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0275 SEAPUIT ROAD - Health
275 Seapuit Road 1 Osterville A= 095 -- 007 - 002 Cwrd o TOWN OF BARNSTABLE -D�o LOCATION 7 S S O%lN�,,'XRd SEWAGE# Z I P /I� 3 6 VILLAGE e rv,,�I ASSESSOR'S MAP&PARCEL 0� INSTALLER'S NAME&PHONE NO. lr"'p co•l I j�!' SEPTIC TANK CAPACITY �j d �yt S% LEACHING FACILITY:(type) F X,t S 1 (size) NO.OF BEDROOMS OWNER Ctt R�rS C d PERMIT DATE: lk 10111"I COMPLIANCE DATE: 6 )34 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 C-N co �, r� �- 1 I I O I � F1 Sol 'z �c _ t GAt �r= C.� z v p TOWN OF BARNSTABLE LOCATION o �5 set�c,: .( 1 , SEWAGE# VILLAGE ©�Jcry [1r ASSESSOR'S ct II MAP&PARCEL v�CS" 3 �- INSTALLER'S NAME&PHONE NO. 3. MG cc l�s dam- Ydd-Sratc SEPTIC TANK CAPACITY /5-60 C9-/ 66/a5) 1 LEACHING FACILITY: (type) AMC# %(Cau�,Pit 1 (size) NO. OF BEDROOMS GARAGX OWNER C"AAC5 W, `Iul Tory PERMIT DATE: 0-/oZ 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 S c t 1 71' - _l N v � r � c l TOW OF BARNS-TABLE w StA , R� SEWAGE#. VILLAGE OrrP-rV,16, ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY W'O LEACHING FACILITY.(type) �rr (size) /Ow JAI. NO.OF BEDROOMS 3 OWNER S 0 A/\ PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility feet Private Water Supply Well and Leaching Facility(if any wells exist on site or within 200 feet of leaching facility) feet. Edge of Wetland and Leaching Facility(if any wetlands exist within 300 feet of leaching facility). - feet FURNISHED BY ?/1;SP?, TI A A a b 3 3 ors 3�� y Y3 140 No. )-y a ' t Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ✓ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftplitation for Misposal *pstem Construction permit Application for a Permit to Construct(Q Repair( ) Upgrade( ) Abandon( ) ❑Complete System Individual Components Location Address tors Loot No. s' �37 Owner's Name,Address,and Tel.No. Ass0e oia my, �-l�►i��'l,E 59 L=ct.lvuC��r� p — 0 275- 55AfrU tT Cp 0,S n?_VI Ltd Installer's Name,Address and Tel.No. 6-0 8 $ Designer's Name,Address,and Tel.No. zrvve I�G ee����o`? Sol Q SULLIA)P yj `ry c2�v�� CK c &Zt?awa( ST, chs a." 'r7 _ Type of Building: Dwelling No.of BedroomsN rr Lot Size ��J, sq.ft. Garbage Grinder dt1J Other Type of Building p 1°�1`No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min,,.required) 'A'4CD gpd Design flow provided_ S ?L.US gpd MPlan Date 0-\/ Number of sheets Revision Date KI a#4 U Title?QQ 'SjiC 1Ykk PeayGyvt r�a'c-S g2 Z`Z5 �EFp.?N.:) Size of Septic Tank Z7 NF-\AJ Type of S.A.S. CX1S`�l�r�Q Description of Soil r A Nature of Repairs or Alterations(Answer when applicable) A y 1 q k\L j�ycl i Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar of ealth. Si Date Application Approved by _ Date 11602 Application Disapproved by � Date for the following reasons Permit No. �.p ' _J 6 a Date Issued y ---------------- ----- ,.'`Rk'+'"''i1'=.•�,tt� is�.r.a�++:---.- ri,l. ;.H-::-:,.i:a4'u'M'�.y'ai'^..": ,.. ...�.,4;i�.-...:o-.,.......a..... .>;::s =��_ - „_ .. ,r - r 2 No. - 3C1� Fee d at THE COMMONWEALTH O MASSACHUSETTS Entered in computer: ✓ PUBLIC HEALTH,.DIVISION - TOWN OFBARNSTABL'E, MASSACHUSETTS Yes �+ ftplitatlon.for ]Disposal Opstent Construction i9ermit Application for a Permit to Const/0N) Repair( ) Uptgad6( ) .Abandon( ),.. ❑Complete System �]Individual Components ��. Location Address or Lot No. "15 S C-A' U i�� Owner's Name,Address,and Tel.No. Assessor ap/Parcel n fl S _00 7 -noZ 7 S J H,-_U�T Installer's Name,Address,and Tel.No. `>'�8 c l Designer's Name,Address,and Tel.No. . ST.� ,51R �,Ut_c_.aelJ�,etJ �iUG,.