .. .. i. I. 4 b "A- I b•',P't - �. -.l�- B Loy,., 1'. . .. IG" :13L1 C ', h1erdws lc`I�e s4 I? LI. RS� TIi�N �OL` ,L�C dole:# beplh from Solti-lorizon Solt Texture Soll Color Solt Other' + ' . Surface(hi) (USDA) (Munsell) Mottling (Structure;Sloires,I3oulJeres. . .. d,,lOv Aj Saw4J Loath, 1.0.'i11 ..3 " q to 13: �o.: tc.� y/1 'V►►c �b`�aR ' 60" :132. et. F11cJ. lb.'�tK 7�3" : ' l� Z�O SI t A'� pN)r pl iJ Lpp �ul+v# L . Depth IYom 5011 iioriion SoII.Texture,, Soli Color Solt Other . Surface(hr.); (USDA) (Munsell)` Mottling (Slruclurb,Sloncs,.batilJcres: 1. c '.. - ..- - I. - <i . . . . DR 5ATION:XIOU LpGIt�1c# tleplh from Sorizon ' { Soll texture Soil Calor Soll Olhcr 1. Surface(in) : I (USDA) (Munsell) Mottling. (Structure Slopes,poulderes. . 1 .. . ) A blood Iusurtince Rafe Maur: ti "�o; . . . Above 500 year fiocd boundary .i,� Yz tf . Within 500'year boundary -:No f/: Yes . . , . AVlthin 100 your flood boundary.No Yes ,'tl►of Na•knrall cc)trriiig Pervious MAkI rlal . . Does at least:four feet of li:eturally occurring pervious material exist in all areas observed tliroughout the : area proposed for the toll absoroUb.n,system7': A _ : If'110L:what is the iepth of tiaturally oct:urritig pery pervious material? _ Certificatlon I 1 : . . I certify that on �' ?S.. (date)I liave passed ilia soli evaluator examtitatton approved by the. _ , Depart(nent..pf.9; ...vi,ronmental Protection and,that tiie above analy.15 was performed by.)Tie,consistentwith . .. the required training'expertise and experfetice described In.310 CMR`15 017 ' Signature'.;.._,.,..­.�.�� .�7!zI I ..r. Date 3 ZB"e3 - . h a Ay-},'y- (r-i 4; It .. . r . A :. - Town of Barnstable Board of Health P.O. Box 534, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Wayne Miller,M.D. June 11, 2003 Mr. Stephen Wilson, P.E. Baxter,Nye, and Holmgren, Inc 812 Main Street Osterville, MA 7 RE: 69 eaview Avenue, Osterville A ^zd m7 — Dear Mr. Wilson, You are granted permission, on behalf of your client, Paula Madonna,to construct an onsite sewage disp system designed to be connected to seven bedrooms proposed to be constructed at 69 aview Avenue, Osterville. �31 The septic system shall be constructed in accordance with the submitted plans dated March 31, 2003. Sinc ly yours, W ne ller, M.D. Chairm BOARD OF HEALTH TOWN OF BARNSTABLE Q:HEALTH/WP/W ilson7Beds DATE: R, K � � REC. BY Town of Barnstable �. SCHED. DATE: Q� Board of Health • N �$ 367.Main Street,Hyannis MA 02601 U Office: 508-862-4644 Susan G.Rask,RRS. FAX: 508-790-6304 Sumner Kaufman,M.STA Ralph A.Murphy;M.D. Request for Approval of Septic System in Excess of Five Bedrooms LOCATION 5 Property Address: Se n-j t c w f�y G►t�!-e OSr N i I c Assessor's Map and Parcel Number Size of Lot: Wetlands Within 300 Ft. Yes ✓� Business Name: No Subdivision Name: APPLICANT'S NAME: �s�l a 1�10�o r�n a Phone Did the owner of the property authorize you to represent him or her? Yes ✓ No PROPERTY OWNER'S NAME CONTACT PERSON Name: I�a.�Iz Y1�14eQonr►a Name: Sh�ploj A 0ilsea .Pt, $o,t1s� tl�e. Address: n-y 4ax. 664. "%t Address: Sm ►7► al% bra, Os� fflA oZ6SS Phone: Phone: (-saq �f. 26—2AA4, cyc¢/3 Checklist(to be completed by office staff-person receiving variance request application) Four(4)copies of engineered plan submitted(e_g.septic system plans) Four(4)copies of floor plan submitted(e.g.house plans or restaurant kitchen plans) APPROVED Susan G.Rask,ILS.,Chairman NOT APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Ralph A.Murphy,M.D. Q:/wp/VARIREQ ti Transmittal Leiter To: +.Board of Health 1 200.Main Street _ _ Hyannis, MA 02601 Attn: La From: Stephen A. Wilson, F.E. Subject:• - ds �.f Date' 2.eo2 J�r -APk 16 ?_F 5i I We are sending you ®Attached ❑Under Separate Cover TOVvr.;� HE6�L1 vJL I. . The following documents: ®Prints❑Order of Conditions El Variance Approval❑Recording Slip ❑ Septic System Permit ❑Notice of Intent❑Other DATE QUANTITY DESCRIPTION .3 9/ O 3 `9� >!r<<s f• lc�r Ire+" S'...E A"en 3/ Q3 y awe0 Ike J OOR o s a These items are transmitted as checked below: ❑ For Your Use ❑ As Requested ❑ For Your Files ® For Review and Comment ❑ For Recording ❑ As Required Other: n P- BonvrQ rcoiu.J cev.� a161c��^oJ®x• c•+� Z/Z 4 Additional Distribution C 4 v raL•. File No. Zero2-095/ Baxter,Nye&Holmgren Inc. Phone: 508-428-9131,ext.13 812 Main Street Fax: 508-428-3750 Osterville,Massachusetts 02655 E-Mail:swilson@jkholmgren.com TransmitUlLener4.doc AILS� �I� s ��7�92` 0 2 "DATE . ------ oo� ocQTv pppRESS : 959_Seaview-&Y--------- //?? 0sterville MASS . - - - ---- -- - 02655 ------ --------fA ® INSPECTION On the above date, I Inspected the septic, system at the above addgEPEIIVED This system consists of the following: 1 . 3-cesspools . Two on the westside and one on the southside JUL U 8-2002 2 . West side are in series . South side is sigular .' � TOWN OFBARNSTABLE 3 . #1 West side 6 ' X9 ' overflow 5 'X7 ' . South side . 6 X7 HEALTHDEPT. Based on my Inspection, I certify the following condltlons: Y' r) 7 9 4. This is not a title five septic system. 5. This is a sewage system. ( 3 cesspools 6. The system has been in hydraulic failure in the past . 7 . A new title five septic system needs to be installed . 8 . The age of the system is around 50 years old or older . SIGNATURE :, Name : _ � _�._ Macomber Company : Joseph_P _-Hac_o_mber_& Son Inc � cOress : Box 66 Centerville , .Ma . 02632-0066 Pnone: 508- 775- 3338 , I THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. Tanks•Cesspools•Leachflelds Pumped & Installed Town Sewer Connections P:O. Box 66 Centerville, MA 02632.0066 775-3338 775.6412 • � I !7I COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS iqj, DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION PropertyAddress:959 Seaview Ave stervi e , a Owner's Name: Thelma Dinkello Owner's Address:145 Blue Trail Hamden Conn . 06514 Date of Inspection: 6/2 4/0 2 Name of Inspector: (please print)J o s e p h P.Macoinber Jr:. Company Name: J. P.Macomber & Son inc. Mailing Address: Box 66 Centerville , Mass - 02632 Telephone Number:508-775-3338 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 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 t Conditional(, Passes _ Xeeds,Further Evaluation by the Local Approving Authority ,} �r/Fails Inspector's Signature: r Date: "d The system inspector shall S. mit 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 -****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. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 1 1 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 959 Seaview Ave stervi e , ass ._ Owner: Thelma Dinkello ` Date of Inspection: 24 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any ' formation which indicates that any of the failure criteria described in 310 CMR 15.303 or=trt 310 C R 15.304 exist. Any failure criteria not evaluated are indicated below,. ,Comments: - The sewage system is in failure . A new title five septic ssem needs to be installed ,was in hydiauttu failure erit 7/19/01 B. System Conditionally Passes: Ji f� 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 tic tank s 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: /f ( -Observation of sewage backup or break out or high static water level in th istribution o ue to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System wi 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 Page 3 of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Propem. Address:959 Seaview Ave stervi e , ass . Owner.Thelma Dinkello Date of Inspection: 6 24 02 C. Further Evaluation is Required by the Board of Health: Conditions exist which require funher evaluation by the Board of Health in order to-determine if the system is failing to protect public health, safety or the environment. I. S)'stem 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: 66 Cesspool or privy is within 50 feet of a surface water d,Q 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 environments !Q6 The system has a septic tank and.soil absorption system (SAS) and the SAS is'withirt 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 supple. 