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HomeMy WebLinkAbout0040 BEACH PLUM HILL ROAD - Health 40 Beach KOM l{ill;load Marstons Mills A-097-005=004 SMEAD I Na 2-153LY UPC 12M sm®ad com a We to USA � _ �W �- ai,� �,�� � �� ��� � ��t� �E= �s/���GE �I.�asflLID � 7 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ,..°y 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's ame required for every information is W am M MA 02454 9-12-15 page. frown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information ///on the computer, �l/ /{ 9/ use only the tab 1. Inspector: key to move your cursor-do not Jason Burnie use the return Name of Inspector key. All Cape Septic LLC ffi Company Name 618 Rt 28 Company Address W.Yarmouth MA 02673 CityfTown State Zip Code 774-268-0857 S15011 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 9/15/15 Inspector's Signa Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 8 V� t5ins-3H 3 Title 5 official inspection Fomm Subsurface Sewage Disposal System•Page 1 of 17 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. Cityrrown 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: ® 1 have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: The system was found to be in good working order upon inspection. 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-3113 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 ,. 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. CityrTown 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 box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken 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: 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 t5ins-3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owners Name information is required for every Waltham MA 02454 9-12-15 page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health(and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool El ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 4 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high 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 col'rform 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 El El 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 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. Cityrrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes"or"no"as to each of the following: Yes No ® ❑ Pumping information was provided 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? El ® Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ® Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)[310 CMR 15.302(5)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 5 Number of bedrooms(actual): 5 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): SAS@ 660gpd t5ins•3113 Title 5 Official Inspection Forth: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 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. City/rown State Zip Code Date of Inspection D. System Information Description: The system consists of a septic tank, distribution box and galleys Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ 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)): 14- 1696gpd13-2162gpd Detail: Customer has irrigation Sump pump? ❑ Yes ® No Last date of occupancy: seasonal Date Commercial/industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): ` Grease trap present? ❑ Yes ❑ No f 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 Commofnwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. Citylrown 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: Last pumped in 2007 per Barstable Sewer dept. Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons i How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool l ❑ 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 N ❑ Tight tank. Attach a copy of the DEP approval. 9 ❑ Other(describe): t5ins-3/13 Title 5 Official trispection Form:Subsurface Sewage Disposal System-Page 8 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments °y 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 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: The septic tank and distribution box were new in 2012 per info at the BOH. The SAS was original from 1985 per info at the BOH Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): 3'4" Depth below grade: feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 10+ feet Comments(on condition of joints, venting, evidence of leakage, etc.): The main line showed no evidence of any problems in the past. Septic Tank(locate on site plan): Depth below grade: Inlet- 1' Outlet-9" Deck-2'5" feet Material of construction: ®concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain) Tank at normal level, inlet and outlet tees are in position. Also the tank is an H-20 If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No` Dimensions: 1500gal Sludge depth: 6" t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 17 it Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 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 3+ 6" Scum thickness Distance from top of scum to top of outlet tee or baffle 4"+ Distance from bottom of scum to bottom of outlet tee or baffle 11+ How were dimensions determined? Tape and estimate Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): The tank was found to be at a normal level upon inspection. Niether the scum or solids were heavy. 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 Tide 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments J' 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800$outh St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. CityrFown State Zip Code Date of Inspection D. System Information (cont.) Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection)(locate on site plan): 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•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �y 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owners Name information is required for every Waltham MA 02454 9-12-15 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 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.): The box cover was 8"deep. There was no root infultration and the water was at a normal level. 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: SAS was located. t5ins•3113 Title 5 Official Inspection Forth:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts lugTitle 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ® leaching galleries number: 5 galleys with stone ❑ 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.): We opened the cover to the SAS and found it to be dry. There was no evidence of staining or hydraulic failure. The cover is a 32" H-10 concrete cover that is 3' deep. 