HomeMy WebLinkAbout0211 MAPLE STREET - Health L
aple Street
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CERTIFICATE OF ANALYSIS
Barnstable County Health Laboratory (M-MA009)
Report Prepared For: Report Dated: 9/16/2015
Arne Ojala Order No.: G1590319
P O Box 191 t""I
W Barnstable, MA 02668
Laboratory ID#: 1590319701 Description: Water-Drinking Water
Sample#: Sample Location:; 211 Maple St.West Barnstable, MA Collected: 09/15/2015
Collected by: Received: 09/15/2015
Routine
ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE
Nitrate as Nitrogen 0.23 mg/L 0.10 10 EPA 300.0 LAP 9/15/2015
Copper 0.16 mg/L 0.10 1.3 SM 3111B LAP 9/15/2016
Iron ND mg/L 0.10 0.3 SM 3111-13 LAP. 9/15/2015
pH 7.7 PH AT 25C NA 6.5-8.5 SM 4500-H-13 DCB 9/15/2015
Sodium 13 mg/L 2.5 20 SM 3111B LAP 9/15/2015
Total Coliform Present P/A 0 0 SM 9223 RG 9/15/2015
Conductance 280 umohs/cm 2.0 EPA 120.1 DCB 9/15/2015
Recommended maximum contamination level exceeded due to Coliform Bacteria. Tested Negative for E.coli. Retesting
is recommended.
Attached please find the laboratory certified parameter list. Approved By: _
(Lab Director)
ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level
Superior Court House, PO. Box 427,. Barnstable, MA 02630 Ph: 508-375-6605
Page: 1 of 1
CERTIFICATE OF ANALYSIS,..
Barnstable County Health Laboratory (M-MA009)
Report Prepared For: Report Dated: 9/22/2015
Arne Ojala Order No.: G1590421
P O Box 191
W Barnstable, MA 02668
Laboratory ID#: 1590421-01 Description: 'Water-Drinking Water
Sample#: Sample Location: 211 Maple St. West Barnstable, MA Collected: 09/21/2015
Collected by: Ojala Received: 09/21/2015
Test Parameters
ITEM RESULT UNITS RL MCL METHOD# ANALYST TESTED NOTE
Total Coliform Present P/A 0 0 SM9223 RG 9/21/2015
The recommended maximum contamination level for drinking water exceeded due to Coliform Bacteria. Tested negative
for E.coli.
Attached please find the laboratory certified parameter list. Approved B
(Lab Director)
r
ND=None Detected RL = Reporting Limit MCL=Maximum Contaminant Level
Superior Court House, PO. Box 427, Barnstable, MA.02630 Ph: 508-375-6605
.............
�.. TOWN OF BARNSTABLE
211, MAPLE STREET , W . BARNSTABLE . 2003-448
LOCATION SEWAGE #
VILLAGE WEST BARNSTABLE ASSESSOR'S MAP & LOT1 3 2/ 5
INSTALLER'SNAME&PHONENO.ELLIS BROTHERS CONST . CO.. 362-6237
SEPTIC TANK CAPACITY /� '�-6
LEACHING FACILITY: (type) �t`� (size) ��O
NO.OF BEDROOMS
BUILDER OR OWNER ARNE AND SARAH OJALA
PERMIT DATE:9/ 1 5/0 3 COMPLIANCE DATE: 1O Z f/0
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility. (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
_ �y
i3s-
p,--3 ' d"1 �
A1A%a.
No. 1)��� y/0 - Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer. tl
Yes
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE,, MASSACHUSETTS
2ppricatton for Zig;pool *potem Construction Vermtt
Application for a Permit to Construct( , j Repair( )Upgrade( )Abandon( ) O Complete System O Individual Components
Location Address or Lot No. Owner's Name,Address Tel.N
All� Ih�QL� s r- am , ddres and e. o.