^�`+v�cCL�cUG �h1G r�hUti`� C�S�c���k�r \ Type of Building: say Pam` 4� S � Dwelling No.of Bedrooms '� � -; v;u`_Q, ! Lot Size , sq.ft. Garbage Grinder 4)c) Other Type of Building a, s`1,'No.of Persons Showers( ) Cafeteria( ) Other Fixtures t Design Flow(min 111.required) , gpd Design flow provided �:J�),C-) LUS gpd ' Plan Date Q O V P_-,, r��Q l2. Nwmber of sheets Revision Date KA O$-I C; 7 Title RcZO St i-G twtX51QAVG44 EJTS P Z7 EA�F' t-7 ti Size of Septic Tank S Ste© -k-2U N&'VJ .Type of S.A.S. .S, Jk (p Description of Soil /_.a 4 rr 5tL ert C Nature of Repairs or Alterations(Answer when applicable) A,o ij 1 A t_x<. Date last inspected: w Agreement: ` The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Boar of ealtl SITI / i Date Application Approved by Date y. Application Disapproved by I Date for the following reasons Permit No. I ., o -3 6 t] Date Issued t I ob 1 - - - - - �` THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, •MASSACHUSETTS P Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed(l/) Repaired( ) Upgraded( ) Abandoned( )by S#G1pC/,t r-fl ai-T•''" at Z r7,5� 5 Ek),AU (-7 (ZO t��7 05'(- 011(&is been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. °i 1 -3(0 G dated t i t t A It�- Installef,Drv(.r / /C%,CC,1115 / Designer �l t VN�tit lJC tty/t 111 G� 11 C #bedrooms Ll Approved desigr�flow L/V o n 1 gpd The issuaance of this/pe (it��shall not'be construed as a guarantee that the system f fuln�ccti"onrw;Ae esigne;d Date 1/ �/��/ l 1 � (/l �—� I _ .Y Inspector (I �/ 7 No. o 1 ".� a Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal Opstetn Construction permit Permission is hereby granted to Construct( ) Repair( ) Upgrade(,1�) Abandon( ) System located at 2?� �rt�U t "� c., Ds. " and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date / '!"1/r 2 Approved by SULLIVAN ENGINEERING INC 7 PARKER ROADIP O.BOX 659 OSTERVILLE, MA 02655 phone 508-428-3344 fax 508-428-9617 November 13,2012 Health Division a " Town of Barnstable '. 200 Main Street Hyannis,MA 02601 RE: 275 Seapuit Road,Osterville - To Whom It May Concern: As a follow up to our meeting with your staff on November 13,2012,I would like to summarize our discussion with regard to the above referenced property. • The property is listed as having three(3)existing bedrooms by the Assessors Office, and a Septic Inspection. 41 The area of the lot is 43,582 square feet. • The property is located within the Estuaries Overlay District,a Town of Barnstable Groundwater Protection Overlay District,and a State Zone H. • The existing septic system is located in the Estuaries Overlay only,which would.limit the allowable number of bedrooms to four(4). • The existing septic system passed a septic inspection in 2009. 0 We probed around the existing 1,000 gal leach pit and determined that there is at least 2' of crushed stone. • Calculations show that this existing septic system has the capacity for at least 549 gallons per day. The owners of the property are proposing to renovate the existing house and construct detached accessory structure. Combined the total number of bedrooms as proposed would be four(4). After our discussion on November 13,2012,it was decided that present Health Division policy would allow the owner to go forward with adding the additional bedroom,with no change to the existing septic system, as the existing system has the capacity to support a 4t'bedroom . I . . . . , I trust this meets your present needs. If you have any questions or require any additional'information, please feel free to call.- Very trul nyours, ' JYhn O'Dea,P.E. , Sullivan Engineering Inc. Members of American Society of Civil Engineers,Boston Society of Civil Engineers # d x f f ,. a r :,y 1. a . 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M AM loll t 33 t'^ ff j f :e KNOWN, 7-7 w. i iA v .