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 feet or more from a private eater supple well,'. Method used 11 to determine distance 14/ 'This s' stem passes if the well water analysis, performed at a D'EP cenified 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 rriggered. A copy of the analysis must be attached to this form., 3. Other: - This is a sewage system. House built in 1920 ' s . Cesspools have been in hydraukic failure and pumped in e past- _ Last time done 7/19 O1 2—cesspoo s on west si e . d-. .cesspools__are _in _.series . 1—cesspool on the south si e ot house . 3 Page 4 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Proper-Ty Address:959 Seaview Ave 0sterville , Mass . Owoer.Thelma Ti nkPl 1 o Date of lospection: 6/21s f 02 D. System Failure Criteria applicable to all systems: You must Indicate "yes" or "no" to each of the following for all inspections Yes NO _ 10/acscup of sewage nto faciliry or system component due to overloaded or clogged SAS or cesspool ischarge or pondtng of c filuent to the.surface of the ground or surface waters due to a.n overloaded or clogged SAS or cesspool jotIG C Static liquid level m the dismbution box above outlet inven 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 ''A day now Required pumping more than 4 times in the last year NOT due to clogged or obstrveted pipe(s). Number _ u�(times pumped ) . JAny ponion of the SAS, cesspool or privy is below high ground water elevation. r� Any ponion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface — water supply. /Any ponion of a cesspool or privy is within a Zone] of a public well. Any ponion of a cesspool or privy is within 50 feet of a private water supply well. Any ponion of a cesspool or privy is less than 100 feet but greater than 50 (eet.from a private water supply well with no acceptable water quality analysis. (Tbis system passes If the well wafer analysis, pert,rmed at a DEP ceniricd laboratory, for coliform bacteria and volatlle 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 aoalysis must be attached to this form,j 7`'� (Yes'i;o)rThe system fads. I have determined that one or more of the above failure criteria exist as described in 310 CMR 1 5 303. therefore the system fails. The system owner should contact the Bo!,-- 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 now of 10,000 gpd to 15,000 gPd You must indicate either"ycs or"no" to each of the following: 1 Tie following criteria apply to large systems in addition to the criteria above) yes n�/ ' P (he system is within 400 (eci of a sarace drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply Zinc system is located in a nirrogen sensitive area (Interim Wellhead Protection Area — I WPA)or a mapped Zone II of a public water supply well !fyov rave answered "yes" to any question in Section E the system is considered a significant threat, or answered es" in Section D above the large system has failed. The owner or operator of any large system considered a s:zn:. scant trveat under Scction E or (ailed under Section D shall upgrade the system in accordance with 3 10 CMR ;0� The s3-stem owner should contact (he appropriate regional oMcc of the Department. 4 Page 5 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address:959 Seaview -Ave Osterville ,Mass . Owner: Thelma Dinkello Date of Inspection: 612 4/0 2 Check if the following have been done—You must indicaie'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 /A f 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,Wcluding the SAS, located on site ? Were th eptic 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 an&clepth of,scum ? Z _ 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/ 1� Existing information. For example, a plan at the'Board of Health. v _ 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)J 1 ' House is presently vacant . 5 Page 6 of I I OFFICIAL INSPECTION FORM _ NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE-DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION: Property Address: 959 Sea view Ave ' Osterville . Mass Owner: Thelma Dinkello Date of Inspection: 6/2 4/0 2 FLOW CONDITIONS - RESIDENTIAL Number of bedrooms(design): Number of bedrooms (actual): . DESIGN now based on 310 C1,-T 15.)03 (Moor example: 110 gpd x # of bedrooms)6 l) el 41 Number of current residents: � Does residence have a garbage grinder (yes or no);%+fi Is laundry on a separate sewage system (yes or no)• z_ ) (if yes separate inspection required) Laundry system inspected (yes or no): � Seasonal use: (yes or no):X5 Water meter readings, if available (last 2 years usage (gpd)): •2000-35 , 000 gallons-95. 89 GPD Sump pump(yes or no): A 2001-37 , 000 gall ons-101 . 37 GPD Last date of occupancy: ry,.rf COMMERCIAUINDUSTRIA L ' Type of establisbment: Design now(based on 310 CMR 1 5.203): _mil gpd Basis of design flow (seats/persons/sgft,etc,): Grease trap present (yes or no): ALY Industrial waste holding tank present (yes or no): �} Non-sanitary waste discharged to the Title 5 system (yes or no):,&I Water meter readings, if available: Last date of occupancy/use: OTHER (describe): A9 GENERAL INFORMATION Pumping Records Source of information: Was system pumped as pan of the inspection (yes or no): _ If yes, volume pumped: 0 gallons •• H w was quantity pumped determined? Reason for pumping: 1/0 TXPE OF SYSTEM Septic tank, distribution box, soil absorption system r Single cesspool$ Overflow cesspool ;F0 Privy ,�VShared system(yes or no) (if yes, attach previous inspection records, if any) Innovative/Alternative technology-Anach a copy of the cturent operation and maintenance contract (to be obtained from system owner) dTight tank A!f Anach a copy of the DEP approval Other(describe): Approxyyimate aoe of all component , date installed (if known) and source of information: Were sewage odors detected when arriving at the site (yes or no)'! F 6 Page 7 of I 1 OFFICIAL INSPEC ON FORM- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE )`�VAGE DISPOSAL SYSTEM INSPECTION FORM PART C N'STEM INFORMATION (continued) Property Address:9 5 9 S e a v i . A v e sterviT1 Hass , Owner: Thelma Dinkel Date of Inspection: 6 24 0'. BUILDING SEWER (locate on : t pian) Depth below grade: bZ Materials of construction: cas. � bother In a40 PVC her(explain): Distance from private water supp. t:!I or suction line:/d ji- Comments(on condition of joinu i.ting, evidence of leakage, etc.): Joints appear tight— do evidence of leakage . The . system 'is vented through the. us;e venets . SEPTIC TANK44f�V,(locate on s t. f'±an) Depth below grade: Material of construction:,fJ�conc r i�metal,d4 fiberglass IL,4 polyethylene �j4other(explain) —1119 If tank is metal list age:*4 is a . _,•;Caned by a Certificate of Compliance (yes or no)-,j!9 (attach a copy of certificate) Dimensions: Sludge depth: Distance from top of sludge io bo:.