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0468 WIANNO AVENUE - Health (2)
468 WIANNO AVE i Osterville A= 163 - 003 I r TOWN OF BARNSTABLE LOCATION e SEWAGE# Z l ! i V� VILLAGE y ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. �rrY1��`hS mil` �T���gZ`agS, SEPTIC TANK CAPACITY 90000 �d]�t,t l�� � ,�0���/��e•�� LEACHING FACILITY:(type) �P"S (sizej g111 S F NO.OF BEDROOMS �S OWNER i1 Gti- l I PERMIT DATE: ii COMPLIANCE DATE: Wq 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 leaLhina facility, -!l Feet FURNISHED BY49nt:-- N W N , - -r`- Ul r/1 � _ 00 Lt?C�A'�'i0N � e' GSEVJAIE# VXLLA AS SF.SSmR'S �1Sq'pdxit'S it;Pi IQIdB I+IO. S5P11C.1, I CAPA { i; F11PiG 1P,14CIf�Fi"Y:.t�Ypg�. Q, 5 (sue), _. ..------� --�: C? GP' 3Dd�'t1O�[i5 6lIL1C'99 OR DWiT l� _... S+prtration D+seunaa Bstvie. Vie; Maxi ►umAd*�usbf:tl Gr0urpdwsi: 16.ta the&ttacno� htn ac►lu}i _tae Pr S i VJeRt aa�c�t.ea itt .6m. (f��3+welis:�xist ivy . . .. .Y..,..:- post a�sits oe wittua 2AQ`feet sri?to aciairi :f�ci�it}) W.dSc•�i i�letiaii agd JLoHcdtin�lact�llcy mny wetlands exist r :iaic�_3OQ f ..: p�ieaclrid :luaiilry) -pot dF c� 1 90 - � s V1 Cl ► °, J. ell �o r — fl No. / t lY Fee 16 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZippliLation for Misposar �p t"M Consttuttiun 3pennit Application for a Permit to Construct( ) Repair( ) Upgrade( Abandon( ) Complete System ❑Individual Components 7 Location Address or Lot No. f �J 1 (, Owner's Name,Address,and �fTel. No. P Assessor'sMap/Parcel Installer's Name,Address,and Tel.No. Desi er's Name,Address,and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.requires}) ,y gpd Design flow provided ; ..s gpd Plan Date , { Number of sheets 21 Revision Date Title 6 t, Size of Septic,Tank ( & f S.A.S. Description of Soil T6=41 g'— 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 ode and not to place the system in operation until a Certificate of Compliance has been issued by this Bo d o alth. , ed Date Application Approved by Date Z Application Disapproved by Date for the following reasons Permit No. )i"j— y Date Issued A-7�2_ g:. _. •-., t Fee � �- No. ( + (,Q THE COMMONWEALTH OF MASSACHUSETTS Entered/in es PUBLIC HEALTH DIVISION - TOWN OF BARN_S,T BLE,,,MASSACH Pf$ET'TS 2pplication for Mispo8al 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( bandon( ) omplete.System ❑Individual Components f Location Address or Lot No. Owner's Name,Address,and Tel:No. Assessor's Map/Parcel Sfi S„YC Installer's Name,Address,and Tel.No. Desi er's Name,Address,and Tel.No.on e of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder,(_ Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures �+ Design Flow(min.required) gpd Design flow provided i_ �.'L gpd Plan Date Number of sheets ,Z Revision Date Title �6 Size of Septic Tank at � o S.A.S. Description of Soil VV v Nature of Repairs or Alterations(Answer when applicable) t .i f; OF Date last inspected: t Agreement: R The undersigned,agrees to ensure the construction and maintenance of the afore described -site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the stem in Aeration until a Cert�icate of Compliance has been issued by this Boafd.o alt'R_— ' S ed Date Application Approved by Date Application Disapproved by Date ` y for the following reasonsrN Permit No. 7 n ar_ / y(_ Date Issued U I ------------------------------------------------------------ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CER IFY,that the On-site S�w� Disposal system Constructed( ) Repaired( ) Upgraded(Ile Abandoned( )by ►'1 !� }►Tr'` at _ v has been constructed in accordance with the provisions of Title 5 and the'or DisposalVV 'System Construct on Permit No; )kj /►.1 j dated Installer H ( �. �(�r^ l �_ i{. Designer #bedrooms J Approved design w /\ gpd w The issuance of s pe it shall not be construed as a guarantee that the system will functio is esigned. Date Inspector t,l ------------------------- - .�- --------------------------------------v----------,1 --------------------------------- N6.ez7 Q n ; Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS MispoBal *pstetn Construction Permit Permission is hereby granted to Construct( ) Repair(" ) Upgrade Abandon( ) System located at ul X I s [0 d } and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply wit h Title 5 and the following local provisions or special conditions. Provided:Con truction must be completed within three years of the date of this permit. Date Approved by A - 1 Town of Barnstable o Regulatory Services Richard V. Scali, Interim Director h T k BAR"7STABLE, �. . "'A Public Health Division i639• �`� °rFnMa+a Thomas McKean,Director 200 fain Stt eet,Hyannis,MA02G.Oi Office: 508-862-4644 Fax: '503-790-6304 I Installer & Desianer Certification Form Date: 613 I('i Sewage Permit# �q' ��� � lv3 -cT�3 b Assessor s 14�ap\Parcel 1)esi?ner: Installer: nVA� Address: Address: `xt_3�_..__i2' {fin v n vi`s Cxcc.Vn.JA2J� was issued a permit to install a. ate (installer) septic system.at-TIQ WNC"V%VVd based on a design drawn by . (address) dated � 1.9 . (designer) - Ll-r`certify that the septic system referenced above was installed substantially According to the design, which may include minor approved changes such as lateral relocation cif the distribution box and/or septic tank. Strip out (if required)was inspected and the soils were found satisfactory. I certify that the septic system referenced above was installed. with major changes (Le. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. Strip out(if requited) was inspected and the soils Were tound satistactorv. l certify that the systelrt referenced above was constructed it \•vlth the teITlls of the I\A approval letters (if'applicable) � `M �S 1pe �yvsF _ McEN-TEE nstaller's Signature) GNiL . NO.'35109 0 `• RfOIS1 (Des]guer's.Signature) (Affix signe ..ere.) PLEASE, RETURN TO BARNSTABLE PUBLIC HEALTH. DIt'IS.ION. CERTIFICATE OF COMPLIANCE- WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE, PUBLIC FIEAL'I`H DIVISION. THANK YOU. (laseptic`Desi.