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HomeMy WebLinkAbout0253 SEAPUIT RIVER ROAD - Health 253 Seapuit River Road OsLerville A= 051-002 t� i F�� Town of Barnstable ' Barn r P� KY Regulatory Services Department aaamencac g � 6ARNS"CA6LE. 'MASS. - 3 Public Health Division i6gq. �g m pTE0 NtA�a. 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL # 7006,0810 0000 3524 5518 December 28, 2011 - Yasmine Realty Limited 160 Federal Street Boston, MA 02110 - YOU ARE SCHEDULED TO APPEAR BEFORE THE BOARD on Tuesday, February 14th at 3 pm in the Town Hall,'Hearing Room, 2nd Floor 367 Main Street, Hyannis, MA due to your failure to repair or replace the failed (7/26/2009 Main House) septic system at 253 Seapuit River Road, Osterville, MA The State Environmental Code Title V.Requires all failed septicsystems to be repaired or replaced within two years. The Town of Barnstable Board of Health has more stringent deadlines dependent upon the type of failure identified. In this case, the septic system has been in failure beyond the established deadline: You will be given the opportunity to testify, present witnesses,documentary evidence, and other official information regarding this case. PER ORDER OF THE BOARD OF HEALTH Wayne Miller, M.D. Chairman Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\253 Seapuit River Rd.,Ost..doc No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISJON - TOWN OF BARNSTABLLE, MASSACHUSETTS Yes Application for Mi,5pooaf *p5tem C ow5trUCtion Permit Application for a Permit to Construct( ) Repair( ) Upgrade OO Abandon( ) ❑x Complete System ❑Individual Components Location Address or Lot No. 25-3 S<c.Pp��t vRwrr R4 Owner's Name,Address,and Tel.No. ��94cP KarlaOrs Y&Srno,nc Vco16J LTD 5/a Qoabub n CG frclal , 7nr, Assessor's Map/Parcel Fe_c eav-41 St.) Bog¢otn,M9, Install Name,A dress,anq Tel.No. cJ�(j�—L f Designer's Name,Address and Tel.No. 12r-UCC hkM111 _ `.�>-vktn A.Lit Igce%OPP. f f 0,e_kt- Nyt (8 W _M� �$ $•�O� ?s 00CRA 5k (-1 c,wvt+9 MA dZfoO[ Type of Building: Dwelling No.of Bedrooms Lot Size 3,9 Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) AICQ gpd Design flow provided 13 2.e3 �ft G,, gpd Plan Date `1_ Zq1 Zot a Number of sheets ja e Revision Date 'd Z?J 2 d O Title Size of Septic Tank 3806 9,y I lor+s Type of S.A.S. eh,�.r Cka.•,I .-r— I IO�x[L x21 }, Description of Soil (Q�).,� .In c,ni I lc�j5 &4 pl&o C F— 1331 bS 4 1 Nature of Repairs or Alterations Answer w p ( when applicable) IR�i„tT�YGS h eng �f�5_jae5�B 1 O lV t Date last inspected: y 200�1 ae N Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental CV e nd not to place the system in operation until a Certificate of Compliance has been issued by this and of Hea N Signed Date i- =e Application Approved by 6 Date I .29—f U t t9` 0 Application Disapproved by: Date for the following reasons Permit No. a Date Issued rT"w, 1 7� !< I I c ems` " ' No J1 ,.s } .R} Fee . 4 =' W, HE COMMONWEALT,H.OF MASSACHUSETTS Entered incomputer: '^ .,r' 0& Yes PUBLIC HEALTH DI-VI14-6 ` TOWN OF BARNSTAB:LE, ' 'M,�ASSACHUSETTS A ,f � rication t i5po a � tem onot1 uction Permit r Applicatio for a Permit to Construct( ) Repair( ) Upgrade K) Abandon( ) ® Complete System'❑Individual Components 1A, Location Address or Lot No. .Z$?j•-Scc .a�� 1��.lrr CZ�o" Owner's Name,Address,and Tel.No. ` prIcr a'-6orS ...+" '��~. „T45YXIvtc lPGol l-5., LTD 'Vo Cc.pc6i Assessor's Map/Parcel , d4D,:Fcatcr4l S4� Yh� $I� P�,rc,! Z,• � Installer-Name,Address,and Tel.No. �j� Designer's Name,Address and Tel.No. vru � cG 111_�F_? slo-ph%an A. w,1ScA pp r r(,,t �� ��` I J J r "I9 IJorltn Sk r Hya•�vt.y f"A OZle01 1 Type of Building: I , Dwelling No. of Bedrooms Lot Size 3.$S f}c -sq-fd. Garbage Grinder ( ) ' Other Type of Building No.of Persons Showers( ) Cafeteria( ) i Other Fixtures Design Flow(min.required) .-9��Q gpd Design flow provided gpd o Plan Date 9 Zcf I Z01 o s Number of sheets JW p Revision Date ad Z21 Zo 10 Title Sew};c. Uri v+eecQc �l r. Size of Septic Tank 3o0 0 q 1 I c.,s Type of S.A.S. �,�, t,,,,,� Ckt„,b,,-sr- i i o'xi n. } Description of Soil (2,1..� }�,� Sri' I Iva s c.� ,�I c.✓► P�' 1 y S 4 1 ` Nature of Repairs or Alterations(Answer when applicable) 'rf'IR[.i.�tT r1Ct5� Ce's'G•�v�r�i i. Date last inspected: //A/ZooI �9 'V # /greement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in i accordance with the provisions of Title 5 gfrthe Envirdnmental Code nd not to place the system in operation until a Certificate of Compliance has been issued by this Board of Heal Signed % GC i - Date -Application Approved byIz Date 1 � ' �U ro Application Disapproved by: Date 0 for the following reasons' Permit No,. 01 L) Date Issued U THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded (X ) Abandoned( )by at 253 Scz 624 AlAre l;P OY5,�­ Afa^hO.-r has been constructed in accordance q with the provisions of Title 5 and the for Disposal System Construction Permit No. 610 - 3y6 dated Installer f'a�ro ^y((" Designer,�l�ti�., d misew. A.- A!,.4-, Atee_ #bedrooms 8 Approved design flow 13 Z �,E:to r �r„��� gpd The issuance of this permit hal/n,t be construed as a guarantee that the systfn will'f,n tion as designed. Date L Inspector -� ? Fee 1 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS i . li5po5al *p!5tem Construction hermit Permission is hereby granted to Construct ( ) Repair ( ) Upgrade (x) Abandon ( ) System located at Z5q SCuou++ i2ivm 1 n�Ski 1}c.�-lobes i and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to.comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date - 'Z r- U Approved by c Town of Barnstable Regulatory Services - Thomas F.Geiler,Director MASS• snRrrar� Public Health Division Thomas McKean,Director - - -- 200 plain Street,Hyannis,VIA 02601 Office: 5087862-4644 Fax: 508-790-6304 Installer& Designer Certification Form Date: / (o2012, Sewage Permit#o?0/O-396 Assessor's MaplParcel 067-006), Designer: Installer: -B ru c.e. Address: 18140-r-AS17 - 34L:` l 'P100k Address: 8°1 oK4 o6-rit-t-u,,�t�, . MCL On 1-`t-o"Lo t L t^V r-e. "Q_C r_ l ,f was issued a permit to install-a (date) (installer) V�septic system at o253 SCAD �� 2�N' Os based on a design drawn by (address) r7 dated �' (designer) W I certifj that the septic system referenced above was installed substantially according to the desiamn, which may include minor approved changes such as lateral relocation_ of the distribution box andior 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 follow. _ .. IN OF lygss9 O STEPHEN CyG ALLYN. (Installer's Signature) " No.30216 �9ooF9F�/STERE���y'�``e s/ANAL (Designer's Signature) (_affix Designer's Stamp Here) N PLEASE RETURN TO BARNST:ABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF o i COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORIM AND AS-BUILT CARD ARE �- RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Desiener Certification Form 3-26-Odoc �/ { - .. TOWN Of BARNSTABLE LOCATION a53 SngP^ ,T l*�'i vet/a/ SEWAGE# o10/0 % VILLAGE ©STe�-V t((e ASSESSOR'S MAP&PARCEL OS/-- C>00, INSTALLER'S NAME&PHONE NO. -ssa SEPTIC TANK CAPACITY � 06 0 6 0-r-L C1-/,;4 LEACHING FACILITY:(type)5U0 6H/'CAs 41A6cP 6\ (size) x 76 NO.OF BEDROOMS 8 OWNER �1 Sn���1 E 2ea,QE 1,-Tt(. PERMIT DATE: C),q-1 a COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY �Do o(2 A Ole«, C2 3y _a� vd AW Town of Barnstable . P# pp3ME rp� y� Department of Regulatory Services i B STABLE, 'r Public Health Division Date s- 1639. 200 Main Street,Hyannis MA 02601 °1FO MPS Date Scheduled a Time 4 Fee Pd. Soil Suitability Assessment for Sewage Disposal Perfonned$y: Skoglu- L�,�Ji/T. P,40' Witnessed By: .."(/w'••C� �. ��_� P� LOCATION & GENERAL INFORMATION Location Address -,' Owner's Name �C< .Iv l ale C)p I'o<f', rr • 'Ni"L" 03�e� I� Address.I J16✓os;A 62/10 Assessor's Map/Parcel: try1,rp OS f Engineer's Name - cy,I-rc,.; 13 PJV NEW CONSTRUCTION REPAIR Telephone N Sc� ;�(- /��-.)Z , �_ .•._. )s; Land Use lac-,AAA ho"( Slopes(%) fa-2_"jam Surface Stones Distances trom: Open Water Body 950 ft Possible Wet Area It Drinking Water Well tt Drainage Way ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) TENNIS 1 COURT"�, \'y.k i +`ab 1` G 0 , os \bti4.3PSESS 0 S� Zy V. Cn r— '���A1�\I 0:. Parent material(geologic) a c. ,k, k Depth to Bedrock Depth to Groundwater: Staliding Water in Hole: Weeping fromPit Face Estimated Seasonal High Groundwater DETERMINATION F.OR SEASONAL HIGH.WATER TABLE" Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. Index Well f♦ Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST. j Date Zo Timezo nw Observation J Hole# 2 Time at 9" Depth of Perc (ITime at 6" Start Pre-sonk Time ate_ Time(9"-6") End Pre-soak truww6ls. Aa Sccik J Rate Min./Inch .. vn� !'Ic.t_ Site Suitability Assessment:` Site Passed _ . Site Failed: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back ---- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one (1)week prior to beginning. Q:HEALTH/W P/PERCFORM A I'20o�—o�zlDy�. f 1 1 1 V HOLE LOG Hole #" -I- DEEP OBSERVATION l'; O Depth from Soil Horizon Soil Texture Soil Color.. Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. ConsistenGy.° Gravel) i� 0 a/,� ?I DEEP OBSERVATION HOLE LOG Hole# 2: Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gr el r�amy ,50.4 l o ylR;'Al Z A, Srj [ YYlc.�ww 5a lf2 Y/Y ���� a tr V�cclww 5CM4 to YR 713.2. DEEP OBSERVATION HOLE LOG Hole# : 3 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. --,-Cons i stency,° Gravel) a YAv b.oanre3 Ja�� Ira YV_ iwst� Zvp �06W� )0 5t)-I t{®`I C VM r.rlt On sraua to. Y.IR 71 DEEP OBSERVATION HOLE LOG Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling- (Structure,Stones,Boulders. —Consistency,%Gravel) AP 10" 2Z 401my 5zad K) y K 5/3 C, Mtdt' S��Q 10 qR 3�H M e_dt,.v4 Sail It q K 7/j Flood Insurance Rate Man: Above 500 year flood boundary No— Yes _ Within 500 veer boundary.. : . No'K Yes. Within 100 year flood boundary No X Yes. Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed,throughout the area proposed for the soil absorption system? G If not,what is the depth of naturally occurring pervious material? Certification I certify that on Dori I.'Imo+ __(date)I have passed the.soil evaluator examination approved by the: Department of Environmental Protection and that the;above analysis was performed by tn.e consistent with the required training,expertise and experience described in 310 CMR 15,017, Signature Date Q:HEALTI-I/W P/PERCFORM � 2ooq-O el2101/ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms on the ✓� computer,use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC. Company Name r� P.O.Box 763 Company Address Centerville Ma. 02632 ICI City/Town State Zip Code (508)428-4028 S14454 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ❑ Passes. ❑ Conditionally Passes ® Fails tsi -- `' ❑ Needs Further Evaluat' n by the Local Approving Authority co r;, -0 11/4/2009 "' InspecWLDate t,r... r...a E The's stem inspector shall submit a co of this inspection report to the Approving Authority Board ,Y P PY P P PP 9 Y( of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or o 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. MThis 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. U �I . t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal/ybejage 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M ,•''v 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 13) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 3 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/68 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water,supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ❑ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ElElDischarge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ❑ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ❑ Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins•09108 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville _Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ❑ Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ❑ Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ❑ Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ❑ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ❑ The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins-09108 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 7 Number of bedrooms (actual): 7 DESIGN flow based on.310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 770 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection D. System Information Description: The septic system is a split system with one single cesspool in front and two cesspools on right side. Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ❑ No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ❑ No Water meter readings, if available last 2 ears usage NA 9 ( Y 9 (gpd))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 10/27/2009 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M s 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ® Single cesspool ® Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts low Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner_ Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3'feet Material of construction: ® cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations,.inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments, M 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G M , 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 1 single in front and 2 on right side. Depth—top of liquid to inlet invert Dry Depth of solids layer 0 Depth of scum layer 0 Dimensions of cesspool 6'x10' Materials of construction Concrete Block Indication of groundwater inflow' ❑ Yes ® No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Sytem in front has a single cesspool with no overflow which is a automatic failure.Side system is dry. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 J Map Page 1 of 2 Town. of Barnstable Geographic Information System Parcel Viewer Custom Map I Abutters Map Size ® Zoom Out ,In 111r RJR £cV'q '�i 1 � \ a . i 1 is \ 1 � t' \ i e. - "" 40 Feet Set Scale 1" 40 ' I Aerial Photos I MAP DISCLAIMER r`nnvrinhf?nns;_?nnQ Tnuin of Ramefohln RAA All rinhfe meant, httn //www.town.harnstahle.ma.us/arcims/annaeoann/man.asnx?nronertvID=051002&ma... 10/16/2009 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 11/4/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of CP 9.5'feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 A • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 253 Seapuit River Rd.(Main House) Property Address Ocean Coast Construction Owner Owners-Name information is required for Osterville Ma. 02655 11/4/2009 . every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out forms the computer, r,use 1. Inspector: ✓ i only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC. Company Name % P.O.Box 763 Company Address Centerville Ma. 02632 City/Town State Zip Code (508)428-4028 S14454 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340Rf Title 5(310 CMR 15.000).The system: t , o ® Passes ❑ Conditional) Passes ❑ 'Fails p N b ❑ Needs Furtgvalby the Local Approving Authority 10/14/2009 _ In o s SI natur Date w 9 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage isposal System•Page 1 of 17 -- Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins-09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ❑ The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ❑ The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17 Commonwealth of Massachusetts Title- 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is Osterville Ma. 02655 10/14/2009 required for . every page. City/Town State Zip Code Date of Inspection D. System Information Description: The septic system consists of one main cesspool and one overflow cesspool. Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ® Single cesspool ® Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 51 feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line. 10'+ feet Comments(on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form . Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank (tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts w Y Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 . every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ® overflow cesspool number: 1 ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Sandy dry soil.No signs of hydraulic fail u re.Overflow cesspool was dry at time of inspection.Stain line observed 48" below invert. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration 1 main cesspool 1 overflow cesspool Depth—top of liquid to inlet invert 6 Depth of solids layer 4" Depth of scum layer 0" Dimensions of cesspool 6'x 10' Materials of construction Concrete block Indication of groundwater inflow ❑ Yes ® No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G M , 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Sandy soil.No signs of hydraulic failure.Water was 6' below invert with stain line up to overflow invert.Overflow was dry at time of inspection with stain line 4' below invert. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Map Page 1 of 2 Town of Barnstable Geographic Information System Parcel Viewer Custom Map Abutters Map Sfze zoom Out 'In • y h[ R T r R �y �♦ j 1 ♦ ♦ ♦ \ l \ I 1. 