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Home My WebLink About0895 CEDAR STREET - Health 895 Cedar Street West Barnstable A=019-012 I a�9-U7a- Commonwealth of Massachusetts 4 Title 5 Official Inspection Form <a Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable IIIMa 02668 1-25-17 page. Cityrrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. Important:When filling out forms A. General Information on the computer, use only the tab 1. Inspector: key to move your cursor-do not Matthew Gilfoy use the return Name of Inspector key. B&B Excavation rQ Company Name 374 Route 130 Company Address Sandwich Ma 02563 Cityrrown State Zip Code (508)477-0653 S113640 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: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority 1-25-17 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority (Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 /Deus i Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is bl t Ba rnstable Ma 02668 1-25-17 required for every W j page. Citylrown 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: System was in good working order at time of inspection. Tank was pumped after inspection for maintenance. B) System Conditionally Passes: ❑ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. Check the box for"yes", "no" or"not determined" (Y, N, ND)for the following statements. If"not determined," please explain. The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ❑ Y ❑ N ❑ ND (Explain below): t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 page. City/Town State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumps/alarms not operational. System will pass with Board of Health approval if pumps/alarms are repaired. B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution 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•3/13 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 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: D) System Failure Criteria Applicable to All Systems: You must indicate "Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/z day flow t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 I Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 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.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered"yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments �M 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for even West Barnstable Ma 02668 1-25-17 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): 5 Number of bedrooms(Actual) _4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 577 t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form e) Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 _ page. City/Town State Zip Code Date of Inspection D. System Information Description: Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? (Include laundry system inspection ❑ Yes ® No information in this report.) Laundry system inspected? ® Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available last 2 ears usage d See below 9 ( Y 9 (9P ))� Detail: "Well Water" Sump pump? ❑ Yes ® No Last date of occupancy: CurrentDate Commercial/Industrial Flow Conditions: Type of Establishment: NA 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 895 Cedar Street 'M Property Address Terence Ford Owner Owner's Name information is West Barnstable Ma 02668 required for every 1-25-17 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: Pumper driver- Was system pumped as part of the inspection? ® Yes ❑ No If yes, volume pumped: 1500 1500 gallons How was quantity pumped determined? Tank size Reason for pumping: maintenance Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 l i Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments °M 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 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: 2006 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 11101, Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: >150'feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: 101, 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: 1500gallons Sludge depth: 8" t5ins•3/13 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 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 page. Cityfrown 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 28 Scum thickness 5 Distance from top of scum to top of outlet tee or baffle 5 Distance from bottom of scum to bottom of outlet tee or baffle 12 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.): Tank was in working order at time of inspection with liquid level equal to outlet invert. Tank was pumped after inspection for maintenance. Grease Trap (locate on site plan): Depth below grade: NA feet Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date t5ins•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 17 Commonwealth of Massachusetts w Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 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: NA Material of construction: ❑ concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain): Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments ;M 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box (if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box was in working order at time of inspection with no sign of past back up. 