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0041 SHIPS EAGLE LANE - Health
41 Ships ,Eagle Lane Osterville A = 165 096 - i 0 No. Pc/G — C)3 1 °I �(/�tC fJ i YI �h��l/ �5 �T�'/ Fee ✓ d THE COMMONWEALTH OF MASSACHUSETTS �['?//+nteredincomputer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS application for 7( upgrade sa' 6pstrut (Construction Permit Application for a Permitto Constr ") Repai ( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. �� Owner's Name,Address,and Tel.No. lU;k�,,t Assessor's Map/Parcel _0 Installer's Name,Address,and Tel.No. t 9 Designer's Name,Address,and Tel.No. .%qJ;Ak1C LN!,W4 -Lklh-Ai Type of Building: Dwelling No.of Bedrooms k Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �SA�tty, NJ t; / e\c rt"cyn 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 TitA5ofhe Environmental Code and r '� - ;in operation until a Certificate of Compliance has been issued by this B ealt M X S' Date 10 its Application Approved by Date Application Disapproved by Date for the following reasons Permit No. to 3 Date Issued �� THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) m A- 1� DATA No. r7`���. — C7 3 l 1 f H P/�tf f jP(� Fee ! ✓ Q THE COMMONWEALTH OF MASSACHUSETTS a/' Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01pplitatlon for Disposal *p4rm Construction Permit Application for a Permit to Constru �) Repair Xupgrade Abandon Complete System Individual Components k Location Address or Lot No. 1S �ryy LAr,c-- Owner's Name,Address,and Tel.No. Assessor's Ma cel 1 p � <0��'� Y A. Installer's Name,Address,iiVee No. , tDes�gner`-'s Name,tAd'dress,and Tel.No. l t •b>'Y %1;5 Y.g`-lk'�Z. +M t f Type of Building: Dwelling No.of Bedrooms / r Lot Size sq.ft. Garbage Grinder( ) Other Type of Buildin 4 .. No.of Persons Showers( ) Cafeteria( ) Other Fixtures `: - 'Design Flow(min:required)] gpd`--besign flow provided I gpd Plan Date #C Number of sheets Revision Date Title ` l `�. )1s7.� t• r c' t t.f Size of Septic Tank Type of S.A.S. t 4 (i 1 .. , Description of Soil d f.t•e 1t Nature of Repairs or Alterations(Answer when applicable) A-AS*fA _-t 6wn a, r i Date last inspected: . -S, 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 he Environmental Code and not to�,-plaeethe.syst_em in operation until a Certificate of Compliance has been issued by this Boa,d f ealt . J�Signe _ Date 7_ /, Application Approved by / Date i► Application Disapproved by : } Date ' for the following reasons Permit No. Date Issued TH E COMMONWEALTH OF MASSACHUSETTS I! n r f(D o- �Uusp �0 BARNSTABLE,MASSACHUSETTS kr� , h` Certificate of Compliance 1°P THIS SI TO,CERTIFY,,that the On,site Sewage Disposal system Constructed(ar Repaired — Upgraded(JF ) is%r -� _ ` � Abandon d( ,)by 6 S tm ,� ` 1:.0 at 1 L YY r ,%e has been constructed' accordance A i G / with the provisio o Ttle 5 and the for Disposal System Construction Permit No. r�� ✓5 dated )(Installer I Designer ; #bedrooms V W 4- Approved design flow t -k-T i r gpd The issuance o this permit shall not be construed as a guarantee that the system wit l f l ctipn as designed.. r Date 11 Inspector C „ v - - - - � - --- - - - - oer No G 3� - 'Fee THE COMMONWEALTH.OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Disposal *pstrm Construction Vermit Permission is hereby kanted to Construct(�), Repair( ) Upgrade( ) Abandon( ) System located at 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. f Provided:Construction must be completed within three years of the date of this permit. _ Date by Y � No. c,;�l 5 (U!'1'c-( ovidr-ri i1 f � T4�r'p/ C.Oti�Q. i D� `/. Fee C THE COMMONWEALTH OF MASS IACHUSETi7Te/(7(`�Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zippfitation for Misposal *pstem Construction permit Application for a Permit to Cons ( ) Repair( ) Upgrade( ) Abandon(/0 Complete System ❑Individual Components Lo ation Address or Lot No. ,$� s �a9�{, LA-L Owner's Name,Address,and Tel.No. ft4_ -LM (rw�►'c�Zs� Assessor's Ma celo�/�\\ - ,s'0 (p �T�p i82� �t a.�.k Installer's Name Adqress,and Tel.No. Designer's Name,Address,and Tel.No. S® LA, p cw's Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) �( n f,gkv ,a 6k 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 Bo rd of Health. ly Si d Date ��1 IV— Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 5 41 O— Date Issued .moo/ r,� �, No. r � � ��{� f t l �i �Jj Jf 711,Entered n computer: THE COMMONWEALTH OF MASSACHUSETTS / r • A Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 2pplitation for Misposal �&pstrm Construction 3pPrmit, Application for a Permit to Cons ct/( ) Repair( ) Upgrade(. Abandon( ❑Complete System ❑Individual Components a Lo ation Address or Lot No. Sti.��,e �'�( �L »-- Owner's Name,Address;and Tel?No. iM L �eat �rti-+-rj � /Is ,0vi �Mrs��! Assessor's M cel S-U C ©18 2-'? ,d. v k/ . �_,.F_ Installer's Name Address,a e1.No.- . �ti o �„ Designer;�s Name,Address,andjel,No?te r }�� Sot. . y Serf CE- ��' da nti t: 9 Type of Building: li Dwelling No.of Bedrooms `ate'*t Lo Size <' "4 sq.ft. Garbage Grinder t ,� Other D Z.b Type of Building ` ' No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ' gpd Design flow,pro�ide�dr gpd Plan Date Number of sheets Revision Date Title Size of Septic Tank i,f; Type of S.A.S. l h" n + Description of Soil Nature of Repairs or Alterations(Answer when applicable) "C'N&a�, Date last inspected: °; r Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in r 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 Bo ird Of Health. Sigiled Date�Z' Application Approved by y~ Date Application Disapproved by Date for the following reasons P Permit No. a (t� — Date Issued � HE COMMONWEALTH OF MASSACHUSETTS_ BARNSTABLE,MASSACHUSETTS Certificate of Compliance y THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( : ) Repaired( ) Upgraded( ) Abandoned(✓by `` o..� �iet���� wC�'-. �4-�S CAA:„.c at 5►:. _ T E r ( t"a has been cons cte"dmaccordance � 4�1 C c..►-•T-G4 �o q �� i the a pro 'sions of Title 5 and the for Disposal S.ystem�ConstxriictionjPer'mit.N "5Y'Odated /,9 Installer .` , "" Designer .+' #bedrooms' A/ Approved design flow gpd �. The issuance of this permit shall not be construed as a guarantee that the system3*v1'I'_functi as-de is gn d. J Date / // Inspector ------------------------------ --------------------.------- No. C/L ,�'`- Fee c � THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS 3 1 t Disposal *, pstrm Construction J)Ermit Permission is hereby graed to Construct( ) Repair( ) Upgrade ) Abandori( ) �/ System located at t S 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 b compl ted within three years of the date of this permit. Date ���._�..r Approved by TOWN OF BARNSTABLE " LG%ti.10N �� Sfi��/S 4 Lh SEWAGE # ZdaZ ,VILLAGE 05 Lryi ASSESSOR'S MAP & LOT 146Z 9 INSTALLER'S NAME&PHONE NO. J45'O n SOULQ . 771!-836-02" SEPTIC TANK CAPACITY Ire v / .LEACHING FACILITY: (type) Th cl Mrr. S (size) II 2 NO. OF BEDROOMS -BUILDER OR OWNER Cy tG5 PERMITDATE: /G 22 O _COMPLIANCE DATE: 10 2q 63 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 r c, ZGAv iS' 8f 2 y.. qa 89� a 0 13 (3 N • �0 O 6aN��,Oy e S ✓� 16 / o 0 Ott *SEE p► a�j P , FU.� ) TOWN OF BARNSTABLE SEWAGE # VILLAGE nSTFrL ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO.OF BEDROOMS BUILDER OR OWNER C 04 V0 QnF PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Jf�. Feet Edge of Wetland and Leaching Facility(If any wetlands exist "� within 300 feet of leaching facility) � Feet Furnished by C� �qC�C Or .400SG No. 3 .�K/ � -,� Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppYfcation for Migool 6potem Construction Permit Application for a Permit to Construct( . )Repair(K)Upgrade( )Abandon( ) Complete System ❑Individual Components Location Address or Lot No.4 1 Sh'rs I c Owner's Name,Add ss and Tel.No. Assessor's Map/Parcel bf J q/ Installer's Name,Address,and Tel.No. 11� Designer's Name,Address and Tel.No. au Type of Building: Dwelling No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( ) Other 'I�pe of Building 4--c-0,�' No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 30 G gallons per day. Calculated daily flow 330 gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S.r%e,(W r 311. -zS Description of Soil S Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has beq issued by this Board of Health. > Sig a Date 1,0 Application Approved by Date to Application Disapproved for the following reasons Permit No. __ 9L�3 1 (o Date Issued � �w •�--- � � _� Yam- . . � _ .. _ _-ti.:.� No. -� _ 'W � ,q �-bn z- Fee r- ): F Entered in computer: e A} THE COMMONWEALTH OF MASSACHUSETTS Yes ° PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS 2"lication for JMigogal *Potent Construction Permit Application for a Permit to Construct( )Repair('K)Upgrade( )Abandon( ) XComplete System ❑Individual Components Location Address or Lot No. ( S h i pwner's Name,Addre and Tel.No. C h AY(eS 8,)F- f Assessor's Map/Parcel Installer's Name,Address,and Tel.No. 1? 'Designer's Name,Address and Tel.No. -7 IAA,«.le S i� sloe- k�> Type of Building: M Dwelling No..of Bedrooms 3 -*"Lot Size -sq.ft. Garbage Grinder( ) , Other Type of Building wt 1A i No.of Persons t Showers( ) Cafeteria( ) Other Fixtures .,_'- Design Flow 3 3 o G Qt\ gallons per day. Calculated daily flow 9 3-o gallons. Plan Date Number of sheets Revision Date Title 'Size of Septic Tank /90 Type of S.A.S.Field N r 3y. .2S Description of Soil 1 H Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has bVa issued by this Board of Health. Sig Date Application Approved.by Date Application Disapproved for the following reasons Permit No. 9-1=)O 3 Date Issued O ne '°J;WE COMMONWEALTH OF MASSACHUSETTS � rSQ�c}¢� IO424 ,� 5� BARNSTABLE, MASSACHUSETTS ►-�^e Certificate of Compliance NeP� THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded( V Abandoned( )by _ A at H SA,'r1 s <�4 r L..� . has been constructed inf accordance . with the provisions of Title 5 and the for Disposal System Construcuon Permit*:o. h U 7 -_, 16 dated I th 9/ n Installer A_ 5wz4 Designer Pvk-f-,_ '' -a i The issuance of this permit shall not:be construed as a guarantee that the s, a will function ,esigned Date I O-L-DgL 0 Inspector V � 3 _ . .. .. . No. eacc�3 —Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE} MASSACHUSETTS Miqu al *pgtem Construction Permit Permission is hereby grantel tt/o Co truct( )Repair( t)Upgrade( )Abandon System located at `f/ n C 444 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 da a of this e Date: � Approved b� A TOWN OF BARNSTABLE s�' s L SEWAGE # ZG�3 -JG"d LOCATION y� i '1I ASSESSOR'S MAP &LOT L 1119LLAGE �Ji � — 6 -OZGG INSTALLER'S NAME&PH OI`1E NO. ? .ia3 SOu Zct . 