1 \_ 1 1 1 1' \ 1 i 1 1\ i 1 f. ♦♦ \l. \ l co _ Cr ,i 40 Feet ... Set Scale 1" 40 I Aerial Photos I MAP DISCLAIMER r`nnurinhf 9M0._9M0 Tnuln of Pnma#�Kln KAA All rinhfe ma—, httn //www.town.harnstab]e.ma.us/arcims/anneeoann/man.asnx?nronertvID=051002&ma... 10/16/2009 Commonwealth of Massachusetts Title 5 Official Inspection Fora _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of CP 8.2' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 253 Seapuit River Rd. (Guest House) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist E Inspection Summary: A, B, C, D, or E checked E Inspection Summary D (System Failure Criteria Applicable to All Systems)completed E System Information—Estimated depth to high groundwater E Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Map Page 1 of 2 Town of Barnstable Geographic Information System Parcel Viewer F Custom MapIF Abutters Map Size zoom Out In (�}�! 11 IC R,71 F + � -..,:� ,, �� � Wiz•• 4 1 �. 1. � l , �? C M3 r. S S /p a l 0. 40 Fee t Set Scale 1" =;40 I Aerial Photos MAP DISCLAIMER r,—,,inht,)nnr-,)nnQ Tnum of P—+.hle hAA All rinhfe reennn http://www.town.bamstable.ma.us/arcims/appgeoapp/map.aspx?propertyID=051002&ma... 10/16/2009 :y Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments G M , 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name -- information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important: A. General Information When filling out I forms on the computer,use 1. Inspector: only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide enterprises,LLC. Company Name t� P.O.Box 763 Company Address Centerville Ma. 02632 City/Town State Zip Code (508)428-4028 S14454 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15 340 0 Title 5 (310 CMR 15.000). The system: 40 � C ® Passes ❑ Conditionally Passes ❑ Fair ❑ Needs Further Evaluation by the Local Approving Authority w _ tv ' 10/14/2009 Inspect is Signature Date V The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. I t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sew a Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for 02 Osterville Ma. 655 10/14/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health,will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name_ information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: "*This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must.indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow t5ins•09/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts 4 . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,M 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion'of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the 'questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? E El Were all system components, excluding the SAS located on site. ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, ,depth of liquid, depth of sludge and depth of scum? P q P 9 P ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information Description: The septic system consists of two cesspools.One main and one overflow. Number of current residents: Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonaluse? ❑ Yes ® No Water meter readings, if available (last 2 years usage(gpd)): Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 10/14/2009 Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts u Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ❑ Septic tank, distribution box, soil absorption system ® Single cesspool ® Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 3'feet Material of construction: ® cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10'+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appeat tight.No evidence of Ieakage.System vented through the house vents. Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: Sludge depth: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection 'D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 N Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ® overflow cesspool number: 1 ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Sandy dry soil.No signs of hydraulic failure.Overflow cesspool was dry at time of inspection.Stain line observed 4' below invert. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration One main and one overflow Depth—top of liquid to inlet invert 2' Depth of solids layer 6" Depth of scum layer 0" Dimensions of cesspool 8'x10' Materials of construction Concrete block Indication of groundwater inflow ❑ Yes ® No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osteryllle Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Sandy soil.No signs of hydraulic failure.Water level was 16" below invert at time of inspection.Overflow was dry. Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 M Map Page 1 of 2 Town of Barnstable Geographic Information System Parcel Viewer Custom Map Abutters Map Size MEN Zoom Out 'In y K R.7f F6 P R ry i♦ � � f ♦ _ a a � J a a f ':a i 1 � \ 1 f. a a / �Z y - i.. 40 Feet Set Scale 1" =.40 I Aerial Photos I MAP DISCLAIMER r.nnurinhf)nnj;-gnnO Tnuin of A-fohlo RAA All rinhfc roconn httn://www.town.harn stab]e.m a.us/arci m s/ann geoann/man.asnx?nronerty ID=051002&ma... 10/16/2009 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of CID 8.2'feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers- (attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts } Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 253 Seapuit River Rd. (Cottage) Property Address Ocean Coast Construction Owner Owner's Name information is required for Osterville Ma. 02655 10/14/2009 every page. CitylTown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Board of Health Town of Barnstable P.O. Bose 534 No... --- 1 Hyannis, Massachusetts 02E�11 FE$.... '............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ocv ...................OF.� r»-s IQ ................... Appliratioat for Biovoii al Works Toatstrurtian Famit Application is hereby made for a Permit to Construct ( ) or Repair an Individual Sewage Disposal System at: 53 S¢aPuiT-Kucr ,. bi�r4!pal�i./JI -• -•--- -- --------- --- -----------• ---- - Location-Address Lot �loRA N T�caas S . o n/ - s---•--------•--- Owner Address f, W S.lo�Co 356 1244i.9 5 ri..t!Mq�T 4rA1o(i1�1F�. ........................................ ... Installer Addres QType of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons__._________----_-__.__.---- Showers ( ) — Cafeteria ( ) a Other fixtures ............................ . ' W Design Flow............................................gallons per person per day. Total daily flow_.._......:_._______._.___.__.__..._........gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No. .................... Width..................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No.--_____---_-_-.-_-- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date.................................. Test Pit No. 1........_-------minutes per inch Depth of Test Pit.................... Depth to ground water---_--______--___-___- G%, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water...___-__-______------_- Ra' -•-•----•--------------------•--•-._................_................-•-------•-••---••-•-••-_----•-......................................................... 0 Description of Soil........................................................................................................................................................................ x c, --------------------------------------------------------------------------•----------------------------------------------------- --------------------------------------------------------- --------------- W - ----- ---------- ------------ - - - - ----------------------- ......•----------••---------•--•-----------------------•----------------•---•----- I UNature of Repairs or Alterations—Answer when .........................................._ _.Felcgxk / cs__-._N. -_w1,� .., �s_r< �rtd------ ---------------------------------------------------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TIT1:;. p of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed _:! !x' ' .. ��'! . Date Application Approved By............... �.._... ----•-•.� '1-� �'------ Date Application Disapproved for the following reasons------------------------•-------•--------------------------------------------•--•------------------........_...-- _.....----•--------------••-•------------............----•----------------•------•----.......--------------....------......-----------------------------------•--•------------------------------....... Date , PermitNo.------... �_',.2------------------------- Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 77TOsW.n....................OF.7�4.Ma ......................................................... kTrrtifirabr of Toutph attrr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by................... s J ---...0 'w!,CO...