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.): NA * If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 895 Cedar Street 'M Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: (1) Trench w/7infiltrators ❑ 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.): Leaching was in working order at time of inspection. Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration NA Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No t5ins-3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments �M 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 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: NA Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins•3/13 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 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately AIP 27' A2.2917" MJ•537' A44f A5 �� r; 84- L" fit #art 15ins•3113 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 �M 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 page. Cityrrown 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: No GW 144" 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. .June 13 2006 Date ❑ Observed site (abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Plan on file with BOH. Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•3113 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 l_ Commonwealth of Massachusetts i Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 895 Cedar Street Property Address Terence Ford Owner Owner's Name information is required for every West Barnstable Ma 02668 1-25-17 page. City/Town 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•3/13 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 ' w 4s Commonwealth of Massachusetts o- v Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 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: A. General Information When filling out forms the computer, r,use 1. Inspector. U TVJ only the tab key to move your Ricky L.Wright cursor:do not Name of Inspector use ft a tetum key. B& B Excavation, Inc. Company Name VQ 14 Teaberry Lane Company Address Forestdale MA 02644 City/Town State Zip Code 508477-0653 S14595 Telephone Number License Number B. Certification 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 16.000).The system: = c 4 5 ® Passes ❑ Conditionally Passes ❑ Fails`a -; ❑ Needs Further Evaluation by the Local Approving Authority 12 91 oq22 Inspector's Signature Date 0% M 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. IL Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 every page. Cityf rows 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: 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): Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ' 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 every page. Cityrrown 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 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 895 Cedar Street Property Address Peter Eldridge Owner owner's Name information is required for West Barnstable MA 02632 12/9/09 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 %day flow } Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage.Disposal System Form-Not for Voluntary Assessments M 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 1219/09 every page. Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 16,000 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. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 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): 5 Number of bedrooms(actual): 4 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 550 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 every page. Citylrown State Zip Code Date of Inspection D. System Information Description: Number of current residents: 3 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 N/A 9 ( Y 9 (gPd))� Detail: Sump pump? ❑ Yes ® No Last date of occupancy: CURRENT 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: Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 every page. CitylTown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: N/A Was system pumped as part of the inspection? ❑ Yes ❑ No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: 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): Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 every page. Citylrown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known)and source of information: 7/21/06 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 1 1/2' feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: 50 feet Comments(on condition of joints, venting, evidence of leakage, etc.): at time of inspection building sewer appears to be in good shape Septic Tank(locate on site plan): 9" Depth below grade: 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: 5.5'X 5.5'X 10.6' Sludge depth: 6" ti Commonwealth of Massachusetts r Title 5 Official Inspection Form a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for west Barnstable MA 02632 12/9/09 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(coat.) Distance from top of sludge to bottom of outlet tee or baffle 27" 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 12" How were dimensions determined? measured with scour 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.): at time of inspection tank appears structurally sound. T's and gas baffle present. Liquid level equal with outlet invert-installed in 2006 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 i _. