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HomeMy WebLinkAbout0064 WARREN STREET - Health 64 Warren Street Osterville A= 139-068 tM M u Q Cfi Pool equipped with Automatic Safety Cover ASTM F 1346 Barrier exception#2 in Section 305 Please see attached documents 80 ft.7 in. 16ft. 10' X 50' 13 ft.6in. c 0 N Leaching Field CD L J i N Septic Tank�� 64 Warren St::: )C Parcel 68 Dartmouth Pools & Spas Inc. Designed by: 880 Mt. Pleasant St Phone: 508-998-7100. Dan Cosby Designed New Bedford Ma 02745 Fax: 508-998-2307 4/9/2018 for: Maryanne English TOWN OF BARN=�E LOC PTIO �O� f�C'e.'v�, SEWAGE# z D 3 �3 g� V`ELLAGE ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. t N-)r SOS ' Sgo —5J O? SEPTIC TANK CAPACITY 15 Q-0 '�A -Z o LEACHING FACILITY:(type) `� ®� 5 (size) NO.OF BEDROOMS OWNER dv t PERMIT DATE: I 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 (, CQ N,5"r'V 1V Oki t Z� o i 0 5 3 t3 a t No. n-o1 3 ee 15 THE COMMONWEALTH OF MASSACHUSETTS Entered mcomputer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSET�TS 4pliLation for jBisposal 6pstrm Construction 3permit Application for a Permit to Construct(* Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 64 1,1/A/ziz VW S i ` Owner's Name,Address,and Tel.No. (774) S2►-3801 q o S-M4 Vi"E. GyNrr H i A PARR C-`.c,A Assessor's Map/Parcel 13 q- O(og 13o X 4-93 Ins�ller;s Nne,�ddress and Tel. o. u-09 O q6175 Designer's Name,Address,and Tel.No. r f.�p,C,STIr vt i J t- /__Atm C v 7 E. N /'/ /►��CHA�-Ei 13o2sEu/ P, Type of Building: Dwelling No.of Bedrooms Lot Size �'�8(O rO sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures . Design Flow(min.required) 440 gpd Design flow provided ¢5-5, gpd Plan Date 9-/2 -/ Number of sheets 313. Revision Date Title 6f cyAy 2-sew -5% S Size of Septic Tank I�Od Type of S.A.SS. Gc/. �yf/9GLO C�fyQ�ia� Description of Soil eo ft�25� 5 Z•may 7/3 Nature of Repairs or Alterations(Answer when applicable) f Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the re described on-site sewage disposal system in accordance with the provisions of Titl e n ' e a t to e the system in operation until a Certificate f f Compliance has been issued by t '.Bo of Hea _. Sign Date fcp-- Application Approved by Date Lb 13 Application Disapproved by Date for the following reasons Permit No. �`��5 Date Issued q3 21 f �� 3, 7 { ... ° Fee - 'r f THE COMMONWEALTH OF MASSACHUS�ETTS Entered in computer: Yes J" PUBLIC HEALTH DIVISION -TOW_ N OF BARNSTABLE, MASSACHUSETTS 1pflcation for VoppBal Opstetri`�O strUtt[OYY Prlttlt App�cation four ar a Permit to Construct(* Repair( ) Upgrade( ) "Abandon ) +❑Complete System ElIndividual Components ca'1=ton�Address or Lot No. rpol• WR-i22 EM ST ' Name,Address,and Tel.No. 3 8� paaaC-Gc,f+ Assessor'sMap/Parcel ( 'j q- p(pg f t,." '$3n/5T7i73,[ . -1 il'e s me,6ddress�and Tel.� -SON 1 O rib Designer's Name,Address,and Tel.No. (�G& 4qs--t2 2� A35 V 4'f .0 � AJC. /—ALMIOA/ yl.•�E.J(i/i�/EEJ2iivG1A, // /J I.�..,;✓��, w F, F,I L�a�sFu� Pir Type of Building: Dwelling No.of Bedrooms Lot Size 14 Q to sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 440 gpd Design flow provided $ASS gpd Plan Date 9-1 a '/3 Number of sheets 3�3 Revision Date ; Title 49WA-7—2 N ST 4:rYl5P'//y P,90,005�GQ� T.174 S Size of Septic Tank /�04 Type of S.A.S. Description of Soil eO y Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: { The undersigned agrees to ensure the construction and maintenance of the fore described on-site sewage disposal system in }:,accordance with the provisions of Title-3 oftfie Enviro. e e and t to /�lce the system in operation until a Certificate "f � Compliance has been issued by this Boat of Health-' ; � •---Y•---'-~" Q •~.,,. S'ign�e ,F' -�-•2-t Date _ Application Approved by ` r Date '+ Application Disapproved by Date for the following reasons "* Permit No. � ' DFf Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed 01 Repaired( ) Upgraded( ) Abandoned( )by � a �a k at 6 4 Gt//`h e."A 5/. (d 17 k�f�/t�� has been constructed in accordance with the provisions of itle 5 d the for Disposal System Construction Permit No.a013 S dated Installer Designer I-,)�tMUyl / �i�ls/rvEivlf #bedrooms 4 Approved design flow 4S5' gpd The issuance of this permit shall not lbe-construed as a guarantee that the system ill on d signed. / Date ��) r� / / Inspector - - ------------------ ------------------------------ ----------------------- ----- -- ---_--------_----------------------------- No.6�0 �J _��S ..t Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC.HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS ' r3ispoBal Opstem ConetrUction permit Permission is hereby granted to Construct( ') Repair( ) Upgrade( ) Abandon( ) System located at 64 W A7e� S-", d 15 E and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. Date I b" J Approved by ' Town of Barnstable `"E r°ytio Regulatory Services Richard V. Scali, Interim Director * anaivsrnst e, M�: 1m�' Public Health Division iOrEo wu►+°i Thomas McKean, Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form o, f Date: �l��,� Sewage Permit# Q 1 Assessor's Map\Parcel Designer: FALYnuo-Tf - T3.16_,W .Installer: ti57i2 em 5t w�('Sa� i - Address: ��, Address: On 2-0 14 i Q was issued a permit to install a dat ! lII ' '1' (installer) septic system at 64 Wla' twA * Il l e based on a design drawn by (address) _J=A,LVl4,zy�i E.N&WV1 u, _ dated a k (designer) 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. Strip out (if required).was inspected and the soils were found satisfactory. 