-ner Certification Form Rev 8-i4-1 3,doc Engineers note:This certification is limited to an.as-built inspection of system components as installed prior to backfill.The engineer did not supervise construction of the system. The installer assu ,es responsioil'ty`or all materials,work;ransnip,backfilling to specified grades with proper ccrnpacti r: on and setting risers covers as shown on t'te design plan. ,lam+. 'Town:of urns ��e { +p# r Department of Regulatory services Public Health Division, _ Bate _ 169. 200.Main Street;H .nnis MA 01601 t J ty A,far�* I • Date Scheduled. / T -_ ��-w F Fee Pd." s i ail Suitability Assessment fo Se . e I� sposezl Performed By: c e— �� S�—�5�2 Witnessed By- LOCATION& GENERAL INFORMATION Location Address Owner s Name. Ad-..:..M T d ess' ` �^``A� Assessor's Map/Parcel, 16�' O 3 Lngineer's Name 9 t y W rfrts e NEW CONSTRUCTION/ / REPAIR Telephone# SQ — '_7'7--9 Land Use' /_12e S��cJ�r/l�l�cll Slopes(30) 2 Y Surface stories Distances-from:. Open.Water Body t Possible Wet Area 6 Drinking Water Well ft Drainage Way /� ft Prope;iy Line ft Other fC SKETCH:(Stree,(name,dimensions of lot,exacrlocations of test holes&perc tests,locate wetlands in proximity to holes) �... _ � T►' �� . 4 Parent material(geologic) r 1 »' Depth.to Bedrock, Depth to Groundwater Standing Water in:t tole: 9" o Weeping from:Pit PpCe t y'tY�u Estimated:Seasonal Nigh Groundwater DETERNIINA:TION FOR SEASONAL HIGH WATER,TA LE ' - Method Used: . Depth Observed standing in obs.hole: _ _ in. Depth 16 soil mottles. . in. Depth to weeping from side of obs.hote;'._ ___,�_in, Groundwater Adjustment R. lndez Well# 'Reading Date: tndez Well level 3 Adj,factor _ Adj.Clydu,idwater.Levei n PERCOi.rA l,J!ON A.1 ST Observation - - Hole# )Z a,i 'Ci file'at,h'' Depth of Perc: "g ' fo. _ Time at 6?' Start Pre-soak rime C> � k Time(9'-611): End Pre-soak Rafe Min:/Inch. Site Suitability':Assessment. Site'Passed - Srte.:ailed: Additional Testing Needed(Y"- Original: Public'Health Division Observation Hole Data To lie"Completed on Back. . --- - f ***If percolation test is'to be conducted within'100' of wetland,you amust first;notify,the. Barnstable:Conservation Division at least one(1)week prior to-beginning. Q:\SEPTlC\PERCF0RM.D0C DEEP OBSERVATION HOLE LOG Hole# 1 Depth from Soil Horizon Soil Texture .Soil Color Soil Other Surface(in.) (.USDA) (Munsell) Mottling '(Structure,Stones;Boulders, on i teri r vel G- to A Laaw� s�j l vyrt 4/z F t', DEEP OBSERVATION HOLE LOG Hole* �— Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA} (Munsell) Mottling (Structure,Stoues,:Boulde.rs. } Consistcncv.% rave 0 1 T- U ej DEEP OBSERVATION HOLE LOG Hole# Depth.from, Soil Horizon Soil Texture Soil Color Soil other Surface(in) (USDA) (Munsell) Mottling (Structure;Stones,Boulders. nsiste c Grave ]DEEP.OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders, ,on"i stencyi, ra Flood Insurance Rate Neap, Above 500 year flood:boundary No_ Yes Within 500;year boundary No� Yes Withit,100year flood boundary No./ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious materig,exist in all areas observed.throughout the area proposed for the'soil absorption system? If not,what is the depth of naturally:occurring pervious material?;�-` Certification I certify that on I `1�9"f{date)I have passed the soil evaluator examination approved by the Department of Environmental Protection and that the above analysis was performed by me consistent with . the required training,expertise and experience described in 3jo CUR 15.017. Signature 'tr`t t "`_��` Date ) _�__� , QAgE1YrlCVERCF0RM.D0C Town of Barnstable Barnstable Inspectional Services �ca 9 Public Health Division m 200. Main Street,Hyannis MA 02601 2007 Office: 508-862-4644 Thomas A.McKean,CHO FAX: 508-790-6304 CERTIFIED MAIL#7015 1730 0001 4989 0441 December 11, 2018 MALVERN REALTY LP PO BOX 10 ORLEANS, MA 02653 ORDER TO COMPLYWITH STATE ENVIRONMENTAL CODE, TITLE 5 d The septic system located at 468 Wianno Ave, Osterville,MA was inspected on 11/12/2018 by Shawn McElroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995.TITLE V (310 CMR 15.00) due to the following: • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. 3 You are ordered to repair or replace'the septic system within one (1) year from the date r you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH Zha ean, R:S., CHO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\468 Wianno Ave Osterville.doc zr*E rq� Town of Barnstable • inRrrsrnar..E, Regulatory Services Department Public Health Division 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Richard Scali,Director FAX: 508-790-6304 Thomas A-McKean,CHO Feb 6, 2007 Rev. 5/11/16 DEADLINES TO-REPAIR FAILED SYSTEMS (Town Code §360-44 and Title V: 310 CMR 15.000) An"x"marked in the ❑ is the failure criteria and associated repair deadline 60 DAY DEADLINE CRITERIA ❑ Discharge or ponding of effluent to the surface of the ground o.Pumping more than 4 times during the last year not due to clogged or obstructed pipe. ❑ Backup of sewage into the house due to an overloaded or clogged SAS or cesspool ONE 1 YEAR DEADLINE CRITERIA Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ Any portion of the SAS, cesspool, or privy below high groundwater elevation ❑ Any portion of the cesspool within a Zone.1 to a public well ❑ Any portion of a cesspool within 50 feet of a private water supply well with no acceptable water quality analysis. (This system passes if the water analysis indicates the well is free from pollution). TWO (2) YEAR DEADLINE CRITERIA ❑ Single Cesspool . ❑ Any"conditionally passed systems" (broken cover, relocation of a pipe,relocation of a driveway due to H-10 components, etc) ❑ Leaching facility with standing liquid level at or above the invert pipe (per Town Code §360-20 h) OTHER Repair deadline: , Q:\SEPTIC\DEADLINES TO REPAIR FAILED SYSTEMS.doc f - 003 Q ._ Commonwealth of Massachusetts ,5 Title 5 Official Inspection Foam C�'f Subsurface Sewage Disposal System Form -Not for-Voluntary Assessments 468 Wianno Ave Property Address s 2 Malvern Realty LP/Roger Cooper Owner Owner's Name information is required for every Osterville '✓ MA 02655 11-12-18 page. City/Town State Zip Code Date of Inspections, .M 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. 