-:-, cf outlet tee or baffle: Scum thickness: Distance from top of scum to top :.tart tee or baffle: AM Distance from bottom of scum to , , .:•. of outlet tee or baffle: 'JlW How were dimensions determine( A11A Comments(on pumping recomm(. e :tuns, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidenc .eakage, etc.): Septic tank is not —sent . GREASE TRAPI�i:(locate on Depth below grade: Ar/I Material of construction:.44 cone; W�} rr etaW fiberglass, Polyethylene other (explain): Dimensions: - Scum thickness: 4 Distance from top of scum to top t;et tee or baffle: /Jt Distance from bottom of scum to :}` m of outlet tee or baffle: Date of last pumping: Comments(on pumping recornnw--,--i r,s, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert, evident cakage, etc.): Grease trap is not f' Sent . 7 Page 8 of 1 OFFICIAL, INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 959, Seaview Ave Ostervi e ,Mass . Owner Thelma Dinkello Date of Inspection: 6/2 4/0 2 TIGHT or HOLDING TANKS(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: AA Material of consrruction:IvAconcrete , metal fiberglass,&Y polyethylene��other(explain): n Dimensions. R Capacity: gallons Design FIoN:EE� gallons/day Alarm present (yes or no): _ Alarm level: _yM Alarm in working order(yes.or no): �• .' Date of last pumping: ivy* Comments (condition of alarm and float switches, ett.): Tight or holding tanks are not present . DISTRIBUTION BOXrt� (if present must be opened)(loca.te 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.): Distribution box is not present . PUMP CHAMBER/.L"(locale on site plan) Pumps in working order(yes or no): s Alarms in working order(yes or no): � Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber is not present 8 Page 9 of 1 1 , y OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM .PART C SYSTEM INFORMATION (continued) Property Address: 959 Seaview Ave stervi e , ass .. Owner: Thelma Dinkello Date of Inspection: 6 24 02 SOIL ABSORPTION SYSTEM (SAS): (locate on site plan, excavation not required) Three cesspools . 2—in series and one singulsr If SAS not located explain why: Located see page 10 Type AZ& leaching pits, number: .1,1 leaching chambers, number: d/Q leaching galleries, number: (6 leaching trenches,number, length: i!P 7leaching fields, number, dimensions: overflow cesspool, number: S innovative/altemative system Type/name of technology: Conuncnts (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): r , Loamy sand to medium fine sand . There are signs of past hydraulic failure - So i s -are ry : ege a ion isNEW TITLE FIVE SEPTIC SYSTEM NEEDSHouse is presently cant . CESSPOOLS: K (cesspool must be pumped as pa�f inspection)(locate on site plan) Number and configuration: %invert: Depth—top of liquid to inle Depth of solids layer:xtJ Depth of scum laver (� 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.): Same ae ahnvP RntlRp l4 vacant " PRIVY4.de(locate on site plan) Materials of construction: dh't Dimensions: Depth of solids: AJ F Comments (note condition of soil, signs of hydraulic failure, level of pond ing, condition of vegetation, etc.): s Privy is not present . 9 Pav 10 0! 11 OFF1CLAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL, SYSTEM ,INSPECTION FORM PART C SYSTEM INFORMATION(,,,,inucd) PrpPcrT� Aodreff959 Seavie.w Ave Ostervi e , 0rocr: Thelma in e rJilc of lnipiciioo, 2 SKETCH OF SEWACE DISPOSAL SYSTEM Pro.ioc I l Lo of iII Icwsjf 4ilpossl syslcm Including lies 10 al least rwo permancM rcfcrcncc lancmarx, or oancnmuki lociic �n ..clli" .iihin`I-00 Logic where pvblic walcr Ivpply cnlcrs the bvilding. 1 cyv�a,h VN 0D �,, r - - Page 1 1 of 11 OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address:959 Seaview Ave ; Osterville ,Mass . Owner: Thelma Dinkello Date of Inspection: 6/2 4/0 2 SITE EXAM Slope Surface water Check cellar Shallow wells - Estimated depth to ground water /'J� i feet Please indicate (check)all methods used to determine the high ground water elevation: �Obsevedwsite om system design tans on record - If checked, date of design plan reviewed: A-4 (abutting propetry observation hole within 150 feet of SAS) Ae- ith local Boar o ealth-explain: Checked with local excavators, installers- (attach documentation) Accessed USGS database-explain:h t t p ; l l t o wn , b a r n s t a b 1 e .ma u s You must describe how you established the high ground water elevation: Used ; Gahrety & Miller Node1 : 12/16/94 Ground water elevations above sea level . Used ; Observation well data . June 1992 USGS Used ; USGS ; :Technical hu.11etin 92-000-1 Plate #2/ Annual ranges of ground water elevations . Leaching Pit 'eet. Groundwater, Feet Below Bottom of Pit A h,Crroundwater Adjustment 1.8 ft per Frim ter Method $.,.. , p p ..Therefore, the vertical separation distance between the bottoms i of the leaching pit and the adjusted groundwater table is ,/ feet. 11 - i ',.rrnr. -n.rr—•rrrnrrt+r•rmra�+n.�•.-r.mr.:•.rr+-.m�:�.r-mr*n r�-�v*.crrr<r.mn . Barnstable TOWN OF BOARD OF HEALTH 0 -,-T -- .-SUIISURFACF 9FWAGE OI fOSAL ,SYYSTF,'M INNSI'ECTION FORM PART D •- CERTIFICATION tnnn ..r.rrrr•�• �..� -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 959 Seaview Ave Osterville ,Mass . ASSESSORS MAP , BLOCK AND PARCEL 090-007 OWNER' s NAME Thelma Dinkello PART D - CERTIFICATION i NAME OF INSPECTOR Joseph P.Macomber Jr:'. COMPANY NAME J. P.Macomber & Son ince-e COMPANY ADDRESS Box 66 Centerville , Mass . 02632 Strvvt Town or City S t a t 9 LIP COMPANY TELEPHONE ( 508 ) 775 - 3338 FAX (508 790 -1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported is true , accurate , and omplete as of the time ofeinspection , The inspection was performed and - any recommendations regarding upgrade , maintenance , . and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the env ironment .as defined in 310 CMR 15 . 303 . Any ' failure criteria not evaluated a'r'e as stated in the FAILURE CRITERIA section of his form . System FAILED* The inspection which I hive con acted has found -.that the system fails to Protect the public health and the environment i'n ` accordance with Title 5 , 3.10 ..EMR 15 . 303 , and as specifically noted on PART C — FAILURE . CRITERI-A".of this inspection form . Inspector Signatur bate �L=-� ne cop•y• :of this r—tification must be provided to the OWNER, the BUYER ( where applicable ) and the 130ARD OF HEALTH. w If 'the inspection FAILED , the owner or='*oparator shall upgrade • the eyetem within one year of t))e date of the inspection , unless allowed or required otherwise as provided in 3.10 CHR 16 . 305 . partd . doc i 7/l/02 0 AT E : ----------- oo� ocaTv � pOR,ESS 959 _Seav_ie-w--Av— Zr- -ge ' _0sterv-i-l-he Maas__--- -- - 02655 On the above date, I Inspected the septic system at the abo e sIVED This system consists of the following; 1 . 1-5 ' X6 ' cesspool . JUL 0 8 2002 TOWN OF BARNSTABLE HEALTH DEPT. Based on my Inspection, I certify the following conditions: 1 - 2 . / This is not a title five septic system. r3'. This is a sewage system . Systeme is 45-50 years old . _ 4 . This a strictly used seaonal cottage . Has very little ueeage . 5 . The sewage system is in proper working order at the present time . r SIGNATURE :_,. Name _ _�._ Maco�ber �r Company : Josevh_P . Macomber A Son , . Inc , CCress : Box 66 Centerville , Me •_ 02632-0066 Phone : 508- 775-3338 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY � • I JOSEPH P, MACOMBER & SON, ING,LL Tanks•Cesspools•Leachflelds Pumped & Installed Town Sewer Connections P 0. Box 66 Centerville, MA 02632.0066 - 775.3338 775.6412 COMMONWEALTH OF MASSAC HUSETTS r EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 959 Seaview Ave ( Cot:t,age ) Osterville ,Mass . Owner's Name: Thelma Dinkello Owner's Address: 7/1 /02 Date of Inspection:Same Name of Inspector: (please print) Joseph P.Macomber. jr Company Name: J. P.Macomber & Son Inc . Mailing Address: Box 66 Centerville ,Mass . 