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 every page. Cityrrown 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 Commonwealth of Massachusetts Title 5 Official Inspection Form o Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert equal with 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.): installed in 2006-At time in inspection D-box structurally sound. No signs of solid carryover. Water level equal with outlet invert 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: inspected through inspection port-at time of inspection no water in leaching trench Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ❑ leaching chambers number: ❑ leaching galleries number: ® leaching trenches number, length: (7) H20 infiltrators ❑ 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.): no sign of damp soils or hydraulic failure Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 895 Cedar Street Property Address Peter Eldridge Owner owner's Name information is required for West Barnstable MA 02632 12/9/09 every page. CityrFown 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.): i • Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments ` r 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 every page. Cityfrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view of the sewage disposal system, including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Check one of the boxes below: ® hand-sketch in the area below ❑ drawing attached separately reot4r n � AI - 2R' 3 zo A2 % 26 , A 3-- 4z Ay - 69 ' -Bz= 321' 133= 233 T' I t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9109 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: greater than 20' feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health-explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: Before filing this Inspection Report, please see Report Completeness Checklist on next page. Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 895 Cedar Street Property Address Peter Eldridge Owner Owner's Name information is required for West Barnstable MA 02632 12/9/09 every page. CityrFown 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 ^* ENVIROTECHI LABORATORIES,INC. MA CERT.NO.:M-MA 063 449 Rte.130 Sandwich, MA 02963 908(888-6460) 1-800-339-6460 FAX(908)888-6446 CLIENT: Markwood Corporation LOCAT►ON: Lot 6 ADDRESS: 110 Breeds Hill Rd., Unit 10 Abigale Snow Rd. Hyannis, MA 02601 W. Barnstable, MA COLLECTED BY: DA Scannell SAMPLE DATE: 5/28/2001 a SAMPLE TIME: 4:0013M. WATER SAMPLE TYPE: New Well DATE RECEIVED: 5/29/2001 ' LAB I.D. #: 0105584 WELL SPECS.: 104' RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Analyzed Limits Coliform bacteria /100ml 0 0 9222 B 5/29/2001 pH pH units 6.5-8.5 6.02 4500 H+ 5/29/2001 Conductance umhos/cm 500 78 t 120.1 5/29/2001 Nitrate-N mg/L 10.0 0.073 300.0 5/29/2001 Nitrite-N mg/L 1.00 < 0.003 300.0 5/29/2001 Sodium mg/L 28.0 7.5 200.7 5/29/2001 Iron mg/L 0.3 < 0.1 200.7 5/29/2001 Manganese mg/L 0.05 < 0.008 200.7 5/29/2001 Volatile Organics ug/L See Report ND EPA 524.2 6/6/01 ND= None Detected COMMENTS: pH is below recommended limit and may have corrosive characteristics. WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES FOR PARAMETERS TESTED. <=less than Dafe � >=greater than R nald J. Sapft TNTC=too numerous to count L oratory ire for C PRTI.FICATE OF ANALYSIS page.. 1 LAPUCK LABORATORIES, INC. RMULTEepared For, Report Wted: 06/t2/2001 Envirotecb Laboratories,inc. Order Numlber: L01 b9355 Roo Saari 449 Rte. 130 Sandwich, Ma 02563 ab a -v In - UI 69355-01 i atirtlo , 1.ot 6 Ahlpll �lantple}}; SatgaUlh►n Locuttunc Collected: Collected byr Customer Itecelved: OS/3l12Ut11 Te4t Parameters V. MDL LA1J.Orgaltics MTUE ND ppb 1.o PPA 524.2 06/00/2001 EPA 5241.2 - volatile Organics by C,CiMS �Z�s _ -Mohod# rested LABt Orga►tiex 1,14,24retracbloroethane ND ppb 0-5 UPA.524.2 00/06/2001 111,1-Tricbloroethane ND ppb 0.5 PPA 524.2 06/06/2001 1,1,2,2-Tetracblorocthane ND ppb 0.5 EPA 524.2 00/00/2001 1,1,2-Trichloroethane ND ppb 0.5 EPA 524.2 06/06/2001 1,.1-Dle111oretbune ND ppl+ 0.5 IPA 524.2 00/0/2001 1,1-Dichloroethene NI) ppb 0.5 PPA 524,2 06/06/2001 1,1-Dlchloropropene ND ppb 0.5 rl'A 524,2 06/00/2001 1,2,3-Trichlorobenzene ND ppb 0,5 EPA 524,2 06/06/2001 1,20-Trichloropropane ND l,pl, o.s EPA 524.2 06/06/2001 1,2,4-Trichlorobenzene ND ppb 0.5 [IPA 524.2 06/06/2001 1,24-Trimethylbenzene ND ppb 0.5 1?PA 524.2 06/06/2001 1,2-Dibromo-3-Chioropropa ND ppb 0.5 EPA 524.2 06/06/2001 1,2-Dibromoothane (ED13) ND ppb 0.5 EPA.524.2 06/06/2001 1,2-Dichlorobenzene ND ppb U.5 EPA 524.2 06/06/2001 1,2-Dicbioraethalxe Nll ppb 0,5 NIA 524.2 06/06/2001 1,2-01chloropropane ND ppb 0.5 EPA 524.2 06/06/2001 1.,345-Trimethylbenzene ND ppb 0.5 03A 524.2 06/00/2001 1,3-Dichlorobenzene ND ppb 0.5 KPA 524.2 06/06/2001 1,3-Dlchloropropane NU ppb 0.5 EPA 524.2 06/06/2M 1,4-01chlorobenzene ND ppb o.5 kPA 524.2 00/06/2001 2d wdeb:ze TOOE ZZ .unf 8666TOV I8Z : 'ON XeA satao;paoctpl jondp1 WO�jj UItTIFICATE OF ANALYSIS Page: 2 LAPUCK LABORATORIES, INC. Rjevorta ed a.epvrt I)ntcdf 06/12/20Ol Envirotech Laboratories,lne. Order Number: LOl G9355 Ron Snarl 449 Rtc. 130 Sandwich, Ma 02503 Laboratory nk 0I G9355-01 kkuinllou: Lot 6 Abigail samplr#: antpling L��cnt Collected; Collected by: Customer Recdvccl: OS/3i/1001 2,2-Dichioropropane ND ppb 0.5 FpA 524.2 06/06/1001 2-Chlorotoluene NO ppb 0.5 EPA 524.2 06/06/7,001 4-Chlorotoluene ND ppb 0,5 H1'A 524,2 06/06/2001 4-1sopropyltoluene ND ppb 0.5 EPA 524.2 06/06/2001 Henzene ND ppb 015 