13 A. Inspector Information S - / . ,.p 3 Shawn Mcelroy Name of Inspector, ' 0 - Upper Cape Septic Services Company Name P.O. Box 73 Company Address E. Falmouth MA 02536 City/Town State Zip Code 1-508-495-0905 S13971 Telephone Number License Number B. Certification I certify that:l am a DEP approved system inspector in full.compliance with Section 15.340 of Title 5 (310 CMR 16.000);1 have personally inspected the sewage disposal system at-'theproperty address listed above;the information reported below is true, accurate and complete as of the time of my inspection; and the inspection was performed based on my train'irig and experience in the proper function and maintenance of on-site sewage disposal systems.After conducting this•inspection,l have determined that the system: ` 1'. ❑ Passes'. 2. ❑ Conditionally,Passes . w.; 3. r❑{ Needs Further Evaluation by the Local Approving Authority 4. ® Fails -. . 11-12-18 I is 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 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 form should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. Please note: 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. t5insp.doc-rev.7/26/2018 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 18 Commonwealth'of Massachusetts • Title 5 Official Inspection Form t �Io Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 468 Wianno Ave Property Address Malvern Realty LP/Roger Cooper Owner Owner's Name information is Osterville MA 02655 11'12-18 required for every page. City/Town State Zip Code Date of Inspection C. Inspection Summary Inspection Summary: Complete 1, 2, 3, or 5 and all of 4 and 6. 1) System Passes:`` ❑ I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: 2) 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): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 18 i Commonwealth of Massachusetts Title 5 Official Inspection Fo:rrn" r�l Subsurface Sewage Disposal System"Form-Not,for-Voluntary Assessments .F ► :. 468 Wianno Ave r f Property Address Malvern Realty LP/Roger Cooper ,, .,,: - .; ;; -;-4 , Owner Owner's Name : information is MA 02655 11-12-18 required for every Osterville page. City/Town -- - • ;, .. State Zip Code Date of Inspection C. Inspection Summary (cont.) 2) System Conditionally passes_.(cont.): ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/ala'rms are'repairedk ❑ Observation of sewage backup or breakout 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): ,�t =,' . .. F '� I �+ • ..s�.�i ,` ..fit _`' •t F ,�. .�_ •. '1 '` `'❑ - broken pipe(s)'are replaced' ' �'❑-Y "f❑N '' ET ND (Explain below): ❑• '' `-,obstruction is removed - }' t' ' ' `❑'Y `❑N ' ,El-ND (Explain below): ` El ' 'distributi'on boz is leveled or rep laced' ' ❑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( ) are replaced ❑Y ❑N ❑ ND (Explain below): • ❑ obstruction is removed ❑Y ❑N ❑ ND (Explain below): 3) 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 orthre environment: a. 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: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 18 c Commonwealth of Massachusetts Title 5 Official Inspection. Form. i Subsurface Sewage Disposal System Form Not for Voluntary Assessments 468 Wianno Ave Property Address Malvern Realty LP/Roger Cooper Owner Owner's Name information is required for every Osterville MA 02655 11-12-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) 4 . - . I . ❑ 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 b. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: ** This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. c. Other: r. 4) System Failure Criteria Applicable to All Systems: You must indicate "Yes"or"No"to each of the following for all inspections. Yes No 4 { ® El clogged 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 t5irsp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 18 Commonwealth of Massachusetts . ,. .► „ . ~ Title 5 Official- Insp F ectiori r'm + r G Subsurface Sewage Disposal System Form -Not for,Voluntary Assessments.*, , 468 Wianno Ave Property Address z•. Malvern Realty LP/Roger Cooper Owner Owner's Name information is required for every Osterville MA 02655 11-12-18 + page. City/Town . State Zip Code Date of Inspection C. Inspection Summary (cont.) ,4 , System Failure Criteria Applicable to All Systems: cont. r ; Yes No ® ❑ 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 1/2'd4 flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ®> Any portion of the SAS;,cesspool.or privy is below high ground water elevation. ❑ t ® r�Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to'a surface water supply. T ' Any portion of a cesspool or privy is within a Zone,1 of a public water supply ,_ f ' . �❑ . ® ,r, well: ` �. - • .r� -. ' 'ET ® 'Any portion of a cesspool or privy is within 50 feet of a private water supply well. } ,--r. ' 'N ' 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 , a and chain of custody must be attached to this form.] The system is a cesspool serving a facility with a design flow of 2000 gpd- ' 10;000 gpd. {' ' 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 .k-tr,t system owner should contact the Board of Health to determine what will be necessary to-correct the failure. 5) 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"1to each of the following, in addition to the questions in Section CA. 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 t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 18 cam° Commonwealth of Massachusetts - 3 Title 5 Official Inspection Form i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments Vt 468 Wianno Ave Property Address Malvern Realty LP/Roger Cooper Owner Owner's Name information is required for every Osterville .