7`�'83 Ire v ITY z� SEPTIC TANK CAPAC ' 1/� LEACHING FACILITY: (type) �h f� $ (size) NO.OF BEDROOMS 3 BUILDER OR OWNER .Cy� CGS PERMITDATE: �b Z2 O - COMPLIANCE DATE: ::01jifL Separation Distance Between the Feet Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If'any Wells exist Feet II on site or within 200 feet of leaching facility) exist Edge of Wetland and Leaching Facility (If any Feet within 300 feet of leaching facility) i Furnished by oa+ Q 2G , of Jv p A �'s -4 i„v,,4— c. 6 HS O , 4 A t3�'g 0 mr ? •• g � Sb. V j H13 SI • N y out 1 ti G. r A k ,„TOWN OF BARNSTABi. C� MAIN LOCATION _ I E SEWAGE #� VILLAGE�a� So�f� M�ii - 5 Vla ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. Cl/js &2QS (�wj$ f' SEPTIC TANK CAPACITY i l 000 LEACHING FACILITY:(type) (size) (I O®O NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER t 6(-Qc -- BUILDER OR OWNER -J-; MA&V Z('00017 DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: ' ! ' VARIANCE GRANTED: Yes No �C .- -1w J _ Back of Ooos& d THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH TOWN OF BARNSTABLE _'6Aez'_P�- - Appliratinn for Bi"asal Works Tnmunr 'pan i# Application is hereby made fora Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at• s /i won. ess � � or )`:.ot.- .... ................. ..__._... � .>... 9.r !�/ ................ ..---..... � _Alad.. :. .. ! �. �_, Otter / Address. E '* Installer Address dType of Building ,may Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) '_l Other—Type T e of Building ersons____________________________ Showers Ga YP g ------------------------.... No. of P ( ) — Cafeteria ( ) C4 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-----------_............ 93:4 Test Pit No. 2................minutes per inch Depth of.Test Pit...:................ Depth to ground water........................ 04 -------------•----------------•---••--•---•--•--------•------•-••----------.......----------.....---......................................................... 0 Description of Soil............................................................................... ------------------------------------•-----------------------------------------------•... x .-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------•------•--••. w ------------------------------------------------------------------------------------------------------------------ -----------------• . x -------------- c U Nature of Repairs or Alterations—Answer when applicable... f. ___ f_ ......`=<..:�.._..._ -` Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance-has b n issued by f health. Signed ---------- m.- -- Application Approved BY C� .. - ------------ ------------------------------------------------ ------...`.-�:�� Dace Application Disapproved for the following reasons- ...............................----------------- ---------------------------------- ----------------------------------------------- ................................................. ....................................................... ---------------........-...---------------------------------------........................ .................................... Date Permit No. .. -----���--------------------------- Issued ----------.------=----------------------------- . --------- Date f • /e THE COMMONWEALTH OF MASSACHUSETTS BOARD OF • HEALTH S �` TOWN OF BARNSTABLE y��j _'-0-, r, -9 _ App iration for Bh�paaal Works Tonarnr inn, �ertt�it Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ......... '_- -••--•--- ----------- ---•------- ----- ---- ------------- �y'��j ................./ �r7^ or Lot Nam` �Oyner o4 Address y Installer ✓ Address Type of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) 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. I................minutes per inch Depth of Test Pit.................... Depth to ground water......................... 44 f Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 9 .----------•----------------•••••--•-.......-•-----••-•••••------•••...-••--••--•-•---•-----•-••-•----•-- ---------...... -------- •------------------------- 0 Description of Soil....................................................................................................................---.................................................... x U -•--•-••--•••-•••---•----•---••--•-•-•-•------••-•••-••••••--•••-•--•--------•-•-•------•-------••----•••--------••--•-••-•-----•-•-•••--••---•---•---___----•••••--•••-......._•-•----•-•--------.... W M. -----•---••----------------- --••••----------••••••-•--..._..•---•------------•---••--•-•---••--•-----•----..--------------•-•----•••---- U Nature of Repairs or Alterations—Answer�when applicable.__ ___ ._,��, �_......�_.c� :�_�_.._.�± • L•••.•••=° '•..... ' = �'it ._:.. T-to cl�' Imo = `.. Agreement: I The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bb .................... issued by th d�of health. Signed ------------- " -'--- _=- .:... .... -- ,lDatf Application Approved By ------------ --------------------------------------------- --------. .. --. :.. . .. Dare Application Disapproved for the following reasons- ----------------------------------------------------------------------------------------------------------- - ---------------------- .............................................................--------------------------- �j - I Dare PermitNo. ----1 -------- --Ytll--------------------------- Issued ------............................................................. Dare THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE Certif ratre of Comyliance THIS IS TO.CERTIFY, That the Individual-Sewage Disposal System constructed ( ) or Repaired ( ) Installer at ............... 2 �......... .....--....--------------...-------- -----------...-------- -------- ---- .-- --- has been installed in accordance with the provisions of TITLE 5 f The State Environmental Code as described in the application for Disposal Works Construction Permit No. ......-f...�-......�Z. �i......... dated ................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE-------------------- 1. ..fJ........0/ G..... Inspector ) _1 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No......r�...-..`� y TOWN OF BARNSTABLE 4z` •tr=-'i'� FEE._...:t::........... Roposal Workii Tonotr ion famit cam,r _ .........................................s� Permission is hereby granted._ ._._aC- '-r-1� - 1? , to Construct ( ) or Repair ( V) an Individual Sewage Dis osal System at No. �, ..- -. ram*!, "' V�- ��- �`' Street as shown on the application for Disposal Works Construction Permit No,.. "��l Dated.......................................... 9 ................................ -� .............--••----•--.---------•................_ / k.-) Board of Health DATE................. "----•-----------•----- FORM 36508 HOBBS 6 WARREN,INC.,PUBLISHERS °:—TOWN OF BARNSTAB& LOCATION SEWAGE #! Q � vf . � VILLAGE_da"24' SOu� Ulf S ' --e ASSESSORS MAP & LOT rr INSTALLER'S NAME & PHONE NO. SEPTIC TANK CAPACITY f s cO®. LEACHING FACILITY:(type)��-� (size) 1, Obp NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER u&LLB i BUILDER OR OWNER Zc�3�t7 DATE PERMIT ISSUED: _ 9 DATE COMPLIANCE ISSUED:_ VARIANCE GRANTED: Yes No i gook of Nooscr a I GR�w,�pf� i I I 1 Commonwealth of Massachusetts Tile .5 Official ,sped io Form Subsurface Sewage D'a4p0sal-Syst6m Forme-Not-for Voluntary Assessments 41 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J -Owner -Owner's Name information required4ova Osteryille MA 02655 8/28/14 required,for 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. hnportantzwhen A. General:Information filling out forms. on the computer, use only the tab 1. Inspector: key to move your cursor-do not Robert Paolini use the return key. Name of Inspector Robert Paolini Septic Service . Company Name 17 Playground Lane Company Andress Yarmouthport MA. -02675 " Cityrrown State Zip Code 508 362-3555 S 14454 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based 'my raining and''experience in%the`proper-function and maintenance.Oton 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: 0 Passes ❑ Conditionally Passes '❑ Fails El Needs further Evaluation by-the Local Approving Authority - 8/28/14 Inspector's Signature Date The system,inspector shall submit a copy of.this.,inspection.report to the Approving,Authority.(Board y of.H:ealtft or DEP)within 30.days.of.completing.this:.inspection. If the system is:a shared system:or- has a design flow-of 1.0,000..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 .atthat time.This;inspection..-does-not address how the system will._perform in the;future under the same or different conditions of use • I� t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts UIVTitleS VW 5 E} fiEIspetioror�r�_ Subsurface Sewage Disposal'System Form Not for Voluntary Assessments 41 Ships Eagle Lane 4 Property Address DOE, CHARLES F& DEBORAH J Owner Owner's'Name inirequired,fo is Osterville MA 02655 8/281,14 required;.for-euery page. Cityrrown State Zip Code Date of Inspection B. Certification (cunt.) , ` Inspection Summary: Check A,B,C,D or E/always complete all.of Section.D A)', System Passes:` ❑x 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: The.septic-system.is,in.pr_pper;working order at,the.,present time B) System Conditionally Passes: one>or.more system-co'mponents•as described irrthe:"ConditionaWass"section neeflo'be replaced or repaired,..The system,:upon.completion of the replacement:or repair, as.appro...ved: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,tankis metal and over 20 years old"or the.s6pt,ictank.