EPA,524.2 06/06/2001 Bromobenzene ND ppb 0.5 IPA 524.2 06/00/2001 13romochloromethane ND pph 0.5 UPA 524.2 oe/06/2001 gromodichloroethane NJ) pph 0.5 EPA 524.2 06/00/2001 Bromoforni NO ppb 0.5 1 PA 524,2 06/06/2001 Bromomethane NO pph 0.5 EPA 524,2 06/p6/2001 CarbonTetrnchlorlde NO ppb 015 PPA 524.2 06/06/200t Chlorobettzene NO ppb 015 EPA 524.2 06/00/2001 Chloroethane NO ppb 0.5 03.A.524,2 06/06/2001 Chloroform ND pph 0.5 RPA 524.2 06/O6/2001 Chloromethane NO pph 0.5 EPA 524,2 00/0/2001 cis-142-Dichlorethene NJ) ppb U.5 EPA 524.2 0e/O612001 cis-1,3-01chloropropene NO ppb 0.5 EPA 524.2 06/06/2001 Dibrolmochloromethane ND ppb 05 EPA 524.2 06/06/2001 Dibromomethane NO ppb 03 NPA 524.2 06/06/2001 Dichtorodifluoromethane ND ppb 0.5 EPA 524,2 (1619G/2001 Ethylbenzene NO ppb 0.5 LPA 524.7 06/06/2001 14exachlorobetudiene NO ppb 0.5 r:NA 524.2 06/06/2001 Isopropylbenzene ND ppb 0.5 HPA 5242 06/06/2001 MethyleneChlorlde NO ppb i.o ETA 524.2 06/06/2001 n,Butylbenzene NJ) ppb 0.5 HIA 524.2 06/06/2001 n-Propylbenzene NO 011h 0.5 EPA 524.2 06/06/2001 Naphthalene ND ppb 0,5 rrA 524.2 06/06/2001 see-Dutylbenzene NO ppb 0.5 EPA 524.2 06/00/2001 bd WdOt,:ZO ZOOZ Zti -unf 8666TOV Z8z : 'ON Xdd Satao;paoge-I �,jondp1 WOdd CERTIFICATE OF ANALYSIS Page: 3 LAPUCK LABORATORIES, INC. &Port amed + Report Dated: 06/12/2001 Envirotech Laboratories,Inc. Order Number: L0109355 Ron Saari - 449 Ric. 130 Sandwich, Ma 02563 Laburatory ID#: 0169355-01 aucr►jtlloat: Lot 6 Abigail 9arrrplc M: �DT�rlJt ocntlon: , (collected: Collected by+ Cumtomer Rccclved: 05/31/30111 Styrene ND ppb 0.5 EPA 524.2 06/06/20ol tent-Butylbenzene ND ppb 0.5 EPA 524.2 06/06/2001 Tetrachloroethene ND ppb 0.5 EPA 524.2 06/00n001 Toluene ND vpb 0.5 PPA 524.2 06/06/2001 trans-1,Z-Dlehioroethenc ND ppb 0.5 EPA 524.2 06/06/2001 trrans-193-Dichloropropene ND ppb 0.5. PPA 524,2 ob/06n0o1 Trichloroethene ND p1)b 0.5 rPA s24,2 00/06/2001 Trichlorot9uolromethaue ND ppb 0,5 8PA 524,2 06/06/200i VinylChlorlde ND ppb 0.5 EPA 524.2 06/06/2001 Xylene ND ppb 0.5 EPA 524.2 06iuo/2uo Approved By:, �` S' 7—rA (LAII Manager) - This report ix rendered upon the condition Vint it is nt,t to be reproduced wholly or in p.trt for advertising or other purposes ovor Our signature or in canncction w/ our name without spacial written permission,Total 11xhility is llmitrd tO the invoiced amount, the results 1i,stotl rcicr only to tcst.cd samples and/or applicable Sd WdTb:?0 TOOE ET .unf 8666TOP T82- 'ON Xdd Satao;-e-toqe-j �Jondp- ; WOaA 12/03/2009 THU 15: 57 FAX 5083627103 Barnstable CTY HealthLab - Barnstable Health ®001/001 .............. $1°F�� CERTIFICATE OF ANALYSIS Page: 1 Barnstable County Health Laboratory ` nCli13 ass Report Prepare P d For: Report Dated: 12/3/2009 ..-` Frank DeStefano William Raveis R.E. Order No.: G0955404 1284B Main St. Osterville, MA 02655 Laboratory ID#: 0955404-01 Description: Water-Drinking Water _ 4 Sample#: Sampling Location:'Z895 Cedar St.West Barnstable,MA'S Collected: 12/1/2009 Collected by: F.D. Map 089 Parcel 012 Received: 12/l/2009 Routine ITEM RESULT UNITS RL MCL Method# Tested Nitrate as Nitrogen 1.7 mg/L 0.10 10 EPA 300.0 12/1/2009 Copper 0.34 mg/L 0.10 1.3 SM 3111 B 12/2/2009 s Iron ND mg/L 0.10 0.3 SM 3111 B 12/2/2009 Sodium 28 mg/L 1.0 20 SM311IB 12/2/2009 Total Coliform. Absent PIA 0 0 SM9223 12/I/2009 f Conductance 450 umohs/cm 2.0 EPA 120.1 12/1/2009 s pH 7.9 pH-units 0 SM 4500 H-B 12/1/2009 Sodium level is above the maxium contaminant level. Those on a low sodium diet may wisle to consult a physician. Attached please find the laboratory certified parameter list. Approved By.: ( irector) // s 3 X 7 ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 • NOW, THEREFORE, P of c' 'F_ r es hereby place the ( � � �c e.T,da (owner's name) following restriction on his above-referenced land in accordance with his agreement -Tzwmoj Ramstahle Roard of Health, wTTrun estrtetian shalt run with the land and be binding upon all.successors in title: 1• S I5 may have constructed (address) upon the lot a house containing no more than Ti ve. (5) bedrooms. agrees that this shall be permanent deed (owners nam restriction affecting cm r` located on W �rn 1� A, and . being shown on the plan recorded in Plan Book=S( , Paged Or on Land Court Plan I-) n m For title of see the following deed: Book o`Zo9l , Page 1 cl 7 . Or Land Court Certificate of Title Number Executed as a sealed instrument day of Owner' signature ` Own s signature Owner's signature COMMONWEALTH OF MASSACHUSETTS f(> l . 202 Then perso Ily pea red th bo, re-named � —1/a�ew�o-sae to be the person who executed the foregoin t and 'P L4� acknowle ged KATHLEEN M. PETERSON DJA the same to be free act d deed, before me, NOTARY PUBLIC U.M."Onweaith of Massachuselb K,r My commission Expires : yo �A y� April 08,2007 Notary bli� • My commi sioil expire 119414 oY N Nr� (date) dw& BARNSTABLE REGISTRY OF DEEDS Bk 21099 P:9 190 -11F37568 06-15-2006 a 09 = 55a ,recommends thst tha applicant seek legal advice to prepare a properly worded deed restriction document. DEED RESTRICTION WHEREAS, Of (owners name) GaLn (Yu,. MA m (address) is the owner of S4l� raja —\t, 7 located (address) at W-Q� MA (hereinafter referred to as and being shown on a plan entitled "Subdivision of Land in 3 LA E t e I a Eck�S rJ MA, Property et al,Sot)Auv;s n -�''?