Assessor'sMap/Parcel ��R1VST14��C. ARuX j Sp pAF-j. GJ1-tL/1—
M 3Z P 5
Installer's Name,Address,and Tel.No. �L,.� Designer's Name,Address and Tel.No.
PO ca P-e C_N 't tr%le x y
T. 3� ti
Type of Building:
Dwelling No.of Bedrooms _ Lot Size a'2?i Ac,, ft. Garbage Grinder( )
Other Type of Building 12Pst ZeA t CA- No.of Persons 7_ Showers( ) Cafeteria( )
Other Fixtures
Design Flow— 3 3 o gallons per day. Calculated daily flow gallons.
Plan Date Re 6 Z- Zo O3 Number of sheets Revision Date
Title
Size of Septic Tank 10 o c; +X V_ Qt L510 0 Type of S.A.S. Q t T"'
Description of Soil; S a h _ �c p c, 4-CL„ �C l( �tC�tc U t` �'►'► v V-�
Nature of Repairs or Alterations(Answer when applicable) M o V-e- `3Q P'f t L
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 n place the system in operation until a Certifi-
cate of Compliance has been issued by this Bo d of Heal .
Signed Date 9 /S
Application Approved by X9 Date /
Application Disapproved for th following reasons
Permit No. 0 0 — Date Issued / — o
f No—, U — / �- 7 Fee
� 4 f� y-� Entered in computer:
THE COMMONWEALTH OF MASSACHUSETTS Yes
PUBLIC HEALTH DIVISION -TOWN-OF BARNSTABLES MASSACHUSETTS
Zfpprication for Migooal bpg;tem Construction Permit
Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) O Complete System El Individual Components
Location Address or Lot No. All M R q L� S T"
Assessor's Map/ParcelOwner's Name,Address and Tel.No.
w toSTRY', A2NZ I SA " k4
�.-
Installer's Name,Address,and Tel.No, Designer's Name,Address and Tel.No.
Type of Building: ,
Dwelling No.of Bedrooms .3 Lot Size c'2?J AC-sq.ft. Garbage Grinder( )
Other Type of Building Q PS i D-P.,jr c A No.of Persons Z Showers( ) Cafeteria( )
Other Fixtures
A,... Design Flow 3 o gallons per day. Calculated daily flow gallons.
Plan Date F p e;o Z Z U 3 Number of sheets Revision Date '-
a Title
Size of Septic Tank 1 0 o ca -i-'A ti (L t$'y y Type of S.A.S. f fJ 1 T'
Description of Soil: S G.n c( Qj P��.c.t "h (e_ �. ( cC�((t c `�" t'U w► a V-e
d
Nature of Repairs or Alterations(Answer when applicable) ro Cj v 4 `�P �+i C_ 'f A V) �L
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-t place the system in operation until a Certifi-
cate of Compliance has been issued by this Board of Heal .
Signed Date 9 IS
Application Approved by .�. • Date g /f
Application Disapproved forth following reasons t
Permit No. 0 v — y�� Date Issued 9�/ u
i
---------------------------------------
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 11 Iv AOI e 11, has been construcjed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. a Ou?- hf dated ' /1 v 0 _
Installer Designer
The issuance of this p'rmit s'all not be construed as a guarantee that the system will=`�t'o as e i'fed:
Date 10121163 Inspector
---------------------------------------
No. Di)03 — Fee /00
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLES MASSACHUSETTS
Migpogal bpgtem Construction Permit
Permission is hereby granted to Construct )Repair( )Upgrade( )Abandon( )
System located at 2 0 ro r�n'e S� I
r
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:Cons�ctio must be completed within three years of the date of s permitti
Date: 01I(/ (J Approved by
C TOWN OF BAPNSTABLE
211 MAPLE STREET , W . BARNSTABLE 2003-448
i LOCATION SEWAGE # -
WEST BARNSTABLE 132/ 5
VILLAGE ASSESSOR'S MAP & LOT
INSTALLER'S NAME&PHONE NO.