(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. d. Y ❑' N O ND (Explain below); t5ats-3113 TiBe'S'OffidiaPtnspectiomFortn:Subsurface Sewage.Disposalsystem•Page 2of.17 Commonwealth of Massachusetts Title- 5-0-fficial% lncspection F t� ., . Subsurface:Sewage_Disposal System Form -Not for Voluntary Assessments 41 Ships Eagle Lane Property Address _ DOE, CHARLES F& DEBORAH J Owner Owner's'Name information is Osterville MA 02655 8/28/14 required.fgrevery page:'. City/Town State_ Zip Code Date of Inspection B. Certification (cunt.) t , ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cunt.): ❑ 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 Tom❑ 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): El 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 failtn.g;to protect public health,.safety or,the environment 1 stem will pass;`unless Bb rd I Health d6terrnines Irl accordance with 340 GIVIR is.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 nor>privy is vithiin 56 feet=of a°bord&,i'rig-vegetated`wetlb.h&or'a salt marsh t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts ., Title-- 6 0,ff� -isi i s-pec-tio For mr Subsurface Sewage Disposaa System Form°-Not for Voluntary-Assessments " 41 Ships Eagle Lane . . Property Address DOE, CHARLES F& DEBORAH J ....Owner -.Owner's^Name information i required for every Osterville MA 02655 8/28/14 e $ page. Cityrrown 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 aseptic 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, 4 supply:well. ❑ The,system-has aaeptic tank and_SAS.and the SAS isle ss than:1,00.feet but,50 feet or f more from a private water supply well**-.,, Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence'of ammonia nitrogen and nitrate nitrogen is equal to-or less than 5 ppm, provided that,no,otherfaiture>enteria are triggered:Acopy-of the-analysis-must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You.-must indicate"lies'-'ar"No"t6-eac6e:ofthe fotlo g for-aH-inspectiinns: Yes No Backup of sewage into facility or system component due io,overloaded or clogged SAS or cesspool 0 Discharge orponding 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,abo�e outlet.inver1.t;due.to-an overloaded. or clogged SAS or cesspool ❑x Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Tit e.,,5 of icial Inspectti-ors Forte Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 41 Ships Eagle Lane Property Address DOE, CHARLES F&DEBORAH J Owner Ownees.Nam 1.e required<fo information r.every is Osterville. MA 02655 8/28/14 page. Cityrrown 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` ❑ ❑x 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. 0 Any portion of a cesspool or privy is within a Zone 1 of a public well. . "-0 'M Any portion of a cesspool or privy is within'50 feet of a private water supply well. ❑ ❑X 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;-far-,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.] ` ❑ 1 The system is a cesspool serving a facility with a design flow of 2000gpd 10,000gpd. . N The system_fails. .: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 considereda 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 'El El the system is within 200 feet of a tributary to a surface drinking water supply b El - the system is located:in-a:hitrogerrsensitive-area (interim Wellhead Protection Area—IWPA)or a mapped Zone 11 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;.Eor failed.under Section D_shall.-upgrade the. system in accordance with 310 CMR 15.304. The system owner should contact the appropriate ..regional of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title., 5- Official, l?s,poC:tio: Fora Subsurface Sewage.Disposal System Form-Not for Voluntary Assessments 41 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name . information`is required for.every Osterville MA 02655 8/28/14 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes . No: ❑x ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ❑x Were any of the system components pumped out in the previous two weeks? 1=1 !] Has the.system received normal flows in the previous two week period? Have.large volumes of water been:introduced to he system:recently or as part of this inspection? 0 ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) S ❑x ❑ Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ Was the site inspected for signs of break out? FZ ❑ Were all system components, excluding the SAS, located on site? A 0 ❑ 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?- ❑x ❑ 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:.. ❑ Q Existing.information:For example;:a plan at the Board of.Health., El EllDetermined.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 k F t5ins-W3 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 4 . .s . Commonwealth of Massachusetts Title 6 O# c a lr pe Fc r Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 41 Ships Eagle Lane r Property Address DOE CHARLES F& DEBORAH J Owner Owners':Name information is required for every Osterville MA 02655 8/28/14 . page. City/Town State Zip Code 'Date of Inspection D. System Information Description: Number of current residents: 1 Does residence have a garbage grinder? ❑ Yes ❑x No Is laundry on a separate sewage system? (Include laundry system inspection ❑ 'Yes 0 No information in this report.) Laundry system inspected? 0 Yes ❑ No Seasonal:use? 01 Yes. ❑ No Water meter readings, if available last 2 ears usage d na g ( Y 9 (gP ))� Detail: Sump pump? ❑ Yes N No Last date of occupancy: NA Date Commerciallindustria[Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) ==Basis-of design,flow i(seats/persons/sq fit,-etc.): Grease trap present? ❑ Yes ❑ No t Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary.waste discharged•to the.Title_5-system? ❑. Yes-ElNo Water meter readings, if available: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title Official Inspection-:Form....' nspection Form . Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 41 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name . information is required for every Osterville MA 02655 8/28/14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Last date of occupancy/use: Date Other(describe below);; General Information Pum P� g in `Records: Source of information: Robert`Paolini'Septic Service Was system pumped as part of the inspection? ❑x Yes ❑ No If yes,,volume pumped: ' 1500 gallons: How was quantity pumped determined? Measured Reason for pumping: Maintenance Type of System: Septic tank, distribution box,soil,absorpt on system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy, t ❑ 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 El Tight tank. Attach a;copy of:the DEP approval. ❑ Other(describe): t5ins-3113 Title 5 Official'Inspecfion Form:Subsurface Sewage Disposal system-Page 8 of 17 Commonwealth of Massachusetts - Tiffe 6 Offic a.F-InsO c iar Farr Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 41 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Ownees:fdame information is required for every Osterville - MA 02655 8/28/14 . page. Cityrrown 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? s 0 Yes ❑x No Building Sewer(locate on site plan): Depth below grade: 21 ;feet Material of construction: ❑ cast iron ❑x 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 evidenceof leakage.System vented through the building;vents: Septic Tank(locate on site plan): 1611 �Depth below.grade: feet Material of construction: concrete ❑ metal El fiberglass ,❑ polyethylene ❑ other(explain) A 'j If tank is metal, list age: years Is age confirmedby a-Certificate.of.Compliance?(attach a copy-of certificate) ❑ Yes ❑ ::.No. I 1500 gl Dimensions: Sludge depth: t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts 1 Title 5 official Inspection, Form. ' - Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 41 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name requir ati for a Osterville MA 02655 8128/14 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) W 34" Distance from top of sludge to'bottom:of outlet tee or baffle Oil Scum thickness 810 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? Measured, Comments (on pumping recommendations,,inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.):'• Pump tank every 2 years.Inlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound. Grease Trap(locate on site plan): Depth below.,grade: • Material.of construction: El concrete ❑ metal ❑fiberglass{ ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle • 4 Distance from'bottom.ofscumto.bottom of outlet tee orbaffle i Date,,of last pumping: Date t5ins•3/13 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 41 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's.Name ?_ information is required for every Osterville MA 02655 8128/14 page. CitylTown State Zip Code Date of Inspection D. System Information (cunt.) .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 Elpolyethylene El 'other(explain): Dimensions: ' Capacity: - � gallons Design Flow: r 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official. Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 41 Ships Eagle Lane Property Address 4 DOE, CHARLES F& DEBORAH J Owner Owner's Name information-is Osterville MA 02655 8/28/14 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) Distribution Box(if.present must be opened) (locate on site plan): Depth of liquid levelabove outlet invert No Comments (note if box is level and distribution to outlets equal, any evidence.of solids carryover, any evidence of leakage into or out of box,;etc.): t. Box is Ievel.Box has one outlet laterals.No evidence of solids carryover.No evidence of leakage. Pump Chamber(locate on site plan): -Pumps in working order:, E Yes El No*" Alarms in working order: ❑ Yes El No" Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): If pumps or alarms are not in working order, system is a conditional.pass. Soil Absorption System(SAS) (locate on site plan, excavation not required):, If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 41 Ships Eagle Lane Property Address DOE CHARLES F& DEBORAH J Owner Owner's Name information is required for every Osterville MA 02655 8/28/14 page. CitylTown State Zip Code Date of Inspection` D. System Information (cunt.). Type: ❑ leaching pits number: p leaching chambers number: 5 Infiltrators ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Sandy soil.No signs of hydraulic failure. Leaching was dry at time of inspection. Cesspools (cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth-top of liquid to inlet'invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction- Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 " Commonwealth of Massachusetts Title 5 Official. lnspection' Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments' 41 Ships Eagle Lane Property Address DOE CHARLES F&.DEBORAH J Owner Owner's Name e information is Osteryille MA 02655 8/28/14 required for every _ page. Cityfrown State aip Code', Date of Inspection" .D. System Information (cost.