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HomeMy WebLinkAbout0088 TOWER HILL ROAD - Health 88 TOWER DILL RD. QSTERVILLE A = 141 031 I i � t a 0 o 111 � 2J��cvccAo�� Il1l UPC 12134 N0.215 GN 'bsrco � HASTINGS,UN � y�Iif✓�f�rJ9'bl G/�✓ O%�v� . y + 1 ` i i Message Page 1 of 1 Miorandi, Donna From: Diana Zaglio[diana.northside1@comcast.net] Sent: Friday, February 20, 2015 10:25 AM To: Miorandi, Donna Cc: 'Gordon Clark' Subject: RE: Crow Project Drawings from Northside Design Hello Donna, Thank you for the recommendation. We have discussed the garbage disposal with John and he has said that he rarely uses it so we will pass your recommendation on to him. Diana Diana.northsidel@comcast.net Diana Zaglio Northside Design (508)362-2210 From: Miorandi, Donna [ma ilto:Donna.Miorandi@town.barnstable.ma.us] Sent: Thursday, February 19, 2015 4:29 PM To: Diana Zaglio Subject: RE: Crow Project Drawings from Northside Design Hi Diana: I have consulted with my colleagues since they will be the ones to sign off on the building permit. It is highly recommended that John Crow remove the garbage grinder because he does have old permits in file stating 3 bedrooms. Doing a deed restriction would forever prohibit him from going to 3 bedrooms. Donna Miorandi -----Original Message----- From: Diana Zaglio [mailto:diana.northside1@comcast.net] Sent: Thursday,, February 19, 2015 4:20 PM To: Miorandi, Donna Cc: 'Gordon Clark' Subject: Crow Project Drawings from Northside Design Hi Donna, Please find attached the existing and proposed plans for John Crow at 88 Tower Hill Road. I've CC's Gordon so you will have his e-mail address as well. Thankyou Diana Diana.northsidel@comcast.net Diana Zaglio Northside Design (508)362-2210 2/20/2015 Fee r No. D C �� f �. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION-TOWN OF BARNSTABLE., MASSACHUSETTS 2ppricatiou for Migpoml *pgtem Corvgtruction 30ermit Application for a Permit to Construct( . )Repair( )Upgrade(/Abandon( ) Complete System . Y Individual Components Location Address or Lot No. 811'fpw ec 1.4-,11 R p A d Owner's Name,Address and Tel.No. Assessor's Map/Parcel ry 1 3 I &Ot Nils fLb os�2v.11c rm Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. CnPew;dt SOTS 1,q -A2 lira `Ye•I S M5 P.Q. %Qj, ��7 L(y/FrvniS ✓Y!p SOR 740 -cTZ'1(j Type of Building: Dwelling No.of Bedrooms 2- Lot Size Ito 10 G sq.ft. Garbage Grinder(✓) Other Type of Building Sin )— � +�y No.of Persons i w. Cafeteria( ) r— Other Fixtures Design.Flow 2-z-z,- gallons per day. Calculated daily flo(evision `t1 . gallons.Plan Date 2-?- o V Number of sheets 2 Date (� N �r Title $� T ' kk ��A Size of Septic Tank 1 Soo i 100 Type of S.A.S. 500 4 L- Le.gcS. c-L,4,6 c,. Description of Soil: 15:5z;�Q Qlb.V-% Nature of Repairs or Alterations(Answer when applicable) Ab joou so) 4-Zo I�k- To Gs�s� (.1pnA<2 1,3e LR4-d.�•Xjj QC tom) sdo 15om- l u4a Lam,.a(sex t ` Date last inspected: Agreement: . The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board of H lth. Signe : Date 3•Z—Zb b(o Application Approved by _ Date Application Disapproved for the following reaso s Permit No. Date Issued I r.-•`No°wr.[: Dt-' ` �/ `�� � l e' Fee 't ''` P3• THE COMMONWEALTH O;F-. MASSACHUSETTS Entered in computer: `IM . Yes PUBLIC HEALTH DIVISION -TOWN OF`BARNSTABLES MASSACHUSETTS ���ricatfonfor �ig�ogar, �p�terrt �Cor�gtructior� �errrYit Application for a Permit to Construct( )Repair( )Upgrade(,, Abandon( ) O Complete System LI Individual Components t Location Address or Lot No. ai$ -Fo w e r a 11 2 v A GQ Owner's Name,Address and Tel.No. \ Assessor's Map/Parcel I t l' 1•k 1 1 r USiE(Zv.�IG r'Y�r Installer's Name,Address,and Tel.No, Designer's Name,Address and Tel.No. t; aPew,de N ,Cvrl(„Sc5 �G �I22 t,i 1,.10rc, �Z5 141 A 710 C�{v,.;it e vv✓•� c.t e 3 t .��•,, S vlir,q Type of Building: Dwelling, No.of Bedrooms ' Lot Size 1�2 0 G sq.ft. Garbage Grinder(VI) Other Type of Building 5;Ac e 4�, ( No.of Persons I veers Cafeteria( ) Other Fixtures —r c_I' a' Design Flow 2� gallons per day. Calculated daily flo 4`{ (0 1`� gallons. Plan Date 2-7 - Zo a ` 3Numberiof sheets 2 evision Date Title 'Zi T e2 V�\\\ " Size of Septic Tank 1 S700 eX'15k;nL I00o Type of S.A.S. t L �,e s ✓.�,. Description of Soil <C:ca' 1 n, , Nature of Repairs or Alterations(Answer when applicable) ) 10 o O 0I / -Z u s{p ,c i l2 f Ta tRtcv ,M - J��e .6 't, GA y Gem" Ll•,A�Ga-f s . Date last inspected: - ` Agreement: ' { t 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 this Board of Health. Signed " 4 . ✓9 (— Date 3-2. ,,,--'Application Approved by / l / �' I Date *Application Disapproved for the following'reaso s v y Permit No. Date Issued i — THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS - Certif irate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired( )Upgraded(tom'') Abandoned( )by GAPd j%'A2 L e.(P/ 5e 5 LCe ` • at ZZ T a,,j2r 0 1 Ad O S TC 2 v i 1 I e ha bee constructs in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No dated Installer 11(�aR_ �n f=' i -r Di 1 5&5 LL L Designer G s d3 L i n c. 2 • S E = The issua ce`���o'this permit shall not be construed as a guarantee that the system(will function as designe Date /7/ Inspector11t) c Ai. tes D. — ----------- ------- -------Fee No. — Fee - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE MASSACHUSETTS ligonl *p.5tem Construction Permit Permission is hereby granted to Construct( )Repair( )Upgrade( ✓Abandon( ) System located at 18 'Fo w e'r t4,1� G S i k 2v+ It 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. x s: Provided: CXnruc Ion ust be completed within three years of the date of thi pe it. Date: 1_2 a t Approved b PP y i L_ Town of Barnstable Regulatory Services Thomas F. Geiler,Director MAKI Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 • Installer&Designer Certification Form w Date: ,3­14'C76 Sewage Permit# Assessor's Map\Parcel l 1 Designer: Lj,5�1 Installer: 6*6 Cafj�e 0i-', Address: 4-YAWA115�W-T6tP_ Address: 000-36x 7& 3 HY"Afis; tires 0260 61 tl, 0 7 G 37. On 3 i ( .C;7fi,Uf was issued a permit to install a (d te) (installer) septic system at (nj -/bk)gY ALl— 43, DS-f based on a design drawn by (address) /J W L dated (designer) t/ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed-with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State &Local Regulations. Plan revision or certified as-built by designer to follow. IIU��� �� of Massy 014b AW —� staller s SIgnature) o : too (Designer' i ture). (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE'WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. M Q:Health/Septic/Designer Certification Form 3-26-04.doc r GRAIN SIZE DISTRIBUTION Data Sheet 6 Project Job. No. 2005-23k Location of Project A8 Tower 44:l1 1ZJ Boring No., Sample No. Description of Soil" Depth of Sample Tested By. Daww C&pe Date of Testing Grave! Sand Coarse to Fine Silt Clay medium U.S. standard sieve sizes " 0 o i o0 0 ^ .. V CM Z. Z . "Z 0 6 6 Z Z Z t00 — ( I I I I I 1 I 1 I . sCD 6o I 3. - 1 a ao 20 " ► ( I I s� I 0 O -... O .p -.p Grain diameter, mm Visual soil description o�►m Soil classification: System r 'Idi °"' 75 ✓1.9BNIRACFOP BNALI:.VERIE �,} Ayy yxNppwPDUDH OPFJ11Nc6 CDNTMOTOq 6MALl VERIfl K T-R1 Im pp :DIMENBIONe PPIOR TO tk. L'CONBTRIICTIDN:,CONTMCTOP� TNaep TNmO '{u. 41�B6UkE6 gEePoN6161Utt FOR MI961HO Oq.INCOPRECT ' 1 - THAT ATTENTION OF THUGHT TO �7( y'�L ^ro'IX DES—EMION OF THE- h OA B Y 7- - -- I I I I I I I DE6IGNER I Prrd IX I III r I a .6oP I!