Loading...
HomeMy WebLinkAbout0194 WASHINGTON AVENUE - Health 194 Washington Avenue -- . Osterville F A = 139 084 44 y dam rjf i J F y a d 'S N .. ...n.. r. .. ... .. 1 TOWN OF BARNSTABLE LOCATION ` At SEWAGE# 910 L1(o Q VILLAGE CtTr ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. $ �7u���lrlu�iv Sys-9d�1`{ SEPTIC TANK CAPACITY S 00 LEACHING FACILITY: (type) (size) (size) NO. OF BEDROOMS OWNER \ — PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY crc,c 0 `i jig- "z 7- 3 I_3" No. Fee � � THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: s PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS ftphfation for disposal *pstrm ConstCUCtion Permit Application for a Permit to Construct(V) Repair( ) Upgrade( � Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. W,441-1/N4 1d^,' AIVE Owner's Name,Address,and Tel.No.C`274)-'1-Z1- 3$Q 9 Assessor's Map/Parcel 139^aw ® FDA✓l 1> O' In taller' me, dress, d Tel. J-0 Designer's Name,Address,and Tel.No. 68)+'S-/Z ZS` Type of Building: Dwelling No.of Bedrooms Lot Size 07 3 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 40 gpd Design flow provided ��j gpd Plan Date /2^ 7 —/(t.? Number of sheets 13 Revision Date Title IC-)()S7'/A/4, Pep RV3,A-6 A 4i�7 4 Size of Septic Tank f�0.0 Type of S.A.S. l Description of Soil 1 Cd Arls-E- 70 /)9Yj/4111 5'A7V,3S Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore describe on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and- o e em n o eration un' ertificate of Compliance has been issued by this Board of It Si d - Date A2 _ 771 `0 Application Approved by Date ! �D Application Disapproved by Date for the following reasons Permit No. �� — Date Issued �� No. ^�Q , Fee 150 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS s 2pplication for Disposal *pstrm Construction 3permit Application for a Permit to Construct(V} Repair( ) UpgIrad ( 'JA bandon( ) El Complete System ❑Individual Components It Location Address or Lot No. 1�f�f WA SM i 1'4{ 1a V OVV* Owner's Name,Address,and Tel.No.('?7 )Yz l- 39 g Assessor's Nlap/Parcel 139—0& ST � ✓//--> Installer's/Name Address d Tel.Iy� v 5 o Designer's Name,Address and Tel.No. 68 9 t S-/Z ZS Co�cJi��c atc� �A`iY►v✓T7I �vGi� 'iv4 1'5_4 -7 A e,41�r11 t L Al 17 L 025.1-0 Type of Building: Dwelling No.of Bedrooms Lot Size /�� 1 sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers YP g ( ) Cafeteria( ) Other Fixtures '! Design Flow(min.required) 440 gpd Design flow provided 4.5� gpd Plan Date j 2^ ' —/(c> Number of sheets Revision Date a Title"FX)57;/ V 4. P D PDsk—!J rr `J7 L S RAI B Size of Septic Tank /�CJ O Type of S.A.S. Z d <1/4j9" sle S Description of Soil Cd A4 sF 76 ZVAMlm 5-AW D S Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described/on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and-nol to—place t e s ste o eeration unt a-Certificate of Compliance has been issued by this Board of ealth. Si d j Date Application Approved by Date 50 ! Application Disapproved by Date for the fallowing reasons Permit No. g —G +�V Date Issued C� -------------------------------------------------------------------------------------------------------- ---- — - 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 at f'jq tu;VA &4 70k-/ A'✓,L_ 4297 has been constructed in accordance / with the prgyisi�of T'1e 5 d the f r Disposal ystem Construction Permit No. 7/r -�/ dated Installer v Cy 06U Designer rA/n/ti%�l i 1&(IAI #bedrooms Approved design flow gpd 1 The issuance of this permit shall not/fie constKied as a guarantee that the syste wil�fumnc �.. esi�ed. Date / ' Inspecto --------------------------------------------------------- No. �� Fee �V I THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposar 6pstem Construction permit Permission is hereby granted to Construct Repair( ) Upgrade( ) Abandon( ) System located at jit/f}S1_4l ov -trIv ?�.> a 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/m�ust a comple e Jwithin three years of the date of this pe it. C Date��ct-'� � '7�0 Approved by Town of Barnstable ,,oFj"E lOwti Regulatory Services Thous F. Geller,Director B MASS.� � Public Health Division 9 MASS. g i639• �� ATFp n��' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 f f Office: 508-862-4644• Fax: 508-790-6304 Installer &Designer Certification Form . Da te: 41710- Sewage Permit# 206 - 460 Assessor's Map\Parcel_tVL0 HIM vTtl ����i�����//i/� ��/� 4! �7IC 102v, /AAA Designer: Installer: Address: /7�f � � v" Address: �tnyn NA aj¢�57 s /Gcsf Dz sr— IZZs, (5-69) 15'10 —9447f on was„issued apermit to install a (date) (installer) septic system at i ^*IV6 M-14 '� �; based on a design°drawn by P (address) �73J JFIL.lGya5 /W�,, lwe— dated /2. (, (designer) V/ I certify that the septic system referenced above was installed sub stantially'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 accordance with State & Local Regulations. Plan revision or , certified as-built by es' er to follow. jH OF Mqs� y GNAEL J. �y BORSELLI cGn (Inst is ign at o civil ' ure No.35054 Q Z ST,EP�c��tQ Fss/ONAL esigner's Signature) (Affix Designer's Stamp Here) 4 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. y Q:HeDVSeptic/Designer Certification Form 3-26-04.doc Commonwealth of Massachusetts Title 5 Official Inspection Form 1 � Subsurface Sewage Disposal System Form -Not for Voluntary Assessments • 194 Washington et ashin ton Street ►-►�.. Property Address Craig Rockwood Owner Owner's Name/ information is re uired for every Osterville Ma. 02655 05/05/2016 page. CitylTown State Zip Code. Date of Inspectio Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Michael T Bisienere use the return key. Name of Inspector 40—T, Cape Septic Inspections ICI Company Name 624 Old Barnstable Road �I Company Address i Mashpee Ma. 02649 City/Town State Zip Code 508-280-3356 S13938 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 16.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority -t6-- Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ***"This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins-3/13 Title 5 Official 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 M ,•�' 194 Washington Street Property Address Craig Rockwood Owner Owners Name information is required for every Osterville Ma. 02655 05/05/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.30.3 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: This home has a H-10 1500 gallon septic tank a H-10 D-Box and two 500 gallon leaching chambers the system was installed on 11/24/2009 and it appears to has seen little use 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): t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -.Not for Voluntary Assessments 194 Washington Street Property Address Craig Rockwood Owner Owners Name required for is every Osteryill2 required for eve Ma. 02655 05/05/2016 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution ibox due to broken or obstructed pipe(s) or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s) are replaced ❑ Y ❑ N ❑ 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-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts u W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 194 Washington Street Property Address Craig Rockwood Owner Owner's Name information is required for every Osterville Ma. 02655 05/05/2016 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: i ❑ 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 ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/day flow t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts - - Title 5 Official Ins- pection Form A Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 194 Washington Street Property Address Craig Rockwood Owner Owners Name information is required for every OsteNllle Ma. 02655 05/05/2016 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: . I ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. , ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public-well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection 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•3/13 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 194 Washington Street Property Address Craig Rockwood Owner Owner's Name information is required for every Osterville Ma. 02655 05/05/2016 page. City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as NIA) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? a ' ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CM 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): '330 t5ins-3/13 Title 5 Official 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 ,.•'' 194 Washington Street Property Address Craig Rockwood Owner Owners Name information is required for every Osterville Ma 02655 05/05/2016 page. Citylrown State Zip Code Date of Inspection D. System Information Description: Number of current residents:. 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ❑ No Seasonaluse? ® Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Detail: In 2015 32,000 gallons were used and in 2014 29,000 gallons were used I Sump pump? ❑ Yes ® No Last date of occupancy: occupied fall 2015 Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins-3113 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 M ,.•''v 194 Washington Street Property Address Craig Rockwood Owner Owners Name inormation is Ostervlllerefuired for every Ma. 02655 05/05/2016 page. CitylTown 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 E No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts 4 - Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 194 Washington Street Property Address Craig Rockwood Owner Owners Name information is required for every Osterville Ma. 02655 05/05/2016 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 29"feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints, venting„evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 20"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) r If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: • standard H-101500 gallon Sludge depth: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 4 ,.•''~ 194 Washington Street Property Address Craig Rockwood Owner Owner's Name information is required for every Osterville Ma. 02655 05/05/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle apx. 35" Scum thickness 1' Distance from top of scum to top of outlet tee or baffle apx. 5" apx. 12" Distance from bottom of scum to b p bottom of outlet tee or baffle How were dimensions determined? sludge Judge Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): I would recommend the new owner put the tank on a maint. plan with a local septic pumping co. based on the future use of the home.The Barnstable Health Dept. has a list of local pumping co Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Washington Street Property Address Craig Rockwood Owner Owners Name information is required for every Osteryille Ma. 02655 05/05/2016 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of V Commonwealth of Massachusetts a Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 194 Washington Street Property Address Craig Rockwood Owner Owner's Name information is re uired for every Osteryille Ma. 02655 05/05/2016 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 011 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.): At the time of the inspection there no signs of solids carryover or evidence of past hydraulic failure i r 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.): *If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Washington Street Property Address Craig Rockwood Owner Owner's Name information is OSteNille required for every Ma. 02655 05/05/2016 page. Cltyfrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: Two ❑ leaching galleries number: E { ❑ 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.): At the time of the inspection there were no signs of past hydraulic failure Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 194 Washington Street Property Address Craig Rockwood r Owner Owners Name information is required for every Osterville Ma. 02655 05/05/2016 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 14 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Washington Street Property Address Craig Rockwood Owner Owners Name information is OStervllle required for every Ma. 02655 05/05/2016 page. Cltyfrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 15 of 17 TOWN OF BARNSTABLE LOCATION ICH r _SEWAGE�! D 11-- VILLAGE ;tX_A SOR'S MAp&PARCEL I INSTALLER'S NAME&PHONE N0. � SEPTIC TANK CAPACITY J SW LEACHING FACILITY:(type)' L7,��,,,_Lam„} (size) NO.OF BEDROOMS OWNER . PERMIT DATE: COMPLIANCE DATE: t Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Private Water Supply Well and Facility —Fea Leaching ty(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) _Fect FURNISHED BY — ^�-" •r-�to b.js 07' 67=1y' . 