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. Strip out (if required) was-inspected and the soils were found satisfactory I certify that the system referenced above was constructed in co ance with the terms of the I\A appro4tterspplicable) VOFMICHAELBORSELLInst er's Si na CIVIL g 9 No.35054 O Z AQ) aQq A ONAL EN signer's S1gna re (Affix Designer t mp Here)e ) 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. Q:\Septic\Designer Certification Form Rev 8-14-13.doc Town of Barnstable �yy Departiment of Regtdatory Services RARNSrABM : Public Health Division ate D Q� U , rbjg $ 200 Main Street,Hyannis MA 02601 LA x Date Scheduled Time f d rcc Pd. S®oll Suitability Assessmentfor Se z ® V I Performed By: Witnessed By: . J / LOCATION& GENERAL INFORMATION Location Address 6#wAQ,e� 57- Owner's Name F/E"_� �© Y/MP Address 1? NS 02630 Assessor's Map/Parcel: Engineer's Name f 7i=NG//V fur(V771 4 /MiK�E�oQtiE4(„/ PE NEW CONSTRUCTION REPAIR Telephone# eyW S t�Gl�"rl�1, [and Use Slopes Surface Stones Distances from: Open Water Body ft Possible Wet Area 2'5;L5b ft Drinking Water Well 01) ft t� Drainage Way Sw ft Property Line ft Other ft a• SIMTCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proxinuty to holes) .I - oc7vn�, —FouNo — FOUND 19.5 ,! a _0 1 19.7 0 EP W Gp 20* 19'40DECID. GCONIFEF DECID.. /{ d jS CFrIFER� 1 __ PRGWO O •- ,, CONIFEP (a O. l7.8 g DECID. D PARCEL 68 DECID N < ® 2,- o,9.fi 14.866t S.F. 25' m DeaD. 0.34 ACRES ECID. ' Z 'SLIN f o.. O x110 22G.s 5 26 PROPOSED m m DECID. lj Is O DECID. 771P OF GARAGE O FOUNOA71aV e.0 IP U 10'MIN. S 4 110'A/1 ye' 20.7 =120 :To,ow. FOUND 10 9.2 0" i PS 20' 0 - le.s DECID. .._............... 16/ � DECID. !LL I&7 RESER6£Y Is.s �00�°DEciD. 0 01 j DJ ' r AREA 9' 19.6 10 1J 41 I + q0 I a�.x LJ7 COVERED ( ": I." GI OB-S PROPOSED P. LN 13" '.DECID. /N-20. — MIPFWAY DECID.O jQ DECID. 65 I �� JI 00 ryg. PP as� �' 2 I9/4 ,500 GACCAY 20 agyy @17.5 TANK g CONIFE Q. 7.s G..9 �. 190/y 10J OU�D CONIFERO ND SB/DN .m.- L`ATCH .._._.._.._G GATE — '� FOUND `�'r•t'. BASIN S' 22 I9. PP,-Q,- VALVE le.s A. Ci RIM=17 64 DECID. CONSFER 339/1 WARREk .z (40'„7oE, -- fifi efi taz IFF j j STREET 17.6 I7.7 WRIER D SERMF •'OF PAVEMENT PP le. '9w Parent material(geologic) ciJfl Depth to Bedrock l` �Depth to Groundwater. Standing Water in Hole: Weeping from Pit Noe aJq_ ('i7 Estimated Seasonal High Groundwater a o DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: Qf3S!Z!RyA-no,. OF- Sv2Rc7 vs^,pro,�r- ><F_A }- Cc�vr. tin -P Depth Observed standing in obs.hole: in, Depth to soil mottles: h12 tom? In. Depth to weeping from side of obs.hole: IJ V h In, Groundwater Adjustment Index Well# -Reading Dnrec -_--Irdex Yell 1 L-1 'Aqj,factor._,,,.,,°,,_,— Adj.Givundwuter Levcl e PI♦RCOLATIONTEST uate ><ittteL� .Sa Observation p Hole It l Time at 9" Depth of Pere l9 Time at 6" Start Pre-soak Time @ _ Time(9"-61) D� 3v E9 ,��_j End Pre-soak . W'ATF-AL nrl ice. Rate.Min./Inch .l� l �/V1 1 j V Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Pubic Health Division Observation Hole Data To Be Completed on Back----------- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one (1) week prior to beginning. Q;ISEPric\PERcFORM.DOC DEEP.OBSIJIZVAI'ION HOLE LOG Hole# _� . Depth From Soil Horizon Soil Texture .Soil Color Soil Surface(in.) Other (USDA) (Munsell) Mottling (Structure,Stones;Boulders. • of - onsi�tency %Oravel) DEEP 013SERVATION HOLE.LOG Hole# Z Depth morn Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Shilomrc;Stones,Boulders. - -- onsisten `Yo ravel Z— DEEP OBSERVATION MOLE LOG Hole#- -3 — Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in-) . (USDA) (Munsell) Mottling (Structure,Sloncs,Boulders. ` Consistency,%Gravel) 6, to Yt24/z- •N iA 10 DEEP OBSERVATION HOLE LOG Hole# _ �-- Depth from r tL""r,, Soil Horizon Soil Texture Soil Color soil Other Surface(in.) r. (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency, 6 s Ott ` 10 vsz Flood Insurance Date Man: Above 500 year flood boundary No— Yes-1Z ��N OF MqS Within 500 year boundary No 2�)— Ye, p MICHAEL J. y BOR G Within 100 year flood boundary No,0� Yes� SELLI cn o CIVIL Depth of Naturally Occurring Pervious Material " 9 No.35054 Does at least four feet of naturally occurring pervious material exist in all areas observed througho °�F�G/STE?' area proposed for the soil absorption system? _Y[�—:5_ FSS/ONALEN�'�C If not,what is the depth of naturally occurring pervious material? Certification t 9 9-5 I certify that on PCB (date)I have passed the soil evaluator-examination approved by the Department of Environmental Protection and that the above'analysis was performed by me consistent with the required