02632 Telephone Number: 508-775-3338 CERTIFICATION STATEMENT 1 certify that 1 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. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes _ Conditionallv,Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date: The system inspector sha I s mina copy of this inspection re ort to the Approving Authority(Board of Health or DEP)within 30 days of c pleting 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 Cornments• °.�"This-report-on ly 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. Title 5 Inspection Form 6/15/2000 page 1 r Page 2 of 1 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 959 Sea view Ave ( Cottage ) Osterville ,Mass . Owner: Thelma Dinkello Date of Inspection: 7 1 0 2 Inspection Summary: Check A,B,C,D or E/'ALWAYS complete all of Section D A. System Passes tb I have not found any information hick 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 cesspool is presently . The cesspool is in p.r_o_ p4er " wer- ki—na—erd®r at the present time— B. System Conditionally Passes: s, 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. 4?&et:'iThe se tic s 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 ouf or high static water level in th di o ue 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: J Page 3ofII OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Propem Address:959 Seaview Ave ( Cottage ) , Ostervi e , ass . Owoer: Thelma Dinkello Date of lospectioo: 7/1 /02 C. Further Evaluation is Required by the Board of Health: A,"Cl 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. I. 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 bealtb, safety and the environment: ZD�Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a borderingetated wetland or a salt ve g marsh ? System will fail unless the Board of Health (and Public Water Supplierjf any) determines that the system"his functioning in a manner that protects the public health, safety and environment: �yU The system has a septic tank and soil absorption system (SAS) and the SAS is.within 100 feet of a surface water supply or rributary 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 supple. nd SAS and the SAS is within 50 feet of a private water supply well The system has a septic tank a The system has a septic tank and SAS and the SAS is less than 100 feet b t 50 feet or more from a private %kater suppi\ -ell— Method used to determine distance "This s.\stem passes if the well water.analysis, performed at a DEP cenified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that faciiit) and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are rriggered. A copy of the analysis must be artached to,this form. 3. r - - title fiv tic This is a sewage system. Not a e se p system. The system consists o one VX61 cesspout . lines are not evident . Ob viuos y cottage nas } use if any in the past 2 years . The cesspool is presen y y . 3 Page ; of I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWACE DISPOSAL SYSTEM INSPECTION.FORM PART A CERTIFICATION (continued) Property Address:959 Seaview Ave ( Cottage ) Osterville , Mass . ., Owoer:ThPl ma Di nkPl 1 o Date of Inspection: 7 /1 /p 7 D. System Failure Criteria applicable to all systems: You must indicate "yes" or "no" to each o(the following for all inspections: Yes ^obackup of sewage into faciliry•or system component due to overloaded or clogeed SAS or cesspool Discharge or pondtng of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool �F Static liquid level in the distribution box bove outlet invert due to an overloaded or clogged SAS or cesspool Liquid depth in cesspool is less than 6" below invert or available volume is Less than 'h day now Required pumping more than 4 times in the last year NOT due to clogged or obsmveted pipe($). Number of times pumped 0—. - � Anyponton of the SAS, cesspool or privy is below high ground water elevation. , Any ponion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface /water supply. �y portion of a cesspool or privy is within a Zone I of a public well. �� y ponion of a cesspool or privy is within 50 feet of a private water supply well. Any ponion of a cesspool or privy is less than 100 feet but greater than 50 feet,from a private water supply well with no accepuable water quality analysis. jTbis system passes If the well water analysts, performed at a DEP cenificd 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.) tYcs'No) The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15 30). therefore the system fails. The system oµ-ner.should contact the Boar: :' 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 now or 10,000 gpd to 15,000 9Pd You must indicate tither"yes"or "no`' to each of the following: (The following criteria apply to large systems in•addition to the criteria above) Nes no 1hc system is within 400 feet of a surface drinking water supply _ �e system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nirrogen sensitive area (Interim Wellhead Protection Area - IWPA)or a mapped . Zone 11 of a public water supply well !f you rave answered "yes" to any question in Section E the system is considered a significant threat, or answered es" to Section D above the lVge system has failed. The owner or operator of any large system considered a s:e.^.:f;cant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 5 ;04 The system pwner should contact the appropriate regional ofTice of the Department. I Page 5 of 1 I OFFICIAL INSPECTION FORM - NOT�FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B ,CHECKLIST-- , Property Address: 959 Seaview` Ave ('- Cottage_. F) OstervilleiMass . , Owner: Thelma Dinkello #u. Date of Inspection: 7/1 /02 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 Ywere anv-of the system components pumped out inthe previous two weeks? „ b _ZHas the system received normal flows in the previous two week period ?,` Have large volumes of water been introduced to the sy stem.recently or as pan of this inspection ? Were as built plans of the system obtained and examined? (if they were not available note J� Was the facility or dweI ling yinspected,for signs of sewage backup,?'• Was the site inspected for signs of break out ? • Were all system components, cluding the SAS, located on site ?n Z dd" Were thejse nc anholes 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 propel maintenance of subsurface sewage disposal systems? ` The size and location of the Soil.Absorption System (SAS)``onI 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 Pan C is atyissue approximation of distance is unacceptable) (310 CMR•15:302(3)(b))' 5 Page 6 of I I OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 959A Seaview Ave ( Cottage ) stervi e , ass . Owner: Thelma Dinkello Date of Inspection: 1 0 FLOW CONDITIONS. RESIDENTIAL Number of bedrooms (design): Number of bedrooms (actual): DESIGN now based on 310 CMR 15.203 (for example: 110 gpd x # of bedrooms):/t/�rl�" '�� Number of current residents: 6 Does residence have a garbage grinder(yes or no): .