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 MDimensions of cesspool- Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•3/13 Tide 5 Official Inspection Forth:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): 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 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. City,Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the.boxes below: ® hand-sketch in the area below ❑ drawing attached separately Lam' Sioc OF 1 I-�Se , A I O b o l o a 4 _ 0 3 i A _ . INeto 3 L16�°3 3 a 33. o 2 3 : ,')-0(0 4 - 33• �� e N i - 10'u 1 t5irm•W13 Me 5 Of del Inspection Form Subsurface Sewage Disposal Systern•.Page 15 of 17 I - Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water 2 Check cellar ® Shallow wells Estimated depth to high ground water: 12'+ per original plan and 2 inspection reports on file at the Barnstable BOH 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: 1984 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: MIW-29 Zone B water level 9.1 3.4xl2=3'5"adjustment You must describe how you established the high ground water elevation: From grade to bottom of the SAS you have an overall dpeth of 8'. The orginal test hole on the plan dated 1984 shows no water at 12'. This gives you a proven seperation of 4' between bottom of SAS and to where groundwater is known not to be. Also there has been 2 inpsections done that are on file at the Barnstable BOH which shows no water at 20'and 30' due to the property having a sharp dropoff that shows no signs of breakout. 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 f Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 40 Beach Plum Hill Rd Osterville, MA 02655 Property Address Edward J Faneuil Trust 800 South St P.O Box 9161 Owner Owner's Name information is required for every Waltham MA 02454 9-12-15 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ❑ Inspection Summary: A, B, C, D, or E checked ❑ inspection Summary D(System Failure Criteria Applicable to All Systems)completed ❑ System Information—Estimated depth to high groundwater ❑ Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t I II t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 Assessing As-Built Cards Page 1 of TOWN OF BARNSTABLE LOCATION D '0 FA C1 P4aM y/C 4 SEWAGE# VILLAGE 0,57 /46 Pi!ASSESSOR'S MAP&LOT a f, E�9�'?�'S NAME&PHONE N0.,e ?3 �P SEPTIC TANK CAPACITY LEACHING FACII=: (type) (size) NO.OF BEDROOMS WILDER OR OWNER �•� y �����'� ���L iA�+, rFRMITDATE: 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 BARN R Jr 9 _s•• P 3y. .r http:/hown.bamstabie.ma.us/AssessingfHMdisplay:asp?mappar 097005004&seq=1 9/14/2011 �I AsBuilt ` Page 1 of 1 TOWN OFF,B A�R�NSTABLE LOCATION 40 ,�.uA I J,,J &J SEWAGE# /D g VILLAGE QQ ASSESSOR'S MAP&LOT INSTALLER'S NAME&PHONE NO. /�i.a26-4t Cg2f e . 4.Z 4-9:? O O SEPTIC TANK CAPACITY LEACHING FACILITY:(type) JeaA;E" (size) NO.OF BEDROOMS BUILDER OR OWNERI� � PERMITDATE: 41 o 2 L2 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 A " ( — 14. to 14-f A - .2 - q - 3= a2 ►. a6 8 A A _4_ 44 ,0:5 a o I 4 - 5 - 5o. oe o a A - 6 = 59 a 3 Q - ! = 4 3 ' 34.0f a _ 4 3 :1. OG 13 33 , 10 I http://issgl2/intranet/propdata/prebuilt.aspx?mappar=097005004&seq=2 9/14/2015 THE COMMONWEALTH OF MASSACHUSETTS , BARNSTABLE, MASSACHUSETTS (Certificate of Compliance THIS IS TO CER FY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) 0 Abandoned(• '�by at 48 .&,,A- 9( has been constructed in accordance with the provisions of Title and the for Disposal System Construction Permit No*, ��� dated Installer �� �+-�f�- Designer #bedrooms Approve esign flow gpd The issuance of this perm t shall otf be construed as a guarantee that the syQtermriill cti n signed.Date ���/ d— Inspec - _- - - ------- - -- - - -- -- -�-_--- Fee._.__- -- -- - -- -- — —No. vl� -00(0 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS �Ngogat �§pgtem Congtruction Vermit Permission is hereby granted to 'Constructp( " ) Rep it ( ) U ade ( ) Abandon System located at ® e �.es:�>� i �( �/.2 i�.� IWA� 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 ust be/completed within three years of the dat of this p Date � �// Approved b _ x 52i 13104,1L 4,, E ��125 6 � 1 zO O®� 5 199 01, x 39.1 pro x 36.2 �o TREES x 36.5 x 32.9 x x 5.7 OUTDOOR SHOWER/ x STOCKADE FENCE 32.7 x 35 x Me 35.3 — — �'2 LAWN x 35 / i x32.8 -S3 31.2 3 ,x 33 C UNITS b3 LP \ x 33.3 `l• =34.6 FFE \ x 32.7 2 \ ST a O \ h PROPOSED 16 x 22 SCREEN PORCH 3•5 \ FFE=33.3 FFE=34.8 \ LF�g1- 3 . IN, 27. A�� \ 2 srcl �x 32.8 \ / DIG FFE=34.6 "��OQr UG UGE / a �34:'. ��Y� �� UGE x 32.6 DIG.-S F 6,Q70 75,. y 1.P• 1G x q O _ A. 3 �2xi 911, o�a TH'.DEP , 24 ��' . .0 x `� - 2 x 28. 2 � 24.4 STONE RETAINING k 4t) c� x 24 �� . `\ �8' WALLS 77 rnl PEASTONE _ 26.9 .RLOCATE SEPTIC TA�C` " \` M4.3 �. + i 8 �+ \�\ ��-� x 2 \-L-E`4CHING SYST M RUSH . P R6Xr of EXISTING LAWN.TO BE R A-, AND `.� �/ OX J MITIGATION PLANTING (SEE �ONSERVATIQN NOTE { 7)• t .1._........L,..�.�r. _ � ... .�,a, a /� .rvfarsnVH 1 A TC nr, •rinAt.--.. �'\ TOWN OFBARNSTABLE LOCATION 40 a_* . P,P SEWAGE # 26/2 ' I D g VILLAGE © ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) JC�(AaZa,w. (size) NO. OF BEDROOMS - BUILDER OR OWNER /aZw 4' ,O C�iC c PERMTTDATE: ��0'17 �!2 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 A - t ' - � A - .2 = / 1- 07. 9 A 06 Q ,� A - 4 = 44 , 03 c p A - 6 = 5 ?- 33 . off 3 - 34,01 .8 " - ��• �� No. �y�O� i1o� Fee / 6 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Nplitation for VepoSaY *p em Construction Permit Application for a Permit to Construct( ) Repair(4pgrade( ) Abandon( ) [:]Complete System ❑Individual Components Location Address or Lot No. Q �e e c� VRIVI _�Q 04. Owner's Name, ddress,and Tel.No.Assessor's Map/Parcel ®y] ®p _ /-®8 y/o/ d� .5r ItLstallerr's Name,Iddress,and Tel.No. 4;t g_,9 3 pQ Designer's Name,Address,and Tel.No. 510 -7 7 r Type of Building: Dwelling No.of Bedrooms _ti Lot Size 0 71 O sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) S 5 o gpd Design flow provided !T gpd Plan Date 9`,3D Number of sheets / Revision Date �A 1 A.? Title 4C, Size of Septic Tank /SD© Type of S.A.S. Description of Soil 1y 4 Nature oARepn airs or Alterations(Answer when applicable) �_ Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of H ]th. igne - Date W075142, Application Approved by Date �7 Application Disapproved by Date for the following reasons 'c� Permit No. o�-V . o Date Issued 1 --------------- No. r��l�J Fee , THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BAy RNSTABLE, MASSACHUSETTS application for MisposaY �p0thn , nstruktion 3pPrmit Application for a Permit to Construct( ) ' Repair(PUpgrade}`( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. (� ft Q .P Owner's Name,Address,and Tel.No. , Assessor's Map/Parcel c� D O ® i � ' '� �"� L° P1013 -/��/4a" �� Installer's Name,Address,and Tel.No. ,!