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of bonding, condition of vegetation,; etc'); } t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 41 Ships Eagle P 9 . _. Property Address DOE,CHARLES F.&DEBORAH J Owner Owner's Name information is required for every Osterville. MA. 02655, 8/28/14 page. Cityrrown state _ Zip Code Date of Inspection D. System Information (cost:) Sketch Of Sewage. Disposal System: Provide a view of the sewage.dispmal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all welts within 1,00 feet. Locate where public water supply enters the building,, Check one of the boxes below: 17 hand-sketch in the area below drawing attached,separateiy d • G. tb 3 . -: SAS � • � . zG ' g ~ ' @Asj� 0 ` Aw Aiq so Ajq4 '° OL& a ' s 15ers v3113. T*5 Officialkrspeermn form:Subwrlace Sewage Dsposal Sytem'Page 7501 17 D sachusetts Commonwealth of Mas Title 5 Official Inspection form Form fi Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 41 Ships Eagle Lane K _' 'Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name , a information is required for every Osterville MA 02655 8/28/14 page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt:) Site Exam: FZ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to.high.ground water: Bottom of leaching 5' r 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: As-Built Checked with local excavators, installers-(attach documentation) ❑ ' Accessed USGS database-explain: You must describe how you established the high ground water elevation: ` USED:USGS observation well data.USED:Technical bulletin 92-0001 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 16 of 17 . r IfN Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments' 41 Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J, Owner Owner's Name information is required for every Osterville A MA 02655 '8/28/14 page. Citylrown State r., Zip Code Date of Inspection E. Report Completeness Checklist , ❑x Inspection Summary: A, B, C, D,oe.E checked Inspection Summary D (System Failure Criteria Applicable to All Systems) completed 0 System Information—Estimated depth to high groundwater . Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file J t5ins•3113 - Title 5.Official Inspection Form:Subsurface Sewage Disposal System.•Page 17 of 17 Commonwealth of Massachusetts Title 5 Official lospectio-r Fo m Subsurface Sewage Disposal System Form-Not for Voluntary Assessments- °¢ 41 B Ships Eagle Lane Property Address DOE CHARLES F& DEBORAH J Owner Owner's.Name . information is Osteryille MA 02655 . 8/28/14 required for 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:When filling out forms A. General Information on the computer, I (nJ use only the tab 1. Inspector: key to move your cursor-do not Robert Paolini use the return , key. Name of Inspector Robert Paolini Septic Service IL�I Company Name - 17 Playground Lane Company Address Yarmouthport MA 02675 _ Cityrrown` State Zip Code 508 362-3555 S14454 Telephone Number License;Number B. Certification t 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>expene.nce,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: x .,Passes ❑ ,Conditionally Passes ❑ Fails. ❑ Needs Further Evaluatiorrby the;,Local roving Authority 8128/14 Inspector's Signature Date The-system inspector shall,subm it.a.copy of this:inspection report to...the.Approving Authority_(B.oard 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 mot address how the system will perform in the future under the same or different conditions of use. t5ins•3113 .+i Till.5 Official I sp 'on Form:Subsurface Sewage Disposal System•.Page 1 of 17 I usetts Commonwealth of Massach Title 5 Official Inspection Form" , Subsurface Sewage Disposal System form-Not for Voluntary Assessments V.y't 41 B Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J ° Owner Owner's Name information is required for every Osterville MA 02655 8/28/14 page. City/Town State Zip Code Date of Inspection B. Certification (cunt.) Inspection Summary: Check A,B,C,D or E I always complete alf 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: 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* orthe septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltrationor 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 *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): t5ans•3113 Tide 5 Official Inspection Form:Subsurfam Sewage Disposal System.•Page-2 of.t.2 ` Commonwealth of Massachusetts Title 5 Official Inspection Form ti Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 41 B Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J r Owner Owner's Name information is required for every Osteryille MA 02655 8/28/14. page. Citylrown State Zip Code Date of Inspection B. Certification (cunt.) Y ❑ Pump Chamber pumps/alarms not operational. System will pass with'Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes,(cunt.): ' ❑ Obsery Lion 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- ❑ NO (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ NO (Explain below): C) further Evaluation is Required by the Board'of Health:" ° ❑ Conditions exist which require fuither 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 CHAR 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 El Cesspool or privy is within 50 feet of a bordering,vegetated wetland or a salt marsh t5ins.3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Farr Subsurface Sewage Disposal System.Form-Not for Voluntary Assessments 41 B Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner owner's Name information is Osterville « MA 02655.. 8/28/14 required for every page. Citylrown 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 sort absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water.supply., ❑'The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a.private water .. supply well ❑ The system has a septic tank and SAS and the SAS_ is less than 100 feet but 50 feet or more from a private water supply well"', Method used to determine distance: ` **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal - - coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less.than 5 ppm, provided that no other failure criteria are.triggered: A copy of the analysis must be attached to this form. 3. Other: t ' D) System Failure Criteria Applicable to All Systems: :You must indicate"Yes"�or"Na"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 ❑ 0 Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow t5ins•3/13 • Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title, 5 Officiai Inspec#ian- Foy Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 41 B Ships Eagle Lane Property Address r DOE, CHARLES F& DEBORAH J . Owner Owne?s:.Name ' information is Osterville MA 02655 8/28/14 required for every , page. Cityfrown State Zip Code Date of Inspection B. Certification (cunt.) Yes No ❑ �= Required-pumping..more than 4.times in the.last year,NQF.due to:.cloWed;or_. obstructed pipe(s). Number of times pumped- El . Any portion of the SAS, cesspool or privy is below high ground water elevation. z ❑ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. _0 .0 Any portion of a_cesspool or privyis 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. ❑ . FXl 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-iif 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.] N The system is'a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. nX .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 f 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 -11 '❑ the system is within 200 feet of a tributary to a surface drinking water supply., Elthe system is located in a nitrogen sensitive area(Interim Wellhead Protection 13 Area— IWPA)or_a mapped Zone II of a public water supply well If you have answered"yels" 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 orfailed'under Sectiort 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-3/.13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title-,5. Offic-ia inspection- Form, Subsurface Sewage Disposal System Form -Not for Voluntary Assessments - 41 B Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owners:Alame information is Osterville MA 02655 •8/28/14 required for 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 ❑x . ❑ Pumping information was provided by the owner,occupant, or Board of Health ❑ p Were any of the system components pumped out in the previous two weeks? ❑x 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? 0Were as built plans of the system obtained and examined?l(if they were not El available note as N/A) Q ❑ Was the facility or dwelling inspected for signs of sewage back up? © ❑ Was the site_inspected.for signs of break.out? ❑x ❑ 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 propermaintenance of,subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS) on the site has been determined based on: x❑ ❑ Existing:information. For-example,a..plan at the:Board-of-Health:. ❑ ❑ 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•3/13 Title 5 official t ispection 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 41 B Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name information Osterville MA 02655 8/28/14 required for every page. CitylTown State Zip Code Date of Inspection D. System Information Description: � 9 Number of current residents: NA 'Does residence have a garbage grinder? ❑ Yes D No Is laundry on a separate sewage system?(Include laundry system inspection p Yes 0 No information in this report.) Laundry system inspected? Q Yes ❑ No Seasonal use? .Yes ❑ kIa.. Water meter readings, if available last 2 ears usage d na 9 ( Y 9 (9P ))� Detail: Sump pump? ❑ Yes R No Last date of occupancy: * NA Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): `Gallons per day(gpd) =Basis.of design flow.(seatslpersons/sq ft.,'etc.): Grease trap present? ❑ Yes ❑ No . Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the,Title 5-system? C7 Yes ❑ No .. Water meter readings, if available: _ t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Officiall In pecfion� Fora. . Subsurface Sewage.Disposal System Form-Not for Voluntary Assessments` 41 B Ships Eagle Lane Property Address N DOE, CHARLES F& DEBORAH J Owner Owner's:Name information is Osterville MA 02655 8/28/14 required for 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: _ Robert Paolini Septic Service Was system pumped as part of the-inspection? ® Yes ❑ No If,yes, volume pumped: 1000 .. gallons, How was quantity pumped determined? Measured Reason for pumping: Maintenance - Type of"System: -� Septic-tank,.distribution-box, soil:absorptiorn system ❑ Single cesspool C7. 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): 15ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts . . Title,5 Official= lnspecticn, For m- -., Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 41 B Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name information is Osterville MA 02655 8/28/14 required for every page. Cityrrown 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: feet Material of construction: ❑ cast iron ❑x 40 PVC ❑ other(explain): Distance from private water supply well or suction line: le feet Comments(on condition of joints,venting, evidence of leakage, etc.): Joints appear tight No evidence of Ieakage.System vented through the building.vents. Septic Tank(locate on site plan): 1 Depth below grade:, feeett Material of construction: ®concrete C1 metal 1 fiberglass ❑polyethylene ❑other(explain) If tank is metal,-list age: - years -is age-confirmed by a Certificate iof Compliance?-(attach-a_copy of certificate) ❑ Yes ❑ No Dimensions: 1000 gl 311 Y Sludge depth: f t5ins•3113 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17, Commonwealth of Massachusetts r it le 5. OfficialIn Inspection: Foy Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ry 41 B Ships Eagle Lane " Property Address t DOE, CHARLES F& DEBORAH J Owner Owner's Name information is Osterville• MA 02655 8/28/14 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cent.) Septic Tank(cont.) Distance from top of sludge to bottom,of outlet tee or baffle 32". . 2,. Scum thickness i Distance from top of scum to top of outlet tee or baffle 6 1211 Distance from bottom of scum to bottom of outlet tee or baffle - How were dimensions determined? Measured Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump tank every 2 years.Inlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound: Grease Trap(locate on site plan): . Depth below grade: feet Material of construction: . ❑ concrete ❑ metal a ❑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 E Date of last pumping: Date t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 41 B Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J t ,owner oamersName information is Osterville MA 02655 8/28/14 required for 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): - -------- - - i ' Dimensions:, Capacity: gallons Design Flow: gallons per day .Alarm present: E1 Yes ❑ No Alarm level Alarm in working order: ❑ Yes ❑ No., Date of last pumping: Date Comments(condition of'alarm and float switches, etc.)` t Attach copy of current pumping contract(required). Is copy attached? y❑ Yes ❑ No t5ins•3/13 7(de 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 r . Commonwealth of Massachusetts Title 5 Official Inspection Form. Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 41 B Ships Eagle Lane t Property Address DOE, CHARLES F& DEBORAH J Owner Owner's Name -information-is Osterville MA 02655 8/28/14 required for every _ page. Cityrrown State Zip Code Date of Inspection D. System Information (cunt.) S Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outiet.ihvert. No Comments(note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Box is level.Box has one outlet laterals.No evidence of solids carryover.No evidence of leakage.. r Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes. ❑`No* d Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): *If pumps or alarms are not in working order, system is a conditional pass. F Soil Absorption.System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: .• t5ins•3113 „Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Titi ..5-Official_ I-nspection Form . Subsurface Sewage Disposal System Form =Not for Voluntary Assessments 41 B Ships Eagle Lane ` Property Address DOE, CHARLES F& DEBORAH J owner Owners Name information is required for every Osterville MA 02655 8/28/14 page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Type: 1 6'..x-6;.with 2'. leaching-pits number, - stone ❑ leaching chambers number: ❑ leaching galleries , number: leaching trenches numberjength: p leaching fields number,.dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: . Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Sandy soil.No signs of hydraulic failure. Leaching was dry at time of inspection.Stain line observed 34"below invert. Cesspools(cesspool must be pumped as part of inspection)(locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Tine 5 :f?ffia�f Irsecion For - Subsurface Sewage Disposal System Form-Not for Voluntary Assessments _ 41 B Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J owner Owner's Name. information is required for every Osterville MA 02655 8128114 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil,signs of hydraulic failure,-level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding,condition,of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 F Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 41 B Ships Eagle,Lane Property Address DOE,DHARLES F&-DEBORAH J Owner Owners Name-. information is required for every Osterville MA 02655 8/28114 page. city/Town State Zip Code Date of Inspection D. System Information (cunt) Sketch Of Sewage Disposal System:'Provide a view,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:Check one of the boxes below: ❑ ` hand-sketch in the area below ❑ drawing attached separately, 7. r. 'F fF o Q rA 154ts•'3113 Tide 5 Official Inspeedon Forth:Su6sutf a Sausage S} •Page 45 q I T :i t • Commonwealth of Massachusetts Title. 5:,..0ffic al Lns.pection._Form . Subsurface Sewage Disposal System Form-Not for Voluntary Assessments) 41 B Ships Eagle Lane" Property Address ' DOE, CHARLES F& DEBORAH J Owner Owner's Name information is. Osterville MA 02655 8/28/14 . required for every page. Cityrrown State" 'Zip Code Date of Inspection D. System Information (cont.) Site Exam: Check Slope Surface water ❑ Check cellar y Shallow wells Estimated depth to high ground water: ' Bottom of leaching 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) ❑x Checked with local Board of Health -explain: As-Built ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high groundwater elevation: USED:USGS observation well data.USED:Technical bulletin 92-0001 annual ranges of groundwater elevations. Before filing this Inspection.Report, please see Report Completeness Checklist on next page. t5ins•3113 Tide 5 official Inspection Forth:Subsurface Sewage Disposal System•Page 16 of 17 • 'Commonwealth of Massachusetts e -,Official Inspection on or Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 41 B Ships Eagle Lane Property Address DOE, CHARLES F& DEBORAH J Owner Owners Name -information is required for every Osterville MA 02655 r` 8/28/14 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist Inspection Summary: A, B, C, D, or E checked Q Inspection.Summary D.(System:Failure:Criteria.Applicable,to..All.Systems).completed. ' 0 System Information—Estimated depth to high_groundwater N Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file - s. t5ins•3/13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 11-26-1997 04:11PM CENT OST FIREDEPT 5087902385 P. ewm 1 q c u=F401 U111911L- y Fire Department retains original application and issues duplicate as Permit. �>;LyY�y�'LQiJ'bGlJ2Cri��, ��/,��G?,6Q,Q,C�ZG:CfPz�b �, gel,a y� one�ca�uZceG lc oaixtLa�C rrxe � � APPLICATION and PERMIT for storage tank removal and transportation to approved tank disposal yard in accordance with the provisions of M.G.L. Chapter 148, Section 38A, 527 CMR 9.00, application'is hereby made by: o - Tank Owner Name(please print) C. Brown Qh� � x ' Address 229 Main Street �ili02655 Oty stare Tip Company Name Enviro-Safe Corp. Co. or Individual Enviro-Safe Corp, Print - Prnt Address P.O. Box 810, E. Sandwich, MA Address P*1 rent Signat app rig far hermit) Signature (if applying for permit) 1FCI Certified Other 7 IFCI Certified = LSP# Other F-71ij al Tank Location 229 Main Street, Osterville, MA 9taBr RdOre55 COY Tank Capacity(gallons) 750 Gallons? Substance Last Stored Gasoline Tank Dimensions(diameter x length) n 1(0'�x3' Remarks; Firm transporting waste Enviro-Safe Corp. State Lic.# 329 Hazardous waste maniies-,�A E.P.A. # MAD985269323 Approved tank disposal rrd Turner Salvage Tank yard# 002 ` Type of inert gas r Tank yard address 235 Commercial Street, Lynn, MA Centerville 01920 City or Town FDID# Permit# Date of issue November 26, 1997 December 10, 1997 Date of expiration Dig safe approval number. 974704788 Dig Safe Toll Free Tel.Number-800-322-4844 I Signature/Title of Officer cranting permit After removal(s):send Form 7-F-290R signed by Local Fire Dept.to UST Regulatory Compliance Unit,One Ashburton Place, Room 1310, Boston, MA 021 08-1 61 8. FP-292(revised 9r96) TOTAL P.02 � 1 �,�,,' �l \,, � p•- � � � � 1 �� �R .� l� /Q''1 ��� PAR ] Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 165 094- - Account No: 91279 Parent : Location: SHIPS EAGLE LANE Neighborhood: 31BA Fire Dist : CO Devel Lot : 20 Lot Size : 1 . 03 Acres Current Own: BROWN, WILLIAM L State Class : 106 80 BLACK OAK RD No. Bldgs : Area: Year Added: WESTON MA 2193 Deed Date : 070187 Reference : C111474 January 1st : BROWN, WILLIAM L Deed MMDD: 0787 Deed Ref : C111474 Comments : Values : Land: 100900 Buildings : Extra Features : 2000 Road System: Index: 953 (MAIN STREET (OST. ) ) Frntg: 100 Index: 2179 (SHIPS EAGLE LANE ) Frntg: Control Info: Last Auto Upd: 082397 Status : C Last TACS Update : 082097 Land Reviewed By: Date : 0000 Bldgs Reviewed By: Date : 0000 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [165] [095] [ ] [ ] [ ] i J PAR'• ] Real Estate System - General Property Inquiry] Help [ ] Parcel Id: 165 096- - Account No: 91297 Parent : Location: 41 SHIPS EAGLE LANE Neighborhood: 31BA Fire Dist : CO Devel Lot : 19 Lot Size : 1 . 