{l0 Is laundry on a separate sewage system (yes or no): 4.0 (if yes separate inspection required) Laundry system inspected ( es or Seasonal use: (yes or no): i -- - "- * Water meter readings, if available (last 2 years usage (gpd))' Main House & Cottage are on Sump pump(yes or no): O the same meter . Last date of occupancy: �u�L f 2000-35 , 000 gallons=95. 89 GPD 2001-37 , 000 gallons=101 . 37 GPRD COMM ERCLAULNDUSTRIAL Type of establishment. Design now(based on 310 CMR 15.203): gpd' Basis of design now(seats/persons/sgft,etc.j: 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).'.,l Water meter readings, if available: Last date of occupancy/use: A10 OTHER (describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as pan of the inspection (yes or no): _ If yes, volume pumped: O gallon;�- How was quantity pumped determined? Reason for pumping: >l/ 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 ci tikined from syste owner) ,oTight tank Anach a copy of the DEP approval Other(describe): _ f App 5!1r,Ige o/f all components, date installed (if known) and source of information: Were sewage odors detected when arriving at the site (yes or no):�� 6 l Page 7 of I 1 OFFICIAL INSPECTION FORM -NOT FOR VOLUNTARY'ASSESSMENTS SUBSURFACE SEWAGE-,DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 959 Seaview Ave (_Cottage ) Osterville ,Mass . Owner: Thelma Dinkello Date of Inspection: 7/1 /0 2 BUILDING SEWER(locate on site plan) Depth below grade: 6� Materials of construction: cast iron/ t0 PVC_Zother(explain): '/j,�v Distance from private water supply well or suction line: Comments(on condition of joints, venting, evidence of leakage,etc.): Joints appear tight . No evidence of leakage . System is vented through the cottoge vents . SEPTIC TAN}44"locate on site plan) Depth below grade: Material of construction lf&concreteVmeta 44�fiberglass�;!'Polyethylene �/i¢other(explain) ' If tank is metal list age: is age confirmed by a Certificate of Compliance (yes or no)lL�(attach a copy of certificate) Dimensions: 40 Sludge depth: ,y Distance from top of sludge to bottom of outlet tee or baffle: .� Scum thickness:_yam Distance from top of scum to top of outlet tee or baffle: .0/11 Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined: 10/2 Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity,liquid levels as related to outlet invert, evidence of leakage, etc.): Septic tank is not present . GREASE TRAA4406(locate on site plan) Depth below grade:de Material ofconstruction concrete meta4�WfiberglassV,,�ppolyethylene4Tother (explain): rt/A 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.): Grease trap is not present . 7 Page 8 of l l ` OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 959 Seaview Ave Osterville,Mass . Owner:Th 1 ma Di nk 1 1 o Date of Inspection: 711 Inn TIGHT or HOLDING TANIGL 41 ,(tank must be pumped at time of inspection)(locate on site plan) Depth below glade: V Material of construction: �/Z concrete.X4 metal,,V,4 fiberglass. polyethylene. AA fA other(explain): Dimensions: Capacity: 4.1W gallons Design Flow: V0 gallons/day Alarm present (yes or no): !I Alarm level: Alarm in working order(yes or no):X0 Date of last pumping: AIM Comments (condition of alarm and float switches, etc.): Tight or holding tanks are not present . DISTRIBUTION BO?G(j.ere, (if present must be opened)(locate on site plan] Depth of liquid level above outlet invert:1�d f 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.): Distribution box. is not present . f _ PUMP CHAMBER0We (locate on site plan) e Pumps in working order(yes or no): 414 Alarms in working order(yes or no): Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Pump chamber is not present . t . - 8 . 1 Page 9 of I 1 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: 959A Seaview Ave ( Cottage) Osterville ,Mass . Owner: Thelma Dinkello Date of Inspection: 7/1 /0 2 SOIL ABSORPTION SYSTEM (SAS): Zlocaie on site plan, excavation not required) 1-5 'X6 ' cesspool . Cesspool is dry . If SAS not located explain why: Located ; See page Type leaching pits, number: ZL leaching chambers, number: leaching galleries, number: _fl leaching trenches, number, length: Oleaching fields, number, dimensions: a All overflow cesspool; number: _d,b innovative/altemative system Type/name of technology:Adr Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil,condition of vegetation, etc.): Loamy sand to fine sand , No signs of hydraulic failure .No stain line visible - Sails, arP dry Vegetation is normal . - CESSPOOLS: Z(cesspool must be pumped as part of inspection)(locate on'site plan) ) Number and configuration: f_1 Depth—top of liquid to inlet invert: Depth of solids layer: Depth of scum laver. Dimensions of cesspool- X ; Materials of construction: Indication of goundwater inflow(yes or no): ti Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Same as above 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.):. Privy is not present . 9 Pagc 10 0( 1 I OFFICL -L INSPECTION FORK! — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL, SYSTEM INSPECTION Fop PART C SYSTEM TNFORIvLATIOK (conlinvcd) pIoperT� Addreu:959 Seaview Aver . Qstervi e ; . OwOcr: lma Din e o Dllc o( Inlpc<Iioo: 7 1 SKETCH OF SEWACE DISPOSAL SYSTEM Piovioc I Ixcich o(Ihc l(WITC dilpolll iyltcm Inclvding IIcI 10 cl IcISI two permancm rcfcrcncc IenCm�rk1 0. 0111("ukl Locitc III -(III wilhin 100 (ccl. Locllc whcrc pvblic w11tr lvpply cnlcrt the bvilding. ' y I l� 11 10 . M Page 1 1 of I 1 OFFICIAL INSPECTION FORM:- NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) PropertyAddress:959A Seaview Ave ( Cottage ) stervi le ,Mass . Owner: Thelma Dinkello Date of Inspection. 7 1 02 SITE EXAM a. o Slope Surface water Check cellar Shallow wells Estimated depth to ground water 140 feet Please indicate (check)all methods used to determine the high ground water elevation: NO Obtained from system design plans on record- If checked, date of design plan reviewed: NA YES Observed site(abutting property/observation hole within'l50 feet of SAS)' NO Checked with local Board of Health-explain: N A ` yU Checked with local excavators, installers-(attach documentation) Accessed USGS database-explainh t t P 1 t own _ h a r n s t a b l e .ma. us,. You must describe how you established the high ground water elevation: Used ; Gahrety & Miller Model 12/16/94 Groundwater elevations above sea level . Used ; USGS . Observation well data . June 1992 Used ; U — — group waterunr elevations . Leaching , Pit G t :eet Groundwater-9 Feet Below Bottom.of Pit Agh_,Groundwater Adjustment 1.8 ft per Frimpter Method Therefore, the vertical separation distance between the bortg .. of the leaching pit and the adjusted groundwater table is 7j7 feet. a 11 e �1'RTT RI'1T*--Y•Y- rrr.-arn•R1TrPa•'1+n.1•Trr.rrr,:•.T+rnr:�rp�s.^nrn rn-'.\Za T.a••�iYsr.r:l•. • .rn••1•••-'-,r.—r-:..--.r..,' 1'UWN OF Barnstable IIOARD,OF HEALTH SUnSURFACF SF•WAGF DISPOSAL SYSTEM INSPECTION FORM - PART D CERTIFICATION •••T••I•T••••• -TIIl.��.T.T.TR1•R:1TiTT1Tf1 P'TT.T9'.r •.•1•"•IITT1fT'I.T"1"RTI'IR'P.Ir I1T'RIt1lTfA"IPrtnm nA -TYPE OR PAINT CI,EARLY ° PROPERTY INSPECTED _ . STREET ADDRESS959A Seaview „Ave Osterville','Mass . ' ASSESSORS MAP , BLOCK AND PARCEL # . 090-007 OWNER' s NAME Thelma Dinitello PAJ?T D - CERTIFICATION I NAME OF INSPECTOR Joseph P.Macomber Jr . T` COMPANY NAME J. P.Macomber & Son Inca:" '° COMPANY ADDRESS Box 66 ' Cente.rville , Mass . 