training,expertise-and%erience described in 10 CNM 15.017. Signature Date Q:\SF-PTI0PFRCFORM.D0C TOWN F BARNSTABLE LOrA'°t70N a ®/� //7 l� SEWAGE # VILLAGE /I S&1'411;4 ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACII.TTY: (type) `�"i1///XE&0 (size) 1/ 33XZ NO.OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: �1" L COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility f Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist .. within 300 feet of leaching facility) Feet Furnished by C J 0 too No. � Fee r THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS AA OV Zf ppYicatiou for �Digozar *potem Cow5tructiou Permit Application for a Permit to Construct( )Repair( )Upgrade(Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 6 Owner's Name,Address and Tel. o. Assessor's Map/Parcel 7-ew /,�,?/ Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Ba1^1-ple-,i114i C®ed,7" 3 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder(-C-P 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 / a Type of S.A.S. Description of Soil 1) 1T/xx L X Z Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issu�tiof Health. Signed Date Application Approved by 0 Date Application Disapproved for the following reasons Permit No. Date Issued ' � �1 � .. .ti. -.,.rrr—� .. .. .,. .. •y`.y �"a.vY�� ..+ ..ter. - .. _ .. s. dC�� No. It � 1 /" Fee THE COMMONWEALTH OF MASSACHUSETTS Entered'in.computer: — — Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS7 0(pprication for Migogal *pztem Construction Permit Application for a Permit to Construct( )Repair( )Upgrade(Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 6/` Owner's Name,Address and Tel No. l�arr�� .sr Assessor's Map/Parcel,:'' o Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 3 Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft. Garbage Grinder(.Cafes Other Type of Building�e��G�No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 14� gallons per day. Calculated daily flow 3 3d gallons. Plan Date Number of.sheets Revision Date Title r Size of Septic Tank Type of S.A.S. y :Z-# Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance'of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issyedby t is B of.Hbalth. Signed ' Date- Application Approved by 0 Date ' Application Disapproved for the following reasons Permit No. '-- Date Issued WWY THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired ( )Upgraded Abandoned( )by el 2 G.®1:�I!r 6%0h 2741cl>_i®r at G!/e/" /? ® 7`�/�l//� q744ated constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. Installer Xel-rdGo�`f/ 4�fAt5,7 Designer The issuance of this permit shall not be construed as a guarantee that the system w*11 fu ction as designed. Date r>, . " � � - � Inspector"« • ------- ----------------- ` .'"G'r�� Fee i__ _ No.0 41 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migpogal *p5tem Conotruction 'Permit Permission is hereby granted to Construct( )Repair( )Upgrade( Abandon( ) System located at l! /' G5 Inof V/ d? 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 rm' . Date: Approved by / � r` NOTICE: This Form Is T® Be Used For the Repair Of Fail ed led Septic Systems Only. CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL, WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS) I, hereby certify that the application for disposal works construction permit signed by me dated �13/�7 concerning the property located at � Ile- meets all of the following criteria: ere are no wetlands within 300 feet of the proposed septic system ere are no private wells within 150 feet of the proposed septic system The observed groundwater cable is 141 feet or greater below the bottom of fie leaching facility re is no increase in flow and/or change in use proposed There are no varianccs requested or needed. SIGNED : DATE: 3 A7 LICENSED SEPTIC SYSTEM INSTALLER IN THE 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]. q:health folder:cert u a rl u ✓ � �r3 o a ps J. TOWN OF BARNSTABLE / �jI/ G(/�I��Ii�J S SEWAGE # LOCATION /j¢ VILLAGE ASSESSOR'S MAP & LOT INS TALLER'S NAME&PHONE NO. ��/�'�Gn//I�D � 7T `�✓?�� SEPTIC TANK CAPACITY �a l LEACHING FACILITY: (type) 1-.ct4L fs�'i�dr`S a_ (size) NO.OF BEDROOMS 3 BUII:DER OR OWNER PERMIT DATE: COMPLIANCE DATE: ' Separation Distance Between the: S!f Feet Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist fFeet on:site or within 200 feet of leaching facility) exist ' Edge of Wetland and Leaching Facility(If any Feet within 300 feet of leaching facility) Furnished by 00 q,Lv .i Commonwealth of Massachusetts upTitle 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Warren St. Property Address Marilyn Field Owner Owner's Name information is required for every Osterville MA. 02655 9/27/12 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 A. General Information filling out forms on the computer, 'v, '.