�P61III , ________________, ' I� i W.C. BALCONY AREACOMPUTER I Y aiuA A.5 N0. REVISION DATE ' I �__� ❑ �A WOO F O RDE—THEREBv EXPaE68ly RE6ERVE8as co"ON-N mil' T{�• -0�---6'_y`-�-i I ' COESE PLANS , TNE6EPLNOTTO6E REPROp. MRM.RMA A.8 I - uAT IX I COPIED N ANY FORM OR M.WNER _ T IX __............._.. -..-._........_........................ 'MUT 4EVERYATNWTFWST A OBTMNINOTNF EtPREs6veDTTEN PERNa ONSIXrOF C SI.E utO NOaTN610E DESIGN A650CIATEG. mn� WET BAR I urn I I BUILDER: 1 1 1 Fan Pno. RECREATION RM, mN0 m•TC �s�'� DESIGNER: NORTNSIDE DES Y ® I ASSOCIATES -�'l ` Islty-wo laalva.w —BALCONY .. 14 xmnxuq,ycwdsrHn w .. nra:' 1 4 wt wrAnm - STRUCTURAL ENGINEER: TAYLOR DESIGN LLC F" STAMP: I ❑ PROJECT: °n'�TO1G PROPOSED CROW NOTE: GARAGE !I °�°•�T°'D .uL NB¢+aN9 ARE TO Be 88 TOWER HILL ROAD ,ILE•❑ VI OSTERLLE,Mk u1LEB9 orNERwBE NOICD.' GRIUEB AFRIm PFR BUILDING PLEVATIDILT • TRLE: SECOND FLOOR PLAN -14i NpU0Np7BNiNG54 lowivgpi i n®a TNoa T- 'J`' '°''fie •� QoTBIT IIEBKiNNNUT,FDPR­ R _ "h�A, rWM10.TIllNCDRRRO A` TD L..T A `.. ^Tf____ _ __, 1 * COMGUTEq Y '"' .� ,�Y "' 'AW'�3N'bF.;' •L'4 i WC. I AREA 'BALCONY T 1 nA-.vn I II III 1 I I • � NN q i hy,• rl _ATDRf(d___. I $ &,F 0 os'?aq '� xy •.�k` 1 L>IT ODOR C! �'xFP-p Q C�P11L TF+�•• NDRT01 NeWl NBPgY 6LY � �• T � ar• •.. � Ss 'Y�+.� CEBEp'jEBDe�w1MfRl w't 1MEg6E��wARE ROT{FtBR D!MlATED A.5 --. .. To vAUL.IX vAULr a. I or- ......... IwITTAIM60TN A.s '' NOgTN810B OEe10NA680CIA I WET BAR I I ,IRk .�'8,._Y ;;$. y I BUILDER m��en elE P sE. mvmanTG rw RECREATION RM. uvice wai - arARrxn Root ; e,DESIGNER ti $1°"PITd N _ OR'PH81D Y . DESIGN� - Y.NLT IX YAIAT L.1. _ ®`AssociAms1 - - .Frt01IX LOvan o,i x[•IgipO uRMr xCNlmrauFx :.. •D[Ix —_BALCONY �' ....'.-.-.. ...... -..... .::.,: f.rl Nu•m STRUCTURAL ENGINEER:' r-c eAlr'vre Ti TAYLOR DESIGN LLC STAMP „y` ! �A - PROJECT: PROPOSED CROW d GARAGE tr Nl NINDaef ARE To Be 88 TOWER HILL ROAD ❑ ANDEA901.10p 9ERIp• OSTERVILLE.MA LFarESB orNFRx6sE x°rm. fdilD.p APPLIED FFR ' BUILDING ELEVATIDN9 ' TITLE: mEA,Ta„w .......... ttD I SEr —I, w' w GARAGE i I rur � wu _ c.v xc. . w« _.._.. \� .BATH �w.M °n rr wna„mJ STONE PATIO p ,rw `�• AIQ+ csoert ° awe i w'wivaTM 'w��,., � ewulTMlomo soi..vmu I E 1 ' DECK ....._ i_.1_� ASSOGLlTE9 -- I .�m.mmm.mmmm.m.0 b .• w e�Evomve exo wevuuo J / w....v.n....m,. w+u i I / xm„v��...o.�• gRDESIGN LC TA- GROIEGt: i, aoanc CROW � GARAGE wu/ mT—R D / / —ERNLLERiM. / R£: GROUND FLOOR PIhN I PROPOSED GROUND FLOOR PLAN OF /, oATOEv,v+s 4 li I cExEMI TOTES aO'fi- I, -r- I !u I xo. oxre - /,,—/_____T ¢ ummwxoEevx.xe«ur I \\ g$ -- REROx \ ' cEscxEH: I \ ®0.nttHrsllxp¢ � I DacEw.K I r , i a .�.°EO ...:e�i.oxv .:.. °m -. p � srvunuvu Exc xEe+. I - aE'� �-- �� / TAYLOR DESIGN LLC mlc j CROW / =.'IG vow /' f£MERNLLE W. TRLE. SECOND FLOOR PUN ____--------_ _____________ __ �__________________________� A III �EET I PROPOSED � Z 2ND FLOOR PLAN OF 4 TOWN OF BARi`dSTABLE �- LCt�'1"iOPd�� uu�tr 11 SEWAGE # (A0 Vu, AG o S tCE U L Uf ASSESSOR'S MAP &,LOT I'ALLER'S NAME&PHONE NO. ►? wtn �4 ,S'y y'att yu.IQ SEPTIC TANK CAPACITY !s 0 U LEACHING FACILITY: (type)� UO C�Q r� e.. (size) NO.OF BEDROOMS .BUILDER OR OWNER PERMTTDATE: _?/7 46 _COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility A10 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 Zb � K W •J W ` 4c. r TOWN OF B/ARNSTABLE 0/ °C,�� L• ATION ' men G SEWAGE #20M / VILLAGE � �''�y` P r ASSESSOR'S MAP & LOT A_ of INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) ��f'`` tf(size) NO.OF BEDROOMS BUILDER OR OWNE PERMTTDATE:--16b 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 I No. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 2pplication for Migpogat *pgtem Construction Vermtt Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.6 Sr To,,..,^ l ltt � Owner's Name,Address and Tel.No` 6 .� Assessor's Map/Parcel j` 1 ysS+- s� h 4 Installer's Name, dress,and Tel.Ns. �� & Designer's Name,Address and Tel.No. di OL Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other 'Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alteratio (Answer whe plicab ) 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 Environ�i n ecde and not to place the system in operation until a Certifi- cate of Compliance has been issued by t ' B of ReM Signed %° M __ o Date Application Approved by ' Date Application Disapproved for the following reasons Permit No. Date Issued No. _.- fie THE COMMONWEALTH OF MASSACHUSETTS Entered in-Computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Zippfication for Mizpogal *pgtern Construction Permit Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System 0 Individual Components Location Address or Lot No.&SI I 6.&^ M lk V A Owner's Name,,Address and Telt.,.Na. Assessor's Map/Parcel Installer's Name,.gddress,and Tel.No. 2 Designer's Name,Address and Tel.No. « Type ofZuilding: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder{ ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtdres" Design Flow gallons per day. Calculated daily flow gallons. j Plan Date k Number of sheets Revision Date ' Title - Size of Septic Tank Type of S.A.S. Description of Soil i r t �Nature of Repairs or Altera Answer whe a e) `! AQ 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 is ed by this B6afd of Health;' all o Date O �� r F. Application Approved by Ir Date �r Application Disapproved for the following reasons r Permit No. Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance , THIS IS TO C h the - " e w System Constructed( )Repaired ( )Upgraded is os l Abandoned at constructed in accordance with the provisions of Title 5 and the for isposal System Construction Permit No. Lq dated Installer Designer The issuance of this permit shall n �t be construed as a guarantee that the systefn'` i 1 function as�ielsigned. v Date �n �� Inspector AM ------ -��--------------------------- — — -- No. / Fee= THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Ziopozal Opgtem Conotr ction Permit Permission is herebyrR to C ct(� air( )YTale( Aba�o System located at U r 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 mu t be co pleted within three years of the date of&9�k Date: �a 0� Approved by TOWN OF BARNSTABLE LOCATION �e1'! / SEWAGE # .�CVW VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY IS LEACHING FACILITY: (type); (size) . NO-'OF BEDRROOM.S iBUILDER OR OWNS �V 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 oiwithin.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 M TOWN OF AMSTABLE LOCATION l SEWAGE # VILLAGE 1d ,c �� ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) (size) 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 Pi III," I ►� y ,a DATE: 7/8/99 PROPERTY ADDRESS:--88. Tower Hill Road --------------------- Osterville ,Mass , 02655 On the above date, I inspected the septic system at the above address. This system consists of the following: 1 . 1-1000 gallon septic tank . ! �� "�, 2 . 1-1000 gallon precast leaching pit . a 3 . 4— infiltrators . �p Based on my inspection, I certify the following conditions: �0 4 . This is title five septic system. to 11040, o 1. 1 5 . fThe septic system is in proper working order �'`� -'999 gat the present . time . - �� �o4j� 6 . The overflow line to the infiltrators comes from j J the leachin pit . Not a distribution box. SIGNATURE: _J Name:_JLFL Macomber Company: Jose2h_1 . Macomber_& Son , Inc . Address: Box 66 Centerville , Ma . 02632-0066 Phone: 508-775-3338 THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY JOSEPH P. MACOMBER & SON, INC. Tan ks-Cesspools-Leachfields Pumped & Installed Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 775-3338 775-6412 COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION ONE WINTER STREET, BOSTON MA 02108 (617) 292.5500 TRUDY CO: Sacreu ARGEO PAUL CELLUCCI DAB B. STRU! Governor C o mm-s-s`o t SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPEcnoN FORM PART A CERTIFICATION PropeMAddr".e: 88 Tower Hill Road Name of Owner Donald Corey Osterville ,Mass . 02655 AddressofOwner: 330Beacon greet D au of kupect;w: Boston ,Mass . 02116 Name of Inspector:(Pteasa Pram!Joseph P. Macomber Jr. 1 am a DEP approved system kupectoe purwarrt to Section 15.340 of TMa 5 (310 CMR 15.000) company Narne: Joseph P. Macomber & Son, Inc. MasngAd&—: p0X 6 6 Centerizille, Ma n2632-0066 Telep�wrw Number: �,fl R_ S—3��8 . CERTIFICATION STATEMENT I certify that I have personally Inspected the towage disposal system at We address and that the Information reported below is true, accurate and complete as of the time of Itupectlon. The Inspection was performed based on my training and experience In the proper function and maintenance of on-site sewage disposal systems. The system: Passes Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Fails kupector s Signausre: The System Inspec shall submit a copy of this Inspection report to the Approving Authority (Board of Health or DEP)within thirty 1301 days o1 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 owns ' shall submit the report to the appropriate regional office of the Department ohfnvkonmental Protection. The original should be sent toZru system owner and copies sent to the buyer, If applicable, and the approving authority. NOTES AND COMMENTS `ryop y /`99e9 revised 9/2/98 Pass i of 1 %, Pnnted on sk"led Pape, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM {> PART A CERTIFICATION (continued) PropertyAddre": 88 Tower Hill Road Oaterville ,Mass . Owner: Donald Corey Data of Inspection:y/8/9 9 INSPECTION SUMMARY: Check A, B, C, of D: A. SYSTEM PASSES: 1 have not found any information which indicates that any of the failure conditions described in 310 CMR 15.303 exist. Any failure .criteria not evaluated are Indicated below. COMMENTS: S. SYSTEM CONDITIONALLY PASSES: /t/t/ 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. Indicate yes,no, or not determined(Y, N, or ND). Describe basis of determination In all Instances. If "not determined-, explain why not. The septic tank Is metal, unless the owner or operator has provided the system Inspector with a copy of a Certificate of Compliance (attached)indicating that the tank was Installed within twenty (20) years prior to the date of the inspection: or the septic tank, whether or not metal, Is cracked, structurally unsound, shows substantial infiltration or exfiltration, or tank failure is imminent. The system will pass Inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. N� Sewage backup or breakout or high static water level observed In the distribution box Is due to broken or obstructed pipe(sl or due to a broken, settled or uneven distribution box. The system will pass Inspection if(with approval of the Board of Health). broken pipe(s) are replaced obstruction Is removed distribution box is levelled or replaced - The system required pumphlg-more than-four•times a•yeardue to broken or obstructed pipe(s). The system wilf-p-ass-- Inspection if(with approval of the Board of Health): - broken pipes) are*replaced obstruction is removed revised 9/2/98 Page 2ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 88 Tower Hill Road -Osterville ,Mass . Owner: Donald Corey Date of Inspection: 7/8/9 9 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: _0 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health, safety and 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.INILL.PRQ7ECT THE PUBLIC HEALTH AND SAFETY ARID THE ENN.08ONMENT: Cesspool or privy is within 50 feet of 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 FUN CTIONING IN A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE 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 soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm. Method used to determine distance _(approximation not valid). 3) IOTHER 1C� revised 9/2/98 Page 3of11 1 SUBSURFACE SEWAGE DISPOSAL SYSTEM WSPECTION FORM PART A CERTIFICATION (continued) PropertyAddreas: 88 Tower Hill Road Osterville ,Mass . owner: Donald Corey Data of trt PO don: 7/8/9 9 D. SYSTEM FAILS: You must Indicate either 'Yes' or 'No' to each of the following: - I have determined that one or more of the following failure condltlons exist es described In 310 CMR 15.303. The basis for this rJi)- determination Is Idendfied below. The Board of Health should be contacted to determine what will be necessary to correct the failure Yes No Backup of•troWage lnw iacif{ty-or-vTelem component•due¢o an overloaded orcbgfled'SASor-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 di tribution¢ox�4ove oytlet Invert due to an overloaded or clogged SAS or cesspool. Liquid depth in c'R's'P"I less than 6 below Invert or available volume Is less than 112 day flow. Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped 0. Any portion of the Soil Absorption System, cesspool or privy Is below the high groundwater elevation. Any portion of a 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 60 feet of ■ private water Supply well. Any portion of a cesspool or privy is less than 100 feet but greater than 60 feet from a private water supply well with no acceptable water quality analysis. It the well has been analyzed to be acceptable, anach copy of well water analysis for coliform bacteria, volatile organic-compounds, ammonia nitrogen-and nitrate nitrogen. - E. LARGE SYSTEM FAILS: You must Indicate either 'Yes' of 'No' to each of the following: The following criteria apply to largo systems In addition to the criteria above: The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to puol. health and safety and the environment because one or more of the following condiUons exist: Yes No ('// the system Is within 400 lest of a surface drinking water supply the systsm•ls-witk;n 200laelof+rt�iLuteryioesurfaoadrirslcirigv+atea suQPly -- _ y the system is located In a nitrogen sensitive area (Interim Wellhead Protection Area IWPA) or a mapped Zone 11 of a pubic water supply well) The owner or operator of any such system shall upgrade the system In accordance with 310 CMR 15.304(2). Please consult the local regional office of the Depanment lot tunher Inforpadon. i revised 9/2/98 Peee4of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ;1' PART B CHECKLIST Property Address: 88 Tower Hill -Road Osteeville ,Mass . Owner: Donald Corey Pate of Inspection: 7/8/9 9 Check if the following have been done: You must Indicate either "Yes" or "No" as to each of the following: Yes No Pumping information was provided by the owner, occupant, or Board of Health. -None of the system-con4waants.ha6w`"n pua►pad4oFatJeasutwo%veaks aaat•tbe•rystem hasbsea�mcswiaq awasal flo rates during that period. Large volumes of water have not been Introduced into the system recently or as part of this Inspection. As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. _ I The system does not receive non-sanitary or Industrial waste flow. _ The site was Inspected for signs of breakout. _ All system component3,41uding the Soil Absorption System, have been located on the site. _ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of batf, or tees, material of construction, dimensions,depth of liquid, depth of sludge, depth of scum. The size and location of the Soil Absorption System orrthe site has been determined based on: Existing information. For example, Plan at B.O.H. Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is unacceptable The facility owner.(and.o—paats,if difieraW from oxcnar),snreraprnyided.with infnrtnatioafln?ha pinpar ainta az a of SubSurface Disposal Systems. revised 9/2/98 Page 5ofII i L f 1 �1 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 88 Tower Hill Road Osterville ,Mass . owner: Donald Corey Date of kupection: 7/8/9 9 FLOW CONDITIONS RESIDENTIAL: Design flow: JAY g.p.d./bedro m. Number of bedrooms es) n),, Number of bedrooms(actual):_ Total DESIGN flow Number of current residents: Garbage grinder(yes or no): Laundry(separate System) (y a brl�o If yes, sepamtslnspection.required --. Laundry system Inspected ry`0 or no) Seasonal use(yes or no): y� Water meter readings,if available(last two year's usage(gpd): — � V2 Sump Pump(yes or no): r�� S'%p�H r 1� Last date of occupancy: _' COMMERCIALANDUSTRIAL: Type of establishment: AA Design flow: A)A QPd ( Besad on 16.203) Basis of design flow Grease trap present:(yes or no)Aff Industrial Waste Holding Tank present:(yes or no)—AX Non-sanitary waste discharged to the Title 6 sysie :(yes or no)A0 - Water meter readings,If avail le: Last date of occupancy: OTHER:(Describe) Last date of occupancy: GENERAL INFORMATION PUMPING REC RDS an ource of inf r ation: System pumped Inspection: (yes or no)19 If yes, volume pumped: gallons Reason for pumping: ./ f YSTEM eptic tank/dL%ulbutinn��Y/soil absorption system ingle cesspool verflow cesspool rivy hared system(yes or no) (if yes, attach previous inspection records,if any) A Technology etc. Attach copy of up to date operation and maintenance contract ight Tank _Copy of DEP Approval Other APPROXI TE GE of all components, date installed{if known)-and source of,;nformation: — Sewage odors detected when arriving at the site: (yes or no)�l revised 9/2/98 Page 6of11 Macomber Customer History Screen 7/9/99 i Customer number 1846 Company — Name Hallatt Plumbinca A dgdog Create New invoice Customer Name Donald �� Find Invoice JobAddrese 88 Tory► 'll Road — Jobaty Carterville Find Customer Jobstate MA Add Billing Address Jo6`��ip 02655 Tel F '° Print History Fax �' Customer List Ming Address Main 6keol ' 4 Print ggty �Jst�ville Buongstate MA wingrip 02655 Notes 121105 Dump BE 260.00 21141qfi 9/161_ p�p I&E.260.00 10096 t J i_! 6t96 pump T&P 26Q00 2/21W hance billing daess to Tcwer Hill Realty Trust 777'7 Carey Lane ibis etas an check 1ldilt�an. Ma 02186 3/i 8197 pwp w 260-00 6117197 5124/97'purnp BE 260.00 Rd _,tea:�u" ;Juba / jr'���,�1.�� �s� I z ` r s ,e i r t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r � PART C SYSTEM INFORMATION (corrtinuod) P,opertyAddraa.a: 88 Tower Hill Road Osterville ,Mass . Owrw: Donald Corey Dau of won: 7/8/99 BUILDING SEWER: (Locate on alto plan) Depth below grade: Matarlai of construction; cast lion�0 PVC,_other(explain) Distance h rjprlvau water supply well or auction line Diameter . . _ I.. , Comments: (condition of Joints, venting, evidence of leakage,-atc.) s gri ouse vent . (locate on site plan) Depth below grado: L � er Malarial of construction: 4�concreto� �F matallberglaas�Polyethylane�th (ax plain) AN II tank Is (netaJ�,sU/st age (/Is,ape•contivmed�by Certificate of Compliance a, (Yes/No) Dimensions Sludge depth Distance from top f sludge to bottom of outlet tee orbstfio: CJy Scum tNcknosa: V1 Distance from top of scum,to top of outlet toe or baffle: _ lj Distance from bottom of scum to b m of outlet t e or baffler How dimensions were detsrm bon Comments: (recommendation for pumping, condiion of Wet and outlet tee♦ or•bafflea, depth of liquid lave! In relation to outlet evert, avucture:;fut