` MA 02655 11-12-18 page. City/Town State Zip Code Date of Inspection C. Inspection Summary (cont.) If you have answered "yes"to any question in Section C.5 the system is considered a significant threat, or answered "yes"to any question in Section CA above the large system has failed. The owner or operator of any large system considered a significant threat under Section C.5 or failed under Section CA shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 6. You must indicate "yes" or"no"for each of the following for all inspections: Yes No • ❑ ® Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal'flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ❑ ® Were as built plans of the system obtained and examined? (if they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® a ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Wasthe facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS) on the site has been determined based on: ❑ ® Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] r . t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 6 of 18 Commonwealth of Massachusetts +, r: .• Title 5 Official- Inspection .Form �i Subsurface Sewage Disposal System Form Not for Voluntary.Assessments i ,• ' a 468 Wlanno Ave �- ,t , •c. Property Address ., Malvern Realty LP/Roger Cooper ,•,r,, . : s , ,. Owner Owner's Name u information is required for every Osterville ,- MA 02655 11-12-18 r page. City/Town State Zip Code Date of Inspection D. System Information . 1. Residential Flow Conditions: j ,,• -, Number of bedrooms (design): 8 Number of�bedrooms (actual): 8 DESIGN flowbased on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 880 Description: i • Number of current residents: --, 0 Does residence have a garbage grinder? �4 ,.k jr, ..!,. r ❑ Yes ® No Does residence have a water treatment unit? ,,, ❑ Yes ® No If yes, discharges to: Is laundry on a separate sewage system? (Include laundry,system inspection , _ El Yes ® No information in this report.) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available (last 2 years usage (gpd)): Detail: Sump pump? ❑ Yes ® No 2017 Last date of occupancy: Date • ' - Date t t5insp.doc-rev.7f26/2018 a Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 18 Commonwealth of Massachusetts r ,w. Title 5 Official Inspection %Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 468 Wianno Ave Property Address Malvern Realty LP/ Roger Cooper Owner Owner's Name information is required for every Osterville MA 02655 11-12-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) t 2. 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 Water treatment unit present? ❑ Yes ❑ No If yes, discharges to: Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe below): 3. Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 8 of 18 I Commonwealth of Massachusetts ,'. Title 5 Official Inspection Fora, ` 'I o Subsurface Sewage Disposal System Form-Not for Voluntary;Assessments > 468 Wianno Ave Property Address v . Malvern Realty LP/Roger Cooper A Owner Owner's Name information is Osterville MA 02655 11-12-18 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 4. Type of System: ® Septic tank, distribution box, soil absorption system, ❑ Single cesspool r - ❑ Overflow cesspool F, ❑ 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.-..; r ,, Other(describe): Approximate age of all components, date installed (if known) and source of information: 1980's Were sewage odors detected when arriving at the site? ❑ Yes ® No 5. Building Sewer(locate onsite plan): Depth below grade: 36"feet Material of construction: ® cast iron 0 40 PVC ❑ other 1(ezplain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): Good condition. I t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 18 Commonwealth of Massachusetts Title 5 Official Inspection Form h. i�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments fly 468 Wianno Ave Property Address Malvern Realty LP/Roger Cooper Owner Owner's Name information is required for every Osterville MA 02655 11-12-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 6. Septic Tank(locate on site plan): Depth below grade:, 30"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑•polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 gal H-10 Sludge depth: 12" Distance from top of sludge to bottom of outlet tee or baffle 20" Scum thickness 3" Distance from top of scum to top of outlet tee or baffle 5" Distance from bottom of scum to bottom of outlet tee or baffle 13" How were dimensions determined? Tape Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tank is in good condition with no sign of leakage. Concrete outlet baffle needs to be replaced. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 18 f Commonwealth of Massachusetts . • . , t �7 011, Title 5 Official 'Inspection- Form- i,�l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments R 468 Wianno Ave •.. , . Property Address .. Malvern Realty LP/ Roger Cooper ,+ , • , Owner Owner's Name information is ill tOSefVe . i .'.� required for every MA. 02655 11-12-18 . page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 7. 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 Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): ' 8. 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 t5insp.doc•rev.7/26/2018 r ,- Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 18 r Commonwealth of Massachusetts , ,w, Title 5 Official Inspection Form , C�i Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 468 Wianno Ave Property Address Malvern Realty LP/ Roger Cooper , Owner Owner's Name information is required for every Cisterville MA 02655 11-12-18 Inspection City/Town/Town State Zip Code Date of Ins page. y P D. System Information (cont.) 8. Holding Tight or cont. 9 9 Tank (cont.) 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 9. Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): H-10 d-box in parking area shows signs of back-up with stain lines above inlet invert. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 18 I Commonwealth of Massachusetts Title p echo In i n orn•. ts . - R 14 Subsurface Sewage Disposal System Form =Not for�Voluntary Assessments � r 468 Wianno Ave a A Property Address Malvern Realty LP/Roger Cooper 71 Owner Owner's Name information is required for every Ostewille MA 02655 11-12-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 10. Pump Chamber(locate on site plan); �= •• , " Pumps in working order: ' El 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. 11. Soil Absorption System (SAS) (locate on site plan,-excavation:not required) If SAS not located, explain why: Type: c. ` ® { leaching pits'' number: 2-1000 gal ❑ leaching chambers number: ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 18 Commonwealth of Massachusetts .� ,. Title 5 Official Inspection Form' it Subsurface Sewage Disposal System Form -Not for Voluntary Assessments r� ,r 468 Wianno Ave Property Address Malvern Realty LP/Roger Cooper Owner Owner's Name information is Osterville MA 02655 11-12-18 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 11. Soil Absorption System (SAS) (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leach pits empty at inspection with stain lines above inlet inverts. 12. 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 lals of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 18 Commonwealth of Massachusetts - f,; -f _, y ., . _ eta Title 5 Official Inspection Torm: *� of Subsurface Sewage.Disposal System Torm -,Not for Voluntary Assessments 468 Wianno Ave Ir '=r Property Address , Malvern Realty LP/Roger Cooper Owner Owner's Name information is required for every Osterville f_, c'.it.; r ,, MA 02655 11=12-18 page. City/Town State Zip Code Date of Inspection , D. System Information (cont.) F . w . ` , -. 13. Privy (locate on site plan): - •T� '''r �'` `' •`. .' Materials of consfiruction:+t Dimensions ,►^-; , Depth of solids Comments-(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5insp.doc•rev.7/26/2018 - Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 18 Commonwealth of Massachusetts t y Title 5 Official Inspection Form ? rC► Subsurface Sewage Disposal System Form -Not for Voluntary Assessments o, _ 468 Wianno Ave Property Address Malvern Realty LP/ Roger Cooper Owner Owner's Name information is required for every Osteryille MA 02655 11-12-18 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) 14. Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately 1 - a' All, 3 ; 4 l� ,y O e,. im t5insp.doc•rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 18 s Commonwealth of Massachusetts ,s:. . '. r 3 Title 5 Official , Inspection Form' I,I Subsurface Sewage Disposal System Form -Not for�Voluntary,Assessments 468 Wianno Ave Property Address Malvern Realty LP/ Roger Cooper Owner Owner's Name information is Osterville MA 02655 11-12-18 required for every ' page. City/Town State Zip Code Date of Inspection D. System Information (cont.) - 15. Site Exam: ❑ Check Slope ❑ Surface water + • ❑ Check cellar _ ❑ Shallow wells Estimated depth to high ground water:, r. k 12' feet' Please indicate all methods used to determine the high ground water elevation:; ❑ Obtained from system design plans on record :• , If checked, date of design plan reviewed: Date ® .Observed site (abutting property/observation hole within 150.feet'of SAS) ® Checked with local Board of Health - explain: ® Checked with local excavators, installers- (attach documentation) ® Accessed USGS database- explain: You must describe how.you established the high ground water elevation: USGS and town maps show groundwater at about 12'. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 17 of 18 Commonwealth of Massachusetts _ Title 5 Official Inspection Form l Subsurface Sewage Disposal System Form -Not for Voluntary Assessments . 0 4§ 468 Wianno Ave Property Address Malvern Realty LP/ Roger Cooper Owner Owner's Name information is required for every Osterville MA 02655 11-12-18 page. City/Town State Zip Code Date of Inspection E. Report Completeness Checklist - . - . . .. Complete all applicable sections of this form inclusive of: ® A. Inspector Information: Complete all fields in this section. ® B. Certification: Signed & Dated and 1, 2, 3, or checked I ® C. Inspection Summary: 1, 2, 3, or 5 completed as appropriate 4 (Failure Criteria) and 6 (Checklist) completed ® D. System Information: For 8: Tight/Holding Tank—Pumping contract attached For 14: Sketch of Sewage Disposal System drawn on pg. 16 or attached For 15: Explanation of estimated depth to high.groundwater included i ; t5insp.doc-rev.7/26/2018 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 18 of 18 .i 1" -4 ` U.S.POSTAGE>>PITNEY BOWE,, oF';E'�wti' Town of Barnstable Public Health Division ' BAR' S8LE00P 200 Main Street °`1a`'a''% ZIP 02601 `/NNA� /MMA�7a P a 1 I .' MA 02601 02.4VY F + Hyannis, ::aT. D MA Y > = ` -- 0000.3.36455 DEC. 11. 201 f 7015 1730 0001 4989 0441 1 IN ... D NOTICE , `RETURNED — MA ERN REALTY LP O BOX 10 5• F',E 1 2/3..r3 ' 3 RETURN TO SENDER. 1 NOT DELIVERABLE AS ADDRESSED � 1 U ABL E TO PORWARO 1 9400921669'352:3.3,0 UT'F ' SC' 02601400200 *1669-01383-•22 -02, SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3. A. Signature - f ■ Print your name and address on the reverse X 0 Agent so that we can return the card to you. ' ❑Addressee I' ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Date of Delivery I or on the front if space permits. I 1. Article Adc'—i` D. Is delivery address different from item 1? ❑Yes If YES,enter delivery address below: ❑ No MALVERN REALTY LP PO BOX 10 + - ORLEANS,MA 02653 1 it l illlll I'II lel l II I II II II 6III it 9III III El Adult S gn ture ❑Registered MailTM ess® 1 III ❑ dult Signature Restricted Delivery ❑R istered Mail Restricted 9590 9400 2 4116 8092 9357 87 rtified Mail® Deeli very I z r'� Certified Mail Restricted Delivery dl� etum Receipt for ` ❑Collect on Delivery ("Merchandise ,. 2- Article Number(Transfer from service labeq ❑Collect on Delivery Restricted Delivery C?Signature ConfirmationT^� :) ❑Insured Mail ElSignature Confirmation. - 015 1730 00111 49' .0441 of Nail Restricted Delivery Restricted Delivery PS Form 3811,July 2015 PSN.7530 02-000-9053 t {{ - t 1 i i t T f`r--f.