{ use only the tab 1. Inspector: 1 key to move your p cursor-do not Robert Paolini use the return Name of Inspector key. Robert Paolini Septic Service Company Name 17 Playground Lane Company Address Yarmouthport MA. 02675 CitylTown State Zip Code 508 362-3555 S14454 Telephone Number License Number -, -# c� Q CD B. Certification a 1 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; ite sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15:3401.6f Title 5(310 CMR 15.000). The system: J Z Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 9/27112 Inspe4sigrqeza 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. t5irrs•11/10 a cial Inspection Form:Subsurface Sewage Disposal System Page 1 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 64 Warren St. Property Address Marilyn Field Owner owner's Name information is required for every Osterville MA. 02655 9/27/12 page. Cityfrown 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: ❑x 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time. B) System Conditionally Passes: ❑ . One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): • �I t5ins-11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 � i i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 64 Warren St. Property Address Marilyn Field Owner Owner's Name information is required for every Osterville MA. 02655 9/27/12 page City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): Cl broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15:303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments e" 64 Warren St. Property Address Marilyn Field Owner Owner's Name information is required for every Osterville MA. 02655 9/27/12 ' . page. Cityfrown State Zip Code Date of Inspection B. Certification (cant.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered: A copy of the analysis must be attached to this form. 3. Other: 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 ❑ ❑x Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ 0 Liquid depth in cesspool is less than 6" below invert or available volume is less than day flow t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments •''�t 64 Warren St. Property Address Marilyn Field Owner Owner's Name information is required for every Osteryille MA. 02655 9/27/12 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ © Any portion of the SAS, cesspool or privy is below high groundwater elevation. ❑ 0 Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ 0 Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ❑x Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ 0 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.] El 0 The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ 0 The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be • necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no".to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered"yes" to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•11/10 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 64 Warren St. Property Address Marilyn Field Owner Owners Name information is required for every osterville MA. 02655 9/27/12 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 ❑ ❑x Were any of the system components pumped out in the previous two weeks? 0 ❑ Has the system received normal flows in the previous two week period? ❑ 0 Have large volumes of water been introduced to the system recently or as part of this inspection? 0 ❑ Were,as built plans of the system obtained and examined?(If they were not available note as N/A) 0 ❑ Was the facility or dwelling inspected for signs of sewage back up? 0 ❑ Was the site inspected for signs of break out? 0 ❑ Were all system components,excluding the SAS, located on site? 0 ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? 0 ❑ 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: ❑ 0 Existing information. For example, a plan at the Board of Health. ❑ 0 Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is.unacceptable)[310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 t5ins•11/10 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 64 Warren St. Property Address Marilyn Field Owner Owner's Name information is required for every Osterville MA. 02655 9/27/12 page. Cityfrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ❑x No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes E9 No Laundry system inspected? 0 Yes ❑ No Seasonal use? ❑ Yes ❑x No Water meter readings, if available(last 2 years usage(gpd)): NA Detail: Sump pump? ❑ Yes © No Last date of occupancy: unknown Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CM 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-11/10 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 64 Warren St. Property Address Marilyn Field Owner Owner's Name information is required for every Osterville MA. 02655 9/27/12 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.). Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes 0 No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: 0 Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ -Other(describe): t5ins•11/10 Title 5 Official Inspection form:Subsurface Sewage Disposal System.