--------........------.......------------------.......-------................................-----------....._........_....-------------- Installer at-•--•-------•--•..__.._ - - -----1 -----------�� .................................................. has been installed in accordance with provisions of TIT E 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE® AS A GUARANTEE THAT THE SYSTEMS WILL FUNCTION SATISFACTORY. DATE...........................•---..........................._•-------------•_•---- Inspector.................................................................................... _ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .... ........._.-------......OF......:..................':......... - Applirativat for Dispaiiaal Works Cnomitratrtion rrutit Application is hereby made for a Permit to Construct ( ) or Repair {--) an Individual Sewage Disposal System at: _ ............:...... ........................... .........:... ................ ........... ................•--..........---------------- ....----------....----- Location_Address + t - t T or Lot No. ................................................................................................. ..........-•...................................................................................... Owner t Address / FM-1 Installer Address Qr Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Other—Type T e of Building No. of persons............................ Showers � YP g --------•---------••-------• P ( ) — Cafeteria ( ) Otherfixtures -------------------------------•-•-•-----------....---•-------•---•---•---------------- ............................................................. W Design Flow............................................gallons per person per day. Total daily flow----_---------------------------------------gallons. Septic Tank—Liquid capacity............gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water----------.............. fi Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water..------------.--____-_- a' -------------------------------------------------- •------------------------------------------------- -------------- •--------------------- •-•------------------ O Description of Soil....................................................................................................................................................................... x U -•----------•••-•-•----...•------•-•---------•--------------••------------.........-------------•--------•-••••--------...•-•--------•--••------•••--•-----••-------------..........---•----•----•---•-- W U Nature of Repairs or Alterations—Answer when applicable __._..._ .. e. •� � I. ...... ...........................................••••......--.....--------•---------•-•-••-•------------------------•--------•-•••...-----•--•----•----•---•••-----...-------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of A.-L p 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed---------1............................�--------•---------•---------•------_...._ ....... ...................... Date Application Approved By..............�-._.... _u Date Application Disapproved for the following reasons:_...........--------------•---------•--•-----••---••--•---•----•--••-----••--------••-----•---•------....... ---------------------•-------------.......-----------------...-----------...------------.....--------•---.............---•----------------------------------------------...---•--------------------•-•--- Date PermitNo.---.---- = ��-------------------------- Issued........................................................ Date r, J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH '!..........................................................................- . . ..,. t (.5rdifi atr of TompliFana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired (;L;-) r f.3 r Installer at--••----------------••Z...... ...... �`�..... ?�•------------------- has been installed in accordance with h the provisions of TIT E 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No......................................... dated----------...................................... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector...........................................................=------------------------ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH' ' ............................� �?5 No...,�.�......--•-- ... FEE........................ �o�a���ruan Permission is hereby granted. ....= . •--c�!`ct� != . ........ to Construct ( ) or Repair ( " ) an Ind..i.v_iA.AS-111 a e Disposal System atNo............ _�------- 1b A ----- � ..................................._. Street r as shown on the application for Disposal Works Construction Permit N60LI.7�_f_._ bated---------------------- ....... #,P.arof Health DATE--.---•-----•-•---------••- , - , _ _ _0 1 FORA 1255 HOSES & WR-EN_ N C,I ,3 PU136Sh.t.RS riR .-••-, ...=-....n-...,-... -v-.,> -�-�«..-r*,�- +..e-..`.n .. �iw4-�t+wK7r'4.7wt:xs**his.:s4:..i.<.,...-»�.ti.-.,s�:.n.,....-n.--.e3-P. TOWN OF BARNSTABLE - UNDERGROUND FUEL AND CHEMICAL) STORAGE REGISTRATIIOON lift MAP NO. 1I PARCEL NO. ADDRESS OF TANK: 253 Seapul.t River Road VILLAGE: Osterville MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : Hostn Projects,, Inc* 160— Federal sT. YD yy i,.{,P CI} 13 f.�iSl♦ V C Y Y lY Her ert W. Vaughan) Truste-e OWNER NAME: PHONE: . INSTALLATION DATE: t n rt fl Tn 't�/by: I"!STALLER ADDRESS: CERT.NO. *TANK LOCATION: courtyund of Main Savee DQ®OR i SIB TANNK LLO AAT I/O_N WITH RNOPIECT TO OU I t_D IsN4m,)✓f CAPACITY 1 �000 TYPE OF TANK -� AGE � 9YRS.. FUEL/CHEMICAL r,l l"(f IL LEAK DETECTION C J CHECK IF. N/A TYPE/BRAND Kam. ZONE OF CONTRIBUTION [ ] YES C ] NO DATE TO BE REMOVED .Xa FIRE DEPT. PERMIT ISSUED C J YES C J NO DATE Hone via Robin Crosby ,•. F'>r e Dept . CONSERVATION C ..] , CHECK, IF .,N/A DATE, BOARD OF HEALTH TAG NO. [ ] DATE t!'a �CC f�'lA * .PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD C �V � p J A a A I J x . o .,. ti r--- 'ti'. "),..-`�,,'�--�----y t.r-ti .._.j�.,_,r,�h,���:�""-a�.y^y,-�,4r.^,;f•'+�`,,r�YR,.,a..K'bw>,.cH Lr....-++-.n.ar."-+..,,,-r_,.....,,,/.y , TOWN OF BARNSTAHLE. - ,UNDERGROU'ND FUEL AND CHEMICAL STORAGE REGISTRATION r s MAP NO. ` PARCEL NO. ti ADDRESS OF TANK: 253 Se�apuit River, Road VILLAGE•Osterville NLAm bwr MAILING ADDRESS ( IF DIFFERENT FROM ABOVE) : Bostc�n 1'roj cI Inc. 160 Federal Street , Boston, Ma. 02110 OWNER NAME: Herbert W. Vauahau. . T'rustec4—.- -.,_ :-:f PHONE: INSTALLATION DATE:unknown BY: I"!STALLER ADDRESS: � � CERT.NO. *TANK LOCATION: near drive:way�to Caretake'r..' s Cottage (Di6CR I�sy R�•_To LOCATION WITH P MMF-GCT TO HU I L_0 z Nm/ �) / I 3$4 CAPACITY 275 bat TYPE OF TANK t :/C� -- ( AGE unkno YRS. FUEL/CHEM I CALr_D 11 G (1 `. TESTING CERTIFICATION [ ] PASS, C J FAIL DATE LEAK DETECTION C ] CHECK IF N/A TYPE/BRAND j��f --•ice�� C� d. .. ZONE OF CONTRIBUTION [ ] YES [ ] NO DATE TO BE REMOVED A! e ra i FIRE DEPT. PERMIT ISSUED C ] YES C ] NO DATE None via Robin Crosby ' Fire Dept. CONSERVATION [ ] CHECK IF N/A DATE HOARD OF HEALTH TAG N0. [ ] DATE � Ak 7 . * _PLEASE PROVIDE ,A. SKETCH SHOWLNG THE. TANK LOCATION ON THE BACK OF THIS CARD v v � � � �� �� ' � A �"Q �Tr -� S Y 0 C �n i �' A �FTHE rO TOWN OF BARNSTABLE d OFFICE OF BA1119TABLE, _MAse. BOARD OF HEALTH Q679'�� 367 MAIN STREET MAY HYANNIS, MASS. 02601 19.89 Dear o Enclosed -#s• brass valve tags#_9 & V lea e a tack to the fill pipe of your underground tank . You must do the following as indicate d: ---- Remove your tank. I have enclosed information for you regarding tank removal . ��- tested startin ant)) You must test Have your tank t g LV�__ __ during the loth, 13th, 15th, 17th and 19th y r and annually thereafter. Removal in the year have enclosed information regarding tank testing. ** In order to have your tank tested you must first contact an - have. "eilgYiee�`iti� company (gee attached) to ham. E =a morltorir.,g well installed. Once the monitoring well has been Installed you can then call 362-2511, Ext.334 and ask for Charlotte Stiefel or George Heufelder at the Barnstable County Health Department, to have your tank tested via the Soil Vapor Analysis Test. Currently, the test is clone free of charge under the auspices of an EPA grant. ____ Due to the unknown age of your tank we must presume it is twenty (20) years of age . You must have it tested every year and remove it by the year 1993 . To have it tested please follow the procedure as indicated above from the ** (asterisk) on. If you have any questions please feel free to call me at 775- 1120 , Extension 183 . Thank you, Donna Miorandi Health Inspector TOWN OF BARNSTABLE V"bAJPi UNDERGROUND FUEL AND CHEMICAL STORAGE SYSTEMS G ASSESSORS MAP NO._ D ,J PARCEL NO. 002 A ADDRESS: 253 Seapuit River Road VILLAGE: Osterville 99jj e� NAME;. - - . Fawz.i.Al-Saleh CONTACT PERSON Terry Vincent PHONE NUMBER LOCATION OF TANKS:_ CAPACITY: TYPE OF FUEL AGE: TYPE: LEAK OR CHEMICAL: DETECTION SYSTEM' underground tank for gasoline s HAS NEVER BEEN USED SINCE PURCHASE OF PROPERTY ON MAY 15, 1979 SELLER, Richard M. Burnes might :have information regarding same. DATE OF PURCHASE OF. EACH: 1. 