3 . oa © 7 6 B " A bV� c. t Commonwealth of Massachusetts 4 - Title 5 Official Inspection Fora' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,•• 194 Washington Street Property Address Craig Rockwood Owner Owners Name information is Osterville required for every Ma. 02655 05/05/2016 a e. Cit own p /T 9 y State Zip Code Daespection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: 11 plus feet feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting( g hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: I augered a hole at a lower elevation and shot it with a transit to show five plus feet of seperation Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal system-Page 16 of 17 Commonwealth of Massachusetts 41 W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Washington Street Property Address Craig Rockwood Owner Owner's Name information is required for every Osterville Ma. 02655 05/05/2016 page. City/Town State ZipCode . Date of Inspection i E. Report Completeness Checklist E Inspection Summary: A, B, C, D, or E checked E Inspection Summary D (System Failure Criteria Applicable to All Systems)completed E System Information.—Estimated depth to high groundwater E Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file- S r V t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 1 . Commonwealth of Massachusetts Title 5 Offici'l Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 11 . ,.•'•y 194 Washington Ave. Property Address Craig Rockwood li Owner information is Owner's Name C required for every Osterville MA 02655 12/12/2013 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 completene§s checklist at the end of the form. Important:When A. General Information filling out forms on the computer, 9 l use only the tab 1. Inspector: key to move your \\ 5 cursor- not James Ford �J►' key the return Name of Inspector Y� r, rzb Company Name I P.O. Box 49 Company Address Osterville MA 02655 City/Town State Zip Code 508-862-9400 'i S12482 Telephone Number License Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below isIrue, accurate and complete as of the time of the inspection.The,inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The:system: I E Passes ❑ Conditionally Passes El Falls Needs Further valuation by the Local Approving Authority 2/16/13 Inspe s Signature Date The s s em 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 redional.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 inspecliidn foes not address'how the system will perform in the future under the same or different conditions of use. I � t5ins-3/13 Title 5 Offidal Inspection Fr: surfacfe Sewage Disposal System-Page 1 of 17 Commonwealth of Matsa+chusetts = Title 5 Offici [ inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 4 M 194 Washington Ave. Property Address Craig Rockwood - Owner Owners Name information is „ required for every Osterville MA 02655 12/12/2013 page. City/Town t, State Zip Code Date of Inspection B. Certification cone. i ' Inspection Summary: Check'A,B,C,D or E/always complete all of Section D A) System Passes: ' .i, ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 ar 1:310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. r Comments: } <t B) System Conditionally Passes: r ❑ One or more system co,��nponents as described in the"Conditional Pass"section need to be replaced or repaired.Oe system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "po":or not determined' (Y, N ND)for the following statements. If"not determined," please expl 'in'#; �. The septic tank is metal a'd-over 20'years old"or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exf'iltration 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 IJ s 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): r if 1' — 15ins•3/13 S Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 yi Commonwealth of Massachusetts Title 5 Official Ins ection Form p Subsurface Sewage Dispo'ztl System Form -Not for Voluntary Assessments T. 194 Washington Ave. ` Property Address Craig Rockwood ' Owner Owners Name information is + required for every Osterville MA 02655 12/12/2013 page. City/Town i State Zip Code Date of Inspection B. Certification (conf Y ❑ Pump Chamber pumps/hlarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes(cont* ❑ Observation of sewage,backup or break out or high static water level in the distribution box due- to broken cr obstruct4.pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(wiih'approval of Board of Health): ❑ broken I e s J'are1re laced P P O, P ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction Is'removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box its leveled or replaced ❑ Y • ❑ N ❑ ND (Explain below): V ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipes) re replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction Is,removed ❑ Y ❑ N ❑ ND (Explain below): J i, n• , 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, safetyaand the environment: ❑ Cesspool or pricy is within 50 feet of a surface water ❑ Cesspool or envy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 I iI . Commonwealth of Massachusetts Title 5 Officif Inspection Form Subsurface Sewage Disposl System Form-Not for Voluntary Assessments •°•y 194 Washin ton Ave. Property Address Craig Rockwood f Omer Owner's Name information is required for every Osterville MA . 02655 page. City/Town F 12/12/2013 State Zip Code Date of Inspection B. Certification (cont ) - 2. System will fail 6 riless the Board of Health (and Public Water Supplier, if any) determines that theisystem 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. i ❑ The system has a eptIc 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 ater supply well". Method used to determine i,,, ;dstance: **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. r 3. Other: F1 z y{ 1 D) System Failure Criteria Applicable to All Systems:. rt , You must indicate"Yes;'or"No"to each of the following for all inspections: Yes No ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ Static Liquid level in the distribution box above outlet invert due to an overloaded or clogiged SAS or cesspool El ® Liquld.'6pth in cesspool is less than 6" below invert or available volume is less than 34,day flow t5ins•3113 I}. tj Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts „. ; Title 5 Official. Inspection Firm Subsurface Sewage Disposal:System Form -Not for Voluntary Assessments 194 Washington Ave. ; Property Address Craig Rockwood E Owner Owners Name information is Ostervllle required for every MA . 02655 12/12/2 013 page. City/Town State Zip Code Date of Inspection B. Certification (cont j Yes No ❑ Z Re4ui�ed pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any,pRrtion of the SAS, cesspool or privy is.below high ground water elevation. ❑ ® An�iportion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Anyipertion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any,pi�rtion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd El ® Thej system fails. I have determined that one or more of the above failure critedailsxist 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 ne+sary 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 gpolto 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 I1 VPA)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 Sectipq.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 wi4 3;10.CMR 15.304.The system owner should contact the appropriate regional office of the Department.* i t . t5ins•3/13 Title 5 Official Inspection,Form:Subsurface Sewage Disposal System•Page 5 of 17 f I Commonwealth of Ma sachusetts -Title 5 Offici4 Inspection Form Subsurface Sewage Dispo4&i;$yytem Form -Not for Voluntary Assessments 194 Washington Ave. Property Address li Craig Rockwood Owner Owners Name .I required for is every Osterville required for eve MA 02655 12/12/2013 page. CityrTown 1;�:. . State Zip Code Date of Inspection C. Checklist Check if the followinghave:been done.You must indicate"yes" or"no"as to each of the following: , Yes No ' t l•`4 • ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Werl any of the system components pumped out in the previous two weeks? ❑ Has hej1system received normal flows in the previous two week period? ❑ ® Have larga volumes of water been introduced to the system recently or as part of this Inspection? ® ❑ Were*,s built plans of the system obtained and examined?(If they were not available note as N/A) ❑ E Was6th`e facility or dwelling inspected for signs of sewage back up? ® ❑ Was�the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were tote septic tank manholes uncovered,-opened, and the interior of the tank inspecfed for the condition of the baffles or tees, material of construction, dimensions, depth of liquid,,depth of sludge and depth of scum? ❑ ® Was4the,facility owner(and occupants if different from owner) provided with inforr, ,aUon on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been;determined based on: ® ❑ Existing:information. For example, a plan at the Board of-Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approx(mation of distance is unacceptable) [310,CMR 15.302(5)] D. System Informati,oh Residential Flow Conditions: Number of bedrooms' desl ' 2 ' ( �)� Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 220' I t5ins-3113 ii ` „ Tille 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 17, 1 a Commonwealth of MassAchusetts Title 5 Offici.at Inspection Form , Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 194 Washington Ave. 8' Property Address a Craig Rockwood kt Owner Owner's Name information is required for every Osterville MA 02655 ! 12/12/2013 tl page. City/Town r State Zip Code Date of Inspection D. System Information Description: .t Number of current residehtsi 0 1, Does residence have a gar.We grinder?. El Yes ® No Is laundry on a sepafate sewage system?(Include laundry system inspection information in this report.); ❑ Yes ® No 5 Laundry system inspected?t' El Yes ® No Seasonal use? f r,' ❑ Yes ® No Water meter readings, if available(last 2 years usage(gpd)): Detail: unavailable Sump pump? y ❑ Yes ® No Last date of occupancy: unknown i� . i Dat e Commercial/Industrial F).oiw Conditions: F; Type of Establishment: Design flow(based on 310 GMR 15.203): Gallons'per day(gpd) Basis of design flow(seats/persons/sq.t.etc:): I, f . Grease trap present?'i. ❑ Yes ❑ No Industrial waste holding tank',Epresent? ❑ Yes [INo Non-sanitary waste discharged to the Title 5 system? El Yes ❑ No I Water meter readings, if available: t5ins•3/13 r Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 I " is 1' r. , Commonwealth of Massachusetts . Title 5 Official Inspection Form a Subsurface Sewage Disposal,System Form -Not for Voluntary Assessments M 194 Washington Ave. Property Address Craig Rockwood Owner Owners Name k information is required for every Osterville MA' 02655 12/12/2013 page. City/Town V State Zip Code Date of Inspection D. System InformatlPh (cont.) Last date of occupancy/use ., q .