-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Warren St. Property Address Marilyn Field Owner Owner's Name information is required for very Osterville MA. 02655 9/27/12 e 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: Were sewage odors detected when arriving at the site? ❑ Yes ❑ No Building Sewer(locate on site plan): 2' Depth below grade: feet Material of construction: ❑ cast iron 0 40 PVC ❑ other(explain): Distance from private water supply well or suction line:. 10+ feet Comments (on condition of joints, venting, evidence of leakage, etc.): Joints appear tight.No evidence of Ieakage.System vented through the house vents. Septic Tank(locate on site plan): Depth below grade: 18"feet Material of construction: Z concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate). ❑ Yes ❑ No Dimensions: 1500 gl. Sludge depth: 4" t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 64 Warren St. Property Address Marilyn Field Owner Owner's Name information is required for every Osteryille MA. 02655 9/27/12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cunt.) Distance from top of sludge to bottom of outlet tee or baffle 32" Scum thickness off Distance from top of scum to top of outlet tee or baffle 6" Distance from bottom of scum to bottom of outlet tee or baffle 14" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump tank every two years.Inlet and outlet tees are in place.No evidence of Ieakage.Tank appears structurally sound. Grease Trap(locate on site plan): Depth below grade: feet Materi�l of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora IS Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 64 Warren St. Property Address Marilyn Field Owner Owner's Name information is required for every Osterville MA. 02655 9/27/12 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•11110 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 11 of 17 P. C NN Commonwealth of Massachusetts Title 5 Official Inspection Form u Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 64 Warren St. lg - Property Address Marilyn Field Owner Owners Name information is required for every Osteryille MA. 02655 9/27/12 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert No Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Box is level.box has one outlet laterals.No evidence of solids carryover.No evidence of leakage. Pump Chamber(locate on site plan): Pumps in working order: ❑. Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal"System•Page 12 of 17 l Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 64 Warren St. Property Address Marilyn Field Owner Owner's Name information is required for every Osterville MA. 02655 9/27/12 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑x leaching chambers number: 4 Infiltrators ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Sandy dry soil.No signs of hydraulic failure.No ponding or damp soil. 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-11/10 Tile 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 �eY'e 64 Warren St. Property Address Marilyn Field Owner Owner's Name information is required for every Osterville MA. 02655 9/27/12 page. City/Town State Zip Code Date of Inspection M' System Information (cont.) Comments (note condition of soil, signs.of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Map http-.H66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=1390... Town of Barnstable Geographic Information System Parcel Viewer Custom Map Abutters Map Size ❑ ❑ ® Zoom Out Q 0 a 0 0 0 Q a®In .ram■'. I 1 - 1. . W� t 1 qO ti r � vY r 0 20 Feet. ------------- Set Scale 1" _'20 ( Aerial Photos ( MAP DISCLAIMER 1 of 2 9/29/2012 8:21 AM j Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °� 64 Warren St. Property Address Marilyn Field Owner owner's Name information is required for every Osterville MA. 02655 9/27/12 page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: Check Slope ❑x Surface water M Check cellar ❑ Shallow wells Estimated depth to high ground water' Bottom of leaching 9' 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) 0 Checked with local Board of Health-explain: As-Built ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. f5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 f Commonwealth of Massachusetts Title. 5 Official Inspection'Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 5° 64 Warren St. Property Address Marilyn Field ' Owner Owner's Name information is required for every Osteryille MA. 02655 9/27/12 page, Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist Inspection Summary: A, B, C, D, or E checked FZ Inspection Summary D (System Failure Criteria Applicable to All Systems)completed System Information—Estimated depth to high groundwater Sketch of Sewage Disposal System either drawn.on page 15 or attached in separate file t5ins•11/10 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 , 4 �r ^' M - V1 v ) y N F71t r-, /10 E UnN- pq IIII 11 - CUAWN 3028 CUAWN 3028 / CUDH 2O22 2/1 CUDH 2628 2/1 CUDH 2O22 2/1 \� �, / cn a NJ N u ., .. .+,• - .