- .'IV : :, t - �- + ..� D°mestic Return Receipt l '• - __ Apc IHE Town of Barnstable Barnstable Inspectional Services edc$�1 lARNWXBLF4 HUM Public-Health-Division-- - -- ---=-—. m-- ---- — pTFa"A0� 200 Main Street,.Hyannis MA 02601 2007 Office: 508-862-4644 Thomas A.McKean,CHO FAX: 508-790-6304 CERTIFIED MAIL47011 1730 0001 4989 0441 December 11, 2018 MALVERN REALTY LP-- PO BOX 10 ORLEANS, MA 02653 ORDER TO COMPLY.WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 468 Wianno Ave, Osterville,MA was inspected on 11/12/2018 by Shawn McElroy, certified Title V Septic Inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Fails" under the guidelines of 1995.TITLE V (310 CMR 15.00) due to the following: r • Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool. You are ordered to repair or replace the septic system within one (1)year from the date you receive this notification. Failure to repair/replace the septic system within the deadline period will result in future enforcement action. PER ORDER OF THE BOARD OF HEALTH EDrho.- ' ean, R:S., -HO Agent of the Board of Health Q:\SEPTIC\Title V Inspection Report Letters Mailing\Failed or Needs Further Evaluation Letters\468 Wianno Ave Osterville.doc P p ,a -- ----- ---------- .» I II I N ------ ---- 1----''--------I n .r ------ ---- -----------I z II z 1------0---- -----------I D I o II I z O _-IT--�T---ZI---TIr--ter'-- z O I ° c z 0 ° o IIOn\�J6 l p o � L--11=-DZ Ek___-IS__�L__I o r--11 1I0 0� IPA\ 7 o D z p --11---IL--- —-——-- rn ——————— —————— rn ——————————— ——————————— - ----------JI -----------I m ---------- I ----------1F-----------I D - --------"---- I L77C I p z rg z z '00 0 O 010,0 0 N Nm o O y 0 N N `�. ^� D O A rn*� O O rn 0 c o 0 °0 J @ -D1 O @ �' Z O @ Z p p RI rn 0 n o n N 0 O 7kirn 0 rn 0 - O O Ll "i rnp rn p rn < O O z p p o 0 STEP I°DOWN TU 0 . ..... r-—————————�fi—————_ �, _ A p O 0 ro rn G D p C O -1 z0 Z F O S 0 p I - A ------------o--0oA-I ---------AA ----------1---= =-0 ----nLI I------ 0 -----z ----------------0oz N0 A <N = 0 V` Ornp O { Trn rn D 3 11 U ----------- � --�;-.- oN N _ - A n 1 I qY{x 5W STEEL BEAM -- -o.m -N-M- p C9 IZ I I �T EMAIN °z N - n -- -- 0 - . m❑N A (l 9 ° LE c CL- ________ ___ N 0 z z - n - _ ----- - II I ml I------------ Nrn z -- A ------------ o rn m x p0O� 0 - --- �' 4Arnl A ---- —----- rn II- N y '9 ---------- A - O 0 0 rn II 1 .O G - N TEP DO 3' ZO CC p � UN Z° G � -{I1III�A D D O - 00 p A OO O 01 0101 Q N rnA y A � - -I In A > m - Op O - Z 0 N p N \� p,�o `ti z 0 c �N ���rn p 0 \orn O 0 rn N cArni rnp0 m z \ O p -iA rn 70 LT� y rn \ 03 0 rn O n 0 � rn ° rn rn 0 O� O Z� O 0 < zr Q� ° @ ° �c z AG) A = 0 O 0 a < rn p O EXEX15tinq First Floor Plan Date: 10.14.2019 LA CASA studio I Sullivan Residence PO Box I I OG-Harwich,MA 02645 468 Wianno Avenue, 05terville, MA 02655 Phone:(505)308 8614 f 1 Z 0 g Z z N O O O rn 0 0 3 N A < . O < n rn rn p p C O 7 � 7 pO p� 0 00 G �J w (� 5 O v o A O a O ———_ a 50 D o G I1 N n = O z/ 1a.G/51/2 N o _ O O I loo i ve.s N ti rn O O- o ( 5TEI L _ N 70 0o I rn rr n w 0 n II v� o - O z0 IM77 rn 00 r N rn CD' 6)0 O 2/,.G/5I 2 n .gyp n n (,rnj D X O o 0 ~ 1 O O _ O O N rn p m N A A �� G1 7 -i z C 7 0 o a 2/e.sn v2 l C o O 0 G J p OFll O rn 1 Nn N C) 0 O N c� aZ r 0 m 70 O 2/e G u2 m 0 O rn rn � < �i > p z � 0 < r m p z a 0 o � � z 7 p 0 F ' o rn N z-0 n O�> 6 p 4z c s 0 rn rn 0 O rn p , EXExistm Second Floor Plan Date: 10.14.2019 LA CASA Studio Sullivan Residence PO Box I I OG-Harwich,MA 02645 - 2 468 Wanno Avenue, C5terville, MA 02655 Phone.(soa)308 86I4 1 Q, �.r r- . i���wryryi tld N -u p � � A ,^ X X p z z D D D O O Z � A Z N r 0 Z r rn O O p p rn � (zN 0 Z O Z z 000 D z - n r 0 o D O o O rn rn rn Fn 24'-G" O o FX15TING DIMENSION A O Z-u o A O� 7,0Z n Z 0 O A ��op W ZIT ONrn0 DO-D13C W y00 zzo2R)2 p j: 4-6ON Ni 'O-=-irnDprn�rn rn OpN C.taNFr 1 z'Op �OI�AnONrn-=j rn @rn Q=o71 Z!T Nrn�p AO rnO pzO QKm rn �n;m OrnAOrnN pp A �j, zrn rn N Q�rn ���Orn�NOD rn z 0 N O� rn 0 Z1 66 D O� O Gl - DN Z,z, S:I1 0DC 17~ Nrn -1 rn O p 6l M.O=nCN V rn�rn Z N N N rn p �`G-�pp�D�� �rn y 0 D D rnZrn "fir rn D E 0z < z K p� ON ONO z O m p rn `1 F C Off, � rn IIIIIIIIIII z = rn r 7 G) W IIIIIIIIIII p Ol ---Y -- —J� �LIJ�LIJ III--�_--__—❑ — z rn I N 3 34'-8" N zz EXI5TING DIMEN510N FX15TING DIMEN51ON EXI5TING DIMEN51ON - p, z NI N I O I x l I III I ml 1� 1 I la 1 I I INI IAlll GI I 1 101 101 IIF z rn IA I I 13 1 'I 1 1 1 1 1 I �I 1� 11k-t--- N I �1 I I1 101 I311�-0 ___ x Z 1 0 1 I I 11 1 I I I N 0 I I III 0 W 11 1 Iol I I II 1 1 1 I Izl I I IF ---- I I I� IIL 1I Iml I I L _____ -� - IG N rn - PX I I I� I I I T I I 1 III <\� IZ D� 1 Z I 1 1 0 1 1 1 NIIF------ O ,� \ Ip z w N T I I I �I I 1 1 I I I o I I I I NIIL------ \ Iz O _N ➢n7oz D iE 6AA>� N O -L- 0----- O_ za �Yrn 0 Z I IO I - o I I III OA I O ��D��o= O I I I 'GQI D I IIL------ z >>A��°A o A Ind I III a o 7-i5'�A 71 o p zno0 �"- o Z 171 G�OrnZ DN z p. z z z O z -D-1 a A N AO o rn N O� 0 z 1x. N Fj7 z 0 0 O p D �c rn OZ D �z 70 O 'v O G) p D a c G ➢ x 3 z) rn rn - rn O rn O rn J0 03 O O 0 rn rn O i O z pX rn N N rn N D ' 'U z z f D I i 1 2'_0" G'-T O I EX15TING DIMEN51ON rn 7' 10" 34,_7" 32'_9" o I EXSTIN IG DIMENSION EX15TING DIMEN51ON EXI5TING DIMEN51ON O I � rn 1 I p 1 I Pro osed Foundation Plan Date: 10.07.201J LA CASA Studio I PO Box I I OG-harwlch,MA 02G45 Sullivan Residence Phone:csoe>soa 8G I4 468 Wlanno Avenue, 05tervllle, MA 02655 r 7 0 0 z U IF —cO------ -----------I W I I I _ ----------I NI ----------7 r——---------I = I II I ----------� F-----------I rJ ----------I -----------I I -------_ ILI -1 r o --IT--1T--- I Z O 00 11 I o I � II i1 I • II I ----------� �-----------I ----------1r----------- I II I ------_--- I F-an-- --O —-IQy--—---l---❑--MI4- ---------- ----- -- TIII�lIIIII O I III 3 0 XZrnzOrnzZ-�XN°OA n 3 4O°'-8" Z EX15TING DIMEN510N F EXI5TING DIMN`�=wC E N-5 IOoA N-52 4'"�a 0-Z3a- i/Vz 9'-�m1 0 rfII"II'_7 6-7 10'-94' T cX 0OA 'ny- NI 13'23° 5-7i�71 4 -5'-mo-IO, I I I Iz - 