�g_ g 30 C. Designer's Name,Address,and Tel.No. 50 C' -7-7/ Type of Building: Dwelling No.of Bedrooms�5 Lot S ze 7, /,(, sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) l Other Fixtures Design Flow(min.required) r co gpd Design flow provided 1 gpd Plan Date Qi/3p /he ! Numberjof shee�s / Revision Date ��� /,7 Title ap �D...Q � � f Size of Septic Tank / ©© ,,,x Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of f Compliance has been issued by this Board of Health. igne 17 �. Date Application Approved by Date 7 Ap lication Disapproved b Date p PP Y 1 for the following reasons Permit No. 'an A0 Date Issued L- All 4 -------------------- -- ' =r - ------------ ----------------------------------------------- -------------------------------- pa THE COMMONWEALTH OF MASSACHUSETTS 5� a liar BARNSTABLE MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,,that the On-site Sewage Disposal system Constructed( ) Repaired(l� Upgraded( ) Abandoned( )byat �� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No�)O/k ^,,L dated Installer�. �/ - Designer #bedrooms Approved design flow S S o gpd The issuance of this pemjit shall not be construed as a guarantee that the system will funrtio a*s de 'g ed. Date 1t 1� �'` Inspector ------------------------------------------------- ----------------------------------------------------------- ----------/--------------- No. O I 'a U FS-- Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal *pstem Construction i3Prmit Permission is hereby granted to Construct(n p) f Repair(e< Upgrade( ) Abandon G#�nt�� ( ) System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this pe it. Date L4) YD 'a-- Approved by i No. o 0fo Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes Application for Migo!gal *paem Cougtructiou Permit Application for a Permit to Construct O Repair O Upgrade O Abandon(V��D Complete System LYJ Individual Components ,Dn 1l,,nn/n� �- Location Address or Lot No. *0 !..", 174yj Owner's Name,Address,and el.No. paw ®o t3 116 1 + /4z.6L b�45 Assessor's Map/Parcel 0 installer's N � "am P A d_res�s,.�and Tel.N (n/ o.(�/ p esigner's Name,Address and Tel.No. /% �`"�".� '.e-(/""'°"."u'v�' •rim(„ 5,� p1a� L 029 -42R- 91-300 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.required) gpd Design flow provided gpd Plan Date Number of sheets Revision Date Title Size of.Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the constructid and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of tb nvir nmental Code and not place the system in operation until a Certificate of Compliance has been issued by this Boa d of ,x Signed! _ Date Application Approved by Date l Application Disapproved by: Date - - for the following reasons Permit No. (-Y-4-1 Date Issued No. 0/,� Q G V Fee t THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIpplication for Bigo4m �§p!gtem Con0truction permit Application for a Permit to Construct O Repair O Upgrade(-) Abandon(b) ❑.Complete System ®Individual Components Location Address or Lot No. *0 ems" AA.— Owner's Name,Address,and Tel.No. 5.4 9 Ax. �- Po 43 9'46 1 a 't /Y►�o� o 4g ') Assessor's Map/Parcel 0 9P 7 Installer's Name,Address,and Tel.No. j xp &��i—la e0esigner's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq. 8. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd Plan Date• Number of sheets Revision Date Title Size of.Septic Tank Type of S.A.S. Description of Soil 1 Nature of Repairs or Alterations(Answer when applicable) Date last inspected:a l , Agreement: dJ The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the�Environmental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board,of Health_/ t ` Signed / /, - _� i�`l%'$/ Date /a / 4 Application Approved by w ,'Date Application Disapproved by: for the following reasons Permit No. r*0 I/ ' Date Issued ------------------------------ VYI-IC THE COMMONWEALTH OF MASSACHUSETTS �(�•� BARNSTABLE, MASSACHUSETTS Certificate of Compliance .rt THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed Repaired Upgraded g P Y ( ) P ( ) ( ) Abandoned( -, byr at 4•1) A. . C�evw 9d,+�� �_� � has been constructed in accordance with the provisions of Title 5 and the for`Disposal System Construction Permit No. �, o OO(p dated Installer �Y /f/. .men Designer #bedrooms Approved design flow gpd The issuance of this permit shall not be construed as a guarantee that the system will function as designed. Date Inspector = ————————————————————————————— ^ ------D (O ri.--------------------------------------•-'---------------- ----- -- ---. --- No.C 910/CQ Fee�� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE, MASSACHUSETTS Miopool *p!5tem Construction Vermit Permission is hereby granted to Construct ( Repair ( ) Upgrade ( ) Abandon (�� System located at �j�© � t�, ,Y C %.Tr �rA and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided: Construction must be completed within three years of the date of this permit. Date /L/�,/ / hr� , A roved b �_ .lt�l f,- ---- Pp Y -_ TOWN OF BARNSTABLE (� LOCATION U SEWAGE # VILLAGE T �nx /�- i ASSESSOR'S MAP&LOT , �8 f'�yCo Sob' 77J- -apo0 £R'S NAME&PHONE NO. SEPTIC TANK CAPACITY s LEACHING FACILITY: (type) ---- (size) NO.OF BEDROOMS ,�MDER OR OWNER -5//I y ���' �.�L /AA EERMTTDATE: ..CZYMPEbe4CE DATE: 1 D '20 o 7 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 sifi�or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist withifla"300 feet of leaching facility) Feet .y Furnished by i3ARN �s o - TOWN OF BARNSTABLE LOCATION 9 C �1, R) SEWAGE# VILLAGE OS"4-e ASSESSOR'S MAP&PARCE . INSTALLER'S NAME&PHONE NO. \ . _:��.