- ., CFCIR 3980 w 00 e i 0 D El CUDH 2428 2/I1, m - © © (2)CUDH 2428 2/1cn ___FIRST FLOOR� 1� O FRONT ELEVATION(SOUTH) 0 SCALE V4-T-O' Ed ® W CUAWN 3028 Q J - J QQQCUDH 2424 2/I \ CUDH 2424 2/I O -1E _ _ 1 CF'ELP 324E (3)CUDH 2428 2/1 (4)CUDH 2428 2/1 - M SHEET . REAR ELEVATION(NORTH) SCALt V4',rT4 Al f� JOB: 1302 DRAWN BY: KW DATE: 10/16/13 O Cf) CY) EPI W cn (2)CUDH 2424 2/1 c l 00 (2)CUDH 2424 zn —w CUDH 2428 2/I CVDH 2428 2/I - (�1 w ---J' L---J O PJOHT ELE ATON(E S-0 CUDH 2428 2/1 SCAM VW a T-a RO 30 3/W.64 7/6" � O Z z - Z o � o _ Q5F/ CUDH 2424 2/I oW Fr SHEET LEFTLEFT ELEVATION��' /�L/'` 2 5GN-E V4'=T4 JOB: 1302 DRAWN BY: KW DATE: 10/16/13 it ° • • 66'-0" , • ' � ' ,. # 20'-0' 16'-0' .(2'-O" 4'-7' �I'=11'� 10�_0ii , 10'-0° a'-0° B'-0° cn m co ss o m CN o m 2B d p V m CUIFD 2870 L , - v V RO 34 7/16'486 1/2' \P' CUDI-1 2428 2/I \\ ^ W vJ RO 30 3/6"x64 7/0" 00 - N - 0 �. IB'-I 1/2' 2+0 'v IW-10 1/2" CN M c m MWSTER p w o BEDROOM - L CUSFD 10060 GREAT m MASONRY RO 120"x%' RAM _ FIRE PLACE - _ •Y __ P CUDN 2428 2/I _ P RO 30 3/8'x64 7/8' - w 2 k � z N _ 21 \p cy) 0 CIO x 20'-3 3/4° `W. � m 6'-8 1/2' 10'-II 3/4. - d" a �- CUIFD 304PA • \ RO 3B 7/ - - _ C" (2)CUDW 2424 2/1 0 o n N v BATH RO 30.3/8"x 56 7/8° _v -� �\ r PWDR 21k I ' p s o \ p CUAWN2424 $ 2&. 2Q RO 25'u23 s/a° - STEEL BF"P.M ABOVE FLU \. - e ." _ I I 1 KITCHEN - 7a° II'- 1/4' z'_O - REF. '. 2¢ CLOSET REF. LITE m FIRE v 6'-5 3/4' 2'-4° 5'-0°o B'-4 I/2° - 4'-I I/2" RATED - z 7o n • 7'-0' 1 14'-6' 2Q 1 �� MUD Roots 2Q ' P N =L CUAWN 6020 RO 6I"xlq 5/8" i1 m I � G E 8'-q 3/4" 13'-4 I/2" 0' II'-8 I/4" p lI II " nLAUNDR.Y p 1I .. in .. i"15g __-.......- MASONRY o o DINING ..SNDY FIRE PLACE -_ - m r WN,6020 \ w 1 RO 6111ol 5/8" N I \ FLAT CEILING - p - _ -- =------- -- --- ZJ CUA BY ;o a �J AAA i J J �- o - - OWNER OPEN TO - -__ s S� S3 T.B.D. .u E ekq'O.N. DOOR I 8'uq'O.N. DOOR - _ _ APP A O O i ORIENTATION (f� n m . m O � � o i � om o � om N \ O O O O • it FIRST FLOOR PLAN SHEET 4i_0. 4'_Oe 7i_On / 7i_0n / 4'_d' 4i_On / 6 i_0n 61 _011 . A3 22 0° f e'-o° 4'-0' H'-0" 12'-0' zo^ FIRST FLOOR+GARAGE=2796 SO FT JOB: 1302 DRAWN BY: KW DATE: 10/16/13 20'-0" 16'-0' 2'-d HUD SILL cJ I)SEE DETAIL (F�l` '^ SHEET S2 cp ' N ---- ---------- Q F---=�---------- I—� fie --- 00 V-4. r 4• I a O W I. v DRAWL SPACE I j —4 I I a-L• a-4' _ I 'I j •'X4G•CONCRETE WALL I V 1 n WAGO CONTINUOUS FOOTING I .. 42'XGOkA' I i• FIRE PLACE FOOTING 1 J G'-11' i'-N• i'-IP 6'-II' 7'-0' I I I I W r t/l r r BmI � W L_ 1-��1I ` I L9i'x3G'x12'FOOTING TYP. I / I I - O'x46'CONCRETE WALL I6'x10'CONTINUOUS F NG 5 8 NOTEANCHOR BOLTS ,.' I "1' 0. EMBEDDED 7' 1 ' r cn CRAV✓L SPACE SPACED 32" O.G. cS 12" FROM CORNERS - 2'CONCRETE DUST CAP WASHERS 3'%3•XI/4• J 10 MIL VAPOR RETARDER 1 — — § I •—,_p• 6,_2. i'-o' 6 2• T-a. T-a, 2' I O PgT ' /T I I DROP T.O.W. 40 - - ---- ------ «i DOWELS—T� r-'�------"T-------------- -- ------ - -------_ l�_ se DOWELS kI PLAC •B DOWE�_s— FoarIw. I `� E I : I • OW O.C. > > I ------------•iD'O.C_J I Z e'xT-9'CONCRETE WALL pQ+ I6'x10l CONTINUOUS FOOTING DROP WALL Id --_�i-------- i i L_'• a 6 '• ST IN10�'� i-E+ F s Gf ST RACE ' r----------- Y Y Z I V I AT DOORwAL� —f —' 10'-a' L_I—J _ l0'_G• li'wd CONTI ING 2 1: G {} shfty _ I 1 I I IcarrtRAcnoN to J _ L a L J I n y I %'�ei'X12'FOOTING TYP. I I N b _ g I.EARLY ENTRY CUT I - 1 in h i I CONTRACTION JOINT I 32 FULL 28 I L- -8'x46'CONCRETE WALL i B45EMENT I IL'x10'CONTINUOUS FOOT h I I �,�BTnR�GE 3 In'coNCRETE SLAB � L-1 '. � IO MIL VAPOR RETARDER I Ge2nl�c_ 5 8 NOTE: BOLTS 6 4' i 4' 5'i• 6'i••CONCRETE SLAB EMBEDDED 7 �jl PITCH TOWARD DOORS SPACED 32" O.C.12" FROM C.oRNERSC• _ , p,WASHERS 3•X3"xl/4" - L—_---- O (C - •- - - O'xr L CONCRETE wALL PKI rlcT _1 M— DTI '• I Y u 11L I DRDP wALL 1d DROP WALL 10' I � •le'o.c. I .' �wxlo•cGNTINuouB FOOTING � 1 I 'v I —�AT DOOR AT DOOR— J I : L ----------.� ' 1 ..L-- —J Q. --- --- -- ------ 0 3 z --CONDtQlTEAPPRON - ---------- r--------- - . . N ' O t GxG P.T.POST I 7 GALV.METAL P05T ANCHOR 1 O 12''SONO TUBE'PER W/ ' 28''BIG FOOT FOOTING TYP. j I \1 9'-4• 4'-d 4'-O• 22'-d •'-0' 14'-d E'-d 12'-0' 2'-W FOUNDATION PLAN I SCALE VW•T-O' ��••// JOB: 1302 DRAWN BY: KW DATE: 10/I/n/13 w - 64'-O" VC•�.\/ i O Q _ 1 T E. Lo N � cy) O 00 cn d" a 3 r EGRESS V K ...a,m,. .,�.^,__ m � a STAIR o - m 2� HALL 2¢ m m 22'-2 1/4' B'-7 I/2' I/2° _ B'-3 3/4' y � o fq DN BEDROOM p3 2& n b a 29 - 0 3i_p' a_9ii 7'75 1/4" _6'-0e. /l P II-5 BATH#3, CUDH 2424 2/I e A m \ RO 30 3/B"t56 7/8" 2 2 Q 2 B BECIPOOM#4 (2)CUDH 2424 2/I _ f I I N RO 30 3/8'u56.7/8" N Q. n BONUS ROOM 2Q 2B 2p 2Q 42' P 2Q 24 TTIIF - - BATH 1}2 21. 2A I BEAIE BEAM ABOVE v m n I 1 CUDH 2424 2/I _ BEDROOM#F n z Z RO 30 3/B"K56 7/8" O I I j Q sN I s� Q U V K O N p• sm sm n 4 4'-0' 2'-0". 7'-0' i 7'_0' 2'_2 " 4'_0r 2'_pn 6'_p, b'_pa - r i 22'_0' B'-O' / 14'-0' I , 5'-0'_r 12/0" 514EET ' 42 0° e / , 1 SECOND FLOOR PLAN CA SLE V4' T-P 1302 SECOND FLOOR HOUSE=1,100 S r JOB:sin F __-. _ _ ----- _.__-------_ SECOND FLOOR GARA!