`fin duly recorded in Barnstable County Registry Of Deeds in Plan Book S-� �o , Page Or on Land Court Plan Number _ 171� n WHEREAS, _ a� lAL-4 n Sr' as the owner of said lot has (owner's name) agreed with the Town of Barnstable Board of Health to a restriction as to the number,of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works construction permit in compliance with 310 CMR 15.000 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage; 3 WHEREAS, the Town of Barnstable Board of Health, as a pre-condition-to granting a disposal works construction permit for a septic system in compliance with 310 CMR 15.200, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the =r Barnstable County Registry of Deeds by recording this document, u k TOWN BARNSTABLE a r , LOCATION SEWAGE / 0% VILLAGE SSESSOR'S & LO INSTALLER'S NAME&PHONE NO. lap SEPTIC TANK CAPACITY LEACHING FACII:ITY: (type) e NO.OF BEDROOMS BUILDER OR OWNER PERMUDATE: (� //o�� 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 EBge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) .Feet Furnished by F4 e"jT c' A i 1 7 53 . 7/� i R39`�,, 7�, __ 13 No ZA I Fee THE C!.MMONWEALTH OF MASSACHUSETTS Entered in computer: L---- PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ZIppYicatton for Bigonl lq§p5tem Con.5truction Permit Application for a'Permit to Construct Repair O Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. 69 J Owner's Name,Address,and Tel.No. r► d Assessor's Map/Parcel Installer's Name,Address,and Tel.N� Designer's Name,Address and Tel.No. u 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 Plow(min.required) 0 gpd Design flow provided �� gpd Plan Date 3 Number of sheets Revision Date ~-- Title Size of'Septic Tank Type of S.A.S� Z�} \ re-An r Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the constructioAmiaint ce the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environnot to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed Date Application Approved by Date Application Disapproved by: Date for the following reasons Permit No. )—oD 6 Date Issued 06 No. 4 Fee Entered in computer: . J {� THE COMMONWEALTH OF MASSACHUSETTS 1- ---M"` .PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 2pplication for Migonl 4p.temc Con.5truction Permit Application for a�ermit to Construct�!)1 Repair( ) Upgrade( ) Abandon( ) ❑ Complete System ❑Individual Components Location Address/or Lot No. l Owt,'s Name,Address,.and Tel.No. / (eacr >r(artdS C Assessor's Map/Parcel O R9 y _ CG fY a?y i.T-LQA"\,2 `+l-uv� Installer's Name,Address,and Tel.Nq.v J� Designer's Name,Address and Tel.No. �U� 1Ji Iti l/1N4 � 41�1 Type of Building: Dwelling No.of Bedrooms Lot Size o , NC_ sq. ft. Garbage Grinder ( ) Other Type of Building RCS J No.of Persons Showers( ) Cafeteria Other Fixtures t Design Flow(min.required) S 5© gpd Design flow provided �� gpd Plan Date /j3� Number of sheets I Revision Date —' Title s n 1 Size of Septic Tank I Type of S.A.S� /� H2O L LA ��Gt�f Q I r Description of Soils s a o 'Nature of Repairs or Alterations(Answer when applicable) C9J t - Date last inspected: Agreement: The undersigned agrees to ensure the construction and main ena c 6f the�afore de scribed on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental de a 9'not to place the system in operation until a Certificate of Compliance has been issued by this Board of Health. Signed {��' 'fir Date C11516r Application Approved by l _ Date s O Application Disapproved by: Date for the following reasons Permit No. .�' ? Date Issued -------------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS _ BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal,System Constructed ( Repaired ( ) Upgraded ( ) t (Abandoned( )by at f3l:�5 ceJOI&I.1 W has been constructed in accordance with the provisions of Tittle 5 and the for Disposal System Construction Permit No. �-tJID _ 2 dated Installer `__3C Vc3 l? UCi Designer s le #bedrooms Approved design flow -5S() gpd The issuance of this permit ss iall.n t be construed as a guarantee that the sys in will fu t o as designed. Date �/ '1�� Inspector ------------------------------------ No. 2_oxo —2,9 Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION—BARNSTABLE, MASSACHUSETTS 1wigpont *p.5tem Construction Permit Permission is hereby granted to Construct (L -)---Repair ( ) Upgrade ( ) Abandon ( ) System located at cc 4 af- sA-. 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: ConstructionGmu f'be completed within three years of the date of tl i ,permit. Date - / / v Approved b` y FROM :down cape engineering inc FAX NO. :15093629980 Aug. 10 2006 07:45AM P1 Town of Barnstable Regulatory Services 1 Thomas F. Gefler, Director Public Health Division •es Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508.96246" Fax: 509-790-6304 Installer&Designer Certification FQrm Date. I� 06 Designer: Inst$ller: Address: _ 39 M a in S�Y P.p _ `J Address: PO rt � On G " 6- - 06 9-'T- �0-110 u ct ^was issued a permit to install a —Tcto - k (ins er septic system at U (.c&6Lr 5��f-C based on a design drawn by (J ,�jev(. dated 'J vn� 'duo 6 eslgDer) I certify that the septic system referenced above was installed substantially according to the desiW4 which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank- _ I certify it the septic system referenced above was installed with ma or changes (i.e.. greater 10, lateral relocation of the SAS cr any vertical relocation of any component of the 'c system)but in accordance with State &Local Regulations. Plan revision or as-built by designer to follow. `Z k OF IAA'S"c ARNE H yG��= OJALA oistaq s igriature) CIVIL No. 30792 STEA�\r: FSS�ONA EN x e er's tamp ere) PLEASE REIL T B ST LE S TJBIJIdHEALTHOT 1SHI FOE TIFI AS� p L O JUL B $ TART B L TH D VIS N. Q:F4eattb/SeptiCM0Si9ner Certiaeati=Form a SB��da'lCh, MA W63 508(8 8.6460) 1,8m-M9-6" PAX(508)88&64M CLIENT: Markwood Corporation LOCATION: Lot 6' ,ADDRESS: 110 Breeds Hill Rd.,Unit 10 Abigale SnowHyannis, MA 02601 W. Barnstable, e5vg COLLECTED BY DA Scannell SAMPLE DATE: 5/28/2001 SAMPLE TIME: 4:OOPM WATER SAMPLE TYPE. New Well DATE RECEIVED: 5/29/2001 ' LAB LD #: 0105584 WELL SPECS.: 10v RESULTS OF ANALYSIS: Parameters Units Recommended Results Method Date Analyzed Limits Coliform bacteria ]loom[ 0 0 9222 B 5/29/2001 PH pH units 6.5-8.5 6.02 . 