� SEPTIC TANK CAPACITY LEACHING FACILITY:(type) ryl VtfX ILA� 3 NO.OF BEDROOMS OWNER e PERMIT DATE:IM Ii•-2-7-7 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 BYS ln1- 2 2 �� .13 1..,) ;�� e� f vJr 3-T ' ��n,ox AsBuilt Page 1 of 1 ,/ TOWN OF BARNSTABLE LOCATION�7 O OF1101 Pun #"CC SEWAGE M VnIAGE 057 ASSESSOR'S MAP&LOT a f7- n• RA/sPfe ,� d8 ('�NCo Sob• 7�5- roo �S NAME&PHONE N0. ,2 SEPTIC TANK CAPACITY LEACHING FACILrrY:(type) (size) NO.OF BEDROOMS WILDER OR OWNER rF-RMrrDATE: SCE DATE: /N fP(C�oh 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 Weiland and Leaching Facility(If.any wetlands exist within 300 feet of leaching facility) Feet Furnished by 3ARN 14-10 �s, � :39 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=097005 004&seq=1 Town of Barnstable Regulatory Services Thomas F. Geiler,Director • BMW9rABM Public Health Division MAM 9�°rF 39. Thomas McKean,Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: 7 2y ?.U12 Sewage Permit# 2012 - Lot Assessor's Map/Parcel 097 a0S-ooS/ Installer&Designer Certification Form. Designer: 13axler Nyc. Installer: PA%6r•c fxcru,4f-Lan Address: 721 bJor►NA Sd^. Address: P.oe UQro l2861 I-l'yftU%hLS 02.601 rores+Cly 1t 6ZGl/�f On q /Z w 86rc Zioc&oG4 &m was issued a permit to install a (date) (installer) septic system at 40 deacA plow, 91# f&q,,t based on a design drawn by (address) V3 cxl-cf- c dated yl2>r,/Z (d signer) T _ I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. ' Yeere found LivaF,^J SAS Wc&s rcuscaR , nc..> seph+c +U .1t $ D-10064, I certify that the septic system referenced above.was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local_Regulations!.Plan revision or certified as-built by designer to follow. Stripout (if required) was inspected and the soils were found satisfactory. . "OF MAss9 O� STEPHEN �y ' G � u' �ffihstaller's Signature) g ALLYN r*, o WUON No.30216 y Ado �F6 Pip �Q esigner's Signature) (A p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH D SION. 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. gAoffice formsWesignercertification form.doc TOWN OF BARNSTABLE,_� d 9"7 � 85_004 LOCL=N`Y� 4?c.4c.,4 SEWAGE # VILLAGE DS Q(/f � ASSESSOR'S MAP & LOT ,Q INSTALLER'S NAME & PHONE NO. .AAe-�f e'&.y ST SEPTIC TANK CAPACITY l S O G1 Ille -� S LEACHING FACILITY:(type)6�//&iS CS ) (size)v2zf �C �AO.,OF BEDROOMS--_PRIVATE WELL OR PUBLIC WATER v BUILDER OR OWNER J J/�X 1 / "► = ? 1��� �i9vE2 �2�y DATE PERMIT ISSUED: . /-��Q A' DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No r � g � POOH 45SC-5soe-5 mptp 3-7 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................... ................................ Allpfiration for Uhipmal Workri Towilrurtion Vamit Application is hereby made for a Permit to Construct (K) or Repair an Individual Sewage Disposal System at: .................................... Location-Address k —9— D-6 C170..VJI��Lfkf� 51 ------------- .A.. -------------------------- ... ... (G"A�T%VC� Owner Address ...............jV CT..........ff.QC,.1h ............................ ................................................................................................. Installer Address Type of Building Size Lot-1-11.9.4................-- �� U Dwelling—No. of Bedrooms..........I.................. .............Expansion Attic q6 Garbage Grinder Y6)2-> Other—Type of Building ............................ No. of persons............................ Showers Cafeteria Otherfixtures ........................................... ......................................................................................... Design Flow...... t...S>/,o..........gallons per Total daily flow-----&.(4?C)............................. ............gallons. WSeptic Tank—Liquid capacityAbStOgallons Length.'%O.-.0.. Width. .. Diameter________________ Depth_'..... Disposal Trench—No. ..A.............. Width....0........... Total Length....Z.4......... Total leaching area___)1Z......sq. f t. Seepage Pit No--------------------- Diameter--__-___-_-----..... Depth below inlet.._................. Total leaching area..................sq. ft. Z Other Distribution box (ya Dosi%tank (go Percolation Test Results Performed ................ �_l A- -------- Test Pit No. I... .....minutes per inch Depth of Test Pit---�Q........... Depth to ground water- ai�;t"9,&TMW riq Test Pit No. 2_4Zt......minutes per inch Depth of Test Pit....LZ.......... Depth to ground water... ----­----------L- f 9 ............................................. ...................................................... 0 Description of Soil.....1�---L------0.... ..................................... 111.1 4: :L...0 12—C(". U ..................... ..............1.W:7 ­ . .....k� P------------------------------------ ................................................................................................................ ......................................................... ...................... U Nature of Repairs or Alterations—Answer when applicable----------------------------------------------------------------------------------------------- ...................................................................................................................................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of'TT LE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has bee q-_mue 15�,Iy the oard o"-h Signed � / ..................... Date Application Approved By.............. ----------- Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo......_Ft.12)........................... Issued....................................................... Datz 5Sc5SCJ `'( No...21....1al F►C�� S' 'P FEB . THE COMMONWEALTH OF MASSACHUSETTS --�^ BOARD OF HEALTH .. ..-------.....OF.....!.Jf�4 ....................................... Appliration for Diiivnsaal 10orko Tutuitrurthitt 11truat Application is hereby made for a Permit to Construct or Repair ( ) an Individual Sewage Disposal System at: :S /-\c P tom- +_v i-A � !LL 2c)A ) � Mk &�� � � c�i.5_ I-aT I� ... ................... .• ................................................... --............. Location-Address or 3 f �tit��,,y►.t�c��I.a�...�-'�� t 0...-!�t� �Sl l� r /t-- -�•^OG 878 l.tOwner ------------------•---------- ........................... 1.1 Address ............. ............•.....--•-••-••-••---••--•---...... _........-----•--•-•••••...... ..-•••---•-------•-•------•-•--.......••------••-•----.............------•--•-------.......... Installer Address A Type of Building Size Lot-1-.al.............. c�-'felt Dwelling—No. of Bedrooms.•_....-�................................Expansion Attic OQC) Garbage Grinder AE)s Other—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ------------•-•-------••------•. ��C_4',7 Wk------------- w Design Flow...... per persert-per-dpr Total daily Pow...... WSeptic Tank—Liquid capacity)b�.�gallons Length Q.�U .. Width. '._`�-,>.__ Diameter................ De th_....' _.._. x Disposal Trench—No._A.............. Width...Q._.._...... Total Length...44........