•E=400SOFr DRAWN BY K R W DATE: 10/16/13 6q� q� D NECK"' PARCEL 70 PARCEL -69 p � W N/F N/F > PROJECT MARILYN C. WILBURN & BRUCE S. & KATHERINE D. U) LOCATION PHILIP L. CHASE OLD, ET ALS TR. SEP•pE APPROXIMATE �i4N77/CKET LOCATION OF SOUND EXISTING SEPTIC TANK , - „q LOCUS o oSB/DH FOUND NOT TO SCALE FOUND ,s.s PP Fu D 1s.oN8014O6E ,9 0 18.4 82.1 20"CONIFEER 19.7 19.7 - OF PP ENC. ��1001)' q oQ20.4 20" 19.4Q 20" CONIFER 14" POR. 24' v a• CONIFER b,, DECID. DECID. m a GATE,�N ++ SCRN• ,� 0 '��%3%, VALV - "P�TR 1s.7 1O pOR. ` X21.0 11" ' �N 19.3 15'O EXIST►NG 0.1_ DECID. \ CONIFER HOUSE #64 `20 0 PARCEL 62 Z \F r� F.F. 21.35 Q $+,7.s Ct a S 20.3 ry LDtCID. � \�tiC 19" ' D LOT 2 0DECID. < N/F Qi 9.6 \ T25" Q 20.5 } .�D1D L to m DECID. � q ZJOHN W. & KATHLEEN H. BRESLIN ,204 2a.2 20.5 ARCEL 68- C ti`.\tiF 26" I 4,866f S.F. 1o" rn DECID. / 0.34 ACRES DECID. 18.0 19.2 if O IP 203 ,19.e� FOUND ,20"(i) O 2 1 ��0 20. 16 _ rn 18.5 DECID. 16.6' 18.7 i`, `�� DECID. V 19.5 , 6 1 PII ` � 14 APPROXIMATE OI 13" DECID. 20" 0 c" \ LOCATION OF EXISTING I n DECID.O JQ DECID. 18.6 cQi \ SEPTIC SYSTEM I +18.5 I ;, LEGEND. I �I oo PP 1s.s 10" �I �:�y`��• 259/4 y H g" CONIFEf) I rn Q. �+17.5 _ s.o ` 0 ND ONIIFER 1 / SB/DH -_------- EXISTING 2' CONTOUR L�ATCHj El , ; 19.4 19. DATE FOUND zc- - EXISTING 10' CONTOUR BfCSIN i `.�' 22" o PIP G�, I VALVE 18.5 DECID. io CONIFER 339/1 +19.5 EXISTING SPOT ELEVATION f _ 18.8 fNARREN �`/ (40' WIDE) STREET18.8 182 �� CONIFER EXISTING TREE z. 17.6 17.7 ~�, PP EXISTING UTILITY POLE -' G O PAVEMENT PP - 18.7 �� y2o EXISTING HYDRANT • - ONE o STONE BOUND WITH DRILL HOLE - o H� v BENCHMARK: PARCEL 76 TOP.OF HYDRANT EL. 21.77 PLOT PLAN - EXISTING CONDITIONS FOR #64 WARREN STREET PREPARED FOR _ DAVID PARRELLA GENERAL NOTES. H QF M9s � IN OSTERMLLE MA 1. HOUSE NUMBER: 64 4 ��� MICHAELd. �y� B0B5ELLI u> PLAN DATE: SEPTEMBER 12, 2013 PLAN SCALE: 1 =20 o CIVIL ` 2. ASSESSOR'S NUMBER: MAP 139, PARCEL 068 " NO,35054 SSOSA/STE?' ��� CIVIL ENGINEERING L M O T V r p WETLANDS PERMITTING 3. ZONING DISTRICT: RF-1 'NA WASTEWATER DESIGN COASTAL ENGINEERING 4. FLOOD HAZARD ZONE: C 5. TOPOGRAPHIC INFORMATION COMPILED FROM AN ON THE GROUND SURVEY. TITLE 5 PLOT PLANS �� ` y}` PIERS AND DOCKS 6. ELEVATIONS SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM. 20 0 10 20 40 LAND USE PLANNING GINEERI COMMERCIAL/RESIDENTIAL 7. LOT COVERAGE BY EXISTING STRUCTURES: 1,711 S.F./14,866 S.F. = 11.57% Serving Cope Cod and Southeastern Massachusetts FLOOR AREA RATIO: 1,711 S.F. & 623 S.F. (2ND FLR. BARN) = 2,334 S.F./14,866 S.F. = 15.7% 1 - --- SCALE: 1 INCH = 20 FEET 29 SIMPSON LANE UNIT 1 - FALMOUTH, MA - 02540 - 508.495.1225 - 508.495.3229 fax PROJECT NUMBER: 13081 CAD FILE NAME: 13081 SP DRAWN BY: L.M. SHEET 1 OF 3 i F 0 o you \ q PARCEL 70 PARCEL 69 m �G N/F N/F D MARILYN C. VNILBURN & BRUCE S. & KATHERINE D. U) oo/vo PHILIP L. CHASE OLD, ET ALS TR. ---� PROJECT NEW TRANSPLANTED PROPO.S�"O UNAW6X GYJNO LOCATION - -- R#00a9ENOR6w SLWEEN STAR EASEMENT SERYILES('ELECT., CA71, )ZZ.,) (m'1 >oX>3o't � P RAAOSED 6'Nxv FENCE P�pE`N NANTUCKET SB/DH FOUND• 18.9 FpCF FOUND SE / S0!/NO FOUND 18.5 PP N80'14'06" 19.1 _ 19.0 . - - - rV 8. 20 , ,9.7 F w- LOW S + o E 20: �p , - NOT TO SCALE O 20 CONIFE r) 18 20" 19.4+DECID. o DECIP. /( v PRG100SW 4f'BLAcX NNYL CCIrIIFER 19+6 A - --- =-E/ 0Q `� °� CHsI/N LINK FEND f 19.7 x21.0 ` X21.O - 11" p N 21' PRGtPO.SEO O 20 DECID. 16x,�2'P o CONIFE ti - 2°.p / " „$ PARCEL 62 a R11000A9VOR6W TO REMAIN o I 1 0 20.3 191, ECID. D N LOT 2 33 PARCEL 6 + DECID. / C m m c„ 0 ,. 019.E 14,866f S. 25" m a a N/F � 24 DECID. 0.34 ACRE o D" Z JOHN W. & KATHLEEN H. BRESLIN I 20.4 + +20.2 q - C X2L 0 20.5 PRGY'OSED ''� I ' 0Ra00.S�O 4' Nf//7E - 3.3.5 26" f/Ov-q- DECID. ` DECID. 18.0 O O PICKET FENCE DECID. GARAGE � F INATI�V IP • 10'MIN. 5' 10'AfI ,9.a 20.7 = 22.0 ,T0=-MIN. FOUND .Y - 500 GALL 0V CHAMBERS 20 19.2 + 1 o" O �� B' 20. 16 �2 +18.5 DECID. KITH 4'Ate'S77aNE ALC 18.7DECID. � 1'''` DECID. AAWNO (H-20J + )WgrRkF 19.5?1,. 19.7 19.6 ` 14, *.ARC4 , 2� OB 5 �� I �� xPRGI�O.S�013 WkFREO 1 14. OAYAFff,4 P� DECID.O (DECID. 20" . / DECID. 1a.s .���• 31' O O �� + 8.s ry Q PP 8.8+ IN-1 0!' CAM WATER by 1,500 GALL 20 ,� 259/4 LEGEND EASEMENT 10'r1010' _ ANKSB/DH $" coNIFEf� �+17.5 \ 19.0 �11 20v OUND CONIFER 0 / SB/DH CATC H ,f -G t9 6 GATE FOUND EXISTING 2' CONTOUR �-BI \El \55 22" 19.4 Pp� VALVE 18.5 IM=17. DECID. CONIFER• 339/1 17.8 \ 20 EXISTING 10' CONTOUR 18.8 � ,/`/WARREN � (40' WIDE) STREET i88 18.2 ~�\ +19.5 EXISTING SPOT ELEVATION 17.6 / REET PROPOSED 17 7 PROPOSED SPOT ELEVATION WA7ER �y x21.0 OF PAVEMENT ,S�"war 10" EXISTING TREE PP 18.7 CONIFER 0 PP <-0, EXISTING UTILITY POLE 0 H{ , > EXISTING TEST PIT ti EXISTING HYDRANT BUCUMARK: SB/DH PARCEL 76 TO 2�HYDRANT FOUND ❑ STONE BOUND WITH DRILL HOLE PLOT PLAN GENERAL NOTES. FOR #64 WARREN STREET 1. HOUSE NUMBER: 64 PREPARED FOR 2. ASSESSOR'S NUMBER: MAP 139, PARCEL 068 - D AVI D PARRELLA 3. ZONING DISTRICT: RF-1 U" fl's�s OSTE RVILLE MA 4. FLOOD HAZARD ZONE: C fo� MICHAELJ. yG PLAN DATE: SEPTEMBER 12, 2013 PLAN SCALE: 1"=20' �� BORSELLI rn 5. TOPOGRAPHIC INFORMATION COMPILED FROM AN ON THE GROUND SURVEY. (a CIVIL No.35054 i 6. ELEVATIONS SHOWN ARE BASED ON NATIONAL GEODETIC VERTICAL DATUM. Ah'p��'/S E CIVIL ENGINEERING �L M O v WETLANDS PERMITTING 7, LOT COVERAGE BY EXISTING STRUCTURES: 1,711 S.F./14,866 S.F. = 11.57., <FSS �d EN WASTEWATER DESIGN COASTAL