svidance of leakage, etc.) Pll - " ana snows no evidence of leakag' GREASE TRAP: (locals on alto plan) Depth below grada:� Material of consuucdon;'concroty(Amota&FlborglassrfJA Polygthylenallothar(explein) AJA Dimensions: 24 Scum thickness: Oisunco from top of scum to top of oudot toe or batfls:—&-� Distance from bottom of }yum to botom of outist toe or,bahle:A, Date of last pumping: : � Comments: lrecommsndstlon for pumping, condition of Inlet and outlet teas or baffles. depth of liquid level In relauon to outlet inert. rrr�ca al evidence of leakage, etc.) Grease t revised 9/2/98 Pata7°r11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) PTop*MAddrau: 88 Tower Hill Road Osterville ,Mass . owr4e: Donald Corey Date of Inspection' /8/9 9 TIGHT OR HOLDING TANK: (Tank must be pumped prior to, or at time of, Inspection) (locate on site plan) Depth below grade: Materiel of construc 'on:� concrete qmotaIVAF1ber9lasa4Polyathyleneotharlexplainl Dimensions: Capacity: gallons Design flow: gallons/day Alarm present Alum level: Alarm In working order:Yesy4LNo&4 im Date of previous pumping:� Comments: (condition of Inlet tea, condition of alarm and float switches, etc.) Tight or hold]g Yanks ara nnt :meant DLSTRIBUTION BOX:AX (locale on site plan) Depth of liquid level above outlet Invert:_ Comments: (notrif level and distribution is equal, evideno-o of solids carryover, evidence of leakage Into or out of box, etc.) — — Dist Distri buti on h n x- i s not nrecant PUMP CHAMBER:/ (locate on site plan) Pumps in working order:(Yes or No)� Alarms In working order(Yes or No) Comments: (note condition of pump chamber, condition of pumps and appurtenances, etc.) _ P i revised 9/2/98 page 8ofII SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (Continued) prop-tyAddres.s: 88 Tower Hill Road Osterville ,Mass . Owne(: Donald Corey Dsu Of trupection:7/$/9 9 SOIL ABSORP_nON SYSTEM ISAS):_L"I approximated by non-Intrusive methods) (locate on site plan,If possible: excavation not required,location may be It not located, explain: Type: leaching pits, number: leaching chambers, number. leeching galleries, number: /►� f leaching usnches, number, length: —��J—r�r-�� leaching flelds, number, dime slonV_- �n '>L/"r overflow cesspool, number . Alternative system: Name of Technology: Comments: condition of soil, signs of hydraulic failure, level of ponding, damp toil, condition of vegetation,,etc.! (note L m iI sa 0 of s are CESSPOOLS: (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 consuuct)on: Indication of groundwater: Inflow (cesspool must be pumped as part of Inspection) r es Comments: ilure, level of ponding,condition of.vegetation, etc.! (note condition of soil, signs of hydraulic la PRIVY: (locate on site plan) Dimensions: Materjals of constructign: /U Depth of solids: Comments: (note condition of soil, signs of hydraulic failure, ravel of ponding, condition of vegetation; etc. Pr i. revised 9/2/98 Pee 9 0l 11 L SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM r PART C SYSTEM WFORMAnoN(continued) ProperryAddrau: 88 .Tower Hill Road Osterville ,Mass . ow^"' Donald Corey Dau or ku-0.ctiwi: 7/8/9 9 SKETCH OF SEWAGE DISPOSAL SYSTT-V: Include dss to at Fait two permanent ralerance landmarks or bsnchmarks locate all walls wlWn 100' (locate wham public water supply comas Into house) 1� $� Iot.U2.,n 1 revised 9/2/98 Paerloorll SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 88 Towerhill Road Osterville ,Mass . Owner: Donald Corey Date of Inspection: 7/8/9 9 NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep _ SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater/—O—Feet Please indicate all the methods used to determine High Groundwater Elevation: Obtained from Design Plans on record Observed.Site(Abutting grope observation hole, basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps !/Checked pumping records __J,/Checked local excavators, installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) Used water contours map . Gahrety & Miller Model 12/16/94 revised 9/2/98 Page 11of11 1 •I.'An�RIT1�T1-\11fJ"lRI•I\iPf!\/'R.Il1Rl�I.Rl1T71RITlT.T1T\11R\L A11Y'I�•f1r1'1 .TTT'f-•t�.V+"T...�..,- Id f TOWN OFBARNSTABLE [X)ARD OF HEALTH � SUDSU!lFACF 9FHAGE DISPOSAL�SY�3TFM IN�9i'F�CTION FORM - PART D .- CERTIFICATION —TYPE OR PRINT CI.EARL1'— PROPERTY INSPECTED STREET ADDRESS 88 Tower Hill Road Osterville Mass ASSESSORS MAP, BLOCK AND PARCEL OWNER' s NAME Donald Cofey PART D - CERTIFICATION NAME OF INSPECTOR Joseph P. Macomber Jr. COMPANY NAME Joseph P. Macomber & Son, Inc. COMPANY ADDRESS Box 66, Centerville, Ma. 0263.2-0066 Street Town or City State tlP COMPANY TELEPHONE (508 )775 -3338 FAX ( 508 )790 -1 578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system nt this address and that t11e information reported is true , accurate , and complete as of the time of .inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one , System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or -the environment as defined in 310 CMR 15 . 303 , Any fail�lre criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . System FAILED* The inspection which I have conducted has found that the system fails to protect the public health and the environment in accordance with 'title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signatur U ` l� / Date One copy of this rt.ification must be provided to the OWNER, the BUYER ( where applicable ) and the 130ARD OF JiEAL1'1(: • If the inspection FAILED, the owner or•'o` aator shall u Pr pgrado ' tho eyotem i within one year of the date of the inspection , unless allowed or required otherwise as provided in 3.10 CHR 16 . 306 partd . doc 2_ a TOWN OF BARNSTABLE LOCATION 8 701,h9 i�l b SEWAGE# 1 - --�-vs;aQ + VILLAGE Y�S� � A- ASSESSOR'S MAP& LOT I V 1 0 31 INSTALLER'S NAME&PHONE NO. All:) SEPTIC TANK CAPACITY LEACHING FACILITY: (type) I A341 (size) U NO.OF BEDROOMS BUILDER OR OWNER -PERMIT DATE: Z=s�� ` g 7 COMPLIANCE DATE: -7 Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet I` Furnished by -- -- - -- 1 No. G Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS 01ppYication for Dtoo i *pgtem Congtruction Permit Application for a Permit to Construct( )Repair )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.C`� \� Owner's Name,Address and Tel.No. Assessor's Map/Parcel I b31 . I er's Name ddress,and Tel.No. Designer's Name,Address and Tel.No. o - Do- Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow c-34) gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank %!�OD Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) 00 �— LA kk I !C.d vim- (AJ C k--, Uye✓ 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 kvironmental Codpe4nd not to place the system in operation until a Certifi- cate of Compliance has been ' 's Bo Signed Date -7'a 9.97 Application Approved by Date Application Disapproved for R follo ing reasons Permit No. Date Issued -4, .v :. No. - 3 9' 1 Fee J THE COMMONWEALTH OF MASSACHUSETTS A Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS, 2ppricatton for -Mig o f *pgtem Con!6truction Permit s Application for a Permit to Construct( )Repair )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Owner's Name,Address and Tel.No. Assessor's Map/Parcel I -I er' Name ress,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: welling No.of Bedrooms = Lot Size sq. ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow j j gallons per day. Calculated daily flow -334D gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank S(� Type of S.A.S. _ ` _fin Ca pLi7;5��'{ C�(.C�4\U Description of Soil vv�P 5 K1 Nature of Repairs or Alterations(Answer when applicable) 00 5 < ID—A by `A kA.i �,., Ca Cr I v4i C._T-VCzV 0 YU w I q V Si 0 SWJ V 5 U w Date last inspected: Agreement: ' The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage6sposal system in accordance with the provisions of Title 5 of the vironmental Cod not to place the,,''system in operation until a Certifi cate of Compliance has bee�tn ss Bo Signed r Date . Application Approved by Date '7 -� Cf- 77 Application Disapproved for tfd following reasons Permit No. % ;7- 3 R I Date Issued w THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CER t t 0n-s' a Disposal System Constructed( )Repaired ( ) Upgraded( V) Abandoned( )by �o c� c ��k�;v� at e8`T"OUIJI�(L '. 0S-( Vt e.- has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. %7- ► dated Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date 1 r� - '�/ -7 Inspector �_N __N__1 s -------------------------------------- — No. Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS MiOpoga[ *pftem on5truction Permit Permission is hereby granted to Construct( )Repair( Upgrage on( ) System located at 579 and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date: 7 Approved by f i NOTICE: This Form is to be used for the Repair of Failed Septic Systems Only i CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRUCTION PERMIT(WITHOUT DESIGNED PLANS) hereby certify that the application for disposal works construction permit signed by me dated -7--o1�-mot , concerning the property located at <6—T meets all of the i following criteria: • There are no wetlands within 300 feet of the proposed septic system • There are no private wells within 150 feet of the proposed septic system • The observed groundwater table is 14 feet or greater below the bottom of the leaching facility • There is no increase in flow and/or change in use proposed • There are no variances requested or needed. s SIGNED: DATE: LICLNSED SEPT C SYSTEM-INSTA.ILLER>Tl TNF TOWN-OF BARNSTABLE NUMBER'_ . [Attach a sketch plan of the proposed system. Also if the licensed installer posesses a certified plot plan, this plan should be submitted]. d D7- 0 TOWN OF BARNSTABLE , LOCATIONVR 7'ni.i4CO SEWAGE# 3 8 I ' �21�' • ASSESSOR S MAP& LOT : . VILLAGE fI p �/j. _ 1 y L 03 I INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY J"�-o b S �^ LEACHING FACILITY: (ty ) ` 1,s►/ (size) �/�, NO.OF BEDROOMS BUILDER OR OWNER PERMITDATE: - - 9 7 COMPLIANCE DATE: 7 —a 9- _ Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by IL �. t� Z -�f �Z� 3, 1 u �, �' .�.�. .. ,_- - .� ,: -- F. _, �. .,. . . a.. � r: _ ti _ �.w .� r � � - ,: -, • - - '�= _ r. �- ti.. y 4 .�_.L�,, ,;. �� a `ry`.. .. -- �•K. ' � _ - _ f`i d,r �- �. Yv_ - u.��, s n d ACME PRECAST 520 THOMAS B. LANDERS RD., W. FALMOUTH, MA. TEL. (508) 548-9552 n n i 5 PRECAST SEPTIC TANK ST 1000 1,000 GALLONS 1 -2 1 ACME PRECAST 520 THOMAS B. LANDERS RD., W. FALMOUTH, MA. TEL(508) 548-9552 w ® v 5'- 11" 1 ,000 GALLON PRECAST SEPTIC TANK HT ST 1000 HEAVY TOP 1 -26 i L .OCATION SEWAGE PERMIT N0. �teP� ; i��, VILLAGE INSTA LLER'S NAME & ADDRESS UILDER OR OWNER D'A T E P ERMIT ISS.0 E D J DATE COMPLIANCE ISSUED a L� : r z+I/!Assessor's map and lot number - 1 . 1.1.1� .E yoVT"Eros Sege Permit num er , i House number .........................#� ...................................... Z H98l9TSDLE 9� M6 9 E. TOWN OF BARNSTABLE BUILDING INSPECTOR E5 Enlarge bedroom APPLICATION FOR PERMIT TO ........................................................................................................................... TYPE OF CONSTRUCTION ..........:....WR4d,.. .Ulme..........................................................:......................:......... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....88...Tower„Hill ...... ...�sterv„ille..............................................:................................................... Proposed Use .....Enlarge...bedroom„with...8.1....X..14�...addition.................................................................. Zoning District ...RC...............................................................Fire District .Qenter;yille 0steryille Name of Owner . ...C4.t.Unt....Jx....................Address ...$. T.Qwa :..UUL.RdA..................................... 1-1 ' . `Name of Builder Richard DesJardins . . Address ...De.nni.s..................... . ....... .. .Name of Architect .........................-."....................................Address .................................................................................... Number of Rooms .5...r o.oms...existing.......................Foundation .......block.......................................................... Exlerior ................WOOd..shl21gl9....................................Roofing .......asphalt...shingle..................................... Floors ..................PA)NA ,k........................... ................Interior ........she,et... ock.................................................. - Heating }ti._..__..... Xlhf/4.,a . Plumbing ..MAX.,y..Q.oP.P.er,,...:Lw .hgthq.................. Fireplace ..............Q.Xi133jXW...............................................Approximate Cost .....0.1.099!.............. ........................ Definitive Plan Approved by Planning Board -----------_---_—-----------19 . Area ..........le. f Diagram of Lot and Building with Dimensions Fee .............. . ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH ts0, 0 l °q j U I H it Z 3 � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........ .. ......... ................... 