4500 H+ 5/29/2001 Conductance umhos/cm 500 78 120.1 6/29/2001 Nitrate-N mg/L 10.0 0.073 300.0 5/29/2001 Nitrite-N mg/L 1.00 <0.003 300.0 5/29/2001 Sodium mg/L 28.0 7.5 200.7 5/29/2001 Iron mg/L 0.3 <0.1 200.7 512MOOl Manganese - mg/L 0.05 <0.008 200.7 5I2912001 Volatile Organics ug/L See Report ND EPA 524.2 6/6/01 ND=None Detected COMMENTS: pH is below recommended limit and may have corrosive characteristics. 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I COMP PORCH I T 10'-5 3' Q% if\ 2'-54' - !L ---- -- ES, / \ 3' T ( ------ 1 5fowa a 3'9 w 12' 2436 da4* I MA59R 10'-9' I. rupoom A,, 40 614'-e -11 r 43 ---- __ �- S z ® 06 I2249' c 11'76' T-24' 5'-9 ` ` ` \5 ----- /-- -- -- 3' 6' 3rcr 4 F7 18 .� 24 _.._- 5; 45'-10j' - .. __ ` DOUBE �. 3' 1 ' �AnAir ®�-- --�® WY�/'l tl. 3'� - 6'-3'. 44'-6' .... ! I 4 2'b 4'-1 • 4'-3 6'-0 S'- 4'-8 16'-3 .. 4-6-. 5-6 4'-6' -4' 3'-9 31- _3' 3'-1 S 2X6 WALL" center of Q orb.. radius --- _ - - � R.6'. 10'-1'' - - . 1 P 21-28' 2, 4-3j' 4'-7a' Q� 1 '-7 I nININ 12'I 3'-10 2 � 3-9' . 4._51. 3j.. � - .- I V,II,� `- ------- �4 4'-3.1' -a. 4',-96' @ 8 51unY V 9' 2 b, O 4 FOW 5' 6'-6 4' 3'-10 _ 5'-1' - 5 4 5 1' — 69 50FA \/ 6-6' 6-6' 6-6' 6_6' 6' 2a' 66'-2 J. FII\/f FOR V —6'-2a'—,� `K 2618 50/�1 E14 - 13, 13' 6' 15' 10'-5 ' 14'-6 ' T-9' 12-3' �'1 PLC I � QC 4'-lli' 8'-10�' 21'-4 S'-1 '. 8'-2'. 4'-8 8-2' —14 O 5' 3 0 2'-10' I I XAf ROOM MOW 1 3' 13'-6j'o 13 ... TPVOOM ' 2'6 2'6 open railing: I d� 10, 2,6 w 5'-9' "60NU5 BOOM JIB Iy 4'6 I 8-8 1 Z ° I pp '6 � 28'-6' . i----i 5Ab5QPf. 1'' K _� II 6-2' center open ralling 3'-10 ' 7'-0 4'-6- 3'-7j' 8'-5 11'-10, 0 I� 4' of radius 3'-9' 'T b lJ1 —�X I s (�,., / \ 2'6 I s'i 5'-9'' Jr 16 I'b 2 51 -71 i 1 I V I�h V'!4 1 L I 1 4'-3' ---- 3'-10 , 7'-0 4'-0j' 7'- 11'-5j' 15''74' 11'-9' MOROOM I 1. Open r Ring 3-0 2'-!0' 4'-51.. 3'_72'_5' ®b tiPNf 4'-2j' a' 2 111 PROOM Z — 1 2' co .5, . 5�CON F�OOp ((�p/�� 6'- 6'-2 �j}c.p7 .�` �y v\ 6-22. i �yavn� o b G 15' 12'-5 ' 14'-6j' 14'-3 S'-8 ' CONVy�/1��O I „ 94' 13'. 13' 6' 22-3�' . 9'-2�' 14'-0b' 16-5j' 59k ffAM INIX twaF war�v 4'-11' 7' 7' 4'-1 nwoR �5 0Z Tn�,ryyV�l�� . VIA/V11 W10X22 (. `% w'. segmental retainingwnlls Fcis E /. S rlay others WIOX71 ' - 3'-2' 12' sono tube on top V5 (4)95a -1 of 24' dlam, big foot �\ - (v951N. .on all tubes `. 610'3 LV5 12)9.61v1 22'1-112 9 ' lMOX2Z 21'-101' T-11�' T-11 T-11 - drop concrete - �/ '5J 2 cc retaining wall I 57 . mom 241-1/49 2 8' here ll'-0 �- 56 W10X12 ZZ Z'I Z 5 drop foundation full helVt here 20'x10' footings r- ------ , I i -- ----------- I — j 1 1 3-10�' r-------------, I r-3.------------ -----, 1 3. - 7. 1 - I . 11 Fina GYM I F-- ------, I I 1 I 2' clr I �- ------ �� I (2) #5 reba below all win l yI extend 1'3' a andL---- --- 2' - 6' 1 I L----- drop window Y 71------ 1 1-- -, 14' 11' i I7' 14'L------- -- = I I 6-9' L06 M 16 YAK VW 36I I 1 I I 1M M FME drop foundation I beam pocket to be full height here j 8' wide x 12' deep strip footing I drop garage I I I _ r-- 10' deep I UIIW V/K I I 1 fo ndntlon 2' 1 I I " ' 18' wlde min B70 strip footing 1 L--- - 0 deep - (NO StOV�) 9_'-6 drop 16' I 1 g� 18' wide min. I I o I 1 2'7111' (2> # rebar along bott 3' clr 1 T � 1 I door I r----- � I 1 29" D630 I o �1 FRDJ�1 GLNIXG!t�1f6 2'3 6 ' - $ 16'-3 I �� I I e15'O/C 9'-10j' f 1 10'-11' 13'-51 I I I f 2' I 1 96xconwacncaalcxA�ea4w I I n ]� I o i � - 33' 42'-3 1 (2) #5 rebar below 3'-9 '� 6'-11 �'-7 12'-5 4'- � 1 12'-0 I I T , 1 I 2' clr (each fnce) 4'-A I r r drop foundatid I I I extend 1'3' beyond• r--- I I 5' here I I I I 1 I j �I 9'-5' I I r--- `--' L 3UxJ0z10 footings � - J L--' -.- beam pocket 1 . 1 drop 16' I 4'-1' 8'x12' deep @ door beam pocket .1 L of L J to be 8' wide x 9' deep - 12'-9h' 8'-06 - 12'-5a'. 14'-6�' .3'-1 16'-3 I I pu drop window I S 2' I 1 .15'-3j'I 14'.�� 1 fULea�lgl#;. f3A11I:. 1 I } 8'9"YU1148"E1CK I I 15'-3�'. I I 1 L- W1V 0FfWVA40tdEg10kOD&9aU banm pocket 1 I. 16' 3) 9.5 lvl 8'xl1' drop '16' 1 4'-8 ; 1 . . drop window 1 9'-6' 1 drop 'garage 10'-4 ''i. @'door I drop window 14' .. 'I 1 I foundation 2` -- ,-. 14' ..I - �. r - , -r-(2),#5 rebar under I I w r.--- ., ,I I. .extend 1'3' beyond j .. I' I 4'- i L 1 2'-5 I 4 r I I I�drop window 1 1. 30x30x10 footings --------- --- ndow 1 L-- 4,_g � �. I 51v114'p F r-`f� - -- -ZZr . 