[ 77 LET -- Most TOO 7771 --- .f - E } is — _"-__ 7 fi � 7 S { / 7 t t t — } 3 POOL # - { t nvurao tna� uat n:tuc f 200 Maki SUVek 11Y�MA 02601 Office: 509-=4644 Pax: 908-7%-6304 InsraRer&Designer Certification Forms Designer �A iUslier2 V'-u q-< C4 I d ! cr Address: 7 PsA,, Address: On f 7��� � Or NCLU-1( 3 was issued a permit w insmil a .(daze) (installer) septic sysmin at 02? 5 e&Jot,- t cr, �� based on a design drawn by O zv\ , lem�\S. dated ti/0v- 8�a01� (designee). I certify that the septic system refaced above was installed substantially according to the desipe 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 insualled with for changes(Le greaw than 10'lateral relocation of the SAS or any vertical relocation of any component of the septic system)but is accordance with Sty&Local Regaladons. Plan wv&"or certified as-built by designer to follow PL'(N OF Mgssq�ti Y- M JAYo JOHN C. G O'DEA crc^ (installers Signatius) o o CIVIL ccn No.48168 �FG/S i (Designer's Signature)- (Alfc " L Here) PLEASE RETURN TO BARI-STABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLUNCB WILL, NOT BE LSSUED UMTIL BOTH THIS W)R14I M-D AS-MILT CARD ARE RECEIVED BY THE BARMS -ABLE PUBLIC HEALTH DIYISIOM. THANK YOU Q= _ Cas =F ;n3Q64 SULLIVAN ENGINEERING.M. 7 PARKER ROADIP O BOX 659 OSTERVILLE, AIA 02655 phone 508-428-3344 fax 508-428-9617 November 13,2012 Health Division Town of Barnstable 200 Main. Street Hyannis,MA 02601 RE: 275 Seapuit Road,Osterville To Whom It May Concern: As a follow up to our meeting with your staff on November 13,2012,I would like to summarize our discussion with regard to the above referenced property. • The property is listed as having three(3)existing bedrooms by the Assessors Office,and a Septic Inspection. • ' The area of the lot is 43,582 square feet. • The property is located within the Estuaries Overlay District,a Town of Barnstable Groundwater Protection Overlay District,and a State Zone H. • The existing septic system is located in the Estuaries Overlay only,which would limit the allowable number of bedrooms to four(4). • The existing septic system passed a septic inspection in 2009. • We probed around the existing 1,000 gal leach pit and determined that there is at least 2'"of crushed stone. • Calculations show that this existing septic system has the capacity for at least 549 gallons per day. The owners of the property are proposing to renovate the existing house and construct detached accessory structure. Combined the total number of bedrooms as proposed would be four(4). After our discussion on November 13,2012,it was decided.that present Health Division policy would allow the owner to go forward with adding the additional bedroom,with no change to the existing septic system, as the existing system has the capacity to support a 4th bedroom .I trust this meets your present needs. If you have any questions or require any additional information, please feel free to call. Very trul yours, 'O�L J in O'Dea,P.E. Sullivan Engineering Inc. Members of American Society of Civil Engineers,Boston Society of Civil Engineers ,�_ Illlllllllli I Iloilo - _ I 6IIIIittiitlllll111/ i _ - - - -, � = I � � . . . �IIIIIilllliillllli � _ - �r���i�11111�11111�' ! � s� G TOILET - UTILITIES -1 GREAT ROOM BACKFILL UNDER GARAGE BASEMENT PLAN -------------------------------------- i I ' � I I I I � I I I I I I I I i I y I � I Q I � a 1 I p I � I I I dF NMOQ I I ® I O I I • I I i I I I I I I y I I "II I I I I I I I I I I I I I ® l O I I I ® I I I I a I I rn I '77 I I I H I I I I I I - L 4 I I b Z L---------- -- ------------------------------J i µV _--.--------- __ -------------- I I I � i I I I i 0 i � I 0 I 0 I � I N I 1 I O rn � C�7 � O v a -n m c-- 70 O -v c-- a Z R y.. 