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Home My WebLink About0022 THIRD AVENUE (OST.) - Health THIRD AVE. OSTERVHA E} A= lllo o I i 1 t 1 i a i _ V i Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments aG:w 22 Third Ave. Property Address I`Q Clay ' Owner's Name rn Osterville MA 02655 6/19/17 CitylTown State Zip Code Date of Inspection r"^' Inspection results must be submitted on this form. Inspection forms may not be altered in any way. A. General Information 1. Inspector: Frank Nunes III Name of Inspector saa Company Name Box 841 Company Address , East Falmouth MA 02536 City/Town State Zip Code 508.272.6433 Telephone Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 6/19/17 Inspecto Signa Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under h the same or different conditions of use. 22 Third Ave.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 1 of 15 for �� Commonwealth of Massachusetts Title 5 Official' Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 6/19/17 CityTrown State Zip Code Date of Inspection B. Certification (coot.) Inspection Summary: Check A,B,C,D or E-/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: Pumping suggested every 3 yrs to prolong the life of the system B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Answer yes, no or not determined (Y, N, ND) in the ❑for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old"or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of.Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: n/a ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed 22 Third Ave.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 I i Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 6/19/17 CityrFown State Zip Code Date of Inspection I B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: n/a The system required pumping more than 4 times a year due to broken or obstructed i e s . The ❑ Y q p P 9 Y PPO system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: n/a t C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 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. 22 Third Ave.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 i I. i Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third Ave. Property Address Clay Owner's Name ` Osterville MA 02655 6/19/17 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or . more from a private water supply well". Method used to determine distance: *"This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: n/a D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool - ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than %day flow 0 E Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 22 Third Ave.-03/08 Title 5 Official Inspection Form.Subsurface Sewage Disposal System-Page 4 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 6/19/17 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems(cont.): Yes No ❑ Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ElThe system fails.•I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a. design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ Or the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 22 Third Ave.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments yl 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 6/19/17 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 ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® . Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 22 Third Ave.-03108 Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 6 of 15 f— Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 6/19/17 City/Town State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No t Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No ` Laundry system inspected? ❑ Yes ® No Seasonal use? ® Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: seasonal Date Commercial/Industrial Flow Conditions: Type of Establishment: n/a Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.):' Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No 1 Water meter readings, if available: Last date of occupancy/use: Date Other(describe): n/a 22 Turd Ave.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 6/19/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) General Information- Pumping Records: Source of information: No pumping per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped:' gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): - Approximate age of all components, date installed (if known)and source of information: Original septic tank; new d-box and leach chambers 2006 per BOH Were sewage odors detected when arriving at the site? ❑ Yes ® No 22 Third Ave.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 15 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 6/19/17 City/Town State Zip Code Date of Inspection D. System Information (cont) Building Sewer(locate on site plan): 2,6., Depth below grade feet Material of construction: ❑ cast iron ®40 PVC ❑other(explain): Distance from private water supply well or suction line: >10' feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): 2 Depth below grade: feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) Outlet cover raised to 6"of grade If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 100og , Sludge depth: 41' >12" Distance from top of sludge to bottom of outlet tee or baffle Scum thickness trace >2r. Distance from top of scum to top of outlet tee or baffle >2„ Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Measured 22 Third Ave.-03108 Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 9 of 15 i Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form v Not for Voluntary Assessments M 22 Third Ave. Property Address Clay Owner's Name . Osterville MA 02655 6/19/17 CityrFown 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.): Pumping suggested every 3 yrs to prolong the life of the system Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): n/a Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom.of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): n/a 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): n/a 22 Third Ave.•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 6/19/17 CitylTown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): n/a Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 11 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.): H-20 box 3' below grade, cover raised to 18", no adverse conditions Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No ' Alarms in working order: ❑ Yes ❑ No I 22 Third Ave.•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �M 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 6/19/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a Soil Absorption System (SAS)(locate on site plan, excavation not required): If SAS not located, explain why: Type: ❑ leaching pits number: ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: i , T ❑ 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.): Chambers were video inspected and are damp at this time, no indication of past failure conditions 22 7hird Ave.-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 15 I Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 '6/19/17 Cityfrown State Zip Code Date of Inspection .D. System Information (cont.) 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 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.): n/a 22 Third Ave.-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 6/19/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. r R> dA Ll C- 22 hird Ave.•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 15 f: r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third Ave. Property Address Clay Owner's Name Osterville MA 02655 6/19/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water: >12 feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from.system design plans on record If checked, date of design plan reviewed: Date ❑ Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: USGS TOPO maps show home at 32'above sea level You must describe how you established the high ground water,elevation: see above 22 Third Ave.•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 15 D i Management, av d . Burnie Mana n I 9 e t -1 nc .307A Commerce Park .I South Chatham, MA 02659 508-432-0223, 1-866-980-1440 Fax 508-430-1450 ` Please find corrected inspection-report enclosed. The only change to.the report is the off cape billing address. E�P ' 'D e 4 is 7tS'? �' ,mac -41377 DEED RESTRICTION WHEREAS, J. Gregory Murphy and Maria Martignetti Murphy of 22 Third Avenue, Osterville, MA are the owners of 22 Third Avenue located at Osterville, MA(hereinafter referred to as 22 Third Ave. and being shown as part of Lot 22, containing 4,000 square feet on a plan entitled "Plan of Land in Osterville, Massachusetts, belonging to James A. Lovell, January 1909, Frederick O. Smith, C.E., which Plan is recorded with.the Barnstable County Registry of Deeds;Plan Book 27, Page 135. WHEREAS, J. Gregory Murphy and Maria Martignetti Murphy as the owners of said,lot has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, 'Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as a-pre-condition to granting a disposal works construction permit for a septic system in. compliance with 310 CMR 15.200, State Environmental.Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the'issuance of a building permit for the construction-of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable Registry of Deeds by recording this document, NOW, THEREFORE, J. Gregory Murphy and Maria Martignetti Murphy do hereby place the Following restriction on this above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors .in title: e 1. The 22 Third Avenue,.Osterville, MA may have constructed upon the lot a house containing no more than (3) bedrooms. J. Gregory Murphy and Maria M. Murphy agrees that this shall be permanent deed restriction affecting number of bedrooms located on 22 Third Ave., Osterville, MA, and being shown on the above referenced Plan. For title ownership see the following deed: Boole 22068, Page 275. Executed as a sealed instrument the 17h day of August, 2010. Owner's S' : J. regozy Murphy Owner's Signature: Maria Martignetti IrAy COMMONWEALTH OF MASSACHUSETTS Barnstable, ss. August 17, 2010 Then personally appeared the above-named 6 reacs-Y More hu known to me to be the person who executed the foregoing instrument and acknowledged the same to r��g°¢y mu fiFree act and deed, befoz•e rne, Jjulie m ,M.c 5 o rso� (Notary;Public.) JULIE M.MASTERSON Notary Public . Commonwealth of Massachusetts My Commission expires April 22,2016 My commission expires: —, 6011v (date) L�tT�R L �1 3 t . 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name information is required for every Osterville MA 02655 8-18-10 . page. Citylrown 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 A. General Information n filling out forms I on the computer, L use only the tab 1. Inspector: <I j key to move your cursor=do not 5 E t' 6 RE��D use the return David J. Burnie _ J key. David J Burnie Management Inc IRV IC—V Company Name 307A commerce park Company Address So Chatham MA ' ' 02659, City/Town State Zip Code 508-945-6111.............1-866-980-1440 S1386 Telephone Number, License Number - B. Certification '- I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of " Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 8-18-10 - pe tor's Si a C/ Date Ca The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system_ owner and copies sent to the buyer, if applicable, and the.approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under " the same or different conditions of use. t5ins•09/08 Title 5 Official Inspection Fond:Subsurface Sewage Disposal System-Page 1 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name information is required for every Osterville MA 02655 8-18-10 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of.Section D. A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: _ Septic tank at normal level, distribution box at normal level and leaching Chamber#1 found with 1 inch standing water and leaching chamber#2 found dry. ' NOTE.. THIS PROPERTY HAS A GARBAGE DISPOSAL AND IT SHOULD BE REMOVED, THE SEPTIC SYSTEM,IS NOT SIZED FOR THE GARBAGE DISPOSAL. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old' or the septic tank(whether metal or not) is structurally ( unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying,septic tank as approved.by the Board of t , Health. I *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): gins-09/08`,. a Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary,Assessments 179 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name information is Osterville MA 02655 8-18-10 required for every. _ page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will } pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): obstruction is ,removed ❑ Y ❑ N ❑ ND (Explain below): ❑ - distribution box is leveled or replaced' ❑ •Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipes)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): C). Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in,order to•determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public_ health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 or 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third ave Property Address ; Gregg Murphy 39 Middle St. Hingham Ma: 02043 Owner Owner's Name : , information is Osterville MA 02655 8-18-10 required for every 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) t determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. - ,` ❑ The'system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and.SAS and the SAS is within 50 feet of a private water ` supply well. The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or 'j. more from a private water supply well**.' t, Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform ' bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: - ,. D) System Failure Criteria Applicable to All Systems: - You must indicate"Yes"or"No"to each of the following for all inspections: Yes ,No - Backup of sewage into facility or system component due to overloaded or El 0 clogged SAS or,cesspool Discharge or ponding of effluent to the surface of the ground or surface waters ❑ ® due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded ❑ ® or clogged SAS or cesspool ® Liquid depth in cesspool is less than 6" below invert or available volume is less El than %day flow t5ins•09108 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 22 Third ave Property Address Gregg Murphy 39 Middle St:Hingham Ma. 02043 Owner Owner's Name information is required for every Osterville MA 02655 8-18-10 page. I Citylrown State Zip Code_ Date of Inspection B. Certification (cont.) c? Yes No q e i E ® Required.pumping more than 4 times in the last year NOT due to clogged or - obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. 'El ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑. Z Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody.must be attached to this form.] ®. The system is a cesspool serving a facility with a design flow of 2000gpd F 10,000gpd. - ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails..The system owner should contact the Board of Health to detemiine 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. q F 1 For large systems, you must indicate either"yes"or"no"to each of the,following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the-system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection ' Area-1WPA)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 E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304-The system owner should contact the appropriate regional office of the Department. t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name, information is required for every Osterville MA 02655 8-18A 0 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 ® 0 ' Pumping information was provided by,the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of ` ® this inspection? { ® Were as built plans of the system obtained and examined?(If they were not❑ '+ available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑' Were all system components, excluding the SAS, located on site? ® ❑ Were the septic.tank manholes uncovered, opened, and the interior of the tank inspected for the'condition of the baffles or tees, material of construction, dimensions;depth of liquid, depth of sludge and depth of scum? ® El 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 jF been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue , approximation of distance is unacceptable)[310 CMR 15.302(5)] „ .D..System Information Residential Flow Conditions: Number of bedrooms(design): 3 Number of bedrooms(actual):... 3 1 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 333.49 gpd i5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 s Commonwealth of Massachusetts Title 5 Official Inspection. Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,. 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name information is Osterville MA 02655 8-18-10 required for every page. ,. City/Town State Zip Code Date of Inspection s D. System Information Description:' 1000 gallon septic tank, distribution box and 2 500 gallon drywells.per plan on file BHD dated revised 9-20-05 Number of current.residents: Seasonal Does residence have a garbage grinder? ® Yes ❑ No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No • Laundry system inspected? ® Yes ❑ No Seasonal use? ®'Yes ❑ No Water meter readings, if available last 2 ears usage yes 9 ( years 9 (9pd))� . Detail: 2009=66gpd.....2008=47gpd Sump pump? - ❑ Yes ® No Last date of occupancy: seasonal Date I Commercial/industrial Flow Conditions: ' Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(9Pd) Basis of design flow(seats/persons/sq.ft., Grease trap present? ❑ Yes ❑ • No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09/O8 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System form-Not for Voluntary Assessments 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham,Ma. 02043 Owner Owner's Name information is Osterville MA 02655 8-18-10 required for every page. City/Town State Zip Code Date of Inspection k D. System Information (cont.) - t Last date of occupancy/use: . Date Other(describe below): - General Information Pumping Records:, Source of information: None per BHD = Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? t, Reason for pumping: Type of System: Septic tank, distribution box, soil absorption system ❑ Single cesspool Overflow cesspool ❑ Privy ❑ - Shared system (yes or no) (if yes;attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach copy of the current operation.and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A systeni by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): k t5ins•09/08 Title 5 Official Inspection form:Subsurface Sewage Disposal System•Page 8 of 17 } r Commonwealth of Massachusetts Title 5 Official Inspection FormF Subsurface Sewage Disposal System Form-Not.for Voluntary Assessments ` 22 Third ave M ' Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name information is Osterville . MA 02655 8-18-10 required for every - page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if.known)and source of information: COC'dated 12-30-05 - ` Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 22" Depth below grade _ feet F Material of-construction: ❑cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: Town Water feet Comments(on condition of joints, venting, evidence of leakage, etc.):, All pipe and connections normal. Septic Tank(locate onsite plan): Depth below grade- feet Material of construction: ® concrete ❑metal ❑ fiberglass ❑ polyethylene ❑other(explain) Tank at normal level r If tank is metal, list.age: : b years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) -. w ❑ Yes ❑. No' Dimensions: y 1000 gal per plan Sludge depth: Est. 0-2" t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name information is Osterville MA 02655 8-18-10 required for every page. CitylTown State ' Zip Code Date of Inspection D.. System Information (cont Septic Tank(cont.) r Distance from top of sludge to bottom of outlet tee or baffle Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Tape + - Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, r - liquid levels as related to outlet invert, evidence of leakage,- etc.): 11, recommend service every 3 years, all looks normal • Grease Trap(locate on site plan):" ' Depth below grader feet. Material of construction: concrete• ❑ metal ❑fiberglass ❑ polyethylene . ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date :Sins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name information is Clsterville MA 02655 8-18-10 required for every page. CityrFown 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): I Depth below grade: _ Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: t - - Capacity: gallons Design Flow: ' - gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.):. *,Attach copy of current pumping contract(required). Is copy attached? ❑, Yes ® No t5ins•09(08. Title 5 Official Inspection.Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third ave Property Address ' Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name information is Osterville MA 02655 . 8-18-10 required for every page. Citylrown State .Zip Code Date of Inspection D. System Information (cont.) ` Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level'above outlet invert Normal level 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.): Normal level, box is clean Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No } Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Y Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Located and viewed with a sewer camera, found dry well# 1 had 1 inch of water drywell#2 was dry. t5ins•09/08 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 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name information is required for every Osterville MA 02655 8-18-10 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Type ❑ leaching pits number: ® leaching chambers number: 2 i ❑ 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.): None 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.09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments M 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name information is required for every Cisterville MA 02655 8-18-10 page. CitylTown 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.): None t , a i5ins-09/08 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 �M 22 Third ave - Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner Owner's Name information is Osterville MA 02655 8-18-10 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 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 f ® drawing attached separately . • IJI1I � s } _. .f " 5ins 09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 TOWN OF BARNSTABLE LOCATION J.1 /h SEWAGE# ;z vr_LAGE e57z%,ef-y/111-e- ASSESSOR'S MAP &LOT 7d INSTALLER'S NAME&PHONE NO.. —0 0119 SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �� s �/ size) . NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLLANCE DATE: 11 3Z6* Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching.Facility Fat 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 i Furnished by it .® R y - 41 r i - • � Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M SVey'�t 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham Ma. 02043 Owner owner's Name information is Osterville MA 02655 8-18-10 required for every _ Ci frown - State Zi Code Date of Inspection tion a e. tY P Pe P9 D. System Information (cont.) Site Exam: T. ® Check Slope ' t ® Surface water { ® Check-cellar . 4 ® Shallow wells ' Estimated deptti to high ground 25'water: 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: 7-22-05 _ Date ❑ Observed site(abutting property/observation hole within150 feet of SAS) ' ® Checked with local Board of Health -explain: Plan dated•7-22-10 • ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: . r see below" t You must describe.how you established the high ground water elevation: Plan'on file shows a test hole dry at 10'. Bottom-of leaching is 6' below grade Usgs Map Cotuit dated 1974 shows the general elevation of this area at elevation 30' Parkers pond elevation is elevation 5' = 25'to estimated Ground water. Grade less 6'to the bottom of the leaching area less an adjustment of 14 3'=Gives an estimated seperation of 16'to high ground water.Well#MIW 29 Zone B level 8.7' adjustment of 3.0'. ' Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third ave Property Address Gregg Murphy 39 Middle St. Hingham Ma.-02043 Owner Owner's Name information is Osteroille MA 02655 8-18-10 required for every page. Cityrrown State Zip Code Date of Inspection E. Report Completeness leteness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary,D(System Failure Criteria Applicable to All Systems)completed + ® System information—Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file f . I 5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third ave M - Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name information is required for every Osterville MA 02655 8-18-10 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 [ I� on the computer, use only the tab 1. Inspector: $EP O :8 REC'D key to move your cursor-do not David J. Burnie use the return key. David J Burnie Management Inc Company Name 307A commerce park Company Address So Chatham MA 02659- Cityrrown _ State Zip Code 508-945-6111.............1-866-980-1440 S1386 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).-The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 8-18-10 ector's Sign %!.✓• Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board - of Health or DEP)within 30 days of completing this inspection.-If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-09/08 - Title 5 Official Inspection Form:Subsurface Sewage Dispo I System-Page 1 of 17 Commonwealth of Massachusetts Title 5 Official- Inspection Form, Subsurface Sewage Disposal.System Form -Not for Voluntary Assessments a 22 Third ave - Property Address *: Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name information is Osterville MA ' 02655 . 8-18-10 required for every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D"o'r E/always complete all of Section D� A) System Passes: ® .I have not found any information which'indicates that any of the failure criteria described in 310 CMR 15.303 or,in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: • 4 .. Septic tank at normal level, distribution box at normal level and leaching Chamber#1 found with 1 inch standing water and leaching chamber#2 found dry. NOTE.- THIS PROPERTY HAS A GARBAGE DISPOSAL AND IT SHOULD BE REMOVED, THE SEPTIC SYSTEM IS NOT SIZED FOR THE GARBAGE DISPOSAL. 