} Date Other(describe below): . t p�p General Information 9 Pumping Records:. F t: Source of information: unknown y Was system pumped as partw the inspection? Yes- ® No i tr If yes, volume pumped: gallons How was quantity pumped determined?' Reason for pumping: Type of System: ® Septic tank,�distribution box, soil absorption system El Single cesspool ❑ Overflow cesspool t ; ❑ Privy ❑ Shared system (yes or no)(if yes, attach previous inspection records, if any) �I t, ElInnovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspectiorf of the I/A system by system operator,under contract ❑ Tight tank' Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 8 of 17 i Commonwealth of Massachusetts Title 5 Official:; Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 194 Washin ton Ave. Property Address Craig Rockwood` Owner Owners Name information is required for every Osterville MA 02655 12/12/2013 page. CityfTown t State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all co ponents, date installed (if known)and source of.information: installed - 11/24/2009 Were sewage odors detected when arriving at the site? El Yes ® No i . Building Sewer(locate`n.slie plan): Depth below grade: i ' feet Material of construction; s . ❑ cast iron ®40,PVC ❑ other(explain): Distance from private water supply well or suction line: 1 feet Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on sie°plan): Depth below grade: 4 20" ll feet Material of construction: a ' ® concrete ❑ ni'tat ❑fiberglass ❑ polyethylene El other(explain) If tank is metal, list age:, years Is age confirmed by a Certlflcate of Compliance?(attach a'copy of certificate) El Yes ❑ No � Dimensions: kk, 1500 gals. t i t 2 Sludge depth: (Sins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 ti t, s1sachusetts Commonwealth of Ma Title 5 Official Inspection Form Subsurface Sewage Disposal,�$ystem Form-Not for Voluntary Assessments 194 Washington Ave. i Property Address I Craig Rockwood Owner Owner's Name information is OStervllle required for every MA 02655 page. CitylTown 12/12/2013 State Zip Code Date of Inspection D. System Information (cont ) Septic Tank(cont.) ` Distance from top of sludg06 bottom of outlet tee or baffle 2911 F, fl . Scum thickness g Distance from top of scum fo tqp of outlet tee or baffle 6" Distance from bottom of scu m'fo bottom'of outlet tee or baffle 12" How were dimensions determined? measured Comments (on pumping r'ocommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): There were no signs of leaka 'e.The outlet cover was 5"below grade. t. - { Grease Trap (locate on slte!loan): Depth below grade: ii feet Material of construction: El-concrete ❑ metal?- ❑fiberglass ❑ polyethylene ❑ other(explain): N/a Dimensions: 9 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: II Date 15ins•3/13 z I Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 110 of 17 Commonwealth of Mkspa'chusett Title 5 ■ ■ Official lns ection Form Subsurface Sewage Dispgsal System Fo to -Not for Voluntary Assessments 194 W t` ashin ton Ave,, }; Property Address tl Owner CraigRockwood I 'information is Owner's Name required for every Osterville ii ' page. City/Town MA 02655 _ , 12/12/2013 w State. Zip Code D. System InformaDate of Intion (cont.) spection Comments (on pumping rec;6�mmendatic ns, inlet and outlet tee or baffle condition, structural liquid levels as related to outlet invert, a idence of leakage, etc.): integrity, r; ^ Tight or Holding Tank(tank:must be PL mped at time of inspection)(locate on site plan �) ) Depth below grade.- Material of construction: ❑ concrete ❑ metal El fiber lass g ❑ polyethylene ❑other(explain): N/a Dimensions: Capacity: : + gallons Design Flow: I ; gallons per day Alarm present`. ❑ Yes ❑ No �. Alarm level: �'"`�- Alarm in working order: ❑ Yes ❑ No Date of last pumping: Ei t � , Date y Comments (condition of alarm and floats itches;etc.): :. i i Attach copy of current pumping contract required). Is copy attached? 1� .: El Yes ❑ No t5ins•3/13 t Q., 1 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 a , Commonwealth of Massachusetts Title 5 Official inspection For d Subsurface Sewage Dispos'a ;System;Form-Not for Voluntary Assessments 194 Washington Ave. Property Address Craig Rockwood Owner Owners Name 3 information is required for every OSteNllle MA 02655 12/12/2013 page. City/Town 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 n/a Comments (note if box is lev;,ei and distribution to'outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): i " ' , Pump Chamber(locate on.1site plan): Pumps in working order. ; " ", ❑ Yes ❑ No" Alarms in working order: 1., ❑ Yes ❑ No' r• Comments (note condition of pump chamber, condition of pumps,and appurtenances, etc.): N/a & P * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System.,(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: 4f. _ l5ins•3/13 • III �, Title 5 Official.Inspection Form:Subsurface Sewage Disposal System Page 12 of 17 I _ Commonwealth of Massachusetts i _ Title 5 Offici � t a�, Inspection Form - Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 194 Washin ton Ave. Property Address + .t y , Craig Rockwood t Owner Owner's Name i information is required for every Osterville page. Cityi I own Mae 02655 12/12/2013 Zip Code Date of Inspection D. System Information (cont.) t Type: Elleaching �tts !> number: ® leaching chambers number: 25'x12.83' ❑ leaching galletnes number: ❑ leaching tenches . number, length: ❑ leaching fip Ids: � number, dimensions: ❑ overflow cesspool number: innovative/alternative system' Type/name of tgchnology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): The chambers were dry and,clean. There was no signs of failure.A camera was used for the inspection. i, f ,4..: - - Cesspools (cesspool mush#be pumped as part of inspection)(locate on site plan): I Number and configuration?, N/a Depth—top of liquid to inlet invert Depth of solids layer I ;i Depth of scum layer f Dimensions of cesspool ;i ' Materials of construction Indication of groundwater i`�ow ❑ Yes ❑ No a 15ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal system•Page 13 of 17 1 i } Commonwealth of Massachusetts Title 5 Offic Al Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments • � t 194 Washington Ave, Property Address E Craig Rockwood Owner Owner's'Name information is 3 required for every Osterville ?. , MA 02655 12/12/2013 page. City/Town f• .'" State Zip Code Date of Inspection D. System Information (cont.) I' t r Comments(note condition of;soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 1 'I 3 j. Privy(locate on site plan): Materials of constructicp-" Dimensions k f Depth of solids ' Comments (note conditioh, of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): N/a r 0 f , • 1 1 i. 1, 1 I of 15ins•3113 . t:'I Title Of 5 ficial inspection Form: ESubsurface Sewage Disposal System•Page 14 of 17 F fi t Commonwealth of Massachusetts : Title 5 Offic aI, Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ' 194 Washington Ave. Property Address CraigRockwood Owner Owner's Name information is required for every Osterville MA 02655 page. CitylTown r . 12/12/2013 State Zip Code Date of Inspection D. System lnformati6n (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: �i ® hand-sketch in the area below ❑ drawing attached separately E A LQJ i, 3o a :13 O d 3 3a aq s y I'll 33 ' f { 14 l5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 it 1 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments I: �µM a 194 Washington Ave. Property Address Craig Rockwood Owner Owners Name information is ' required for every Osterville q MA 02655 12/12/2013 page. City/Town , State Zip Code. Date of Inspection D. System Information (cont.) Site Exam: ❑ Check Slope e. t ® Surface water i ❑ Check cellar >i ❑ Shallow wells � Estimated depth to high ground water: 15+ feet Please indicate all methods�used to determine'the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date - ❑ Observed site(butting property/observation hole within 150 feet of SAS) Checked with local Board of Health -explain: Using topo an`d.water contours maps ❑ Checked with�ilocal, excavators, installers-,(attach documentation) ❑ Accessed UStGS database-explain: You must describe how you established the high ground water elevation: see above Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3/13 1 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 'e , Q ' .. ' Commonwealth of Massachusetts ft Title 5 Official Inspection form Subsurface Sewage Dispo's,al System Form -Not for Voluntary Assessments t . 194 Washington Ave. Property Address # Craig Rockwood Owner Owners Name information is required for every Cisterville MA '02655 12/12/2013 page. City/Town �'"; State Zip Code Date of Inspection E. Report Completemgss Checklist ® Inspection Summary` A, B,:C, D, or checked ® Inspection Summary,Qp(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 it r• . i 4,�'; 4• ., ':A a ., N r x (Sins•3/13 l i. Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 e TOWN OF BARNSTABLE NOCATION IM SEWAGE# f b'1-Xa& VILLAGE �;��,@ AS SOR'S MAP&PARCEL 1'2z INSTALLER'S NAME.&PHONE NO. SEPTIC TANKCAPACITY 1 s oi> G41; LEACHING FACILITY., (type) (size) NO.OF BEDROOMS::. OWNER PERMIT DATE: �1 . �l . API COMPLIANCE DATE: l ' Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY s t IV)n aq t q � f No. ' 1 "" 0 Fee J �' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: t/ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZippYication for ;0i!6poq;a1 6r)Abandon ems Construction Permit Application for a Permit to Construct( )Repair( Upgrade( ( ) Complete System ❑Individual Components Location Address or Lot No. IC,l' 5�1 ti�g-1 :j,V�_ Owner's Name,Address and Tel.No. F_ Lwvnh 01-�' Assessor's Map/Parcel Installer's Name,Address,and Tel.No. 'PASTGZ6 ExLA'V ATl4 Designer's Name,Address and Tel.No. A 9-M LA-x)V 51;@Z0 �. 0 iw-1 11 b9 F'tPZ!5_T)PA-LZ 1,A)A., L/8 /L119JW sr vnr>T 3 o,2 5 0-1 - u�3 cj Gsl 'O 2 t-7 3 Type of Building: y s LZ AG� Dwelling No.of Bedrooms Lot Size -sq-ft' Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 0 gallons per day. Calculated daily flow 3 3 a gallons. Plan Date -7 Number of sheets ^) Revision Date Title Size of Septic Tank )SOa Type of S.A.S. Z S-Ibt 1 6 UQ -S Description of Soil s t?LAO S61L. Nature of Repairs or Alterations(Answer when applicable) T-A)Lbn Ss1i Date last inspected: Agreement: The undersigned agrees to ensure the constructi enance f the afore described on-site sewage disposal system in accordance with the provisions o e Environmental e and not to lace ystem in operation until a Certifi- cate of Compliance has been i y t oard of Healt Si 42 09 Date Application Approve b e Date 7 " Z I-Z-" Application Disapproved i0f0tihe following reas Permit No. 20PI- 2 Z 6 Date Issued Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: r.. -1 Yes a PUBLIC;HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 11ppri`cation for 30ioposW .terry Conztr"uction Permit - - Application for a Permit to Construct( )Repair(Y Upgrade( )Abandon( ) C1 Complete System ❑Individual Components 1 Location Address or Lot No. 11'Ll W ta5F1 i N6`t 3+J �V . Owner's Name,Address and Tel.No. R1 tll):X1z D5 of ' Q AUK 10 Assessor's Map/Parcel 68 9 TM" Inst"er's Name,Address,and Tel.No. 7AST6 ZG Z,N C.A V AT 10-0 Designer's Name,Address and Tel.No. A 4-M 1.A J-P 5 62V 1( p. U, 11U4 17,a9 FctzST0ALz ")A S,. (�n >T 3 t �Sc>2> S0� - vuZ3 GJsST 4-r�nvuo � 7-1n UZ L-73 } Type of Building: Z Z A( b Dwelling No.of Bedrooms -3 Lot Size -5q-ff- Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow 3 3 U gallons per day. Calculated daily flow 3 3 y gallons. Plan Date -7. o Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Z SOa �� �-Wes'^8Z.r-S Description of Soil Sb, 1?LAQ SOIL- Nature of Repairs or Alterations(Answer when applicable) rn oT' Y5T-rtA Date last inspected: - - Agreement: The undersigned agrees to ensure the_construction-and-maintenance of the tafore descr be�on-site sewage disposal system in accordance with the provision�fPTitle-5 the Environmeaa��V;oi�end not'>to�pla ie.the ystem in operation until a Certifi- cate of Compliance has been issued by t oard of Hea. � t t Sig oe Date Application Approved b 'S' Date 7 - Z Application Dsappro d or the following reas s oe C Permi0o e,q)q-- Z Date Issued Z — —————— ———————— -- 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 PA—rX Q i> Ek e./� at �Q A—,11 I AUK, , <::!'