2. 3. 4. 5. _ DATE-'GF FIRE DEPARTMENT PERMIT: TESTING CERTIFICATION SUBMITTED: PASSED DID NOT PASS 10VA PLEASE PROVIDE A SKETCH SHOWING THE LOCATION OF TANKS ON THE BACK OF THIS _CARD. V R/ I W � - ou G�► � o C 'fit a GUEST HOUSE ' RENOVATION GUEST HOUSE REN O VAT I O N 253 SEAPUIT RIVER RO OSTERVILLE MA 253 SEAPUIT RIVED RD. r t OSTERVILLE, MA GENERAL NOTES: ............... myaI-111E ............... k.,rK U — — LH 1 1 8 m = -- — --------- — — -- — — — — — — — -- — t 00co - oQ ---- ---- - - - - - — ISSUED FOR PERMIT NICHOLAEFF ARCHITECTURE+DESIGN5 0 YfY 2010 s 512 Main Stfj*-,A b 1�A Oder,. gfrc-}2s 3- �M ,f r so 4go J AR,•, S F 5�: �L1U+`�• l•���.. -REDUCED SET- �_ 1 �, DRAWINGS NOT TO SCALE ,x, �. yet ARCHITECTURAL ABBREVATIONS. GRAPHIC SYMBOLS DRAWING SYMBOLS PROJECT DIRECTORY DRAWING LIST 1 W s - - FXISII 8c t5S11%IO DRii °X l`�0 2 s,'..eols°.bb°.°bbAwrkn.: z- A1G -WINGSg G[iNS,IFIOUSEa LO' T7 GUEST HOUSE wb F° _� °' arry CO UMNGRIO OWNER VASMINE REALTY i1.0 TITLESNG SI ��-•/%j/^ RENOVATION ao.wuv we°bbaET «° T 253 SEAPUIT RIVER RD C-1 EXISTING STE PLAN ,-va�,: OSTERVILLE,MA sty ,warmmb.,n oEvcomv Ru OE(�(�A,11LS C-2 PROPOSE[)SITE PLAN OSTERVILLE MA - - °ow aouR 4Oba«�.° ar av om�� Y is yi�.aT�Os m°o o-a XLO EXISTING BASEMENT PLAN �nvJe T l0 C - All4 Y SITE/CIVIL X1.1 EXISTING FIRST FLOOR PLAN Pm.bum r1.2 FJQSTING SECOND FLOOR PLAN a °..m im a� E BOXIER&NYENVE ENGINEERING& DRAWN BY:OJO.DN,GM 4 Eua Iwmb Owl m SECTION rvwroa SURVEYING " - X13 EXISTING ROOF PLAN 3 vww •4'- ca om�sw.n a 78 NORTH STREET THIRD FLOOR SCALE:AS NOTED .. ILL °ww�.w+oow anuv QO0 aEs �4 Y f - Aa erkwrbbe OL 0bo Wo:W RE •oc .. � gswt om,nw ,o°m s HYANNIS,MA 02601 X2.1 EXISTING ELEVATIONS 3 3 % 11vnq^""°A4`I.IEL \\ k WALL TYPES oab rv. a X2.2 EXISTING FLVEVATIONS STRUCTURAL ENGINEER DATE:S JANUARV 2010 N i c h o I aeff °°°'� "o 'P'µ0 cwwErE P oc. ERIC CEDARHOLM X3.1 L3a$TING[;JILDING SECTIONS . wqm \�/ 44 CHADDERTON WAY HOR na°mrmwu DOOR NUMBER D1.0 H4SE7.•IDY1'DEMOLITION PLAN Architecture + Design �� M .a MIDDL4-0358 MA 02346 >ww,b —uo�wo .�`� rwn 508-40a-0356 Dl.l FIRST DEMOLITION FLOOR PLAN a4A, 1^1 , a Y°°I °'°I .— WINDOWTVPE w D1.2 SECOND DEMOLITION FLOOR PLAN '.s °wcw°mn �sa�owr.rov sua a�o�° you ss` ba c c DI 3 ROOF DEMOLITION PLAN 812 Main Street j� s ry<� r %: s a�b EN ry s"aos�b WINcsE,rtisr IEa w mk L° CEILING HEIGHTS ^AttcNi[]E[rt7i2aG DRA„ _, Y'TOUSE ' Osterville, MA 02655 o w —`""�a °E'°° 3 rvsr.Eowaoo ' T 508 420 5298 "pw' NOTATIONS A1.0 H4SFT�Lf PLAN comae „�,Iwo O °rbn aaomw wnoo: AL I FIRST FLOOR PLAN F 508-420 2240 `°` ""`"°' - w �o °°°4b rvb4l° AI.3 ROOF SECOND FLOOR OR PLAN gg • :A vx qm Lano°.OnN DETAIL AREA TITLE I Y F3 I nicholaeff.com «� oa�° as 4 ry M �1,; 3 I N A21 ELEVATIONS 8 ��° Ens rrP q x....�wooa '@—oI tenon HEEi•3 A22 ELEVATIONS.x awwm EQUIPMENT I 3 3oEP mwimum un°ss.w�bborEuA3.1 BUILDING SECTIONSEE� t o I & ow a� Mii a ..Pw o°.re.. '• s A4 1 MISC DEI•AIL AT S II^ q n A 3g III x q mmo°b OM bmmN°n rn a v°°ow 11B 5 N RTH mbmm k ,,y, a oR boa _ VOnk° ILL TO REMO/E M a m r,w YECR aft, ,Yt ,� ry 5 4 wb O ARROW L bwbb nu-. mbcoubwwn Ow ka� rd Nro mwvn(wl w " ....-_Msc.rO aENOW Pan w°nn PmlM awwawl ''I t`.., a .3>>t �..»,it•o 3k - S,LRUC,'FOUN ATION N,GS..._!;:C;UFST,liC1kISE. off SI.O FOUNDATION PLAN B.DETAIIS S1.1 FIRST FLOOR FRAMING PLAN n�Ioo nw to�.am "° sm.esub REVISIONS 51.2 SECOND FLOOR FRAMING PLAN Po,,,m� wvosooa 51.3 IROOFFRAM[NGPLAN21 Tl -00 `° w0 e�rvM a�gao � �Rabbn,�,bn 3 ty� 3 GUEST HOUSE � RENOVATION ' 3 Y 253 SEAPUIT RIVER RD OSTERVILLE MA �5s � GENERAL NOTES: o� `a E16T41G BASEMEKT xs�' Ex¢t o LIB �'�• 31 NICHOLAEFF ARCHITECTURE+DESIGN 812 Main S1ree1 Ost`rYlle,MA 02655 - _ - T 508 420 529a F 508 420 2240 nicnolaetccom PROJECT NUMBER:SLH-GUESTHOUSE DRAWN BY:OJO.ON.GM SCALE:AS NOTED - DATE:5 JANUARY 2010 # I EXISTING 6 §!EMEN,T xi 00 EXISTING BASEMENT FLOOR PLAN SCALE:1/4"=1'-0" 7 GUEST HOUSE RENOVATION - ..253 SEAP,U IT,RIUER RD ,OSTERVIL}L,E M.. , � r 3 t GENERAL NOTES: KITCHEN TiLL F1.S1 ` BAT BILLIARDS 104 103 BEDROOM HALL 10B STAIRS . SCREENED PORCH -- 1C)1 TRY NICHOLAEFF ARCHITECTURE+DESIGN r � ` 812 Main Slreef Oslery lle.MA 02655 --- — T 608 420 5298 F 508 420 2240 nicholaeff.com PROJECT NUMBER:SLH-GUESTHOUSE DRAWN BY:OJO,ON,GM SCALE:AS NOTED DATE:5 JANUARY 2010 W } � �Ka. k AITli - N x z f PLAN�� i $ 33 YIE II I }T .�.. lN mTr i... ._ ; >;: x 1 1 EXISTING FIRST FLOOR PLAN SCALE:1/4'=1•-0' 1 4_ sir , T � GUEST HOUSE RENOVATION 253 SEAPUIT RIDER RD' � -OSTERVILLE MA j 3' R: GENERAL NOTES: _ mcm� e e,n a.:een rronn��reg1eq,oror men aryen u m on a an e ZCLOSET;] zos BAT 7CfFi---- -----------� ___——_ ESE . 205 BEDROOM GLOsOSET-STAIRS'F1 201 202 HALL C zos zos NICHOLAEFF BEDROOM BEDROOM - ARCHITECTURE+DESIGN 812 Main St eat Oalerville,MA 02655 T 508 420 5298 F 508 420 2240 nicholaef/.com -------- S3 J:2 PROJECT NUMBER:SLH-GUEST HOUSE DRAWN BY:OJO,ON,GM SCALE:AS NOTED DATE:5 JANUARY 2010 .A r SECOND FLOOR LU PLAN z,g I, Xl .m2 EXISTING SECOND FLOOR PLAN SCALE:1/4—V-O' 1 r ' GUEST HOUSE ,' f RENOVATION x253 SEAF?UIT RIDER R " ?OSTERVILLE MA di I 3 � 3 Ix � kr'� GENERAL NOTES i. —_ z z. v h s wa C11I-I--ICI— ------I I--- --------1 I • :�a r i I .... \� rll , III II i -- Rom $. \YTI i LL z a- 1 -- if NICHOLAEFF I — fvi ARCHITECTURE+DESIGN Ipplu \\ 1411 612 Maln Sveal III I I a Oalemlle,MA 02655 j— LL— PROJECT T 606 420 5298 F 506 420 2240 f--------- /L/_----- __— nicholaelf com r---------------\ I---(_ — NUMBER:SLH-GUEST HOUSE DRAWN BY:OJO.ON.GM SCALE:AS NOTED DATE:5 JANUARY 2010 HI ' Xl m3 EXISTING ROOF PLAN SCALE:1/4'=1'-O' , ' ,GUEST HOUSE RENOVATION - ..253 SEAPUITIRIUER RD � ' OSTERVILLE MA GENERAL NOTES: 27`OY2 6'-4Y4 9'-j3/4 w�.+owdmo dm m...ndw.di 12'_0' 4._5. 6'_p. 6'-3' 9'-3' 3'-6Y2 T-5Y2 3'-103/4 4`-6"-T 3/4 5'-1• 1T ,00d �._, .,.., ImEmmi— ?w 12'_117/0 I 7'-6• 33/B - - I 107 I v � E m v v 51W 111E - �KN e000 I _ o I 1 v - - I NTH. —ILU v Per —J to G me k Y kk m - - _ .S.L•�E� S.U. N nLNP1G ROOM SRTING RM v1 P `is}I m R— 6 - -mF al SCREEf1ED PORCH � 103 BIRDS NICHOLAEFF - ARCHITECTURE+DESIGN 612 Main sveel ry u.01 o _ OsleMlle.MA 02655 M wood .� T 508 420 5298 - F 506 420 224 TRT0 - 1_ Y2 1-B 2 4'-6S/e 6-Sy4 5'-6Y<• 5-g3/4 6'-4' _ 4-6S/el 6'-1Y2 L 5'-11Y2 .• .. 12'-O' 36.-3Y2 12'-1' RAM" 60--4Y2 PROJECT NUMBER:SLH-GUESTHOUSE - - - DRAWN BY:OJO,ON,GM " - - SCALE:AS NOTED DATE:5 JANUARY 2010 - , /. ERED A �. N i cly No. 6622, jFl SET FLOORa �� 3j �j , - BOSTON, PLAN, I'". b li MA JJ 3 ��TH OF MPSS ,,., Al 1 RENOVATED FIRST FLOOR PLAN SCALE:1/4'=1--0' 1 GUEST HOUSE RENOVATION ,253 SEAPUIT RIVER RD ;OSTERVILLE MA � I � 3 3 48-4Y2 GENERAL NOTES: 4._5. 29'_6. 6'_O• 4'-B7/B 3'-11�/6 2'-103/4 5`10% 6'_0• 5�_9. 5._5. 3'-3Y2 ----------7. _ JF I 20B 'v c wwox000 ... ,i 0 BEDROOM_ "0Y4 -2.�3q' 2 7'X3 13/4 .� ^_'YB ( � oHl vG iy y� 870RAGE m _ I 4'_OY2• 12 4 ❑ - OD 3-33/4 7-1Yq 3-13/4 ry ry 4 m h fQ, P 20 m Y m 4n m I - 7 Q O P NAPoKD�� ' O N P a E m 2 1 ALL x01 JIFDPMM DECllmmg�mlK N zo3 a."•' A_�fUY.��'TUki�Y DESIC 'i ' 6 DR ro 2`53/4 ~� ^9, coa I S5 I �MA¢02655.j� 'Y1+. n ET>8�20'22�' ;o kl"I.R.cof3(J`',TCJ i�.. S.D. Q \���� YL� 2'-BYZ 2'-BYZ �/fe /f 4'-63/B 6'-63/4 2'-2Y4 4'-103/0 5'-3Y4 "10Y• 6'-3Y2• 4'-B�/e' 3'-4Y2' S._5. 3'-3Y2 V��V Y V/ - 13'-3Y4 10'-15/B - 12'-105/0 12,_1. _ .PROJECT NUMBER:SLN-GVEST HOUSE 4B'_4Y2 DRAWN BY:O.C.ON,GM SCALE:AS NOTED DATE:5 JANUARY 2010 y Tj17LE - i SECOND FLOOR:� � r Al v2 RENOVATED SECOND FLOOR PLAN SCALE:1/4'=17 1 a y n X "f I of !C'7 y J > n 3 I .r� X , D 31 .................. iz r ..........L....�:. . n A i r b j D USES. .,Z r I ri R ti LIMA O z z v) i3 x n _ ri gal 1 'R UJIY'i ..... ... .:_ l �Y m LOW :J I 3 F s - �i r ! { 5 -1 { € R ................... 104 t Z { I ilia! R — - ;1Z © - >, 711 O z., {_ `s� $•` r Y N utiJ 3 - t 4: 4 ` 1 n y< ( i l i - (Ail 93 V I'ARD-WIRED P."QTGF.L E1L%TF C;SMOKE L)ETCC:`Ori -.'