1.4CAT`10N SEWAGE PERMIT NO. VILLAGE tauCAi�e�' ��(, L��t 5 �' de w i s 1,ck- INSTA LLER'S NAME i ADDRESS - 3 UILDE R OR OWNER DATE PERMIT ISSUED � � L0,� .`� DATE COMPLIANCE ISSUED �1 �, � � -6" �=- ;- �; .................. THE COMMONWEALTH OF MASSACHUSETTS I BOARD ,PF HEIL4TH. - --------OF..... /I...... ................................. Appliration for Dhiposal Works, Tomitrurtion ramit Application is hereby made foX a Permit to Construct or Repair �an Individual Sewage Disposal System at: f/ . 1--K/_ ;.. ................................... i .. ............... .............................................. .8ocation"Acm4gs I N Owner. . . ....... ca" ....................... ................................... ess .......... ............................................... Installer ---- ------------------- Address Type of Building Size Lot........................"""Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic Garbage Grinder '_l P4 Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Other fixtures ..................... ................. Design Flow............................................gallons per person per day. Total daily flow...........................................gallons. 9 Septic Tank—Liquid capacity------------gallons Length................ Width.......__.______ Diameter-___..__-___-_- Depth...._...._...__. Disposal Trench—No. .................... Width..............._._.. Total Length.................... Total leaching area....................sq. f t. Seepage Pit No..............:...... Diameter.............._..... Depth below inlet.............._..... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I............:...minutes per inch Depth of Test Pit_._._.._............ Depth to ground water..__.__....._........__. Test Pit No. 2................minutes per inch Depth of Test Pit.............._..... Depth to ground water-_-_--_____--__--_..___. ................................ .....*..........**.........."--------------------------------- ------ 0 Description of Soil-----------------........................................................................................................................................................ ......................................................................................................................................................................................................... 42­ dalc_� .4..,(—. Nature of Repairs Alterations Answhen ppiicabie _IjI Agreement _.r --. .- ...............................The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TLIME 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been i�511 the Ord of health. Signed...�� 01 06� .......... .............................. . ............... ......... Date ApplicationApproved By................................................................................................... ---------------------------------------- Date .Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date Permit No......................................................... IssuecLlj.�...� ....................... Date Noy ,.:r... :: ...� Fims ::`.:....._............... THE COMMONWEALTH OF MASSACHUSETTS BOARD F HE L H ........OF....:' .. Appliration for ll1opoii al Work# Tonstrnrtion Prrulit Application is hereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal Systemat: t. .. s � 4! - __.... .... ----.i ... ............... ... ... ..................................................... ocatio A .... ..._ .... . f; - f•E•-�`2' 1°Q✓ :�Lot N .`.e ................................• _'Owner ress .--_ a�•-tpG.`. t !. .. ,.�.. ..... ......... ..... .. .. .. ................................................ Installer Address Type of Building Size Lot............................Sq. feet U g— ............................................Expansion Attic ( ) Garbage Grinder ( ) Dwelling No. of Bedrooms.................................. `4 Other—T e of Building ._.•_...__..._. No. of persons............................ Showers — Cafeteria tZ•I YP g -•---------•- P ( ) ( ) .. _-----------------------------•-•-•---•---••--•------------- ----••---------------- � 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........................................ ,4 Test Pit No. 1............:...minutes per inch Depth of Test Pit.................... Depth to ground water........................ (T, Test Pit No.2..:_':::_._.....minutes per inch Depth of Test Pit.................... Depth to ground water........................ :.`::....::.--•--•---------------------------------------•---............--------•--•-•-•------•------............---------...--••-----..........__........._...... 0 Description of Soil....:....::............................._.............................................................................................................................. W ------•••-•--•--.....:---•---••••-•-----••-•-------••-•••••••-•. •---•-•--•---•-•-•....••-••-•--•- UNature of Repairs o Alterations—Answhen pplicable ---......_.. Agreement: /f The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance-with the provisions of TIT12 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issM��Z,4 the rd of health. ,•#x, r _ Signed •C ra = Date ApplicationApproved By•••-••-•-••------•-----•---...---•..........................................., Date Application Disapproved for the following reasons: -----------------------•------------------------------------------......-------- i .................................................:....................................................................................................................................................... Date Permit No............................................... Issued-....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD F HEALTH r:... �.........OF . . ........... ....... ............................... Trrtif iratr of Totnpllatta ' THIS IERTIF , That,the Ind vidual Sewage Disposal System constructed ( ) or Repaired by......... _. .... .................. at._ .��. Install _ i . '^._----------•---------•-----------------•--•---- has been installed in accordance with the provisloris of�'TI F 5 of T e State Sanitary Code as ' the application for Dis o al Works Construction Permit No . 3..... dated_...._ f�,. fir THE ISSUA E OF THIS CERTIFICATE ;SHALT: NOT BE CCl:6dST E® AS GUARANTEE THAT THE SYSTEM WILL, UNCTION SATISFACTORY. ' DATE �l !� 7 Ins eeton - S. P j r a ... .�w✓�•# y(L r-.,..rr r :4� �+�n :v.�'a .. rr 7 a'�'• �, t%;;-.+4 r h L tx`I' ,� s k, `w� .asr lr.k• v�..a i:v'�x '� y, Y^' s° ' `Y,a 'i++n.a, r s e . 