13) `System Conditionally Passes: 0 One or more system'components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by ` the`Board of Health, will pass. Check the box for,"yes", "no"or"not determined' (Y, N, ND)for the following statements. If"not - !' determined," please explain. - +; The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally_ unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass ' inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. 4 *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. t ❑ Y [I N -ND (Explain below):- - t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 ._ 1, 1 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third ave - Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name information is Osterville MA 02655 $-18-10 required for every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditional) Passes ((cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): , ❑ n broken pipe(s)are replaced, ❑ .Y ❑ N ❑ ND (Explain below): obstruction is removed; ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ 'N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ElY El. N El -ND (Explain below): I' C) Further Evaluation is Required by the Board of Health: ❑, Conditions exist which require further evaluation by the Board of Health in order to determine if - the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a_ manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within•50 feet of a bordering vegetated wetland or a salt marsh t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 22 Third ave Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name information is required for every Osterville MA 02655 8-18-10 page. City/Town State Zip Code Date of Inspection B. Certification'(cont.) 2. System will fail unless the Board of Health.(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water r supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or t more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other. -ta D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool z W ~' ® Discharge or ponding of effluent to the surface of the ground or surface waters El due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded El ® or clogged SAS or cesspool 4 Liquid depth in cesspool is less than 6" below invert or available volume is less El ® 44 than '/day flow tSins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 22 Third ave Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name information is required for every Osterville MA 02655 8-18-10 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ Z- Any portion of the SAS,cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ , ® . Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd _ 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems,you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system'is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection E] ❑ 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 E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third ave ' Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name information is required for every Osterville ,MA 02655 8-18-10 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 ® ❑ Pumping information was provided b the-owner, occupant, or Board of Health P 9 Y ❑ . ® Were any-of the system components pumped out in the previous two weeks? ®} ❑ _ Has the system received normal flows in the previous two week period. . Have large volumes of water been introduced to the system recently or as part of El Z this inspection? ❑ ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components,excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? Was the facility owner(and occupants if different from owner) provided with ® information on the proper maintenance of subsurface sewage disposal systems? # The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] D. System Information - Residential Flow Conditions: - Number of bedrooms(design):' 3 Number of bedrooms(actual):' 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 333.49 gpd t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third ave L Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name information is required for every Osterville MA 02655 8-18-10 :page. Cityfrown State' Zip Code. Date of Inspection D. System Information Description: 1000 gallon septic tank, distribution box and 2 500 gallon drywells.per plan on file BHD dated revised 9-20-05 Number of current residents: Seasonal Does residence have a garbage grinder? ® Yes ❑ No s Is laundry on a separate sewage'system? [if yes separate-inspection required] ❑. Yes ® No Laundry system inspected? E Yes ❑ No Seasonal use? ® Yes ❑ No .Water meter readings, if,available(last 2 years usage(gpd)): yes r Detail: 2009=66gpd.....2008=47gpd Sump pump? ❑ Yes ® No Last date of occu anc : ` • seasonal P Y Date Commercial/Industrial`Flow Conditions: Type of Establishment:. ,.. - Design flow,(based on-310 CMR 15.203) Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑: No .Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Y Title 5 Official Inspection- Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r 22 Third ave - Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name ' information is required for every . Osterville MA 02655 8-18-10 page. Cityrrown State Zip Code Date of Inspection D. System Information.(cont.) Last date of occupancy/use:; Date Other(describe below): General Information + Pumping Records: - Source of information: None per BHD Was system-pumped as part of the inspection? ❑ Yes ® •No If yes, volume pumped: gallons How was quantity"pumped determined? Reason for pumping:. 4 Type of System: - v ® Septic tank, distribution box, soil absorptio6 system ' ❑ Single cesspool ;, ❑ Overflow cesspool, L ❑ Privy. ` ❑ Shared system (yes or no) (if yes, attach previous inspection records, if a6y) ❑ Innovative/Alternative technology.Attach aycopy of the current operation and ` t maintenance contract(to be obtained from'system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ u Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): F� -.5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17, 3 Commonwealth of Massachusetts Title 5 Official Inspection Form- Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �. 22 Third ave Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name information is required for every Osterville MA 02655' 8-18-10 page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: COC dated 12-30-05 - Were sewage odors detected when arriving at the site? ❑ Yes ® No F Building Sewer(locate on site plan): 2211 Depth below grade: feet Material of construction: ❑cast iron = ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: Town Water .-feet Comments(on condition of joints, venting, evidence of leakage, etc.): All pipe and connections normal: Septic Tank(locate on site plan): 171' Depth below grade: feet Material of construction`` , t ® concrete ❑ metal :.❑fiberglass ❑ polyethylene ❑other(explain) Tank at normal level If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) 0 Yes ❑ No Dimensions: 1000 gal per plan Sludge depth: Est. 0-2" t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 - Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1 22 Third ave Property'Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name information is required for every Osteryille - MA 02655 8-18-10 page. Cityrrown State Zip Code Date of Inspection D. System Information_(cont.) Septic Tank(cont.). Distance from top of sludge to bottom of outlet tee or baffle 30" Scu thickness - 072" m Distance from top of scum to top of outlet tee or baffle 8" Distance from bottom of scum to bottom of outlet tee or baffle • 4 . How were dimensions determined? Tape Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): recommend service every 3 years, all looks normal _ Grease Trap(locate on site'plan): Depth below grade: feet , i Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: y _ Date 5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts ` Title 5 Official Inspection Form, Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 22 Third ave Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name information is required for every Osterville MA 02655 8-18-10 page. Cityrrown 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: " El concrete ❑ metal El fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: • gallons per day ` Alarm present: ET Yes ❑ No 1 - i 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 15ins•09108 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 22 Third ave Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name information is Osterville MA 02655 , 8-18-10 required for every page. Cityfrown State Zip Code Date of Inspection D. System.Information (cont.) Distribution Box(if present must be opened).(locate on site plan): Depth of liquid level above outlet invert Normal level ' 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.): Normal level, box is clean Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: _ - Located and viewed with a sewer camera, found dry well# 1 had 1 inch of water drywell#2 was dry. t5ins-09106 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 M ' 22 Third ave Property Address Gregg Murphy 39 Nibble St: Hingham Ma.`02043 Owner Owner's Name information is required for every Osterville MA 02655 8-18-10 page. CityrFown } State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers n r.umbe 2 ❑ Teaching galleries - number:- leaching trenches number, length: ❑ leaching fields number, dimensions: t ❑ overflow cesspool number: r ❑ 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.): ` None 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 El Yes ❑ No t5ins•09/08 h Title 5 Official Inspection Form:Subsurface Sewage Disposal System°Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments - 22 Third ave Property Address Gregg Murphy.39 Nibble St. Hingham Ma. 02043 Owner Owner's Name , information is required for every Osterville MA 02655 8-18-10 page. Cityfrown 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.): •1 . - - , is - :. Privy(locate on site plan): - Materials of construction: Dimensions r •Depth of solids y Comments(note condition;of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): R None • � .. ' _ _ - ` •sue t5ins•09/08 Title 5 Official Inspection Forth: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 . �M 22 Third ave Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name « information is required for every Osterville MA 02655 8-18-10 page. Citylrown State Zip Code Date of Inspection D. System Information(cont.) 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 '1 rf r e 1 .t5ins-09108, Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 r - TOWN OF BARNSTABLE r LOCATION SEWAGE#8-5--ir4;Z Vr-LAGE j!!7Jf7-�er'Y/rl/4e- ASSESSOR'S MAP &LOT 7d INSTALLER'S NAME 8t PHONE NO. gv- �vp- . erL 'S� -e Ir, o 1 t SEPTIC TANK CAPACITY r r LEACHING FACILITY: (type) "S'D® ,��. !v size) /` , X &,x . � i NO.OF BEDROOMS BUILDER OR OWNER �` 1 PERMIT DA I E, COMPLIANCE DATE: Separation Distance Between the: •. Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility.) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by 4 IS ( tk VN E Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 22 Third ave M - Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owner's Name ' information is r required for every Osterville MA 02655 8-18-10 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: 3 ® Check Slope F f , ® Surface water. ® Check cellar ® Shallow wells Estimated depth to high ground water: 25 " feet 3 Please indicate all methods used to determine the high ground water elevation: i ® .Obtained from system design plans on record If checked, date of design plan reviewed: Date 5 - Date >.. ,. ❑ Observed site(abutting property/observation hole within 150 feet of SAS) t ® Checked with local Board of Health -explain: ` -Plan dated 7-22-10 ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: see below. f You must describe.how you established the high ground water elevation Plan on file shows a test hole dry at 10'. Bottom of leaching is 6' below grade Usgs Map Cotuit dated 1974 shows the general elevation of this area at elevation 30' Parkers pond elevation is elevation 5' _ 25'to estimated Ground water. Grade less 6'to the bottom of the leaching area less an adjustment of 3'= Gives an estimated seperation of 16'to high ground water.Well#MIW 29 Zone B level 8.7' adjustment of 3.0' Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins-09/08 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments �M Syey',a 22 Third ave Property Address Gregg Murphy 39 Nibble St. Hingham Ma. 02043 Owner Owners Name information is required for every Osterville MA 02655 8-18-10 page. Cityfrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, B, C, D, or E checked ® Inspection Summary D (System Failure Criteria Applicable to All Systems)completed ® System Information— Estimated depth to high groundwater ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t_ } it t5ins•b9im Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 TOWN OF BARNSTABLE LOCr PION //t ii-�Aee"e- SEWAGE Vr,LAGE OfT,ed'1//, d- ASSESSOR'S MAP & LOT -7® INSTALLER'S NAME&PHONE NO. 1,�� y� ��.� S��o'� "e . SEPTIC TANK CAPACITY LEACHING FACILITY: (type) " size) 11i.IC X A,s°X 2 NO.OF BEDROOMS BUILDER OR OWNER 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) . Feet Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feet of leaching facility) Feet Furnished by �i_cG,�1 Ti fy d 3 ul fir 114 r No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Application for &!6pool *p!6tem con!truction Permit Application for a Permit to Construct( . )Repair( Upgrade( )Abandon( ) O Complete System �ndividual Components Location Address or Lot No. ZZ(�,�.