_ Total leaching area._S 9t..---.sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. z Other Distribution box ff E� Dosi tank (No) _ ,f '+' ~' Percolation Test Results Performed by ! _� : ', .. '_ -cti ................ Date_h!Ov.2.t--113b4___..___. Test Pit No. 1._�. .....minutes per inch Depth of Test Pit...�_P........... Depth to ground water-_ Us eac l�v.e', 4s Test Pit No. 2. Z..._..minutes per inch Depth of Test Pit----1.�.......... Depth to ground water...1_--_____________�__� O Description of Soil__- ---------U-- _.}_va�rer _.(t� SGt cam- Z---�C� C c_An( +�v.� P V --------------- '- w UNature of Repairs or Alterations—Answer when applicable............................................................................................... -----------•-•-----••--•---------------------------------------------------------------------------------------•-----•-------- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TT T IZ 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be ue -by the de •Signe •---•---•-- ................. .. ............................... ---------• Date Application Approved BY �_ "' { s- �^..-^=„�.. `'1�- ----•---•-- Date Application Disapproved for the following reasons---------------------------••---•---------------------------•-------------------•------•--------•------......._ ....................•---•--•-•-----------••-••---•---••--•---•-•-••-------•---•--•---••-....-•---------...-•--•------•--...----------•--------------•-----------•--•---•----•----•...••-•----•-------••-. Date Permit No.......gy- 1?-/........................... Issued_.................. Date THE COMMONWEALTH OF MASSACHUSETTS 41 BOARD OF HEALTH `!I-; love' I?�gi��� t•4"-'"L' .G_1.f, y��li ............OF............... . .. r#"�...4�- - {,r -714, uprrtifirate ,af Tuutpli aure THIS IS TO CERTIFY, That the Individual Sewage Disposal System OC-) or Repaired by................... 6 .1).t....._.!1d C t+rAcam%r � . ------......�..........--------•-•-•---•---------------•-•---.........-•---...........---.............-•----•---------...-----...-- Instal has been installed in accordance with the provisions of TITIE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No........ ....... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTIO SATI'SF TORY. DATE.............I--.. . ...� C -- Inspector . [ - _ r THE COMMONWEALTH OF MASSACHUSETTS BOARD yOF HEALTH Trm"-v1.............OF...........1. ................... ......1: : C ......-.._...... r- 1V O._. •--` �-••- .......... FEE.. ........... Dispasal Workiibutt tr�trtimru erutit Permission is hereby granted......... ' �!�?_t:�........ '_. `r.!1''3a �G -----•---------------•--•--------•--........................--•.•••-- to Construct (>C) or Repair ) an Individual Sewage Disposal System at No. 6-� ...�.�j!.._.. .............. ......fJ'Jll.....Rl&_i.......A --M---••-•--------•---•-------------•-•---•---•--- Street c� - -- / as shown on the application for Disposal Works Construction PerStreet o._rV X—/.... Dated.....•------ -----1---- `. ------•---.. DATE. Board of Health . ._ i FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS L V M zN O Now IA V ® w lf7 QD z � fi � MM ~ p A to EL •• 91 15 DEGREE LINE - .. Vol FRONT ELEVATION O LU co W•. k Im r� a C'_` `.} IFPHI LU W w 0��00 Q El II m _MHO NE11,E] , J ❑ I ❑ ❑ Q ® � ® ® ® � g w Lij I,TT I z 1 1 Q -----Li Q w L REAR 'ELEVATION 1 SHEET JOB: 1120 DRAWN BY: KN DATE: 10/9/11 i••r � Tp ® � F►I ob La Elm mm ® �® m �o0M— Po 000aIT � n a c X :41t)C Iu z U Q N z Q . o — 0 -- -------------- ----- —' Q LLI ® ® o w LU ® Q LL- I L---------------------------- ---U m I RIGHT 3�ELE�VATION --- SHEET A2 JOB: 1120 DRAWN BY: KW DATE: 10/�1/11 L_I _J r----I L__J L__J ; tillw I I J r L =12 x ! P , Now w vnm ♦ .>G i +A� rFA vf5sa } ----t ---- ' 2L-M . �3 t3 1■■I V til I H=BAR w ------------ P)iW�w 6p1LmDA�s Omr C -----.- ..... e C. IS q m L euRerl anu __ � 1 _ I � Now CtAxlvr M _ RAIN ww A=Ro%" if . ARM d r 'I y �wertiwv a i F V w N - a Q ' J N FIRST FLOOR PLAN S Z c Z J w nc � 6 . ... _ JOB= ...H2O DRAWN BY, KW DATE= 10/q/II =ter"• d • aq��IO101 Vd WEI MW w IL Rom OWN s i — o I s a i s _Q o rr V R BASEMENT PLAN: Qe lu JU w ------------ - --- ate,--=- ----------� _-- _ -- IlkQ lu > W as Z C n new ZQ 0- Wet v ------ -- -- --- A i W EmIL ---------J, 't V-�' Pd Pd V-T Vd Vd . Vd II aad L'd SHEET Lb Vd wd Vd Vd 1A4 Q-0 SECOND FLOOR PLAN GARAGE SE!;%p LOOR PLAN >vw.r-a DRAWN 1120 BY- KW 10/6/11 . N O . _. Rwle®Tc A,w OMEN :. _ .. .. - - I L 00 AIFlLL .. W ,e•.BOGY IMLL,.00„�G i i ' r '� , 1 I wWOM .. ::.'W�NOLLCLV . .: 'ONYII LL uweao: O rtI i .. � - � � 'rr°mle - --- y6•§ ' ,�• . : �_ .. ..I � i _ _�/• - .. _ z . m I 1 �.1COvu`""G waa _a I FROST oM o I . oReP TO Ga .. � I . - TA.M.TO MTd puGTGIG ... � .. .. '...' .. r-1•W11D TO MTG pG9T1K � M - n .. - .. . ` Cb UP Ul FOUNDATION PLAN A ♦'l Ii� .. .. .: .'. ,We• -Rues r.osl.a. w . _ d o � a Z d r � z OL LL Q I, SHEET 2n-a S1 JOB: 1120 DR4NN BY: KW DATE: 10/q/11 z O i••r �p m memo r.� W 8-4 p 1 w w � .. .. ul r aver w--- I+ BASEMENT RBWE - RAIlEO►ATID .I 0iI1LL - 1IOILL SI (@pILL �. RFe°WE A KR CY vAl1M � - A. Qr pelp ewaroc cur _—-—_—_—_—-g�;I;I %y///�J �- m- r _—_—_— .. D .. . elve LLI .. .. .. .'tom` Aocee�art ... Y LL EXISTING FOUNDATION PLAN N p .. Dove• .. .� . Remove � Q wine Z Q ll1 SWEET 32 III JOB:.: 1120 DRAWN BY: KW DATE: 10/9/11 re _ 4 _ GENERAL NOTES : - �' ;. � • j }. y, � , ., a. SEPTIC SYSTEM INFORMATION � � ,,$� ; , ,�,L , ,;� � ,�: ,J � .�';., 1a '�o•• ` ' " r- �,y- �. r B�►XTER NYE 1. THE INTENT OF THIS PLAN IS TO DETAIL PROPOSED WORK AT THIS SITE 9. 5. A TITLE SEARCH HAS NOT BEEN PERFORMED FOR THIS SITE IF DETERMINED ) EXISTING SEPTIC PERMIT N9-121: �,: } , • j + •q • �; 1D BE NECESSARY, A TITLE SEARCH SHALL BE PERFORMED BY OTHERS. ''` �' iir r'" .-. 10 FT X 24 FT LEACHING GALLEY SYSTEM _ r • . • , x ! _ , �}e r��,t, w, EN GINEERING INEERING & 1 500 GALLON SEPTIC TANK - .� ' 2.) LOCUS AREA IS COMPRISED OF: • THE CONTRACTOR SHALL CONTACT DIG SAFE (AT 1-888-DIG-SAFE) AND UTILITY COMPANIES TO LOCATE :,r�� �.k.