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Home My WebLink About1360 OST.-W.BARN. RD - Health 1360 Osti, Marston's Mills F -N I 126 007 0 - a. 90 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01ppliLation for Disposal *pstem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Ab on( ) ❑Complete System ❑Individual Components Location Address or Lot No. � e 's Name,o-�vs _ rame Address,and Tel.No. Assessor's Map/Parcel I 1 Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. aVL;A-Ni �_sS lj�� 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) -M.0 ile- 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 e A. r Si Date �� r �—l� Application Approved by Date Application Disapproved by Date for the following reasons Permit No. 2-0( Date Issued �� T f,. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF"BARNSTABLE, MASSACHUSETTS 2ppfication for Misposal 6pstem Construction Permit Application for a Permit to Construct( ) Repair( ) Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.% ON er's Name,Address,and Tel.No. Assessor's Map/Parcel (,(J T V' C + �- ��I t S X, Installer's Name,Address,and Tel,No. Designer's Name,Address,and Tel.No. 1'A/(� Type of Building: Dwelling No.of Bedrooms 1" Lot Size sq.ft. Garbage Grinder Other Type of Building No.of Persons Showers( ) Cafeteria( ) r: Other Fixtures =a Design Flow(min.required) �(/ gpd Design flow provided 7 gpd r Plan Date Number of sheets Revision Date • t r a Title Size of Septic Tank Type of S.A.S. r Description of Soil i.: Nature of Repairs or Alterations(Answer when applicable) o(/L P/j 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 aft)eal h. r jgned.. / Date P—1 '?- Application Approved by Date '(6'-`/' Application Disapproved by Date for the following reasons Permit No. 2C7 Date Issued 7 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ) Upgraded( ) Abandoned( )by -at 1 13(O / has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. 201 T 2 dated Installer ,� / Designer ,�' / #bedrooms /v Approved design flow 7� gpd The issuance of this permit shall no be construed as a guarantee that the system wW—function as designed. Date �d/� �� Inspector�_. - ---------------------------- - - '- No.0'17 T� Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposar *pstem Construction Permit Permission is hereby granted to Construe) Re_ ( Upgrade( ) Abandon( ) System located at ! 1W, - - r r 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 cc Tpleltp within three years of the date of this pe Date �� Approved by ?10 g�E 2�49 C1 �A, EXISj GAR �%K. 4(t V MP L1 66 V ? ;.ARC ., EXISTING SEPTIC LINE PROPOSED i9 PROPOSED SEPTIC LINE ADDITION LOT 2 ��- 52,119t S.F. (1.20f AC.) S w L. MAP 126 I ¢ PCL 8 I I MAP 126 PCL 29 I 1 SEPTIC LOCAgON IS AN APPROXIMATE LOCATION AND BASED ON BOARD OF HEALTH AS-BUILT RECORDS. CONTRACTOR TO VERIFY SEPTIC SYSTEM COMPONENTS MAP 126 AND RELOCATE SEPTIC LINE FROM EXISTING 1000 GAL TANK TO EXISTING D-BOX AS NEEDED TO BYPASS PCL 9-2 PROPOSED ADDITION SITE PLAN LOCUS :1360 OSTERVIILE WEST BARNSTABLE ROAD jH OF BARNSTABLE (MARSTONS MILLS), MA JOHN SS9cycs REF LAND COURT PLAN #12034-8 DEMAREST,JR N o No.368591, PLAN PREPARED FOR SNO " JEFFREY & CARISA PHILLIPS N SCALE 1"=60' DATE 8/15/2017 DATE G. SURVEYO D EMAR EST EN S U RVEYI N G ASSESSORS MAP: 126 PARCEL 07 338 MAYFAIR ROAD SOUTH DENNIS, MA 508-364-9049 FILE=1708E._DWG �t,E, Town of Barnstable Barnstable . ° Ny � Board of Health RAWMBAMIZ ea � 200 Main Street,Hyannis MA 02601 I Cb 1639. RFD Mpi A 2007 OF-ice: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 JunichiSawayanagi Donald A.Guadagnoli,M.D. August 30, 2017 Mr. Keith C. Gilmore P.O. Box 17 Centerville, MA 02632 RE 1360 Osterville West:Barnstable Road,=Marstons M:iIIs, MA . A= 126 :007 Dear Mr. Gilmore, You are granted a variance on behalf of your clients, Jeffrey and Carisa Phillips, in order to construct an addition in close proximity to the existing septic system leaching facility located at 1360 Osterville West Barnstable Road, Marstons Mills, Massachusetts. The variance granted is as follows: 310 CMR 15.405 The foundation wall for the new addition will be located eleven (11) feet away from the existing leaching facility, in lieu of the minimum twenty (20) feet setback required. Sincerely yours i au r if�,i D.M.D. Chairman Q:WP\Gilmore Phillips 1360 Osterville West Barnstable Road Variance 2017.docx �I ' • •N E&TION.ON DELIVERY. Complete items 1,2,and 3. A.Si re ■ Print your name and address on the reverse X la Agent so that we can retum the card to you. ee ® Attach this card to the back of the mailpiece, B. ceive �n C. at of Delivery R. . Is delivery address d' Brent from item 1 es t If YES,.enter delivery address belo,Ar:� No Brian& Carol Malone �� APO ��VV00 356 Race Lane Marstons Mills,MA 02648 \��D j 3. Service Type ❑Priority Mail Express® '3 Adult Signature /❑Registered Mail- � II�Illlillilillllllllllllllllllllllillllllll 13AdultSignatureRestdctedDelfvery ❑RegisteMdMaflRestdctedl 9590 9402 2762 6351 2526 50 ed Mail Resift Delivery ❑Re Rd1e Receipt for ❑C.olteet arrDi tivery 2._ArtiC le-Numb er fTransfer fmm_sPrv%ra-lahPI) —O Cenrarr Delivery Restricted Delivery ❑Signature Confirmation*'° 7 016 i 0 910 '0 0 01R 3 9 7 5 '28,23 i �l Restricted Delivery ❑Signature confirmation PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt USPS TRACKING# First-Class Mail Postage&Fees Paid USPS Permit No.G-10 9590 9402 `' 51 2526 50 United States •Sender.,Please print your name,address,and ZIP+411 in this box• Postal Service 4._,.. .. I Keith C.-Gilmore Enterprises,L.L.C. P.O.B ox 17,Centervilles Ma 02632 I � I E I I I I `if=l;Il 31i°Ilt:i=: 1:.►ill '1l�=flti: ti SECTIONON. ■ Complete items 1,2,and 3. A. 919n ia; Print your name and address on the reverse Q Asent so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, B. Received by(pri d Name) C.D of Delivery D. Is delivery address different from item 1? Yes If YES,enter delivery address be►pv: [3 No Dawn M. Johnson n, \Y 14 5 Michaels Ave \� �( IDeruusport,MA 0263; ;1 � 3. Service Type ❑Priority Mau Express® II"I�I' I'llI�IIIII (IIII II Illrl�lIIIIIIII ❑Adult Signature ❑RegisteredMaih" 0 Adult Signature Restrlcted Delivery O Registered�Mail ReWcted - 2762 6351 2526 98 i Certified Mall® De ety I ^ ^A_n7 Certified Mail Restricted Delivery ❑Return Receipt far 70 Z ❑Collect on Delivery Merchandise 2. ArUC e D 91O QQQ - ❑collect on Devery Restricted Delivery ❑Signature Conf(rmationTm 1 3 9 7 5 0 -insured 1 Ire Mail a��I Restricted Delivery ❑Signature Confirmation Restricted Delivery PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt USPS TRACKING# First.-Class Mail Postage&Fees Paid USPS Permit No.G-10 9590 9402 2762 6351 2526 98 I I United States •Sender:Please print your name,address,and ZIP+4®in this box* Postal Service I I Keith C.Gilmore Enterprises,L.L.C. P.O.Box 17,Centerville,Ma 02632 I I I 1 f. . . '1Fr Ifltllti it i'f�t i ! ' �17 f t i 1' '�i��111��1Flil Mild III-ill,.'llilill jljt+.�fttfIi...FF. COMPLETE •N COMPLETE THIS SECTIONON DELIVERY ■ complete items 1,2,and 3. a Signal: I a Print your name and address on the reverse X p Arid ssee eq so that we can return the card to you. n Attach#his card 0 the 049K of the maiipiece, B. Rece by(Printed Name) C. to of eli�i 1• Y 4D. Is delivery address different from item 1 Y s Town of Barnstable If YES,enter delivery address below: �p o Property ID# 126004 1 367 Main Street �\\� �0� Hyannis, MA 02601 4 N 3. Service Type ❑Priority Mail Express® I I IIIIlI I'll 111 l 111 l�llll l lily 111 l ll l 11 ll l lll� ❑Adult Signature ❑Registered Mail"" I IQAdulE Signature Restricted Delivery ❑RealstetedMa l Restricted Mal1 9590 9402 2762 6351 2526 74 O Certifled Mail Restricted Delivery ❑a®tPPum Receipt for 1 ❑Collect on Delivery Merchandise 2, Adieiu.lUumhnr_/Tronefar n r a:o,.r.,..