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Name.of Inspector: (Please Print) James M. Ford Company Name: Janes M. Ford Mailing Address: P.O.Box 49 Osterville,MA 026554049 Telephone Number: (508)862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the.sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of;the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I.am a DEP approved system inspector pursuant to Section 15340 of Title 5(310:CMR 15.000). The system: ✓ Passes onditionally.Passes eds Further Evaluation by the Local Approving Authority a Is Inspector's Signature: Date: May I;2009 The system inspector shall Sul. 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. DER The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Cotmnents ****This report only,describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the.future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 . ' Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) .: Property Address: 275 Seapuit Road Osterville, MA Owner: Carey Sloan Date of Inspection: April 20, 2009 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: ✓. I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below: Comments: B. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced'or. repaired. The system,upon completion of the replacement or repair,,as approved by the Board of Health,will pass. Answer yes,no or not detennined(Y,N,ND)in the for the.following statements..If"not determined',please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent.. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance . indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,,settled or uneven distribution box. System will pass inspection if. (with approval of Board of Health)' broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than'4 tunes a year due to broken or obstructed pipe(s): The system will pass inspection if(with approval of the Board of Health): broken`pipe(s)are replaced obstruction is removed ND explain:. Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 275 Seapuit Road Osterville, MA Owner: Carey Sloan Date of Inspection: April 20, 2009 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further,evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the.environment. 1 System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or.a salt marsh 2. System will fail unless the Board of Health(and Public Water.Supplier,if any)determines that the system is functioning.in a manner that protects the public health,safety and environment: The system has-a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply-or tributary to a surface water supply: The system has a septic tank and,SAS and the SAS is within a Zone l of a public water supply. The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well: The system has a septic tank and SAS and the SAS is les's,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 colifon-n bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than.5.ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 t Page 4 of 11 OFFICIAL INSPECTION FORM-NOT.FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 275 Seapuit Road Osterville, MA Owner: Carey Sloan Date of Inspection: Ayri120 2009 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ ✓ Discharge or ponding of effluent to the surface of the ground or surfacewaters 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'h day flow ✓ Required pumping more than 4 times in the last year NOT.e.