>73I'trz.v7 V_\_5 has•been constructed-in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No, Z20 dated -"2 Z Do� Installer a Y � G�Gi\y�� Designer Qi M t,�, .p 5 o2.v t L 1 The issuance of this permit shall n,t rbe conj��ru d as.a guarantee that the s stem wi°11ffuncUionoas designed. Date j ! T Inspector �� 1 s- No. 2 p0 LI— 2 20 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS M.5 o5a[ p$tern Construct�OYU , e it Permission is hereby ranted to Construct( )Repair( )Upgrade( )Abandon( ) System located at 9 y ►U 6-t lT1J P, 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 p4 it. Date:_ Approved by /`---- - �• .s, Town of Barnstable �.++E Regulatory Services Thomas F. Geiler,Director * RNSTAB� MASS. `Public Health Division , i639 Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-8624644 Fax:;0;;304 Date: !Z l � SewagePermit# 'Z.6dj'-Zt0 .Assessor's Map/Parcel " J Installer&Designer Certification Form Designer: ��, o,4 `. Installer: Address' r� "� -Address: t GI, A,� 026 73 17aOn 2( Dl (w�1 was issued a..permit to install a (date) (installer) septic system atbased on.a design drawn by f (address) w�P v .dated. (designer) ` I certify that the septic system referencedabove was installed substantially,according to f the design, which may include.minor approved changes such as lateral relocation of the distribution box and/or septic tank. Stripout .(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 b designer to follow. Stripout(if require s inspected,and the soils satisfactory. kA OF 44ss9cy �o LINDA J: �N _ o PINTO stalle ' gnature) � CIVIL �' m No.46504 QFG/STE��OC��� esigner's Signature) (Affi p Here) PLEASE RETURN TO BARNSTABL . . E 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:\office formsldesignecertification form.doc Assessing As-Built Cards Page 1 of 2 TOWN OF BARNSTABLE LOCATION lct t �a A.►� SEWAGE# b D —5..- VILLAGE V:h A SOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. q� SEPTIC TANK CAPACITY lsoi> Gq LEACHING FACILITY:("ey_a,vw p�'� . (size) NO.OF BEDROOMS OWNER, - PERMI f DATE: - COMPLIANCE DATE: 1 , Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Beet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet .FURNISHED BY •: ,S c- b'a''f q� 4?:1y' 14, e 7 bru http://www.townofba.mstable.us/AssessingfHMdisplay.asp?mappar=139084&seq=1 12/20/2016 �u Assessing As-Built Cards Page 2 of 2 http://www.townofbamstable.us/Assessing/liMdisplay.asp?mappar=139084&seq=1 12/20/2016 r - Assessing As-Built Cards Page 1 of 2 4 SEWAGE INSPECTIONS 12/19/03* L6CAnON 194 Idaahington Ave DATE VIILAGE Oateavtt I11�.Iw.i+ 1N5 . •INSPI30TOR 20,6eP4 SEPTIC TANK CAPACrrY "Von 1000 ga g2oae. LEACHING FAC]Lrry:(rid y (sizey N0.OF BEDRODMS 2 —= BUILDER OR OWNER OWNER MAILING ADDRESS P.O.Box j88. 0-61"v-Uge,fla.ae. 02655 „. • M F.00A-- http://www.townofbamstable.us/Assessing[HMdisplay.asp?mappar=139084&seq=2 12/20/2016 Assessing As-Built Cards Page 2 of 2 http://www.townofbamstable.us/AssessingfHMdisplay.dsp?mappa►-139084&seq=2 12/20/2016 r 1 Town of Barnstable P# l 2- Department of Regulatory Services UMNgrABL& : Public Health DivisionHAM Hate 200 Main Street,Hyannis MA 02601 ` • - Date Scheduled a.. U Time ^1 Fee Pd. f Soil Suitability Assessment for Sewa a is osal g P Performed By: Witnessed By: �� LOCATION& GENERAL INFORMATION / (�Location Address '! y W A SA!-- ) *,.- Atit Owner's Name PA vI J' �u CK Woa�L 0 $*r v 1 Of dvt/J/� l q y Gv C�S 4�w�j k--1 Address C q J os�-c�„tll Assessor's Map/Parcel: 3 / Engineer's Name 4 NEW CONSTRUCTION (. REPAIR ✓ • Telephone#' S-0 5 7-7 'j(o o o. Land Use � $��t1opes(gb) ! 2 <a y Surface Stones NO Z�j rC aCG�affcJ �v�J+?J) Distances from: Open Water Body �o ft .,Possible Wet Area J ft. Drinking Water Well ft Drainage Way � ail- ft Property Line �5 ft Other QS l ZG/ ft SKETCH:(Street name dimensions of lot,exact locations of test holes&perc tests,locate wetlands In proximity to holes) AJ � /S f lrl _ t ti �ACO � Parent material eolo is r / (g g ) —� Depth to Bedrock g Depth to Groundwater Standing Water in Hole: Weeping from Pit Face Al hR Estimated Seasonal High Groundwater. yes W/Ah _ DETERNUNATION FOR SEASONAL HIGH WATER TABLE ` Method Used: N Depth Observed standing in obs.hole: U In. Depth to Sall mottles: ti� in, Depth t weeping from side ofob�s.�ole: In, Groundwater Adjustment ft: Index Well# Reading Date: /y/,! Index Well level Adj,factor &?ii, Adj.Groundwater Level PERCOLATION TEST Tone���, Observation Hole# Time at 91, ���,wf•Depth of Perc Time at 6 Start Pre-soak Time @ h'1 M1�yA/ Time(9"-6„) 'V End Pre-soak Rate Min./Inch Site Suitability.Asses'sment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original:. Public 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:\SEPTIWERCFORM.DOC DEEP-OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture .Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones;Boulders. Consistency,°b vel /I/o iZvund �. �ti01 o �l DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color ' Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) �4 rr v�4.y, a YR " 9 24.=/Z ' c 2 S�' 11V6 UJ D /(/O DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency. • Tom,„, Flood Insurance Rate Man: Above 500 year flood boundary No— Yes Within 500 year boundary e No= Yes Within 100 year flood boundary No— Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? S If not,what is the depth of naturally occurring pervious material? Certification ' I certify that on (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 train' ertise a d p to described in 3 10 CMR 15.017. Signature Date Q;\S.EPTICVERCFORM.DOC Town of Barnstable Barnstable Regulatory Services Department adcacftv Y �y�. p*�. Ib IARNti'rASM Y HAS& Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO May 6, 2009 David Rockwood U .' P.O. Box 188 Osterville, MA 02655 Re: 194 Washington Ave., Osterville MA You are scheduled to appear before the Board of Health at their public meeting scheduled on June 16, 2009 at 3:00, to show-cause why your property or dwelling should not be condemned to continued use of a failed septic system. According to our records, your septic system failed on 1211912003 and you were notified by certified mail to repair or replace your failed septic system on 03/02/2009. However, to date, the system has not been repaired or replaced. The purpose of the hearing is to provide you the opportunity to provide testimony, documentary evidence, and/or witnesses pertaining to the repair or replacement of your septic system. PER ORDER OF THE BOARD OF HEALTH Thomas McKean, R.S., CHO Agent of the Board of Health C:\Documents and Settings\malkusk\Desktop\194 Washington Ave board meeting request.doc I o, Ln cc Postage $ rq o PENIS Mq Certified Fee ru Postm IQ p Return Receipt Fee Here N (Endorsement Required) A O C3 Restricted Delivery Fee —+ (Endorsement Required) / E3 rqTotal Postage&Fees L ru `SPS entTo I�Vj �G6 .Vjbo 0 SYieet,Apt No.;---------• --------------- 3 or PC Box No. N --------------- City,State,ZIP+4 Certified Mail Provides: o A,mailing receipt A o A unique identifier for your mailpiece m A record of delivery kept by the Postal Service for two years Important Reminders: o Certified Mail may ONLY be combined with First-Class Mailq or Priority Mailo, a Certified Mail is notavailable for any class of international mail. o NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. a For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. a For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. It a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 fi COMPLETE • ON DELIVERY a Complete items 1,2,and S.Aso complete A.C SignatUre item 4 if Restricted Delivery is desired. X /V- ❑Agent■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. Received (Printed Name) *ate of D�liv ry E Attach this card to the back of the mailp iece, ()�N / or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No Vivid �(LWO 0 d � . NtrVille, WA- 3. ice Type /'� (� El Certified Mail ❑Express Mail V Z—J 5-5 ❑Registered ❑Return Receipt!or Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes .2. Article Number 7OD6 215� 0��2 1041 8597 M (rransfer'from serv/ce labeq PS Form 381 1,February 2004 Domestic Return Receipt 1tI2595-02-W..1540 UNITED STATES POSTAL SERVICE First-Class Mail `Postage&Fees Paid LISPS i Permit No.G-10 I • Sender. Please print your name, address, and ZIP+4 in this box• I-UNI Of I3WHAOe, -I +M HT) P\/I S i 0 V1 20 b V1j Ivi 4- 4 Avlvlis) W DZ69 D I � l F7HE r Town of Barnstable Barnstable Pao Mme icaC-ny Regulatory Services Department sA�x�-raai:e, Public Health Division 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-799-6304 Thomas A.McKean,CHO 03/02/09 David Rockwood PO Box 188 Osterville, MA 02655 O Q FINAL ORDER ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 194 Washington Ave, Osterville, was last inspected on 12/19/2003,by J.P. Macomber and Sons Inc., a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Failed" under the guidelines of 1995 TITLE 5 (310 CMR 15.00) due to the following: "The system is in failure due to the rooted cesspool and the-age of-the 6'X6'. cesspool" The deadline for repair has past. We, The Department of the Board of Health, have not been informed that you have taken any steps to bring your failed system into compliance. Therefore, you are ordered to repair-or replace the septic system within 60 days from the date you receive this notification. You may request a hearing before the Board of Health, a written petition requesting a hearing on the matter, within seven (7)days after the day this order was received. Failure to repair/replace the septic system.within the deadline period will result in future. enforcement action. " PER ORDER OF THE BOARD OF HEALTH as McKean, S., CHO Agent of the Board of Health FAILED INSPECTION - DATE.:12/1 9/03____ PROPERTY ADDRESS: 194-0a.6h.ington Ave _____ O�.teav i fie; Na s,s. � ------------------------ 39 02655 ------------- On the above date, I inspected the septic system at the above a_d.dress.__. This system consists of the following: RED-[Vr-_D 9. 1-6 'X6 ' 9-cock ce.6,312ooi 2. 1-4 'X5 ' &.lock ce.3,3/2oo 2 JAN 2 0 2004 3. 7h.i,3 .i-6 a z12-eit zy-6tem. TOV1,N OF EA,ti:STAB LE Based on my inspection, I certify the following conditions: HEALTH DEPT. 4. 7h.ih i 6 not a t.it 2e 4ive ze/zt.ic 3y,6tem. MAP �9 5. 7h.i,6 .i.6 a sewage zy.6tem. Inztai.eed 72a.ioa 1950 n 6. 7h ' 5 ' ce,3.s1zooi .ih aooted. 