0OODOD 1w pmOp_pC_AcN9l ol=- O G i z Oco N O IC)rn G) O 41a 0 N z _2� CONV TEA A3_ z DN _ + - - D➢ KSINGL OVE � Q O DXZGZXOZO_l 2"DEEP FLOOR TO CEILING CABIEGl z G) 0 O Z O N NO < A N p Z OOA z 6 z -D z O OO � ND 3-_1vc i c` an- TNpD7 ZD 2 N 05 OWN wzO zil l O O O - N O N N O rn r 0 Z 'O c <Ao�N _ 3--5� Z =O O NT�1� z� -n A rn Orn aFN cc Drn(P� O rnN 00 X O 73O A DN-i O O� 0�5� O D II �' _ � y G) Z� O_ N� orn D I �N N 0 © o I D Z O A D F Z p p 4'VANI A O C - O_ 05 z - `Dz A`� ------------ On _--�- -- - ^' C rn� rn = W O ci4�'- _ zz rD N rt1 A O z AI-`c Z + z U A z rn-i - c p OD p> O NO y z z rn w 0 Do �Z z z _n p 3,_1 - � � z nc3o- 4pO0 G) D➢ z-0 _ zn rn ➢a 0Z 7u ➢ Arn O rG rn 8._21 b' " O 3'-5 3'-5 ' 0 2 5-G - 44 5-T z = n p � Z OO4i o O Z O o 7' fX15TING DIMEN5ION cps n Z o NEW BUILDING p{z o T-10" 34'_T - a 32'-9° EXI5TING DIMENSION EXI5TING DIMENSION EXISTING DIMENSION . O A D@ Pro o5ed IfIrst Floor Plan Date: 10. '201 9 Rev.: 11.20.201019 LA CASA Studio 5ulllvan Re5ldence PO BOX I I OG-Harwich,MA 02G45 A- 2 468 Wlanno Avenue, 05tervllle, MA 02655 . Phone:(505)305 8G 14 z z to O O O D D O rn rn c C�N z rn u o o OOz � C - U rn D N A a O A- -Di @ O N.. D Q O _ N rn Q I� Q N C A� T NCZ R Q -1 D A p�� N N I n Q NOA N Z rn�y Z (71 A OO TAN O �rn N �nC �A �Q C� Z m G1r CO X., Q Q n rn n rn r 71 .O lP 71 z F D O 7. �Q rn O rn A is O Z /-9 D �� -1 vN N r O N C z Z C �_ 6A Z O nD z 0 Z 70 �AT O N nZ �rD rn• Z O� OD 70 Z T� =Z rn� rn= D rn w N rn z � T N rn �Z 1 <- N rn D O z �Q c Og N N N 2G'_G" o 40'_10" EXI5TING DIMEN51ON EXI5TING DIMENSION I4'-5" 5'-2q° 5'-7q° O z :E , D n O © © z z z GT � n rn 7-1 o-' 5,_83�� 1 T-24" to N O D µ^ < Gzi 81-1 1 I 1 3'_43" co N Q O 3 C. 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N /y. -- -- EXISTING CONTOUR fast x 11.98 EXISTING SPOT GRADE Bay W EXISTING WATER SVC. po W PROPOSED WATER SVC.po oAi P G EXISTING GAS SVC. P^ �, -UGW- UNDERGROUND WIRES of : TEST HOLE gel�old Rd a BENCHMARK 10.61 LOCUS LEGEND N 5325'30" W 10.36x cssEA 10.88 G�y�o 142.04' 10.64 Crystal _ Lake 1 I LOCUS MAP NOT TO SCALE i F3' - - �5.93 �\ •� Z N x 4.90 I 12.14 > / I O N O m Cx / x 4.44 ' I ,p mt x 4.82 LOT A ' x 6.75 I i 59.129tSF 1 rt ` PARCEL ID: 163 \003 , x 8811 13.52 I � x 4.85 \ x 4.64 5.82 I x / .. �..EX�NG S.A.S. tea' TO BE PUMPED, FILLED WITH 6� \ SAND & ABANDONED 9 7a � m 15.16 PROPANE TANK / 7.86 � 10 \ x 9.50 9.03 101 O �983-_ '3e x J FEMA ZONE AE (EL 12) o -- F E 17.66 ' .10 ► 17.08 '� FEMA ZONE X 6?y '.,:>;neos' ` : - r9.2 GARAGE �; �: 1 - y N CELLAR FL. -- _15.96 - nE RET. WALL, +- -6.39 17.29 FENCE 17.4 �� PO17.62I S 15.05 :0 16.6OL BENCHMARK \ 18.2 ' .;i ..2::•5i? `.i;r: -2 19.14 18.26 19.10 \ 17.00 PATIO (�+� 16.11 n �\ x x VENT m 42 ': ` . + MAG. IL SET WSO 19,72 18.57 18'17 molr + W LK - T 20.20 20.39 20.99 x \ INGROUND 1 17.07 EX,9 x EXISTING S.A.S. \ \\ ' SWIMMING rwv.=rs.si rwv=rs.st x \ v POOL SSE SEVER m ®;0.9 TO BE REMO,I/ED \ - �c�-�� 20.49 � le z7 � EX/S71NG SEPTIC -I s9. 18.83 _ CELLAR FLOOR x � TANK 21.1a ` � A °v EL.=18.Ot/ 22.54 Z TO BE REMOVED x 3 Z� ° 11 0 W 21.65 �"- 0 \ a 24.01 23.18 00 OCb o OF Mgsllti `� 18.26 PA TlD 18.22 �/ a) O 23.S8 c ►�/ 23.54 DECK 22.91 .C. . . . . o PETER T:' �, zz.a7 HOUSE(#468) \0 rn 3 McENTEE .CIVIL N PAno T.O.F.=24.7t' \ GREAT ROOM 22.53 v No. 35109 / / / / I x • 23ft O x 22.52 NEW 1N .0 23.6 24.27 RfGISIE.�`' F I 23.13 * 24.18 C \ 24.19 / 'x 24.29 A x 24.24// 9�0 0( r` 0x 22.47 23.02 23�Q�4Y+�. 23.97 23.13 x 23.48 �* 202.71' FENCE 24.79 cu 23.55 SIDEWALK S 55'12'00" E SIDEWALK 23,20 PK SET -� 0 UP' 23.53 24.81 CATCH BASIN edge of pavemenF berm 23.54 23.53 23.46 OWNER OF RECORD 23.50 LITCHFIELD, WI TRS FORTUNA NOMINEE TRUST WIA.NNO ' AVENUELNVL FLOOD ZONE DESIGNATION 330 ORLEANS ROAD MAP NO. 25001CO776J NORTH CHATHAM, MA 02650 EFFECTIVE DATE: JULY 16 2014 PLAN REFERENCE: LAND COURT PLAN 7684 -B, LOT A EXISTING CONDITIONS ZONE AE(EL1.2) & ZONE X Engineering by: • ; I I SCALE DRAWN JOB. ND. PROPOSED SEPTIC SYSTEM UPGRADE PLAN 'Engineering Works, Inc. 1"=30' P.T.M. 101-19 12,West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. 468 WIANNO AVENUE OSTERVILLE MA (508) 477-5313 2/4/19 P.T.M. 1 of 3 Prepared for: Regina Sullivan, 8 Monadnock Road, Wellesley, MA 02481 N /y, -- -- EXISTING CONTOUR p °s� Bat x 11.98 EXISTING SPOT GRADE q Bay 1N EXISTING WATER SVC. W PROPOSED WATER SVC. G EXISTING GAS SVC. e^ �, -UGW- UNDERGROUND WIRES °l TEST HOLE e<�p1a Rd BENCHMARK 10.61 LOCUS LEGEND N 53*25'30" W x 10.88 10.36 9��\ _ CBSEA Gt► 142.04' 10.64 crystal __.gam 1 Lake LOCUS MAP \ NOT TO SCALE f / x 4.90 , ' 12.14 O - / x 4.44 x 4.82 LOT A ' x 6,75IT- \ \ I o I 59.129±SF • I ►� PARCEL ID: 163 ,003 x 8.81' 1 13.52 x 4.85 x 4.64 5.82 x o -- €LNG S.A.S l m { tea' TO BE PUMPED, FILLED KITH / 9.74 \ \ Is•16 SAND & ABANDONED PROPANE TANK / 9 / PROPOSED S.A.S. \ / O � 9.S�e-�. 9.0% /1 10.1 p•� x J AMA ZONE AE (EL 12) ` -- E 17.66 17.08 M M MA ZONE d - � PROPOSED SEPTIC T GARAGE ` 1 :;•` "> ;" .: 02 N 1� -(2'EOMPARTME CELLAR FL.=9.2t 15.96 -_ .. _ - � - ..._ TIE RET. WALL - .__t5.06_x 2 � ._,.. . - _. L'-�659- 17,62 15.05 NEW/NV.=14.5 ;� :1D�'.' v29 n.ao WAY''• 1 1 lb FENCE pppL 16.16 16J5 V'F: 'L BENCHMARK 8Z6 SHED E O `' G O -2 19.10 19.14 \ n.00 PA no c D' O 16.11�1 Y c2j x O 1:;.� VENT m \ 1 2 -''t < • :; MAG. IL SET \\ 18.57 m ove+Q 1 18.17 x, WSo 19.72 \ \ W LK MINA OUT 20.20 20.39 20.99 x 1 INGROUND 1 .07 Ex.,sE x.,sE a x EX/SANG S A.S. . \ \ SWIMMING ,av--=s.zt ,NY.=15.51 - 2o.a9 POOL ssvEo w / 20.9 TO BE REMOIiEO An x � 18.27 B - � -" EXIS77NG SEPnc 'ft89. 18,8 x CELLAR FLOOR x -� TANK 21.14 �` A °a EL.=18.0'± 22.54 TO BE REMO QED x 3 y 2 -IN. \ 21.65 -j \ 24.01 23.1E O o _ 18.26 PA no 18.22 07 O n o 2c� 23.54 1 DEGK 22. 23.58 EX/S.IING \� J o OF M 22.47 HOUSE( 468) \0 rn gssq�yo P no T.O.F.=24.7t' o PETER T. J' GREAT ROOM 23 22.53 x 22.52 NEW INV.