-livery Restricted Delivery ❑Signature Confirmation^" 7 016 0 910 0001 3975 2854 i ❑Signature Confirmation Restricted Delivery Restricted Delivery BPS Form 3811,July 2015 PSN 7530-02-000-9053 s� Domestic Return Receipt USPS TRACKING# First-Class Mail Posthge&Fees Paid USPS Permit No.G-10 9590 9402 R&N'`t51 2526 74 I I United States •Sender:Please print your name,address,and ZI P+4®in this box• Postal Service I Keith C.Gilmore Enterprises,L.L.C. I P.O.Box 17,Centerville,Ma 02632 • • 0MPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3. A.S idi ��/]�■ Print your name and address on the reverse X ��W` l�Agent so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, Receivedr b�y(Printed ,Na��m1 e)) C. Date of Delivery j D. is delivery address different from item 17 ❑Yes If YES,enter delivery address below: [3 No Dawn Colton Mund 1380 Cisterville Road West Barnstable, MA 02668 , 4 3. Service Type ❑Priority Mail Express® III I I I I'I I I�) I"I I III I III I I I I�I II II(I II I ❑Adult Signature ❑Registered Mal AduR Signature Restricted Delivery [3Re8gglstered Mall Restricted rtified Mail® DeUvery 9590 9402 2762 6351 2526 81 - certified Mall ResWMd Delivery ❑Retum Receipt for ❑Collect on Delivery Merchandise —sat on Delivery Restricted Delivery ❑SignatureConfim�atlonTm 7 016( p 91010 0 01 if 3 9 7 S :2&4 7 i 1• €1 red Mail ❑Signature Confirmation 3 .,, ,,t r i., . a+ + Mail Restricted Delivery Restricted Delivery over$500 PS Form 3811,July 2015 PSN 7530702-000-9053 Domestic Return Receipt USPS TRACKING# s§Mall+` ;8i°Fee�Paid 9590 9402 2762 6351 2526 81 United States •sender:Please print your name,address,and ZIP+4®in this box• Postal Service Keith C.Gilmore Enterprises,L.L.C... P.O.Box 17,Centerville,Ma 02632 I F�i�FA.�IJFF��i'FF�ai�'}llift!}I�:ftll�rJjl�F"iJ7JrFJ{ i�J��{f�f�FFt �'� i _a G rq �. • RJ WES Ain PS �SJE 17 d . r- Certified Mail Fee Q- $ $3.35 (0 s5 m extra ervices&Fees(check box,add fee ate) � ElReReturnReceipt(hardcoP» $ Ii � •� r ❑Return Receipt(electronic) $ $Q i)(j QQ piAmark C3 ❑Certified Mail Restricted Delivery $ ( r�i(� G Wre 'Q ❑Adult Signature Required $ [:]Adult Signature Restricted Delivery$ $ostage $0.44 0 Total Postage and$F�s,. �r 06/1 , .17 k" $ Sent To r9 -! P3 - ------ - Sireel d�pDo.,orP YgxxxjN�o:/ /------/( x City, to ,Zl 4® J S ! � """"" ------�b�-�------ Q, Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailpiece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipient's retail associate. signature)that is retained by the Postal Service- Restricted delivery service,which provides r for a specked period. v t';t y Idelivery to fhe'addreSsee spetifi or to the addressee's abihbhzed agent Important Reminders: Adult signature service,which requires the ■You may purchase Cerfified Mail service with signee to beat least 21 years of age(not First-Class'Mail®,First-Class Package Service®; ^ available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service is notavallable for t-'!-i E i,l requires the signee to be at least 21 years of International mail. tit-t.!t° and provides delivery to the addressee spec fi de ■Insurance coverage is not available for purchase,1-t k by name,or to the addressee's authorized agent with Certified Mail service.However,the purchase 1�� (not available at retail). of Certified Mail service does not change the :. 'i To ensure that your Certified Mail receipt is Insurance coverage automatically included with accepted as legal proof of mailing,it should bear a certain Priority Mail items. ;�' USPS postmark If you•would like a postmark on ■For an additional fee,,and with a proper this Certified Mail receipt,please present your endorsement on the mailpiece,you may request Certified Mail item at a Post Office-for the following services: postmarkinglf'you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion of delivery(including the recipient's signature), of this label,affix it to the mailpiece,apply You can request a hardcopy return receipt or an appropriate postage,and deposit the mailpiece. electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt-attach PS Form 3811 to your mailpiece; IMPORTANT:Save this recelpt for your records. PS Form 3800,April 2015(Reverie)PSN 7530-02-000.9047 1-7 or,THE rqk, DATE; 3 I FEE; 1 + BAANSrABLE, v 1 `0� REC.BY• tl� S�- �prF°'��° Town of Barnstable �A SCHED.DATE: 0 Board of Health 200 Main Street, Hyannis MA 02601 � Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Junichi Sawayanagi Donald A.Guadagnoli,M.D. Alternate:Cecile Sullivan,RN,MSN VARIANCE REQUEST FORM LOCATION i ]_- �J],/ �,{/� Q Property Address: /�j tp0 0s4&r l-L W a+ �,r�siL�(� � A�)'`S7 J S /'`'��St MA Assessor's Map and Parcel Number: Size of Lot: -5-7 Wetlands Within 300 Ft. Yes Business Name: No_-t�r_ Subdivision Name: APPLICANT'S NAME: 4kil, G I"Oj-c Phone S i5 ` Uot- - Up a!o Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME l CONTACT PERSON I Name: Tk_P� C l ar 1 S� �t I+ t,OS Name: Address: 13(GO Address: PC) $Dx 17 C t" 'V- ttit.R- S Al -6 J C4�*D- O Z {0 3 Z Phone: G60 • to 61 ' 0(D0-0 Phone: sQA - 362, -06 b& EMAIL: ,l von" Ae-64 .V`00 i r2 cCrke ts'-"-"VC VARIANCE FROM REGULATION(List Reg.) REASON FOR V 1ANCE(May attach if more space needed) 6�C/•O NATURE OF WORK: House Addition House Renovation Repair of Failed Septic System 0 Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in S separate,collated packets. Five(5)copies of the completed variance request tone Five(5)copies of cnginccrcd plan submitted(e.g,septic system plans) F ve(5)copies of MA DEP approval letter for I/A septic systems only. Fwc(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for 'Fitle V and/or local sewage regulation variances only) FLII menu—Five(5)copies of fullmenu submitted(for grease trap variance requests only). S95.00 variance request application fee collected (No fee for lifeguard modification renewals , grease trap variance renewals [same owner/lessee only),outside dining variance renewals[same owner/lessee only),and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Voriance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Donald A.Guadagnoli,M.D. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BMQD49H2\VARIREQ Rev APR2017.DOC ti O NSl 08x's gp.R N Z,49 25 E �'� Exlst GA ti MAP 126 2 PCL. 6 F O xx �6, titi ro 0. QPROPOSr ADDITION LOT 2 52,119t S.F. (1.20t AC.) S sg. 1g44,W MAP 126 PCL. 8 i MAP 126 PCL. 29 I I SEPTIC LOCATION IS AN APPROXIMATE LOCATION MAP 126 AND BASED ON BOARD OF HEALTH AS-BUILT PCL. 9-2 RECORDS. SITE PLAN LOCUS :1360 OSTERVIILE WEST BARNSTABLE ROAD BARNSTABLE (MARSTONS MILLS), MA REF LAND COURT PLAN #12034-8 PLAN PREPARED FOR JEFFREY & CARISA PHILLIPS DATE REG. LAND SURVEYOR SCALE : 1"=60' DATE : 6/10/2017 D EMAR EST LAND SURVEYING ASSESSORS MAP: 126 PARCEL 07 338 MAYFAIR ROAD SOUTH DENNIS, MA 508-364-9049 FILE=17088.DWG 22'-0' New Both (0 t. New Bed 16'-0' W/D New CLIJ New CL e ve oor Remove Window C_L Existing Family Room CL Exisfing Bed Existing Dining Room Existing Office Existing_ Kitchen 51air Bath — Ba�h Phillips Residence Existing Den 1360 oste W. Barnstable Rd. Existing Bed Marstons Mills, MA CL I I Foxer I JUL ProlDosed New Bedroom Addition EXCERPT FROM THE BOARD OF HEALTH MEETING MINUTES ON JULY 25, 2017: A. 'Keith Gilmore, Gilmore Enterprises, representing Jeffrey & Carisa Phillips, owners — 1360 Osterville West Barnstable Road, Marstons Mills, Map/Parcel 126-007, . 1.20 acre lot, proposed additional, setback to leach field variance request. GRANTED. The Board voted to grant, without conditions, the variance and reminded applicant that if they do need to move the pipe running through addition, a permit will be required to be taken out. S l l f or,I Et DATE; W I FEE; It ~ ri • _ PO i BARNSTABLE, • 4,J MASS. l/ 4C6p 1e39• `0� REC.BY• V ' Town of Barnstable �! SCHED.DATE -X: ram:, Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Junichi Sawayanagi Donald A.Guadagnoli,M.D. Alternate:Cecile Sullivan,RN,MSN VARIANCE REQUEST FORM LOCATION I ' Property Address: Sr yiff - Wits+ ��L��l _ 7 I'(1d•Y`Sf��S /t`+t�/I�� i"ll� / �O Assessor's Map and Parcel Number. Size of Lot: ✓—2 )!9 S&P+ ( )-Z e 4C Wetlands Within 300 Ft. Yes Business Name: No_eT Subdivision Name: �CQ t \APPLICANT'S NAME: , G! "O rc Phone 501 3�0 Z ' 66 A Did the owner of the property authorize you to represent him or her? Yes -X— No PROPERTY OWNER'S NAME CONTACT PERSON Name:. p A I 1�GL �(� Name: r-2_ Address: (3(DO 05t• W. Address: p gVx -7 nti I+-� S Itil 6 f. O`Z U 3 e Phone: OS to 61 S to 0V Phone: 5- EMAIL: .9 i) i re 5 Q CtfLytCW'� VARIANCE FROM REGULATION(List Reg.) REASON FOR V IANCE(May attach if more space needed) NATURE OF WORE: House AdditionX House Renovation LJ Repair of Failed Septic System Lj Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in S separate, collated packets. Five(5)topics of the completed variance request form Five(5)copies of engineered plan submitted(e.g.septic system plans) Five(5)copies of MA DEP approval letter for I/A septic systems only. Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) _ A completed seven(7)page checklist confirming review of engineered septic system plan by submitting'engineer or registered sanitarian Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified snail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) _ Full menu-Five(5)copies of full menu submitted(for grease trap variance requests only). $95.00 variance request application fee collected (No fee for lifeguard modification renewals , grease trap variance renewals Isar owner/lessee only],outside dining variance renewals[same owner/lessee only],and variances to repair failed sewage disposal systems[only if no' expansion to the building proposedl) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPF-OVED Junichi Sawayanagi REASON FOR DISAPPROVAL Donald A.Guadagnoli.M.D. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BMQD49H2\VARIREQ Rev APR2017.DOC le I RNS�P��E �p511 ,�� EX15Z Q,\v °rye MAP 126 Z PCL. 6 O24, xx c' h PROPOSED �!9 ADDITION LOT 2 r 52,119 t S.F. (1.20t AC.) S 66 lg 44 w MAP 126 PCL. 8 I . IMAP 126 PCL. 29 I SEPTIC LOCATION IS AN .APPROXIMATE LOCATION9-2 AND BASED ON BOARD OF HEALTH AS—BUILT PCL MAP 12 126 6 RECORDS_ S ITE PLAN LOCUS :1360 OSTERVIILE WEST BARNSTABLE ROAD BARNSTABLE (MARSTONS MILLS), MA REF LAND COURT PLAN #12034=8 PLAN PREPARED FOR JEFFREY & CARISA PHILLIPS DATE REG. LAND SURVEYOR SCALE 1"=60' DATE 6/10/2017 DEMAREST LAND SURVEYING ASSESSORS MAP: 126 PARCEL 07 338 MAYFAIR ROAD SOUTH DENNIS, MA LILE=!70B3.DWG 508-364-9049 22'-0' New Bath (Opt. J New Bed W/D New CLIlNew CL CL Remove Window CL Existing Family Room CL Existing Bed Existing Dining Room Existing Office Existina Kitchen 02 Sfair ILI Bath — Bafh Phillips' Residence Existing Den 1360 Osfo We Barnsfable Rd. Existing Bed Marsfons Mil MA jjQ_L_jj;l4oejrR;;�, Proposed New. Bedroom Addition 4 At Propoat Keith C. Gilmore Enterprises, LL,C HIC #134443 P.O. Box 17, Centerville, MA 02632 MA CSL 998047 Phone: 508-420-9934 rya Fax: 508-420-9935 Date: 5-15-17 C> Project#PH108 Client Name: Jeff& Carisa Phillips Phone#508-681-8600 Billing Address: 1360 Ost.WestBarn.Rd, Marstons Mills,MA02668 Alt.4774-487-2175 Fax# Uri Project Address: Same as billing Email :jeffphillips@capecod.com Project Description: Design, permit and construct a new 22'x 16' rear addition on the home. Construction to include excavation, full height foundation, Bilco ultra series bulkhead basement access, 2x6 wall construction, framing to meet existing floor heights and roof pitch, batt style insulation, plaster wall and ceiling finish, primed interior trims, pine interior doors, Harvey vinyl windows to match existing including new nursery boxed frame mull1ion window, removal of kitchen dutch door and relocation of kitchen french door, vinyl siding and roofing to match existing, pvc exterior trim, laminate flooring, relocation of laundry to new addition, electrical and plumbing hvac to code, painting of exterior trim, interior ceiling, walls and trim with one top coat latex, and door hardware to match existing. Client responsible for site engineering cost and any upgrades to project scope once final design and subcontractor bids are obtained. Client will pay subcontractors directly. Project Task Items: In house design, permitting, labor, materials and waste total. $ 57,132.00 Excavation subcontractor preliminary budget total. $ 4,492.00 Foundation subcontractor preliminary budget total. $ 6,890.00 Insulation subcontractor preliminary budget total. $ 2,662.00 Plaster subcontractor preliminary budget total. $ 5,590.00 Plumbing hvac subcontractor preliminary budget total. $ 7,162.00 Electrical subcontractor preliminary budget total. $ 6,616.00 Total $ 90,544.00 Initials rid NOTICE OF CONTRACT Notice is hereby given that by virtue of this contract dated 5-15-17 between Jeff& Carisa Phillips of 1360 Ost.WestBarn.Rd, Marstons Mills, MA 02668 Customer-Homeowner(s) Residential address of Customer And Keith Gilmore Enterprises of: P.O. Box 17,Centerville, MA,02632 Contractor Address of Contractor's business Said contractor agrees to furnish or has furnished labor and/or materials for the erection, alteration, repair or removal of a building, structure, or other improvement on a lot of land or other interest in real property described on the previous estimate page [s] of this proposal. Said work to be performed in a timely and workmanlike manner on or before the Summer-Fall Season 2017 at the property located at: — LEGAL DESCRIPTION OF THE PROPERTY 1360 Os .Westbarn. Road Marstons Mills MA 02668 Properly address including street number Town State Zip "Note: material availability, weather conditions,and permitting may affect scheduling and some delays are unavoidable. We will do our best to schedule work as conveniently as possible. Owner is responsible for moving all personal objects,furniture,fixtures,and other similar objects from work area. All items on or against walls should be considered for removal during any exterior and/or siding work to guard against damage. In the case of any roofing and/or ridge venting,dust and debris should be expected and any items in the attic should be removed and/or covered. Keith C. Gilmore Enterprises is NOT responsible for any damages if said items remain in place. In the event of rot repairs, roof repairs,or any related work requiring immediate attention,we will proceed without customer approval or when appropriate,with verbal authorization. Curtains,drapes,and window&door treatments may need special removal, reinstallation,or replacement by customer due to sizing on door and window replacements. This is NOT included in this proposal. Keith C. Gilmore Enterprises is NOT responsible for any damages that may occur during construction to landscaping or any finish ground work, plantings,asphalt or stone driveway,etc, Flowers and shrubs against house may need to be repaired or replaced by homeowner. Any alteration or deviation from specifications contained in this proposal involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate except as specified above. All agreements are contingent upon strikes,accidents,and/or delays beyond our control.Owner agrees to carry fire, tornado,homeowners, liability,and other necessary insurance for the work,and owner's property. The Customer states that they are the legal owner of the property described above or acting for, on behalf of,or with the consent said owner. Pagel of? Initials f JE = PAYMENT TERMS t The amount or est_mated amount of said contract is $90,544.00. Customer agrees to pay the Contractor according to the following terms: $ 4,564.00 Due at scheduling $ 4,564.00 Due at issue of permit $46,004.00 Due in weekly installments during production $ 2,000.00 Due at completion $33,412.00 to be paid out directly by client to subcontractors Description of payment terms All work will cease und--r this contract if payments are not made pursuant to the terms described herein. Workmanship issues must be documented by the Customer, in writing,to the Contractor within fourteen(14)days that Homeowner knew or should;have known. There will be no refund for special-order materials and/or any other non-stocked items after three days from approved proposal. Any other refunds shall be calculated and/or determined by Keith Gilmore Enterprises. The Contractor retains aCl legal remedies available if the Customer fails to pay including the recording of a mechanic's lien on the property pursuant to M.G.L.254,§ 5 to secure the payment of all labor, including construction management and general contractor services and materials, including those furnished by Keith Gilmore Enterprises. Customer guaranties the t e payment of all sums owed to the Contractor. Customer understands