1 w^t '''•�� ,,,6 � .wr «-.eE t g THE COMMONWEALTH OF MASSACHUSETTS ,.. ,,:BOARD F HEA TH ... ?Y1 .........OF... G r.f�4K + N _,_ FEE...: .............. Disposal 19 rk. Toni ,urtion �erntit Permission is hereby grante .---- .... r ................. to Construct-( ) or Repair Individ al ewage Disposal S,y�+s�tem at No........ " St: {= �. .__.... uls'`�=- '`Z�"4�' t. .. Street as shown on the application for Disposal Works Construction emit A Dated... 3 ram. .................... $-•---------------- B/ oard of H th w DATE.... ------------------------------•--••-------•---•--•••-••--•-•...... s FORM 1255 HOBBS & WARREN: INC., PUBLISHERS Azo1 2 �LONGFELLOW D E S I G N B U I L D e-2' * 8'-Z, a-1314" ---------------- ---------------- ---------------- ------- Z. 29-G' 'm -23/4 -._._r ,.._1 r__., _ __ t.__� _ ___ J___.• r.... .d LONGFELLOW DESIGN/BUILD ._., , ._ _ 0 "'t - _ 367 Main Street,Falmouth r MA 02540 (774)255.1709 1 11'-11" T-1112" 5'-6" 3.-IMF _ - [24-W. STORAGE UTILITY CL "" =PROPOSED STEPPING t0 NICHE STONE PATHWAY _ r ° EQ.' EO. 3'-23/a" 4'-8314" 5'x5' PROPOSED 26'-613r32" O7 © Eleva[af `"_'' ..._ STONE PATIO n e o e i �\ .. CK) ' r -- - - - 3"ANGLED LIP r T-5 7116' N 24°W.NICHE IN l r 3'-73/32" ANGLED WALL x m r tx GARAGE to 4' r___7-01 ___ _.._..._..._.._..___..._-2" i i I _ - � m 2N-0^ i 10/2 5'-217132'�4'-2139 O - O r 1 A201 A202 2 m No. D—ription Date I . KEY i I ® Exis-nNG WALLS - ® PROPOSED WALLS i John Crow `88 Tower Hill Rd. Proposed Ground Floor Plan c 1 Project number Project Number Date Issue Date Azoz Drawn by Author GROUND FLOOR PLAN Checked by Checker A101 Scale - A2o1 2 .L:ONGLLLLOW D E S I G N 9.UIL,D 2S-0• 67-9114" .7 8314' 6•6314" - 6-91m, 4'"70916' • it � o® .. 6•-01re 115'-77/2" ouwx j1 LONGFELLOW DESIGN/BUILD to 4 U—UBATH 17 " i 4"*l 1'4T MA 2367 540 Street Falmouth 4'-412 9-91/2^ Q74)255-1709 to 8 5" ao I to CE POWDER OFFICE -s-o 1re 0 1 0 - 3' 0• 3 0" 11 c 9-8irr I t _ 5'x5 t. 1 Elevator' 1 12 15. 1 f 73/41"/f4r " T-6" 3' 0• 5-221/32" S�0" 6'-4• 7-115116"' g - � F 1 1 II •T - - WET BAR El ENTRY o II -----------_____________ - - I I ®iV e30 1 j LIVING RM. 1 i I . 7 3/4"/T-ty. 1 � I m I Fz o� 4•/1-(T 1 r i 4"/1.4• 1 A207 _ Azoz r-------- - - - 4•-111" - 6' 0" 6' 0' ® 6' 6' 1- No. Desciption Date i; fo 25 0" 4 John Crow 88 Tower Hill Rd. Proposed Second Floor Plan Project nambe Project Number 1 Date Issue Date . 8 Drawn by Author A2oz Checked by Checker a n SECOND FLOOR PLAN Al 02 N Scale 1/4"=1'-0" a EXISTING 1500 G TANK - H-20 1000 GAL TANK - H-20 DISTRIBUTION BOX 500 GALLON PRECAST CHAMBERS CROSS SECTION LOCUS PLAN NOT TO SCALE NOT TO SC= NOT TO SCALE NOT TO SCALE NOT TO SCALE NOT TO SCALE BM: 100.0 CAST IRON CO T CAST IRON CO T '� FINISHED GRADE FINISHED GRADE J 4 BAN 0 97.3 w COVERS TO BE WITHIN 6"OF GRADE 4"SCH.40 P.V.C. 9-1 3"WN1M1JM 3"MINIMUM I 3/4"-1 1/2"DOUBLE WASHED STONE A 4- 40 EX-Cn 4"SM.4D P.V.0 `, MAX.36"COVER 3" 1/8".1/2"WASHED SI O 1 1L, =0.01 MIN. EXSITING311 J 3 ;f �411 &95.20 -j1- �411 94.85 „«: .;5;„kw<z :,.`\ �_LOCUS 95.45 / i 4 . _ o 9 .35 o0 0 o e e _ o 0 0 r: 6' 4.0 9a,o ./ o0000000000 ,., 4. 94.18 9�.0 :�'�ti�'� MIN 10.0 40777777T777 .0 I 1' g•-„ 4. 3• 6"OIISTONEi1i+TDERTANIi:i::i::i:::r:::. :i:::6`OPSTf9NE If+lti�Ii�ANiCr:::::r::;:::: ::,r:i 42. ' SOUTH MAIN STREET ilk .. . .• .j g.5'. .I 0 TTOMOB3 81.9' 10' SITE SPECIFIC NOTE S DESIGN CALCULATIONS GENERAL NOTES 40 ML VINYL BARRIER TO BE INSTALLED ALL PIPING TO BE SCHEDULE 40 P.V.C. ALL LOCATIONS OF UTILITIES SHOWN ARE AS TANK TO HAVE CAST IRON COVER(S) TO GRADE ��� P31 EXISTING BEDROOMS 2 110 G.P.D.=+50% FOR GARBAGE DISPOSAL 330 G.P.D. MARKED BY DIG-SAFE AND ARE TO BE INSTALLER T❑ N❑TIFY DESIGNER 24 H❑URS VERIFIED BY INSTALLER PRIOR TO PRI❑R TO BEGINNING OF JOB TO C❑ORDINATE 11 20� NO. OF UNITS 5 CONSTRUCTION INSPECTIONS 1 DEPTH BELOW INV. V THERE ARE NO KNOWN WETLANDS WITHIN +��� ���� WIDTH 10' 150' OF THE PROPOSED LEACHING FACILITY LENGTH 42' UNLESS SHOWN. SIDEWALL AREA 208.0 SF THERE ARE NO KNOWN POTABLE WELLS WITHIN BOTTOM AREA 420.0 SF 50' OF THE PROPOSED LEACHING FACILITY. TOTAL SQUARE FEET 628,0 SF WITHIN OF SOEOFOT KNOWN PROPOSED LEACHING CAPACITY SIDEWALL 00.6 124.8 G.P.D. FACILITY CAPACITY BOTTOM 0 0.6 252.0 G.P.D. THIS PROPERTY DOES NOT FALL WITHIN A PROPOSED SAS CAPACITY TOTAL 376.8 G.P.D. FLOOD ZONE AS SHOWN ON FIRM MAP THIS DESIGN DOES REQUIRE VARIANCES 5 500 GAL CHAMBERS TO TITLE 5 (310 C.M.R. 15.00) OR IN A 2' X 10' X 42' TRENCH THIS SYSTEM IS DESIGNED TO BARNSTABLE SUPPLEMENTAL REGULATIONS. 1' STONE AROUND ENDS AND 3' ON SIDES ACCOMODATE A GARBAGE ALL CONSTRUCTION SHALL BE IN ACCORDANCE DISPOSAL NTH TITLE 5 AND BARNSTABLE SUPPLEMENTAL FILL - C3 (ELEV 93.2) TO BE REMOVED FOR 5' AROUND REGULATIONS. XIN-LINE ELEVATIONS PROPOSED AS-BUILT SURVEY INFORMATION INV. 0 HOUSE (EXISTING) ROPERTY LINE DATA FROM INV INTO TANK 95.45 (EXISTING) INV OUT OF TANK 95.2 (EXISTING) YANKEE SURVEY CONSULANTS 8/26/99 10 INV INTO TANK 95.1 INV OUT OF TANK 94.35 5 NV INTO D-BOX 94. PLAN TO BE USED FOR INSTALLATION _ I INV OUT OF D-BOX 94.18 OF SEPTIC SYSTEM ONLY i INV INTO CHAMBER 94.0 BOTTOM OF CHAMBER 92.0 NOT FOR DETERMINING PROPERTY LINES --------- ---- --------- r BENCH MARK �✓ ... +e/ BOTTOM OF JBS HOLE $7.7 Li V 11 WATER TABLE NONE ENCOUNTERED CORNER OF STOOP 100.0 (ASSUMED) T GARAGE 6, 8.5 DATE: OBSERVED BY: WITNESSED BY: I i SOIL LOGS JAN 18, 2006 STEPHEN WILSON . DON DESMARAIS SOIL EVALUATOR BOARD OF HEALTH I OB 5. HOLE #1 6.5' W ELEV. DEPTH 98.5 FILL 011 J 0 97.8 0 0, Ap SANDY LOAM 81, 97.4 Ig SANDY LOAM 13 11 0 [7 96.3 10YR 513 26" Jam, ff Cl SANDY LOAM(TRACE,SILT) EXISTING LEACHING AND 95.4 IOYR6/6 38„ 1 f�~ DISTRIBUTI❑N BOX TO BE C2 STONEY SILTY TILL REMOVED 93 2 10YR 5/2 4„ C3 FINE SAND(POCKE S OF CLAY) 87 1OYR 7/1 130" W W NO GROUNDWATER ENCOUNTERED ---"�"� INSTALL 40 ML VINYL 3: MEMBRANE AS SHOWN AROUND SIEVE SAMPLE TAKEN FROM C3(8411) 0 1000 GAL TANK ANALYSIS SHOWS A VERY FINE SAND USE CLASS II SOIL @.60 LTAR / Benchmark set /// Lef't corner stoop E1.=100.0 (Assumed) VARIANCE REQUESTS REQUEST THAT NEW TANK BE 6.5' FROM GARAGE SLAB. 40 ML VINYL BARRIER WILL BE USED �Q•.. •�� PLAN SHOWING: t PROPOSED SEPTIC SYSTEM REPAIR IN BARNSTABLE SCALE O ' ��,1A9� b FOR: DRAWN BY: LISA C. LYONS • er=' `��^ JOHN CROFT DESIGNED & CHECKED BY: v$ \`. ��Qw LISA C. LYONS ��` LOCATION: REVISIONS:DESCRIPTION: DATE: �A /STEREOGI 8 TOWER HELL ROAD OSTERVILLE DIMENSIONS OF SAS 3 06 ,+� 111111�� M141 Pglt FEB 7,2006 LISA C. LY R.S. I CERTIFY THAT THIS PLAN CONFORMS TO L I S A C. L Y 0 N S , R . S. (508) 790-9270 TITLE 5 AND BARNSTABLE B.O.H. REGULATIONS HYANNIS, MASSACHUSETTS (774)487-1638