05 Acres Current Own: BROWN, WILLIAM L State Class : 101 80 BLACK OAK RD No. Bldgs : 1 Area: 1107 Year Added: WESTON MA 2193 Deed Date : 090188 Reference : C115594 January 1st : BROWN, WILLIAM L Deed MMDD: 0988 Deed Ref : C115594 Comments : Values : Land: 66000 Buildings : 53000 Extra Features : 7200 Road System: 41 Index: 2179 (SHIPS EAGLE LANE ) Frntg: 135 Index: ( ) Frntg: Control Info: Last Auto Upd: 092196 Status : C Last TACS Update : 070196 Land Reviewed By: Date: 0000 Bldgs Reviewed By: Date : 0000 Tax Title : Account : Taken: Account Status : Hold Status : Cancel [ ] Press XMT for more data Next screen [PAR ] Action [ ] Owners Name [ ] Road Index [ ] Road Name [ ] Parcel Number [165] [097] [ ] [ ] [ ] a ,M � � No..l._. �. 94 Fps r. . .� .. ........ .. . APB THE COMMONWEALTH OF MASSACHUSETTS nstat6 BOARD OF HEALTH �-� OF........th(w§?� .u.. .......................... 58 'ed ...... ............ Gas 66' ppliraflo � for Disposal Works Tonotrurtiun rrmit Application is hereby made for a Permit to Construct o� or Repair ( ) an Individual Sewage Disposal (9 System at: V ............--..... ............... ..... a ................................. " Locatio -A dress or t No. i ,11�... :�f_ . ' ..d `------------------------------------ Owner Address W Installer Address r f U Type of Building Size Lot... Dwelling 0.of Bedrooms................ ........................Expansion Attic (K)6 Garbage Grinder aOther—Type of Building ........................... No. of persons............................ Showers ( ) — Cafeteria ( ) a' Other fixtures .................................. ---....---------------- ---------- W Design Flow.........................I—ID........gallons per person penday. Total daily flow.._.................�._�.?.......gallons. W Septic Tank—Liquid capacity 2-CW_gallons Length_______________ Width......./_....__ Diameter................ Depth..._...._.._.. x Disposal Trench—No. -------/.......... Width_./,F...._.... Total Length...I..�......... Total leaching area-----S.';t ..sq..ft. Seepage Pit,No..................... meter------------------- ::_ Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box (1/ ---- '-Dosin tank �< �`Pi0 y_— ��p Percolation Test Results Performed by._. _..__.. 1t.) •.................................... Date.....��?-_ $.'�L.��'........ ,aa Test Pit No. 1..�2_.minutes per inch Depth of Test Pit____ ----- Depth to ground water.-(1-vi'......... Li Test Pit No. 2................minutes per inch Depth of Test Pit----La;�........ Depth to ground water........................ p+� 9 Description of Soil--- �, ....... -- -------------------------------------.... --------------- 1 -- �CJI --� ---• w ---------------------------------------------------------------------------------------------------------------- w -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- U Nature of Repairs or Alterations—Answer when applicable................................................................................................ ---------•----------------------------------------------------------------------------------------------•------------------------------------------------------------------------........--------•------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental 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 ---- --------------------------------------------------------------------------- Date Application Approved By .......... . ' -aX- Date Application Disapproved for the following rea.rons: .............._--................--.........---......--..........--.._._..................: ...........................'--------------....................................................................-...........................................................................-------------------- -------------...D ate.................. PermitNo. - --------- Issued --------------------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BOARP OF HEALTH ... ram'u........................ OF --...:.. .?1r7171 L-�................................................ THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( i/j or Repaired ( ) by.. ......... ........................//..........------......-q.......... yµ� /.. �/, ` at -_---,0.4......L-.."................... -G_.. ............�fl �.�--..�i----er ���{/...(-�-�r�----.._.................................................................... has been installed in accordance with the provisions of TITLE 5 of The State Environmental Code as described in the application for Disposal Works Construction Permit No. ..------. ---.- i............... 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 w. .......0F.... y`.�! ................. No.....y'. /.f .... FEE..../ ��......... Disposal Works TraInstrudiou Upamit r Permission is hereby granted..................................................................................._...-----------........-•--------•---•--................. to Construct A o�j epair ( ) an Individual Sewage Disposal System at No.......P ..-�5- ml /! !+ `7 ..J.. -•-------------------------------------------------------- Street as shown on the application for Disposal Works Construction Permit No._7i6,31.... Dated.......................................... -------------------------------------------- ......................................................... Board of Health DATE............................................................................... FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS No......................... FEs............................. THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH .. ...........OF........ ` '. F tJ ._:-:--_-------------------------- Appliratiou for Disposal Works Toustrartiou Frrutit Application is hereby made for a Permit to Construct (>�' or Repair ( ) an Individual Sewage Disposal System at: ......................................................E... - .. . Location-Address ` or No. ...... :�� t C'11 -------•-------------- ` 1C1 _ .1` ��. ..................................... Owner Address W Installer Address t �/ Ply Type of Building_ — Size Lot______ _ .. Type feet Dwelling t""No. of Bedrooms............... Dwelling Attic ( Garbage Grinder ([.-), Other—T e of Building No. of persons____________________________ Showers — Cafeteria a' Other fixtures ................................. . W Design Flow.........................Z.1.0........gallons per person per day. Total daily flow...................... _ ........gallons. WSeptic Tank—Liquid capacity_ '_gallons Length---------------- Width....... Diameter---------------- Depth•-..__---_----- x Disposal Trench—No. ......./........... Width-./_o�............. Total Length...7.__ ........ Total leaching area..... -a_sq. ft. Seepage Pit No--------------------- Diameter-------------------- Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ('✓`) Dosinytxnk ( ) �. y a =� �.'- Percolation Test Results Performed b ...___._____�_�..lr:� .. . .:............4...t _........ aTest Pit No. 1__C.. =_--minutes per inch Depth of Test Pit----L2 Depth to ground water_la v `-r--_- Test Pit No. 2................minutes per inch Depth of Test Pit..../.fi.?.._....... Depth to ground water-._____---_-___.-----_. ai4--------•--•--------- ........ ............... O Description of Soil.-- ' ' -L �D �r U� `.? tt ? - - - ------------------------ ------------------------•--------------------------------.---------- UAwl.......`1_%'_.-�......--••--•----•-----•----•-.....-••---•--•--•-------•----•--•-•--•------•---•-------•-------•-•------•---------••-•••-••-•-•-••--•-•-----•....................•- W ----•-•--•----------------------------••-------•--••---------------•----------------------.....--------- ............................................................................................ UNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental 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 ........................ ... ..................... ...... ........................................... ....................................... Date ApplicationApproved By --------------------------------------------------------------------------------------------------------------- ------ ..........------------------------------ Date Application Disapproved for the following reasons: ........................................................... .......".".....................""............................................................... .......... ..... ......................................"..------------------... -- ------------."....---------- ---------------...------------...---------.-.------------------------- ------------------ -------------------- Date PermitNo. ......".............................. ......................... Issued -------------------------------------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS BOARP OF HEALTH (11elr#tfira e of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed (t• j or Repaired ( ) by ."."..........................................�...------.n ---- --............------ ------------i 11 ----------------------------..........------------------.-................------------------------------. .. �'�� I.. ` Installer ....................................................... --------------- -- -- -- ------....----............--- has been installed in accordance with the provisions of TITLE 5 of The State Environmental 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 No......................... FEE........................ Disposal Workii TpaInstrudivitUpamit Permissionis hereby granted----------- -••-------••--•--------•--------------•------•---••----•----•---------•-----•---•--••••.......-•--•-------•.....---•............ to Construct(, .--or Repair an�J a ivid al e wage Disposal Sy t/em at No....... ... _� f r , ( . •------••••.... -••-------------••-------•.....--•-•......._....--•.--••••---••------- -------- -•--- ------•---•-•--•••----•-•--•---•••-•---•............•- Street as shown on the application for Disposal Works Construction Permit No--------_----------- Dated.......................................... ..............................------•-----------....