026321, ° Street Town or C1ty, State LIP COMPANY TELEPHONE ( 508 1 775 - 3338 '' _ '_FAX . ( 508 .),` 790 - T578 CERTIFICATION STATEMENT I certify that I have .personally inspected the sewage dieposa1 system at DrIecoinmendations his address and that the informition °reported is true , accurate , and omplete as of the time ofinspection ,� The inspection was performed and any regarding upgrade`, .maintenance ,, and repair" are consistent with my training and experience i'n the proper. fun'ction and maintenance of on- site sewage disposal .systems ne Check �, 1�' ,I •,'i � ` System. PASSED r The inspection which 7 have conducted has 'not found any information which indicates that the. system fails to adequately protect public stealth or Lhe environment as defined in 310 CMR 15303 ,''Any failure criteria not -evaluated are R... stated i'n. the FAILURE CRITERIA section of this form , System FAILEll* . The inspection which I 'have- conaUc"ted Kas found` that the' system fails to Protect the j)ubl.ic health and • the environment in accordance, with. Title ,5 , 3.10 CMR 15 , 303 , and as specificalLy,,noted on PART•,C - FAILURE:_ CRITERIA of this inspection form , Inspector Signatu Date` ne copy of this certification must be provided to the OWNER, the BUYER ( Where applicable ) and the 130ARD OF IfRAL11I. * It the inspection FAILED , the owner or'"*•o arator shall upgrade ' the ayatem - ` within one year of the date of the inspection , unless allowed or required otherwise as provided in 310 CMR 15 . 305 . • partd .doc T t aµ' <A/1. M ya• 9 e Re• 44 Aµ' 44 5/4' T-e V7 2-0? 214 W 7 S-0 7AV7 p J � G l ��1� ' 05 A g SCREEN P H A n (Vd Y P. rsVT ( 4IVJ' " aVY I aV! 1 // 44 W' " 4 W' 44 W 44 1W i2141 V4' 44 IN 44 W 7i0 1/4 s4 VS FT s'-W A . 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Lr ® CN 1 WW.MYT........tiTj IT8CT9.COM u\ --- am ° — lau oh ecaiaiw aret� t MAOR4 MADONNA LJAUNDR ° A ®i F RE5IDENCE 04 a e M MAIN HOU5E TOILET'{ s o e " S ° a �: K ROOM a ° OSTERVII I r MASSAGHU5ETT5 10, 44/l!r e4• e'/J In' 4'A Vr IO-II• e'S 4'A' S!• . r-0 t ate{a• N4 VA. faTi V7 I I 1 Ad01 FIR5T FLOOR PLAN I I FIRST FLOOR PLAN f�asn{!b MLL5 To RewN r"1 I O . . . r'NEW WALLS To BE GONSTRXTW .a o ' Aa01 1412 V2' u'o tw r r-0• 7-W ow i I M OI C. a 4 THROOM I 1 aYl �® 5WROOM 92 MASTER 5WPWM#1 s, 1 PORGH� � D (' a { A+ r-i w• 1 a � � . i a VJ' ! { a yr d VI V2' aim '�• 3'-0 VY s'-T 7a• P 2•T w• 112' p ItiO {'�vv Y8 9'-0• 7D41 W' T a U7 c. - 2pc BEDROOM#3 { I ! 0 T 9/4' ' b 9 7 y I I�CII VY �t 9 .�� I M1S• 6'C ]411f]' 9�0' <+ 2W 20 STAIR HALL 2oa Q WPILSN STQE •I 1 ® 9 VY IGIiM ' 1 AS BATH . cLo5ET 301 IKl 3°2 I 2 N X I ' a V2 ; a I I ® I 1 Pew ova�a .- - - a'i• I'-10'^ 9'-I w' S-1 i 4'-Y 74' j {'4 V2' Yd IA' I 1 a i I { A ] !off a ?� I j S DESmP oEVE1LPta+r(APPROVED) rt:.s • -. 14 YY i I 1'r Ipl a ' 1 T"Y 1 m SCO04AM VM&I(APPROVED) C-:a43 I I VV $ 367 I CN i I 9 VS j 1- O § ExISnM6 conolnas ia3+2 aw — EBY,N P-0 7 V] LI ' .. - rv. O PLC�91[LP QVL91Q14 DAR VY K � BATHROOM illm �, MARK H UTKER & a I STAIR Z. ASSOCIATES FRG®ROLM 3 ARCHITECTS �m n .e { O I � (.i\� NRGNITECTV RE Bc VJ Y WE5T BB�EW^ROOM#4 Z. a ail? 1 �OM� � � P.•wc..o.om.N a. �:o':o'o� an nwvr awvY I saU2 aIn �M T WWW.MUTKB RwR eCT9.COM MADONNA j RESIDENCE MAIN HOUSE m We W OVEONK6 A00Vt, I y� I . . jg��—/�- OSTERVILLE MASSACHU5ETT5 a'4• Rt !aW Y-{VY 21W 310' IOW' 1•-0• 9'A VY N&{' i 941/2' 26W i t wew A-0HI _t SECOND FLOOR PLAN 12 I. G )SECOND FLOOR PLAN A-Im w•.ra It! I' EOSTINb VIAI.L.S TO RB•1AIN NBN Mij-a.Ik TO M WMTfa Tm A—1 O 2 1 , 1 § ale 1/7, ro 9'a ru Jk i ra sro ra sro s a yr 82 ro sro s'a 1ro § ' It •1 I !1 1 O O >r PLAY ROOM r�r a so soo 1 � § Y CHANICAL ROOM i ` z bB '` Ur ME �ZD HALL BATH ROOM O S r-r a�yr s e µa• sv ra w•$ 111.1r- o 1�'IROGE0,33 1 i � - 1,7 reoar otolw n u' uv se• sa' Ur eesisa vtivfl.cr'v+r rAr'raovevl 04a4-0 d — 5uoarlc oesisN urrrrnWl 02•25-o3 STORAGE i ® I ex�enra GQv0ir1019 10.21.02 f. Wool FW91 to chre e J MARK ` H UTKER & ASS ATES ARCHITECTS O i ARCHITECTURE Bc - i � INTERIOR OESfGN I _ � �/]• eNcnvowo R.9urtt V. a . - M �eosy000e vueobeeo+ooa wem e'a yr ea lrr I ww.r.0 r Ksn w Acwi*e crs.cor+' MADONNA RESIDENCE I MAIN HOUSE OSTERI/ILLE MASSAGHU5E175 ' I • A Mecl A•el THIRD FLOOR PLAN THIRD FLOOR PLAN t yp.1.0 EXIsnN&WADS TO REMAIN . NEW WALLS TO EIE GONSTRIZTED sl'a r-0• r-r r-r r-0• �-0• r-0• r-r r-t re• 10`r - , ems. SHOVM § 4 SNACK GHANG I NG , ROOM ROOM --g F3�Il�DIlS ®F1ffi�BN ®lY ~ YIATER 1+ DECK [FF11. I i s In v MEGH ' • n FYiW 4 A � ' n 4 ' e,,c• y_T e�-0 In• y4' pea,lrt m.oi.m 5TUD10 P . DATE MARK I 4 B 2 AR 6ARA6E a, H U T K ER &G ASSOCIATES ' Sln Ti S/4 T-10 V1' I T 1'A' /4 S VT ARCHITECTS A�GHITE_C T'U INTERIOR 17E51�N ATHROOM 0 $ s n STAIR112 woo.,p,M Mo MADONNA v RES I DENGE r-0• r-r a,_T s-4• y-ir sir s�4• 1�r r-r 1•-0• —_-- _.._...... GARRIA6E HOUSEoSTERVILLE - —.__.,. _.._..' ............ ST 9-1' 13 In' 9-Y y-r 9 4• MASSAGHUSETTS SECOND FLOOR PLAN &1263ROUIND FLOOR PLAN 51-*a-u4••"-V -us•.ra• CARRIAGE HOU5E PLAN5 A-121 t . � J i i .. ,'¢ N � N l` ic • UU � b 'r t Ef - � D•� Lam;, � 2 is >' f� {• ♦ � 6 ,;, � c:.�.. .a c-r` ,. r •��• •�' - Yi L :K � 1 ". III LOCUS MAP SCALE: 1'=2000' LINE BEARING DISTANCE L1 S 0350 00 E 12.84 12,0 L2 N 03'50 00 W 10.08 4 YDRANT 4 - #79 �~ 13.4 am-mm 12.0 , mmm-� VT 12.0 •P O TBM PK NAIL FND A5�� W { 113.7 O EL = 11.67 ---• k - ® OHS- �- 13.8 �� 11,48 i or+w 1 160.00' w----H 1 A3 59.00 f,,,2.00 LSA ,1}'8 1z.zsA 9 x 12s LEGEND/ABBREVIATIONS �_ IP FND 0•gA R / x I1r 160.00' / 1 .3 5 LAWN , 12.8 `rr � o fah 11.6 12. ® UTILITY POLE/GUY WIRE / WOODED' = CATCH BASIN l w ® MAIL BOX WOODED i r 0.52. w 0 1 w ® = TELEPHONE_ RISER W - HYDRANT 1 ,5 # = YARD/LANDSCAPE LIGHT c ' = WOODEN FENCE / W DETAIL NTS KETCH OHW OHW-- = OVERHEAD WIRES 1 _� -13.Q o TREE/BRUSH LINE 12.4 �, 13 13.o 0 O C3 = TREES & SHRUBS o = CONCRETE BOUND t % d 40.0 = STAKE& TACK SET . 12.0 ,' WOODED 3,7^ = PK NAIL 1 . , 13,2 � �r �---,00-._-� _ :CONTOURS x 13:7 x�oo.o = SPOT GRADES 1 x 3,0 s r( 13.2 o x 13.4 CONC. = CONCRETE LSA = LANDSCAPED AREA x' 12.1 13.1 `� 1 . SB = STONE BOUND / 13.1 LOT $ 20 CL = CENTER LINE CB = CONCRETE BOUND 2.6 r r L.C. PLAN 2664 U 9 1 5.�" DH = DRILL HOLE IP = IRON PIPE 1 3 a F.F.E. = FINISHED FLOOR ELEVATION 13.1 �t► x ci z\ 12, F5 SLT v WOODED a�.8 x 13. , W / �'9 i 11.9 r N 2/ r i r �Q 7 i LOT AREA lr o LOT 5 x 10.5 x\11.0 LAWN \�. UPLAND AREA - 87,532 SO. FT / L.C. PLAN 10939 D i 10.9 i I 2.01 ACRES DUNE / BEACH - 22.895 SO. FT. L_ ' _ t 1 0.53 ACRES / 11.14 x 11.3 11.2 11, © b - i 11.1 11.3 L.C. PLAN 2664 Y g I Li 3 11. 11.9 11. _ WOODED i R µ 11.7 12 12.0 SB FND ( •' �0 11.4 PROJECT BENCHMARK ; DATUM = NGVD \� 12.0 12.111.8t TBM PK NAIL SET IN PAVEMENT A ELEV.=-11.67 ZONING DISTRICT: RF1 LS ► 12,1 '; OVERLAY DISTRICTS: -AP (AQUIFER PROTECTION OVERLAY DISTRICT) - p 11.71 _ RPOD (RESOURCE PROTECTION OVERLAY DISTRICT) 12,1 ( x 12.3 a _- 1`}\ xi 12.1 2.0 ti JW 1�'k4GARDEN ',� 'i MINIMUM LOT AREA 2 ACRES S9�oo,• 12;0 , LAWN 12.3 1�.34REA I MINIMUM FRONTAGE: 20 100.08 x _ � - - _ _ ' ', ) ` � MINIMUM WIDTH: 125' S 87'43'30" E H +! 12.1 _ WOODED o,_ 1 FRONT YARD = 30' SIDE YARD = 15' REAR YARD 15' N 11:9 x 12.3 2,2 i 11.9 `5.� 1 :o j LOCUS PROPERTY IS SHOWN AS: 11,8 �\ LAWN 12.2 Z m, p• ' \\ 12.0 W i W , ASSESSORS MAP 90 PARCEL 7 X�Q 4� ' ESSP 12.0 � '4: . W . - LOCUS DEED: ' 11.6 �� OVER 12..i0 i CERTIFICATE OF TITLE: C68395 11.7 •1 6 i PLAN REFERENCES - . . , 2,0 ' L.C. PLAN 2664 U LOT 7 43.5' L.C. PLAN 2664 Y L.C. SSP PLAN 10939 D .6 Q CCOVFR, �. i L.C. PLAN 10939 D {X LSA - i 100' OFFSET FROM COMMUNITY PANEL NUMBER 250001 0018 D 12. 