9'-98-1' ----------� \ \ 135 /. T-71�'J6' bean po L-L-'4- I 4 walls backfilled w/ 8'x9'. - �k --- ' 1 I max exposed I I I I F0u PAWN FLAN ILA \ — — 13, 13' 6' - 15'• 12'-5�' 14'-6 7'-9'' 12'-3' A I VUIVVAIION / 1� MAN 21'-6 2-0`0mop Mo.sa»a y<3_ 2x10 p.t, beam snwcruun 1 -B 12' sono tubes 6 2x10 p,t. beam 16, cc KS IN c 5' 4j 15-44' < ) p t. x1 14 2) p. 2 10 (2) p.t. 2x10 9'-3' - 10'-4 Isl hc,)gi rs ty - sI Ipwn tus 21 ) /2 ofo Vk 016' c �� r Nits t 3 1 Jol t iar gets yp 1 11 if I 1 11 la l g o _ hoi se 32 o . oll b e h(re o bo e l l m oIsFot ban a c post above I. ' oll 1,d k er for beam i I 2) 9, lv e t 21 9. lv 9 j g ng ° > J 0 D L R L❑ D I D L R LO D � , 2ND FLOOR LOAD 2 _9. t D L OR LOX `o N F 00 JAI� 1 � 3) 9. lv .r 1 ® ' s ee d 1,11 n t I e g. S Ks- l0 dL J J. 21N .111 1 DA14DFLORL D 06 2ND FLOOR LOAD _ N F ❑ 2) 9. lv Q_ L- dt n er ) .5 vt 161, <2 9. l - ( Ablf �I ub I an er D 7LI OR LIE D L A Lt. f 4'-6 1 Alt Y o bo a �. (2 A 2 j ) f.5 Jl 3-9• ILL O' 21 9 t _ F161' FOOD RAMUA PA JLA / i6 ��AMING PI AN I i V L MiCNEI.E'r9 o� 24-9' d MC. . f.s"4 . ssnucruRw T-11 7'-11 T-11 �'h�Y,1s 77:;f (2) 7.25 LVL BELOWcc II I1 9 v� II II O I I 50 PO I I \\ \ II 9.5 rim Joist ( 9 t l vl e e v op wall .. .. O h are. 31-3/4' Joist ia ge i p. Itt 49.5 _ v bE ow o t J i t at wall (3) 9.5 LVL ib" L62 c 16' If. �. O F LOAD (3) 9.5 lvl I ROW OA \---2 . 9. lv ROOF LOAD ❑ ❑A O post -down . o 5 b t te A 0 0' a 21'-4 t c u lcw I bolt steel to lu n 4' 30' 5-8of t an e YP• steep column below - e l w 6'-Il ILIM (3)9.5 V 3) 9.5 LVL - of s I ee t lvl cc um b to o r po a or _ m _ cl k r ps x h ad r o - 8 h e 2) t ❑ AlIST HA GE S Y �� el w ost down S 11 fj P frame b ROOF ) •5 bolt steel to Y 05 ,4 steel column below s ee c lu t others BOLT HERE LOA lvl WA CN e 'lo ' 1! (2) 9.5 LVL triple lvl hanger 2 (31 9.5 ivl IAV, e ) 9.5 lvl header S� below R❑ F OP j •5 L o is s t U -4' 2 ' 9.5 RIM JOIST . O Is in ng or. ,Yf 12'-5�' ROOF LOAD i d op wall 4'-6' 5' h re 31-3/4' Aa - 9.5 rim oist 20 611 _----- ---- L LL 9.5 .RIM JOIST V 1 5�COI P F V R MII�I PLAN 6. 2NMOOP Al PLAN . g c4 No.STRUCURAL (2) LVL BELOW sre • 7.25' avu I1-7/8 lvl hip hiP7/8 lvl- ` cc .. � RI ROOF 2X12 HIP I I� CRICKET RO 4 u II p iru 2X12 VALLEY II II (2) I1-7/8 LVL N II u II' O 2X12 HIP BEAM 11-7/E L L II II II <2) 11-7/8 HI > XI In n lssu 2X12 RI GE 2X1 L I EX12 RIDlE. _- II 2x6 LAY-OVER ROO v ;r - _ _ BE RIG R kF1-R 4 , (A 11-7/8 LVL - -- ) 1- /8 L , 2 Y R 2Xi2 RIDGE / H o - - NO 1 w" mW,1 DG 3) L L E W < -7/8 LV U1 HIP S �EP UNPJ. 11 tS XI .R 12 OZ$ t it 7/ L L 1 LAY-OVER ROO �- (2 11-7/8 LVL (2) 9.5 LV L tF n IVE R .F BELOW L0. E (2 -7 ) 11 /8 HIP _ O 2X12 HIP `\ 2X12 VALLEY (3) 9.5 LVL .BELOW 3) 9.5 LVL BELOW 2X12 HIP 2X12 HIP \ 2X12 HIP RAFTERS A ROOF �:AN • 12' 13' —16' -0 12'-6' 16 alrleady -'d ® Z/ofRv 2e2rvlr ve for ridge ' 12' .6-1/2. plumb 2x8 collar. ties 8• UOO"a -�. VFW@ 16' O.C. sprnucrunn� �1 �Ql5fE 0 rafters �� H2:5 cups 12 10 PONl ROOM12 12' 8-0 9'-4j' 6'-6' 2x6 watt 5'-6 2 10 rafters �BflQ�I —'I� H2.5 clips \ ... 10zfw 1'-8' 4�F.FtDMFLYfOfl.Y solid blk - .. - 10 - (2) 9.5 lvl @; cathedrals 9.5 rim Joist (2) 9.5 (vl l� shdlran - Akjlmo - d 2x6.walts O - „ 9•_ll. (4)Zd0 (3)2d0 (3)1il0 ° 9'-1 1/2' cdx 8 sw no 25'-26. Ce//��h�� 9'-10�' lla I 8'-3�` 2x6 shoe plate 81 3/4' sub-floor fDf.IGI jl p.t. plate 11 AG2095 2 iDf.4WACE (2) #5 rebar (2) 9.5 Wt. (3) 9.5 lvl 8' concrete wall O p saw,cut control Joints 4' slab sloped - 25'o.c. min towards doors <2> # 5 rebar 8' concrete wall 9' T top 2' 1/2' tally.column dampproof S�C�10N G eC2) #S.:rebnr key footing 3. (2) # 5 rebar bott..2' ' 2x12 ridge 2x12 ridge 24x10 footing O �� 2x' colllnr ties 30x30x10 footing 5�CON M S asphautt shingles �. cam 2x8 colllar ties 1/2' cdx 2X10 RAFTER 10 2x12 ridge 10 2xi2 ridge 12 1 r 2x8 collar ties p ADJUST SEAT-CUT 7'-9gAIjC 10' plumb Zq2 AT�C 2x10 rafter impson Selo (3) 16' lvl 10' plumb R30 Insulation. 2X8 JOIST 2x8 collar ties 2x8 collar ties HANGERS i bath dog (3) 1� LVL R30 Insulation OZ$ house - .. 8'-4 ' e' studs IPS OKWOM N25 CLIPS 5foRAL,E 1 plumb 8'-4 iEYOW 6' 10 ' �RON1( nR00M R�A�f 17R00M 5 V2 0 R19 insulation 12 2 height of 4' 31' 6-1/4 plumb i LIPS (3) 9.5 lvl bedroom wAit 2x ader 10 S lv(3) 9, r.c.clnpboard' great room watt squns blks (3) 11.8.75 lvl 2ic8 collar ties. @ 4' t.w. �4'-3 header.over 2x 04 5/8 @ kitchen window " 1/2` cdx. e'-4 • MASt�R C3A1N MM5V�f7100M nINING ROOM 9'-1 ' WCO COW IT P PORCH, 6'-10 ' 2x6,..wat( 104-5/8 studs - 7 6' O SOLID BLK 9'Insulation solid.blk rgl s OVER BEAMS -\` un ring was p t. 2x10 led er 1 becotIn C�I 1 0' f 1 Vic- 11 w/ hangers 9 yP de'r bearing ll 9.5 rim Joist (2) #5 (2) 9.5 Wt. of o concre to ��. (2) #5 rebar (3) 9.S,lvl £ re- a — r RE-BAR w10 x 22 ° Pa. 2x10 :i keep backfitl simp n } (3) p.t. ® down 2' f. R [�.AA�.�i� Lcc rles caps ' concrete wall 2x10 \ 9' DAMPROOF_ t3A� ACK 8'-9� 3-1/2' column �a36" 12' sono tube r� (2) #5 rebar 4' SLAB W/ 3.5 .diam. 4• deep + 24' diam. 12`-9' POLY:UNDEq�- ( big foot �'" k (2) #5 \ 30X3oX10 key footing \\ RE-BAR FOOTINGS s S�C1" N �. kC:- 22x6 key 5EC1lON5 10 MP A(//' / I! �. 5MON A a V cc 9'-4i5 b. . �Bfl00C ———- — 10PRAtE QO ------ — ST S In t I J se � 1 6 5'-44' I .- 9- Cx----- I ---- — .7' r 7 ------- ---------- - ---------- —————--- NOW A\A o _ AlO %CCION 5 1 0 cc 14'-9A'. O 20'-3 9-2�'ce FUM Wt71A r;OOM 119FM PAr FIB �! 20-94' - (NO 51"OVf GYM 0Y1 . 27' 19 1' 23-5co WoM 1L1 0 5fMq r 51"oW y . 5fO �INISH�n CAS M Nf pl;A�l o 1852 5q/ - �INISI�t7 ` AMftT I j i LEGEND ASSESSORS MAP: 88 PARCELS: 1 & 2 ® PROPOSED WATER WELL ZONING DISTRICT: RF H -109- EXISTING CONTOUR MINIMUM YARD SETBACKS:* e�Yco<oNr FRONT = 30 SITE LOCUS REGALE +109 EXISTING SPOT GRADE SIDE = 15' SNOW RD o--p PROPOSED CONTOUR REAR = 15 - TH1 SOIL TEST HOLE 0 „ „ FLOOD ZONE: C BARNSTABLE o 0 SEE TEST HOLE LOG(S) COMMUNITY PANEL 25001 0001 D sF�h Gas UTILITY POLE JULY 2, 1992 0 0 CATCH BASIN GROUNDWATER OVERLAY DISTRICT: AP PLAN REF: BOOK 558 PAGE 13 LOCUS MAP +104.12 NOT ALL svMBOLS MAY APPEAR IN DRAWING PLAN REF: BOOK 556 PAGE 38 SCALE: NM \BENCHMARK: CONCRETE *VERIFY WITH TOWN OFFICIALS , ` BOUND ELEV = 106.9' +1 8.6 `�. 