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 l of a public well. ✓ Any portion of a cesspool or privy is within 50 feet of a private.water supply well. ✓ Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and,volatile organic compounds indicates that the well is free from pollution.from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less,than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to'this form.] No. (Yes/No)The system fails. I'have determined that one or more of the above failure criteria exist as described.in 310.CMR 15.303,therefore the system fails: The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. Large System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd• You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply _ the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above.the large system has failed. The.owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR- 15.304. The system owner should contact the appropriate regional office of the Department. 4 Page 5 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 275 Seapuit Road Osterville, MA Owner: Carey Sloan Date of Inspection: April 20 2009 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 noi-inal 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: Yes No ✓ Existing information. For example,a plan at the Board of Health. — Determined in the field,(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. Page 6 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 275 Seapuit Road Osterville, MA Owner: Carey Sloan Date of Inspection: April 20, 2009 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 3 Number of bedrooms(actual):. 3 DESIGN flow based on 310 CMR 15.203 (for-example: 110 gpd x#of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no); Wa [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): No Water meter readings, if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Unknown COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): gpd Basis of design flow(seats/persons/sgft,etc.):. Grease trap present(yes or no): es Industrial resent al waste holding n p (y or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings, if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of infonnation: Pumped after inspection for maintenance Was system pumped as part of the inspection(yes or no): Yes If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank, distribution box,soil'absorption,systetn Single cesspool Overflow cesspool. _ Privy Shared system(yes or no).(if yes,attach,previous inspection records,if any) Innovative/Alternative technology. Attach.a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of infornation: Date of installation unknown Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of 1.1 OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL.SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 275 Seapuit Road Oster^ville, MA Owner: Carey Sloan Date of Inspection: April 20, 2009 BUILDING SEWER(locate on site plan) Depth below grade:_ Materials of construction: _cast iron _40 PVC other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting;evidence of leakage,etc.)`. SEPTIC TANK: ✓ (locate on site.plan) Depth below grade: 10" Material of construction:. ✓ concrete _metal _fiberglass _polyethylene _other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no):, (attach.a copy of certificate) Dimensions: 1000 gal. Sludge depth: 2„ Distance from top of sludge to bottom of outlet tee or baffle: 30" Scuin thickness: 6" Distance from top of scum to top of outlet tee or baffle: 6 Distance from bottom of scurri.to bottom of outlet tee or baffle: 10 How were dimensions determined: Measuring stick Comments(on pumping mcornmendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels . as related to outlet invert,evidence.of leakage;etc.). Cement tees were present. The liquid level was even with the outlet invert..There did not appear to be any si�ns of leakage. The tank was pumped after inspection GREASE TRAP: None .