7he 6'X6' ce,3.6/2ooe z day. PARCEL �� 7. 7he'' z ouid ge upgaaded to a t.it ee �-ive ze/zt.ic -6y,6tem. LOT 8. The 3yztem .iz i:n �a.iivae due to the tooted ceAzpooi and the ,�e o�e the 6 'X6 ' eezzpooe. - � - SIGNATURE:� Name:_J _ Macomber Jr_______ Company: Jose_ph_P. _Mac_o.mber_& Son, Inc . Address:_ Box-66-__ 9 (�/� -_--_-__-- 2004 Centerville , Ma. 02632-0066 ------- TOWN OF BARNSTABLE Phone:___508_775=3338 ____- HEALTH DEPT. THIS CERTIFICATION DOES NOT CONSTITUTE%.A. GUARANTY OR WAFthA14TY MEOW— LJOS.EH P. MACOMBER & SON, INC. Tanks-Cesspools•Leachfields Pumped & Installed Town Sewer Connections x 66 Centerville, MA 02632-0066 775.3338 775-6412 COMMONWEALTH OF MASSACHUSETTS Z EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS r�� Y DEPARTMENT OF ENVIRONMENTAL PROTECTION y V- TITLE 5 OFFICIAL INSPECTION FORM-.NOT FOR.VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A :CERTIFICATION - Property Address: . 94 bNazhington ,4ve Owner's Name: David Rockwood Owner's Address: vzt,eliv.7727e, a,3.6. 5 Date of Inspection: 12119103 Name of Inspector: (please print)j o z e R h I, Na c o m g ea J/z Company Name: , 2, Macomle2 & Son .Inc. Mailing Address: Cen eavi e, a s.6. 026 32 Telephone Number: 5 0 8-7 7 5-3 3 3 8 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on,site sewage disposal systems.I am a DEP approved system inspector pursuant toSection.15:340 of Title 5(310 CMR 15000). The system: Passes Conditionally Passes eeds Further Evaluation by the Local Approving Authority %Fails g Inspector's Signature: r 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. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that ��. time..This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A ' CERTIFICATION (continued) Property Address: 194 Ua shing.t on Ave O�stenv�..e.ee,l7a�s�. Owner: David /2o ckwo od Date of Inspection: 12119/0 3 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes s0 II have not found any information which indicates that any of the failure criteria described in 310 CMR or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: ThiA LA n A,1?2 -1 ,suilem-42 cezz000i iz tooted. 4 new t.it-ee �-i.ve gg�ntir 614Afom noor -A fn Do i_nAt-a,PPerJ. #1 ce.6b/2oo-e iz o.ed yyelty oid. 7h-iz 12ooi zhouid aizo to om-it.ted. B. System Conditionally Passes: /J? One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer yes,no or not determined(Y,N,ND)in the for the following statements. If"not determined"please explain. A,&-I&The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years.old is available. ND explain: XJOiUC,,Observation of sewage backup or break out or high static water level in the distribution box due to broken.or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with approval,of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 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 obstruction is removed ND explain: 2 Page 3 of 11 OFFICIAL"INSPECTION FORM-'NOT:FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION=FORM PART A CERTIFICATION(continued) Property Address: 194 Oazhington 4ve Owner:. %)r/))Jrl 1?nrkwnnrl Date of Inspection: 12119103 C. Further Evaluation is Required by the Board of Health: Al 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 mannerwhich.will protect public health,safety and the.environment: .Lt? 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 I 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: tb 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. RJ0 The system has"a septic tank and SAS and the:SAS is'Within a Zone 1 of a public watersupply. 4P The system has a septic tank and.SAS and the SAS is within.50 feet of a private water supply well. 4b The system has a septic tank and SAS and the SAS is less than 100 feet.b 50 feet or-more frog a private water supply well". Method used to determine distance "This system passes if the well water analysis.,performed at a DEP certified laboratory, for coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5.ppm,provided that no other failure.criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: I 3- Page 4 of 11 OFFICIAL-INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE.DISPOSAL SYSTEM INSPECTION F.ORM PART:A. :' CERTIFICATION(continued) Property Address: 1.94 Oath ing.t on Ave Owner: Date of Inspection: 2/ 9/0 D. System Failure.Criteria applicable to all systems:. You must indicate"yes"or"no"tovach.of:the:following for all inspections: Yes No _ ��ackup of sewage.-into facility or system component due to overloaded or clogged SAS or cesspool �/.Discharge:or,ponding.of effluent.to the surface ofahe.gcound or:surface:waters due to an overloaded or clogged SAS or cesspool Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or _ �cesspool .:v 1A _ _A`iquid depth in-cesspool is less than.6"below invert or availableolume is less than .day flow equired pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times pumped ZI . Any portion of the SAS,cesspool or privy is below high ground water elevation. Any portion of cesspool or privy is within 100 feet of a surface water.supply or tributary to a surface water supply. Any portion of a-cesspool:or:privy is within Zone 1 of a:public well.. ✓ y portion of a cesspool or privy is within:50 feet of a private water supply well. Any portion of a cesspool or privy is less-than 100 feet but greater,than 50.feet from a private water supply well with no acceptable water quality analysis. [This system..passes f the.well water.anslysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates:that the.well is free from pollution from:tha.t:facility:and.the presence-of;ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered:A copy of the analysis must be attached:to.this form.] - (Yes/No)The system fails.I have determined that-one onmore: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 1:0100.0 gpd to 15;000. gpd. You must indicate either"yes"or"no"to.each of the following: (The following criteria apply to large systems in addition to the criteria above) yes no — e 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 _ _�e:system is located in a nitrogen sensitive area.(Interim Wellhead Protection Area IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes"in Section D above the large system has failed.The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner should.contact the appropriate regional office of the Department. 4 Page 5ofII OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE'SEWAGE IlISPOSAL SYSTEM:IN PECTION FORM PART B CHECIMIST Property Address: 194 Oaz h.in u.t o n R v e v 0,3.te2v.i.e.ee. /?a s.6. Owner: [avid Rockwood Date of Inspection: 12119103 Check if the following have been done.You must indicate•"yes or"wY`as to each..of the.following: . Yes No — Pumping information was provided by the owner,occupant;or Board of Health _ /Were any of the system components pumped out in the previous two weeks? — — Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or,as part of th#sinspection? /Were as built plans of the system obtained and examined`?(If they were not avail ablerilDte N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out?. �— Were all system components,ekluding the SAS, located on site ? Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depthof sludge and.depth of scum? Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site.has been determined based on: Yes noVxisting information.For example,a plamat the Board of:Health. t✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(3)(b)] 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM_INSPECTION FORM PART C SYSTEM,INFORMATION Property Address: 194 Na sh.ia q.t o n Ave- 0.6 t e-,z v-i i i ea, Mazz. Owner:Day.id /2ockwood Date of Inspection: 12119/0 3 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design) Number of bedrooms(actual): 9 DESIGN.flow based on 310 CMA 15 203(for example: 110 gpd x#of bedrooms) Number of current residents: Does residence have a garbage grinder(yes or no): W?' Is laundry on a separate sewage system(yes or no):.,V,�p [if yes separate inspection required] Laundry system inspected yes or no):i(fd Seasonal use: (yes or no): Water meter readings,if available(last 2 years usage(gpd)):20 01=18, 0 0 0 ga i e o n i=4 9. 32 qC%D Sump pump(yes or no): d16 2002=13, 000 gaeeon.6=35.'62 GP D Last date of occupancy: COMMERCIAUSTRIAL Type of estabbs ent: Design flow(based on 310 CMR 15.203): RPd Basis.of do#0,11ow(seats/persons/sgft,etc.):, Grease trap present(yes or no): Industrial waste holding tank present(yes or no): j Non-sanitary waste discharged to the Title 5 system(ye.s or no): Water meter readings,if available: Last date of occupancy/use: . T O HE R describe GENERAL INFORMATION Pumping Records Source of information: Ate. i9t�i�>��•07� Was system pumped as part of the inspection(yes or no): If yes,volume pumped: gallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM 40c)Septic tank,distribution box,soil absorption system 'Z Single cesspool ,&P.Overflow cesspool Privy Il/d Shared system(yes or no)(if yes,attach previous inspection records,if any) innovative/Alternative.technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight tank Attach a copy of the DEP,approval /UDOther(describe): Ap roximate age of all components,date installed(if known)and source of information: r `y. Were sewage odors detected when arriving at.the site(yes or no):4,22 6 Past 7 of 11 O'FFIC;IAL.INSPE CTION.FORM. NOT FOR VOLUNTARY ASSESSMENTS SUSS- R A-CE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property xddress: 194 Na,3hjn ton4ve U1s e v -e..11u4r1.' owoe.r: David /2o c cvo od Dstc of Ins.pcctfot}i 3 �• ' BUILDING SEWER(locate on site plan) 4" oorangorgeorg pipe Dcpth Wqw grade; Mucrtais of coAstrtictio t troFt .40 PVC 2ther�expiain)- 4" Lire w ie gh l VC iRe Distance from private witcr-supply well or suction line: Commcnrs(on conoltlpn .. joints, vsnting,c.vidcricc or Ic age,c.te.): o into The 6y,6ten2,6 aore vented .thorough .the 200 ventz. SEPTIC TANIC�'�locate on site plan) Dwh below grade: 40 Mi.tcrizt orconswctlon: concrete,{�,motal�frbergkass�l»polyethylcna- Al�j othcr(cxp.lain) , I l uu<k is metal if;.t.age !s ago cgtiCumc by a t et lftctetc or Cornpllance(ycs or noW,4(attach a copy of ccniftc'atc) `� bimcnsions: Sludge dcpth Distance from top or sludge to bonom of outlet tee or baffle: 8n/ Scwn thickness: Distance from top or scum to top or outict tee or baffle: Ayw Distance frgm bottom of scum to bottom of outlet tee or .ba:ffk: .4 Row w.cre dimensions determined; C.o:mmcn'ts.(on.purrp.ing recowncndatign-s, tn).et end outlet tee or baffle.condi:tion, structural integrity, liquid levels as rcliwd.to out}ct invem,av1.dcnce or.lcakagc,etc;); ,S,P- 1 r . Ynn7. lr i.� n�f nn cnnf v GREASE TRA plan) t (Locaw on site I • '', Depth below grad; Material.of ,fiberglusgapolyethylenc�4othcr (cx.p.lain); D.imen:.ions: . All Scum th.icknCo.. 