�"��'•' Y r•rr--�- �, y�'' S� ; 'fir > IDENTIFIES EXISTING SYSTEM DAILY DESIGN FLOW PROVIDED FOR 660 GPD. 6.) THE PROPERTY LINE INFORMATION SHOWN IS BASED ON CURRENT AVAILABLE RECORD INFORMATION ALL EXISTING UTM 71M AT LEAST 72 HOURS PRIOR TO THE START OF CONSTRUCTION. THE LOCATION of �, � , `�,+ •t ``- a�" ' �` r :`'� �`\�' , * � SURVEYING z � ASSESSORS MAP 097 PARCEL 005/004 CONSISTING OF PLANS AND DEEDS, DUSTING UNDERGR UND INFRASTRUCNRf.. UTILITIES, CONDUITS AND LINES ARE SHOWN IN AN APPROXMAiE THIS INCLUDED A GARBAGE GRINDER. THE RECONSTRUCTED HOUSE WILL `' w ;r ^' '�" ' '-! - *- CERTIFICATE 1195128 WAY ONLY, MAY NOT BE LIMITED TO THOSE SHOWN HEREIN AND HAVE BEEN RESEARCHED BASED ON THE ELIMINATE THE GARBAGE GRINDER. THEREFORE, THE EXISTING SYSTEM .y ' -<•�-S"`� " r_` - d„ ' ' THE EXISTING FEATURES SHOWN HEREON WERE OBTAINED FROM AN ON THE GROUND FIELD SURVEY AVAL48LE UMITY RECORDS NOTED HEREON. THE CONTRACTOR AGREES TO BE FULLY RESPONSIBLE FOR SUPPORTS 6 BEDROOMS WITH NO GARBAGE GRINDER. '_,`%`_r ' ,• " e - ;',+;; :` p �` x ti .c '. ,; ✓ APPLICANT. 4O BE PLUM HILL ROAD R.T. PERFORMED BY BAXTER NYE ENGINEERING & SURVEYING ON SEPTEMBER 14 THROUGH 16, 2011. ANY AND ALL DAMAGES W41CFI MIGHT BE OOGISiONED BY THE CONTRACTOR'S FALl1RE TO LOCATE SAID NO MODIFICATION TO EXISTING SYSTEM NEEDED. � -'��` y i;, ' _ , �` ,' r+ ' ` Registered Professional Engineers EDWARD J. FANEUIL, TRUSTEE t Y INFRASTRUCTURE AND 11T1.lTIES EXACTLY. IF FIELD CONDITIONS DIFFERS FROM PLAN MVFT)RMM110N, THE _ . P.O. BOX 9161REDESIGN. . fro 7.) COMMUNITY PANEL NUMBER: 25MI 0018 D CONTRACTOR SHALL NOTIFY THE ENGINEER IMMEDIATELY FOR POSSIBLE R •�' �, WALTHAM, MA 02454-9161 , 3 and Land Surveyors RESIDENTIAL: 5 BEDROOMS PROPOSED �^ THE FLOOD INSURANCE RATE MAP DEFINES THIS AREA ADUCENT To Mmsm S MILLS RIVER AS { .. •.' F s,:4" '`l "`-\, "T �,,� �i.. 4 • x 10 GPD BEDROOM o K , r .�►, a,. 1 ,• '•. •� 1 ,�, 3.) PROJECT BENCHMARKS: AS SHOWN ON THIS PLANNDERptOUND ELECTRIC SERVICE SHOWN AT LOCUS WAS FIELD LOCATED BY BAXTER NYE 904EMM & � �� _ ,F�, t.� ,� 78 North Street - 3rd Floor � ZONE AlAlI (EL 11), WITH THE REMAINING PARCEL AS ZONE C. A NON-HAZARD AREA = 1 ,� s ,•�- :�, . SURVEYING FROM DIG-SAFE MARKINGS. TOTAL DESIGN FLOW 550 CPO Hyannis, Massachusetts►� tts 02601 . 4. ZONING INFORMATION •: ti' r _ , a 8. ENVIRONMENTAL INFORMATION: 4 GAS LINE SF10WN AT LOCUS WAS FIELD LOCATED BY BOXIER NYE ENgNEERIVG d` SURVEYING FTtOM NO GARBAGE GRINDER SEPTIC TANK 550 x 200% = 1100 GAL. :• = �`" "" ZONING DISTRICT . RF (Residential) DIG-SAFE MARKINGS. APPROXIMATE LOCATION OF ADDITIONAL LINE AND GAS SHUT OFF SHOWN AT BEACH USE 1500 GALLON TANK �' -'` s 't; r l r' •�,, "f • " `/�,. G ,, �' �T Phone - 508 771-7502 ' • SiTE IS NOT WITHIN AN A.C.E.C. AREA OF CRITICAL ENVIRONMENTAL CONCERN). r,l a S ,; - , ( ) 1 ( ) PLUM HILL ROAD TAKEN FROM A SKETCFI FRONDED BY NATIONAL GRID (SKETCH SN2681). ELEV TM �, ` ..1 i * c�.a--- ` , .►_ - ••• CURRENT MINIMUM ZONING REQUIREMENTS: a . ti� �.� y , ,.. Y tiff? ,. Fax (508) 771-7622 • SITE IS NOT WITHIN AN AREA OF ESTIMATED HABITAT OF RARE WILDLIFE PER �, '• C � ^,. - �- .-.;; _ r ,.. • APPROXIMATE LOCATION OF SEP71C COMPONENTS SHOWN AT LOCUS WAS TAKEN FROM AS-BUILT 90M �,. U ,. ,+c, �1 �'� .r }--` � : - www.boxter-nye.com 1 .r `J��. �.. ti_, f • /fir MIN. LOT AREA = 87,120 S.F. NHESP MAP OCTOBER 1, 2010 'E'SITMAT® W4NITATS OF RATE WILDLIFE' FINISHED FLOOD ELEVATION 34.8 _ I , -►` � `-, ,-L . ._1. •t !,,� . r,',s a'..t `-PROVIDED BY THE BARNSTABLE BOARD OF WEALTH„ PREPARED BY A dt B CANCO (DVIIID 10/2%3). r 1 :,�•• FOR USE WITH THE MA WETLANDS PROTECTION ACT`REGULATIONS (310 CMR 10).' �... � 11 -` �, M1 MIN. LOT FRONTAGE = 150' SKETCH DOES NOT SPECIFY TYPE OR SIZE OF LEACHING REED, SIZE OF LEACHING FIELD WAS TAKEN FROM SEWER INVERT AT HOUSE 1 31.1 ;c ��' 1 MIN. 0 WIDTH = NIA B.O.H. PERMIT No. 89-121 DATED 2 12 90 WHICH SPECS A lO x24 LEACHING AREA WITH 5 GALLEYS n: .: _L. `3 ti� ; _ 3 ••- �- ti* LOT ` 1' 7 STAMP STAMP / � � SITE DOES NOT CONTAIN A CERTIFIED VERNAL POOL PER NHESP MAP OCTOBER 1, 2010 � •� / / SEWER INVERT AT HOUSE 2 29.7 `�-°. �,����•• �'^"i'�s�>s� :f�,R+, ;., s-�•� , � ' S r'r'' •� - FRONT YARD = 30 SIDE do REAR YARD = 15 / 15 CERTIFIED VERNAL POOLS (3 STONE ON SIDES AND 2 ON ENDS). A TITLE 'V INSPECTION REPORT WAS PREPARED BY CAPEM7DE r: *� + � •*.�� .�`- .•S ` 1" • ►1'„'+'� 'f , SEWER INVERT INTO SEPTIC TANK 28.9 ::--!� r`'`•. '-..:' `` M >r• . �;' '✓,;`� ��cH of M EWTERPRfsE'S ON 8/17/11. LOCATING SEPTIC TANK' AND D-BOX ONLY. � r �.� --* +: ��J OVERLAY DISTRICTS: RPOD, GP, STATE DESIGNATED ZONE II AND •SITE S NOT WITHIN A PRIORITY iiABiTAT PER NHESP MAP OCiOBER 1, 2010 'PRIORITY SEWER INVERT OUT OF SEPTIC TANK 28.6 - S, ' r ZOC SALTWATER ESTUARIES HABITATS OF RARE SPECIES' FOR SPECIES UNDER THE MASSACHUSETTS ENDANGERED SEWER INVERT INTO DISTRIBUTION BOX 21.8 �� +' Id. " ` *� art • '. STEPHEN yN SPECIES ACT, REGULATIONS (321 CMR10). • APPROXIMATE LOCATION OF WATER LINE AND HYDRANT WAS TAKEN FROM TIE CARD -10i79-N FRONDED Z m BY C-O-MM WRIER DEPARTMENT (SERVICE DATE 9/25/89), RECEIVED 1M FAX ON 9/19/201 L SEWER INVERT OUT OF DISTRIBUTION BOX = 21.6 Locus Scale 1 1�o� _ No.30z16 Cn • SITE IS WITHIN A STATE APPROVED ZONE I GROUND WATER RECFIARGE PROTECTION AREA SEWER INVERT' INTO SAS. -21.5 P �Fc�srcR�o • SITE IS WITHIN A ZONE OF CONTRIBUTION TO A SALTWATER ESTUARY (BARNSTABLE B.O.H. # NOTE. FIELD ADJUST DISTRIBUTION BOX AS NEEDED FSS�ONAL EN� REG. 3150-45). D.E.P. File #SE 3 9� • WETLAND DELINEATION BY LORI MocDONAIA, M.S., P.W.S. OF BAXTER NYE ENGINEERING do SURVEYING - SEPTEMBER 15, 2011. CONSULTANT Order of Conditions Expires: November 22, 2014 CONSERVATION NOTEs: APPROXIMATE LOP OF TYPICAL SYSTEM PROFILE DOS7MIG FiNISH FLOOR = 34.8 NOT TO Sc" 1. NO WORK IS TO BE DONE UNTIL FORMS Ado B ALONG WITH REQUIRED - CONSULTANT PHOTOGRAPHS ARE SUBMITTED TO CONSERVATION COMMISSION. DOSINdG GRADE _ 32.St SET AT LEAST OiE MN40E ERNE 2. UMTT OF WORK SHALL CONSIST OF HAYBALES AND SILT FENCING N ac COVER TO WRHIN s' OF FPM GRADE I To BE MAINTAINED IN GOOD REPAIR UNTIL COMPLETION OF PROJECT. RSERS a CMIERS SHALL BE WATERi HT SET COVER TO 6" BELOW GRADE � 3. A COPY OF THE AS-BUILT FOUNDATION PLAN SHALL BE DELIVERED TO 4q1V'0 MAP 097 PARCEL 005-003 FINISH GRADE M 320t FINISH GRADE THE CONSERVATION COMMISSION. c0�'Ql A HN/F x 38 , 0 z s ALLER PREPARED FOR : 4. ALL ROOF LEADERS SNAIL DISCHARGE TO DRY WELLS OR DRIP TRENCHES. S15rFFN 137 LOT 15 - L.C. PL. 13104E 3' MN. S 04 •;.....•• _ =; INN 5. POOL DISINFECTION SHALL BE BY ANON-CHLORINE METHOD. F3�•25' E e 6' PVC 11� OUTLET PIPE 40 Beach Plum HIII Road R.T. 6. AS-BUILT LOCATION OF POOL DRAW DOWN LEACH PIT SHALL BE 5 1gg 0�' X 39.1 R 10' MN. I • L I T Edward J. Faneuii, Trustee FORWARDED TO THE CONSERVATION COMMISSION, BY THE X Pool CONTRACTOR. 34.3 B�AFFTE .:: ... ..;:..• P.O. Box 9161 SHEID 14•/_ 'tCRUSHED . aE,BASE Waltham, MA 02454-9161 7. ADDITIONAL MRIGAl10N WITHIN 50' BUFFER ZONE TO IP/FND X 36.2 taf>NFORCED CONCRETE s' BE PLANTED IN CONSULTATION WITH THE CONSERVATION STONE BASE A ,.