1 , WETLAND FLAG LINE THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONES p FRAME , V17 (EL.16), A14 (EL 12), & B i EXISTING W00 ti \`DWELLING 1L9 No. 95>�� 12,8 LAWN i FLOOD LINES DIGITIZED USING FIELD/TOWN GIS SHEET LOCATION OF 11.7 `l PORCH ^� EXISTING BUILDINGS ON LOCUS AS ORIENTATION; TOWN GIS SHEETS ALIGNED WITH FIRM COMMUNITY PANELS USING ROADS AND WATER LINES. 1191 x 1 11,6 ,t ;' WETLAND RESOURCE AREA (DUNE) DELINEATED NOVEMBER 20, 2002 BY 12.4 2 ' STAN HUMPHRIES OF ENSR INTERNATIONAL NOTES: EMq FLOODS.12_0' _ 50' OFFSET FROM 95 STATE ROAD 1. COASTAL DUNE/UPLAND DELINEATION BY STANLEY M. 11.6 11 � 2 x 2 2 �z i _ _ 1, WETLAND FLAG LINE SAGAMORE BEACH, MA 02562 HUMPHRIES, ENSR, 11-20-02. 508-888-3900 � LAWN' 11,6 o 2. FLOOD LINES DIGITIZED USING FIELD/TOWN GIS SHEET LOCATION OF : c LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND EXISTING BUILDINGS ON LOCUS AS ORIENTATION; TOWN GIS SHEETS 1�1,0.0' ----- � SHOULD BE VERIFIED IN THE FIELD BY THE APPROPRIATE ALIGNED WITH FIRM COMMUNITY PANELS USING ROADS AND WATER LINES. x 2 �'�_ 'o. UTILITY COMPANY PRIOR TO ANY CONSTRUCTION. x 10.7 BRUSH 3. D 785R AND B 382R REFER TO DEPARTMENT OF ENVIRONMENTAL 11.0 •' THIS PLAN IS BASED ON AVAILABLE RECORD INFORMATION AND �` •'• 1 lo.o .• PLANS AND AN ON THE GROUND FIELD SURVEY BY THIS FIRM MANAGEMENT WETLAND RESTRICTION PROGRAM DESIGNATIONS (LOCATION 5, 4 #�fpcf .. 10.3 PNp, `; ON 10/2/02 do 12/1%2 APPROXIMATE) SEE PLAN BOOK 356 PAGE 90 -. .a_- : �r r• ? a1P_�i _ - PROPERTY OWNER: all,o u.1 11.0 ROBERT RITUCCI, TRUSTEE OF THE 959 SEA VIEW AVENUE REALTY TRUST •F- }. x 11.8 _ :.o BRUSH ; g P.O. BOX 664 o �-- WEST BARNSTABLE, MA 02668 w ?� 2,2 2 121,- f i21 i :� \' 11,3 X 12.6 �l _ I 110 x 959 Sea "View Avenue 13:�100-- VEL061 ZONFf1,IL'16.0 /l \ 3X--X�il•7 _ ,¢ 1 6- 2 Osterville, Massachusetts 1-:01�9_ x 11.32.2 / C4dr Sl 0 PREPARED FOR j • • -- / _/ -7;7��"- ----- 9 -- _- _---- - -I .r- x _8._4 8,1 Paula Madonna X-7,8----- -H- -------- _ - x 7:4 BEACH GRAS1S` •7,0 p TITLE 785R 6,6 _ _ Existing Conditions Site Plan j� X 6.5 _i x 6�Z�' x 5.4 ,.r 6 5 7.1 7 �=B -";EACI� 4.7 -- --------------- ----------- - BAXTER, NYE & HOLMGREN, INC. -- ---- BEACH Registered Professional _--------------------------------___ Engineers and Land Surveyors _- 3 --------2,5 2,5 __ 3 -- 2.5 OBSERVED MEAN HIGH WATER , _ x , , _K 2.6 $12 Main Street, Osterville, Massachusetts 02655 -- 1b-o 2 ' - __X 2.s Phone - (508)428-9131 Fax - (508)428-3750 SCALE: 30' A 41MUCKET SOUlVP 30 0 30 60 °FAQ s SCALE IN FEET r2 TEPHEN tiN - SCALE: 1" - 30' DATE: 03/31/03 9 vii o Q REV. DATE: REMARKS ' ON L Cm 1. 3-21-03 1 WETLAND BUFFERS DRAWING NUMBER H:\2002\2002-094\SURVEY\worksht\2002-094ws3-FloodZone.dwg Job#: 2002-094 . - - LEGEND x k• 113 ,► r'�; • , - o ' DATE:MARCH 28,2M r � EXISTING PROPOSED SOII. LOGS • • 'r r •aa r .�.• ,¢ YD 9ANT C 4 13.4 / \ .i ( - 11.2 11,E 1*=P 10,440 I A Stake do Tac Set/Found •u. .; . , �- 12.0 11 1 ENCIlVEER: BOARD W HEALT H AGENT: 0 PK Nail Set/Found • N � x 114 ' I Concrete Bound _ .�•`'' // .,1 .1 z LOT B 22 g STEW WIISONP.E. SAM WHITE ® Gas Gate y . TBt� PK NAIL FND I n3 ?i � o L.C. PLAN 2664 Y .. 11.67'--+ , • 11• 0 Electric Box o 13.8 W >E TEST PIT 1 TEST PIT 2 t` ,� ,,,i< •. , ■ 1.48 ,w---�+ - �,.►---� 160.00, g w� 6 G.S.E. = 12.2t G.S.E. = 11.9'f � Catch Basin :t •: r+r aaf kt.�--i i.. .,1:+��p , • r* n .. 11.1 Water Gate a" 1 + ® TV/Cable Box ' , a "w: �• rz �'� s 1 !8 2 �1' x 11.4 LSA 1.9 I `' 0• San Loam 0 San Loam ' ,: 7° ` sr .k `•� , a° x' r a�4Z• s , o.00' '� 11 11, 7" 10 YR 3 2 10 10 YR 3 2 s••, o IP FND •gA 91.00 16 / / ® Telephone Riser WOODED -O- Utility Pole ! r7 .o.:o+ . + ..:. ' / v; r ► �' 12 12.0 ` Contours s u . " •i .3 ) p , o M, 1 I ( SyB FN�00 B B 200xoo Spot Grade f s A t • i r S �?, p / 12.8 S� p ?� Z a�I-E''�9 \ , CL TOP NE WALL 1.6 12. , w Sandy Loam Sandy Loam Test Pit �►, •�t ) �.• . � i�;.+, '�� b' ay, E WOODED 11,4 J �l 1 16 10 YR 3/1 23 10 YR 4/1 �•- ''4 J t ' 1�,5 r �' WOODS 7 i 0.52' 12. E *b+� -' • V• f {,. t+t t " z LAJ i : •a `~ lfV rrn� 7 / Q' 12.5 ( t,, \ 2 i 1. �11 1 VT' MEDIUM I �s� STONE APRON STONE W Medium Sand Medium Sand •. 4t ' xd VjP L rx, � 1� " 's. �' 2.0 w , 1 I 1 ?, ,'s15 n� r.h + Sr ''w` }.yn `• 'ytiv $ C •t xt•rj , s.... .r. .. ...:• 4a.. x ,;. .. +f : ids r MULL ► 132, 10 YR 5/6 60' 10 YR 6/6 / 11.71 1 , GENERAL NOTES : J/ $ DETAIL SKETCH WALL xl2.1 ` C2 MEDIUM / 3 1 s , w _-_ NTs G DEN '� �'• Medium Sand ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH 1 ,4 I x -_ �3 ) -4a.e q �� 13.0 - 1' '' . ` 132• 10 YR 7/3 TITLE V OF THE STATE SANITARY CODE DATED MARCH 31,1995 LOCUS MAP W -1 ,0 1 3 , - v 1 •0 , 1 = 2000 c r I I \ TP- , , ANY LOCAL RULES APPLICABLE. „ ,� ` PERC O 54 w i� RATE- <5 MIN/W r' ` 1 Q 1 NO'WATER ENCOUNTERED ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING N O N , I �„ 11.9 12.312.2 ��, ` r BY DESIGNING ENGINEER ZONING DISTRICT: RF1 �y / 3,7 "� .�} c' OVERLAY DISTRICTS: AP (AQUIFER PROTECTION OVERLAY DISTRICT) �/X 12.0 , w000Eo r 1 'w ,. LA 2.28' r M m RPOD (RESOURCE PROTECTION OVERLAY DISTRICT) cai a_ cai � 13.2 x 13.7 g i/ 10, Min. .' 2 0 �: "� ; 7,,�• Jy ��`' `93 �'' WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFlLLING, '� , 1 x 12.4 p _ 1 NOTIFY THE ENGINEER dt BOARD OF HEALTH AGENT 13.2 o x 1 a PROPOSm 1 a. a o. FOR INSPECTION. MINIMUM LOT AREA: 2 ACRES ' MINIMUM FRONTAGE: 20' ; P A c s>a oL ` 19.5 ; MINIMUM WIDTH: 125' x 12.1 > 3' `W 1 , , 11 FOUNDATION ELEVATION MUST BE CHECKED WHEN COMPLETED. 2 0 N El 9 13.1 Cl OUT i f _ 4• W / ( LOT 8 20 1.8 i j FRONT YARD = 30' SIDE YARD = 15' 4� / r 0 O 0 O THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN 2.6 / r 6 12 't L.C. PLAN 2664 U LOCUS PROPERTY IS SHOWN AS: `+� x •9 13.6 / 5.�'` �' � G y t � 1 •'i 8 4 APPROVAL BY DESIGNING ENGINEER ASSESSOR'S MAP 90 - PARCEL 7 ►� 4 N , ET FROM x 12. WETLAND FLAG LINE 3 PRO t , I ALL SANITARY DISPOSAL SYSTEM PIPING M BE 4• PVC., SCH 40 1 ► LOT AREA .? rNc WOOD FRAM 18.6• LOCUS DEED: L� 13.1 12.5 EXIS DV"NG CERTIFICATE OF TITLE: C68395 x 119 Z LAWN No. 959 s STONE WALL 56 WHEREVER SEWER LINES CROSS WATER SUPPLY LINES, 13,0 F tq r UPLAND AREA 87,532 SCI. FT. , +t4,p ,, 2, � � � ► 2rOt.ACRES F.F.E. _ t3.82 pIZCIPOb'�' � BOTH PIPES SHALL BE CONSTRUCTED OF CLASS 150 PRESSURE PLAN REFERENCES .+ W � r 11.7 BONE PIPE AND SHALL BE PRESSURE TESTED M ASSURE WATER TIGHTNESS. L.C. PLAN 2664 U •r E DUNE BEACH - 22,�3 SQ. FT. ' TOP OF WALL 16.0 PLAN OF :� , 0.'S3 ACRES 11 1 + zz ' L.C. PLAN 2664 Y WOODED IA ` 1 :: 1 4 STONE 11.X 12.4 15.0' STONE WALK 10.0 PREG�AST LEACHING CHAMBERS EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING L.C. PLAN 10939 D �� PROPOSED $� x 13• ` ( x Y110RK SURROUNDING THE LEACHING FIELD FOR-.A DISTANCE OF 5 , PER OM MAIN & CARRIAGE HOUSES - NO SCALE COMMUNITY PANEL NUMBER 250001 0018 D STONE \ 11.9 (r _. '' LIMITi"""�� _ o, , ETLAN OFFSET G LIE 310 CMR 15.255. THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA AS ZONES ,,� ` WAW rr 11.6 . '� x 2.2 x� \ 12.2 x z1 V17 (EL16), A14 (EL 12), do B PROPOSE E WALL ,\ FLOOD\\ \13 ' 1.6 •�`PROP,..SI IW FENCE 11.6 � goo-�rR FEMA � �ROJECT'PK�NIrIL�SET•IN�PAVEMENT N A ELEV.= 11.67 ' x , $ �� COVER TO GRADE FLOOD LINES DIGITIZED USING FlELD/TOWN CIS SHEET LOCATION OF •'�' x 7 i !1 1 - 'o• EXISTING BUILDINGS ON LOCUS AS ORIENTATION; TOWN CIS SHEETS / 'O ':i' .K'-3`rn,-f}':lay .:tom, ` I •• x } SCALE: 1 304r � x 10.5 I 11.0 ' LAWN\ r SHRUB ENHANCEMEN AREA .x 10.7 BRusH ALIGNED WITH FIRM COMMUNITY PANELS USING ROADS AND WATER LINES. ERVE mo (IN CONSULTATION VA7H C VAIV* AGENT) LOT 5 , \ 20 PEASTOfE , ,. 