�20.0 x McENTEE -, 23,6 24.27 v CIVIL No. 35109 23.13 24.18 ' _ x 24.19 } 24.29 / 1 l eo \pV� r- x 24.24/ '9023.02 23.Q4+�• ` _ + 23.71 x 22.47 2 9 444������� 23.13 x 23.48 �* 202.71' FENCE N 23,55 24.79 2'00" E SIDEWALK 23.20 PK SET SIDEWALK S 55�1 0 UP AP 23.53 P 24.81 CATCH BASIN edge of pavement berm 23.54 23.53 23.46 OWNER OF RECORD 23s0 LITCHFFORTUIELD, WILLIMINE M B TT WI ANNO A VENUE E FLOOD ZONE DESIGNATION FORTUNA NOMINEE TRUST 330 ORLEANS ROAD F MAP NO. 25001CO776J NORTH CHATHAM,. MA 02650 PROPOSED WORK EFFECTIVE DATE: JULY 16, 2014 PLAN REFERENCE: LAND COURT PLAN 7684 B, LOT A ZONE AE(EL12) & ZONE X Engineering by: SCALE DRAWN JOB, ND. PROPOSED SEPTIC SYSTEM UPGRADE PLAN. Engineering Works, Inc. 1"=30' P.T.M. 101-19 468 WIANNO AVENUE OSTERVILLE MA 12 West Crossfield Road, Forestdole, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 2/4/19 P.T.M. 2 of 3 Prepared for: Regina Sullivan, 8 Monadnock Road, Wellesley, MA 02481 NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:14.1 FOR A DISTANCE OF 15' AROUND THE SEPTIC TAN PERIMETER OF THE S.A.S. INSTALL SECURED H-20 RISERS, FRAMES PROPOSED D-BOX PROPOSED S.A.S. & COVERS OVER ALL ACCESS MANHOLES INSTALL H-20 RISER. FRAME & INSTALL H-20 RISER FRAME & COVER OVER ONE CHAMBER SET-TO FINISH GRADE WATERTIGHT COVER SET TO (MIN.) AND SET TO FINISH GRADE TO SERVE AS INSPECTION VARIES FINISH GRADE MANHOLE. CHARCOAL VENT F.G. EL.=VARIES F.G. EL.=16.5 to 18.1 t F.G. EL=16.1 t � F.G. EL.=16.6t MAINTAIN 2% GRADE (MIN.) OVER S.A.S. L3 - 75' L = 2' L = 50'(MAX) 0 S=1% (MIN.) ® S=1% (MIN.) ® S=1% (MIN.) 4"SCH40 PVC 4'SCH40 PVC 4'SCH40 PVC 6" 10" 4' as 4.10"I 14" 12000,03 9 INV.=14.00 48' Q• aBaaaaa 8' 4' G . . BAFFLE BAFFLE INV.=13.75 D-BOX EFFECTIVE WIDTH .= 12.8' ~ H-20 RATED INV.=13.00 PROPOSED 3000 GALLON (H-20) SEPTIC TANK 8-500 GALLON LEACHING CHAMBERS (2 COMPARTMENTS) SURROUNDED WITH STONE AS SHOWN COMPARTMENT NO. 1 - 2000 GALLON STORAGE H-20 RATED COMPARTMENT NO. 2 - 1000 GALLON STORAGE V. N0.1=15.2((H TOP CONC. ELEV.=14.1 t OUSE) BREAKOUT ELEV.=13.50 V. NO.2=14.5(GARAGE) 6aaa V. NO.3=20.0((GREAT ROOM) INV. ELEV.=13.00 Baaaa aBaae aaaa aaa0a NOTES: BOTTOM ELEV.=11.00 2' ENDS 8.5' PER CHAMBER 2' ENDS 1) CONTRACTOR SHALL VERIFY ALL EXISTING PIPE 4' OF NATURALLY OCCURRING REFER TO S.A.S. SKETCH INVERTS, PRIOR TO INSTALLATION. PERVIOUS MATERIAL 2) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE 4' MIN. SEPARATION TO G.W. LEACHING SYSTEM SECTION TRUE TO ON A MECHANICALLY COMPACTED 6" CRUSHED BOTTOM OF TP-2, EL.=6.5 - STONE BASE, AS SPECIFIED IN 310 CMR 15.221(2). 3/4- TO 1-1/2" DOUBLE 3) INSTALL INLET & OUTLET TEES AS REQUIRED. WASHED STONE 4) CONTRACTOR SHALL INSTALL AN APPROVED GAS 3" LAYER OF 1/8- To 1/2- BAFFLE ON THE OUTLET TEE. SEPTIC SYSTEM PROFILE DOUBLE WASHED STONE N.T.S. (OR APPROVED FILTER FABRIC) GENERAL NOTES:1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL SOIL LOG BOARD OF HEALTH AND THE DESIGN ENGINEER. 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS DATE: JANUARY 15, 2019 (REF#15,875) OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE SOIL EVALUATOR: PETER McENTEE PE(SE#1542) LOCAL RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: WITNESS: DONALD DESMARAIS R.S.HEALTH AGENT -310 CMR 15.405(1)(b): 1) A 1' variance, S.A.S. to slab (house). fora 9' setback ELEV. TP- 1 DEPTH ELEV. TP-2 DEPTH 2) A 10' variance, S.A.S. to cellar wall (garage). fora 10' setback 20.5 A 0" 18.0 A 0" 3) A 3' variance to the 3' maximum cover requirement, for up to LOAMY SAND 6' of max. cover. S.A.S. shall be H-20 and vented. 10YR 4/2 FILL 3.-THE SEWAGE DISPOSAL SYSTEM-SHALL NOT BE 'BACKFILLED PRIOR _ 19•7 B 10" 7 0` B 12" - TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. ' LOAMY SAND LOAMY SAND 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING 10YR 5/8 10YR 5/8 FROM THOSE SHOWN HEREON SHALL BE. REPORTED TO THE DESIGN 15.0 36' ENGINEER BEFORE CONSTRUCTION CONTINUES. 17.5 36" • C C. 5. ALL ELEVATIONS BASED ON NAVD88. PERC 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 48"/56" THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. WATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 8: THERE ARE NO WELLS WITHIN 150' OF THE PROPOSED S.A.S. MED. SAND MED. SAND 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL.BE RESTORED AS 2.5Y 6/6 2.5Y 6/6 AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY' 9.5 132" 6.5 138" THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. PERC RATE 3 MIN IN. "C" HORIZON 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS NO GROUNDWATER ENCOUNTERED IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE INSPECTED BY HEALTH DEPARTMENT PRIOR TO BACKFILL. 13. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY AND IS NOT TO BE CONSIDERED A PROPERTY LINE. SURVEY. ®®®® 033 ®®®®®®®®®®® 37" DESIGN CRITERIA 53.30' N ® ---I- _ ®�®®®®®®®®®r--------- Z NUMBER OF BEDROOMS: 8 1 BOTTOM AREA �N SOIL TEXTURAL CLASS: CLASS 1 I 921.6 S.F. - 10 (LOADING RATE=0.74 GPD/SF) 01 r-- 4o.50'- 102" DESIGN PERCOLATION RATE: 3 MIN/IN DAILY FLOW: 880 GPD MI Io DESIGN FLOW: 880 GPD 00 4" KNOCKOUT GARBAGE GRINDER: NO-not allowed with design `-J� PERIMETER=169.6' 20" DIA. COVER LEACHING AREA REQUIRED: (880 GPD) = 1189.2 SF 12.80' SAS DIMENSIONS .74 GPD/SF I(S ETCH 4" KNOCKOUT / 4" KNOCKOUT 62" PROPOSED SEPTIC TANK: 3000 GALLON-2 COMPARTMENT COMPARTMENT NO. 1 - 2000 GALLON STORAGE COMPARTMENT NO. 2 - 1000 GALLON STORAGE PROPOSED D-BOX: 1 INLET, 4 OUTLET (MINIMUM), H-20 RATED 4" KNOCKOUT USE 8-500 GALLON LEACHING CHAMBERS IN SERIES SURROUNDED WITH 4' STONE (SIDES) AND 2' OF STONE (ENDS) 500 GALLON CAPACITY, H-20 LOADING SIDEWALL AREA: 169.6'(PERIMETER LENGTH) x 2'(EFF. DEPTH) = 369.2 SF BOTTOM AREA:............................................................................. = 921.6 SF CHAMBERS 'TOTAL AREA:............................................................................;........ 1290.8 SF ' DESIGN FLOW PROVIDED: 0.74 GPD/SF(1290.8 SF) = 955.2 GPD Engineering by: SCALE DRAWN JOB. NO. PROPOSED SEPTIC SYSTEM UPGRADE PLAN Engineering Works, Inc. N.T.S. P.T.M. 101-19 468 WIANNO AVENUE, OSTERVILLE, MA 12 West Crossfield Road, Forestdale, MA 02644 DATE CHECKED SHEET NO. (508) 477-5313 2/4/19 P.T.M. 3 of 3 Prepared for: Regina Sullivan, 8 Monadnock Road, Wellesley, MA 02481