. WITH 50 ti4.J.' . HARD FWlf'tC)WALL'Mth,NTCARG NWWOXIDE COTTAGE co OFIFC'OR a# _ 1• 'G" (]� HARD-VJIREDFlXEDTEMti£RA'IUREHEATDEI'ECTOR RENOVATION . -_Aq, ,. Hp. WITH EA1TEP.Y ESA QKI-IP T ^C yy h': n. c �. � u r:9 .. AL* DEVICES frf 5E STEM INTO INTEGRATED - YASMINE REALTY SDILDIn3 ALltRM sysTEnn 2�3$EAPUITRIVER RtJ :` "r FIREPROTECTION 2` osTERVILLE IVIA aq �^ t TYP SHEAR WALL• ��:', i �La a�CS - PROVIDE Bo COMMON NAILS x Y 6•o.c.EDGES AND 42'o.c "AR a •w L � �. INTERMEDIATE.BLOCK ALL JOINTS r `i:. ° ♦'" '�`' - A GENERAL NOTES' B6-07/ STD o 9TL0 V LF.- -6' m.v<.» .a ........,._.�„o...�.,-...,n ....,.., - _ s�IL ......... Y � m BATH BEDROCNd I '{'; 'COVERED ENTRY I . Ormw,w /B/+® W'�tTAAeovE ro BE > - 27 ON - 5 4'Xh'NK MI OLe D os 1._\ GA RAC-E173,91 Ex1571tG ORAC�3 64 V.LF. / ' ` WINDOW IN GABLE 4 ABOVE-PROVIDE S.D. BLACK S: PLYWOOD PTD.PANEL 12-BEHIND On I II I .7` •Y - INTERIOR SIDE. `- �. •• t, I / x / d a 7/. _9y2• y2 By2 1 sr 76 1 - NIC ' I I I "s �•_ m I I � :v � i i i Y '...i I .. it x. i .. 7 - OIS - I I .,i I I I ® I I I ® I t' AR OF HOLA � SH Mq S %y camN Cy S ^ ��Pt SS�O aDizI@� I T + <20 _ _ _J L- -- ° O= ERIC:J. yG a<z ym p l 4.Oy; ,D 6'4'/: NEW WINDOW SCHEDULE g CEDERHOLM M CD No.6622 T 1z 4-1z-Oy4 -- 12'oy4__' O - - - - t MARK SIZE TYPE FRAME MATERIAL NOTES V STRUCTURAL o eo.MAON, oC p WiDTH HEIGHT _ N.O. 38962 J ■ ?m 2 2=1' _ 4'-6• __ PELLA ARCHITECT SERVES- A 2��• r pC3 LLA ARCHITECT PE- 4 X-1' 4 6'_ -_ _ __ FELLA ARCHITECT SERIES �0� / - _ qC TIC ( ( I '-6 6 2-1' 4'-5• - - - FELLA ARCHITECT SERIES _- F 7 2-L' X-11— _ - —_ PEL ARCHITECT SERIES '1 r C 2-,' 7-iM FELLA ARCHITECT SERIES r - .. •-: ". --_-_ _ , `1 ------ ir O 2'V 9 6' FELLA ARCHITECT SERIES SERIES .E..T NUMBER.SlH TTT.GE v F O nm _ PRO ..CC 1 1 t i INPW/IPTOiFH I -. - + 1B 1'-1'- 1-11' 1- _ PELl1 ARCHITECT SERIES �b . . 4�11 rox. r__{ •m - 14 1-1' 2-1,' - _ PELLA ARCHITECT SERIES . TYP SHEAR WALL• Q I I I I �. - h PRONSHE �.1 15 _1' RIES 4'-5' - _ PE LLA ARCH ARCITECT T SERIES DRAWN 6Y:O./C,DN,GM PROVIDE eo - F I I o - ----- _ FELLA ARCHITECT SERES COMMON NAILS- ` / I I i 1 ?. COMMON NAILS- T7 2-1'_ 4-6' _ ..SCALF:FS NOTED 6'OM EDGES AHD / 1 h 6'_EDrE9 AND 15 2'-1' .4- - FELLA A-111EGT . 1r o.� TyP. \Y O 12'ac '19 2-1' 4'-6' - '- __ PE1LA ARCHITECT SERIES P17ERMEDIATE _ - -.rL.-L _I.,-- - — - - INTERMEDIATE. 20 2'-1' 4'-6' - - FELLA ARCHITECT SERIES - . - BLOCK ALL JOA TE. /' I I BLOCK ALL JOINTS 21 2'-1' 4'-6' - _-- FELLA ARCHITECT SERIES GATE:OCTGPER 7,2<1p / I 9 I 6 j; 22 s'-T 4`6' __- FELLA ARCHITECT SERIE.9 29 _ 9'-T 4-6- _-_ -- .- PELLA ARCHITECT SER1E8 . y L J \ Yp 14 1'-1T Y-4• ARCHITECT SERIES . / ® 2u6 1:1T 5'_4, - _ ---__—_ ZERIEZ ARCHITECT SERIES _- i a _ PELLA ARCHITECT SERIES 27 T-1r B'-�' _ 2B _ 1'-1T S'-4• —_ --__— FELLA ARCHITECT SERIES _- 8'OBIB T 1�1 B'OBIB PRO 8e COMMON 9 S' 4'_6 - ---- - FELLA ARCHITECT SERIF- NAILS-9•o c EDGES . AND 11 c INTERM o E.AT BLOCK ,t , ` NEW DOOR AND FRAME SCHEDULE ALL 4 - - ALL JO s 1 DOOR - --- �� 1 FIRE S DOOR x ROOM SIZE SWING DIRECTION MATL GLAZING ATIN NOTES SC ocwOR04 WD HGT TIME 101A LIVING/KITGHEn b'- 6'-9 /1' RIGHT ITEGTRIEg NiE1J`{/'FIRST Ft>OR PLFVJ f01B LT VMG/KITCHEN 6'-6 6'-9 4/2'` LEFT - -- FELLA ARCHfTECT SERIES 1oBA -eEDaooM r 6 b'-9,/r LEFr - - 1239 SOUARE.FEET HEATED 1098 SEDR- 1/2• LEFT -- - -I. 005A1/2' RIGHT —Y� 106A _ BEDROOM b J-O'6'-9 1T2' __ LEFT 1 BEDROOM V- 6-99 1 2• N_ A 1 _ 108A BmROOM S'-b 6'-9 1/r LEFT LEFT - _ - ` 15TII1G GARAGE 5'-0'6�9 4/2' EFT - - -- ,ty1 1055 EX TING G GE 8-ID, 7'-O' NA _ - -- D GNER DOOR OR PPROVED EO. 10BC EXISTING GARAGE B'-O' 7 068 '-0' -NA - -- DESIGNER DOOR OR APPROVED MO. • 4'-0y4' 16'-O' 4'-0y4' —TO EXL4TING�aARAGE C'd' T'-O'6'-9-O' NA_. - _ DESIGNER DODR OR APPROVED E0. /w\ . 110A NEW OFFIG€-- S RIGHT ■ 14'-0y'-STUD TO STUD-V.IF. ' NEW FIRST FLOOR PLAN SCALE:1,14' D 7 k - � �• , RENOVATION ,1 u y.,� `' YASIJINE REALTY I. . It -'- - OSTERVILLE MA .k ,v GENERAL NOTES f V� REMOVE EX TING �'. COVERED ENTRY. -.- -- - x --- __--'- --- flt F,L_ I i PL.0 REMOVE it AS-'MO G FiX E TURg \` rMAS RED•TYPICAL_ .L /.. .__ REMOVE ALL EXlsnn� INDOWS AND DOORS SHOWN DASHED In TYPICAL 1 — _� - — --- r.. I r I LL I I TINGwmoows �i � � II r-----------, r----------, ,- --r_ ------, _ DASHED IN RED - ' - TYPICAL. . WALL 6 BLOCK - ! WALL TO BE ? REMOVED m rrs I t'• @ • ! NICHO �t�ED All , _ EnT�eE-rr I t 1 I - ARC T 42 y . ��.� y_. FI No. 6622. T N CHCNNEY TO BE' t - .. c ~ ' .F105T0 N, a I I REMOVED. . O NIA !I 2GvF9 WA-10 OWN • 1^J II ToAJID ITN Of M : L AT. KEYS Il I I I INDICATES WALLS TO BE REMOVED PROJECT NIJME£R:SLH'-COTTP.GE i I mb1CATES WALLS REMAIN �, @ pFAWN 5Y 0.10:JN,GM • @ I M SCALE:AS NOTED Jn' I 1 I `�• ��yt,p� @� -E+ DATE:OCTOSER].n077 . � s _-----Jam.-�" �rC-=7� l`` �(.6•� If - e it I fr REMOVE EXSTMG - _-- ---__ twj C.� NOTE: REMOVE ALL III SLAB S t' OF@ EXL4TWG WALLS AS SHOWN FOIAYDATION DASHED IN RED DOWN TO I BELOW Ohl r @� EXISTPI6 BOOR. 4LL. �qi, SORE NF-D.PORCH j TITLE; @'@ EXISTm6 FLOOR AHD FJ" IMF FOUNDATION TO REMAIN- r . Ohl TYPICAL - - �i - - FIRST�FLOOR DEMO PLAN V, Dl 1 FIRST FLOOR DEMO PLAN SCALE:, -,' 1 ' 1 ' •16'-113�/Bw Dora rro..nrm. ._ �. �,. -------------- ---- -LEVEL COURTY(a O r �^ CRAWLLSSPA— T RAGE BSPOT STAIR wm.w w.n mu.rm Irnvt BN 0 I � i /_ � ..m.• I - Ili O / I DAT ------ -------- �. e%—COO__ —A—SPACE III / RAWLS�SPA— u 61Y0 S�GE _ El El El ❑ i .. CRAWL SPACE ..-.. .... ..... r ABC GRADE II m-ioY' I ' EKED AR �r N1C F RENOVATED BASEMENT PLAN SCALE:1/4'-1'-O' , REVISIONS ! Q• � NICHOLAEFF PROJECT.SLr11NwNROUSE TITLE MAIN HOUSE ® GENERAL NOTES: ARCHITECTURE DESIGN RENOVATED BASEMENT PLAN RESIDENCE `Se ® Q. 2.nMaB.MA BN55 ORAwN BY:G .G O.O , ��•�•� •.:.:um:a mmm.w r.rmn ^SOB 020�300 SCALE:AS NOTED 253 SEAPUIT RIVER RD B.O SIRt.TRI„ r '" rndaocam OSTER/ILLE.MA r '1 Qi. N71PP 6'-�' ^Z�-' •^~~n ! • r • 6 F ♦" • r DATE 135EPIEMBER—a Al . 0 I LIMIT OF WORK Y-3/i a.% Y, r-----------------------------------------------------I-- '" --, I •'AY' 6'.e�• 6'-Y' q- .3Y' sl. s-sY' adje' - rzya' num. m� 1; 0 I I I - �� I'I COVER�D POROi �o o , plT�w I .�SOE FMRr 1 O ® ✓ ---. I. •v o o s�� O B if 0 p 04TH Q s P I .•fiy'I I I � � O � I I FAMLY�ROOM 1 11 II I '� sb. ..• 11 I I V I u'9Yi 1 3Y�t 6'-0�' f9 a:Y- �z'z�' II I II ® _ 1 1 - �n _ — vp�s 11 II I II II I '•� I I I I I I n n COVERE,2 D PORUI e O'-xYi %• Ha a 'a e' �\\ 6� � srxEEZEFrllPoza r o I e•-TY.' >`xY,• e`er' e•-zY.' z-0Y' - -- �r-:Y,• I I o r _ e - e. I , L——— ————————————— ———————— —— --——————— - -----� RENOVATED FIRST FLOOR PLAN SCALE:VA•_,'- y `C NICHOLAEFF aEv5bN5 TITLE GENERAL NOTES: ARCHITECTURE DESIGN PaaEcrf s�ruNtlrou RENOVATED FIRST FLOOR t MAIN HOUSE 9 E= o CE MA DRAWN O 0. RESIDEN y O No. 6622. 253 SEAPUIT RIVER RD. S ti a. .-....ad...meo...�.�... E—E- SNOTED OSTERVILLE MA BOSTON, 1•yT `;Q`�- �..aR """"'tom"' I MA J`� r `O- ,��.ae«��.� GATE.�35EPTEMDER Zete i F9�TH OF NkLIV PSS A 1 1 1 JI Y I LIMIT OF WORK r----------------------------------------------------------- I I soY' x�. m s• I �..}�-..-.-.._.---_-G........_..... ..............._.._ 1 I , I ra• r ray I I - it In 41 1 0 BATH -9r r p r s B. BATH0 ® e 4 = aOu 1 .1 — ��- o a © ------------- N=O AR • ro ik--• �o s_s. I I NnLa. ems' ®.. n 1®' ws�� - : : z r-s z-e• I•-,oY" m ® � - NasTER�auN® ® e 1_ 0 I ___________ ____ I I. II m BBBA pT �- BEO0.00N J O QBATM '= r r 1 or �.I � b11WWtl OOR Sv-e^ z-<S 6'-1 e•____ � -II _ OR©BOON 4 j Oz, aspoe mFJ . sa. s•� rW 6'-+3'e .,T J e• ' _ _------_—_---- I ❑ i � . I � o I sus• zroy s'aYi ,r.�• L--------------------------------------------------� �� NICy F RENOVATED FIRST FLOOR PLAN SCALE:,,`1 1 REVISIONS Q- •Y NICHOLAEFF FRp,IECr•SLFv�rwNRousE TITLE MAIN HOUSE Q GENERAL NOTES: ARCHITECTURE DESIGN RENOVATEDSECOND FLOOR RESIDENCE o ° No.6622, a,zMa 5aa, pgAWN9V: .pp.�N ... -. F ; Os—Nw BS BOS'TON, T sOS<2Osae 253 SEAPUIT RIVER RD. �y MA ���•• ,,,,„,,,e,a,.,,,•a,,,,,� Fsae OmR 40 srxE:AS NOTED OSTERVILLE MA Q 14 —E:I..1-SER of 1010 M Al 2 w 4 I a C .v.l 2 ------- _Li- till - ............................... 41 -- ---- - ---------ht------------- -- =T .M I ---------- ------------------ - ----- Al.. hl It ;v it 7 i LEGEND: _ MEM 42' EAVE €rMMV,, 42' EAVE W/ GUTTER 1 Ece NOTE: -BREW GW/ ar , a - ° 10'EAVE INSTALL ICE B WATER _ nr R G aoD 10' RAKE SHE AT ALL VALLEYS. E'LAEI j FLAT ROOF-EAVE RIDGES,DOORMERS.RAKE 89i EDGES,EAVES,LOW En ,",„,� �� SLOPED AREAS AND vAPoa LenGTH - PROPOSED.DOWN CHANGE IN PITCH R.R - P WALL - SPOUT LOCATION CONDITIONS. z B 10" DORMER RAKE DETAIL SCALE:1.1Z-1'-V 7 RENOVATED ROOF PLAN SCALE:1/4•-1'-D' 1 LAR` ooa Eat w I b 11'RI VALUE: -•• A TY1.ALL RAFT116 e Al-=I-AL of - S.TWeen RAFT_ 12� ROOFwG nsuLAron .. Ie ors Illp ��=R. .G 5/B HKe By WES ER" °H ee =__R._.R. " TYPICAL ROOF CONSTIIUCTION CEDAR ROOF -/e TMC�—W�SR'---- •GLUeD 1B. o EA¢L�Bt BLUE LABEL - DAR R.