that an deb � PY Y to Contractor over 30 days past due is subject to a 1'/%finance charge per month (APR 18%). Customer agrees to pay all legal fees and costs incurred in the collection of any money owed to Contractor. Customer acknowledges that Keith Gilmore Enterprises has a reasonable expectation of payment from the Customer for any materials furnished by Keith Gilmore Enterprises as part of this project between the Customer and Contractor notwithstanding any payments to or disputes with the Contractor. This Notice of Contract is to be construed and interpreted according to the laws of the Commonwealth of Massachusetts. The undersigned acknowledge that they have read and understood all of the enclosed terms and that their signatures appear freely and voluntarily below: 1 fifl orized Agent* Date ontrac or ate Page 2 of 2 Initials_S�p 'x TOWN OF BARNSTABLE LOCATION /�� D�---� �o- - SEWAGE-# VILLAGE ?A✓�� //" 14 ASSESSOR'S MAP & LOT /o��—�� &PHONE NO. . Oa7l�iJ `l? I"br+pc SEPTIC TANK CAPACITY y LEACHING FACILITY: (type) o� (size) NO.OF BEDROOMS O;?, OWNER ,:::a— � PERMITDATE: 4`COMPLIANCE DATE: �y S� Separation Distance Between the: Maximum Adjusted Groundwater Thbie 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 ¢ TO OF BARNSTABLE LOCATION 3� W 4/1 SEWAGE # VILLAGE-M. Mt �S ASSESSOR'S MAP & LOT 007 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY oto — uJi ex) LEACHING FACILITY: (type) A7- (sizee. NO.OF BEDROOMS BUILDER OR OWNER PERMTTDATE: 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 l g facility) Feet Furnished by S eachi on �� TO " V JA a, A a I ay aa3a-I 4a 3 3 too �y �z COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION REECE'IVrD APR 12 2005 TITLE 5 TOWN OF BARNSI,' F HEALTH DEP-1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 1360 Osterville-W. Barnstable Rd Marston Mills. MA 02648 �C C , Owner's Name: Faith Nicholas -•� --M Owner's Address: Date of Inspection: March 30, 2005 FAILED INSPECTION Name of Inspector: (Please Print) James M.Ford Company Name: James M. Ford Mailing Address: P.O.Box 49 Ostervft MA 02655-0049 Telephone Number: (508)862-9400 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: Passes Conditionally Passes Needs Further Evaluation by the Local Approving Authority ✓ Fails Inspector's Signature: Date: Anril3. 2005 The system inspector shall sub i 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 DER The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page I Page 2 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1360 Osterville-W. Barnstable Rd Marston Mills. MA Owner: Faith Nicholas. Date of Inspection: March 30, 2005 Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. System Passes: I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below. Comments: 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. Answer yes,no or not determined(Y,N,ND)in the 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 existina tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage l:ackup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if (with approval of Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): broken pipe(s)are replaced obstruction is removed ND explain: 2 Ili Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1360 Osterville-W. Barnstable Rd. Marstons Mills. MA Owner: Faith Nicholas Date of Inspection: March 30, 2005 C. Further Evaluation is Required by the Board of Health: Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health,safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: 3 Page 4 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: 1360 Osterville-W.Barnstable Rd. Marston Mills. MA Owner: Faith Nicholas Date of Inspection: March 30, 2005 D. System Failure Criteria applicable to all systems: You must indicate either"yes"or"no"to each of the following for all inspections: Yes No ✓ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ✓ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _. ✓ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ✓ Liquid depth in cesspool is less than 6"below invert or available volume is less than '/2 day 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. ✓ 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.coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form.] NOTE:Further failure criteria-single cesspools automatically fail in tl:e Town of Barnstable. Yes (Yes/No)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 System: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large systems in addition to the criteria above) Yes No the system is within 400 feet of a surface drinking water supply the system is within 200 feet of a tributary to a surface drinking water supply the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area-IWPA)or a mapped Zone II of a public water supply well If you have answered"yes"to any question in Section E the system is considered a significant threat,or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 4 I I Page 5 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Property Address: 1360 Osterville-W. Barnstable Rd. Marston Mills. MA Owner: Faith Nicholas Date of Inspection: March 30, 2005 Check if the following have been done: You must indicate"yes"or"no"as to each of the following: Yes No Pumping information was provided by the owner,occupant,or Board of Health ✓ Were any of the system components pumped out in the previous two weeks? ✓ _ Has the system received normal flows in the previous two week period? Have large volumes of water been introduced to the system recently or as part of this inspection? Were as built plans of the system obtained and examined?(If they were not available note as 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: Yes No Existing information. For example,a plan at the Board of Health. v' Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(3)(b)]. 5 Page 6 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 1360 Osterville-W. Barnstable Rd. Marstons Mills. MA Owner: Faith Nicholas Date of Inspection: March 30, 2005 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): 2 Number of bedrooms(actual): 2 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 220 Number of current residents: 2 Does residence have a garbage grinder(yes or no): No Is laundry on a separate sewage system(yes or no): n/a [if yes separate inspection required] Laundry system inspected(yes or no): No Seasonal use(yes or no): 14o Water meter readings,if available(last 2 years usage(gpd)): Unavailable Sump Pump(yes or no): No Last date of occupancy: Currently occupied COl1EVIERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): —_____gpd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no) Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Pumped in November 2004-per owner Was system pumped as part of the inspection(yes or no): No If yes,volume pumped: _jallons--How was quantity pumped determined? Reason for pumping: TYPE OF SYSTEM ✓ Septic tank,distribution box,soil absorption system ✓ Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records, if any) Innovative/Alternative to-.hnology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) Tight Tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and source of information: Septic tank installed on 8120182-per as built card Were sewage odors detected when arriving at the site(yes or no): No 6 Page 7 of I I OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1360 Osterville-W. Barnstable Rd Marstons Mills,MA Owner: Faith Nicholas Date of Inspection: March 30, 2005 BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: _cast iron 40 PVC _other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK: ✓ (locate on site plan) Depth below grade: 24" Material of construction: ✓ concrete _metal _fiberglass _polyethylene other(explain) If tank is metal list age: Is age confirmed by a Certificate of Compliance(yes or no): (attach a copy of certificate) Dimensions: 1000 gal. Sludge depth: 2" Distance from top of sludge to bottom of outlet tee or baffle: 30" Scum thickness: 2" Distance from top of scum to top of outlet tee or baffle: 6" Distance from bottom of scum to bottom of outlet tee or baffle: 