ENGINEERING FLOOR AREA RATIO: 1,711 S.F. & 623 S.F. (2ND FLR. BARN) = 2,334 S.F./14,866 S.F. = 15.7% � ` 8. LOT COVERAGE BY PROPOSED STRUCTURES: 2,970 S.F./14,866 S.F. = 20.0% TITLE 5 PLOT PLANS �A T � PIERS AND DOCKS FLOOR AREA RATIO: HOUSE 2,268 S.F. + GARAGE 528 S.F. + 2ND FLR. HOUSE 1,100 S.F. + 20 0 10 20 40 LAND USE PLANNING 1 NEER1 COMMERCIAL/RESIDENTIAL 2ND FLR. GARAGE 400 S.F. = 4,296 S.F./14,866 S.F. = 28.9% 9. ALL EXISTING SEPTIC SYSTEM COMPONENTS WILL BE REMOVED AND DISPOSED OF AT AN APPROVED LANDFILL. Serving Cope Cad and Sarrtheosts►n Massod�usetts 10. EXISTING POLE 339/1 AND ASSOCIATED WIRES TO BE RELOCATED BY VERIZON. SCALE: 1 INCH = 20 FEET 29 SIMPSON LANE UNIT 1 - FALMOUTH, MA - 02540 - 508.495.1225 - 508.495.3229 fax PROJECT NUMBER: 13081 CAD FILE NAME: 13081SP DRAWN BY: L.M. SHEET 2 OF 3 SOIL TEST Date of soil test: 9/9/13 FIN/SH GWADE SHALL BE 2A'M/N/MUM OIE'R ALL Sq"PI7C SYSTEM 06WRONEN7S USE 4"O/A. SCHEDULE 40 Ply' OR CAST/Rm P/PE Test taken by. MICHAEL BORSELLI 20'MINIMUM SETBACK FROM EDGE OF STONE TO CELLAR WALL Results witnessed by. B.O.H. Percolation rate: < 5 M.P.I. 10'M/N/MUM SETBACK REMOVABLE COVERS SET TO # REMOVABLE COVERS SET Ground water NONE a —tWFINISH GRADE (TOTAL OF 3) TO WITHIN 6" OF FINISH = GRADE (MIN. OF 2) ELEK 20 0 ELEt! = 19,O TEST HOLE #1 TEST HOLE #2 a 0" EL=20.0_ 0" EL=18.5 LOAMY SAND LOAMY SAND S '02 INkERT ELEI! 3' MAX. 9" 10 YR 4/2 L.=19.25 9" 10 YR 4/2 L.=17.75 ° S`\.o = 15.17 2"LAYER OF 1/8" TO 1/2" B B WASHED STONE „ LOAMY SAND „ LOAMY SAND 1500 GALLON sErRRSr SLOPE 11AR/ES ELEI! _ >6.0 30 10 YR 6 6 L,=17.50 30 10 YR 6 6 L.=16.0 a 2'LEbEL S = .01 MIN. I.SEPTIC TANK a: ®®®® 0 ®®®® o (H-20 LOADING) ®®®®®®®®®®®®® C c COARSE SAND COARSE SAND ('H-20 LOAD//1/G� AX 17 2.5 Y 7/3 2.5 Y 7/3 WRim SET SEPTIC TANA- AND D/S7R/BUT/ON BOX II II " " k ,� INSTALL ,3/4 TO > 112 OGY/BLE ON 6 LAYER OF CRUSHED STONE WASHED, CR11S9IED STONE ALL 5' W W AROUND CHAMBERS AND DOi#V h TO THE BOTTOM OF 7HE CHAMBER 132" EL.=9.0 132" EL.=7.5 PROFILE _ SYSTEM FOR MORE DETA/'fir ELEK = 80 BOTTOM OF TEST HOLE NOT TO SCALE TEST HOLE #3 TEST HOLE #4 " 0" EL=19.0 4" 0 EL=19.0 2 - OUTLETS LOAMY SAND LOAMY SAND 1 3/4" 6" 10 YR 4/2 L.=18.5 3" 10 YR 4/2 L.=18.75 '4 36" LOAMY YR gA SD - 1 „ LOAMY SAND - N INLET OUTLET ( ) O INLET M L.=16.0 8 10 YR 6 6 L.=17.5 TYPICAL OF 5 "`��� N 8" 3 - REMOI�ABLE 24"O/A. CODERS REMOI�ABLE 24"D/A. 00kFR EZI 6" 4. 17 2 - OUTLETS .. t. C 24" TE,� OPEN AT TOIL SET COARSE SAND I 3 MIN. FR6W TANK 00k R ' COARSE SAND INLET KNOGy(OYlT x 2.5 Y 7/3 " O I&I-7 KNOC/(OYJ ,• 2.5 Y 7/3 24 /NjfT TEE SET PLAN VIEW CROSS—SECTION 10 AIIN. BELOW L4 Er TEESEr LIQUID Z CkFL D LEhEL O : GAS BA E 132 DB-5 DISTRIBUTION BOX (H-20 LOADING) 4 " EL.=8.0 132" EL.=8.0 NOT TO SCALE r 8 1/2- BASIS FOR DESIGN: ... .. ". .• ,. . . ; ., .. "r'�j.: #'., . :�; , .,, h: - 3 10' — O" 5' — 2" TOTAL RAIL Y ROW IS BASED AN 4&ZW06I 4 NO GARBAGE,01S90SAL 6" 11' - O" 6' - 2" ® ® ® ® O ® ® ® ® TOTAL DA/L Y FLOW_ »O GF'D/BEDROI�1/X 4 BEOROaI/S = 44o a�D 1B5 SFBOT7t.�1/AREAPRlpOSED = 490 .SF 34„ .719E AREA PR6100-CD _ 1500 GALLON SEPTIC TANK (H-20 LOADING = 24" ® ® ® ® ® ® ® TOTAL [EACH/NGAREAPRGMo.SED = s1s.£F l��L�HOF,yl� NOT TO SCALE lop APPLICAAM RA7F= 0.74 6PPAF. MlCFiq ��� ICHAE i „ ClvfL 8 - 6 DE. OV L6,40VING CAPA07Y= 455 CPD > 440 090 9�No.35054 CROSS-SECTION , $' - 6" CONSTRUCTION NOTES: O .. Z .. ° . ° •, °r 0 I 1NSTALLA170V Or 7HE/WOWQW &WA0 SYS"_9VALL BE IN AGWWANCE W71 )7)W 5 SEPTIC SYSTEM DETAILS •' S" KNOCKOUT AND 1HEBOARD GI�HEALIHREGY/LAncWS: FOR #64 WARREN STREET 21" DIAMETER COVER 2 A 000Y 6F 711E PLANS J WALL BE AYAWASLE GW_77F AW fZFE7ENaF AT ALL TIMES PREPARED FOR DURING THE INsrALLA71U1/ Ar THE SEPAC SXS". D A VI D P A R R E LLA J NO LY/ANacS TO 771E,01 YOV S7/ALL BE PERF"W OfN&IT THE APPROVAL 6F 90771 IN 1 5" KNOCKOUT -- 5" KNOCKOUT FALMOWh'ENGYNEERING, INC AND THE BOARD GFHEAL7H OSTERVILLE MA 'd a 4 THE SEPI7C SYSTEM/IS SVRIECT 70 INSPEC7JGW BYFALVa11H DWYNEERINQ INC PLAN DATE: SEPTEMBER 12, 2013 PLAN SCALE: AS SHOWN a AND THE BOARD 6F HEAL/W 5. THE CW7RAC717?JWALL NOTIFY Fi4LVa1T71" WNEDWNQ INC AND T7/E BOARD OF HEAL 771 CIVIL ENGINEERING �L M 0 IN t r WETLANDS PERMITTING 70 INSPECT THE 4-0-PAC S157EN PR16W 70 BACKFILL. Sl�ll/E INSTANCE.S� M4YPE THAN GWE V T ° 5" KNOCKOUT INSPECAW, A/AY BE NEEDED. THE 06W7RAC76W _9VALL GWL Y BAGWF/LL 7HE P6W)76WS OF 7t1E WASTEWATER DESIGN � � COASTAL ENGINEERING a 41 SYSTEA/ 77/AT/1AW BEEN IN-90ECIED AND APPROkW BY FALMaIN D%7NEER/N0, INC. AN,0 ° ' ' ° THE BOARD 6F HEAV71 TITLE 5 PLOT PLANS �O}` PIERS AND DOCKS PLAN LAN VIEW A IF THE 06W7RA070IF ZW0a1NTFRS ANY VARIAAGWS IN JV/7 aW,01770V4 SU01 AS D/fFER/NG LAND USE PLANNING �jNEE COMMERCIAL/RESIDENTIAL SaL4 7rP06WAPHY, AW&",OS GYP OTHER 6 WD/AGNS THAT MAY REaJIRE RE-EYALZIAIIGW 0- 500 GALLON LEACHING CHAMBER (H-20 LOADING,1 7//EoESY6,, 7HE C&IWACILYP "AU 1WEDIA&7YCGWTACTFALMaJTHENaFNEERING; INC Sffvrng Cape COd and 5&1thee W&" M"19CAM Mtts SCALE: 1' 2' 29 SIMPSON LANE UNIT 1 — FALMOUTH, MA — 02540 — 508.495.1225 — 508.495.3229 fax = PROJECT NUMBER: 13081 CAD FILE NAME: 13081dt DRAWN BY: L.M. SHEET 3 OF 3