-n 6/6 THIRED CFDAR ROO c nr GRADE H BLUE LABEL 12 GHwGLEs PERFECTIDI GRAD �� WESTERN RED CEDAR ROOF SHINGLES SAVER CTON OVER 9AV�•VEnT - SRADE N BLUE LABEL 12 301 ROOP FELT OVER 6/BECOX PLYWOODR OVER UnDA ♦MENT CE EyT 12� 12� COrvTB1000s RIDGE VENT W/WOVEN SHMGLE RIDGE UnOeRLAYIIEnT SAVER•VEnT VAPOR m L LenGTH CAPS TYP_WOVEN SHBIGLE HIPS AND VALLEYS.TYP, e/e VIOERLAYnE"T BA,yR�y F WALL CD% W� GENERAL ROOF NOTES ICE AND WATER'�SO SHELD 6/e F5 EAVES ICE AID WATERS IELD PavEAG 1. ALL RIDGE CONDITIONS SHALL HAVE CONTINUOUS RIDGE YP. ICE OIrD WATER sHGLD 7 33. ~ T • EL TYP. TO Be•ABOVE EAVE9 e•A-ove eAves 2 - VENTS AID WOVEN 9HPIGLE CAPS. 30 ELSeWME�De n TYP.30ELSEWHER6 T TTP.>D.FELT TTP. �2]]. 51•B LL O COPPER LwER 2 A VALL EYS SHALL BE CLOSED WITH CONC EL-EWHERE EALED C TwUOV9 e e TER �' b OL LC COPPER 5' FL45HING. Rg�— FL4 Hw R FLA-HMG W/DRIP EDGE „� 3. ALL HFS SHALL HAVE WOVEN SHMGLE CAPS. - LOCATIONS FOR ALL ROOF PENETRATIONS(PL UMBING 9Se BAY Bea.�-� FILL aCALEOTA� NTI AVE me STACRS,FIREPLACE FLUES,VENTS_)SHALL BE SUBMITTED PROPLe •-PLC TRp OF..e TO ARCHRECT FOR APPROVAL PRIOR TO ROUGH-Vl. w T 9CRL.T—T RA 6�• )5/ $y0 3 InorE TALE BLAE < wSecI'DT autBen w-VT 6LOT y tl )`j/• 1 3V0 a VEIT-LOT 1f Y• Inore,PTALBR&.ACR Y' more:T.IUR`FTeR F W °w o�p� i BL.�Iu TG eDGE DP E�, TG BDGE oP e. TD ewe of eAYE 12"GUTTER DETAIL SCALE:1-1?-V'V 2 12" EAVE DETAIL SCALEI-17=PP 3 E DETAIL SCALE,1.11Z 1 4 FLAT ROOF EAVE DETAIL SCALE:1-117-1'-V 5 ROOF NOTES SCALE:N.T.S 6 MAIN HOUSE �� �� yO REV SONS CH TITLE �� N LI ��C GENERAL NOTES: A ARCHITECTUITECTU RE+DESIGN PROJECT♦sLnvAuwrrousE e812 Ma SveB12� ORAwN Bv:GM,o.a,w RESIDENCE MAB 253 SPUR RNER;RD G7! T N ��\` ••��^^�"^^�® FaRp SCALE:As NOTED EA OSTEfiVILLE.MA , O i No. 6622. T eti%- '• •� " BOSTON, W' - DATE:13 SEPTEMBER 2010 - MA �1 1 �� Al I I I i 1 I m I 1 I 1 I I FNOQI �LO� . r6M YA aos I I rCM w ve vooc oGa , I PLJ.IYn OVGn R q.�',a I I atr�mta oven a•O 'I �a...�i.n I � eAanAr�NkTOQAfEI I I aeN. aoovne oven!t•e I �' I �" ovea tAviceP�un•,e• a I rsM RD vvc I Arm rewaa TO l4iGM PCPXH I var,Aro I I I 1 �� am omAn aNnctra B-P V I � I I as I TO MATmI NLL9T � �I// 5a I +, � I I � 1 e' rcv fre•,v I _____________________ ON viears vAvme To �/1 PROPOSED FOUNDATION PLAN SCALE:I1f- 1 PROPOSED PARTIAL FIRST FLOOR PLAN SCALE:,,<'_ 2 PR SED BUILDING SECTION scA�e+a- 3 i -------------- 1 I 1 MASTE1t EFAtOCM I �,'I�� I v�rm I �r osv- 11 . I NAMrAM eo rea+ta, I F1,bN C®.M6 oMENariM 3 I ADOVG eGC010 NroM Q qa. I �,. ------ i --�<y nve•A•rn�r ��s p`My MGM eOLm CONG MOOD r.® — -•—C\ Dona Rum l4;tAL ,r . 4Ir- a{tea - TM overt u�vat.erne reM eteem w.00arw 1 AT eNARMAY TO MATCH etlROON 7 ` ll�� — MYL1 fGNTI•ICSL! � M f CLrK et.m M/ f NGM eCl.m CCRG MOOD V ( m DOOR FnAMH M TLL --- POLY VAPOR eARROt - I ✓�PCRd Pp®y® I e I I I I I I I I >a II I I f! I I I I I II I I Oe y I I ���1JJJ Pitppt dM PaCH II I I I I I p� I II I I I I II I I I I mow— II' I I e.� EO r II 1 I I 1 I _--________� I emr _______ R9 vCRO/ i�81FD J___� ------------- --------------------------------- EXISTING FOUNDATION PLAN SCALE:1/4 7 EXISTING FIRST FLOOR PLAN SCALE-11'-V 2 I dn ------------` ® I 1 wIC I I I I � 11.5,ER®oaX —f— I II I I I "1— I �c I 1 I I I I 1 I , I I I I I I I X I EXISTING PARTIAL SECOND FLOOR PLAN SCALE:1 -1'Q 3 NICHOLAE MAIN HOUSEK GENERAL NOTES: ARCHITECTURE+DESIGN PPOJECT/SLH9hVN—SE e S°"S TITLE d k eat Mdn svwr . D�(IXISTING-PLANS^ `r +�,'I .`<i RESIDENCE �wwXSr:A~•o�•�X a a 1 •, > OataM4e,MA m.5 �- M T 5.Q.S— F o20 2zao 253 SEAPUIT RIVER RD - soe OSTERVI'LE MA.X .� i.'a". Q�P ,,,-,y,� ••'"••••'"••°,'••••"",••" Nuwwen.�„ SCALE:Asrro1ED OP nnTe:zl FEW— IsZ4 EX1 . 1 �' .ram ,f .� •� GENERAL NOTES: yII ,.� +�t "-2, .3 -1• •` ` �. ,''`'�,.-.`Y..: ,� .v` t 'j 'r '� 1.) TW WENT OF 7W RAN IS in SHDW PRMSED W= h 4 �/# ' "^ ,� �Ash.w� �;�•R , � _.spy ���"i�� �+.,`,''a � 2 LOCLrS AREDI B OF: ) •� ;;'s^�• ( '' i ++•� ,,,, r,. ` WATER GATE� � 00•,d UP23A AS�OR'S MAP 051 PARCEL 002 N LOT 1-0 (LAD COURT PLAN 153S/M - JtK 29, ION) � ''�' d • ' LOT 1-P (LAND COURT PUNUNE 20.I&WN - J 1939) :•"'�-•�`•-. •` �_-r�{.c.a , �-;•-�:�-;ate►`'-,�-'-----•--'1tr �; �--. �� ! Nr ,�1 wi t Aw, CER1N1dlTE OF 1i11JE 7I1122 ' • :�P� - ' ..1� � it'i�,y ri"-• APPl1QANli YASMINE REDILTY, LLD. :Itas s►,• �� � - ri? � � ��� � �K,:r C/0 mawGpP[R�N. I�1G. 1 j, y •�'•w�{'.s^.�e,.. �� _ 4 •"�••+y ij"'l' ia.tiPa a i s ��� • 100 FLDwva� SIRES d ;..+ r- I - T r�i 1 wee►- � l ..........'- i� I - a�i ► .�• W 02110 jj r"o*Ter N•?�O'•y 1�+' • �•%��1� ' 1) PRrgRY 8DOMW . NM. SET IN U/P #21. 1.2'ABOVE CI W EL • 25.35 (NGVD) r / •130C /DH FND L .14' PRac BEt( MR RM 36 • F1Ri MP250001 0018 o Of ON CONCRETE- 88• Si01JIAARE B�ISE •I // 7 TRAFFIC UORUdR AT N.E CORNER OF EIIDGE Sf. UP (NO#) / � I ��• ORAMBADf,'E. EL 19.33' (NCVD /929) • / 17.5 EA PU I T RIVER ROAD 4) ING zDN NfioR1UI11ON •� , 9 I ZONM DISINCI: RF-1 (Romer") �' `� z AP. RPOD AND ZOC LOCUS MAP Scale: 1' = 2000' 11.8 / f ,, , CB/DH FND on Ll189.53' %m35�.02' / , ?9�•� x NHS 'o L-144.00 MINMJMI Z01A1G REdUNIDE'Ni'S g 7Rj l MK LOT AREA - 2 ACRES Ise �, MK LOT FRONTAW • 20' '' x 6 ' � x'R\2 I T YARD DiFI�1 SIX REAR YARD 15'/ 15' 14.1 SPIKE SET *, ; x 21.7 18.25 TP #I 11.5 / i SCAPI 5.) A ME SEARCH iIiS NOT BEEN PERAMED FOR INS SRE IF 0EIBMED `,6, __ x 2�- 10 K NECESSAIIY.A MM SEARCH"I BE FERFDIIIED BY 01M RS �( vd- 6.2 #2 �` t. x 17.6 /�1 6 ', � E) if COMMS NMWM�OE SM ON QAU®R AMMANF uIX 7 TP '', 3 21.922.1 THE OEM FEAIUREB SHONN M IE N NEW 08DIiED FRO AN ON 11E dI0W FIELD / 13.3 I \ \, x 23 ?3 1SWKY iR01R,11 S FMIE it 21� 2IER NYE EJIGI MOM!SUtYEM FROM SEPT M 23 / 16.6TP f3+ ---- 3.9 \15.2 ,%- - , TP #3 3 Tp o UP (NO#) ,, \\ � � 6 '�� � > / x 20 � 7.) coIM2Nlnr PANEL NuIIeE>ar 250001 o01ao (y/7/lo12) f4 1 ' 21 2 1K FLOOD/iS1A0MEE ME IIIP DFf1E'S 1HS AREA IS Z=AE; a NO C. 16.4 qP� 7. / ; •SITE 15 Nar MW AN AC.Ea (AREA of Cl ffI ONINDN11ENK CONCERN). '4 1E 96 \ ,Ne, , •SINE 6 N0T MiHN AN AAE>t OF ESTIIIIED FIYlfOiT ff RYE NLDLfE PER 1�Sr 15�7 , \ _ _9 � .8 ' ? ORY ;' x NHESP IMP OL9UBER 1, 2008 'ESiIi11ED NAE>fDITS OF RILE NIDLfE' PROPO6EDi , APgRENT �' \-'f \ 18.2 / 19.6 ;' MAP �61 FOR USE MiH THE w rERNDtS PR0iEC1101I ACT RECIAII110N5(310 CIIt 10�' SCREEN 3 ;' PARCEL 002 •SRE 00E3 Wr O M A COMFIER LIE K FOOL FER NHESP IMP GCIOBER 1. 2000 PORCH o - ,L _ ��16 6 , x 14.2 6 ?, g -- -i9 20.1 121tIF1ED VF]YIiL PbOIS' P -)c 5.�' \ !� 20.9 AREA - 3.85 AC. TOTAL MAP 051 • 1 •SRE 6 NOr MM A FM91ITY ilMrplT PER NHESP WP O.10BER 1 2008 'PINORIIY q�?'p� q I I,-.y� ,� 3 (PER ASSESSOR'S) PARCEL OOt IrIBiM DF RYE VE13 FOR SPECIES t1I1DER BE M�S9MSETiS BOMB B �, B" • % ' / \ Y 1 ; 11SPECIES ACT, RERIAA1100(M CMR10). �•' % CARq ' % 11 \ �'I\ ,' E�OSm CESSPOOL. TO BE PIIA�ED PLAN BOOK 39 PAGE 23 FRAME 1 •SITE B NOr MMA SUN AMC ZONE I NINOIAD IIOER RECWAZ PROIE3CIN ,�,7,�, cE 1 AND FK1.ED NM )FAN SAND AREA 1.0 W •SHE 6 0M TIE ZONE Or CONRMBWION 1O S4Li4W E RMIE'S(ILOA REIL 30-1 1 .615.2 , 19 e� W �' G i (�,,l/ k15.7 j Q ' 1 ( \j '.;.:1 r s ♦;.. rZ -2 0 8 CO ,rJ 14 Y'1 .C1._-_ Q \�. /� n, ° \ •1FE CONTRA =MALL CONTACT IN SAFE(AT 1-Al-d9-SAFE)AM UEff CWAWS TO LOCALE � %ll`l ALL ED�LS'W URLIMES; AT LEAST 72 NOAlS PRIOR TO TIE START OF OOISRNICIDL 11 LOOITION OF A271 q.0 =�� ' 1 ' / � DEROPANEND 16.'� \ 3 21 3 MIOlS71N1COi /N ''�Qsi'!A - 6 I T �, I IM; UROES► CONDORS AND LNI S ARE SHONW TIN Nl • 3E O IIIY NqT K lY1ED w►+?NOSE SIIta]rt AND iN#r O> pY3EDt 1PE •, ' x 10. , M P - AMIABLE UIMIFY REDO m 4 MP NXI EETV ''WMA l I X X=TO K RALLY F yr `T`'AM A2-3 \ ORCH 14.5 �'� '�1r. 2� ,,- 7 �ooITTONs )(21.2 ANY AND ALL DOW MEN 11W K OCCtS101ED BY 1FE CONRIiCFOR'S FMW TO WOME SAID �- MFR671NXWK AND MES EXACIL.Y• IF FIELD COMM OFM FROM FLAN if MOM THE ,�. Bl E -j' \ is 14.4 ' _ / CONHIICTOR SHALL NM11E ENGINEER NrEDN1ELY FOR P065ME REDE3NN 7Ep U a •` ICU j i =''=NpE _ ' •00SiNG SEPTIC SYSTEM NNFORAMiION `LAKEN FROM TRLE'S 0613 'LION OILED 10/14/09, \ \` / t 1�` ••R-••��• �� ___ D$(. .2 i ?20.9 PERFORMED 6Y ROBERT PAOLM OF CAPEMW QITE)V"= LLC. I A3'r5 8 7 x`• CE ', \ A4 •• 21.1 •: •AS PER i SEfiDRIrI110N PROVIDED BY KEYSPAN ENERGY OA1ED 5/11/b7, NO GAS LIES Al;l POM 1 .3 / S DECK s HOUSE" - - ON VOT OVER ROAD (GAS LINES ETD ON BRIDGE SL) 7 A `1$.3 \ _ 22.69 A.II o •BMW LICE INFDRMION PER NSiAR BMW OCRRESPONDENCE RIECENI D SEPiEMBER 23, 2009 16.2� \` `\ \�.` I 4 PROPOSED WOOD PORp1 o GARD4 <,v 00CH STATES THAT POS WLE IIFDERGRO W SO MM FEEDS THIS PROPERTY. CUSi TIER RECORDS `•• `,`9 .� POOL • 9; ' � v ; SNONV 3 SOWN METERS FOR TENS ADDRESS, WON ONE SERVFCE I�DOTED OFF POLE 134/22, ONE At--2, , _ , OFF POLE 134/22A AND 11E 11MiD 6 OFF POLE 134/P23B x8.2 ' -- •ALTER LiE AND/IPPIAtTE1wMIR NlFDINIM11001 5/IPPRODMIE AND S SAWON SKE1CFi 0-372-R x 1.1.9 ' 2 1 0 . �� , � �5 ' , t �` �` � � PROPOSm PA gPED 2 . (dIiED a/ts/J9) PROyDED BY THE NNTER DEPARTMENT VA FAx ON 9/24/b9. Al-3� 6.1 1 15.9 �' a ; 13. 