10" How were dimensions determined: Measurinz stick Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity, liquid levels as related to outlet invert,evidence of leakage,etc.): Tees were present. The liquid level was even with the outlet invert There did not appear to be any signs of leakage The inlet cover was 2"below Qrade. GREASE TRAP: None (locate on site plan) Depth below grade: 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: Comments(on pumping recommendations,inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): 7 e Page 8 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1360 Osterville-W. Barnstable Rd Marstons Mills. MA Owner: Faith Nicholas Date of Inspection: March 30, 2005 TIGHT or HOLDING TANK: None (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/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping: Comments(condition of alarm and float switches,etc.): DISTRIBUTION BOX: Alone (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc.): PUMP CHAMBER: None (locate on site plan) Pumps in working order(yes or no): Alarm:.in working order(yes or no) Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 8 II Page 9 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1360 Osterville-W. Barnstable Rd Marston Mills. MA Owner: Faith Nicholas Date of Inspection: March 30, 2005 SOIL ABSORPTION SYSTEM(SAS): ✓ (locate on site plan,excavation not required) If SAS not located explain why: Type ✓ leaching pits,number: 1 -6'x 6'(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: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): The inlet pipe was at the 4'level. There was 4'ofliauid up to the bottom of the pipe The nit showed signs ofhydraulic failure The bottom to Qrade was 96". The cover was 6"below Qrade CESSPOOLS: ✓ (cesspool must be pumped as part of inspection)(locate on site plan) Number and configuration: 1 -6'x 6'leach pit Depth-top of liquid to inlet invert: -- Depth of solids layer: -- Depth of scum layer: -- Dimensions of cesspool: -- Materials of construction: Indication of groundwater inflow(yes or no): -- Conur_ents (note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): This_p,it serves a bathroom. Liquid in the pit was up to the cover and breaking out to the ground The pit was in hydraulic failure PRIVY: None (locate on site plan) Materials of construction: Dimens ions: Depth of solids: Comments(note condition of soil.signs of hydraulic failure,level of ponding,condition of vegetation,etc.): 9 Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1360 Osterville-W. Barnstable Rd Marston Mills. MA Owner: Faith Nicholas Date of Inspection: March 30. 2005 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch 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. . O a V JA A 4 ! 1 ae ay a a3 a O a 3 10 Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 1360 Osterville-W. Barnstable Rd. Marston Mills. MA Owner: Faith Nicholas Date of Inspection: March 30, 2005 SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water 30+/- feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) ✓ Checked with local Board of Health-explain: topogrgphic and water contours maps Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high ground water elevation: Using Barnstable topographic maps and water contours map, the maps were showing approximately 30'+1-to ground water at this site. This report has been prepared and the system inspected and failed as of the date of inspection. This report is not a warranty or guarantee that the system will function properly in the future. There have been no warranties or guarantees, either expressed, written or implied,relating to the system, the inspection and/or this report. 11 _ Town of Barnstable � OHE} � ti Regulatory Services Thomas F. Geiler, Director I'.• BARNSTABLE, \\MASS. � Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer & Designer Certification Form Date: AUG. a•OOS Designer: STEiSou qA« Installer: i-vc<<`(e�c��", sits' Address: o�g �f��BLrz2 Inc Address: $'Z �ton;� St'_ On vc / - '2000 316C e f la,ec�t/fJ was issued a permit to install a (date) — (installer) / �'0-005'3�oZ ;'ltic systern at 1360 OS% Gcl. Hr�l�Y•. i�_based on a design drawn by (address) dated J V�� oZ 0O� ✓' ��0 ( esigner) certify that the septic system referenced above was installed substantially according to ---- O ateral relocation of the the design which may include minor approved changes such as.lateral distribution box and/or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. greater.than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. 'MOF IL ,(InstWSigna NAIL, E1tA�1��0* t e -- — (Affix Desr� tamp Here.) -- PLEASE SSE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF' COMPLIANCE WIT;L NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- B-UILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH. DIVISION. THANK YOU. Q: Flealth/Septic/DesiJner Certification Form TOWN OF BARNSTABLE LOCA,rIUN 13L�0 OSr-Ar-019QM AZAQ SEWAGE #,60S 3 M N .L�:GE ,1?A�f/off J'Ii1 ASSESSOR'S MAP & LOT 1-21-607 INSTALLER'S NAME&PHONE N0. �• a-iC- SEPTIC TANK CAPACITY 006,g� kS /oao6A� F,c�,i,�,i6., LEACHING FACILITY: (type) 500 6PJ l• CffiM J 6) (size) 13 5. NO.OF BEDROOMS 3 ,/W61 BUILDER OROWNER /fJii'J �l 1S PERMIT DATE:o �- 3-0- - ' 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 306 feet of leaching facility) Feet Furnished by A Of r ' Jo? 7 ^ y4 iao�y" a a� y3 a�� No. rM�� Fee THE C 0 LtAASSACHUs i i.�a. - Entered in computer: ,r Yes PUBLIC HEALTH DIVI:S10 OF BARNSTAB.LE,MASSACHUSETTS ZIppYication for Zig;pogar &VOtem Conotruction Permit Application.for a Permit to Construct(/ )Repair({/Upgrade( )Abandon( ) O Complete System O Individual.Components . Location Address or Lot No. ' 0 0 5-Ter v►l c Lo B" Owner's Name;Addces and Tel.No. G 1=a-" lit�c�-JCL 5 ,�// v�p Assessor's Map/Parcel t 3 p ®S i-UJ e�f32�t_IcDt Installer's Name,Address and Tel No. Designer's Name,Address and:Tel.No. �.�C.bT�� - �� c ke 0a65' Type of Building: Dwelling No.of Bedrooms_ Lot Size AC Garbage Grinder( r� Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow :330 gallons per day. Calculated daily flow --gallons. Plan Date J\1 e- QLQ.AIMS Number of sheets Revision Date Title Size of Septic Tank I1000 6PA, EA VKI—i Type of .A.S. 69 ec, - 5 6q6 T�600O Description of Soil r Ak Nature of Rep 'rs or Alterations(An�wer when applicable) D lo `-% `l �.M �F".�e iil�ti Cesf ool � Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with.the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issu by this Board of alt . Signed Date 1416— —� Application Approved by Date 's`0 Application Disapproved for following reasons Permit No. Gd.S .3-7 Date Issued } q Al No. 'r Sri �d t Fee 1 S= t ' irk^ 4 Entered in computer: i THE.CO MASSACHUi E i s t Yes _ PUBLIC #EALTH,D Ut:S1_0 F BARNSTABLEs MASSACHUSETTS Application for Mi5pogal *p5tem Conotructiott. Permit .. p --.Y Application for a Permit to Construct( )Repair( grade( )Abandon( ) ,❑Complete System ❑Individual Components Location Address or Lot No. ! 