-------------------------------------••-------...._ Board of Health DATE................................................................................ 1 FORM 1255 HOBBS & WARREN. INC., PUBLISHERS 6M/2015 12:00 PM 0 0 9 > O ak• m C z \ rn m r b\ \\ r \ Se o Y C, �. 7-I6 va• v a yy • - J t h-- j I i1 ++tike, -nnl Aa 24 6itm16 Vta! : I -------------------------------------- - r � ,•e.a.- - I Q, . a i • I , i y s•e 1n• s-a• ! s 1n. - n-r Q ` I N M - II&U6 jW4C N-se9e - I ' rn Te : r : • z : I 0 U) b o cz 0 r CO 7C1 99 s o J, Oo 1dg�� L i • �� �\ /' m t m caretaker's house&garage at the A�Ipdyech b IM copynpphlhel m Ihsaepr ardn a meording fo the McLam�y Residence Ar hllaetA', .1 Copyrtghl EGO A R C H I -T E C H u .. :. P otaetlon AeP of IggQ An�aee y, il.r.11 repreduetien er 1�u- 6 school street t 508.420.5335 f 508.420.5304 -41 Ships Eagle Lane �Iene�lLa.plan.wtMutthe Im � ASS 0 CIATE S. info@architechassociates.com wrillen oomenl of AreN O Osterville, Massachusetts 7eehAuoehlealm.,hanMlye- COYUIY, ma 02635 einfo architechassociates.com M ant e11Mt acL An ar n oar- dam or dlaaaDp n�Sa n then o O drawings shall ba hreu hl to the Foundation/Lower Level Plan ;�;�;',,: 1:�;,d a r c h i t e c t u r a l d e s i g n architechassociates.com nda drawings v Sr � o a w -fl Y � > 6 � r A!; m i o0 k%�'6 A \ 4e Z 'tr'41 2-9 x o v lolo b or Il i r� t '-•r m 1014 VT 7'-10 VI' 1'-e'li ba t}9' w a 1, D P ____i o o _ e a�D. MRrBG 6/e) RD•2- % Ill DtNiINS,4/U I - w �? S RO.71 DurtBLs W% s 4 a T O Z P R012 4W9/ C 1%b5 / Y DerHrD6, .,.... :..:- d _e gr 71 11V7' D' B'-5 V4' RD., - X b5 'S. D-0 TILL OD. w -- ----------------------------------------- a 6-6-_I � F Dn-MIX14 51(1 [[R06M VALLEY 4082 T �' 7 urtne,4/ V LU5TOM PANEL 5 - llb RLo.•5'•7 VI'x e'-11') S m S y L 514 F Mirtn6,7n x va '-s V2- 2'-2' _ Sa S YSU 7- � xa� ' � �"� -- r 'Y� r511l9 dN6 FREtGN•SM6 Ib' G g mSrlxelg RD.,2 3 xs 4 w F = r5 D OWDW ero) r T�>a> rn a RD.,7.9 %b 4 i D.. % 5'• B4' Q 5'-0 IQ 5'- 5'-6 I!1' B19 9A1 Durmrs,6ro)w a w 1 i I iQ GUILT-IN w __ ________ e a b 0• C J F � D d DumrS, ro) n `( rn Oda `C ; Cn "'- 4q' Z v, wcv S 1� T o N c m '— S 0 e'-0• le'-0' e'-0' m m w o aretaker's house& garage at the Ah.m Tye.he.Aernv oe.0 Itob.,I..Me b eyl h.e A py.om crdln the W,k.0pyMcLampy Residence .Apel,1199 mz=D u ,."hr R C H I -T E C H 41 Ships Eagle Lane ..0,he l.. Al-1 the 6 school street t 508.420.5335 f 508.420.5304 u PfMthf tA"""'°'""" ASS 0 CIATE S. Osterville, Massachusetts T.PchA..eel.le 1m.,:farMldnMga- COtUIt, ma 02635 einto@architechassociates.com ` ` 1 el IMI.c�Any r '`v' u dom or dlmra anele.on�hne N drawing.atoll he brou hl le Ito u First Floor Plan e11.!n ArchFT.d Noc, en l 'aiuti: architectural design arch itechassociates.com o Milli UM R " A H H 0 N N y. 1` 9 y > rn m (� r i r I z z I � � I k9 I �3. 2-0' 3'31 9'-0' 1\2 l'-0' 44 x IDN , 24s9 d ----------------------------- __T------------- _ a.att6e�ero) ' OM-93Y1 aUN1IN5�a I N 6 U RED..1 -�13(V� � � -• D i 'I sff¢tvAnoW A� P i - Reu11w� 2H7 i 1 (HmiIR9�e/6) _ i { 6-0 VT91q' S'4' 9'-0' i o - 5' y `, MIIttIkSi a 6) 4' r a'-3' 3'fi' + S 1 x 94' 2 21 1,9'-2• 2'-0' 9d-19/4' dr R.p.,24 9/4%HI (M1NnrG 69/1ro) I G b D 4 o FLO' Iwminx ere) i 7M1 7( � 6/6) _ i{{ w _ I i _ 4 - 15/4 El _. i 6 -------- F > x x § — Q V-----------. '' R+A+rbu e a ti ° � u 2 _ GM� CO ADfI�°'e �Xcc m c m c .Z07 \, 2 4'-W 2' ' 6'-0' Ib'-0' b'-0' I'6' Y-0' m m '-t a caretaker's house&garage at the Arches hA.-W.e 1-he ey m w 01 v red°Cmevvu 1h...pyrig�I of m Ih �,vdn.,ceordln Ie Iha M e La m p�/ Residence Archileclur 9 W.rke Copyright G'� A R C H I -T E C I� D . .. .. P le Ibn Acl"of 1994 An 6:riwn 6 school street t 500.420.5335 f 508.420.5304 41 Ships Eagle Lane tlonoll6eapl,uwlhoulihe A S S 0 C IATE S. @ a�reu velllen camenl el Arehi � � � � u OsterVille, Massachusetts TechMwchleelna,h,nMlrm9e- � COtUIt, ma 02535 e1nf0 archltechasSOClateS.Corrl ,nt el Ihel ut An mere e - u d.m er dhns Tee on thus O G eeaeIrbnnlogn ohf,�A1r,,c'h F"T.�h'A" m:1 . dd .olSecond Floor Plan a . . .., .mlch.,, architectural design arch itechassociates.com drumg. BENCH MARK: TOP OF FND: ELE.= �j C�•�O - .(SAS) SHALL BE .n • - MANHOL" CCVE�S TO EXTEND TO + 1 34.25' LONG ' 11.0' 'WIDE _ WTTHIN 6' OF FINISH GRADE r• /� 10' DEEP v S N BAFFLE REQ'D d CS���NCdG1� Q� 4 7-3 T'O/ _L7 55 D-8. - _ _ _ 2' PEASTONE TOPPING - CAP.ENDS GENERAL NOTES: —{ - 3/4" DOUBLE WASHED — ELEVATIONS SHOWN BASED ,ON U.S.G.S. DATUM. STONE AlAROUND'- + EL=.Z� •3'J SYSTEM PIPE SHALL BE' EITHER C.I. OR `y` SCHEDULE 40 P.V.C. THE BOARD OF HEALTH SHALL BE NOTIFIED = 1 5 31 25' .• 5 `' PRIOR TO BACKFILLING OF SEPTIC SYSTEM. 20' MIN. . �" - SEPTIC SYSTEM STRUCTURAL COMPONENTS USE FIVE (5) INFILTRATORS a `' � " z+O SHALL BE. CAPABLE OF WITHSTANDING A SOIL TEST LOG PROPOSED SEPTIC SYSTEM WITH 4.0' OF STONE o SIDES ";.. PERC RATE=< 2 MIN/INCH & 1.5 OF STONE o ENDS H=10 LOADING. UNLESS SPECIFIED OTHERWISE NO SCALE E - —SEPTIC No STON AT BOTTOM • r- ;_ - - -- V 5C � �«" .: V G •` — COMPLY.w1TIiE A NN 20 LOADER DING. S { HALL ! I-t.Lt, - l' THE DESIGN AND COMPONENTS OF THE SEPTIC i �tGVCdJr ��I t 1 A LOAW SAND 1OYR (� I�1 E�.. SYSTEM SHALL BE IN COMPLIANCE WITH THE 2� 9 LOAl1Y SAND 10YR STATE OF MASSACHUSETTS SANITARY CODE ��� - ��+ l3 R �cf�GOv T• TITLE V. AND SHALL BE IN COMPLIANCE WITH . D O H RULES D THE. LOCAL BOAR F HEALTH R AN Cl MEDIUM Sarin to1•Ti Ql t REGULATIONS. — THE CONTRACTOR SHALL BE RESPONSIBLE FOR LOCATION OF ALL UNDERGROUND UTILITIES AND 144" R SHALL NOTIFY DIG — SAFE PRIOR TO. CONSTRUCTION. �0 pocj W /� T ` 2 .�.. NO GARBAGE.GRINDER — 7n 'f- 1 'DESIGN .CRITERIA:- 4.LEGEND: y ._ -, ? .��' ` _ p�jc .;Z DESIGN Flow EXISTING CONTOUR ——— — — % z \ a Q \ `l� 3 BEDROOMS AT 110 G.P.B. / DAY 330 G.P.D. WATER SERVICE —W—W— — — - � �` — REQUIRED SEPTIC TANK: TEST HOLE _� W t , Soo y A L_ GAS SERVICE —G-G TI SEPC TANK PROVIDED BENCH NARK �> SG� � �6 \a. \ DESIGN PERC RATE <2 MIN/INCH �� i• Sys SIZE OF REQ'D (SAS) AREA = 330/0.74 = 446 S.F. ' .+1 r.• °o t�h� ..` ( LOG I �t �a SIDEWALL S2).0.83)(34.25)-F(2)(0:83)(11)= 75.12 S.F. \ 0 61> ! " ���:a g BOTTOM 111 (34.25) 376.75 S.F. 1T� ~ SIZE OF LEACHING FACILITY PROVIDED: a \ f` ` �. 376.75 S.F. -1- 75.12. 'S.F. 451.87. S.F. PRIOR TO INSTALLING THE NEW (SAS) THE 5c �S = 334.4 , GPD CONTRACTOR SHALL PUMPOUT ALL CESSPOOLS EFFECTIVE DEPTH: 10" AND BACK FlLL WITH CLEAN MEDIUM SAND A \ + G A A6e � � 3Z EFFECTIVE LENGTH: 34.25 IF CESSPOOLS ARE ENCOUNTERED IN THE / ` ` (SAS) AREA THEY SHALL BE REMOVED �Z I 1 3� EFFECTIVE WIDTH: 11.0' ' HUNTER ENGINEERING ; -- 3, 7 WEEKS POND DRIVE FORESTDALE MA -02644 �;'. (508) 477-8268 P. 4 ;Y •:i ! HUNT 'a, t - PROJECT: P CIVIL �, { _ .� �— T: SEPTIC TIC SYSTEM REPAIR � 'F R o �h8a 364�a o ti 4•1 Sal E 64- S< f� AS SHOW ,.w or , � N ma, JP MA' tt,5/ LOT• <1.to �er OWNER: 41 SNtps' Lc LA FLOOD ZONE ASSESSORS REF: � X & 0.2% Chance of. Flood Map 165 -.. ; See Plan Parcels 096 ,., Based on Map # 25001 C0563J . July 16, 2014 REFERENCES: LCC 26700 D s CTF 204746 Q= c 6 Y Legend: n�:- Wetland Flag LOCATION MAP: ® Catch Basin Scale: 1"=2,000f' 0 CB/DH - Concrete Bound •4 Guy ZONE: Utility Pole RF-1 Deciduous Tree Area (min.) 87,120 SF (RPOD) 0 Frontage (min) 25' Wetland Resource Line Width (min) 125'Setbacks: FEMA Zone Lines as Flagged by ENSR Coniferous Tree Front 30' As Shown on FIRM 0312006 (SE3-4616) # 25001 CO563J + Side 15' July 16, 2014 0 Rear 15' 01d Cranberry Bog 6�oi l .Y o r �;r„ ''~ _ _ __. _._ -.- -- From Hyannis Follow Main Street to the r f.'% _ _1'j-- ___ ---- --7p� 6' West End Rotary, and then take Scudder N F _ ---- -�" - s-• „ 178.53'� 5�40 25 50''''W Ave.; At the stop sign take a right onto _ _.... .__ _ __ •_. _._ - - / Smith) Street which merges with Craigville _ _ _ _ _ - � 311 M Realty Trust ,,, --~ l �..� - �,�. r- .-' -....,.. -_ .; "'-,. � .. __. _ , o - r / �.. _. . Beach Road At the sto 11 hf take a left �, _ _ 124.52 p g Michael P Adams"Tr -: _ _...._ _...� _. ;,,a. �..... � �:.. -.` .-_ -<_ �. � _..: .._. _. �: ..,,� ,. 1 -- . /'' onto Main Street ' which turns into:.:South _` 77 ___.- ---.. � •_ �.. .__� Main; Turn left onto ships Eagle Lane. r, 4 _ ' . 15--'`' , ' ,•-... - - -,�: ,, 75 _..: .�'- _,,.- ,, - r Project site Is #41. / nnaa( Chance iS O �, ✓ / r' / f r / f , PrOpOse� 6r-ywe _� — ___ ---- --- — -� F C� �. - _ _ G ./ \ --20— . 40 e c; °\ °� o�`e Lot 1 9 f r "� r r _ for `'-bof "runof _ _ _._ _m _. .._ . -- _ ��/ooar`Z _.. _.. _ 3� p r,, r y r' ' .� / m — \ _ _ .......... _ .M _ _ ' . One _. _ _.... _...._ {� / r, .r - _ r r o°a5,656f F 'r 1.05±'AC /. -' r, r, ___ `� _ �.. - - .'' , 4_ (1� J) " --25 w 9 -. _.... � �. _...... .......... ......_ � a1.�h'��., ^.,' - i / ,r ... r' __., � axis tin g p --- _ — __ _ _. _ _.. — gy _. .771 Y O ._._ __.. as per- ' r �. • ., ~ ---25 can -a q,� 1' _.. -- / C up _21- _ Proposed - 3 / :P�0 2 Sty w1 f 30. / / W� _ ./.. �• --.��.' Single Family •-.._. �... •- -v, / y Dwelling • 251 _ Q • o _ gyred,�' f� ° �,. � `---- --- z i 7' _ .Existing ep'tic e�\\t�O��g _. _ .__ —35— �r- _. -._ ........ ......... _. _ _ o (as per Ws eta` / __ .. _: , �.-35 Brick lk ' - _._ _ ......... _ or49e x demolish Gravel _ _..._ r \ B/DH ® Stone Drive 6 p � / / / x o r a.Vel Drive /. r X R=29.1' 24„ / �� J t� Q GYM / C I 01 u , R,52..50 i/ �Z.g�, o r I l / - / f ��1 92 i ! 256 CB/DH nd Deb0r(7hCBID • H , 0 j Fnd41- 1 r a PJ r ! prove c c Vstone _t \ � 1 o _ 1 O . CB H D i / Fn d I CB/DH ■ ' h� Fnd hipsEagle"OLn � ........................... (40,' Wide Private Way) Legend: Light Post Hydrant I i Hose Bib El CB/DH -� Guy Utility Pole NOTES: PREPARED FOR: PREPARED BY. TI TLE: Di OHW— Overhead Wires Site i aI 25 Elevation Contour 1.) The property line information shown was compiled from CapeSurvavailable record information. • En neerin & Proposed Improm117er1tSThe Ships' Eagle - Lane Nominee TrustSU11 gl g l-. y Patrick J. 1%n Consulting,Inc. y � • Holly Tree 23 West Bay Rd, Suite G 2. The topographic ra h1c information was obtained from an on ) P 9 P Mel am pY Tr. � Osterville MA 02655 O , the ground survey performed on or betiween 31/MAR/06 and ( 428ea • eaeoo�659 • 7Parkerfaosd,0atorvi�M,MA02655 (508) 420-3994 / 420-3995fax swiesullivanengin.com • %"sullivanengin.com Lane 02/MAR/15. Some details may be missiing due to heavy www.copesurv:com // 1 Ships Ea 'e T� • Deciduous Tree snow cover. . 