1 ,9 �,_ _..J IAA 15 �� �C 10.3 10.0 ::; - WETLAND RESOURCE AREA (DUNE) DELINEATED NOVEMBER 20, 2002 BY 12' O O O L.C. PLAN 10939 D - N • :.r ~• - STAN HRfES OF ENSR INTERNATIONAL �. ' �y' t�' HUMP TCH ._ .. _ T� ' WASHED STONE 95 STATE ROAD ;.. a 11,1 a 24"EFFECTNE DEPTH 508-888E 3900 MA 02562 x 118' 11.0 ,,: ;,;rj+• ;:.: •�".: ' ';:v ::0 BRUSH ':; ,:.';:•: r • i,•: ,.•:,•: ;j ..:: . `,.,..,. r '. '• 'y'V�A '' '`: `':"° LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND ,:x 2.2 l ? �' ' •:• SHOULD BE VERIFIED IN THE FIELD BY THE APPROPRIATE PLAN OF 12.1�x' k�12.1 ; :1 \' 11.3 l x 12.6 �N UTILITY COMPANY PRIOR TO ANY CONSTRUCTION. PRECAST LEACHING CHAMBERS zx 1 -"'oN 18 11.E� � `• • 12 �'' 2__-.� THIS PLAN IS BASED ON AVAILABLE RECORD INFORMATION AND i3�•too-'� vELoaT'� Z1, i s� ' �ta.3 x x�li•7 2 PLANS AND AN ON THE GROUND FIELD SURVEY BY THIS FIRM GUEST HOUSE - No SCALE liax x 11.3 -J x : ` CONCRETE LEACHING CHAMBER DETAIL ON 10/2/02 & 12/10/02 'Leachin Area Requirements 'V3 ;3 -;� ��- -=-- `_-- - - 12.2 g q x }-1�-�.J CO _ -___ _�/��� `�`- "_��-• --- -1 (H 20 L01DINc) 0 No SCALE Guest House) »1a _-- �_ 9 - _ - '' `\ _ 8.1 PROPERTY OWNER: :: 7•a BEACH cR os,�?��?o ROBERT RITUCCI, TRUSTEE OF THE 959 SEA VIEW AVENUE REALTY TRUST DESIGN SCHEDULE - Guest House ELEVATION 3 BEDROOMS AT 110 GPD/BEDROOM = 330 GPD P.O. BOX 664 FINISH FLOOR 14.2' ADDITIONAL 50% FOR GARBAGE DISPOSAL _NA_GPD __ ^6.6WEST BARNSTABLE, MA 02668 785R r .......... __ _ DoLlOn #SE 3 4127. FINISHED BASEMENT FLOOR kRC RATE _ <5 MIN. / INCH (CLASS 1 ) c :: ,-- "s.a % _ „ " FINISHED GARAGE FLOOR x 6•5 _ _ __,.__ 5 J rlit..^� SEWER INVERT AT FOUNDATION 10.7' LIAR = 0.74 GPD/S.F. __ - -----_ _„r,,,,•,,,,:'•_�'�"5-�-� CONSERVATION NOTES: SEWER INVERT INTO SEP77C TANK 9.9' MIN. LEACHING AREA OF SAS. . 6 __.B ASH GRAB .w*,!r'•-' .,�•',,• a 1. ALL ROOF LEADERS TD DRYM LLS. SEWER INVERT OUT OF SEPTIC TANK 9.6' 330 GPD/ 0.74 GPD/S.F.= 446 S.F. MIN. �*+ "�'''�"' a£ ----`--_--- -- __-- _ 9�9a View Arenas SEWER INVERT INTO DISTRIBUTION BOX 9.5' PROPOSED SYSTEM 9 � 4'7 _ - __----- ' 2. LAIR OF WORK HAYBNE-SILT( FENCE) SHALL BE INSPECTED AND _--- MAINTAINED FOR THE DURATION OF THE PROJECT, 0sterville, Massachusetts SEWER INVERT OUT OF DISTRIBUTION BOX 9.3' - - BEACH SEWER INVERT INTO LEACHING SYSTEM 9.0' SIDEWALL (12' + 32') x 2 x 2' = 176 SF _ --------------------_ _ _-__-- _ 3. VISTA PRUNING REQUIRES THE APPROVAL OF THE CONSERVATION PREPARED FOR BOTTOM OF LEACHING TRENCH 7.0' BOTTOM 12 x 32 = 384 SF OBp MEANIGH WATER • 2.s 2.6 - 3 COMMISSION. 2.5 - WATER TABLE: NONE OBSERVED AT EL 0.9' S60 SF - - '1b-o2 b2 ' ' - ---X 2.5 Paula Madonna A4A T 116A 'T ,SOUAT SCALE: 1 = 30' TITLE Wetlands Permit Plan - House Construction DESIGN SCHEDULE Main House ELEVATION F.F.E. 142 (Guest House) FINISHED GRADE = 12.2f TYPICAL SYSTEM PROFILE NOT TO SCALE FINISH FLOOR 13.8' r F:F.E. _ 13.8 (Main House) FINISHED BASEMENT FLOOR BAX ER, NYE & HOLMGREN, INC. MANHOLE COVER AND FRAME .� (ADJUST TO GRADE) FINISHED GARAGE FLOOR 10.5' Re Pmfessional rwwHOLE Cows d< GRATE SEWER INVERT AT FOUNDATION $ -N of '�'M s FIPIISHED GRADE OVER TANK 12.0E SEWER INVERT INTO SEPTIC SANK 9.9 PdigiIIeels and Land Surveyors 2ya�P sqc FlNtSHED GRADE OVER D. Box = 12.Ot FINISHED SEWER INVERT OUT GF SEPTIC TANK 9.6' 812 Main Street, Osternlle,Massachusetts 02655 sA PHEN GRADE OVER LEACI#NG TRENCH = 12.Ot r^ •- SEWER fNVERT-INTO DISTRIBUTION BOX 9.5 ., 3 min. FIRST 2' (TO BE LEVEL) r 4• scH. 4o PVC 4• scH. 4o PvcF- (TYPICAL) sEWER INVERT OUT OF DISTTnIeuTTON BOx 9.3' Phone (508)428-9131 Fax (508)428-3750 .3o2,e y then o 2.ox 0 2.0% oL2' (m' SEWER INVERT INTO L.EACHIhG SYSTEM 9.0' o�9�G�s �� 9• (min) Cover Leaching Area Requirements �SS�oNALE ` 0 2.o7G 10' INST� 6' SUMP :. • BOTTOM OF LEACHING TRENCH 7.0 30 0 30 60 • •• 4 SCH. 40 PVC 36 (max) Cover WATER TABLE: NONE OBSERVED AT EL 0.9' (Main House dt Carriage House) ME" ,•, ..FINISHED GAS WRE :, �- -) ooNCRETE LEACHING dtAMBERs a>NNEtrraN = SCALE IN FEET FLOOR 1 r 6 BEDROOMS AT 110 GPD/BEDROOM 660 GPO 60 CRUSHED ,•.:<,.A: `'Y` ' vr• ADDITIONAL 50x FOR GARBAGE DISPOSAL _NAYGPD FORCED CONCRETE o 0 0 0 0 o N- FoonNc PERG RATE _ <5 MIN. / INCH (CLASS 1 ) SCALE: -30 DATE: 03/31/03 12 -. ,.. ....� :, LIAR - 0.74 GPD/S.F. REV. DATE: REMARKS 7.0 MIN. LEACHING AREA OF SAS. : -1- 6 18 03 Fence & Plantings '� - 1X 660 GPD/ 0.74 GPD/S.F.- 892 S.F. MIN. 0 5 MIN �p STONE -2- 3 24 04 Rev. Septic & Guest C2 1500 GALLON SEPTIC TANK DISTRIBUTION BOX LEACHING CHAMBER No Groundwater Observed 0 Elev. 0.9' PROPOSED -3- 7 28 04 Revs. Per Horiuchi & Solien L.A H-20 H-20 H-20 SIDEWALL (12' + 56') x 2 x 2' = 272 SF -4- 8 05 04 Revise Septic �MNG NUMBER BOTTOM 12' x 56' = 872 SF H: 02 02-094 surve worksht 02-094 b4.dw 944 SF 2002-094 pip AM Apqh SUN PORCH SCREEN PORCH DINING ROOM LIVING ROOM O TDOOR GRILL FAMILY ROOM LA SCHEMATIC DESIGN MT&. 02-25-03 DN EXISTING CONDITIONS 10-21-02 ------- -- — — ----- I I ( -- - - - - -- --- _ REVISIONS DATE ISLAND �' I I I FOYER LOSEr I MARK _Dw_ i I - H UTK & p ASS ATE AR H a �� c T S KITCHEN i ° A RC ITE iy l't S�: R1 $C 1IVT RlOR SIC. • V �jt ti a TRY FRIG. P I__ \ .rya/ 3 C3,�-�(-.- —1�'- -- P.O.BOX 2347. VirvFrARD H"F_N MA 0.2568 \ EN 1 Z 1 f-V RiSI , -- PHoNE:308 6933344 FAx 5�8�69..38776 314 0IFFOIRD S-r.Su rE 6.FAL mc)L rH.MA 02540 PHoN6:508-5400048 FAX:508-540.4004 UP WWW . HUTKERARCHITECTS . 00M Lu 0 MADONNA - RESIDENCE D — o T 7- - OSTERVI LLE - — — MASSACHU5E175 I'Amm&V, cc El z a 0 M F I R s T F LOO R FLAN ° SCALE - 1/4' = V-0' FIRST FLOOR PLAN M O ,. O N ui N — IOI co W U- } a w D 1 I � ARL L ' Jj - NICOLE'S BEDROOM I I i co MAX'S SEDROOM ------ MASTER BEDROOM iE. y UP STAIR HALL I CLOSET I - SCHEMATIC DE516N we. 02-25-05 ON f I I ^ J EXISTINS CONDITIONS 10-21-02 REVISIONS DATE MARK H UTKl & Ez��";, A R H �' C T S ARC IT1= iNTE�RIOR P.O.Box 2347, VInEVARo HAVEN, : %� Q2568 PHONE:SOB-693-3344 FAX:SC B#i93 8776 -�.2"n.... 314 GIFFORD ST.SUITE 6,FALMOUTH.MA 02S40 . � P oNE:508-5400048 FAx:508-540,4004 W W W . H U T K E R A R C H I T E C T S . C O M 0 1 GUEST BEDROOM 0 MADONNA RE51 DENOE o 0 OSTER-VI LLE < MASSACHUSETTS Z < SECOND FLOOR FLAN SCALE - 1/4" = 1'-0" SECOND FLOOR PLAN 0 O N Uf N < 2 rfl A- 102 O w F- 1 1 i o PLAY ROOM ; 1 . BATH ROOM MECHANICAL ROOM 1 SCHEMATIC DE516N we. 02-25-05 EXISTING CONDITIONS 10-21-02 REVISIONS DATE i MARK STORAGE HUTKk & f ASS } ATE AR H -- .ECTS • .4RC ITS ,•wa�ur.�rx,.�,�Mr s}rq, 1 1 I P.O.BOx 2347. VINEYARD HAVEN . A 02568 314 OIFFORD S•r.SurrE 6,FAL moLrrm.MA 02540 _...._....__.__..._ __._._._................._-..._..- _. ._-.......:. _.._.__......."`x PHONE:508-5400048 FAx:50B•540-4004 E W W W . H U T K E R A R C H I T E C T S . C O M 0 MADONNA RE51 DENCE o OSTERVI LLE 1 MA55ACHUSETTS Z .. Z < Z THIRD FLOOR PLAN L. SCALE - 1/4" a 1'-0" THIRD FLOOR PLAN 0 O N cc X m A - 105 < W I \ / \ / I l I I i - -Q FURN. STORAGE . I ! BE OR I -� POO EQIP. UP ! ! ON ! I i I ! I _ 4- LjI I ! - - IAA ! I I I I I I I I I I / SGHEMATIG CeSI6N MTS. 02-25-03 Y I I - - - - - _ ' I - - I EXISTING CONDITIONS 10-21-02 REVISIONS DATE atST BDOO2 GAR GARAGE MARK � UTK , & ASSATE' ! I I GLOS. I I I 1 r= .r \ A R H CTS I 1 I i hIT R I O 1R •" �'1[ ! I I r ! 1 1 I P.O.Box 2347. VINEYARD HAVEN.,'` 0,2S6S I / \ PHONE:508-693.3344 FAX:50069"776 314 GIFFORD ST.SUITE 6.FALMOUTH•MA 02540 / \ I PHONE:508-540.0048 FAX:508-540-4.004 W W W . H U T K E R A R C H I T E C T S . C O M I I i O MADONNA d RE51 DENGE o 1 OSTERV I LLE % OARRI A67E HOUSE FLAN G A RR I A GE HOUSE 5E G O N D FLOOR MASSAGHU5ETT5 Z SCALE - 1/4" = I'-0" SCALE - I/4" = 1'-0" _ d d CARRIAGE DOUSE FLAN5 co o N Ld N cc d 2 AUS s-- 121 >: W . d N W F-