0 O�T is C v i 1 tc kj�t Owner's Name,Address and Tel.No. ,�1 M�9�57bns f`s`11.5_ Fa, 1`1.c�,v1�s 508 Assessor's Map/Parcel - r t 3 "a I'm Inn a�- 5sa Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size e I �sq Garbage Grinder( YID Other Type of Building No.of Persons Showers( ) Cafeteria( ) .,,,-'Other Fixtures Design Flow_�3�'� gallons per day. Calculated daily flow -gallons. P1an�Date '=gt, me a Number of sheets ` J Revision Date Title Size of Septic Tank Type of S. .S. 6_, 6 KAl �r^,�c �c/ew-lS 6A Ta be Aooc� Description of Soil 4'r Arm 0 6a -- v r ' Nature of Repairs or Alterations(Answer when applicable) s,9, .S-000A1 fir) WC/h - 41 of/YJ a AM, P Fv ci 1; oonr Q�,/ 3~'��T�►z� �'�P �� e- Cc-3l 001 .a Date last inspected: k., Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with,the provisions of Title 5 of the Environmental Code and'not'to place the system in'operation until a Certifi- cate of Compliance has..been issue by this Board of Heaylth. Signed i Date .4611. L-0- - Application.Approved by ' - e- ' Date �"/`o Application Disapproyed for t dfollowing reasons Permit No. orl-s— Date Issued X- tf - _---_---------- --------------------- / _ - - -. _ 3 THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS ; Certificate of Compliance , THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( AKpgraded( ) Abandoned( )by I Hot Ur Can at_ _ 3 Lo 0Sr-i•�- j 1�s$4 �� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. goo C:3 dated Installer 'sTe_%` Designer tSTe'[c�ex H t�1 —� The issuance of this permit shall not be const ued as a guarantee that the;ytetn-wirt Ups designed. Date Inspector No. Gu r 7-2 Fee d� THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mig;pogal bpmem Construction Permit Permission is hereby granted to Construct( )Repair rpgrade )A andon ( ) System located at 1 0 tnS t- Lv. PA. 10 t�S 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 b -co pleted within three years of the date of thi -p�rmit� Date: / o Approved by �' o`er r 6 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out A. General Information forms on 2, computer,,use use 1. Inspector: �J only the tab key to move your Robert Paolini cursor-do not Name of Inspector use the return key. Capewide Enterprises,LLC. Company Name P.O.Box 763 Company Address Centerville Ma. 02632 City/Town State Zip Code (508)428-4028 S14454 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 15.340 of Title 5 (310 CMR 15.000).The system: 0 Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority i 6/17/2009 Inspector's Signa, re 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. LAJ t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 t Commonwealth of Massachusetts L W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments . M 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: The septic system is in proper working order at the present time. B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no"or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old*or the septic tank (whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 Commonwealth of Massachusetts L W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ Y ❑ N ❑ ND (Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND (Explain below): C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh t5ins-09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town 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 coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No" to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than Y2 day flow f t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every 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 coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] El ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area— IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 1360 Cist.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City(Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate "yes" or"no"as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as 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): 4 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 440 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town State Zip Code Date of Inspection D. System Information Description: The septic system consists of a 1000 and 1500 gallon septic tanks,distribution box and two 500 gallon drywells. Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d 2008:14,000 g ( y g (gp ))' 2009:10,000 Detail: Sump pump? ❑ Yes ® No Last date of occupancy: 6/17/2009 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 Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts L Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments GSM ,•�° 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner)and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts L Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 2005 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1' and 2'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.): Joints appear tight.No evidence of Ieakage.System vented through house and leaching field vents. Septic Tank(locate on site plan): Depth below grade: 1000-2' 1500-6" 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: 1000 and 1500 Sludge depth: 5" and 3" t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name• information is required for Marstons Mills Ma 02648 6/17/2009 every 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 27" and 30" Scum thickness 5" and 3" Distance from top of scum to top of outlet tee or baffle 3" and 5" Distance from bottom of scum to bottom of outlet tee or baffle 9" and 11" How were dimensions determined? Measured Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pump septic tanks every two years.lnlet and outlet tees are in place.No evidence of leakage.Tanks appear to be structurally sound. 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•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ;M 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert No Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Box is Ievel.Box has one outlet Iateral.No evidence of solids carryover.No evidence of leakage. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 3 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Sandy dry soil.No signs of hydraulic failure.Water level was 16" below invert at time of inspection with no stain line higher. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy(locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•09/08 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 y 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 ' every 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: i ❑ hand-sketch in the area below ❑ drawing attached separately IJU 15°4 A Aa �a A6 3- o V M'01 6 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Site Exam: ® Check Slope ® Surface water ® Check cellar ❑ Shallow wells Estimated depth to high ground water: Bottom of chambers 60' 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. 2005 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ® Checked with local Board of Health -explain: As-Built ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: USED:USGS Observation Well Data.USED:Technical Bulletin 92-0001 plate#2 annual ranges of groundwater elevations. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 o � . Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 1360 Ost.W.Barnstable Rd. Property Address John Hill Owner Owner's Name information is required for Marstons Mills Ma 02648 6/17/2009 every 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 t5ins-09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 17 of 17 V s5 LOCATION SEWAGE PERMIT NO. /-3 Io ' O&fi, - t j. '/9/�Al R M I L L A G E INSTA LLER'S NAME i ADDRESS 6UILDEIII OR wN 42.,9iV/l hf/C Z,-UG 19 S DATE PERMIT ISSUED �s 7 DAT E COMPLIANCE ISSUED . I. n � 00 .. I . ZVI . is No...8AR: .S 5 Fps... . a..- . THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ............_� ....................................... 1.c��....................................... Appliration for Diipn. al Works Tnntrnrtinn ramit Application is hereby made for a Permit to Construct ( ) or Repair (l�an Individual Sewage Disposal System at: -•� .• . .................................................................. ........----......--- ion ddr s •� rr ....., 1 ........ .. ........... -.... �. � _................ er .�,l�. �� . ..._......11 ----- ------ -------- ---•----•--- Installer Address Type of Building Size Lot.................... .....Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) `4 Other—Type T e of Building No. of � YP g --------•------•------------ persons............................ Showers ( ) — Cafeteria ( ) d Other fixtures ...... Design Flow...........................................:gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter-------7........ Depth................ x Disposal Trench—No..................... Width.................... Total Length...................:Total leaching area------.-------..----sq. ft. Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fs. Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ............................................... ••--•---••---•-.....--•---•------•--------------•---........................................................ 