44 Distance 4•.om tgp of scum to top oroutlet fee yr baffle: Distance from bottom or scum to bottom or outlet tee or b4ffle: 9 Date or wt ptun,ping: Comment$(on pumping recomrnenoattgns,inlet and outlet tee or baffle condition,structural integrity; liquid levels as related to outlet invert,evidence or:kttk.i:gc,etc): Goreabe t /ap1 ,3 a.Rt Pnn.sel7,I Page 8 of I I OFFICIAL INSPEC'PION FORM NOT FOR VOLUNTARY ASSESSMENTS SI fSSU'RFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 194 Washington ,4ve Owner •/�r�1J,i/'� '�j �:.iQn G,� Date of Inspection: 12119103 TIGHT or HOLDING TANKr "Wik must be pumped at time of inspection)(locate on site plan) Depth below.grade: Material of construction: 414 concrete meta1/0 fiberglassWA� polyethylent4 l—other(explain) Dimensions: Capacity: gallons Design Flow: gallons/day Alarm present(yes or no): Alarm level:�j Alarm in working order es or no CY :) Date of last pumping: f'14 Comments(condition of alarm and float switches,etc.): 10 Tight o2 ho d irzg an %s r5.z,� DISTRIBUTION BOX (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: 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.): DIAIR P�t.ioa Sox .ins no �ae�en PUMP CHAMBER:/IH (locate on site plan) t Pumps in working order(yes or no): y/9 Alarms in working order(yes or no):- Comments(note condition of pump chamber,condition of pumps and appurtenances, etc.): /�MD I-hrlmgpn 1.6 not /22ebe12 8 Page 9 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS. SUBSURFACE SEWAGE DISPOSAL.,SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued). PrapertyAddress: 194 Glash.ington Ave a e2vi e a•5T. Owner:.Day.id 1 ockwood Date of Inspection: 12119103 f SOIL ABSORPTION SYSTEM(SAS): locate on site plan,excavation not required) p�jj A14.Aforn, . 1-6 'X6 ' 9,eoc.k ces,32.00_e and I-4 'X5 ' ce,3,3/200 . If SAS not located explain why: Located: See page J0 Type Ak leaching pits,number: Q A leaching chambers,number:0 410 leaching galleries,number:� h leaching trenches,number, length: B 4)0 leaching fields,number,dimensions..: 6P overflow cesspool,number: .,U6 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 .foam to ioamu .sand to medium 41ae innrJ 2 ,3 gadeU /zooted o;thea ceAA12oe)jP 1A r/ny 7hjA la a AaQit ZYZ;tem. So-iiz aae day. Vegetation .ia no2ma e. A new ze/Zt.ic. z.y stem ne z Ito ke irz taiied, CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: v� Depth—top of liquid.to inlet invert: Depth of solids layer: Q Depth of scum layer: Dimensions of cesspool: 'fJXt5-`i Materials of construction: "@ry_ 6 jK,4& Indication of groundwater inflow(yes or no):-.V Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): _Sumo n IS a 611 PR" (locate on site plan) Materials of construction: Dimensions: 4W Depth of solids: AM Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): / n,iyU iA nnfinao QUf 9 Page I I of I I OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued). Property Address: 194 0a6h.ington Rve 0A t,J7»i jP arlAA Owoer: 12119103 Date of Inspection: Dnr)irl /?�kwnn� SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water feet Please indica►e (check) all methods used to determine the high ground water elevation: N0 Obtained from system design plans on record - If checked,.date of design plan reviewe04 YSObserved site (abutting property/observation hole within 150 feet of SAS) &fL Checked with local Board of Health-explain: NA lN(SSChecked with local excavators, installers. (anAch documentation) [Accessed USGS database-explain: h4tp://.town. gaanzta&.2e, ma. u.3. You must describe how you established the high,gro.und water elevation: Cl,3ed: GahlLety & Niitez Nodei. 12116194 Gicound wate2 eievat.iona a&ove .6ea ieve.e. 11,6ed: IISGS: d .talung 1992 11zed: LISGS: TorhnirnP 4,14-P[o�.���'inn_ 92 000 1 Piate #2 Annuai aangez ol gaound watea a eo>>r,f :n,aZ/, �`VfOUra y 1992 Slz.e.it Syatem. 2 ce"Poo2a .eet Groundwater. Feet Below Bottom of Pit High Groundwater Adjustment 1.8 ft per F6.mpter Method Therefore,the vertical,separation distance between the bottom of the leaching pit and the adjusted groundwater table is �© feet. 11 TOWN OF Barnstable WARD OF HEALTH 30I1SURFACR SFHA(;E DISPOSAL SYSTEM INSPFCTION FORM PART D CERTIFICATION ...�.••.T••.••.. -T.t t:^.�.TT1.T..•"RI'II:TTt T'{Tt':f."T11 TTT,'.T�'.'1."'1 tTi+t"(TP1TTCr"TI"+T'RrTt Ti4'tCI1T1'i':TtI'M1TO i'iTTfR1TSTTRTtTO^.TTTTT.•.�.'I'•TT�•1• �.. —TYPL OR PRINT CLEARLY— PROPERTY INSPECTED STREET ADDRESS )94. Oa hih_giod 4ve Ala.616.{ . ASSESSORS MAP , BLOCK AND PARCEL # OWNER' s NAME David Rockwood PAR7' D - CERTIFICATION I NAME OF INSPECTOR Joseph, P. Macomber Jr COMPANY NAME Joseph :P. •Macomber Vion Inc COMPANY ADDRESS Box 66 Centerville Mass 02632 _ Street TQvn or C.lty Stat9 tip COMPANY TELEPHONE ( 508 ) 775-3338 FAX ( 508 ) 790-1.578 - CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at ATMqkLhis address and that' the information reported is true , accurate , and omplete as of the time o€ .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 . »... Syste6 PASSED The inspection which I have conducted ' fas not found any information which indicates that the 'system fails to adequately, protect public health or the environment as defined .in 310 CMR 15t303 , , Any failure criteria not evaluated are as, stated in. the FAILURE CRITERIA section of ,this form , - System FAILEU* The inspection which T , have con Ucted has found. that th.e system fails to Protect the ��ublic ihealth and the environment in accordance with Title 5 , 3.10 CMR 1.5t303 , and as specifically noted on PART -C - FAILURE CRITERIA of -this ins'pectior.. form, Inspector AgEft, Signature d F I�•ate / •. ' � ne copy of this c cIfication must be provided to the OWNER, the. BUYER ( where applicable ) and the BOARD OF HEALTH. * If the inspection FAILED , the owner or operator shall upgrade the system within one year of the date of the inspection, unless allowed or required otherwise as provided in 3.10 Ci,JR 16 , 306 , partd . doc SEWAGE INSPECTIONS 12/19/03 OCAT10Pt 19'4 Ua,3hington Rve DATE -.{ C)'6 e2v i C Qe n . �19PEUVILLAGE.INSPBCOB o,6e h SEPTIC TANK CAPACITY Nonce - LEACHING FACE:IT'f: We- NO. Ceb/�nnn � (size) �OUO yr�CCon�. OF BEDROOMS 2 III BUILDER OR OWNER OWNER MAILING ADDRESS P. 0. Box � �88 02655 a , o ' w-o• IIIIf I 2a-c• u'-c" I5-,3' ✓ 12•-5• z o w W K g B n A-5 � --------- -------------- - ----------------'-1 o - I •`- ---- .. ------ ---- ---------------- o. ---------------� 2 X 10 FLR.1015T5 2 X 10 FLIR.JOISTS START DROPPED SLAB I!I = I I � h_Si8' O' ANC�+OR B4.Ta 9'-n J W Q I W t CAR GARAGE Lll U0 x o - ---------- --- 4' MIN. CONCRETE SLAB ON I N \ 5 A L N Af CORpARCc 1 -� 1 GRADE (3000 ,.1)WITH 6X6 ro c 1 3'-O" 50.X 12" N �) I -- ------------ 1 WWF AT MIDPOINT I- -1- Q \ DEEP(TYP.) MIN 13)2X9 1 - , °• I N SUP LMIPORTeDVAPOR RETARDER IO I �N Q UJ W 3�3 I r X� C 2;!19IIIITH I/7"PlYlllnon I — I, I• I i m Z Q Q Ms r e o,e„ I MIN 2Xgw--�- —� II I J 1 1 I b U) In 2 x 10 FLR.Jolsrs m '°-1 1 1 o < I-'Q ❑ ABv IP'0.c L J MIN 2XI2 WITH I/2" PLYWOOD i"'r 1 .o �.� z SLOPED SLAB J� _� 1 SLAB -I" DEEP EARLY ENTRY Z V LINE SAll CONTRACTION MIN (3)2X9 �- --_-_ 1 A,T 9" I JOINT ITYP.) W =W z U) _ ___r___� I THICK I I I N J N 0 1 G--- ___- __ _ J I W Q- w BEAM POCKET T ( 2X4 (TYP) <( Q a i) A I _- SIZED TO SUITS 2X6 WALL ON STRIP FOOTING?— I -ELEVATOR PIT SEE DETAIL ~+� W it A-I I I 9'-0" DROP FOUNDATION I (f)dj W LU U m '' - - WALL AS NECESSARY }0- L---------------- -.._. -. - ._..- -..-._-.. I i._.. .. .. -..- I _ O'-9i' AT GARAGE DOORS I U . 3'9' ---------------- UNFINISHED I I 18"WIDE X 12•DEEP I I Q AJCiJ I 0 m O I I FLOOR I� I CONTINUOUS CONCRETE � Z I FOOTING WITH 2" X q" q" MIN. CONC. SLAB (3000 psi) I KETWAY(T'i P.) .. 10 MIL VAPOR RETARDER - M Q N I I LLI L--- -e__--_---- ----_ -- p p B' I' I 2 X 10 FLR.JOISTS oP of FOUNDATION" .2 X 10 FILR12' JOISTS... II I ABv.12 °.c. r--- ry F 1 Aev.c'o.c. 1 8" CONC.FOUNDATION 1I o U'3 �77_ L ° -J WALL 13000 0,o WITH 1. g W FDN.DAMP PROOFING I -1 .» T I TO GRADE ON CONT. I r .g noRTAReO KEYED IB"W.X 12" D. I. I I Y 3 ��'Qp•' BwESTONE CAP CON.. FTG.13000 psi) li I I excE "m= L - ---- -- -JI L--- -- ----- ------ — ----- ----- a u __II .J F-- -1 r---- s — — I SLAB ON GRADE I COVERED PORCH r m 4"MIN.CONC.SLAB WITH I ABOVE o`? 2q" 50.X 12"DEEP TURNED DOWN EDGES ON Fa q WOOD FRAME COMPOSITE t. • CONCRETE PAD WITH FROST WALL 1 ETA psi) 10 MIL I DECKING) a i 5'ITYP.) VAPOR RETARDER 0 WITH BOTTOM SET q'-O" ® OF FOOTING B FINISH BELOW FINI GRACE 1 I 2 X 10 FLR.JOISTS I 1 F X< I TOP I ABV.12'O.C. I y n L----------------- 1 - A-, 0 — — — — — SECTION a a SCALE:1/4"=1'-O" V -2' 1 Q 0. I6'-0• 1W_O' =_3 C) .� W G1-O• <W U Z U 0 W Q ELEVATOR PIT _ Q W CL 0- O FOUNDATION PLAN zTHICK ,� ^ I REINFORCED I a SCALE:1/4°=1'-O° W O v CONCRETE SLAB 4'THICK LOT COVERAGE HOUSE =1182 5.F. U W W BA5EMEENT GARAGE,COVERED PORCH=c44 S.F. Lu_> 0'- LLI MIN TOTAL LOT COVERAGE- 1826 S.F. U 0 r' O FOOTING BEYOND ` 195� Q Q O SHEET: C SECTION SCALE:I/2"=I'-O° 2 4 6 8 10 At l5 � 1/4"=1•-0" ..,nip..i•...".. __ •!/1 4 I h O � H'_O• IS'-B}1• 12-4' 22'-0' 5'-3' 2 2-t}• 1 t} 3 1�' 3 81' W � O Cn Ln W I- W W O W x COOL= Nvi A 0 A 0 OC co Jij q 1 _ L J W I —ate < STOVE BATH 0 DO I �_, 2 z -- PANTRY HARDWOODITCHEN KARDWOOD xu HARDWOOD I I Op i,', I Nm LIJ I W Z 1)HEAT 1 O \r5 J J 0 W SINK DW .°�. ® x00 %�¢ _¢ Q W p -1--- of Lu 0 0 ( I �� Mma L j WUd p U m I I Q OL cn m DINING ROOM ISLAND ELEV. L --- Q G > p 1 HARDWOOD MUD N 2 CAR GARAGE-484 S.F. o o w 1 q -------_--__ ROOM (3000 p-OWTHE7E SLAB O Z Z n 7 L HARDWOOD ---- W w W.W.M. ON COMPACTED r a �_ �_ O GRAVEL OL W p p Cj 1�____ OO - O wLLm �m 00 >aLL 4'9' o HEAT BEAM ABV. s+ - ® xw -=m 0SIZED TO SUIT — 0= �D -¢ e•-o'suoEn w n P> M Q I mC) .... .. .. .. SOLID POST IN DN. P 0 -_ . - WALL(TTP) U � O L-------J 0 — I - BEAM ABV. I _ SIZED TO SUIT g OPEN TO ABOVE — - b PATIO BLUESTONE L m O FOYER PO MASONRY WOOD GREAT ROOM n HARDWOOD BURNING HARDWOOD - FIREPLACE BEAM ABV. MASONRYWOOO L9 BURNING r SIZED TO SUIT FIREPLACE Q a a cxc wooD b FRONT CO ERE b O POST(TYP.) RORC H QAZEK DECKING A LXL WOOD POST(TYP.) A A 2'-0. 3'-I}' 3'-3• 3'-3 3-3• 2'-9• 3'-3' 31_31 2'-9' 1'-LJ' 1'-O' II'-O' Q W z z T-2• 14'-0' IG'-O' 12'-O' 22'-0' (L x= < QWU _I0- U l7 OL FIRST FLOOR PLAN <G w CL SCALE:1/4"=1-0" LOT COVERAGE HOUSE-1182 S.F. 0 Q O ., GARAGE,COVERED PORCH =444 S.F. W TOTAL LOT COVERAGE=1824 S.F. U Q IL W W Q=> f— w U G co = UJINCOW 6 PATIO BOOR SCH ECDU LE (n Q U LLINCOWS ~ TAG OTY UTES TYPE ANDERSEN ROUGH G Q MODEL OPENING oz A L 1 3U2H I DOUBLE HUNG TW2116 2'-L'X 1'-9 1/1' EXTERIOR DOOR SCHEr-)ULE (L AB11 1 3W2H I DOUBLE HUNG TW214-2 4'-10 1/4'X 1'-9 1/1' ROGUE VALLEY ROUGH I 3W2H DOUBLE HUNG TW2ML-3 T'-2 3/1'X 1'-9 1/1' TAG OTY ryODEL HARDWARE DESCRIPTION OPENING D 2 3W2H DOUBLE HUNG TW2432 T-L 1/0'X 3'-5 1/2' OI 1 1442 DEL.BORE 16 CASING 1-9/I4 JAMB PFJ 9-UTE 2 PANEL 11-1/2'.82-1/2— THERMA-TRU ROUGH SHEET: 3W2H DOUBLE HUNG TW1132-2 1'-10 1/1'X 3'-5 1/2, TAG OTY MODEL HARDWARE DESCRIPTION OPENING F I 3W2H DOUBLE HUNG TW2432-3 T-2 3/1'X 3'-5 1/2' O 1 5-210(2-8.L-8) DEL.BORE IA CASING 1-9/U JAMB PFJ L PANEL 31-1/1'•02-1/2' G 11 3W2H AINING AWN21 1'-0 I/2'X Y-0 V2' O3 1 5-20(2-8•9-8) DBL.BORE IA CASING 1-9/IL JAMB PFJ 9-LITE 34-1/2'.82-1/2' L 3W2H DOUBLE HUNG TW1132-2 1-10 I/1'X 1'-1 I/1' O I S-2L2(3-0 L-8)) DBL.BORE 1�6 CASING 1-9/I4 JAMB PFJ 9-LITE 38-I/2'r 81-I/Y 2 0 2 4 6 8 10 _� I+3'-V WIDE X V-8'HIGH ROGUE VALLEY SPECIAL ORDER DOOR-CONFIRM R.O.WITH MANUFACTURER 1/4^_1-O H'-O• 28'-0' 11'-0' 0 m 1._0. 1'-,�• 3•-3' 3'_3• 2-10• _0. i._4. 21-11• 3._5. O_ � W 1 � O U k U W I-- W W 0 „ Cl7W/= Q � —— ——————— IV JI 0 II I I II o mZcn I-a b r-----------------� I - O uco Vi 0 LAUNDRY Q I TILE w w z In m II ! BATH I ILI o 4- w I TILE O < > a 6 H w o r-T-� N W I MASTER BEDRO� Z° U v r W C. .CARPET EL-V. �/ (n m CA PEr I BEDROOM-ul ° Q O m o I L CARPET Z z <0 a U) � Lif HALL tig a HARDWOOD rmrT p 0 FI+EBCN O (_)1-6 X 6-8 e-a FOYER _____-J I '❑ OPEN ---- -- -------J I \ / - 2 2 2 2'-5' 2 6'-T 3'-B" 4'-6" 4 \X MASTER / \ BATHROOMAI I I / \ - I fBEDR20M tt2 I `.-•—CARPET I � s I = a s}6 0 BATH TILE } (�� I a 9IL- II �p z z Q 3'-9}' L_5. 1'-I�• 1,_.. 2-_0. 3•_3• 3._3. 