(locate.on site plan) Depth below grade: Material of construction: _concrete _metal _fiberglass._polyethylene _other (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: Date of last pumping: Comments(on pumping recoiiunendations, inlet and outlet tee or baffle condition,structural.integrity,liquid levels as related to outlet invert;evidence of leakage,etc.): 7 Page 8 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 275 Seaguit Road Osterville. MA, Owner: Carey Sloan Date of Inspection: April 20, 2009 TIGHT or HOLDING TANK: None (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: _concrete metal _fiberglass _polyethylene _other(explain): Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no):.. Alarm level: Alarm in working order.(yes or no Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: ✓ (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert Even' Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of. leakage into or out of box,etc.): The D-Box is in new condition and cover is too grade.. PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no); Alarms in working order(yes or no)' Comments(note condition of pump chamber,.condition of pumps and appurtenances,etc.): 8 . Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C i SYSTEM INFORMATION(continued) Property Address: 275 Seapuit Road Osterville, MA Owner: Carey Sloan Date of Inspection: April 20, 2009 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 1 6'x6'1000 gal:pit 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.): 1 The Pit ivas dry and clean. There did not appear to be any sikns offailym' The bottom to Qrade was 8'. CESSPOOLS: None (cesspool must be pumped as.part of inspection)(locate on site plan) Number and configuration: Depth-top of liquid to inlet invert: Depth.of solids layer: Depth of scum layer: .Dimensions of cesspool: Materials of construction: Indication of groundwater inflow(yes.or no): Coimnents (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: None (locate on site plan). Materials of construction: Dimensions: Depth of.solids: Coimnents(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.)*, 9 d Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEMMINSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 275 Seanuit Road Osterville, MA Owner: Carey-Sloan Date of Inspection: April 20. 2009 SKETCH OF SEWAGE DISPOSAL-SYSTEM Provide a sketch of the sewage disposal system including ties to.at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. A P► a - a O �6 as b L 3 3`P 3$ Y� f 10 r Page 11 of 11 OFFICIAL INSPECTION FORM,NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued)' Property Address: 275 Seaguit Road Osterville, MA Owner: Carey Sloan Date of Inspection: April 20, 2009 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 15+1- feet Please.indicate(check)all methods used.to determine the high ground water elevation., Obtained.from system design plans on record-If checked,date of.design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked with local Board of Health-explain: Topographic and water contours nibs Checked with local excavators,installers-(attach.documentation) Accessed USGS database-explain: You must describe how you:established the high ground water elevation: Using Barnstable.topographic and water contours imps, the.inn were'showing approxilnately 15'+/-to ground water'at this site. rl This report,has been prepared onl o the septic s stem and components described herein. This septic system has been p p p Y.T p Y p p Y inspected and passed as of the date of inspection. Tlzis report�s not a wm rant or guarantee that the systeni will function properly in the future.. There Have been no warranties or guarantees,either expressed,written or implied, relating to the septic system,the inspection, this report and/or any components of the septic systemi which have not been located and inspected. 