( Owner's Name,Address and Tel.No. Assessor's Map/Parcel PP^^ �2�j � AVEmzf n f I Installer's Name,Address,and Tel.No. esigner's Name Address and Tel.No. ,„�d.n Z. Q Vllrv�+ � 1M�4 X3 Type of Building: Dwelling No.of Bedrooms 3-� Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafetena( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 3© gallons. Plan Date Number of sheet 2. Revision Date Title w1me IV Size of Septic Tank off)0PI Type of S.A.S. a �n Descri tion of Soil SAW 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 Envi o mental Code Sfto place the system in operation until a Certifi- cate of Compliance has been issue( his Board of lth. Signed Date Application Approved by Date f Application Disapproved for the followi g r s Permit No. Z 00 4�0 Date Issued �'�- r tq vt a`$ fi Yw Ij}� c Qmw41_j,4 No a. Fee r, THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE MASSACHUSETTS es 2pplication. for',nigoml *pgtem Cun5truction Vermit Application for a Permit to Construct( . )Repair( Upgrade( )Abandon( ) rO Complete System Individual Components Location Address or Lot No. 22,-W Owner's Name,Address and Tel.No. z2�� V Assessor's Map/Parcel — AVE,AVE () '� Vr6/ s- t lnstaller�_ e,Address,and Tel.No. esi ner's Name Addr ss and Tel.No.'�I�`,,,n 11�V G y f p ' r to Lc s /e�y/ �l' I�Y�10vr�-� 1�JA 023 Type of Building: Dwelling No.of Bedrooms 3 Lot Size DOV sq.ft. Garbage Grinder JI� Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 33� gallons per day. Calculated daily flow 3� gallons. Plan Date 4 S Number of 2 Revision Date Title �� lh he p PLAN ' Size of Septic Tank 1000 GPL., Type of S.A.S. 500&At" HAP S Descri tion of Soil �~ Q �y-�.� SAW ►n/h Z WIA1 LNG H . N ture oII Repair or Alterations nswer when a- ,licable ' Date last inspected: , Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issue Eby his Board of lth. Signed_. � Date Application Approved by Date l Z Application Disapproved for'the followig,�easg s <" 4 4 — Permit NO. —�d Q —_ —_———_— ——Date Issued _ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS ' Certificate of (Compliance THIS IS TO CER F that the On-site Sewage Disposal System Constructed( Repaired( )Upgraded( ) Abandoned( )by (1")bk r at C�l v� 1 y r "AE_ has been constructed in accordance with the provisions .itle 5 and the for Disposal System Construction Permit No. ��S 5S7 dated Installer Designer. The issuance of this /eAsall not be construed as a guarantee that t�h system ih f ni a designed.Date l/-� Inspecto'r-- 1 �'"'"�'"'� No.C_ o� s- 507 Fee / 50 THE-COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Miopo!5al mpg m Construction Permit Permission is hereby granted to Construct Repair( )Upg ade( )Abandon( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must b completed within three years of the Ca4 of this it. Date:_ 1"� C Approved by 05/01/07 TUE 14�'55 FAX 5084327057 2002 Ar-R-30-2007 02 :57 PM Pesce tra9 i nee r; r7 , - - - 4Town of Barnstable Regulatory Services Q' Thomas F.Geiler,Director R 4 Public Health Division 6"9 Thomas McKean,Director 200 Main Street,Hyannis, MA 02601 Office- 508-862-4644 Fax: 508490-6304 Installer & Designer Certification Form Date: Sewage Permit# 005- �67 Assessor's MapkParcel PA� � ere , Installer: Design n� Address: Address. p�7/!/� On 6a5 was issued a permit to install a 1a1 �� -�-- (date) (installer) septic system at Z� based on a design drawn by ��-�pa 'dres�) pesi .��.�� dated _.),. � pml_5_� er) I certify that the septic system referenced above was installed substantially according co the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. 1 certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the than system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. H OF M4 �c6 EDW L. PECESCE a � m (Installer's Signature) v CIVIL CANo.32001 �17,� FQisTEP \ate �S10NAL EaG\ ( esigner's .lgnature (Ax Designer's Stamp Here) PLCASE RETURN TO BARNSTA.BLE PUBLIC, HEALTH DIVISION. C, TIFICATE OF COMPLIANCE WILL NOT BE ISS 1 D U L BOT T S FORM D AS-BUll..7' CARD ARE RECEIVED BY HE BARNSTABLE PUBLIC HEAJTH DIVISIO IAN YO . \` Q;Health/Septic/Designer Certification Form 3-26-04.doc OFtHE tti DATE: FEE: +'* BAMSfABLE, MASS. REC. BY Town of Barnstable SCHED. DATE: 4 .Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Susan 0.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORM { := LOCATION ' Property Address: 02, A Assessor's Map and Parcel Number: 0 Size of Lot:_ , /M t =' Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name N i f"r i APPLICANT'S NAME:-4 L ' DG — - q24 - Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: Name: W. �• �. Address: 09 FFJAddress: Phone: Phone mL `qW(, yftrNA Ce3(, VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) 31b QAw s i< CRIES s NATURE OF WORK: House Addition X00000 House Renovation ❑ Repair of Failed Septic System ❑ Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic systempians) Four(4)copies of labeled dimensional floor plans'iubmitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) = Variance request application fee collected (no fee for lifeguard modification renewals, .grease trap variance renewals [same owner/leasee only], outside dining variance renewals [same owner/leasee only], and variances to repair famed sewage disposal systems [only if no expansion to the building proposed]) . J_L Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne A.Miller,M.D.Chairman NOT APPROVED Sumner Kaufman,M.S.P.R REASON FOR DISAPPROVAL Susan 0.Rask,R.S. Q:\HMTMApplication Forms\VARIREQ.Doc frJjc.tt`' r'Y Town of Barnstable yp4•�xET c� RegAatory Services 1110mu F.Genera Director Bwllfflag Division ' '°rs0 TomTerrys Building Commissioner 200 Vaia Street, $ya=ias MA 02601 ' �w,to�rnbarnstable;mans , ax: 508-790-6230 ' pffice: SOS-862-4038 Prope1ty Owner Must Complete a:ad Sign T s Section If Using A Builder • as Owner of the subject property to-act on mpbeha) . �hereby authorize.' . r *yters relative to work authorized bri,i *bui&z perrnk application for. in all u� ' (9�.Third v. 11 Address of ob) ,'�� a� Date Signature of Owner Print Name a �ZIHil p� DATE: 4-26-05 � &t - (y C MP 0" ;`� 1 BARNS��BLE FEE: b Js + BARNSrABLE, v�prl6;q� APR PM 3. REC. BY SOMA a Town n of Bar nstab�� SCHED. DATE:5JM46 Board offWeht -- 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Wayne A.Miller,M.D. VARIANCE REQUEST FORM LOCATION 22 Third Avenue, Osterville, Mass. Property Address: Assessor's Map and Parcel Number: 1 1 6/0 7 0 Size of Lot: 4, 006 s q. f t Wetlands Within 300 Ft. Yes Business Name: No �— Subdivision Name: Olde Cape APPLICANT'S NAME: Building Co. , Inc. Phone 508 428-3200 Did the owner of the property authorize you to represent him or her? Yes X No PROPERTY OWNER'S NAME CONTACT PERSON Name: David Hubbell Name: Jesse Caprio/OCBC PO Box 24 333 Service Road Address: Osterville MA 02655 Address:S andwi ch MA 02563 Phone: 617 242-0137 Phone: 508 428-3200 VARIANCE FROM REGULATION(List Reg.), REASON FOR VARIANCE(May attach if more ace needed) 2 x addition with craw space 310 CMR 15. 211 -Minimum needed to get mechanical, equipment setback distances to new addition. New addition to fall within 20 ' setback to leaching field & 1W setback of septic tank. NATURE OF WORK: House Addition JPC0000 House Renovation ❑ Repair of Failed Septic System ❑ Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. _ Four(4)copies of the completed variance request form _ Four(4)copies of engineered plan submitted(e.g.septic system plans) _ Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent him/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) _ Full menu submitted(for grease trap variance requests only) Y Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee only], outside dining variance renewals [same owner/leasee only], and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) _ Variance request submitted at least 15 days prior to meeting date , VARIANCE APPROVED M,4, Wayne A Miller,M.D.Chairman NOT APPROVED Sikh Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL Susan G.Rask,R.S. Q:\HEALTH\Application Forms\VARIREQ.DOC . W r �,y�_ �y cSP _�z, ✓i1 �-- i �_ �� Agostinelli, Joan From: McKean,Thomas Sent: Monday, July 25, 2005 11:48 AM To: Agostinelli, Joan Subject: RE: 22 Third Avenue Thanks Joan- you are absolutely correct. He will have to be charged for copies in the future. Yes, there is a variance fee of $85.000 because this is a new request. The other variance request was officially withdrawn by the applicant. Futher, it involved a different type of variance request. -----Original Message----- From: Agostinelli, Joan Sent: Friday, July 22, 2005 1:58 PM To: McKean, Thomas Subject: 22 Third Avenue Tom: Ed Pesce was here this morning, Friday, July 22nd. I gave him variance request forms. I gave him the associated file and the plans that we had. I worked with him for about 25 minutes. He then proceeded to go to the copier by Lois Lomba and make his copies for the BOH. When he returned I asked him for the cost of the copies and he was surprised there was a cost. iY Lois Lcmba observed him at the Consumer Affairs copier but thought we had directed %,him there and would take the cost of his copies. In other words, he has been making any copies he needs at that copier and has been observed by Lois doing so. I told her I took the cost this time but was not involved other times. I did. let him know in the future there is a cost for any copies since the town leases the copiers, buys the paper and the toner which is expensive. We would have to be fair to all the tax payers to recapture any costs incurred by a business. This conversation was observed by Tom Geiler who may or may not have heard the entire conversation. Pesce gave me the impression he understood and agreed. Question: V, Pesce wanted to know if there was an additional $85.00 variance charge since there was ,R another variance taken out on 4/26/2005 which was paid. I was not certain. Thanks Joan 1 I oFtHE Town of Barnstable Board of Health BARNSfABLE, P.O.Box 534,Hyannis MA 02601 9 MASS. g i639• ATED�,i p Agreement to Extend Time Limit for Acting Upon a Variance Request In the Matter of a variance r quest form receiveedd on the Petitioner(s), �c� -77 regarding the property at 2 2A ' �S�?Y✓1ltU , the petitioner(s) and the Board of Health agree that the Board of Health has until tA119- 1 Y zon (insert date)to act upon the Petitioners'completed application for a variance. In executing this Agreement, the Petitioner(s) hereto specifically waive any claim for a constructive grant of relief based upon time limits applicable prior to the execution of this Agreement. Petitioner(s): Board of Health: r-- i L Signature: Signature: Petitioner(s r titioner's Repr entative Chairman Print: 1r a Print: Susan G. Rask, R.S. Date: 2000 Date: 2000 Address of Petitioner(s)or Petitioner's Representative Town of Barnstable Board of Health MIA- a� -Town Hall Public Health Division Office 367 Main Street, Hyannis, MA 02601 Phone(508)862-4644 Fax(508)790-6304 N' file q:extend.doc t(f • Town of Barnstable "o RegAatory Services ' �- �,, Thomas F.Geilex,Director she $ .. 9� f k�� Building DiYlSion . 6D hM'� TomPerrq, Building Commissioner 200 Main Streat, 35yannis,NSA 02601 www.town•barustable;ma,us Fax; 508-790-6230 Office: 508.862-4038 Property owner Dust Complete and Sign Thi's Section if Using ABuilder as Owner of the subject property -i t .Q,. to•act ors nl7beh dt `hereby authorize - f' tters relative to work authorized by this building perrrnt application for; ul all ma C9�Th►rc1er�� . : Address of ob) Signature of Owner Date Print Nama L� •BUILDING CO.- @Xke INC. Cape Cod * Massachusetts 333 Service Road * Sandwich,MA 02563 Phone: 508-428-3200. * Fax: 508-420-7327 www.oldecapebuilders.com April 26,2005 Board of Health Town of Barnstable 200 Main Street Hyannis, Mass. 02601 22 Third Avenue, Osterville Immediate Abuttors List Mr. &Mrs. John C. Brisby 23 Glenwood Road Upper Saddle River NJ 07458 Mr. Dennis J. Beckingham 192 Commonwealth Avenue Boston MA 02118 Mr. &Mrs. Paul B. Kelly 32 Third Avenue Osterville MA 02655 Osterville Holdings L.L.C. 27 Third Avenue Osterville MA 02655 TOWN OF BARNSTABLE ►�7{ /� c LOCATION SEWAGE # "1� ` d VULAGE_ 0 S / ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) -•',�-�� (size) NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: S7 COMPLIANCE DATE:_F Separatioi Distance Between the: , Maximum Adjusted Groundwater Table to the Bottom of Leachi acility Feet Private Water Supply Well and Leaching Facility (If an ells exist on site or within 200 feet of leaching facility).Zands Ftet any Edge of Wetland and Leaching Facility(If wxist within 300 feet of leaching facility) :Feet Furnished by TOWN OF BARNSTABLE LGCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT II-ISTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) NO. OF BEDROOMS BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separa0on 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 Aw 05 l.a� Lo (zb TOWN OF BARNSTABLE Lido LOCATION 2.1 ;N/CC/ A 4"00' SEWAGE # VILLAGE 0 6 7 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) �"��!'"��' (size) NO.OF BEDROOMS --- BUILDER OR OWNER. PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaoi.10acility Feet Private Water Supply Well and Leaching Facility (If an ells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility.(If any w ands exist within 300 feet of leaching facility) Feet Furnished by I , No. "� � � l � _ v� Fee $5 0 THIE COII&ONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS Application for �Di5pogar 6petem Construction Permit Application for a Permit to Construct( )Repair(X)Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 22 Third. Ave . , Osterville M. Rogers Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service PO Box 1089,Centerville , MA Type of Building: I Dwelling No.of Bedrooms 2 Lot Size 1 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated d ily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank u0 v Type of S.A.S. Description of Soil and. Nature of Repairs or Alterations(Answer when applicable) new Title-5 leach system, D-box and. 2 leach chambers . Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by thi o of Health Signeenzijl o' Date ' Application Approved by Date Application Disapproved for the following rea6X f-I%-- , Permit No. Date Issued 00 6 t./ -� Fee $50 TFOL01#10ONWEALTH OF MASSACHUSETTS " ` Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS r 0(pplitation for �Bigaaf *pgtem, don5truction Permit Application for a Permit to Construct( )Repair(X )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. 22 Third Ave. , Osterville M. Rogers Assessor's Map/Parcel `+ Instali's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Wm. E. Robinson Septic Service PO Box 1089,Centerville, MA Type of Building: Dwelling No.of Bedrooms 2 Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures i. - ., Design Flow gallons per day. Calculated�d ily flow gallons. •ti, Plan Date Number of sheets .Revision Date + Title _,,..Size of Septic Tank • (boo t - Type of S.A.S. Description of Soil -and. ' N ^Nature of Repairs or Alterations(Answer when applicable) new Title-5 leach system, D-box and. 2 leach chambers. j Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi cate of Compliance has been issued by thiso of Health �?- Signe i i o' Date O Application Approved by Date Application Disapproved for the following rea o s kza Permit No. ' ,' Date Issued i THE COMMONWEALTH OF MASSACHUSETTS Rogers BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTrIFY, that'the On-site Sewage Disposal System Constructed( )Repaired( X)Upgraded( ) Abandone b W`='i . Robinson Septic Service at hira.Ave. , Osterville, WIA hag beenconstructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ated t Installer Wm, E, Robinson S r. Designer A 1AA 0 The issuance of this permits 11 n e onstrued as a guarantee that the syst'mdncr�yion des ed. G Date Inspector I f l — --------------------=-------- No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS s Rogers lwtowal *pgtem Construction Permit Permission is hereby granted to Construct( )Repair(X )Upgrade( )Abandon( ) System located at 22 Third Ave. , Osterville, MA ' and as described in the above Application for Disposal System Construction Permit. The applicant recognizes hiAer duty to comply with Title 5 and the following local provisions,or special conditions. Provided:Construction m st be co e _ within three years of the date o th�s pe t Date: Approved by +� 1/6/99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. f CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, William E . Rob ins on,SIhereby certify that the application for disposal works construction permit signed by me dated ,]�v Q , concerning the property located at 22 Third. Ave . , Osterville , MA meets all of the following criteria: • led system is connected to a residential dwelling only. There are no commercial or business /;�� s associated with the dwelling. • e soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch. • ere are no wetlands within 100 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system ere is no increase in flow and/or change in use proposed There are no variances requested or needed. • The bottom of the proposed leaching facility will not be located less than five feet above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the Frimptor method when applicable] • If the S.A.S.will be located with 250 feet of any vegetated wetlands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the maximum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface Elevation(using GIS information) B) G.W.Elevation +the MAX.High G.W. Adjustment. _ DIFFERENCE BETWEEN A and B i Q SIGNED.SIGNED .4 ti DATE: '�� [Sketch proposed plan of system on back]. q:health folder:cen _ �; :� i I a r r i i f I j� � �, ti ..�- t . ; �� ' ', TOWN OF BARNSTABLE q ` LOCATION Z. !N/Kc� SEWAGE # VII.LAGE_ O ( ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE N0.1L��iic-dd:.. 'J,?.VI= '7 SEPTIC TANK CAPACITY /(G� LEACHING FACILITY: (type) ��-rj i-{ (size) NO.OF BEDROOMS �-- BUILDER OR OWNER re•� PERM ITDATE: COMPLIANCE DATE: ��-- i c1 Separation.Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leachi acility Feet Private Water.Supply Well and Leaching Facility (If an ells exist on site or within 200 feet of leaching facility)._ Feet Edge of Wetland and Leaching Facility(If any w•, ands exist within 300 feet of leaching facility) Feet Furnished by eit h� i TOWN OF BARNSTABLE q LOCATION-2 —. SEWAGE # VII.LAGE a cS ! ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. 0 �= � SEPTIC TANK CAPACITY LEACHING FACILrTY: —= G - (type) �- 11 � (size) NO. OF BEDROOMS �-- BUILDER OR OWNER rhea PERMITDATE: !7 COMPLIANCE DATE: Separation.Distance Between the: Maximum Adjusted Groundwiter Table to the Bottom of Leachi acility Feet Private Water Supply Well and Leaching Facility (If an ells exist on site or within 200 feet of leaching facility)... Feet Edge of Wetland and Leaching Facility(If any w ands exist within 300 feet of leaching facility) Feet Furnished by f � . CN � w: P7�-e� Town of Barnstable VAMSUS, Board of Health 200 Main Street, Hyannis MA 02601 4 Office: 508-862-4644 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,MSPH Rayne Miller,M.D. October 17, 2005 Mr. Edward Pesce, P.E., R.L.S. 451 Raymond Road Plymouth, MA 02360 RE� 22�ThirdAeriueOse4ulfe; zAs essorsN Map116parce107Q Dear Mr. Pesce, You are granted permission, on behalf of your client, David Hubbell, to construct a replacement soil absorption system at 122 Third Avenue, Osterville. The revised engineering plans dated September 20, 2005 do not require variances from any local and State sewage regulations. This permission is granted because the applicant demonstrated that there are no variances required. Also, there will be no increases to the current wastewater discharge flow at this site as the proposed renovation will result in three bedrooms total. The septic system is not located within a nitrogen sensitive area, it is not located in close proximity wetlands, and it is not located close to the groundwater table. Therefore, permission is granted to replace the soil absorption system as proposed. Sin r ly, tanePfiller M.D., hn PesceMacnamara2005 I III 1 PESCE ENGINEERING AND ASS /ATES 451 Raymond Road SEP 3 0 Plymouth, MA 02360 2005 Phone/Fax 508-743-9206 TOVv!. epesce@adelphia.net HEAL i H tp l. September 30, 2005 Mr. Thomas A. McKean, R.S., C.H.O. Director, Town of Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Subject: Submission of Revised Plans, Request for Board of Health Hearing 22 Third Avenue, Osterville Dear Tom, Please find attached the following revised plans pertaining to 22 Third Ave, Osterville: 1. Revised Architectural Floor Plans—showing 3 existing bedrooms 2. Revised Septic System Design drawings—showing the existing P Y 9 9 9 9 leaching system relocated (3 bedroom system with no variances required for this design). Since this issue has previously been before the Board (6 Sept 05) regarding a two bedroom system, we wish to request that this matter be placed on the next Board of Health Hearing agenda for October 11. 2005. This will allow us to explain to the Board our position that the original structure was, and has always been, a 3-bedroom dwelling. Thank you for your help on this project, and as always, please call if you have any questions. Sincerely, Edward L.2es P. Attachments cc: David Hubble J 1 1 C A Q � s J Q - �,. ', . NUMBER THE.COMMONVVEALTH O'F MA�SACHUSETTS j ::��:: - FEE � a 37 THE TOWN OF BARNSTABLE $75.00 BOARD OF HEALTH This,is to Certify that Carlton Hendricks ° 185 Route 130, Mashpee, MA 02649 1S HEREBY GRANTED A"DISPOSAL WORKS INSTALLER"S PERMIT TO i CONSTRUCT, ALTER,INSTALL or REPAIR Individual Sewage Disposal Systems u - _ ,This permit is granted in-conformity with the State Environmental Code Title V, Regulation 2.2, :and expires December,31, 2005 unlesssooner suspended or.'revoked:rrr p ' ' Wayne A.�Miller M:D. Chairman s r .:aJanuary�1; t -2005 '� , • � 47 , _ Susan G..;Rask„ R.S. r ....>,, v» .4_ As� �.. �Sunlner KaufmaCl y �Yl f Agent: Thomas A. McKean, R.S., CHO Property Location: 22 THIRD AVE OST MAP ID: 116/070/// le 11 Print Date:O�/12/200 3:12 Vision ID:'O 44 Other ID: Bldg#: I Card I of 'A L ROi+ ERS,LEO J&EMILY B Description Code Appraised Value Assessed Value RES LAND 1010 57,200 57,200 22 THIRD AVE —RESIDNTL 1010 37,200 37,200 OSTERVILLE,MA 02655 RESIDNTL 1010 1,300 1,300 Barnstafle 1998,#A TS(YPPLEMMEN MAL', N- Account# 56478 Plan Ref. Tax Dist. 300 Land Ct# Per.Prop. #SR Life Estate 9DLI Notes: VISION #DL2 . CIS ID: Total l 95,7001 9517001 U OWN j As 0 ROGERS,LEO J&EMILY B 1139/391 Q Yr. I Code I Assessed Value Yr. ICode Assessed Value Yr. I Code Assessed Value Total: 80,800 Total: 80,800F Total:1 80,80011 THERASSEUME).-VTS-' This signature acknowledges a visit by a Data Collector or Assessor Year TypelDescription Amount Code Description Number Amount Comm.Int. 37,2001 Appraised Bldg.Value(Card) Appraised XF(B)Value(Bldg) 0 i Appraised OB(L)Value(Bldg) 1,300 1 F- Total: Appraised Land Value(Bldg) 57200 2, Special Land Value Total Appraised Card Value 95,7001 Total Appraised Parcel Value 95,7001 Valuation Method: Cost/Market Valuation! et Total Appraised Parcel Value 95,700'i 1/w �OAID ""n ��.UILDIN 'IFEr. Permit ID Issue Date Tvpe Description Amount Insp.Date %coinp. Date Comp. Comments Date ID Cd PurposelResidt 5 JNEVA ',5EQ.' "j,L L TIOIV,� P)N�'.� • I B# Use Code Description Zone D Fronta e--QeVh Units Unit Price L Factor S.I. C.Factor N13hd. Adj. Notes-Ad'/Special Pricing Adi. Unit Price Land Vahie 1 1010 Single Fam RC 3 0.09 AC 489,000.00 1.00 5 1.00 27BC 1.30 SPCL(-09,1 J I O)Notes: 10 1 BLD 635,700.00 57,200 Total Card Land Ut.dis 0.09 AC Parcel Total Land Area:L—t- 0.09 AC' Total Land V.1uq'j Property Location: 22 THIRD AVE OST MAP ID: 116/070/// Vision ID:6fY44 Other ID: Bldg#: I Card I of- 1 Print Date: 09/12/2005 13 CONSTRUCTION DETAIL SKETCH........... ............... Clement Cd. Ch. Description Commercial Data Elements Style/� ty I e-/Type 04 Cape Cod Element Cd. Ch. Description Model I I Residential Heat&AC —--I ! I 11S[572] C_ Frame Type E6 Grade C_ Baths/Plumbin- Stories1.5 1 1/2 Stories ...................... .... ................... ................ (Occupancy Ceiling/Wall Rooms/Prtns Exterior Wail 1 14 Wood Shingle %Common Wall FEP Roof StrUCtUr e 2 all Height BAS 22 03 able/Hip 2 4 Roof Cover 03 Asph/F GIs/Cmp UBM 7 7 Interior Wall 1 08 Typical 2 Element Code Description lFactor 4 lInterior Floor t 20 Typical Complex 2 Floor Adj Unit Location 26 26 Heating,Fuel 03 Gas N Heating.Type 109 Typical umber of Units AC Type 01 None Number of Levels %Ownership �Bedrooms 03 3 Bedrooms Bathrooms I I Bathroom 4LU V AT 10 1 Full Un adj Base Rate 48.00 22 Total Rooms 5 Rooms AS 20 Size Adj.Factor 1.18273 'Lth Type Grade(Q)Index 0.89 8 E lKitchen Style Adj.Base Rate 50.53 20 Bldg.Value New 64,224 Year Built 1940 Eff.Year Built 1955 Nrml Physcl Dep 42 uncnl Obsinc 0 Econ Obsinc 0 MIXEDfLSE,' cripLion Per pec.Cond.Code 1010 ingle Fam 100 Specl Cond% 58 Overall%Cond. Deprec.Bldg Value 37,200 _B EA OXOUTBUILDING YARD ITEMS IXF U1LD1NGXXTkA,F Code Description LIB Units Unit Price Yr. Dp Rt %Cnd Apr. Value FF—d—R2 Garage-Avg L 220 20.00 1910 1 100 1,300 -BUILDING SUB-AREA SUMMARY SECTION: Code Description Livini�Areq Gross Area f Area Unit Cost Undeprec. Value 13AS First Floor 732 732 732 50-53 36,988 F ringle Farr FEP Porch,Enclosed,Finished 0 36 25 35.09 1,263 ITHS Half Story,Finished 400 572 400 35.34 20,212 UBM Basement,Unfinished 0 572 114 10.07 5,760 Tff Gross LivILease fl rea 1,132 _11,27&61 Jun 13 05 11 , 03a Olde Cape Building Co Inc 5084207327 p. l w ffiW ULU %P6 'BUILDING GO.- N-10 ANC_ CAPE COD * MASSACHUSETTS FACSIMILE TRANSMITTAL SHEET TO: FROM: Tom—c/o Sharon Karen Loura COMPANY: DATE" Barnstable Board of Health June 13,2005 FAX NUMBER: TOTAL.NO.Or PAGES INCLUDING COVF,R: 508 790-6304 2 PHONE NUMBPA: SENDER'S REFERENCE.NUMBER: 508 862-4644 RU: YOUR REFERENCE NUMBER: Hubbell 22 Third Avenue,Osterville ❑ URGEN-[' ❑FOR UXIEW ❑PLEASE COMMENT ❑ PLEASE REPLY ❑ P1.):AS[: RECYCLE? NOTES/COMMENTS: i Hi Tom, This is to respectfully withdraw our application for variance from Title V from the Board of Health Meeting Agenda on behalf of the above referenced customer. Thank you. LO w o X •• Cd9 m m 333 SERVICE ROAD * SAINDWICH * MA " 02563 PHONE: 508-428-3200 FAX: 508-420-7327 s WWW.OLDECAPEBUILDERS.COM �t K r` . a god . Ll oCQTION ' SEW&(C E PERMIT MO. 'VILLAGE. C6�T--EFULL�.t - - - - INS-TNLLER 5 ►J&ME. 6 ADDRESS BUILDER 5 Q &MF- ADDRESS DIJ,TE PERMIT ISSUED - - - - - - - D ATE COMPLI &J 4CE ISSUED: - - - pT% , r L 7 �... s No.. 1..... '. FRic. -. ........ THE COMMONWEALTH OF MASSACHUSETTS BOARD RF HEALTH ..............OF....... ...................... App iratiun -fur Bhipaaal Hlorkii Tutw4rur#ion Vrrnift Application is hereby made for a Permit to Construct ( ) or Repair (,6-j"an Individual Sewage Disposal System at: ................... Z.14 i te ................... Location,Addr s or Lot •o ................... .................. - -- ---------------------------------- W L _ u p Owne Addre Installer Address Uype of Building Size Lot............................Sq. feet Dwelling-No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther Other—Type of Building ............................ No. of persons............._.....___...... Showers ( ) — Cafeteria fixtures --•-----------------------------------------------•-•-------....-•-••-... W Design Flow............................................gallons per person per day. Total daily flow--------------------------------------------gallons. USeptic Tank—Liquid capacity_._....__.gallons Length................ Width................ Diameter................ Depth.__.-_-._-.----- xDisposal Trench—No..................... Width-------------------- Total Length..................... Total leaching area-------------.------sq. ft. Seepage Pit No..................... Diameter__-_.____-__-_-_---_ Depth below inlet__-____________-__-. Total leaching area------- ..........sq. ft. X Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by-------------------------------------------------------------------------- Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ f� Test Pit No. 2---------_------minutes per inch Depth of Test Pit.................... Depth to ground water-------------------- ---------------------------------------------- ........................................................-........../--------------------•----•------------------------------------ O Description of Soil--1_".-ST-_J- ---------jO'_-_1_. -IPJ _- --- VW ----•----------- ---------------------------------------------•---------•-••------•-------------------------W.. ---....---+----------------------• L--•-- ----•------I�� --- Nature of Repairs or Alterations-Answer when applicable._._ �?. J....______ --- ------ ------------------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitar Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has ee i ue�bby he boof - � l ign -- ---------------------- .3 � ..... .... Date Application Approved By-:--------- ... ............................ Date Application Disapproved for the following reasons:................................................................................................................. --•-•....................••-----•---------•--•------...-------•----------------------•-•-•-•--••----•---•...---•----......................--•-•-•--••-----------•---••----.....-------------------------- `�Date PermitNo......................................................... Issued.................................................• ___ Date THE COMMONWEALTH OF MASSACHUSETTS _ BOARD OF HEALTH . ... --- .OF.......1 ��.+` f r '/ -----------------_--- r pplirtt#ion -for 4:30paottl Works Tomitrur#ion Vrroti# Application is hereby made for a Permit to Construct ( ) or Repair (✓)man Individual Sewage Disposal System at � . 2.11C. 1.11I.Cf71�/_�C ------------------- ----..... ................... .....................................................----••-•--••--••-•-----------•---•--•-'- Location-AddrI s / or Lot No. s n.................................. n-.. .... .----••-------•---•............... / a Owner�l Addre / Installer Addressr' Q Type of Building Size Lot----------------------------Sq. feet U Dwelling—No. of Bedrooms----3---------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other=Type of Building ............................ No. of persons......L................... Showers ( ) — Cafeteria ( ) a' Other fixtures W Design Flow.................:..........................gallons per person,per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity------------gallons Length---------------- Width................ Diameter................ Depth................ _ x Disposal Trench—No- -------------------- Width-------------------- Total Length-------------------- Total leaching area--------------------sq. ft. Seepage Pit No--------------------- Diameter.................... Depth below inlet____-___•______.-._- Total leaching area-..-.--_---_-___-sq. ft. z Other Distribution box ( ) Dosing'tank ( ) aPercolation Test Results Performed by....---------------------------------------------------------------------- Date-•--•---------------------------------- Test Pit No. 1----------------minutes per inch Depth of "Pest Pit-------------------- Depth to ground water...---.__.--.--._-.-_._. rXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water---. ---._-__--.--_--._. W -� -- -- ----- ---- ------------------- Y, •-•- - O Description of Soil_J_'__M-1----' M .........''.. ....r,_ '/ 1 ----------------- ----------- U -----------------------------------------------------------------------------------------------------------------------------------------•.---.---------- ----------------------------------------- - 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 a# the provisions of Article XI of the State Sanitavy Code— The undersigned furth r agrees not to place the system in h operation until a Certificate of Compliance has bee 1,issued by he bo re ofi�6 Signe / ., ..r Date /!�� w k1 Application Approved By......," _ z�. ......(r2? ✓ Date �'' , 6 --------------•-------••-----------------------•---.._............. .......... Application Disapproved for the following reasons_________________________ Date a PermitNo......................................................... Issued........................................................ Date t- } THE COMMONWEALTH OF MASSACHUSETTS t BOARD OF HEALTH I, �J ' OF. USG Apr#ifira#r of f"ompliaurr TH,"IS IDS TO CERT-IFFY, That the Individual Sewage Disposal Sy,, tem constructed ( ) or Repaire� ) f f 7 l ' "y'---�---- ----- --'Installer � '� ........................................................ Installer, at ............... . �Lr l,C.�`1. 1✓3J �'a---------,-�-- ---------&—t- 'ems_-. �* has been installed in accordance with the provisions of ArYi, e�XI of The State Sanity v Code a� described in the application for Disposal Works Construction Permit No.T _)_1... ............ dated__5.......IJ----_7�__----------- THE ISSUANCE OF THIS CERTIFICATE SHALL. �OT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WIL FUNCTION SATISFACTORY. DATE-------• --` Inspector----------v ------ -..... ..................................... THE COMMONWEALTH OF MASSACHUSETTS (/7 9t, BOARD OF HEALTH -------------------------------- No......................... FEi� -7-N �i��o�f ttl �rk� �oo�#rttr#ioat �rrmi# Permission is hereby granted-�`a /2' ........................ to Construct ( ) or5Repar--( �a Individual Sewage Disposal System at No. S e .lam C_rUc _� " as shown on the application for Disposal Works Construction Permit c3 ......_.. Dated-: ............ ----- -------------------------•---- / $oard of Health DATE--b-•- ✓(7y---....- - ��-------------------------------------------• FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS 1dc4 2- 011005 `�s 2 �- 50� ROOF Uu EXISTING w EXISTING ` M/BATH fC i EXISTING; WALLS - o ; o NEW DEN NURSERY ©©© AREA W. °� NEW WALLS B t n ow B EXISTING ,I EXISTING _ - n EXISTING i BEDROOM - ai T,,. HALLWAY 3'-215 3-II z j o w NEW o BATH _ _ _. ___ ___ _______ ___ _____ ___ _ _ V O NEW AREA s = — tM m — 9-31h — - °m -- Lill NEW — p •� EBATH ARE4 ____ _____ _______ _____ ____ _____ ____ o — i1 Q d L1 - � — 2432 - \/ 1 EXISTING 4 NEW a SECOND FLOOR PLAN BATH V CI IRE I EXISTING l I ¢1 Illb�ll>kl�I `EXISTING -� EXISTING - - EXISTING -_ �iI I�III� DEN - _ rII� I - DINING EXISTING FAMILY {. �. .� EXISTING �s FRONT ELEVATION -v KITCHENS - ... ___________ WINDc, III 1 BATH EA CABINETSFIT - EXISTING 4 NEW 0 EXISTING FIRST FLOOR PLAN STORAGE It _ s EXISTING NEW —=.DORMER.- --A5PHALT ROOFING— — jj . _ rr II Ili''L+�JjI I L�.� `��r`T'- I,, i j r�y�j— EXISTING r-•- - EXISTING TCW EXIST W/G SHINGLE GLS EXISTING MATH EXIST. 1I �I 1 _ �I _.t CNR.BRD EXISTING EXISTING EXISTIN —�I 1 1 DIE] ��.�� . l�I I - - `— I� I��r --- --' EXISTING EXISTING �7� !�L�� I REAR ELEVATION ��---I�. RIGHT ELEVATION BUILDER JOB ADDRESS DESIGN /f��///////fn/ j/,o ��///ti- �:. ///� j�/� DATE REVISION DRAWN BY PAGE SCALE KENDALL s WELCH CLAY RESIDENCE RENOVATE AND ADD �W�=%(uIo�/'�[�!�[��0�� C�� U�C%��O O I-II-II » JB •�oF '� 1,4'_I-o° ✓� D�isigns I 22 THIRD AVE. SECOND FLOOR DORMER. LLFOOTING99wALL =x TEND aFDAw E5151 IN=_VERFY DEPiw. W ( 4aE OF DR4WI.NGE LEAv_9 PURCH49ER RE9PON91BL FOR GOnPLIANCE Wliw AL' xACT SIZE AND REWFO?CEn=NT OF ALL CONCRETE FOOT,NG9 _ __ OSTER V ILLE MA. OCAL BUILDING CODES AND ORD,NANCE9, B DESIGNS nAY NOT BE-LD REEPON5I5LE nU9T BE DETERnINED By LOCAL SOIL CCND TION9wAND EPTABLE W ERIFY 9TRUDi RAL ELEnErviS FOR DE91Gv slzE P.c.eox a /5061 494-9534 �I 'FOR 912E CONDIiION9 OR FOR TIE USE OF TwESE OR%•wIUGS DURING COu9TRUCTIO.u. -)PRACTICES OF CON9TRUCTIO1.VERIFY DE IGN WIT LOCAL ENG.NEER. Tw LOCAL ENGINEER AND BUILDING OFFICIALS. TdBLE nd.0�66 fi a' rWALL LENGTH=_26'-Q° ---, FULL HEIGHT 5HEATHING=Ll--4/L2" _ F - 0 ACTUAL SHEATHING- 66 9' •RATIO-2.25 _'-L. I EDGE NAILING —II —_ "—_----... FIELD NAILING—12_O.C. t EXISTING i 4 5'-4' 1-4h' _ ..___ - -. _. SHEAR SHEAR SHEAR r i —.s_. _ --_. —_—.l' WALL —WA L j li�I \, I•.I iII1 II—,!I��L��--.CaG-=�— - —E XI 1_E�I,\Ii II`S IliYj,'I•'16_T_^�rIi�I I NG r EXISTING EII -X— II-dI�lSiI; TIU' NjIufI�.,IiII IIIIl�JG - Ir:r j r� — - — - -�-mr - I E IWX 535 2 �oNmXS— 8T R5- TYP. r P'�.- HANGERS ANGERS zx EXISTIN EXISTING - SHEAR WALL RIGHT ELEVATION EXISTING 4 NEW ROOF FRAMING s m P- Lr _sn v A c N I r` 001 L 2XI0 RAFTERS IC," zI - 1/2"ROOF SHEATHING EXISTIN 15•ASPHALT PAPER ASPHALT 5;'NGLES O EXI R38 INSUL.PING 1/2"WLLBOA 1/2"WALLBOARD ASPHALT 2X6's m 1 . 21 INSULATIONEXISTING ALL SHEATH NEW N I/2"SHEATHING O1/2"W HALL DEN HOSE WRAP OR SIQDU TYP. W2.5A TIES DRIP EDGE 5"GUTTER topSHEAR WALL FRONT ELEVATION EXISTING EXISTING I KCTIE IX5 FACIA DINING EXISTING IX SOFFIT 2-I/4"VENT — 13/4"BED MLDG. EX1sr NG i —NOTCH FRIEZE TO RECEIVE SIDING. EXIS EXISTING BASEMENT77 T111, QQI EXISTINGI� SHEAR WALL REAR ELEVATION SAYESAVE DETAILS CROSS SECTION D- E— TI - 1 I AI. LS BUILDER JOB ADDRESS DESIGN�Ii I / - - //,_ r f�// j�J DATE REVI5ION DRAWN BY PAGE SCALE KENDALL § WELCH CLAY RESIDENCE RENOVATE AND ADD NOW,J033 l%�� j��U t0o��0 (l 1-II-11 n JB • 2 oF�' I/4"-1'-O" JB D�sig/ns 22 THIRD AVE. SECOND FLOOR DORMER" A DRDEnENT DF A D r W (I:PURCH45E OF DRAW NG5 LEAIE3 PURCHASER R-EE5PONSBLE FOR COMPL ANCE W TH AL CT 5 ZE AND RE NF ONCRETE FOOT NG5 )ALL FOOT NGS-ALL EXTEND BELOW FRO5TLIN=IE FY DEPiH. OSTER V ILLE MA. - of CAL BU LD NG CODE5 AND ORD NANCES,lB DES 5'•'S DU. BE HELD RE3PON5 BL= PUS?-BE DETE-NED BY LOCAL 50-COND i ON5 AND 4CGEPi4BLE t vER FY 5TRUCTURAL"E•1ENT9 FOR DES GN.s_ a.o.eox�Bz (50B1 494-9534 Z FOR 5 TE COND T ONS OR FOR THE LLSE OF HESE DR,4u DURING CONBTRUCTIO.N. ft4 L�CE9 OF CONSTRICT ON.VERIFY DESIGN WITH LOCAL ENGINEER. TH LOCAL ENGNEER AND BU LD NG OFF D ALS. u/£ST EAR-A,OSBBB AWC GUIDE TO WOOD CONSTRUCTION IN HIGH WIND AREAS 110 i 1PH WIND ZONE �� n �J r�� (� /�� MASSAGHUSETTS CHECKLIST FOR COMPLIANCE C180 CMR 5301.2.LII © CHECK l m/ � C (__J�� ll l// / �D l�\ /� �� ZZOONIE C OMPLIANCE r( // )r--� l/l)lU)�� ll�J`lJ/ U/l/l\\\L, - 1.1 SCOPE WIND SPEED(3-SEC.GUST)--------------------- _______________________10 MPH r WIND EXPOSURE - t � 1.2 APPLICABILITY - NUMBER OF STORIES(A ROOF WHICH EXCEEDS 8 IN 12 SLOPE SHALL BE CONSIDERED A STORY) - - NunOER OF - _2_STORIES C 2 STORIES fir= JOINT DESCRIPTION COMMON NunBER OF NAIL SPACING ROOF PITCH-------------------______________-------.(FIG 21 ..________-__------ ------MEANROOFHEIGHT--------------- FT(33'�L - BUILDING WIDTH,W___________________________________ (FIG 3)._ 26 FT<80'�L \ TYP,FI=LDINAIL SPACING ROOF FRAMING BUILDING LENGTH,L-_________ _. (FIG 3)-------------------------------------- FT<80'�L ad COMMON m o'O.G. BLOCKING TO RAFTERS(TOE-NAILEDI 2-Ba ?-IOe EACH END BUILDING 45PECT RATIO(L/W)________________________ (FIG 41.____--____--_______.______-.-_-_-_. 2.2Z C 3:1�� \\ Y- RIn B04RG TO RAFTER(END-NAILED) 2-Ibe 3-Ibd EACH END NOMINAL HEIGHT OF TALLEST OPENING'________________ (FIG 4).___-_____----___.__.---------------- 6 S"fir= TYP.1/16"WOOD WALL FRAMING CJ 1,3 FRAMING CONNECTIONS STRUCTURAL PANELS - i TOP PLATE AT INTERSECTIONS-GE-NAILED, ;-Ibp 5-16d AT JOINTS GENERAL COMPLIANCE WITH FRAMING CONNECTIONS._-. (TABLE 2l--------------------------_------------------- y - STUD TO STUD(FAG=E-NAILEll 2-I1d ];6e 24`O.C. 1 \ 'EAGER-O HEADER(FACE-NAILEDI ibd Ibd 16"D.C.ALONG EDGE5 2.1 FOUNDATION ( �\ FLOOR FRA"IING ` FOUNDATION WALLS MEETING REQUIREMENTS OF T80 CMR 5404.1 JI`I r--- JOIST TO SILL-OP PLATE OR G RDER(TOE-NAILEDI 4-Ft a-IOd PER JOIST .� CONCRETE _______ _ ________ ______ __ ___ _______ _______ _ _________ _ ________ ______________ _y I T 5T(T E ED' BLOCKING O JOI O-NAIL ) 2-5d 2-IOd EACH END CONCRETE MASONRY_______________13_-____-__-_-_--_____---_____.-------------------------------------- _tom TYP.EDGE.NAIL SPACING`- ,-' - II I� (8d COMMON m 6"O.C.1 BLOCKING TO SILL DR TOP PLATE(TOE-NAILED) 3-16d 4-16d EACH BLOCK 2,2 ANCHORAGE TO FOUNDATION' �I I �\ �� '� .' L=_bGE_R STRIP TO BEAM DR GRDER(FAGE.NAILE01 3-Iba a-IbB EACH JOIST 518"ANCHOR BOLTS IMBEDDED OR 515E PROPRIETARY T'IECHINIGAL ANCHORS AS IN ALTERNATIVE IN CONCRETE ONLY1115T 11 G RAFTER CONN=CTIONS SAND JOISTDTOEJ03 END N(AOEr,NAILEDI 3-bd a-Ibd PER JOIST 1-1d 1-0. PER OIST BOLT SP4CINGENER4L .____ _______ ___.(TABLE 4) ___ -_._.._ ___ S__. IN. `/ 11 II •,TYP.H2.5 TICS .ROOF SHEATHING TOP PLATE(TOE-NAILEDI 2-Ibd 3-Ibd PE¢JOIST BOLT SPACING FROM END/JOINT OF PLATE ____.(FIG 5) ---___ _._ ___ __.__.� IN <6•-12' NON- I •-` _ BOLT EMBEDMENTLONCRETE. _.(FIG 5) ____ __ _._ _�IN.>l" ./. LOADBEARING. BOLT EMBEDMENT-MASONRY._. _____ _ --.