16 2 1 .3 r'a `�`, �` �`�•`` '�"• •' 20.8 ' , \, o O` �! \ ���\` LIMIT OF WORK FUGPOLE® 8. d, `��. ,1� t A1-4' ,�4.5`, h �� ; k 6. x gig 15.6 jf SITE LONTM. Al=S6. x 8 ,X - _ _ - _ -' - _ x?g.� 2S3 Seapult River Road Al-8, ��9 \ `�. - - _ _ _'__--'_--____--_--___'-_ •L�2_ }13--- --- -- ----- --- --- -_-___==_ Osterrlile, MA o ---- 'X$s �'"'-��, -- - -----'a-"�--__- ------ - AST g CB/DH FND AL , PREPARED FOR sitI ''- -------------- /6.8 ,�vtui ''1. TT --=-_-- ' (TOWN de STA ■ " �� _ _---- - -��cX rr -_---_------------ ,C) Yasm:ne Realty Ltd. ` -- - `� A x 5.9 __ ---- j TIRE PATIO 41j ------ ---- ----- x - .x 7.1` ��` - 100 WAR Septic Upgrade Plan ' ---- (EL 11) Al- � -- .o--- x s.o `, FLOOD ________________ A 11 • - , BAXTER NYE ENGINEERING & SURVEYING x -`- Registered Professional Engineers and Land Surveyors `. �. ;-`------------- 78 North Street-3� .3 \ x 4.2 ,X a- ---_.-- ----------- �\ Floor,Hyannis,Massachusetts 02601 5.1 ' --` Phone-(508) 771-7502 Fax- (508) 771-7622 3------- -- ----------"-' --- --------------------------- ___ %' ---- .__ '` -- `�4_ -------- x 4.7,' ;- 30 0 30 60 P\_,"OF MAssq ` 7s. ------------------------ ---------- --'S- 3_2- S HEN o EDGE: wA ------ -a --- "3 SE 3-4890 �p�,,,,�sed Additions) N s qp •-- 2.5 �� "'Y" SCALE IN FEET o qp�j'► t q� TM 1 5 Order of Cc id k E*kw August a 2013 1"=30' No 30216 N 5 CONSE'RWTION 01071 0 ocF FG/STER``Via` N i sS�QJVALLID -�� A N � 1.) NO WORK SHALL START UNTIL FORMS A B ALONG WTiH RET)UIRED PHOTOGRAPHS ARE SUBMITTED TO THE CONSERVATION COMMISSION. 5 SAW ?, w/11 OELE:TE GARBAGE GRINDER W Rq,�p Z) WORK LW SHALL BE MAINTAINED IN GOOD CONIVION FOR THE 4 SAW lo/21/i REVISE LEACHING SYSTEM DATE: 09/24/10 DURATION OF THE PROJECT. 3 MTM /18/11 REVISE PROPOSED ADDITIONS Jc DECK 2 JRE 10 UNDERGROUND WATER CABLE N 2. 1 SAW /28/lo REVISE LEACHING SYSTEM e r Nwol DATE REMARKS 2.5 DRAWN BY UTIA DESMEP BY: ICHECKED III, MWE DRAWM NUMBER > U 0:\2009\2009-042\CML\PLOT\2009-042SEP5.dwg 0 2009-042 N Oi O CONSTRUCTION NOTES, 1. ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH TITLE V OF THE STATE SANITARY CODE DATED APRIL 21, 2006, AS AMENDED THROUGH THE DATE OF THIS PLAN, & ANY TYPICAL SYSTEM PROFILE LOCAL RULES & REGULATIONS APPLICABLE. NOTES. NOT TO WALE 2. ANY CHANGE TO THIS PLAN MUST BE APPROVED IN WRITING BY 1. ALL MATERIALS SHALL MEET H-20 LOADING REQUIREMENTS. THE ENGINEER. ELEVATION INFORMATION MUST NOT BE CHANGED WITHOUT WRITTEN PRIOR APPROVAL BY THE ENGINEER. APPROXK47E 70P OF 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFILLING, FIN&I FLOOR 22.7 NOTIFY THE BOARD OF HEALTH AGENT AND ENGINEER FOR SET ALL MANHOLE COVERS TO WfTHIN 60 OF FINISH GRADE. EXMING GRAM = 21.1* RISERS & COVERS SHALL BE WATERTIGHT INSPECTION. 4. ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" SCHED 40 TANK 20.51 MAIN hum nNISHED GRADE- OVER TANK =-20.5i- SET COM 70 KIM OF PVC. UNLESS OTHERWISE NOTED HEREIN. /-FOM GRADE ti 19.0* I % Q%X IM & COM SNAIL BE 5. EXCAVATE UNSUITABLE MATERIAL AS NOTED, TO THE "C HORIZON" , FOR A HORIZ. DISTANCE OF 5' SURROUNDING THE 4* SCH 40 PVC 3* MIN. OVER LE4CIWW SYSU 19.5 TO 20.0 LEACHING FIELD, AND REPLACE WITH CLEAN SAND PER 310 CIVIR L- 35 S-2.00X (I.OX MIN ALLOWED) - 4* SCH 40 PVC 67 LF-4* SCH 40 PVC OS-1.OX 9' (min) Cover 15.255 TO THE TOP ELEVATION OF THE SAS. (10 BE LEVEL) INV OUT - 18.7 MIN. - FIRST 2 OF DOUBLE 36' (max) Cover W IN 18.0 MIN. "-lNV OUT-17.75 56 LF (LONGEST LENGTH) 4- WA%O PE4SMNE 6. INSULATE ALL PIPES AGAINST FREEZING AS REQUIRED WHEN I I SCH. 40 PVC OS-1.48X LESS THAN 3' OF COVER. PVC TEE (14- MIN.) .j 2' CONCRETE 1.154CHM CHAMBERS "--GAS BAFFLE W IN 17.07-,-'0" 7.4 DIA, THE SEPTIC SYSTEM DESIGN Q= INCLUDE GARBAGE GRINDER. OUT-16.9 8 ... Illy cm C=I C=� C=3 C=3 C=3 cm cm =3 r-1 cm BOTTOM OF C=I I= cm EM C= 8. CAUTION: THE CONTRACTOR SHALL CONTACT DIG SAFE (AT CHAMBER iT! • - & STONE 1-888-DIG-SAFE) AND UTILITY COMPANIES TO LOCATE ALL REINFORCED CONCRETE-., 6* CRUSHED I F STONE BASE - EL - 14.1 44•T: UNSWABLE SOILS, F EN0OUNT9;1ED BELOW 7HE 60 CRUSHO V4 EXISTING UTILITIES, AT LEAST 72 HOURS BEFORE THE START OF PEASTW ELEV (TOP OF SAS). SHALL BE MOD 70 5' MIN L DOUBLE IIIAM SM CONSTRUCTION. THE CONTRACTOR SHALL DETERMINE THE EXACT SMW BASE THE 'C NORIZOW AS FEM00 - SEE CONSTRUCTION NOTE #5 HEREON. No Groundwater Observed 0 Elev. 5.4 LOCATION, BOTH HORIZONTALLY AND VERTICALLY, OF ALL EXISTING UTILITIES BEFORE THE START OF ANY WORK. THE LOCATION OF tOW GALLON SUM TAW WSTPOUT" BOX AM A080100 SYSIN CAM LUCHM CHAICS flrYMAU EXISTING UNDERGROUND UTILITIES ARE SHOWN IN AN APPROXIMATE (DB-9 or Equal) NTs WAY ONLY, MAY NOT BE LIMITED TO THOSE SHOWN HEREON AND TO BE INSTALLED ON A LEVEL STABLE BASE TO BE INSTALLED ON A LEVEL STAKE BASE HAVE NOT BEEN INDEPENDENTLY VERIFIED BY THE OWNER OR ITS SEPTIC TANK TO BE INSPECTED & CLEANED ANNUALLY REPRESENTATIVE. THE CONTRACTOR AGREES TO BE FULLY RESPONSIBLE FOR ANY AND ALL DAMAGES WHICH MIGHT BE OCCASIONED BY THE CONTRACTOR'S FAILURE TO LOCATE THE UTILITIES EXACTLY. IF ELEVATION INFORMATION DIFFERS FROM PLAN INFORMATION, THE CONTRACTOR SHALL NOTIFY THE ENGINEER IMMEDIATELY FOR POSSIBLE REDESIGN. AT UTILITY CROSSINGS, VERIFY IN FIELD THE LOCATION / INVERTS OF ELECTRIC, GAS, TELEPHONE & DATA/COMM AND RELOCATE IF CONFLICTING WITH PROPOSED INVERTS PER THE ENGINEERS DIRECTION. THE CONTRACTOR SHALL PRESERVE ALL UNDERGROUND UTILITIES AS REQUIRED. 3 9. THE PROPOSED UTILITY CONNECTIONS SHOWN HEREON ARE SCHEMATIC. FINAL LAYOUT SHALL BE AS DETERMINED BY THE 9'MK-3r MAX. CMMU --4 20" DIA�- APPROPRIATE UTILITY COMPANY. T �:-- .4 76' f FE4SMW OR 4.8' C=3 C=1 44 7- , � % - C=3 , * -*A:�S!'�'�-:-"�" 1 J-'N�';' . 0 , • . . Itp cm -3A - IN* DOUBLE -A • 01 24* 1114M $MW C=3 C=3 4 C=3 0 0 0 0 0 0 0 0 0 -1 T 4Jr 3 46 4v 8.5' PLAN V= CONCRETE LEACHING CHAMBER DETAIL CONCRETE LEACHING CHAMBER DETAIL (H-20) (11-20) PLAN OF LEACHING CHAMBERSNO SCALE 500 GALLON LEACHING C11"Mm NO SCAM 4- (8- H--20) --4 20" DIA{•- 3* ** 04 8o-6* TT SITE LOCATION: 253 SEAPUIT RIVER ROAD SIDE VzW 08teM1199 CIA PREPARED FOR Yasmine Realty Ltd. TITLE UMM 8CHEMU B"AnA MACHM AREA REGUNDAMIS EXISTING FINISH FLOOR 22.7 WL LOW DATE 0/20/2= NITROGEN LOADING LIMITATION. ZONE OF CONTRIBUTION TO SALTWATER ESTUARY (BON - SECTION 360-45) SEWER INVERT AT HOUSE 18.7 FI-1%00 BARNSTABLE Septic Detail Shoot Upgrade ALLOWABLE FLOW; 3.85 ACRES x 440 GPDIACRE - 1694 GPO (15 BEDROOMS) SEWER INVERT INTO rO SE TAW 1&0 17.75 SOIL EVALUATOR: BOARD OF HEALTH AGENT: MAIN HOUSE 8 BEDROOMS SEWER WAN OUT OF SOW TAW GUEST HOUSE 3 BEDROOMS SIEVE WILSON, P.E. (SE #2622) SEWER INVW INTO DISTRIBUTION BOX 17.07 DIVE STANTON, R.S. APARTMEW 2 BEDROOMS BASER NYE ENGINEERING & SURVEYING SEWER INVERT OUT OF DISTRIBUTION BOX 1&90 TEST PIT I TEST PIT 2 TEST PIT 3 TEST PIT 4 RESIDENTIAL. 8 BEDROOMS TT BEDROOMS < 15 BEDROOMS SEWER INVERT INTO SAS 16.1 14.1 on G.S.E. = 19.0 o" G.S.E. = . O . . . 18. - o = .4 x 110 GEDIDEOM 901TOM OF SAS. 185 N GSE 0 n G.S.E. 17 Registered Professional Engineers and Land Surveyors TOTAL DESIGN FLOW - 880 GPD NO GROUNDWATER OBSERVED M ELEVATION 5.4 Ap I OYR 316 ; LOAMY SAND Ap 1 OYR 312 ; LOAMY SAND Ap I OYR 312 LOAMY SAND Ap I OYR 413; LOAMY SAND 78 North Street-3rd Floor,Hyannis,Massachusetts 02601 9* 80 1 PERC RATE - <5 MIN, INCH (CLASS 1) Phone- (508) 771-7502 Fax- (508) 771-7622 4 LIAR - 0.74 GPD/S.F. 9 1 OYR 4/4 LOAMY SAND 8 1 OYR 314 LOAMY SAND 8 1 OYR 416 LOAMY SAND 8 1 OYR 4/6 LOW SAND MIN. LEACHING AREA OF SAS. 8 HEN WO GPD/ 0.74 WDISF. - 1190 S.F. MIN. 24* 18 20" 14* jt. L o ct� C ; IOYR 5/4 MED. SAND C I OYR 4/4 MED. SAND C 10YR 516 MED. SAND C I OYR 314 MED. SAND No.30216 PROPOSED SYSTEM B-500 GALLON LEACHING CHAMBERS '9 WITH 4- STONE ON ALL SIDES (2- EFFECTIVE DEPTH) 56m 52" AL cN SIDEWALL AREA: (76- + 12')2 x 2- DO" - 352 SF BOTTOM AREA. ( G' x 12') - 912 SF C ; IOYR 7/2 MED. SAND C • I OYR 7/3 MED. SAND C • I OYR 7/3 MED. SAND C ; I OYR 7/2 MED. SAND TOTAL EFFECTIVE LEACHING AREA 1264 SF 2 2 2 2 138' 144" 140" 144" 5 SAW 12/06/11 DELETE GARBAGE GRINDER DATE: 09-24-10 SEPTIC TANK SONG MAW HOUSE = 880 WD x 200% = 1760 GAL N USE 2000 GALLON SEPTIC TANK; 4 SAW 10/21/11 REVISE LEACHING SYSTEM NO WATER OBSERVED NO WATER OBSERVED NO WATER OBSERVED NO WATER OBSERVED 0 EL 7.5 0 EL 6.5 0 EL 6.3 0 EL 5.4 3 MTM 8/18/11 REVISE PROPOSED ADDITIONS & DECK 2 SAW 10/21/11 REVISE LEACHING SYSTEM 0 0 1 SAW 9/28/10 REVISE LEACHING SYSTEM Cno 2 1 CERTIFY THAT IN AML. 1995 1 HAVE PASSED THE SOIL EVALUATOR EXAMINATION NO., BY I DATE REMARKS APPROVED BY THE DEPARTMENT OF ENVIRONMENTAL PROTECTION AND THAT THE ABOVE DRAWN BY. MM IDESIGNED BY, ICHECKED BY., SAW ANALYSIS WAS PERFORMED BY ME CONSISTENT' WITH THEREQL1IRW TRMING. EXPERTISE DRAWING NUMBEI? f. AND EXPERIENCE DESCRIBED IN 310 CMR 15.017 SMATURE DATE ZOi Z- 0:\2009\2009-042\Civil\Plot\2009-042SEP5.dwg 0 O 2009-042 o) 0 0