+r ,SECTION COMMISSION STFF TREES MANUFACTURER: ROTONDO DB-3 \ ® °�0 COS OR APPROVED EQUAL CB/bH x 36.5 'st0 GALLON ONE-COIPAH SEPTIC TAN H� ) • \ TREES OUTDOOR SHOWER/ x 32.9 x x 5.7 S? <c A DISTFi®UTION BOX W/TEE H•ET • i ? X STOCKADE FE CE 32.7 p fix•`� • x 35 x 29.6 x 32.2 x > >� r 35.3 _ sr _ _ \ _ - 28 2 •2 2j LAWN o .� NEW WATER / W 27,9 CONNECTION / _ _ 32.5 X-2,k6 •, 31.2 X 32.8 3 .i C UNITS 33 \ d�. 32.1 28 D ` `�s 1 7 IP `. 1 \ /FIN ,,\ -, � 1 31.1 20. \ 23.0 '`-, �' 2 � X 33.3 \ " ��, X 34.6 C l _ 23.3�- 2�` FFE=\ So \ cA cc ..� SLf�VE WATER SERVICE 7. �• ,. O .... a mom 5 `� PROPOSED 16' x 22' ° _ tiFo111� FROM HERE TO FOUNDATION \\ IL-31•g / XT to SCREEN PORCH 2.5 'Qi i 'NN' \\ �\ \\ `� FFE=33.3 FFE=34.8 -�, I'c�{y \ x 31.6 \ \ IA \ 10� `_---- _ X 23\ ` \ \�\x27. S'O 32- x 13 h"3\ ` \ _ ,` \ HOLLY \ ,�'1 �c'� E m \`\ �\ _ _ _ _ �\ \ ` �0•\ \ �cf :S� AP X 32.8 / DIG- AF ARKED UI�E a BENCHMARK O CB/bH FND �I \�01 W A 9 9 \ \ \ \ A FFE=34.6 O GE UG CL ? C o \\ \\ \\\\`\ 34 �r4 n, UGE UG UGE 0h \\ EL - 33.43' NM29 C27 2.42�.9 IP/FND - _ ICV 1 18.2F,�Ij v , `d° . \\\ a `R • \ `� `. �` `` x '0 75 4q M y N �'. \ \ ��ip , G UTILIZE EXISTING U71UTY \ �B,• s p 6/ ' W L bv� \��� 1� .\ �S, O I=29.7 VICE CONNECTIONS \ �? .---�`� �� \\`. �.\\ �,\` ,�'�• \�\ \ `\ x 2g. V �� 32 \ �S- 1.4 69 e��' o � \ �\\ \\\ . \`.��� / �• CLEANOUT l �• w ELEC. TRANSFORMER THE \ \ O r� �(; 3t.8 \� #10270/01OA O d V 0 x� s \ x Q► \ ` \ \ 1500 GALLON H- ,o F r \\ 14.X�15.2 62 ,moo. gam. \ \\ \\ �\\ �.69 \\ BAR ..�EPTiC TANK C \ FgSTO \ \_ UGE-, / -- \ \\ x l \� O-y(��A A 2 Q N C \ 2i j rye, \ ® HYD. 269 / "_ \ \ . `\ VVN'. .A'SEP-nc 0.\ G' <O O,Qr \ (NOT FIELD LOCATED) Z ` o UCF (2) 2 GAS LINES cq�j wq �' o X a... ..t•' � �15 0 �� \ 1 \\G'Jfj X�$ \�\ x 24 \ --- 5.5 - CL X 6.6�r r/ r/ r/ / 11.1 ...•/�•••y� /�� \ \ `\ \ \\ f `� - �\4 � x 28. F- �7.... r r r / x159 � �` _ r \� �\ 2 4 4 2 �� �.2 x` \ \ Al-3 COA$fi 1Ll.. ........ rr / 8.5 ,r PATH yrr� i �" �i \ `\ `R'�' STONE REST LNG LAWN \ ��GAS METER ,lq� C� R ► V -- - s'6:8^__� 3 ••.`..... ` �.. .•• a r , J j �(;F i \ `4 \ WA �a' P \ _ LLS � �� m _ ram'• r \ 24. \ x 2 EXISTING GARAGE TO TREES c r0 \ r I o \ REIAOVE` ` �8. OAz, AL &,10.7 0 b ° , p \ \, \� DOSSING �� \ `✓ BE RELOCATED S�FC •-��_ `3 \ In ` \ ` PEAS E rC 1 S \ / \ , SEPTIC TAW ` \ `i PROPOSED ELECTRIC 1 PROPOSED GENERATOR PAD ti tip \, �O r \ r� \ 26.9 1.5 TREES / i �, \ \ ` •r X 15.•3' X 1 1 I 1 \.. \' 1 \ \ cD \\ \ \ i �6 6 C, V IC LANE G + cn t \ Y27�t' 4.3 8r -e--- • , i ••.• `,. \ RUSH. i \ i� \ x 2�� WF+ , 1 X .6 i c\ \\ `� i• i �� l 8 1 �, \\\ \I APPROX�`tE`1�CHING SYS M W C4 PI `•• 4. m �1-3.0. ` , DQSTiNG LAWN TO/BE \� � OX x GAS SHUT-OFF - Og i 6.� i \� \\ `\ + i MI11GA110N PLANTING TO BE)IDQN �, W aox W/ 29.6 L 0 T 1 4 3.2s. �. G• o v' ro 2. 5A1`-s' CbA AL ' \ i (SEE "SERVATI6N NOTE 117). , 25 , T1:E f LAND COURT PLAN No. 131104E - Sh 1 of 2 \ v 5• \\\�\� i , \ �\\ 1� ° 14.9 1 i x 18.8 I 2.8 �' APPROXIMATE LOC TIO X 2 2.0 ACRES f F . r ' c,� �- � 2-PL-60#-1989 22 ,SEE GENERAL N E N• 28.5 x 27.1 PER LAND COURT DECREE '�� r M a O \ h1 i i L TREES PLAN PROPERTY IN 2 _ r U ES \ .5 ' 1 1 Z \` \\� aia 10. \\ \\ i\ i 1� 26.3 356.24' SHEET TITLE a 0. \\ \\ `\ `�+ `� x• /� N 23'08 40 W ■ `a A1-7 COASTAL \\\ IP D ` ``\ 9.9 \ \ \ \ '-_-- BENCHMARK O SB/bH FND REMOVE DISTRIBUTION LWetlands Permit Plan �; o ` Yi�F, , , gym} \ \ \ \ --_\ _ MAP 097 PARCEL 005-005 . " _ Al.�8 ICO'AS1 >' �• \� \\ `_ E. 20.54 NGVD29 TO LEACHING SYSTEM N F . � ; , � ram+ _> ry , Proposed Pool, Terrace It 13.Wl PHEENEY }o N i i 9Q' PROPOSED LEACH PIT FOR & Screen Porch IP D LOT 26 - L.C. PL. 13104I rn � POOL DRAW DOWN (SEE ° + CONSERVATION NOTE #6) SHEET NO i i , WF ' Al f9 OAST ao o RPMP y C3no •7�00 2.7 ?`s•` i i i �� rr •ti'1.38 : . , r �9 N O ' Al- 0 COASTAL a 4"� + N A E : 09 30 11 a Ex F x 10.3 o 20 0 20 40 lsting o I J ^ 5 W�F • - 2.0A1-11 COASTAL SCALE. IN FEET vo SE 308 2 7 Ln �jG SCALE : 1"= 20' �� DRAWNIDESIGN BY: MTM CHECKED BY: MWE 0 i JOB NO: 2011-M C A D D FILE: 2011-050DM-2• -4 0 0 ., � s• o , -�aj - h GENERAL NOTES B�►XTER NYE,,; a�,1 , `,, _�', '•y _ g .,Nt-••ti,,. ..! ,� '�`� � '•..,=ice ..,,:+. '�•.! �� -_✓ _��` ,... • ^ -r lr r �.. � ... :• :.. :� r} ., `9. ,l ,w-�� f ENGINEERING & "' w * q • SURVEYING ) 5.) A 1111E SEARCH HbAS NOT BEEN PERFORMED FOR THIS SIZE DETERMINED 8• UTILITY INFORMATiON SHOWN HEREIN: 1i.� • _c,'•, `'- .r • ' y�r , ter,. , >'` z ti` 1. THE INTENT OF THIS PLAN S TO DETAIL EXISTING SITE CONDITIONS AND ) 9•) 1 PROPOSED HOUSE ADDITIONS TO BE NECESSARY, A TTTE.E SEARCH SHALL BE PERFORMED BY OTHERS. ' • SITE iS NOT WITHIN AN A.C.EC. (AREA OF CRMCAL ENVIRONMENTAL CONCERN). • .. • THE CONTRACTOR SHALL OONTACT DIG SAFE (AT 1-888-DIG•-SAFE) AND UTILITY COMPANIES TO LOCATE y , x' �'' Registered Professional Engineers .r 2.) LOCUS AREA IS COMPRISED OF: 6.) THE PROPERTY LINE INFORMATION SiNOMM is BASED ON CURRENT AVAN ABLE RECORD INFORMATION • SiTE S NOT WITHIN AN AREA OF ESnAIAIm WI<B<TAT OF RARE WILDLIFE PER ALL EXISTING UTUTIES, AT LEAST 72 HOURS PRIOR TO THE START OF CONSTRUCTION. THE LOCATION OF •;,,. ``. , 9 9 CONSISTING OF PLANS AND DEEDS. NHESP AMP OCTOBER 1, 1 _ 4; ,.. t, \ {N , Ili yr f.t ? ,.'*� 5• EXISTING UNDERGROUND N�FRASTRUCTURF, UTN1ilES CWUITS AND LNr1ES ARE SHOWN IN AN APPROXIMATE ;.j - •,� � r; and Land Surveyors r ASSESSORS MAP 097 PARCEL 005/004 2010 'ESTIMATED HABITATS OF RATE WNDLIFE' WAY ONLY, MAY NOT BE UNITED TO THOSE SHOWN HEREIN AND FIVE BEEN RESFaRCHNED BASED ON THErr FOR USE WITH THE MA WERANDS PROTECTION ACT REGULATIONS (310 CMR 10). , CERTTFIGITE 195128 THE EXISTING FEATURES SHOWN HEREON WERE OBTANED FROM AN ON THE GROUND FIELD SURVEY AVAILABLE UTILITY RECORDS NOTED HEREON. THE CONTRACI10R AGREES TO BE FULLY RESPONSIBLE FOR -��' '�•'� � r.� f:, t•� ,•� ,. w `` �" j�;. 78 North Street - 3rd Floor PERFORMED BY BAm NYE SING & SURVEYING ON SEPTEMBER 14 THROUGH 16, 2011. • SITE DOES NOT CONTAIN A CERI F'IED VERNN. POOL PER MNIESP MAP OCTOBER 1, 2010 ANY AND ALL QAMAGES WHICH MIGHT BE OCGi�IONE'D BY THE CONTRACTOR'S FAILURE TO L.OGITE SAq �`�� '=' '�� ., ` f '�rPbn�-_�.• �""""� r✓ APPLICANT. 40 BEACH PLUM HILL ROAD R.T. 'CERTIFIED VERNAL POOLS.' INS IJTiES AND UI EXACTLY F MD CONDITIONS DIFFERS FROM PLAN INFORMATION, THE :w� _ •` -�z .G'�. '' 4 > e Hyannis, Massachusetts 02601 EDWARD J. FANEUIL. TRUSTEE 7.) COMMUNITY PANEL NUMBER.- 250001 0018 D CONTRACTOR Si W L NOTIFY THE ENGINEER IMMEDIATELY FOR POSSIBLE REDESIGN. 1 c , !: m,; �� • r '.;� P.O. BOX 9161 a a�,r�,a,r . _s f ;�. --- - - , •SITE S NOT WITHIN A PRIORITY FNBRAT PER NHE;SP MAP OC'IOBER 1. 