(FIG 5) -_.. _ __ -, O IN )15"_L_ STUD HEIGHT WOOD STRUCTURAL PANELS _____ _. (FIG 5) _ __ 'I UPLIFT - o i PLATE WASHER._- - _ __. -__ _ ..>3'X3'XI/4"�� I LOADBEARING RAFTERS OR TRUSSES SPACED U O o'OC. 8d IOd b'EDGE/b'FIELD FLOOR FRAMING MEMBER SPANS CHECKED.__. (PER ISO CMR 55.00J _ - - �L MAX.WALL 1' II II II .: - _ STUD HEIGHT 54BLE E OR TRUSSES SPACED ONE¢16'O.G. etl lCd 4`EDGE/;'FIELD 3.1 FLOORS HEGHr 20' j P+ GABLE ENDLALL RAKE OR RAKE TRI155 9p IOd EDGE/6 FIELD Q MAXIM M U FLOOR OPENING DIMENSION-----------------(FIG 6).______ -__ _ Q MAX._- FT<12 y II �� it WITH GABLE OVERHANG WALL GABLEE EhDWA.1 RAKE OR RAKE TRUSS 9d D. DGE/b'FIELD FULL HEIGHT WALL STUDS AT FLOOR OPENINGS LESS 2 FROM EXTERIOR WALL(FIG 6) _.___ ______ _-__. �L II 'I Q I �I -' HEIGHT 10' w/STRUCTURAL OJTLOOKERS MAXIMUM FLOOR JOIST SETBACKS ---_�FT(d�L I I� II I� 4j •' - GABLE END ALL RAKE OR RAKE TRUSS ad IOd 4'EDGE/4"FIELD SUPPORTING LOADBEARING WALLS OR 5HEARWALL.(FIG l) ; W/LO GOUT 5-CCK5 _LULL_ - ____ ____ - -• MAXIMUM CANTILEVERED FLOOR JOIST ( I! �' Id _ ,_ •-' - - I CEILINGOSHEATHING SUPPORTING L04DBEARING WALLS OR 5HEARW4LL (FIG B) __ _. _, 0 FT<d V— j I FLOOR BRACING AT ENDWALL5.__ ___ __.(FIG 9) --_-_. __. ___ _ _- �L III I� II . , GYPSUT'WALLBOARD Sd COOLERS l"EDGE/IO"FIELD .___-__ _______ ______ O I FLOOR SHEATHING TYPE _.(PER laO CMR 5500) L WALL SHEATHING FLOOR SHEATHING THICKNESS _ __ __.(PER i60 CMR 55.00) IN.�L - �II I OD-5,11C-ll¢GL PANELS FLOOR SHEATHING FASTENING,___ ____.(TABLE 2) d NAILS AT IN EDGE/ IN FIELD N/A 1 " "- -" 1 I II III _ TLD SFAGED WIF TO 2a O C o 9d IGd EDGE/12 FIELD j 4.1 WALLS - - :JI II II Il ' _- ,2 'ND 25/32 FBERB CARD PANELS 'Sa - 3"-EDGE/'o FIELD WALL HEIGHT II I� +' �I 2 , SUM WALLBOARD 5d COOLERS - T'EDGE/O FIELD L04DBE4RING WALLS- ___ _. __ _ .(FIG 10 AND TABLE 5) __ ___ -_- 0 FT(10' I 1 I� iiII FLOOR 5HEATHING y + G- ' __ ____ __. F ( _-_ _ __ __ _/_. ll, ill ODD STRUCTURAL PANELS NON-L04DBEARING WALL'------------------------(FIG 10 AND TABLE 5) _OFT<20'�� - LATERAL �� WALL STUD SPACING (FIG 10 AND TABLE 5) �'21N(24'O.C.�� _ I I R LESS 9d Ca 6"EDGE/12 FIELD WALL STORY OFF5=T' (FIG l BJ-_--_ FT(d v I I 1 - G¢EATER-HA.N ICe 10. b"EDGE/b'FIELD 4,2 EXTERIOR WALLS' - I� WALL STUDS YR.HORIZONTAL DOUBLE GENERAL NAILING SCHEDULE, - 1 T LOADBEARING WALLS ________ _________________(TABLE 5l----------------.___------- _..21 1N V � II � SHEAR - � „ NAIL EDGE(STAGGERED NAIL NON{OADBEARING WALLS-------------------------(TABLE 5)------._____ -----------2X S2_I-FT IN�L I III II 1 TM�T,RoN 9d COMMON m 3"O.G. I I� IN I GABLE END WALL BRACING' - � FULL.HEIGHT ENDWALL STUDS - .__- -__ (FIG 10) __ ----- �- " I VERTICAL WOOD STRUCTURAL • - WSP ATTIC FLOOR LENGTH (FIG III _ - '-_ -_- -_Q FT>W/3 •' PANEL SHEATHING GYPSUM CEILING LENGTH(IF LISP NOT USED)- ____.(FIG III __ -- __._ -_AFT)0.9W�L I i .�I ' �,Ila AND 2X4 CONTINUOUS LATERAL BRACE m 6 FT D.C.(FIG It)____ __ ____ _ ____ _ ___ �L I - OR IX3 CEILING FURRING STRIPS a 16 SPACING MIN.WITH 2X4 BLOCKING c 4 FT.SPICING IN END----------- II II I TYP.VERTICAL EDGE NAIL - JOIST OR TRU55 BAYS_______ ___ __ ___ _ _ ___ __. �L �^ 1 I I '•- DOUBLE TOP PLATE . _-__ -._._ I I II �I I� '• � - SPACING(Bd COMMON DOUBLE TOP PLATE III I i I m -- __. a FT fit= I III _' •- till SPLICE LENGTH. _ ____ _.IFIG 13 AND TABLE 1 --------------- � I I - - SPLICE CONNECTION(NO.OF Ibd COMMON NAILS) (TABLE bJ-------------------------- ------------ in / IIj I I I TYP,FIELD NAIL SPACING d 11 LO4D5E4RING WALL CONNECTIONS I� I "• COMMON O.C. / - - �' �--•g _ I� LATERAL(NO OF 16D COMMON N41L5)___-___ _-(TABLE l)----------------------------------------2_ �_ NON-L04DBEARING WALL CONNECTIONS 11 1 11 d I O LATERAL(NO.OF Ibd COMMON NAIL5).___ I I� III II' 1 DOUBLE HEADER _ d __.(TABLE S) ____ _____________ ____ _- � �. I 1 i ''�.' I� B n LOAD BEARING WALL OPENINGS(RECORD LARGEST OPENING BUT CHECK ALL OPENINGS FOR COMPLIANCE TO TABLE 9) HEADER SPANS,--_ __ _-(TABLE-3) - -- - ----AFT Q1N.<11'-1_ •I I{ II SILL PLATE SPANS _ ___ _-(TABLE 9) - 3 FT 0I FULL IN,<II'_>[_ II II - 1� I�FULL HEIGHT STUDS(NO,OF STUDS( _ --_ _.(TABLE 9),__ v _ ! NON-LOAD BEARING WALL OPENINGS(RECORD LARGEST OPENING BUT CHE K ALL OP=NINGS FOR COMPLIANCE TO TABLE' I r _ II I YI �I III i ° / II STUD - HEADER SPANS _-_- ,-_ __ ---(TABLE 9) _ -0-FT QIN.<12'� ° - x SILL PLATE SPANS ____ ___ _.(TABLE 9) -__-- -. - __ __._ QFT 0IIN,<R'�L Ge ape ry'> I - d 11 FULL HEIGHT STUDS(NO.OF STUDS)---------------(TABLE 9).--. -__ -___.___ fir= . °0 4' n "" II -- I DOUBLE JACK STUD 1 I� �� 1i ---- ---- o •e o - 0I _ °1+e REQUIREMENTS 4T EACH.END OF HEADER - I y I MINIMUM EXTERIOR WALL SHEATHING TO RESIST UPLIFT AND SHEAR SIMULTANEOUSLl9 ° I Ell -�0 a'-4�e �J•I 0'•' HEADER SPAN HEADER NUMBER O� UPLIFT LdT=RILE ' (j WINDOW SILL PLATE MINIMUM BUILDING DIMENSION,(W) - " 2 o (FT.) SIZE - E !LB.i /L5.) 1 _ NOMINAL HEIGHT OF TALLEST OPENING __ ____ __ ___ - __ _._2_<6'B' �L D UGH STU 5 ' a n, 24 O G MAX 24 O.G MAX.••° I 5HEATHING TYPE. _ __ .- (NOTE 4)._..__ .. ___ _ _.JLZ STJD PAGING 0 e 1 c 1 0 STUD SPACING. EDGE NAIL SPACING __ -_ --_ (TABLE 10 OR NOTE 4 IF LESS) IN.y 2' 2-2X4 I. 211 132 _ !I__ _ __ �' ____ I+___ __________ FELD NAIL SPACING _ J =_. ._- ________ ____ ____ =IN.�- SEE PAGE 2 OF 3 Y _,, <°e''O a O�'tr0'a - ° )o °P o .'G o' 1. •° 3' 2-2X4 2 41'o i98- I 11 t (TABLE 101 _ _ I - ' _______(TABLE 101 ____________ _______ _______—>, �L \ 4' 2-2X4 2 - 554 264 ! .•.;', y SHEAR CONNECTION(NO. 16d COMMON NAIL") (TABLE 10).___ �LI I I'I PERCENT FULL-HEIGHT SHEATHING________ .___ e o o. e o e ' I 5>.ADDITIONAL SHEATHING FOR WALL WITH OPENING)'o'B"f DESIGN CONCEPTS!_________________________ N/A - '.G °.° °•'4 °•+ °• a °• ; °•` 5' 2-2X4 3 093 330 MAXIMUM BUILDING DIMENSION,(L) - - '^ S'e 'N - L'o Z' - [� NOMINAL HEIGHT OF TALLEST OPENING T._ - 6' 2-2X6 3 B31 396 1 '---- -- _ _________ ____ __ _ _____ _LULL 9-L(6'8"�L -- ^_� ,' :i� .{: .{:• 5HEATHING TYPE,___ ___ __ _:(NOTE 4)______ _____ _____ ___ __1/2- �� - • l' 2-2X8 3 - 970- 462E •-�—�w EDGE NAIL SPACING- _ ___ __.(TABLE II OR NOTE 41F LESS),_ _. _ IN- FIELD NAIL SPACING - _ __ (TABLE 11) __ _ _-_ IN _y MAXIMUM WALL STUD HEIGHT STUD SPACING B' 2-2X12 3 I,Ioa 525 SHEAR coNNEcnoN(NO.of 16d COMMON NAILS) (TABLE IU____ __ _-- -- __ �_ SEE PAGE 2OF 3 ` / 9' 3-2XI0 - 3 1,241 594 >•+ e ° e F' R� PERCENT FULL-HEIGHT SHEATHING (TABLE 11) ___ -_-_ ___ ____ % / RAFTER CONNECTION AND WALL SHEATHINGS to' 3-2X12 4 i335 660 �n,- < vo vo 5%ADDITIONAL SHEATHING FOR WALL WITH OPENING)bB"(DESIGN CONCEPTS) ___ __________ N/A o o TYP.ANCHOR BOLTS AND WALL CLADDING I 4-2XIO 4 1,524 l26 0•+° °•+.° o•+, °••e o•'e 3"X3"XI/4"H PLATE WASHER '� ° n a ____________________ - - '� Oe do .°e1e ,'po .'Oc d'a 0'e 4'c vc .°ve 0 I RATED FOR WIND SPEEDi_____________________________________________ _�_ TABLE 9. WALL OF'ENING�S - HEADERS e 5,1 ROOFS ,• .°• °, °. °. ROOF FRAMING MEMBER SPANS CHECKED?(FOR RAFTERS USE IWO SPAN TOOL,SEE BBRS WEBSITEEI y IN LOADBEARINCs WALLS -°°° -411 s.°n n .°n•,°. -°n e .°n e .°v'4 .°v'e.Pe ROOF OVERHANG__________________________________.(FIGURE 19),_.--_----____�Y'FT<SMALLER OF 2*OR L/3�- ' TRUSS OR RAFTER CONNECTIONS AT L04DBEARING WALLS NOTES: a PROPRIETARY CONNECTORS I. THIS CHEKLIST SHALL BE MET IN ITS ENTIRETY,EXCLUDING THE SPECIFIC EXCEPTION NOTED IN 2,TO COMPLY WITH THE ___-_.(TABLE 12)_____________________ ELF 1/ UPLIFT_________________________________ _______________-U•30 REQUIREMENTS OF T80 CMR S301.2.1.1 ITEM I.IF THE CHECKLIST I5 MET IN ITS ENTIRETY THEN THE FOLLOWING METAL STRAPS L4TER4L_____________________________________ .___________________________._______.L•ILF ter= AMC)HOLD DOWNS ARE NOT REQUIREDPER THE WFCM 110 MPH GUIDE SHEAR. _-_- __-_-_.(TABLE 12),..----------------_--------------- V 4:STEEL STRIPS PER FIGURE 5 RIDGE STRIP CONNECTIONS,IF COLLAR TIES NOT USED PER(TABLE 132-----------------------------_-T.2�LE I/ S:20 GAGE STRAPS PER FIGURE 11 GABLE RAKE OUTLOOKER_--------_------------------(FIGURE 20)-------------- 0 FT(SMALLER OF 2,OR L/2 C:UPLIFT STRAPS PER FIGURE 14 TRUSS OR RAFTER CONNECTIONS AT NON-LOADS-CARING WALLS D:ALL STRIPS PER FIGURE it PROPRIETARY CONNECTORS E:CORNER STUD HOLD DOWNS PER FIGURE I8e AND FIGURE 15b UPLIFT._ ._- _-.___.(TABLE I4)_____________________________________U•Ai e. 2. EXCEPTION:OPENING HEIGHT OF UP TO a FT.SHILL BE PERMITTED WHEN 5%15 ADDED TO THE PERCENT FULL-HEIGHT SHEATHING LATERAL(NO.OF Ibd COMMON NAILS)---------.(TABLE 14)-------------------------------------L•.L4QL5. REQUIREMENTS SHOWN IN TABLES 10 AND 11.- - O-WALL STUDS AND HEADERS __ {F ROOF 5HEATHING TYPE_______________ ____________-(PER 180 CMR 55.00 AND 59.00)---______-.___-__-___- - V d A. . THE BOTTOM SILL FROM IO AN I AND-LOCATION LE INT RI , 5 SHEATHING AND N.NOMINAL THICKNESS PRESSURE TREATED-2-GRADE, - ROOF SHEATHING THIGKNE55_--------------------------------------------------------------�_IN,)T/1"WSP�L BUILDING ASPECT RATIO,DETERMINE PERCENT FULL-H-EIGHT ROOF SHEATHING FASTENING__________________________ (TABLE 21-_______-.-__________-_--__.______-____�_ SHEATHING AND NAIL SPACING REQUIREMENT5. AROUND WALL OPENING6 BUILDER JOB ADDRESS DESIGN _ � DATE REVISION DRAWN BY PAGE SCALE KENDALL s WELCH CLAY RESIDENCE RENOVATE AND ADD l�� / ✓oV mil '✓0 % 1 00 1 I-11-I1 u JB __3_OF 3 I14` I'-O^ 22 THIRD AVE. SECOND FLOOR DORMER. W P 5E GS LEAVE5 PURCHASER RE O 5 E OR COMPL ONCE WITH ALL (21 EXACT S Z£AND REINFORCE—OF ILL CDNCR T ALL FOOT N35 5uAL_EXTENDS O ROSTLN-VERIFY DEPTH. OSTERv ILLS MA. R, GDND T °E5 AND DRD NANOES s DES—5 NB_HELD RESPONSIBLE MMUST BE DETERn NED BY 1-0-4L SOIL C TONS AND GC_-EP ISLE r WITH IERIFY 5TRo—RAL=LE- O D_5wu 494-9534 QI ( - NS CR FOR T-E JSE OF THEE ORAWIN ONSTRUCTION. —TIDES OF CONSTRUCTION.'ERIP-DESIGN WIT+-LOCALNENGTNEER. AL ENGINEER AND BULDNG OFFOGLS. -1 BdRN5 J<B<E('/d.OSb6B Z - - OF o PESCE CIVIL _ NO.32W1 i �,rF�E�JSTER� - ON ' v r. .. 100.00, } r _ o PARCEL "70 � . 60' �� -• Exist. 20'7' 4,000+/- S.F. �I Existiag.y D—Box PLAN REF PLAN BOOK 116 PAGE 133 Septic 1 0 0' ASSESSORS MAP.• 116—70 16.8' 43.0' ZONING. "RF-1" 7 2' EXIST. GRO UND.WA TER PROTECTION OVERLAY "AP" 16. 50 T WATER FLOOD ZONE. C' ` 4` p' `2 PANEL NUMBER.- 250001—0016—D PROPOSED Existing y� LINE ADDITION _ DATED. 7-2-92 3 Bedroom � � � � � � � � REL�3CATE o , . D-Box ` ` . D w e l ling ( on sonotubes Hse. #3 PROPOSED SEPTIC T.O.F. = 100' 0' ASSUMED ' : `: : 27 0.10 EXIST SYSTEM REPAIR PLAN 6 _ _ GAS G, 4�0'-G — G G 4z.a' LINE LOCATED AT• �,. 50. 22 THIRD A VENUE Existing "I O OSTER VILLE,, MA. Garage C6I W 1.60' PREPARED FOR: 100.00, RELOCATED OLDS CAPE BUILDING, INC. �., WA TER 101.65 LINE SCALE . I"=10' cr Easement Plan JULY 26, 2005 recorded in Barnstable Existing REV AUGUST 17, 2005 County Registry of Deeds Septic Book 18527, Page 273. LeachingREV AUGUST 31, 2005 (TO BE RELOCATED W/ (2) NEW (H-20) REV SEPTEMBER 20, 2005 DRY WELLS) PESCE ENGINEERING & ASSOCIATES 451 RAYMOND ROAD PLYMOUTH, MA 02360 NOTES, 1) EXISTING STRUCTURES BASED ON DWELLING LOCATION PLAN BY NORM:S N GROSSMAN, P.L.S., APRIL 20, 2005 E P E S C E OA D E L P H I A.N E T 2) THIS PLAN IS FOR THE RELOCATION OF AN EXISTING 3-BEDROOM LEACHING SYSTEM (THE PROPOSED P H.(50 8)743—9 206 CONSTRUCTION DOES NOT REPRESENT AN INCREASE IN BEDROOMS OR WASTEWA TER FLOW) SHEET 1 OF 2 F J# 22TNIRDA TOP OF FOUNDATION EL =100.0(ASSUMR,j) . . - � - 10' MIN. 4" SCHEDULE 40 2"LAYER OF • • P. V.C. 1/2" ' / EL= 98.5' MIN. PITCH 1/8 PER FT. 3�4" TO l-1�2" WASHED STONE. / ♦ / / / / / / / / / / / / / / / / / ♦ / / / / / / / % ♦ _ IfASHED S7YINE RISER , / / ♦ , / __/ / / ♦ / / / / / / . 4" CAST IRON PIPE INVERT INVERT (OR EQUAL] MINIMUM /'/ / ♦ / Pl7L^X 1/4 PER FT EL.=96.2' �j ` =95.6, CLEAN 9„ ` a nin sc// 1 LEVEL --- 5� SAND FILL �� MIN. FLOW LINE ao PIS P/PE lroR 2 EXISTING INVERT 1 10" 14" a MIN. 24" o�ab 0 0 °o�B$ ocb Q 0 00 moo$ EL.__97.5 _— INVERT INVERT INVERT o 0�o� 0 EL.= 97.o--- EL.=96_7' L.= 96_0' $ O O oogPag$$ _93.6' EL. - RELOCATED 4'. ' 4.83' ' r.5' 4.e3' 4' EXISTING 1,000 GAL DISTRIBUTION '` 19.16' g SEPTIC TANK H-10 BOX , • ) 2-500 GAL. DRY WELLS (H--20� " -BOTTOM OF TEST ,HOLE ELEV. = 88.2' PROFILE OF r OBSERVATION HOLE 1 ELEV.= 98_2_ SEWAGE 'DISPOSAL SYSTEM PERCOLATION RATE _Z__ MIN./ INCH AT __3B __ INCHES NOT TO SCALE EL= 98.2 DEPTH HORIZ TEXTURE COLOR MOTT. OTHER EL= 97.28 ,0-11" A SANDY LOAM EL=' 95. 78 'll"-29' B LOAMY SAND JOY5/8 I ` EL= 88.2 ..�99„-122 C MEDIUM SAND 2.5YT/4 / PERC NO 'GROUNDWATER ENCOUNTERED PERC TEST PERFORMED (9 36" DEPTH OBSERVATION HOLE 2 ELEV= 98_1 _ PERCOLATION RATE _2___ MIN./ INCH AT _ 3R INCHES GENERAL NOTES EL= -98.1 DEPTH ORIZ TEXTURE COLOR MOTT OTHER ' M EL= 971 : -tD-12" A SANDY LOAM _.k EL= 95.60 12"-30' B LOAMY SAND 10Y5/4 I 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E-P- EL= 89.1 60"-108 C MEDIUM,SAND 2.5Y7/4 ---- PERC TITLE 5 AND THE TOWN -OF __ BARNSTABLE__ RULES AND NO GROUNDWATER ENCOUNTERED REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. PERC TEST PERFORMED 0 38" DEPTH 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN DATE OF SOIL TEST 0712212005 10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE WITNESSED BY:a DON DESMARAIS - B.O.H. DESIGN CALCULA TIONS.' USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING .AREAS.4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL SOIL TEST DONE BY EDWARD PESCE, P.E- NUMBER OF BEDROOMS . . . . . . . 3 BE MORTERED IN PLACE. GARBAGE DISPOSAL . NO 5 NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH TOTAL ESTIMATED FLOW ( _!r0 _CAL/BR/DAY x _ 3_ BR) 330 CAL/DAY DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO USE r5oo GAL SEPTIC TANK 1500 CAL OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR INSTALL.