1'-10• 3._,. A Q v<= J ¢ wU G- U�7p� �GeO p w Lo p SECOND FLOOR PLAN U w w WINCJOW a PATIO DOOR SCHEDULE SCALE: 1/4-1'-0" CU> Z WIN C)O W 5 SECOND FLOOR = 1663 5.F. in Q U p EXTERIOR BOOR SCH EO U LE TAG OTY LITES TYPE AMODRELEN OPENING TAG OTT HARDWARE DESCRIPTION ROGUE VALLEY ROUGH (L I- w A i 3W2H DOUBLE HUNG TW2411 2'-l'X 4'-4 1/4' MODEL OPENING Q g 12 302H DOUBLE HUNG TW2416-2 1'-10 1/4'X 11-1 V1' O 1 162 DEL.BORE b6 CASING 1-9/li JAMB PFJ 9-11TE 2 PANEL 11-1/2'x 82-1/2'1. �[ TAG OTY THERMA-TRU HARDWARE DESCRIPTION ROUGH (L I SON DOUBLE HUNG TW244-3 1'-2 3/1'X 4'-9 IH' MODEL OPENING p 2 3W2H DOUBLE HUNG TW2432 2'-i 1/8'X 3'-5 1/2' O 1 5-210(2-8 x 6-8) DBL.BORE I S CASING 1-9/6 JAMB PFJ i PANEL 31-1/2'x 82-1/2- 3W2H DOUBLE HUNG TW2432-2 4'-10 1/4'X 3'-5 1/2' O 1 5-212 12-8 x i-8) DBL.BORE IA CA51MG 4-9/4 JAMB PFJ 9-LITE 34-I/2'x 82-1/3' F I 3W2H DOUBLE HUNG TW2432-3 1'-2 3/1'X 3'-5 1/2' O1 1 5-20(3-0 x 4-8) DBL.BORE bS CASING 4-9/IL JAMB PFJ 9-LITE 38-1/2'x 82-1/2' SHEEP G It 3W2H AWNING AWN21 2'-0 I/2'X 2 ��3'-i'WIDE%i'-8'HIGH ROGUE VALLEY SPECIAL ORDER DOOR-CONFIRM R.O.WITH MANUFACTURER _ A3 I 3W2H DOUBLE HUNG TW2132-2 1'-10 I/1'X 1'--14 1/4 I/1' ✓i\I 2 0 2 4 6 8 10 ...,....a.... 1/4'=i-O __,n h o a 14._p. 2B._p. 22•_p. � W -c o � O LID �i 2 � Qc U) w f— H z � ww o �w cn = 2 W �n U) w= Q \ 1 oC N U 1 w o Q U O o =zZ (UNFINISHED ATTICI �U W g w \ STORAGE CD q o o (UNFINISHED) Lu Nv-w LU u I zEm � Ur \ I °L U-) UD a o m In \ I co z\ Z ELEV. a aNl \ ATTIC Dc w . (UNFINISHED) 0 a ' — _ _ _ — — _ _ — _ — - 0 UNFINISHED ATTIC STORAGE (UNFINISHED) In b o DN. UP = °, b� B A T H All TILE � I BEDROCN-93 I CARPET'-- T yM __ ,jJ a _ a =3 Q z Z uJ w Q= Q aw�9U 4_i. 4._p. 4•_p. 4._t. U V Q O W� o ° O 14'-O' 6'-L' Il'-O' 6'-t• 4'-O' IB'-O' 0 Q O w J U fY ILL ww W IN OOW 4: PATIO CD OOR S3 CH E C U LE w U U WINDOWS THIf�D FLOOf� PLAN U)¢U ~ ANDERSEN ROUGH EXTERIOR C700R SCHEC7ULE O F- TAG OTY CITES TYPE ALE:1/4'=1'-O' ROGUE VALLEY ROUGH v, 1— < MODEL OPENING SC CONDITIONED SPACE= 245 S.F. TAG OTY MODEL HARDWARE DESCRIPTION OPENING O Q A L 31112H DOUBLE HUNG TW2444 2'-f'X 4'-4 1/4' 12 3U12H DOUBLE HUNG TW244L-2 4'-10 1/4'X 4'-4 V4' O I 4662 DBL BORE hd CASING 4-9/I4 JAMB PFJ 9-LITE 2 PANEL 44-1/2'v 8I-I/2'LL 0[ B TAG OTY THERMA-TRU HARDWARE DESCRIPTION ROUGH 3W2H DOUBLE HUNG TW2446-3 T'-2 3/4'X 4'-9 1/4' MODEL OPENING p 1 3W2H DOUBLE HUNG TW2432 T-L I/8'X 3'-5 1/2' O 1 5-210(2-8 x L-8) DBL.BORE IS CASING 4-9/IL JAMB PFJ i PANEL 34-1/2'•82-1/2' E 1 311214 DOUBLE HUNG TW2432-2 4'-tO 1/4'X 3'-6 1/2' O3 I S-20(2-8 w L-8) DBL.BORE IA CASING 4-9/IL JAMB PFJ 9-CITE 34-1/2'v 82-1/2' F 3W1H DOUBLE HUNG TW2432-3 T-2 3/4'X 3'-6 1/2' O4 1 S-262(3-0 a 1-8)1 DBL.BORE IA CASING 4-9/9 JAMB PFJ 9-CITE 38-1/2'v 82-1/2 SHEET: (� II 3W2H AWNING AWN21 7-0 1/2'X 2b 1/2' LL 3'-6'WIDE X C-8'HIGH ROGUE VALLEY SPECIAL ORDER DOOR-CONFIRM R.O.WITH MANUFACTURER A 3W2H DOUBLE HUNG TW2432-2 4'-10 1/4'X 4'-4 1/4' 1/4 7T�1 2 0 2 4 6 8 10 a 3RD FLR._TOP PLATE - - - - - - - - - - V 2ND FLR. TOP PLATE LL1 W K � gg$� FiF 3RD FLR.SUB FLOOR - - - - - - - 2ND FLR. TOP PLATE - 3RD FLR.TOP PLATE - - - 2ND FLR. TOP PLATE w I-- C)_ W W N ! R. 5UB FLOOR _ _ 2ND FLR. SUB FLOOR O Q W ry ST FLR. TOP PLATE - IST FLR. TOP PLATE Z Q W EU I LLluauw Z13 W S W z <n o❑o❑o co Lu - u 0 Li - < �j> Qa co w IST FLR. 5UB FLOOR - - - o � U m TOP SILL PLATE _ - - - LL O m _ - _ IST FLR. SUB FLOOR TOP SILL PLATE Q < 7 Q N a w I Q D = I I I I I I I = II II I I I I r I I I I I I I I I I I I I I -lry TOP OF FOOTING - --_ - TOP OF FOOTING LEFT SIDE ELEVATION SCALE:1/4-1-O" 2111) FLR_TOP PLATE - - - - - - - SRO FLR. TOP PLATE 41 0 2ND FLR. TOP PLATE-- -- - - - -- - = - - - - - 3RD FLR. 5UB FLOOR a 2ND FLR_TOP PLATE 3RD FLR. TOP PLATE o❑o❑o ® � � z �J}�`� o 2ND FLR. SUB FLOOR _ _ 1 2ND FLR. SUB FLOOR Lu Z 1ST FLR TOP PLATE - _ - IST FLR. TOP PLATE CL Q= wrn oa° 00 Leo < > w. ULw w IST FLR,5UB FLOOR _ �- _ _ _ _ _ - - ---- -- -- - Pill ''- -- _ 15T FLR. SUB FLOOR. - C_> z -A TOP SILL PLATE - - - - _ - - - _ T PLATE W U U O w OP SILL cn U � LL I I I I I O � _ 0- -——————————————————————- I I I I SHEET: TOP OF FOOTING - - - - TOP OF FOOTING FIGHT SIDE ELEVATION 2 0 2 e 6 s 0 A5 SCALE:1/4-1-O" 1/4'=1'-O- INSULATION LEGEND Ml OPEN CELL URETHANE SPRAYED _ 3RD FLR. TOP PLATE - - - - - - - - - INSULATION 2ND FLR. TOP PLATE - FIBERGLASS GATT Li ALL ROOF NAILING: RIDGE BEAM AS G" EDGE 0 ® NECESSARY 2 X 10 MINIMUM 6" FIELD m � 4" EDGE ON END WALL , I FIBERGLASS ASPHALT I X 6 COLLAR TIES ® - ROOF SHINGLES(30 YR.) 9'-O"O.C. WITHIN ® TOP I/3 OF ATTIC ly�� �'�I SEE SHEET FOR - R-38 OPEN CELL- FASTENING REE QUIREMENTS Z 3RD FLR. SUB FLOOR _ _ _ - _ _ 2ND FLR,TOP PLATE URETHANE INSPRYED A N O 3RD FLR. TOP PLATE - - - - - - 2ND FLR,TOP PLATE- - ISa ROOFING FELT RUN PLYWOOD VERTICALLY 1/2"m COX PLYWOOD ,��� `� ON WALLS^m m^ SHEATHING 5.8 �_ -.I\' In 2 X 10 RAFTERS °14" O.C. ,>- ATTIC 2 w ~ z t_) I—F-- JTYTYLrLNlLrI1yTLNTylLrLN2XB CEILING 12 J w O f2) 2 X L TOP 1PLAATE J0157S ° IL"O.C.CONTNUOUSi��l� w � _ _ _ _ _ _ CONTINUOUS DRIP EDGE �, ,T-` = R. SUB FLOOR 2ND FLR. SUB FLOOR ! - In U 1 IST FLR. TOP PLATE - - - - 1ST FLR.TOP PLATEND FLR. TOP PLATE - ALUMINUM GUTTER I- I X 3 ~-(2) 2 X 4 TOP 0 a O N I X 8 FASCIA . STRAPPING ° IL" PLATE \1_�I - - - - _ VINYL SOFFIT Z Z I/2" BASEBOARD W/ � (2)2 X L CONTINUOUS SKIM COAT PLASTER LLI S w Z N TOP PLATE WALL t CEILING J In J W \ :. 2ND FLOOR o U1 DOUBLE HUNG 4 MIL.POLY VAPOR 2 X 4 ° IL" O.C. T w LU IST FLR. SUB FLOOR - - I5T FLR.SUB FLOOR - ANDERSEN WITH Z�_ U ?- BARRIER (TYP.) I OP SILL PLATE W 1n TOP SILL PLATE TILT-OUT SASHES m Q Q m 0 1 BASEBOARD AS m z Z 15a FELT OVER 1/2'COX SPECIFIED s g PLYWOOD SHEATHING M W I 3/4°T l G 2 X 9 BOTTOM I-I 2 X G CONTINUOUS �SUEFLO R I PLATE L-------------------- ----_-------- BOT.PLATE SUBFLOOR RING �ND FLR.5UBFLOOR - NAILED 1 GLUED 2 X 10 RIM JOIST- TIP OF FOOTING - _-----_ _ _ _ -------- �- TOP OF FOOTING }FIST FLR. TOP PLATE (3) 2 X G CONTINUOUS 2 X 4 TOP PLATE TOP PLATE I PLATE FRONT ELEVATION OPEN CELL 2 X 10 SOLID URETHANE SPRAYED BLOCKING BETWEEN SCALE: 1/4-1-0" (2)2X10 HEADER INSULATION AT BOX FLOOR JOISTS WITH 3/9"G PLYWOOD THROUGHOUT '_8" A.F.F. 2 X 10 FLOOR • DOUBLE HUNG IST FLOOR J015TS °14"O.C. ANDERSEN WITH _ - TILT-OUT SASHES BASEBOARD AS 3RD FLR. TOP PLATE - - - - - - - - - - 2 X L STUDS ° IL" SPECIFIED 2ND FLR. TOP PLATE 2 X 9° 14" O.C. O.C.WITH 2 X B CONTINUOUS �� P.T. SILL W/ SILL SEAL R-20 FIBERGLASS - - - - - - BATT INSULATION 2 X 10 FLOOR _ JOISTS ° IL"O.C. 2 X G CONTINUOUS 3/4'T / G BOT.PLATE ADVANTECH SUBFLOOR 411 F _ NOTE: FRONT PORCH RING NAILED 1 GLUED NOT SHOWN 2 X 10 SOLID 2 X 4 BOTTOM BLOCKING BETWEEN FLOOR JOISTS PLATE o ST FLR. 5UBFLOOR - a BIRD FLR.SUB FLOOR - - - _ - 2ND FLR.TOP PLATE - 2 X 10 RIM 1015T TOP PLATE _ - 3RD FLR. 2ND FLR.TOP PLATE J�TOP OF FOUNDATION —�— _ Y m£ III FOAM A7.PEI ELBOX RAY - FINISH GRADE TO BEI.- III—I THROUGHOUT R-30 FIBERGLASS 'c` DETERMINED AT TIME OF III=T I BATT INSULATION Z CONSTRUCTION - I 5/8"DIA.ANCHOR BOLTS WITH ~ ^^ 0 EMBEDMENT AND 3"X BUILT-UP3) 2X Q _ 3" X A" PLATE WASHERS Z z SPACED AND INSTALLED IN BASEMENT FLOOR WOOD GIRT 2ND FLR. SU6 FLOOR _ _ _ 2ND FLR.SUB FLOG ACCORDANCE WITH THE Q u IST FLR.TOP PLATE - - - 1ST FLR.TOP PLATE - CALCULATION5 AND NOTES. Q w 3 I/2' DI.CONC.FILLED STEEL LALLY COLUMN U Z 30"X 30" X 12'CONCRETE wQ(Z) !� FOOTING(TYP.)(UNLESS - - FOUNDATION DAMP OTHERWISE SPECIFIED) F- _ PRO ::�A OFING TO GRADE Q 2 X 9 CONTINUOUS KEYWAY 4" THICK CONCRETE SLAB ~ Q F2 CONTINUOUS POURED (3000 pm)ON 10 MIL In _ CONCRETE FOOTING VAPOR RETARDER Q (3000pw) 9 U w w w m ` m P TOP OF FOOTING _ • C Q'` LLJ IJI=11 —III—I =ll—III, 0 w —i 15T FLR.SUB FLOOR - - IST FLR. SUB FLOOR L�I -�T-77II I�,I II-�-1 _ _ -II-I I1-I (0< U TOP SILL PLATE TOP SILL PLATE -III=III=III-I _ -� O f- w VARIES SEE PLANS —1 _III=III-I-III Ii= = (L 0 U - oa � o (L I I I I I I I ~ = I I I I I I I = i 1 I 1 1 1 1 SECTION B I I I I SCALE:1/2"=1'-0" A—5� SHEET: I I I I I I I TOP OF FOOTING - ------ -------------------� L�L� - TOP OF FOOTING 1 0 1 2 3 4 S A6 L 1/2•=I•_0• 1/a'=r-o- REAR ELEVATION z o 2 4 8 8 10 ..__. ........_.. . . � ' F PARCEL 79 21.E ce VIRGINIA T� REEVES „ ycl CB/DH FOUND _ N79'07 51 E 75.34 FOUND ry q � O cs m / ►' `/p NV � CB/DISC N / En/ � PROJECT FOUND N80 6'44"6 N LOCATION Q f 9.1 \ PARCEL 84 10,339t S.F. o / / S P��W N NTUCKET I / / SOUND I cs LOCUS / m / NOT TO SCALE o I � N LAB T.H. #1 21.4 + vi� I _ 22.1 ti LEGEND Or , \ 17.1, I � ------------- EXISTING 2' CONTOUR o I SHED o PARCEL 78 ,m IT.H. #2 N/F ---T2o- EXISTING 10 CONTOUR z 21. _ 1 D J > LUCIANN BOYD +21.5 EXISTING SPOT ELEVATION m L _ __ _ _ _ _ _ - - m SULLIVAN, ET AL I ❑ 21.s N m w � x210 PROPOSED SPOT ELEVATION PARCEL 83 I I m00 N�F m OAK G) EXISTING TREE B ALAN B. CURTIS � & EAGAN Fo/Dp a CONCRETE BOUND WITH DRILL HOLE APPROXIMATE � 15 o I LOCATION OF / \ PINE 00 w �-� EXISTING SEPTIC 21.7 •( - r \\2 SYSTEM O 22.9 m OAK o �p° STEPS GENERAL NOTES: 22.3 i ,,/ --- --...'22--� 1. HOUSE NUMBER: 194 4o.T 22.1 �� 2. ASSESSOR'S NUMBER: MAP 139, PARCEL 084 FENCE 3. ZONING DISTRICT. RF-1 I 4. FLOOD HAZARD ZONES: X & 0.2% (FEMA MAP 25001 CO776J) 20.6 I 5. .TOPOGRAPHIC INFORMATION.COMPILED .FROM AN ON THE GROUND SURVEY. EXISTING HOUSE #194 6. ELEVATIONS SHOWN ARE BASED ON NORTH AMERICAN VERTICAL DATUM (1988). I \\ F.F. 2 3.6 0�p 7. LOT COVERAGE BY EXISTING STRUCTURES: 1,184 S.F./10,339 S.F. = 11.5% \ ESN OF A{q �A N OF Nj ss I \ GAAY 9e, �o MICHAEL J. S. 5 BORSELLI 4.5 m 10 0 5 10 20\ $ LABRIE o CIVIL -� l \ No. Z9 U No 35054 N22.2 CONCRETE ��s 9FG! R��P � " G F I \ 22.7 QYgL A 'U'VALE fi�G \ � cn 16„ SCALE: 1 INCH = 10 FEET i w j�l�o2f r� EXISTING OA WATER EXISTING CONDITIONS PLAN I \\ SER\ACE AK FOR #194 WASHINGTON AVENUE I 24 " 22 --N OAK PREPARED FOR CB/DISC CB/DH I „ 22.1 0 K � � �� �� -_ '' CB/DH FOUND FOUNDO 14 "a_,oho ___ 53.03 - �� FOUND BARNSTABLE HARBOR BUILDERS IN - 9' , F OAK 20.33,�, - N74'45 50 E ��-- - MA S80'37 00 W 29.33 OSTERVILLE \ EDGE of PAVEMENT �2 PLAN DATE: DECEMBER 7, 2016 PLAN SCALE: 1 =10' 19.5 \ AVENUE CIVIL ENGINEERING r O T J WETLANDS PERMITTING WASTEWATER DESIGN lJ l COASTAL ENGINEERING (40' WIDE-PUBLIC) .�c TITLE 5 PLOT PLANS � PIERS AND DOCKS WASH I N GTON GrNEERi� \ LAND USE PLANNING COMMERCIAL/RESIDENTIAL BENCHMARK: NAIL & CAP Serving Cope Cod and Sorrtheostem Mossochusetts EL 20.08 17 ACADEMY LANE, SUITE 200 - FALMOUTH, MA - 02540 - 508.495.1225 19.5 EDGE OF PAVEMENT PROJECT NUMBER: 16045 CAD FU NAME: 16045sp new DRAWN BY L.M. SHEET 1 OF 3 PARCEL 79 21.b e / N/F �y l `� 9 F CB/DH CB VIRGINIA T. REEVES N79'07'51"E 75.34 FOUND FOUND _ Go 6' � 6O' o / STONE DUST BOCC/ COURT l ...POND W uj CB/DISC N _ ^ PROJECT i FOUND N80 6'44"E� / cly LOCATION P 9.1 PARCEL 84 / NEw 10,339 f S.F. o / SEP iiVAN7vc/rEr SOUND cs CA I � � LEGEND 10% / o + --------------- EXISTING 2' CONTOUR LOCUS "' E NOT TO SCALE N I POIGY LAWN ---20--- EXISTING 10' CONTOUR I T. #1 21.4 /�' +21.5 EXISTING SPOT ELEVATION x21.0 PROPOSED SPOT ELEVATION TP EXISTING TEST PIT I BL PAW 17.1 OAK O EXISTING TREE I Or IO ITH. 2 \ PARCEL 78 cB/DH El BOUND WITH DRILL HOLE -n 21.1 I I I N/F FOUND _ - _ _ _ _ _ -1 LUCIANN BOYD "' ( _ - - 20 .8 i 2 N o. SULLIVAN, ET AL El PARCEL 83 N ca N/F I �o PROPOSED � m GENERAL NOTES: ALAN B. CURTIS HOUSE & GAIL EAGAN s 57iEY 70 8F PUMPED a9YANo 15" 1. HOUSE NUMBER: 194 I N REMOLD ` PINE 2. ASSESSOR'S NUMBER: MAP 139, PARCEL 084 22.9 3. ZONING DISTRICT. RF-1 °� I 16" 20'M/N h 4. FLOOD HAZARD ZONES: X & 0.2% (FEMA MAP 25001C0776J) II OAK I Ro 5. TOPOGRAPHIC INFORMATION COMPILED FROM AN ON THE GROUND SURVEY. I I RE REVF pP' POR. 6. ELEVATIONS SHOWN ARE BASED ON NORTH AMERICAN VERTICAL DATUM (1988). II 22.3 ' � ` 8, I ----... - - --- - 7. LOT COVERAGE BY EXISTING STRUCTURES: 1,184 S.F./10,339 S.F. = 11.5% 10'MIN. ( --- 22.1 2-78. LOT COVERAGE BY PROPOSED STRUCTURES: 2,052 S.F./10,339 S.F. = 19.8% AN ADD/AONAL SaL EVAL!