11 Large Format Box.#- . Doe # —C2 Image --------------- IMAGL OATA �1 i { i { DIRECTIONS: From Hyannis - Take Route 28 towards Osterville; Take a left onto 5 Corners Rd and Continue onto Bumps River Rd. Continue Straight onto Pond St. and Turn Right onto South County Road Flood Zone Lines Per one FIRM 50' Buffter to (Aka. Main Street). Turn Left onto Seopuit Rd. as House is on the left 275 Panel 250001 0018 D Edge of Vegetated # } Rev July Z1992 Wetland 100' Bu ffter to Edge of Vegitated � yR n Wetland \ ti ! C aura q \ \\ ! >'�943 Final Grading to be \ \ \ Determined with 8J'�}�• I , Proposed,, \ Foundation Plan ° +. ` t• r; 0 \ eto ` \ •� C 8�10' „wl I \ J)rywell for\ !�! I ~ \ �\ \ \ ' \` }_ 'I Ra; Runoff I { -Stone Drive - - - - - - - - Isolated Vegetated Wetland kropo�ed } 1 ° \ I ` `N \ / -� _ LOCATION MAP. as Flagged b \ \ \ Lim { } gg y \Wok it { Y+ > } � tea, I / f, /,, /T Scale: 1" = 2000'f ENSR 311AUG105 \ \ \ \ \ \ SEPTIC NOTES ° f ! 713M EI=22.5' MSL 1. Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours ��\ „�D� Bii } I { l l { \ \ \ i l \„d Top of eB/DH Prior to Any Excavation For This Project the Contractor Shall Make ��, \ . I i / \ .• { \ Prop�Sod\ 1 \ \ /the Required Notification to Dig Safe(1-888-344-7233). - \ alk outresor / j � ZONE• uc 2. The Contractor is Required to Secure Appropriate Permits From Town ! ure Agencies For Construction Defined by This Plan.• Parcel Area \ / ,/ / : ` Floor I \ �\ \ i // 1 / / , RF-1 (RPOD) 43 582f SF g•.' j / / .••' / I Eie. = 25.0' (' slab \ \ \ l / ( Area (min.) 87,120 SF 3. Wherever Sewer Lines Must Cross Water Supply Lines Both Lines Shall ( ' ) / ° 812 1/ / " - 23.\4 ` r 1 Fronta e min 20' 36,194±SF Upland)-AL �` ��,'• l l I 1 / � \ \ J ( ) Be Constructed of Class 150 Pressure Pipe and Shall be Water Tested to ( r: / l l / ;J l j \ / Width (min) 125 Assure Watertightness. In General, Water Lines Shall be Constructed in // / i 1 1 I / I l 2 - -__ _ \( l 1 / / Setbacks: , a /j4' `�-� Front 30' Coordination With COMM Water,and Shall be in Accordance e2.2 Side 15' With 248 CMR 1.00 - 7.00&31.0 CMR 15.00. Phrogmities Area / / / / : / / I { f`� �� / i Rear 15' 4. A Minimum of 9" of Cover is Required for All Components. DESIGN DATA 71 7*-I, 1JIL W / / // / /•,° /; // ° } {'� - , \ \ r 5. All Structures Buried Three Feet or More or Subject 4 Bedrooms: '` / / / �.��f:` i l o { \ / �� \ �-- \ IL to Vehicular Traffic to be H-20 Loading. It is the Engineer's 4 Bedroom 440 GPD L N N I \ \ 231/ / o /20� g 8 @ �. Bts , / , r " \\ \ Proposed ASSESSORS REF: Recommendation that H-20 Always be Used. No Garbage Grinder s�,? 01 AL r` / f j / / :` / �' { , \\ \ Drive \ / / / o a� ' 6. Install Watertight Risers and Covers to Within 6" of Finished Grade Total Daily Flow=440 GPD s' ���8 \ _ / �� // / /1' ��/ / J I \\ \ '- -22-- { Drive/ I ^ Map 095, Parcels 3 & 7-2 Rhodles Over Septic Tank Inlet and Outlet, D-Box,and One Leaching Chamber and N' Accessory Structure ets �, / , ! \\ { ti I t42.3 I / / o To Grade When Paved over. `B- . •''••• I t � 7. Septic System to be Installed in Accordance With 310 CMR 15.00& 2 Bedrooms. � � } t / / : : / /'` �• /� a } \ �\ � � � / / Proposed 1500 Gallon Tank �a�, 1 / / j / / \ \ --22-� OVERLAY DISTRICT. P Y . Bt4 / 248 CMR 1.00 - 7.00 Latest Revision and the Town of Barnstable !8 2 Bedrooms @ 220 GPD R° Board of Health Regulations. \ � ad � °/ f l � 1l � • 1 / � ° gu N6; \ \ s�o9 ! \ / / / ` / / \ \\ \ I / / -ts - AP - Aquifer Protection District 8. All Piping to be Sch. 40 PVC. Main House s o938, f' / / / / ��/ / \ / , GP - Groundwater Protection District i. Dimension of 12 and a Minimum I „ gyp, fY cb ! I / F / j� • \ - l l \ rop s d \ \ I "� FLOOD ZONE: 9. D-Box Shall Have a Minimum Inside 2 Bedrooms: \ l '° aWe { / I l / R y feRin ff�- I-/Sump of 6". Existing 1000 Gallon Tank \ 10. The Separation Distance Between the Septic Tank Inlets and 2 Bedrooms @ 220 GPD \�\ � \ \ � \\ {� �° � a�°s /� '�. ,i'`�� g,�/ / �2?