4 \ 102.92 0 ACCESS COVER TO WITHIN 6" OF FIN. GRADE ACCESS COVER (WATERTIGHT) TO ` TOP OF FNDN AT EL. 119.0 WITHIN 6 OF FIN. GRADE '\ � GROUND SURFACE AT EL. 118.0'f GROUND SURFACE AT EL. 115'f W LL 4 \ 6 + 1a /p :t MINIMUM .75' OF COVER OVER PRECAST 2% SLOPE: REQUIRED OVER SYSTEM PROVIDE INSPECTION PORT WITHIN 3" OF FINISH GRADE RUN PIPE L EL 2 DOUBLE WASHED PEASTONE +06.13 �� •� FOR FIRST 2 Z-OR GEOTEXTILE FABRIC , PROPOSED 1 500 112.0 8• `� s\ DRAINAGE 1 16.0' 1 15.50 ITEE• 115.75 GALLON SEPTIC ' Q0 . MANHOLE COVERS TANK (H-10) ` 00.76 BAFFLE GAS 111.60' 1 1 1.5 o�3.s' ® SIDES 1 1 1.77' +07.2 %'j �� DEPTI OF FLOW = 4 2' ® ENDS ro '\ c CRUSHED STONE OR MECHANIICA� a' 6 � to1.o3 TEE SIZES: 6 �7 looso INLET DEPTH = 10" MIN BELOW FLOW LINE COMPACTION. (15.221 [21) 0800 o� 14" o o F' % + iE.2 `�� t0298 \t�G �` OU-'LET .DEPTH = 14" MIN BELOW FLOW LINE $ �� -� 10 9.5 {y 0 109. 4 A�\r . 1p2 �� 0.32 �Ftt ,03 ,01. 100.43 c TO 1 1 2" DOUBLE WASHED STONE +99.37 +99. 22�� (MIN 2% SLOPE) (MIN 1% SLOPE) (MIN 1% SLOPE) / +02 ` 9 .3+ 's 01'78 \`\ FOUNDATION 11' SEPTIC TANK 17' D' BOX 5' --LEACHING FACILITY 9.5' P S 0 FE +t, .59 AS P R T TE A L AL 70 s .25 A 10 S. P � o �e � SYSTEM PROFILE I SELF-L T I G A ,4. a 09 +1 � 11z. \ , ,03�4 o4.i4 _I_ TH2 EL. 100.0 (NOT TO SCALE) �101.15 i 110.47 o +107.16 +1 2 +1 .zt O ^�D O +t o . I ,� �� _1 t 15. =' A TH13 TH14 � 0 5.99 12.69 DEPTH (IN.) ELEVATION (FT.) DEPTH (IN.) ELEVATION (FT.) w o9 94 ' 0" 126.4 0" 125.5 , oz.ao I LOT 6 f< <��'� ,3.ea + 2e , O 0 . -- +_ . _ PROP. BR 141 REt DWELLING ,s.' 7519 - _ _____ ________________ 1 ORGANIC ORGANIC PORCH +116.39 +t�,isosl .o +101.78 „ 2.5 Y 2.5/1 „ 2.5 Y 2.5/1 SEPTIC SYSTEM DESIGN DATA 3 126.15 3 125.25 +1 4. 113. 6 ► DATE: MARCH 20, 2001 (GARBAGE DISPOSER IS NOT ALLOWED) i 16.73 TOP FNDN = o � ' E E SEPTIC DESIGN: +115.4`7 +1 ro.zs 1 19.0, 10 . a o3.01 ' , DECK AT E. SLAB 2�•2' TH1. 1► r 2.5 Y 6/3 ENGINEER: ARNE H. OJALA, PE; PLS 2.5 Y 6/3 DESIGN FLOW: 5 BEDROOMS (110 GPD) = 550 GPD +11 47 6" 125.9 WITNESS: GLEN HARRINGTON, RS 6" 125.0 + 12. 3 109.0't B EXCAVATOR: BORTOLOTTI B - SEPTIC TANK: 550 GPD ( 2 ) = 1 100 LOAMY SAND LOAMY SAND - +12.3 USE A 1500 GALLON SEPTIC TANK GARAGE T 2 0 . „ 2.5 Y 6 6 / 34 123.57 _ :, 34 122.67 . . r / 2.5Y6/6 ' LEACHING: 1Aa SLAB AT EL. I / C1 SOIL CLHJS: I l.1 - - (1 �a.1. n 7c. R? _- . �i F, C, in.o' S .TT X- --10 3_ F_ +11737 / 103.6 / IL LOAMY SAND' LOAMY SAND , SIDES: 2(49.75 + 10.83) X 2 = 242 S.F. ' 14.01 103.01 �/ PERC RATE: <5 MIN. INCH ``6 - 1' S�03 2.5 Y 7/4 / 2.5 Y 7/4 ` + + \ .f + B. 5 �/ TOP PERCS: 75" TOTAL: 780 S.F. X 0.74 LTAR = •577 GPD > 550 O.K. 1,8 +11 +1 1 5. +1p3.25 USE (1) ROW OF (7) H-20 HIGH CAPACITY INFILTRATORS 1,L0 T +1 1 B. +11 4 / /\ ° 1� � .WITH 4' OF STONE AT .THE SIDES, 3' AT THE ENDS, _ AND 1.4" BENEATH PROP. DRIVE. / / 11 g794 �z2 13 \ B � 13' 113.4 13' 112.5 - �za 11 51 NO WATER FOUND NO WATER FOUND 11 62 +06. 1 / 2.2.99 \ >t w TEST HOLE LOGS NOTES: +t ta.11 \ +�d��'�1 � (NOT TO SCALE) 3 ,ti6 12 .99 ' 0 2 1. THE LOCATION OF EXISTING UNDERGROUND UTILITIES *SHOWN ON N725,iL 1 29 _ THIS PLAN IS APPROXIMATE. PRIOR TO ANY EXCAVATION ON THIS "� 1 0 1 0 `'9� TH13 TH14 SITE, THE EXCAVATING CONTRACTOR SHALL MAKE THE REQUIRED 72� +„9.42 ,,;� N _ DEPTH (IN.) ELEVATION (FT.) DEPTH (IN.) ELEVATION t FT.) /+1 1.65 / 0" 1 14.6' 0" 1 12.0' HOUR NOTIFICATION TO DIG SAFE (1-888-344-7233) AND ANY / = FINAL GRADING TO BE FILL/A/B MIX FILL OTHER UTILITIES WHICH MAY HAVE CABLE, PIPE, OR EQUIPMENT +129.74 co = DETERMINED BY CONTRACTOR IN THE CONSTRUCTION AREA FOR VERIFICATION OF LOCATIONS. +126.71 33rr 24rr ' 2. MUNICIPAL WATER IS UNAVAILABLE. B A 3. .ALL SEPTIC WORK AND MATERIALS TO CONFORM TO 310 CMR ' LS 106.45 DATE: JUNE 6, 2006 LS / 67 +126.75 44r. 1OYR 4 3 ENGINEER: DAVID FLAHERTY, IRS 1OYR 3/2 15.00 TITLE 5 AND BARNSTABLE HEALTH REGULATIONS. „ Cl 110.9 WITNESS: D. DEMERAIS, IRS 27 B 4. MINIMUM PIPE PITCH TO BE 11/8 PER FOOT. +127.63 + . o Y ; MS L$ 5. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H-10. 1OYR 6/8 1OYR 6/8 6. PIPE JOINTS TO BE MADE WATERTIGHT. +122.42 +1z9.e2 r 65 38" 108.8 7. WATER TEST D-BOX FOR LEVELNESS. SOIL CLASS: ,oBB C2 C 8. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO BE i O USED FOR LOT LINE STAKING. o O PERC RATE: <5 MIN./INCH I ui FS BOTTOM PERC: 91" FS 9. PIPE FOR SEPTICSYSTEM - " +, 1.219M 0 �1080 L E TO BE SCH. 40 4 PVC. + 52010. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT +,z,.o6 j 00 1OYR 6/4 1OYR 6/4 INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED 124" 1 1104.2' 144" 100.0' FROM BOARD OF HEALTH. 01 NO WATER FOUND NO WATER FOUND 11 . NO VEHICLES OR CONSTRUCTIION EQUIPMENT ALLOWED OVER PROPOSED SYSTEM. 12. VERTICAL DATUM APPROXIMATED FROM QUAD 13. ANY UNSUITABLE SOIL ENCOUNTERED SHALL BE REMOVED FOR 5' AROUND SAS AND REPLACED WITH CLEAN MED. SAND 1 I TITLE 5 SITE PLAN off 508-362-4541 OF fox 508 362-9880 895 CEDAR STREET IN THE TOWN OF: do wn cape engineering, Inc. WEST BARNSTABLE of S`S1 It A OF/,fps PREPARED FOR: �� oy CIVIL_ ENGINEERS M/M PETER ELDRIDGE j ARNE a o ARNE H a H. "� o� OJALA OJALA. y CIVIL N LAND SURVEYORS No,26 8 No. 307592 DATE: JUNE 13, 2006 SCALE: 1 " = 30' j o� �° �`� BOARD OF HEALTH � a �FSSCNAL O�sTE`�a / �� 939 main st. Yarmouth, ma 02675 30 0 30 60 90 I E 3 ARNE H. OJALA, PE, PLS DATE APPROVED DATE MA 1 06-072 I