0 Description of Soil........................................................................................................................................................................ W U ---•.•---•----•-•---•-•.....•---•---••----•--•.....-•-----•••---------------•......----------•-•----------•-•-------•---••-••-••---......---••-------.................................................. W x ............................................................. -•••---•--•-•-------••-------•----••......------•. -----_� ............................. U Nature of Repairs or Alterations—Answer when applicable_..__._....`1�� .. _ �/,,e ............................. ----------------------------•----•---------••--------------•-----------------------•---.....---......------••---•-----------------------------•----------•----------.....----------.........------••---- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of .PI s:;�. 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued by the bo rd of health. Sign d.. Application Approved BY ....... .......& � L e ..................... Application Disapproved for the following reasons:..............................................................................................ate --------------- ------------------------------ -------------------- •------------------ ------- ---------- ------------------------------------------------------ •--------------------------------------- Date Permit No......................................................... Issued_._...... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH t � , Alip iration for Uispao tl Workii Tottatrnrtion rrntit Application is hereby made for a Permit to Construct ( ) or Repair (i- an Individual Sewage Disposal System at r 1 .....Z ......._ ..... w E.'c::.. .. :. .c...:�s:`.�..._r......4c:C.r.,....... .'j ......"................................................................... . . t Location Address.. -or Lot NoNo _f .............�j. .�rS'./.....,.t� Ze l...t.,.ltf -�:� ............�..r..:!.6> �....._. fi r', .�a:.fn�...e -...._. a •--- `..�: ,��'� ��S,.1�`f �..J*l �1� .. `. 'a: r �.:." ��5'�.:. ..............................yAd . s ......................................... ' dres Installer Address Type of Building Size Lot.................... ......Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) Wa Other—T e of Building _...._..... No. of persons............................ Showers YP g -------•-----•-•- P ( ) Cafeteria .( ). Other fixtures ..................................................... ..... ---•-•--------------------•------------------- .. WDesign Flow............................................gallons per person per day. Total daily flow----.---.--.--.-_--.-_....................gallons. W . ' Septic Tank—Liquid capacity............gallons Length-............... Width................ Diameter................ Depth................ x Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 3 Seepage Pit No_____________________ Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by..............................................................--•-•-.--•-- Date.....-.................................. Test Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................ 44 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ P ---------------------------------------------•---------....-----.....---....----•-•...........--•--•............-............................................ 0 Description of Soil..................................... U . -•-••------•---•--......---••...:..........•---•---.....••••••--•--:_.....--•--•---•--•-•--------•---...----•...--•---•------••------•----------------•----••••----------••-•-•-................------. W VNature of Repairs or Alterations—Answer when applicable......... .__ ..j_.._.: { /%�'�'��"r - ----------------------------•--•----------...-----------•--•--...•--------•--•-----............-------••--•-----------...-------------------•---------•---------•--------------•--•----------••-.....-- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iTIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has beep issued by the board of health ; .......................... .. Application Approved BY f -• G.=...r. ' :�:_, -�J� ............................ / a � ate Application Disapproved for the following reasons:..................... .. , r - ............___._............_......_...._.._._.__......__ ...............................••------•-.....----•-•-•------...---------...-----•------•--•-••-----......--------------•------------------------------------------------••--•--...••------•----•---•.... Date PermitNo.....................:..•---•-----------.....---•••------ Issued.......-................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ,r.................... .....'.�:........: .................................................... (Irrtifiratp of Tputpliatta THIS IS.TO CERTIFY, That the Individual Sewage, Disposal System constructed ( ) or Repaired ( '.--)• by .s :.._1 .. _:�.d _' .: tit .. . a...............}:✓t✓..... f� C i. .� t� jl 4 r i Installer ; � �1`---r. at _...�.......-...................... .... .. ........ ......e._ ......._ ..____... ._.___. ........................................................... _.._.A_...�_ has been installed in accordatce with the provisions of TILE 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.....JFZ.... ........... dated................................................ THE' ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. Y...SFACTORY. DATE. -.! �� --.......... Inspector............ , ........................................ THE COMMONWEALTH OF MASSACHUSETTS BOARD gg O�F" .✓HEALTH ��ASS . ..........OF.... V. ..._.. r. ... * ..°.... . � ~ No.. A................ \ FEE........`................ Mquisal Nimbi (9onstt~l rtwtt , rrmff � J �'"P �� d.+=sAy)�» 7 �V t I Permission is hereby granted...... :. _ .. `.. + .1 ` ' �'.� I ... .... .....Y........................ 1/ ....... - to Construct ( }) or Repair ( ) an Individual Sewage Disposal System at NO .�� 1 �` r 1/ i, ..................•... Street r as shown on the application for Disposal Works Construction Permit No..................... Dated....._._...____..._._........_...:........ �''-------------------• ---------- • j' --- !Board of Health DATE = c f i..f ........................ ..... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS y ICI Li *Remove Door For New Frame CL *Remove Door For New Frame *Eliminate Window CL p CL Living Room Bedroom Din i n Room W *Remove Window For New Frame CL Li Kitchen Pantry Office o Don CL Bath Fridge CL Q ----- DW Range- o_ Bath c0 III o CL o o Den x s 1 Foorocln 8 ' Demo Hotes scale 1 f 4"=1'0" Bedroom CL Foyer CL I ---- ---- -- -- -- --- ---- -- ----- • Client: Pro ject: Revisions: Date: - - PageKeith C. Gilmore Enterprises LLC C Jeff 8 Carisa PhllliMaster Bedroom 8 13 17 (OO P.03ox 17 Centerville, MA 02632 1360 Ost. V.5arnsta' ble Rd. Addition AD/ P: 508-420-9934 F= 508-420-9935 MarstOns MI Its MA Drawn By: lfe,4 ,� gV1.. vte E= gilmoreenterprisesocomcast.net 02648 , „ These desig ied Scale: 1/4 ns are not to be modified or cop-_1w� www.gilmoreenterprises.lnf0 without the permission of Keith C.—Gilmore Enterprises LLC I t i ..................... . Remove Bulkhead, Stairs, Foundation 8 Footing ... ...... .. ...... : . .. ...... ......... ..: stn Exi I g Crawls ace P t I G Existing Full Basement Firebox Ex *ig *inQ Foundcl *ion 8 ' Demo Hoies Existing Partial Full Crawlspace Scale 1/4 -1 l Keith C. Gilmore Enterprises LLC Client: Phillips Pro 'ect: Revisions: Date: - - Pa e # _ p Jeff � Carlsa Phllllps �— Master Bedroom 8 13 17 �— I 0 P.O.Box 17 Centerville, MA 02632 1360 Ost. W.Barnstable Rd. Addition Drawn 508-420-9934 F: 508-420-9935 Marstons Mille, MA By• lf�e,r;e..W O E: gilmoreenterprisesocomcast.net 02648 Scale: 1�4��=�� These designs are not to be modified or copied 2 WWW.gIImOreenterprlses.InfO without the permission of Keith C. Gilmore Enterprises LLC i I i '- " .. 5-3 1/4' 3-5. F030 ,5ed- (? Vv . 