3. The datum used is NAVD '88 a fixed mean sea level 20 1D 20 40 Draft. WHK/�RRL/CTR Field: WHK/RRL/KAR Bamstable ostervillel MASS. W 0 80 / LU + Coniferous Tree datum. Review RRL/JOD Comp.: WHK/RRL/CTR DATE: SCALE: co _ April 1 7=20' , 2 Project: Project # McLampy p i j j SHEET 1 OF' 2 I LiOCUS EAGLE LANE EAST / C.B. FWD. 8AY 3 LOCUS MAP r 2So- 36 SCALE 1 ; 25,000 ���j. 34 ASSESSORS S. FND. 32 C.B. FWD. MAP 16 5 30 ---/� PARCELS 94 & 95 — LOT .19 ZONES / WILLIAM L. BROWN /• ,0°c 28 A.P. CTF. 111474 cam• �� �J�' _ L.C.C. 26700D �`� ��O 26 RESIDENCE F•-1 / �` �' 4 / \ o , MINIMUMS o`:) ti%K AREA = 43,560 S.F. �/ °C� o FRONTAGE = 20' WIDTH = 125' FRONT SETBACK = 30' SIDE SETBACKS = 15' REAR SETBACK — 15 0 BUILDING HEIGHT = 30' (OR 2.5 STORIES IF LESS) o REs o S76.48'41"E C.B. FIND. • shape #163.51' \ 02 95•70 91,890 sq.f �O \ �lb #3 4 f • � j�--?�J � BREAK OUT CALCULATION'S J4 EXPAN SLOPE-7 1: 3.6 1507/3.6 = 42 o� / ! MEA '� 42.0' PROVIDED 'o ` + �OOX SLOPE = 1: 4 150%/4 = 38' 3 25 38.0' PROVIDED #2 � o A0 PROPOSED �8 TP S # 96 1.�► Y 1 / PROPOSED a 2 `•� L_ 0 4 �' DwELL�NG \ C.S. D. \ _ 39- I LOT 25 a �� �' OOR E1-EVASION = 42 o p 30 WILLIAM L. BROWN F� Sy 00 F G 40, � 32 � Cv a _, N o EZ A�N�NG P� - N 34 o CONCRETE c��, oo r' � �. co BONE & �' o `r t� 36 � o `� o S 1� O0 u� �- µ M 1 • � L a 38 _ AGNES V. HALL TR. CTF. 46036 ✓ L.C. 31743 C -. \Ot1S .moo 24.5'C. �U A! / 0 44 ,. D` O� lop 30 I C 2B 26 22 0 f _ ' 20a �— 10 � i" o C.B. FND. bench mar - - y P�4 .. � / 00 e!. 10.14 o --� dl vehtc racks o� \ � �✓Pam__ PROP too \ \ dune P19 5�00D / 2 LOT 24 / 0 M•. \ r 73,184 sq.ft.= .1.68 cc, upland 22,265 sq.ft. dune registered AL 8.040 sa.ft. wetland r / I 2,473 sq.ft.wetland unregistered \ tt 2.44 acres total Y — / AL C.B. FND. 00 / AL AL / Q I NAL 'lip MARSH AL allk. `L - PLAN B ]1A. �\ ; SITE PLAID OF LAND PLAN AL ' (OSTERVILLE) SCALE . 1 = 20' GRAPHIC SCALE 0 20 40 �, �� BARNSTABLE, S. f , �. . FOR R C.B. FNID. .w 1SIVILIJAM L. BROWN SCALE: AS NOTED DATE: JAN. 5 ,1994 AGNES V. HALL TR. '�. " BAX1 ER & NYE INC, a� A OF Af4S GISTERED LAND SURVEYORS �w� Ss CTF. 46036 °� ,, �tN OF MgSs .y�� �y NOTE: L.C. 31743 ��C ., o��,� goyG CIVIL ENGINEERS a��\ wE�6A�a PEER ❑STERVILLE, MASS, �� -14 THE PROPOSED SEPTIC SYSTEM IS MORE THAN 300' FROM A SULLIVAN i" p No. ?E4 H WATERCOURSE. 'THEREFORE, ,,THE 250 RULE DOES NOT APPLY. No. 29733 Fc e A T . N.G.V.D. 0.00' THEREFORE 100 YEAR FLOOD = ELEV. 12.0' AppA��crsTFQ� a`�� ° .x CERTIFICATE REFERENCE: WILLIAM L. BROWN CTF. 91370 & CTF. 111474 - . < : . _ 3126 i SHEET 2 OF 2 WILU L. BROWN jANUARY 5,1994 2"Y 4" HANDRAIL 4"X 4" POSTS 4.0' 0 2"X 8" DECK : 1-11/2" SPACING (TYP) 2"X 12" STEP (TYP) 2"X 12"' STRINGERS I Z T 8.50 , - STAIRS TO BE 8" ON 12" _ EL. 46.0 1"X 4" SUPPORT-- ' EL. 44.0 4 11 w 2"X 12" Z Q EL. 38.0 o 4 m i1 00 a m EL. 30.0 4 11 z z 7.50 EL. 22.0 I 7.0 /\V//� � ���/�� ���/���j� EL. 14.0 \\ \\ \\ \\ \\ \ \\ \ I EL. 8.67 wig A- A STAIR & DECK TYPICAL SECTION EC 1,. = 2, 1' = 10 GRAPHIC SCALE GRAPHIC SCALE 0 2 4 0 5 10 20 I s 1 r S : #P8124 10 1 9 93 0LLEV. = 27.50 i - LOAM & SUBSOIL j - 2.5 ALL COMPONENTS LOCATED IN POTENTIAL ° VEHICLE TRAFFIC AREAS OR BURIED 4 FEET F.F. ELEV. = 42.00' OR GREATER SHALL BE H-20 LOAD CAPACITY. #P8124 ALL PIPES TO BE 4 P.V.C. SCHEDULE 40. 3 2.0 al �� 0 ELEV. = 20.00 F•G•= ���'�� BASEMENT FLOOR ELEV., = 33.00' - %/ G. 28.0 F.G.= 31.0 F. LOAM & SUBSOIL PIPE 2000 GAL. INv" = 31.00' / PIPE SEPTIC TANK INV. INV. = 28.00 50 = 26. INV. = 27.80 2.5 INV. = 21 .00 PIPE DIST. BOX INV. =26.70 MEDIUM SAND °o°000 °o^ o°o o�0000 3" PEASTOµNE %r. / o o O 4' 4r LEACH G LLIESD o O O U O O .� oo0000 000000 000000 ::. •°•° SET D. BOX ON 6' DEEP CRUSHED STONE BASE. o 000 OOOO VOV 0000 VOOOOVOV•00.0•00900 0•V•Ob•00•V000b900p040f Vtb 99VVbV•b O' >V OOtl VOOOY OObbV OCVOVtlV VOV VVV4pVOV >ti0.00♦OOV090V•00•♦♦OOOV•••••♦O•♦00 12 ELEV. - 15.5 % �i e�avvvvov°av'ooao'v'o'v'sa°vooe' <>de ee:.::::.:.:>e:.d::��-�.P��::�:��d: ELEV: - 15.00 NO WATER /// %� 4.0'_ 3/4" - 1 1/2" %/. WASHED / MEDIUM �i sTONE SAND �.! 7 ELEV. = 10.00 P ® ZLE NO WATER N0 SCALE sD M Po A USE 3 4'X 4' LEACH GALLIES WITH 4' X 4' OF STONE ON THE SIDES AND 2' OF STONE UNDER THE SYSTEM DESIGN DATA SIDEWALL AREA = 6X6OX2.5 = 900 GAL. %DAY BOTTOM AREA = 18X12X1.0 = 216 GAL./DAY j SINGLE FAMILY-- 5 BEDROOMS TOTAL DESIGN = 1 116 GAL"%DAY GARBAGE GRINDER REQUIRED GAL./DAY = 850 DAILY FLOW = 110 X 5 = 550 G.P.D. PERCOLATION RATE: SEPTIC TANK = 550 X 150% =850 G.P.D. 1 INCH IN 2 MINUTES OR LESS. SEPTIC TANK = 550 X 2 = 1100 GALS. USE 2000 CAL. SEPTIC TANK i i i 18.0' v v v v v v v v v v v v v v v v v v v v v v v v v v v v v v v�v v v v v v v v v v v v v v v v v v v v v v v v a v v v v v v v v v v v v v v v v v v v v v N v 3.0' 3.0' A 3 4'X 4' CHAMBERS v v N vvv ` vv vv vv v v v v v vvvvvvvvvvvv v v v v v _ 7 v v v v v v v v v v v vvvvvo vvvvvvvvvvvv vvvvC `- 7vvvvvvVvvvv vvvvv vvvvvvvvvvvv 3/4'" - 1 1/2"� - WASHED STONE PLAN OF LEACHG ALLE, S N0 SCALE A�P",ZH OF 414Ss N O F n Ad#14' r PETER o SULLIVAN C r NO. 29733 1 **0,, Fc/ST S�� dy,�twF J: r.3126C -.,_ _'• "'.:.TM_:,..'TFR.1fiY'tEQ,@�'^.'@F')1Y.t3+8£VsD�-fSPFr;9fr!>3+"dr."ys're3me±i�:'+,P' 'r^3a.. ....._..,m_'rFPiF.Pi�SYN=•' :5aft11+-FR%+g+.g6fS3are.};N„_<..:..:..81iAK _. _ ._- _ .. � _ ai=`a:F_Yn+«9+3Swm.2�-.aiP+..t4wJ" --�a�4 ..VA' ".... ... ... _.. .. • e* SHEET 1 OF' 2 DMP�� LOWS SHIPS EAGLE LANE SST / C.B. FND. \ SAY ,3 LOCUS >MAP / ? �e, / •1 36 4 SCALE 1 25,000 `` ;� S. FND. ASSESSORS ce Win. MAP 16 5 �- ._---•---� 30 r�► PARCELS 94 & 95 ,vVl9 '- 28 .ice ZONES / WILUAM L. BROWN ¢, CTF. 1 f1474 / c O 26 A.P. L.C.C. 26700p p %K RESIDENCE F-1 MINIMUMS AREA = 43,560 S.F. ° FRONTAGE = 20' WIDTH = 12 5 l' \ FRONT 'SETBACK = 30' r SIDE SETBACKS = 15' �. 1 REAR SETBACK 15 0 -g, �' �2 \ G� BUILDING HEIGHT = 30 0 , Esti 0 (0R 2.5 STORIES IF LESS) r/ R 2 �� o 76'48 41 E shape #16.51'��� \002 � C.B. F'ND. /' 95.70 91,890 sq.f . O lb 3 i O1K3qo' BREAK OUT CALCULATIONS / .J / �O P = 1: 3.6 150% 3.6 42' ,ao� � SLOPE / o. _ 42.0' PROVIDED / A SLOPE = 1: 4 150% 4 38' 1 0 / 38` 25' 38.0' PROVIDED I 42 OD 20 0 16 Lq' O v j6 / �Q/1�)/ RA- � GA / G �Xv O PROPOSEQ tP G� #1 0 �� PROP OSEQ t.� � 2 \� 2 a o 2¢ QW �trlNG Q LOB' 25 .8. /41*1D. 4 ,J-� 39 j 1.P a8 NATION 42 o 30 ` WILLiAM L. BROWN Ft 5� FLpp�R Et,E �� o E G f�0' — 32 I CIV (IV `O BAN �NING PL .� 34 w o N ESE RED A � In �,. o N oo S BONE °s —to 11 I ~� �. _LIMN - _ i AGNES V. HALL TR. } CTF. 46036 16 / �� \ A 24.5' L.C. 31743 ,CtOp~t10ht o °° ---- Or Ln 404. p OL 30 0 20 1 2 •U, 18' P. \ - N C.S. CD FND. o bench mark ' e!. 10.14 I, \ Ep \ dune \ w I \ t LOT 24 73,184 sq.ft. 1.68 ac. upiond / RE coRQ M� / 22 265 s .ft. dune registeredAL s 8,040 sq,ft. wetland registered 2,473 sq.ft.wetland unregistered 2.44 acres total .F1. FND. .�!' Ak �/ \r MARSH PLAN B AL iL i SITE PLAN OF LAND I N { PLAN (OSTERVILLE) I SCALE : 1" = 20' i GRAPHIC SCALE BARNSTABLE, MASS. Co 20 40 / AL Ak C.B. FND. FOR AL WILLIAM L BROWN SCALE: .AS NOTED DATE: JAN. 5 ,1994 BAXTER & NYE INC. 4 ' AGNES V. HALL TR. ?• Ak REGISTERED LAND SURVEYORS ��` OF M f 1 CTF-. 46036 �y+� ' �taof 414 CIVIL ENGINEERS ? 'L�'A L.C. 31743 ,�c / oe p yG� DSTERVILLE, MASS, N Y E NOTE. PETE.. o SULLIVAN `� p No. 34 ; THE PROPOSED SEPTIC SYSTEM IS MORE THAN 300' FROM A F , W T ERCOURSE. T l{ERFFCRE THE 250 RULE DOES NOT" APPLY. " No. 29133 � BIN% A i N.G.V.D. 0.00' THEREFORE 100 YEAR FLOOD ELCV. 12.0' s A0 a C) #93126 TF, 111474CERTIFICATE REFERENCE: VILLIAM L BROWN CTF. 91370 & C "` i l TT Jam.WMUAM BROWN lr SHEET 2 OF 2 JANUARY 5,1994 2"X 4" HANDRAIL 411X 4" POSTS 4.0' 0 �i 2"X 8" DECK 1-11/2" SPACING (TYP) ' 11 2"X 12" STEP (TYP) 2"X 12" STRINGERS 2 8.50 STAIRS TO BE 8" ON 12" EL. 46.0 EL. 44.0 4 11 1"X 4" SUPPORT---` EL. 3$.0 2"X 12" ? Z 4 11 o m 00 d m EL. 30.0 Q cV 14 1 zz 7.50 EL. 22.0 7.0 `// EL. 14.0 i 1 - _ STAIR & DECK TOPICAL SECTION SECTION A- A 1' - 2' 1' 10 GRAPHIC "SCALE - GRAPHIC SCALE 0 2 4 0 5 10 20 I i I I F s #P8124 10/19/93 I 0 ELEV. _ 27.50 LOAM & SUBSOIL - 2.5 ALL COMPONENTS LOCATED IN POTENTIAL ESTVEHICLE TRAFFIC AREAS OR BURIED 4.7FEET F.F. ELEV. = 42.00' -2"T -3 i/i �' #,P 8124. OR GREATER SHALL BE H-20 LOAD CAPACITY. 40 /i G _� ALL PIPES TO BE 4` P.V.C. SCHEDULE 40. E• � ii ; 0 ELEV. = 20.00 F.G.- 32.0 aiC": ELEV. = 33.00' ii , \ tt. � BASEMENT FLOOR EL� 31.0 . . 28.0 -� PIPE LOAM & SUBSOIL , 2000 GAL. INV. = PIPE SEPTIC TANK 26,50 INV. = 28.00 INV. = 3 i.00' !;i V 2.5 INV. = 21.00 PIPE DIST. INV. = 27.80 BOX INV. =26.70 ij MEDIUM �P Yv.I:'I•Y ii SAND °o°o°o °o o°o o°0000 >;;;; : 3" PEASTONE' °o°o ES� o 0 4'X 4 LEACH G LLI °opoao aooOao o0o0o0 <..:.: .: SET D. BOX ON 6' DEEP - �i o �� r.��. CRUSHED STONE BASE. OObO VOvvvbp PPPPP PP V........... vP PPObPb Pb Pb 4bv Ob bb PPbb vOb OPb Ot PvbP v• 1 2 E( /-_` /� 1 5.5 O<OOV COOOP<VbVVVOVPV VO000bb O vvvvO >O VOOPOOOOpO000VPOP000400tPVPV9VP090 ELEV. N i 9OVOvvOv0000001000VVOOVO00vPvv900 PVOObPO00VVVVVVV4CVtrbbbbVbVVOV40 ELEV. 15.00 PyyyOyyb Oyyyyyyy0 y0OV OvvvvvP bbb Pv PVOvv Ov OOVOvvv v OvevvvO VPV Ovv Ov'vvvOv NO WATER �4 0 `� - 4.0' 3/4" 1 1/2" i% WASHED MEDIUM STONE SAND 7 ELEV. = 10.00PROEM NO WATER NO SCALE USE 3 4'X 4' LEACH GALLIES WITH 4' X 4' OF STONE ON THE SIDES S AND 2' OF STONE UNDER THE SYSTEM 1 DESTIGN DATA SIDEWALL AREA = 6Y60X2.5 = 900 GAL. /DAY BOTTOM AREA = 18X12X1.0 = 216 GAL./DAY SINGLE FAMILY- 5 BEDROOMS TOTAL DESIGN = 1116 GAL./DAY GARBAGE GRINDER REQUIRED GAL./DAY = 850 j DAILY FLOW 110 X 5 = 550 G.P.D. SEPTIC TANK = 550 X 150% =850 G.P.D. PERCOLATION RATE: SEPTIC TANK = 550 X 2 = 1100 GALS. 1 INCH IN 2 MINUTES OR LESS. USE_2000 GAL.SEPTIC TANK i I 18.0 VVV V � VVV �7VVVVV �``DVV V V V V V V V V V V V V V V V '7 V V V V V V V V V V V V V V V V V C'V V V V V V V V V V V V V V V V V p `7 V V V 3.0' I 1 3 0 3 4'X 4' CHAMBERS V V , V V V V V V V V V V V V V V V 1 V V V V V V V 7 V V V V V V V `' V 0 V 0 V V V V V V V V V V V V `'� V C7 �7 V V V V 'K `r 7 V V V V V V V G V V V 9v17OV V V V V V VVV 3/4" _ 1 1/2' WASHED STONE P O CH G.,AILEYS., NO SCALE i F3`�'jH OF of n o•'� 9�'y '�Q v W ILt L A M s o SULLIVAN h NS No. 29733 m �, r31 � .r- :`•csx �: wW.-�a... .,z + .:.*ahot�*«a+t°n..>,z,.w,.,r. rrasx,� rta�-�ear .�etsr�*,�c+c. �..:.- ..a_ ._... _- ... ae. -. asa .. .. ;. ' a'&'vh4+ 'F;�2i:'�+3":- 2�i5&`?#?ti?aF"i rvvrt \\', ....^.:.�'s.""vk.0.aRh..s¢LL:.,.Fh94.:?a=;dRS#cY:�r .^.fz3'.r+�:-. - ',s,.�e:�i'�t€,• _. ...f.�u8°'�., (tea:. '. -=S _ _. :.' .?e&h'91�"F.e .r.. -_ ,. ..Y$' :F K