- 2- (H-20)500 GAL DRY WELLS ( WITH 4' CRUSHED STONE) IS TO CALL "DIG- SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS - SOIL CLASSIFICATION . . . . PRIOR TO COMMENCING WORK ON SITE. DESIGN PERCOLATION RATE < 5 MIN/IN 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS NOTE.• NOTIFY RESCE ENGINEERING EFFLUENT LOADING RATE . . . . . . •74 CAL/DAY/S.F. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. 24 HOURS BEFORE REQUIRED INSPECTION TOTAL LEACHING CAPACITY 339.49 CAL/DAY >° 8) PARCEL IS IN FLOOD ZONE___'�C"= . � SIDE WALL• (19.16' f rs 5) x z' X 2 SSIDES)(74)-_ 105.55 CAL/DAY 9) LOT IS SHOWN ON ASSESSORS MAP _ 116 AS PARCEL 70 __ BOT7YJAf (19.16' X 16.5)(.74)=23394' CAL/DAY 10) NO WATER SUPPLY WELL EXISTS WITHIN 150' OF SAS REV.• 8131105 22THIRDA REV 9/2%5 SHEET 2 OF 2 JOB NUMBER_____________ PLAN REFERENCE :BARNSTABLE COUNTY REGISTRY OF DEEDS PLAN BOOK 416,PAGE 133. _ 2.96, o 40.00' s Exr', tin I g PROPOSED NI - . Garage I ADDITION ,I (on sonotubes) I , r 18 0' 1 1 2' r i �- S 6` Existing 3 Bedroom Ilse. #Dwelling , a . Easement Plan recorded in Barnstable County Registry of Deeds 10.3' Book 18.527, Page 273. - — — I F I Existing Septic x I / Tank we t — ..'-.r.,.Y.-..p,,.,..#„-;.,,,�,.,i„ ._:_.. ++M'.-.�,.�^i-_-tz...-, w-^+�a€; R'r:.�'u-."t„u'��.,^T' .. .. , /� - ..� i. '.,/i•. ,, y- p v I Existing ,II I I I!I Exist. ' ai I I D-Box I I I Septic (I }Future I . • 1 Le ach�t�g Leaching I R L . II eserve I I I LN I�I , PARCEL 70 4,000+/- S.F.' I` NI , 6.11' I . 40.00' v w A ri t THIRD 'AVE, ;r I hereby certify that this dwelling is located on the ground ` as shown, and that the dwelling is located in Flood Zone"C' as shown on F.I.R-M. 25001 0016 D,for the Town of t Barnstable,revised to 07/02/92. '04/20/05 NORMAN GROSSMAN, PLS DATE 04122105 jth change to arawtspace foundation,add teaching reserve Date By Revision HOUSE No : 22 , , »DWELLING LOCATION PLAN ASSESS.MAP 116 0 PARCEL:. ....... 070 # s9� PARCEL 70, #22 THIRD AVE ZONING DIST. RF-1 s FLOOD ZONE:. c �aN OSTERVILLE9 MA. ELEVATION:.... OWNER: "� "0' �2775 SCALE: ill = 10' Norman Grossman P.L.S. David R Hubbell '�FGisS`L 93 Falmouth Heights Road, #4 DATE : APR. 20, 2005 P.O.Box 24 Falmouth, Ma. 02540 ' , Osterville,MA 02655 PLAN NO. : C- 909 508-548A920' r PLAN REFERENCE : BARNSTABLE COUNTY REGISTRY OF DEEDS PLAN BOOK 116,PAGE 133. 2.96' o ,k 40.00' ' I I Existing _ PROPOSED Gauge ADDITION 1 I (on sonotubes) I 11.7' 18.0' 1 10.2' 5.6' ' Existing' 3 Bedroom Dwelling Hse. #3 o • S Easement Plan recorded in Barnstable County Registry of Deeds Book 18527, Page 273. — _ _9.s' _10.3'_ _ Existing Septic Tank 141 10.7' I 11.2' 18 I• 1 4 v I Existing I 11 I—I Exist. Septic 11 Future l I D-Box b Leaching I Leaching I I II - Reserve IN 1 — — — J PARCEL 70 I 1 4,000+/- S.F. I 1 1 6.11' I 40.00' THIRD AVE I hereby certify that this dwelling is located on the ground as shown, and that the dwelling is located in Flood Zone"C", as shown on F.I.R.M. 25001 0016 D, for the Town of Barnstable, revised to 07/02/92. 05/24/05 NORMAN GROSSMAN, PLS DATE - HOUSE NO:..... 22 DWELLING LOCATION PLAN ASSESS. MAP: 116 ' Sf9 PARCEL:.... 070 �y PARCEL 70 #22 THIRD AVE ZONING DISTST..: RF-1 �nAN In FLOOD ZONE:. C a�ossnaa�a �� . OSTERVILLE, MA. ELEVATION:.... --- No. 12775 0 OWNER: �EE© ,,ti SCALE : 1" = 10' Norman Grossman, P.L.S. David R Hubbell t` 0 DATE : APR. 20, 2005 93 Falmouth Heights Road, #4 P.O. Box 24 ;; Falmouth, Ma. 02540 Osterville,MA 02655 PLAN NO. : C- 909 508-548-1920 REV.: 05124105; Change from concrete foundation to Sono tubes � I 7. VARIANCES REQUESTED. j ,. 1) SEPTIC TANK 3,5' FROM SIDELINE (10' REQ UIRED 310. CMR 15,21) 2� LEACHING. AREA 6.8' FROM FRONT . LOT LINE AND RESERVE AREA 2' FROM SIDELINE (10' REQUIRED ';310 CMR 15,,`11) ... , co• 9 - • to nt t w Co • 100.00, y 3 . c::, ram. Nv 71 PARCEL 70 Septic _ O $¢M .., P - Exist. - EL OCa k ' 20.7 4`000+/ S.F. IEx" t ng -B x PA 13 o Tank �RESER VET 1 F PLAN BOOK 116 GE 3 .. 5,� t a PLAN REF T 43 0_. ASSESSOR'S MAP 1 -70 — F-1 .. - '. EXIST � P.- ZONING: 16 8, C" 27. • WATER • FLOOD ZONE. ,. REL CA TED #2 PANEL,NUMBED 250001-0016=D f , .\ D- ox LINE 7-2-92 PROPOSED \ ` `\ Existing W W DATED. o ADDITIONS — — , . 3 Bedroom \ . \ \ \:\ \ ` ` \\` a TP#166 ; \, 3 \,`, \ , \ - PROPOSED SEPTIC on •sonotubes ` ` Hse. \, \\ SYSTEM REPAIR PLAN° T.0.F.= >00' `, \ \, \ ` \ ,\ , EXIST. • 6.0' (ASSUMED) \ , GAS � LOCATED AT. 8. G G� - 22 THIRD A VENUE 4:60' 4z. — G G LINE Existing .' . . TER VILLE. MA Existing _ �, ' �I :6 8 I: Septic ,,,� 1 6 Leaching w Garage RELOCATED PREPARED FOR s RELOCATED) (To BE WA TER NG, INC 1.60' X W 100.00' , LINE.. OLDS CAPE'. BUILDI 101.65' SLEEVE ' �o • °I'=10' - - ,t . - .y SCALE' . - p w Easement 'Ptah JULY -26, 2005 - T t. - - recorded in Barnstabte = REV f . County Registry, o Deeds REV : CouF t z _ y f _ • Book 18527, Page_ 273. REV. PESCE ENGINEERING & ASSOCIATES • ar 451 RAYMOND ROAD n PLYMOUTH, MA 02360 P PHIA.NET E@ADEL . EPESC - .' 2005 PH.(508)743-9206 V P L' S •APRIL .20' NOTE LAND SURVEYING BASED ON DWELLING LOCATION "PLAN B Y NORMAL! GROSSMAt , SHEET I OF 2 J# 02THIRDA - i- • r r ie i - , ,r EOWARD L. PESCE ' C9 0VIL a` No. 32WI 4- 100.00' r { ' Cat o PARCEL 70 &3 . 60' � . _ .., Exist. 20.7 4,,0 0 0+� ' S.F. Exist t cg ti D-Box PLAN REF` PLAN BOOK 116 PAGE 133 a k 10 0 ASSESSORS MAP- 116-�'0 16 8 43.0' ZONING.• '"RF-1"' EXIST. GROUNDWATER PROTECTION OVERLAY "AP"' 16..50. 7r WATER FLOOD ZONE.. .0 4. 0 A2 PROPOSED PANEL NUMBER. 250001-0016-D Existing LINE DATED. 7-2-92 ADDITIONb 3 Bedroom 'co D BoxATE Dwellingco 4 6 (` on sonotubes Hse. #3 O PROPOSED SEPTIC ` T.O.F.= 1 00' 10 � SYSTEM REPAIR PLAN , `.,.;`,`.;.;� ` ;.' ;.,�;`,`.; ;`. � � z7.o� EXIST. 6.0 (ASSUMED) _ _ GAS LOCATED AT. G 4:60'—G 1 G I G 4z.sf LINE 22 THIRD AVENUE Existing �) 0 6. OSTER VILLE, MA. Garage CdI N, ti ti . PREPARED FOR: 1.60' TIT 100.00' RELOCATED OLDS, CAPE: BUILDING, INC. C\i WA TER ._ 101.65' LINE 4 •SCALE. 1"=10' Easement Plan JUL Y 26, 2005 recorded in -Barnstable REV AUGUST 17, 2005 _. —Existing _-__ - - County Registry of Deeds Septic REV AUGUST 31, ' 2005 Book 18527, Page. 273. Leach'n 'TO BE RELOCATED W1 (2) NEW (hf-20) REV SEPTEMBER 20, 2005 DRY WELLS) PESCE ENGINEERING & ASSOCIATES 451 RAYMOND ROAD PLYMOUTH, MA .02360 NOTES- 1) EXISTING STRUCTURES BASED ON DWELLING LOCATION PLAN BY NORMAN GROSSMAN, P.L.S., APRIL 20, 2005 E P E S C E OA D E L P H I A.N E T 2) THIS PLAN IS FOR THE RELOCATION OF AN EXISTING 3-BEDROOM LEACHING SYSTEM (THE PROPOSED P H.(508)743-9 206. CONSTRUCTION DOES NOT REPRESENT AN INCREASE IN BEDROOMS OR 'WASTEWATER FLOW) SHEET 1 OF 2 F J# 22THIRDA 719P OF FOUNDATION EL =100.0(ASSUMED) F-- 10' MIN. ` 2"LAYER OF 4" SCHEDULE 40 P. V.C. 1/8"-1/2" 'MIN. PITCH 118 PER FT. s 31�4" 7V I-I1�2" EL= 98.5' IFY WASHED S7VNE WASHED S7YINE RISER / / , , , , , 4" CAST IRON PIPE INVERT JNYERT (OR EQUAL MINIMUM EL.IN C . CLEAN ' G� PITCH 114 PER FT. 4 Dla SCH 1J� LEVEL =95.6' SAND FILL MIN. FLOW LINE 40 PVC PIPE IR�R 2 lOj �Oj EXISTING 1 10" INVERT ,�I�y 14" INVERT 24„ oo°Od+b � O °04�$ o� O INVERT , INVERT ,_ g EL.= s7 0--- . EL. 96_7 EL.= B6.O'` - 6' O $� O $ g$% =93.B' EL.-_99 RELOCATED . . -- 4' 4.83' 1.5' 4.83' 1 4' DISTRIBUTION ` 'EXISTING 1,000 GAL BOX 19.16' .o SEPTIC TANK (H-10) 2-500 GAL. DRY WELLS (H-20) BOTTOM OF TEST HOLE ELEV. = PROFILE OF. a . OBSERVATION HOLE 1 ELEV.= 98_2_ SEWAGE DISPOSAL SYSTEM PE«COLATION RATE Z__ MIN./ INCH AT _ .�B INCHES NOT TO SCALE EL= 98.2 DEPTH WORM TEXTURE COLOR MOTT. OTHER EL- 97.28 0-11" 1 A SANDY LOAM � EL= 95. 78 11"-29' B LOAMY SAND IOY518 EL-- 88.2 29"-122' C MEDIUM SAND 2.5Y714 PERC NO GROUNDWATER ENCOUNTERED PERC TEST PERFORMED 9 36" DEPTH • OBSERVATION HOLE 2 ELEV.= 98_I _ PERCOLATION RATE _2___ MIN./ INCH AT _ 3B __ INCHES GENERAL NOTES EL= 98,1 DEPTH HORIZ TEXTURE COLOR MOTT. OTHER EL= 97.1 , 0-12" A SANDY LOAM � EL= 95.60 12"-30' B LOAMY SAND 10Y514 1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. EL= 89.1 30"-108 ' C MEDIUM SAND 2.5Y714 � PERC TITLE 5 AND THE TOWN OF =_ BARNSTABLE__ RULES AND NO GROUNDWATER ENCOUNTERED REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE PERC TEST PERFORMED ® 38" DEPTH 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO ' WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12" 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF . r WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN DATE OF SOIL •TEST 0712212005 10 FT. ' OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE WITNESSED BY: DON DESMAIZAIS — B O.H DESIGN CALCULA TIONS: 4f USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL SOIL TEST DONE BY EDWARD PESCE, RE ' NUMBER 'OF.BEDROOMS . ' 3 BE MORTERED IN PLACE. GARBAGE DISPOSAL . . . . . . . . - NO NO TOTAL ESTIMATED FLOW 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH - ' ( _Il0 _CAL/BR/DAY x _ 3_ BR) 330 . CAL/DAY DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO USE 1500 GAL SEPTIC TANK 1500 CAL OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCA VA TION CONTRACTOR INSTALL- 2- (H-20)500 GAL DRY WELLS ( WITH 4' CRUSHED STONE) IS TO CALL "DIG- SAFE" AT 1-888-344-7233 AT LEAST 72 HOURS SOIL CLASSIFICATION . . . I PRIOR TO COMMENCING WORK ON SITE. DESIGN PERCOLATION RATE . . . . < 5 MIN./IN. 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS * NOTE. NOTIFY PESCE ENGINEERING EFFLUENT LOADING RATE . . . . . •74 GAL/DAY/S.F. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. TOTAL LEACHING CAPACITY 339.49 GAL/DA Y 8) PARCEL IS IN FLOOD ZONE-- "C" . 24 HOURS BEFORE REQUIRED INSPECTION SIDEWALL- (19.16' t 16.5) X 2' X 2 SIDES)(.74)=105.55 CAL/DAY 9) LOT IS SHOWN ON ASSESSORS MAP _ 116 AS PARCEL �__70 B07TOM.• (19.16' X 16.5)(.74)=233.94' CAL/DAY 10) NO WATER SUPPLY WELL EXISTS WITHIN 150' OF SAS REV 8131105 22THIRDA REV 9/2%5 SHEET 2 OF 2 JOB NUMBER ______------ 10 9'-5" IB'-8" 8'-O" 4-5 " 2'-11" 4'4" i'-911 31-9u DRAWN BY: JPC CHECKED BY: JPC Q 1�1 ISTING _ s 4 00 wx 0 0Ii - � XISTING 4 z0 Q TH s N °- ahEXISTING KITCHEN I EXISTING w Q 2-6 MUDROOM 4 +- _ _ q o m o I ------ FEcq q p M 1 �n r_ Q -------- EXISTING -------- EXISTING 0 0 $IED ;pOM -------- LIVING ROOM U a • K ------ t ad N 3Mr 6'-2" ol ol ----- ------------------- ol - I I I M 1ST FLOOR FLAN EXISTING SCALE: 114" I'-o" I { _ 1 I EXISTING CLOSEt. EXISTING BATH 14 lu to I ju o 1 Z O N Lu lu EXISTING -------- EXISTING O i� > BEDROOM —————— BEDROOM LU/ I I -------- I ------ i CD lu O I--------------------- I DATE, 3/1/05 26'—o II SCALE: PRO r NO. 2ND FLOOR PLAN - EXISTING 2005008 SCALE: 1/4" . 1'-0" V SHEET NO. COPYRIGHT OLDS CAPE BUILDING CO., INC. 2004 NO, 1 OF 10 C C PLAN Off? ADDITIONS 4 RENOVATIONS AT HU5eELL RESIDENC: E 22 THIRD AVENUE OSTERVILLE, DRAWN 5Y: t v � j r4%1 4C� ' r 33,E 6 VICE ROAD * SA.N0UJICW * MA * 02563 PHONE: 5os 28=320 FAX: 509-420-1321 EMAIL: INFOOOLDECAPE5UILDERS.CoM OWNER OF RECORoo DAV ID R. HU5MELL PvO. IBOX 24 INDEX` OSTER V I LLE, MA 02655 A-1 EX16rINCs FLOOR PI.AN6 A,,2 FOUNOA r/ON FL AN A-3 FIR6r FLOOR PLAN A-4 6ECONO FLOOR PLAN A-5 FRONT $ ,LEFT EVA rION6 A-& READ' $ R1614r ELEVA TONS A-1 6ECrION6 A-8 OEU11.6 A-s FIR6 r Fl.OOR FRA MINCo P/.A N A-10 6ECONO FLOOR FRAMIN6 FI.AN ASSESSORS MAP/PARCEL TOWN OF 5ARNSTAIBLE - 11i&/010 REGISTRY FLAN IBOOK/ 'AGE IBARNSTA5LE COUNTY - 21/135 , TM g'-511 70, 4'-311 DRAWN SY: JpC CHECKED BY: JPC ISTING z-s 0 0 �, o (� I - 4 XISTING _ z 4 EXISTING TH Q p KITCHEN 21.6" EXISTING lK MUDROOM 4 m SF M Q N !LU FE c� 3-O' 3-O' O M EXISTING ---- ---- EXISTING: N rL OFFICE ---- ---- LIVING ROOM O U U d) cg U ,of26'—O" 6'-311 V I-311 LL '018'-4" 5'-411 Ip I-^II �1—^II l LL LL d K U ..+ 21—I11 �V } �----- -------------------- 36-1° I I w I I I I cal ol I i 1ST FLOOR FLAN - EXISTING i SCALE: 1/4" = 1'-0" ---------------------- — I --- I I I EXISTING I CLOSET EXISTING I MATH N N , I I , I JU MI I Lu , Q A �i.t I I EXISTING -------- EXISTING BEDROOM BEDROOM-------_ O I I � I I I I I ---------------------- g'-3" -6 13' " 6'-311 DATE: 3I1IO�J' z&-o SCALE: PROJECT NO. 2ND FLOOR FLAN - EXISTING 200Bi008 SHEET NO. COPYRIGHT OLDE CAPE IBUILDING CO., INC. 2004 NO, i OF 10 DRAWN BY: JPC CHECKED BY: JPC 0 W ' 01 4 4'-012" 9'-6" 18'-0�s" 24'-0" �/ tY Q (it 6'-O" lu ca 77777777777 Q M M 4 O O 3'—O" r � v lIZ71 IL to --------- ----------------------------- ' L--------------r � EXISTING ACCESS � - - '---t'=4t'-x-$" t=41'-x-8 -- S ,, --- --------------------------- a ------------------------� 4 3 r Y�Y r77—XI S°X4' POURED CONCRETE till ; o ; �� If Q. p WALL$ ON 16 X8 KEYED FOOTINGS IIII 1 I NOW IIII I I I d` O z X — I IIII U. fill W ( Z Z 6 X2 6 X1 O POURED ------- CONCRETE PADS iiii , o } ------- un IIII I I — ,h ------- IIII , , V� ✓F4f __-_ -_ 4" POURED CONCRETE SLAB I n I 1 1 m OVER COMPACTED FILL I O I nu 1 6, ------- SA=UT 3'X3' Q -- iiii__-; ((� ILII IIII I � 1 IIII � I p I IIII I I I ------- IIII " I O I I I �I'-8 i t a 1 \ � I11 I I ----------------------------------I"I-----— ------------------------'-- 0 I � I IIII I " UP t v ° b 4 `a a v ° 4 P `a v ° 9 t7 1 --------------------------------------------------- --- Q 40-MIL RUBBER MEMBRANE V l 01 -oil z '111, "> 6'-011 26'-O" 24'-0" Lu lie i I I I I I I I I I I I E NEW =; EXISTING ; E NEW =3 I I I I I I I I O FOUNDATION PLAN SCALE: 114" 1'-0" DATE: 3/1/05 SCALE: 1/4"=1'-011 PROJECT NO, 2005008 SHEET NO, 2 COPYRIGHT OLOE CAPE #BUILDING CO., INC, 2004 NO. 2 OF 11 I ' DRAWN BY: JPC CHECKED BY: JPC W A! � cA a zz' lu ' 3'-11" 9'-5" IB'-8" 24'-O" ol qq yy OC Ll U1 Q 1]! QL 4'-6 4'-8ks" 2'-11" 4'-311 1'-3° 3'-9" 5'-0" 19'-O" ol � � O EXI ING ENCLO ED SHOWER I I 911 I WALK-IN PANTRY di 4'-IOya" 2'-0" D,w, i C12-2 ----------- LF N O O POWDER ROOM I I I I 8" I I II I I I I R G. 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