/A776W 40.7 _ 16 _ 9. FLOOR AREA RATIO: FIRST FLOOR CONDITIONED SPACE = 1,150 S.F. AND PERCDYA770YV 7ES'r STALL RE I FENCE PERr�MEo IN AREA t�'SAS AT 7HE � �I 2ND FLOOR CONDITIONED SPACE = 1,663 S.F. 2 CAR nME Lai'/NsrALLA77ayV. gas 4,� GALLLav � 3RD -FLOOR CONDITIONED SPACE = 265 S.F. r 0 SEP77c rANK N GARAGE TOTAL CONDITIONED SPACE = 3,078 S.F./10,339 S.F. = 29.78% < 30.0% I\ i K11-20) 10 0 5 10 20 II \ O I O O 10 MIN. 22 B 16- II OB-5 10'M/N. I ( SCALE: 1 INCH = 10 FEET (H-20� I ( 2 .8 4.5' 3 - 500 49ALLOV I \NO ArMWkE I 2.2 1 CHAMBERS lN7H 2 S7LWE ALL ARaIND I N AREA i 22.7 i 1 12/21/16 ADD RESERVE AREA, SLEEVE NOTE AND ADDITIONAL SOIL EVALUATION NOTE. \ I I CDBBLE I OAK DATE REVISION 10 MIN. I _ 13'�._ --------' EXISTING I OR/f�EI�YA Y 1 \ WATER I 6p SITE PLAN - PROPOSED IMPROVEMENTS \ O SERVICE 24a / 16K FOR #194 WASHINGTON AVENUE I 4"" -22 - OAK / PREPARED FOR CB/DISC CB/DH I 22.1 04K� Q �/ 53.03 CB/DH FOUND FOUND 14 �,�, C _ FOUND BARNSTABLE HARBOR BUILDERS - 9' �1 I` AK 20.33'�, FOUND ., IN S80'37 00 W 29.33 N74 45 50 E �--- OSTERVILLE MA EDGE of PAVEMENT A/DTF PLAN DATE: DECEMBER 7, 2016 PLAN SCALE: 1"=10' 19.5 \ SZ 91F WA MR LINE IN ALL AREAS .� LESS THAN 10'FRW SFP)70 S!'S" �\ ��� CIVIL ENGINEERINGj *� Cl T J�' WETLANDS PERMITTING AVENUE VE WASTEWATER DESIGN L 1Vi ! ` j� COASTAL ENGINEERING (40' WIDE-PUBLIC) �P��\3, OF MAS GARY TITLE 5 PLOT PLANS ��� t���`. PIERS AND DOCKS WASH I N GTON WEER S. dam' MICHAEtJ. G"�' IABRIE � BORSELU ��. LAND USE PLANNING COMMERCIAL/RESIDENTIAL BENCHMARK: o CI" 54 O NAIL & CAP S&rnng Cape Cod ono'Sartheestern Massochusetts EL. 20.08 EDGE OF PAVEMENT r S' 17 ACADEMY LANE, SUITE 200 FALMOUTH, MA - 02540 - 508.495.1225 19.5 � la/al It PROJECT NUMBER: 16045 CAD FILE NAME: 16045sp new DRAWN BY: L.M. SHEET 2 OF 3 RNI" GRADE SHALL BE-90 M/N/MUM OkER ALL SEPI70 SY57Z7V 6WPOVENTS USE 4"AIA. SOV,6 ULE 40 PIS' aP CAST 1A W P/PE 20'M/N/MUM.SE"TBACK fR011/EOGE OF SILWE rOCELLAR WALL TEST 10'M/N/�I/uM SETBACK Date of soil test: 6/26/09 REMOVABLE COVERS SET Test taken by. ED STONE REMOVABLE COVERS SET TO WITHIN TO WITHIN 6" OF FINISH Results witnessed by. DAVE STANTON 6" OF FINISH GRADE (TOTAL OF 3) GRADE (MIN. OF 2) Percolation rate: < 2 MIN./INCH ELEY = 2JOf 7H.EY = 22.0f Ground water NONE �ELEY - 2-TO-E > > .: ✓: . > ; > , � > e > ; rr ELEY = 20.0# TEST HOLE #1 TEST HOLE #2 S .02 MIN s /Nv£RT1�7 3'MAx LOAMY SAND LOAMY SAND - 1500 GALLON ON 'yi SET FIRST 2 ORE V'' � N'A.SHED STAVE 'V $" 10YR43 0. 6 " 10 YR 4 3 1 s SEPTIC TANK y 2'LEIEL s = .01 M/N. 7 ELEY = 19aof e meson an== e N If va D/S7 BOX LOAMY ®®a®®®®®® ® ELE{! 16.17 LOAMY SAND LOAMY SAND q 26 7.5 YR 5/6 EL. 18.8 24" EL. 19.8 10 YR 6/6 qd (// 20 L OAO/NG) " t� � � :� <. 4i +� h SET SEP770 TANK AND D1STR/BV770N BOX II q INSrALL 3/'(" ro 1 1/2-A9al LE ON 6"LAYER OF CRUSHED STONE #A'49VED, lWUS VED SAWE ALL Bf ARGYINO CHAMBERS AND OONIt MEDIUM SAND MEDIUM SAND AO THE 8077t'al/ 6F THE CHAMBER Z5 Y 7/4 25 Y 7/4 PROFILE SYSTEM. REFER r0 LAYGYIT or S157f�i/f?.�4 A/aPE DETAILS 90TMV ar TEST Ha!E ELEY = la50 132-1 1 EL. 10.0 120"1 JEL 11.8 NOT TO SCALE J - REMOYABLE 24"D/A. CODERS REMOYA&F 24"O/A. COY£R GLEN AT TOY° SET c INLET KNOI,WGtUT 3 MIN. FRW TANK WkER 4 4" a/&ET KN"016174 „ /NLjT TEE SET OY/ T IEE SET 2 - OUTLETS 1 3/4" 10 MIN. BELOlY >4jBELON' "' " OUTLET Le-kiz L/C /D LE{£L ' I C� O INLET GAS BA TYPICAL OF 5 o, 4 h �o N INLET 8" 6 4." " 2 - OUTLETS 24" j 24" 10' - o" s' 2" PLAN VIEW CROSS--SECTION BASIS FOR DESIGN: 722rAL OA/LYRONISBA.q 6W 4&EWO S NO i9AR8AiW_,01S00S4L TANK (H-20 LOADING DB-5 DISTRIBUTION BOX CH-20 LOADIN1500 GALLON SEPTIC r0rAZ DAILYR0W= 1/0 6PD/VEOROIGN/x 4 BEO?"S = 44o a4V NOT TO SCALE NOT TO SCALE 8077W AREA PRO00O.SED = 00 SF. H Of Mq SYDE AREA PROPOSED = 185 S:F. 8' - 3 1/2" o eaC stcl �r 707AL LEAOVING AREA PR6F0_gV - $15 S:F. 6" 3�as4 APPLICAAW RATE= a 74 6P,9AF. ® ® ® O ® ® ® ® � ���`�s�/S r o � DE,A'GyVLEAQVINGCAPAGY7Y 455000 > 440G�'D ® ® ® ® ® ® ® ® ® ® �® ® 34" q � 24" ® ® ® ® ® ® ® ® ® ® ® ® ® ® ® ® E�g ® ® FED ® ® ® ® ® CONSTRUCTION NOTES: $' - 6„ I /NsrALLA770V OF 771E PAWO-W 5ZP770 SY37EM_9VALL BE IN ACWWANCE W711 P&E 5 CROSS—SECTION 12/21/16 ADD ELEVATIONS TO SOIL LOGS. AND THE BOARD ac'HEAL 71-1 REGULA77OVS 8' - 6" DATE REVISION 2. A caRY-aF THE PLANS SHALL BE A,,A/[ABLE 6V.71F F0?REfE7PENCE AT ALL nMES • ' a .' - SEPTIC SYSTEM DETAILS DURING THE INSTAUAA0V ac' THE SEPAC SY57EM. J NO G?YANGr"S rO THEDfYW SHALL BEPERFO"W NITHGYIT 77/EAPPRO11AL arBOTH 5" KNOCKOUT FOR #'1 9'4 WASHINGTON AVENUE FALAIaI77/"QNEER/NQ INC AND 7NE'BOARD OF 11EAL7H 4 " PREPARED FOR 21 °'AMETEK. COVER BARNSTABLE .HARBOR BUILDERS 47HE 52P)7C SYSTEM IS SUB�CT rO IN-WLICAW BY FALMGVI7H ENGYNMFINQ INC AND THE BOARD a-HEAL llL IN o MA 5. THE GGWIRACr6W-WALL N077FYFALMOYI7H ENIQNEER/NG INC ANO THE BOARD GY-HEAL771 I 5" KNOCKOUT 5" KNOCKOUT OSTERV�LLE 70 IN-WECT 7HE SEP77C SYSTEM PRIaO AO BAGY(F/LL. IN SWE INSrAN= Ma4E THAN avE PLAN DATE: DECEMBER 7, 2016 PLAN SCALE: AS SHOWN /NSpECAaV MAY AF NEEDED. THE CGW1WACr0R SHALL OIL Y BAGY( U THE POR77OVS a1- THE SYSTEM 17/AT HAW BEEN/NSpEC7£D AND APPROWD BY FALMa lW ENGJ'NEER/NQ INC AND 0 4, THE BOARD aV'HEAL 711 CIVIL ENGINEERING j O V T 7 WETLANDS PERMITTING 46 IF 7HE CaVIWACr6l?ENCDYINTERS ANY IiARIATIaVS IN S77E CaVO/AaV9 SYICH AS DIFFERING a L COASTAL ENGINEERING TaAOGWAPI/Y, NE7ZANOS 64 OTHER GW,01)7 WS THAT&AYREWAF RE-EVALUA77aV OF 5 KNOCKOUT WASTEWATER DESIGN 7H,F DES/a1; THE 6W7RA07619 SHALL IMMEO/AIEL Y 06WrACr FALAWPI E11467Na Wlffig INC TITLE 5 PLOT PLANS PIERS AND DOCKS I� PLAN VIEW LAND USE PLANNING �GINEER COMMERCIAL/RESIDENTIAL 500 GALLON LEACHING CHAMBER H-20 LOADING 5��9 CoPe Cod and.Southeesrern A/vssochusetts SCALE: 1' 2' 17 ACADEMY LANE, SUITE 200 - FALMOUTH, MA 02540 508.495.1225 PROJECT NUMBER: 16045 CAD FILE NAME: 16045DT DRAWN BY L.M. SHEET 3 OF 3 TOP OF Raise covers to within 6" of STANDARD NOTES FOUNDATION 41NV. inish grade install risers as needed Raise one cover to within 6' of 23.0 1) THIS PLAN IS FOR THE INSTALLATION/REPAIR OF A SEPTIC SYSTEM EL lin 20" access) finish grade install risers as needed 2) ALL INSTALLATION PROCEDURES AND MATERIALS SHALL CONFORM TO 310 CAR t5 000 THE STATE ENVIRONMENTAL CODE 2.0 GROUND SURFACE EL22 0 TITLE 5, AND THE TOWN OF_Barnstable SUBSURFACE DISPOSAL REGULATIONS. Proposed 3) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE OF AVAILABLE PROPERTY INFORMATION WITH RECORDED DEEDS Top 19.94 D - Box 1 OR ZONING REGULATIONS. DB-3 MIN 2' LAYER DOUBLE WASHED d MIN 2' LAYER DOUBLE WASHED 4) THIS PROPERTY IS SERVICED BY TOWN WATER 1/8'- tie' STONE M 1/8'- lie' STONE 5) THERE ARE NO KNOWN WELLS' WITHIN 200' OF THE PROPOSED SOIL ABSORPTION SYSTEM 21.0 2 AIIN-3 AIAX TOP EL 18 95 6) ALL COVERS OF SYSTEM COMPONENTS' SHALL BE BROUGHT TO WITHIN 6' OF FINISHM GRADE N INVERT Li'L 18.9 10" 7) ALL SYSTEM COMPONENTS SHALL REMAIN ACCESSIBLE FOR INSPECTION. NO STRUCTURES SHALL BE LOCATED DIRECTLY Existing INVERT EL 4 4 14' 18.7 - - - - - - - - - - - - 24 33" 1-1 INV EL - - EFFECTIVE UPON OR ABOVE THE COMPONENT ACCESS LOCA7TONS, WHICH WOULD INTERFERE WITH THE PERFORMANCE ACCESS INSPECTION SIDEWALL TALL PUMPING OR REPAIR GAS 18.45 BAFFLE 18.28 18 2 b 8) NO DRIVEWAY, PARKING OR TURNING AREA, OR OTHER IMPERVIOUS AREA SHALL BE LOCATED ABOVE A SOIL ABSORPTION TO 14.26 INV EL 1,N,0 �, 3/4'- 1 1/2' DOUBLE SYSTEMEXCEPT WHEN VEN77NG HAS BEEN PROVIDED. P INV EL IAty _ _ 500 Ga1,Conc (H-10) s, a WASHED STONE -s'S7iDNE BASE Chambers with _4_ stone all around ! 9) SEPTIC TANKS, GREASE TRAPS, DOSING CHAKRERS AND DISTRIBUTION BOXES SHALL BE PLACED ON A 6'STONE BASE 3/4'-WASHED ' DOUBLE (4'--10 x 8'-6" x 2' 9'9 0.TONE16.2 6 2 TO ENSURE STABILITY AND PREVENT SE7TLlNG. Proposed (H-10) o ( BOTTOM EL 10) OUTLET DISTRIBUTION LIKES SHALL REMAIN LEVEL FOR A MIKIMUM OF THE FIRST TWO FEET OF THEIR LENGTIL 05 1,500 Gal Septic Tank H� `O 11) ALL SYSTEM COMPONENTS SHALL BE CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10' f 35' S = 0.14 'S = 001 OF DRIVEWAYS OR PARKING OR TURWG AREAS, IN WHICH CASE H-20 COMPONENTS SHALL BE USED. S = 0.084 18' 8' 12) ALL BUILDING SEWER LIKES SHALL HAVE AN INNER DIAMETER OF 4' AND SHALL BE CAST-IRON OR SCHEDULE 40 PVC. S = 0.06 EL 10.8 Bo Test 13) TILE DEPTH OF = TOP OF ALL SYSTEM COMPONENTS SHALL NOT EXCEED 36' UNLESS VENTING HAS BEEN PROVIDED. SAS (12'--10" x 25=0') Pit 1 14) IN TTIE AREAS OF EXCAVATION, EATST7NG GRADES SHALL BE RJES'T'ABLISHED UNLESS NOTED AS PROPOSED CONTOURS: DESIGN DA TA 15) IF SOILS ARE ENCOUNTERED DURING THE EXCAVATION OF THE SOIL ABSORPTION SYSTEM, THAT DIFFER NOTABLY FROM THE DEEP OBSERVATIOM HOLE LOG, CONTACT A & M LAND SERVICES'AND TOWN BOH BEFORE PROCEEDING. 3 16) CONTRACTOR TO VERIFY LOCATION OF ALL UNDERGROUND UTILITIES: PRIOR TO CONSTRUCY70N Number of Bedrooms: A Pjan _„� 17) CHANGES OR REVLSIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION Garbage Grinder: NO 9596 SER0CES AND TOWN BOH FOR REVHW AND APPROVAL Design Flow: 330 L C. 18) CONMACTOLAND SHALL N077FY TOWN AND DESIGN NGINEEW AT LEAST (110 Gal/BR/Dap x Number of BR) 24 - 48 HOURS PRIOR TO INSPECTION(S). Septic Tank 1,500 19) MAGNETIC TAPE TO BE WSTALLED ABOVE ALL COMPONENTS (Wmimum = Design now x 200%) Gal. Leaching Area: DEEP OBSERVATION DEEP OBSERVATION SidewalL• (2 Sidewa is x 25 o Ft x _2-Ft) + HOLE LOG HOLE LOG (2 Endwalls xL2.83FT x --!?-Ft) 151.c3 SF ® O Test Hole #f Test Hole #2 Bottom: 320. 7SF Map a p 13 ~ l�}, (EL 21.8 -0 (EL = 22.1 -) 12.83 Ft x 25.0 pt) 472. SF ry° > rta oa ��� (11-11) l ea (=A) (YumeB) Long Term Acceptance Rate (LIAR): 0 74 Parcel 8�3 0 0 - a- 2f.r A LOAMY SAND I0YR4A 0 - s" 21.6 A LOAMY SAND 1OYR4A (Sidewall Area + Bottom Area) x LTAR r - 26" 19.6 B LOAMY SAND 7.5YR5/6 6" - 24" 20J B LOAMY SAND foYR6/6 Leaching Area Design Capacity. 349 GPD ) 2s- - rsz^ m.a c JtBDIUY SAND 2.5r7/4 z4^ - 120 1zf t MEDIUM SAND z.sl7/4 2 Map 1 09 349 GPD Provided. - 330_ GPD Required - 19 GPD Reserve Parcel 79 ' 5 O bs Hole Deep Obs Hole Date: 6129/b8 Deep Obe Hole Date: 6/29109 WitSoi ssedEvalu 1� DA ID STANTONSotl fteEvaluator: DAPID STANTON Witnessed DAYID ST tRtaessed Pump, crush, fill , withED STONE 1000SoM SoilPer rate _ CARVER 2 lN/rN p Soli Survey Description:ptbn CARVER Soil Suraey Description OL&%"O . � GedoQtc ltnterial: c>rcr,Q osrsase leoxxuxa 6eomgio tlatarial: srrci�c ocnr"s ysxxuxs G clean sand per Title 5 1 Depth to SteacllaS 1►ater. NA Depth to standing Xater. NA p r'e'1�g Depth to lfeet Rater. NA Depth to Weeping Rater. NA . . �.... _- Cobr}: NA Depth It hn Color): NA bt _ _. ._.-. _U9 O - - 2 Pro�bosed Date f Lest Date of last Measurement NA -..let-9aneaa.+�ta�G7C =::.; t.. - _.. ,. __z:. t NAL J,1V1 - ' /~J t NA Comments: rvetion 11e11: Observation We11 NA Date Yeasuremen comments: Top of CB/DHD-Box �D `r-' Owner of Record Q David Rockwood Parcel not within Zone II Contribution �.. ~ Deed Reference 1, 5 Gal \� C Bk. 2438 Pg. 244 �. ,�'- Tank Plan Reference PI Parcel 101 Pg 11 Farcel A Install C.Q To Grade \ TBM = 21.80 ; op of BRB � G0'� 0 ���IJ ` 3 Q Proposed SAS Q ASSESSORS MAP 139 LOT 084 , 10 in 'CA Install C.O. e To Grade Oe Acre .L' 1Septic Upgrade Repair Plan ~ 7(2,2.8) Ill t / in Barnstable, MA Ob_s Hole #2 Bed �'` Perc Test 2A Located At 194 Washington A ve Brie �t v - �stervllle, MA D�655 L Li V ,j PER OWNER.- Additional cesspool C Bu r11Install CO. located ini this general area. Applicant V13 , To Grade Da vid Rockwood `' Bld 194 13t12``; ���a� Pump, crush, fill with 194 Washington A ve eadoh bo' � , p � `. TOP EI 23. 0 9 clean sand per Title 5 Osterville, MA 02655 `��-- O�erY�life - . , �'a 1�111 TT - - - - 121) SCALE: 1" 10' DATE.' July 6 , ,2009 PINTO -+ CIVIL ? Wianno fifth , L ft.465040 �Q PREPARED RK Yacht urt r °�sTEa ��' A & M Land Services J (23.1 ' 0 0 o sst N�` 618 Main Street Unit 3 v01 Club °NAt E -'� West Yarmouth, MA 0,2673 �/ l0 1 LOCUS 9 East �1 V"' Ph. (508) 737-1777 email anmland0comcast.net Map 1�39 ' °was t ln� n S GRAPHIC SCALE Parcel 78 e/ 10 0 5 10 20 40 - Nantucket Sound IN FEET LOCUS MAP 1 inch 10 ) ft. NT,S. Dwy / 6021.dwg