-I�' � I l r� Qo J► Zones C & A 11(e1=11) Outlets Shall be No Less than the Liquid Depth.Inlet Tees Shall Extend �S \\\ \ o \ j / R dies ! \ ProDpro,�sed /r I / 1 o Community Panel No a Minimum of 10" Below the Flow Line. Outlet Tees Shall Extend 14" Move One Bedroom from Main House to Accessory \ o / / / ° / �Da #250001 0018 D Building and Create One Additional Bedroom for a total `\ _�� �'• \ Gravel July 2, 1992 Below the Flow Line, and Shall be Equiped With a' Gas Baffle. '\� tis • - / l of 4 Bedrooms. g \\ .� I \ ( / ° \ /„, ;. Drive 8tiI r Approx Septic � - -- - - _ - Legend: \ \ \ I \\• x As Per As-bunt vi I\\ \ Card (BOA) Proposed \ Additior,;MITIGATION DATA ., \ �k \\ \ - \ ,�� ;� _ _ \ El CB/DH 2 1-1 \\\� n \ roose (- a a la \ �\�' r1 \ o- Utility Pole 50-100'Buffers \ T `\� \ \\\\ \\ { r a`tion \ ood Deck Light Post Proposed Garage: 809.0 s.f. `� ., \ A- �� \ \ \ \ Area 24.8 g \ o \ .. \ \ \\ \\\ �k k ° \ \ w w w f !\ � Wetland Flag House Additions: 667.2 s.f. �, j\ \ o \� \ \\\� \\\ \ \ \ woad I •� / "_ --ohw- Over Head Wires Driveway: 223.8 s.f. \ \ . \ � \ Deck Total: 1700.0 s.f. Elevation Contour c . \ \ 9 \ \ �o \ ;� / ..........S ......... Underground Utility Line \�\ \ \`sue ' \\ \ \ h Required Mitigation Area dL 2 75 J / 1700 s.f. * 3 = 5100.0 s.f. \ \ \ ` i\\ \ \ h \ o # i 1 a / Deciduous Tree \ sty w 1 Dwelling i AC 9 Provided Mitigation Area ��.\ \ \ \ a��.\ \ \\ \ \ ` \ °'A��� k ;� Unit /f + Coniferous Tree \ \ c ° ioba xisting 1425.17 s.f. Required to Restore °\ \\ \\ 50' Buffer to Fullest Extent Possible ��\ \ III Mitigatio •.\ \ !! Area01 To Remain-P� • � �'.. �° �� ° Cedar Tree \ \ \ \ i \ \ \Rx Rough Lawn ` 9 . i \ \ \ 10 g \ Holly Tree Accesory Structure See Note 6 (typ.) _30- F.F. El. 25.00 I \� \ \ \ \` \ \ \ \ \ \ • 7 \ ' EL 22.5' O \ �, \ \ �' °°tQotir.\ \� �.� ,.`' '.�b...-- / \ F.G. EL. 24.5 F.G �. \ \ \\ �� } \ \ .•\F .\ \ `. \ \ \ \ Flow Equilizers °s� EL. 20.16 As Required \\ \ \ \ \ \ \ \ \�o { a C) Installer To Con firm Prior EL. 19. 3 Proposed �� �\ \ \ \ `�\� ^� \ \ \\ \ \ \ " I (T1 90. To Any Work 1500 Gallon EL. 19.68 Pro \\ \ \ \ �\\ \ \ \ \ \ \ `. _ ............. 1 L` O { H-20 EL. 1 \ \ \ \ \ \ \ l 12 .12' 9.3003 Septic Tank D-Box �\ \ \ 'Ills \ \ \ \\\ S `- rri , MTo Be Installed ; \ \\ �\\\\ \ \\\\ I �. N • 2 42 10' Min On Stable Compacted Base Bedding,"T"s, Inspection Port, \ \ �� N�FN p vis & Baffels \ \ 55 o,brook 2662 DEVELOPED PROFILE OF SYSTEM as Per Title 5 \ �\ H ctf# 19 NOT TO SCALE l OF 41,g8 I J HN C. G s PLAN VIEW TVIL ' • ��; i SCALE 1 "=20' S/0NM_ \ Notes/Revision: PREPARED FOR: PREPARED BY. Title: 1. The property line information shown was Proposed Site Improvements P p y CapeSury compiled from available record information. Charles O Wellington Sullivan Engineering, Inc. Plan of Land at PO Box 659 7 Parker Road 2. topographic hic information was obtained p o � The to 275 Seou t Road P 9 P Osterville, MA 02655 Osterville MA 02655 275 Seapuit Road in from on on the ground survey performed on OSterville,MA 02655 or between 10/MAY112 and 311MAY112. (508)428-3344 (508)428-9617 fax (508) 420-3994 / 420-3995fax The datum used is NGVD '29 o fixed mean Barnstable, (Osterville) Mass. 3.) T , sea level datum. 20 0 10 20 40 gQ Draft: WHK/RRL/CTR Review: RRL Cal c.: JOD/CTR Job # C-307.3 Date: Scale: r► r November 8, 2012 1 =20 Project: Welling ton_3100027 Field: WHK/RRL