2010 'PRHORIiI' , r:••i • ' WAL1HAMd, MA 02454-9161 THE FLOOD INSURANCE RATE MAP DEFNNE,S THIS AREA ADJACENT 70 MARSIONS MILLS RIVER AS ►AIBITATS OF RARE SPECIES* FOR SPECIES UNDER THE � 90ANGERLD • UIDER(;rt M ELECTRIC SERVK,1: SHOWN AT LOCUS WAS FIELD LOCATED BY BAXiER NYE ONpNEERING & �, ,��,�,';. 'ti ��+ . ;i�•����; ^ �� ��- %{ Phone - (508) 771-7502 ZONE Al (EL 11). WITH THE REMAINING PARCEL AS ZONE C. A NON-RAM AREA � t. `��,� , y��`.�`•9 ~ � � � •'-•� �_ FaX - (508� 771-7622 3 PROJECT BENCHMARKS: AS SHOWN ON THIS PLAN SPECIES ACT, REGULATIONS (321 CMIR10). SURVEYING FROM DIG-SAFE MARKINGS. � - �, � ��� � ,_ F,�.�7 � '�.1 s• r,` ' (Fi. ,• • SITE S M1►FNIN A STATE MPROVED ZONE N GROUND MdIIER RECiAR(;«E PROTECTION AREA • GAS LINE SHOMN AT LOCUS WAS HELD LOCATED BY BAXTER NYE E1NG'NNEERNNG & SURVEYING FROM ~ ',• : .• _ .�' .� , •t;�:r�,', . : www.baxter-ny�e.com DIG-SAFE MARKNNGS APPROXIMATE LOCATION OF ADDITIONAL LW AND GAS SHUT OFF SHOWN AT BEACH ,:',' -� +, ,r ;� ems; ;'� :+s.•� ; �" 4.) ZONING INFORMATION • SITE IS WITHIN A ZONE OF CONiRlB MON TO A SALTWATER BMW MV467ABLE B.O.H. PLUM HILL ROAD TAKEN FROM A SKETCH PROVIDED BY NA71ONAL GRID (SKETCH SN2681). �`y°' �` �__' ' , ' ;,.' ` �` ,;` ;, : ` • I; t,• ;�R r"„�r' ZONING DISTRICT : RF (Resk6iWl) REG. 360-45j. ,�� ;;�, I; • APPROXMIATE LOCATION OF SEPTIC COMPONENTS SHOMN AT LOCUS WAS TAKEN FROM AS-BUILT SKETCH �fffy� rf'' 'P'�x'' -' � :� • j.f �r;�t � " STAMP S T A M P • WETLAND DELMTiON BY LORI MocDONALD, MS., P.WS. OF BAXTr:R NYE ONGNELRING & PROVIDED BY THE BARNSTABLE BOARD OF WA IK PREPARED BY A & B CANCO (DATED 1012%3). r" - �� ' `� ' " ` � •. CURRENT MINIMUM ZONING REQUIREMENTS. `--.q SURVEYING N SEPTEM BER 15, 2011. SKETCH DOES NOT SPECIFY TYPE OR SIZE OF LE%I40W FIELD. SIZE OF LEACHING FIELD WAS TAKEN FROM MIN. LOT AREA = 87,120 S.F. B.O HL PERMIT NO 89-121, DATED 2/12/90 10 IC H SPECIFIES A 10'x24' LEACHING AREA WRH 5 GALLEYS .•r'' ir. y`` ,4F �� JoFrN �' MIN. LOT FRONTAGE = 150' (3' STONE ON SIDES AND 2' ON ENDS). A ITTLE V INSPECTION REPORT WAS PREPARED BY MEWIDE rL '^ MIN. LOT WIDTH = N/A ENTERPRISES ON 8/17/11. LOCATING SEPTHC TANK AND D-BOX ONLY. Y = _ 1 , Locus Nap scale 1' = 1000' � ��� FRONT YARD 30 SIDE do REAR YARD 15 / 5 R.. • APPROXMIATE LOCATION OF WATER LANE AND HYDRANT WAS TAKEN FROM TIE CARD ID-10179-N PROVDED OVERLAY DISTRICTS: RPM, GP, STATE DESIGIOTED ZONE II AND ZOC SALTWATER ESTUARIES BY C-O-MM WATER DEPARTMENT (SERVICE DATE 9/25/89). RECOVER VIA FAX ON 911912011. SEPTIC SYSTEM INFORMATION CONSULTANT EXISTING SEPTIC PERMIT W89-121: 10 FT X 24 FT LEACHING GALLEY SYSTEM 1,500 GALLON SEPTIC TANK IDENTIFIES EXISTING SYSTEM DAILY DESIGN FLOW PROVIDED FOR 660 GPD• CONSULTANT MAP 097 PARCEL 005-003 \ THIS INCLUDED A GARBAGE GRINDER. THE RECONSTRUCTED HOUSE WILL N/F \ ELIMINATE THE GARBAGE GRINDER. THEREFORE,THE EXISTING SYSTEM SHALLER SUPPORTS 6 BEDROOMS WITH NO GARBAGE GRINDER. <qN� LOT 15 - L.C. PL. 131 o4E x 38 NO MODIFICATION TO EXISTING SYSTEM NEEDED. C0� 0 SyZI/V 1 31'25* E 6 \ RESIDENTIAL: 6 BEDROOMS PROPOSED PREPARED FOR : FTS 370g 5 o'►' w 39.1 x 110 GPD f BEDROOM F 1gg' 'vx TOTAL DESIGN FLOW = 660 GPD x 34.3 NO GARBAGE GRINDER 40 BEACH PLUM HILL ROAD R.T. \ EDWARD J. FANEUIL, TRUSTEE IP/FTND x 36.2 \ P.O. BOX 9161 o/ WALTHAM, MA 02454-9161 �0• TREES �o \ CB/DH ` x 36.5 \ • x32.9 x � x 5.7 S <� TREES OUTDOOR SHOWER/ x 29.6 • • .3 STOCKADE FENCE 32.7 x 35 x 32.2 35 �Oit���• �`��� \ \ p o 2j . 46- x 28.2 ` . • LAWN x 35 i 32.5 r <j3.7 `. `. `�27.9 ,X'28,6 31.2 x 32.8 C UNITS X33 \ 32.1 \ - LP \ 3,Z.5� \ ,_ Q \ 23.0 x ft FFE=34.623.3 ca x 32 O� a _ r Q6.5 � OtiF \ \\ L-31.9'7cc FFE=33.3 �\ cM \ \ _\ 6 \ \ anon \ \\\ �`.` \\� 27. `rT FFE=34.8 32.5 \ \ �qY � /�I\���HOLLY \ �1Mow \yy (0 ` \ �. �`� ��B,Pj � / t x \ / \ IRKED E BENCHMARK O CB FIND ham• ` o 3 .8 / F U�i CI44� `\ `� `\ `� \ f-A FFE=34.6 S�° \ piG-at UG ri 15 7 `1, `� .bo �`\ �\ `\ `\ `\ `\ `\ q� \ �y U\ UGE P�`' \ \ EL = 33.43' NGVD29 � m O 0 34 O� UGE \ �F �, C4 ` `\ 2 .9 27 7 32. F��� x 3 .6 W !y \ 32.4 `Cp ��Oowns _ _ `�,% J + ih, ND l,� g °l \ `\ �\ `\ `\ `5\\ `\\ 2g 28.2 NC F R D x 3 G ' �P m W CL �- N 17.4 \ T �` 7WELLS\ rid+ (, I.P. 19 PCE �, �%,'"'��-, \`\ �` `\ �`\ `` `` �A Q H ._ �° •` �° `\ `\ x 27.6 q G 6 y - �� \�, ` `\�? �8 �O SERVICE CONNECTIONS \ \89 S Off? ■ /V� • 32 B• c _4 3s~ 1.4 ELEC. TRANSFORMER U TREES ` \ \ \ /I I\ 31.8 \� #10270/010A 4 W m ,2 E . `\ `\ x 31.1 �/ (D y lax \ , \ eA L 0 T 1 4 qsT UGE � 0 r \ �� 1� `\ ` _ p RN M O,I,g ----gym ® HYD. 269 r '` `--- ` `172`,8 AP X. LAND COURT PLAN No. 13104E - Sh 1 of 2 a O r 6.9 1` ``\\ \ `� `\x 19`4 `� \ \ O (NOT FIELD LOCATED) `\\ \16�9 \\ \\ �\ \� \LAWN .\\. SEPTIC TA _ 25.4 �'� 0.$ 2.0 ACRES f y' ---X 5.s ,,� ����♦ �. i� '...,'.. `1s o \•_ \\ • �,s \ r,.\\ x 25.2 oe.s PER LAND COURT DECREE 0 x 6.s,� , 5.�. `\ \ • 2s`� �. x 28. PLAN PROPERTY LINES do �7.. i� i' i' ' ' / x 15 9 ` ` ` \ `\ T\ `\ `\ 4.4 28.2 �\ %_2 .......' ' r i ••' TT 17.1 \ FO \ \ �3.8 r\ \ \ �'\ x 29.5 LAWN G O r 16.8 x \ i \ 10 x .� 8.5 r PATH y' r T i ` \ ` ` ` STONE RETAINING Al-3 COAS -_�5- x_6:8; 3' .•__i. \\\�.�\...... i �~ ���10.5�6' 8.r GF O� \ x 24.4� ��\ `\ \\ 1�8. WALLS a rAt 4 BOAS F1�L 10.7 6: �3�5� < �' r r r r. .1 .\ I \\ \ PEASTONE �� r i I. , \ i \ \ \ 26.9 29.1 Sti U 6 TREES r i \ 1.5 � I ` i I r x 16.4 r \ \ cD \ `\ \ 'Lr° PE G' 7eT4.3 `�'- W 1co \ r r ` I \ TREES •. . � � � i I,• �••• ` BRUSH r ` \ x24:� ` 15.71 1 , I s \ , �' , $ \ 'LCACHING FIE 6 1�5 WASUL �1.6 1 �t \\ I i , , 1 `� �`� APPRZ7X>\ �; C 0 I p •0 • I T OX v x GAS SHUT-OFF , 0 29.6 ? Cgs `. `� �\ `� I II` i r 0 �� `\\ v � �5 R�dS, a6', 5/q-6 CQAS�AL 14.9 r 1Uj APPROXIMATE LOC TIO `+?5•�� 2-PL-60#-1989 �• 0�0 F- �\\\` i i I � ••` •1��° �• \`� it x 18.8 � j 1.8 x .2 h c O \\�\ li �� \ �° `\ `� ,\ ` i i r ; 22 ,S�E GE*ERAL N �iE E x 27.1 ^y O ` \ ` ` \ \ I r �'� I 28.5 2� TREES ,•l, ? i `1.� 26.3 356.24' m v \ A1-7 COASTAL \� `� `\ �\\ `\\ Y.4 IP D N 23'08 40 W oz f 9.9 % . � � \ _ - BENCHMARK O SB/bH FIND SHEET TITLE I MAP 097 PARCEL 005-005 �y x 5 o Ali�8 I(.'O�P►S g� \` EL a 20.54' NGVD29 N/F ■ ■ P �i PHEENEY �s PEER D j j ; ` '+o N ;- eo rt Proposed Addition Plan N � Ii IP/PND LOT 26 - L.C. PL, 13104I S \• I/�1-9 �dAST r N PMP cn i i i ; II i Ii W �k2 N SHEET NO j 3 F�0 � � �?\ I r i i '� R��1 ti �O �j �q �+ Al-10 COASTAL r I I .3 f �. 0 r T r x10.3 r C2w0 Ln -4 SZ A'1 211 COASTAL DATE : 09 29 11 C' \ 2.0 20 0 20 40 f Existing Dock • SE 3-2087 SCALE : 1 SCALE IN FEET "= 20' 0 f ,n 0 DRAWN/DESIGN BY: MTM CHECKED BY: MWE C. 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