0 0 r 3 U n 5cae 1/4 ze'-n• 3'-8 1/2 3'-5" 24 8'-7. New Bedroom 15'-0" 16'-0" 9-2 1/2' 2� Laundry I' � 4�• F-6• 4'-0" 4066 4 D W 6• 3'-9 1/2' Closet m-s Vielocated french door Li 4'-2' CL C L 9-n 3/8' . . CL �I Llv na Room Bedroom i n i na Room 'New boxed window frame CLLl c Kitchen Pantry Office Ii Down CL If Fnd e CL Bath - - ----- DW Ranae Bath 0 CL Den -Co I I Bedroom �l I I �I CL Po er CL • Pro 'ec �� Revisions: Date: 8-13-17 Page # Keith C. Gilmore Enterprises LLC Client: Jeff 8 Carlsa Phillips --� Master Bedroom 60— P O.Box 17 Centerville, MA 02632 1360 Osf. W.Barnsfable Rd. Addition Drawn P: 508-420-9934 F: 508-420-9935 Marsfons MI I15 MA — O ' E: �Imoreenterprises�comcast.net �2648 //_ / // These designs are not to be modified or copied www.Qilmoreenterprises.info Scale: 1/4 -1 without the permission of Keith C. Gilmore Enterprises LLC II " 22-0 --- -0' ,--------- ------------------------------ ------- + , 8"x7'9" Concrete wall 16"x8" Footing � Vinyl Hopper Windows 1 1 I 1 , i 1 5/8' Galy. thread rod 8-1/2'x2-3/4" off corners 5" exposed ' 1 �31-0"� 1 1 10'-8" I I I I I I 1 , 15'-0' ' I ; 3-0 1 1 16'-0' I I I I I 9'-8 1/2" I I I 1 I I 1 i i " I �---- -------------- I I 3 x3 x8 Footing I I 6'-6" I I I �- 5/8' Galy. thread rod 4-1/2' off end then every 72' ' '---------------------------- , , — — — —— — — — Estin blockx 7-3/8' Step down + 1 Existing crawl space I 7-3/8' Step down Existing Bbck ----------------T-4" - 11'-3 1/2" I Existing full basement 11'-5 1/2" Place new wall in front of crawl space cmu wall Match new wall top height to existing foundation Existing house rear corner o roPSlosed P Ic n - -, Scale 114 10 ' I Revisions: Page # Keith C. Gilmore Enterprises LLC Client: Jeff 8 Carisa Phillips Project: Master Bedroom Date: 8-13-17 —�-- - 00O P.o.Box 17 Centerville, MA 02632 1360 Osf. W.Barnsfable Rd. Addlilon , P: 508-420-9934 F: 508-420-9935 Marstons Mills MA Drawn By• ,�;f",� 6 — 0 E: gi Imoreenterprisesocomcast.net 02648 Scale: 1/4"40" These designs are not to be modified or copied wWW.Qilmoreenterprises.info without the permission of Keith C. Gilmore Enterprises LLC Pro3oged ion oo an Hew Adci Scale 1/4 -10 Proposed 4/12 pitch asphalt roof Proposed 4/12 pitch asphalt roof Existi 7/12 Ditch asphalt roof Existing 7/12g_itch asphalt roof Velux M06 I II I I Velux M06 III M Rafters 16. o.c. start off existing rear house wall Existing 7/12 pitch asphalt roof Existirm 7/12 pitch asphalt roof Existing 4/12 pitch asphalt roof Existing 4/12�itch asphalt roof Existing 4/12 pitch asphalt roof Existing 1/12 pitch asphalt roof Existing 4/12 pitch asphalt roof i I l ises LLC Client: ' ' Pro 'eCt: Revisions: Date: 8-13-17 Page # Keith C. Gilmore Enterprises Jeff Carlsa Phillips ---1-- Master Bedroom 0O0 P.o.5ox 17 Centerville, MA 02632 1368 Ost. W.Barnstable Rd. Addition P: 508-420-9934 F: 508-420-9935 Marstons Mills MA Drawn By• ,rf,,� — 0 E: giimoreenterprisesocomcast.net 02648 These designs are not to be modified or copied WWgilmoreenterprises.info Scale: 1/4"40° without the permission of Keith C. Gilmore Enterprises LLC I Ali �' II I i III I I Mach exis}im as roof 12'-6" 1 T V2'2ii A±If)•a.C. iE F, liE iE 6 a 1/2• FTt -Ij 12'-6" FIR —Mffh exlstiro vinyl II New boxed wi Match exietiro Flarvey wirdows I2x6 WeimW o, T-61/2• 6,-8 V Exisfing rear house comer; ) O 16 -r- }hei}i vi I I I I I IY—invl I I 1 I Fl•W 01. Exis}in8 floor frame Grade T----------- - - --------- - I —f 4-2x8 F?irder i i----- f 1 I I I 4'ConcreNe filed lmn 7 " -g " ? I I Icou 'l'-314'I i 8,_5 I I I I I I I I I I I I i 41(talncreke filed colurml I _ — _ T-3f4' G I _..... ... i I i i I 1 8'-`,u - : I I I I — • �.. I I I I I I � I .... .... .. ... ... ........ .......... .•.. I •- —7 z• —.1... L------ L--------------- III I J- �Sltlkf-OPe'�IAI 4010 - ----------------- I , I _I III II 4'-0"-- I I _ =1 I I T-2• T, I _ -- - - -- ' -- ------------; --- L------- ------------------- III III- 16-0 L_L_--4'-5I05 over-6 mTooly _ i " ' ------- I�-I I I I I i— L I -�--- 15 0" I I 0 0 PFODosed u eva ionPro EScale 1/4 -10 evcu u Scale 1/4 10 II I II' I �I . - . • Revisions: - - � # — Keith C. Gilmore Enterprises LLC Client: Jeff 8 Carisa Phillips Project:--J-- Master Bedroom [)ate: g 13 17 Page - 06O P.o.5ox 17 Centerville, MA 02632 1360 Ost. W.Barnstable Rd. Addition 0 P: 508-420-9934 F: 508-420-9935 Marstons Mills, MA Drawn P>y• ,�,t,,( � �,�,�,, ,e�� — O E• Qilmoreenterprisesocomcast.net 02648 SCQIe: 1/4"=1/0/' These designs are not to be modified or co pied WWW.gilmoreenterprises.info without the permission of Keith C. Gilmore Enterprises LLC I � LI I I I III I I 2 Py iL7/8'NI ridge beam R-49 Value spray foam insulation 2x8 Rafters•Wax. Simpson H25A cipe each rafter to wal plate 1/2'Cdx ful height wal sheathing —————— I_1_——————— 20 Wind wash bbcking each rafter bay VT Cdx roof sheathing 8 Colo.tie•1610 c. 2x6 Wal framing•16'oc. R49 Roof/Ceifrg spray foam insuation 5-1/4'W post R21 Batt style wal insulation I I Match existing ftl aidir� 1/2'Plaster wal and ceiling Finish over lx3 strapping•16'o.c. 1 I Relocated door Al fastening to be done according to the WCF M Wb guideinee I I — 9-7-3/4' I I 12'-6' _ _ I Match existiro Harvey window I I Match existing Harvey window —_ Mica uh series Simpson HDU5 hold down at al wal comers ra buldnead r — — — — — — — — r — —— — — — — — — I I I I wrnl boner � I I I I I I 1 1 3/4'Cdx subibor plywood I I 1 I I 2x8 Kd floor joist 0 116'oc. I 1 I I RW Batt style floor insulation I I I 1 2 Py 2x6 Pt oil plate 1 1 I I I 1 I I 4 Ply 2x8 girder I I I I I 1 4'Concrete filed lay cokmn on top of 3'x3'x8'footer I I I I 71-9. 8, I I I I I I I I -�5 I I I I I I I I I I I I I I I I I I I I I --———————-------J L---------------------------11------------------------� I r L—I----------------- J1------------------------�— I—J ------T--------------------- �-----------------� -------------------------J-------�----------------------- ----T-4' 22'-0' - 0 ProDosed evalion , cale 1/4 1 B I ' II C. Gilmore Enterprises ,, LLC Client: Phillips Pro ject: Revisions: Date; Page # Keithp Jeff 8, Carisa Phillips --J-- Master Bedroom 8-13-17 ---�-- O P.o.Box 17 Centerville, MA 02632 1360 Ost. W.Barnstable Rd. Addition Drawn Bv: _ P: 508-420-9934 F: 508-420-9935 Marstons MIIIs, MA — ON E: gilmoreenterprisesocomcast.net 02648 _ , These designs are not to be modified or copied www.ailmoreenterprises.info Scale: 1/4"--10 without the permission of Keith C. Gilmore Enterprises LLC II zo 7 v 7__ 6r��a,�5 7 + C__ Y, 0 -A ,I A, xe Z_ N, z 0 0 0 ==v -7; �4- 7 777777 x 0j) 5 41 7 C;�f Z V_ ell 5Z2,, lx_� 4:k'IS;�Ze�-9 CIVII-/7-7E 2-SE cj� X C�/ 0 -97L 0 �y -7. 7 -DEEP 05)),S' EP VA TIO N HOLE L 0 G - 0 �j 00, ... ......... J Zr 9; 6z- f _471 Y CC TOP OF'FOUNDATION I_Z1 TOP OF FOUNDATION CONCRETE CONCRETE COVERS COVERS CAST IRON 4CAS1 IR 4" SCHEDULE40 4 OR SCHEDULE 40. OR 4 SCHEDULE 40 PV.C. (01,NLY) SCHEDULE 40 P.V.C. (ONLY) PV.C.PIPE MIN hi IN. PU. PIPE MIN. 9.'M IN LEACHING TRENCH ( JOREQ. PIPE PIPE-MIN. I/sll 3 MAX. oil PITCH 1/4PER.FT PITCH 1/4-PER.FT P[TrU I IA"ncn 1/2" WASHED SYO%VE/ PITCH 1/4PER. n- 4r T,ca CZ3.t:31�1 INVpT OLVERT INVEF .......... Flo,�_INVERT DIST E L 91,,4�0. EL. TA TIC TAN 114VERT I VERT r:3.,tv SEPTIC 8 0 X EL,97J7 K S E ffi 16 SEP DIST. 1 - .A INVERT k. R '5 INVER INVEST Pc� EL BOX GAL.. INV INVERT 114� RT EL E GAL.. Precatt 500 Gal Leach 27, EU57, 3/4"-1 V?-' 6"CRUSHED' 6"CRUSHED STO REQ. Chaimber AV-WASHED STONE _-4 H- r r i�x I'a 7/-;;zd C-5- 6;:gz PROR LE OF `6171,,�_V 7e GROUND WATER TABLE TYPICAL CROS3 SECTION SEWAGE DISPOSAL SYSTEM SOIL 0(3 NO SCALE LF-ACHING JRENCH D AT E 111'eq 1AFf SCAL� NO TESTHOLE I TEST HOLE 2 ELEV. . ;9e,.4. ELEV. DESIGN DATA : x Z 1A Wt-SH ED -WmAxt 24�) HUN19ER OF BEDROOhIS SlVIE 6 %zPAAViS y 4431e!"" TOTAL ESTIMATED FLOW GALLONS/DAY Q" 4 BOTTOM LEACHING AREA SO.FT./TRRENCH w-, CY,l -o5P7 12 SIDE LEACHING AREA 30. FTJ TRENCH GARBAGE DISPOSAL—joY�,=.J50% AR:,:A INCREASE) L I TO iAL LEACHING AR-A SQ.FT. PERCOLATION RATE'. INCH TE PLAN 6----g BA P�S TA BL E' MA VILLE WEST � BARNSTABLE ' ROAD, WES T. /360 OSTER LEACHING AREA PER PERCOLATION RATE-ao",4,aso, FT -7 GROUND 'RATER r,2LE e� APPROVED L__j BOARD Of HEAL7H FGP� ..,-/P.WATER ENCOUNTERED DATE ... .... OF AGEAT ,OR 114SPECTOR WITNESSED BY ic ,61TH NICHOLAS BOARD OF HEALJH CA ENGINEER A a 28ioo EVA PETITIONER t4t LAW