E L L I S BROTHERS CONST . CO.. 362-6237
SEPTIC TANK CAPACITY.
Err (size)LEACHING FACILITY: (type)
®O O I
NO.OF$EDROOMS
j BUILDER OR OWNER
ARNE AND SARAH OJALA
PERMIT'DATE:9/ 15/O 3 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 Feet
within-300 feet of leaching facility)
Nmished by
i
'tj
w In `
M v
kA
VI
V
Fee,"f -- ---------
BOARD OF HEALTH
TOWN OF BARNSTABLE
Application fforVerr Con5truct ion Permit
Application is hereby made for a permit to Construct Alter ( ), or Repair ( )an individual Well at:
——air _ /1i PL F fir- lu . .QAeays — /J.Z --
t 1 Location.— Address Assessors Map and Parcel
. /VoS/� he LJ o�RG/� -- o�// lit Pl L__ A.Pr1 Sj �lE-
Owner Address
� bi�'I6i'1l� �IeiL�f�c
— — _—_—_-- ��— --__-----O � — j —=--- _-__
Installer — Driller Address It'7 ���
Type of Building �`
Dwelling _—--- -— —-- —-
Other - Type of Building— No. of Persons-----------------_______
Type of Well --�J—�— Capacity— --142-m-eo? �
Purpose of Well---- — —
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation until a,Certifi aatt of Compliance has been issued by the Board of Health.
sag —
date
PP PP '
Application A rove ;By_ ----------- � a��-----
date
Application Disapproved for the following reasons: -------------- --- ----------- - ----
date
Permit No. b — Issued Lai—
date
-------
date
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate Of Compliance
THIS IS, O CERTIFY, That the Individual Well Constructed ('-<, Altered ( ), or Repaired ( )
--- — — --
by—__ Installer — -- ---—_--_-----
has been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. ----------Dated---- -------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE---- Inspector---------------- ----------
Ok
3 t 1::nVL-----
` BOARD OF HEALTH
TOWN OF BARNSTABLE
s 0(ppCication for'Ver[ Cootructionpr mit
Application is hereby made for a permit to Construct (v , Alter ( ), or Repair ( )an individual Well at:
Sr- lei . 6,geW611I61� -- hi�P/.3a �G� S --
Location — Address Assessors Map and Parcel
le
Owner Address
- — ----------- ----- ------------ - ----- ------------
Installer — Driller Address Oa 6 c
Type of Building J 3
Dwelling -- — —------
Other - Type of Building-- ------- No. of Persons--------------- --------
Type of Well -- - Capacity-----
Purpose of Well--
Agreement:
The undersigned agrees to install the aforedescribed individual well in accordance with the provisions of The
Town of Barnstable Board of Health Private Well Protection Regulation — The undersigned further agrees not to
place the well in operation until a.Certiffiiiccat .of Compliance has been issued by the Board of Health.
S' n d C->��
ate
Application Approved By -- -------- �- --� ---
date
Application Disapproved for the following reasons: ----------- - ----------- -----
date
Permit No. ` b -- Issued-- --- -��=�U-�---- -- -----
date
r
BOARD OF HEALTH
TOWN OF BARNSTABLE
Certificate ®f Compliance
THIS IS.-TO CERTIFY, That the Individual Well Constructed (✓)!Altered ( ), or Repaired ( )
by— �C�!Y(-O/Vy /.IJ�G� �1�P/GC�_�t.I_' � ------- -----
1 — Installer'athas been installed in accordance with the provisions of the Town of Barnstable Board of Health Private Well Protection
Regulation as described in the application for Well Construction Permit No. ----------Dated---- = ------
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE WELL
SYSTEM WILL FUNCTION SATISFACTORY.
DATE----- -- Inspector-----------______-- -- ---___--
BOARD OF HEALTH
TOWN OF BARNSTABLE
Ivell CaOtruct ion A3erntit
No. r '� l� Fee_ ---
Permission.is hereby granted
to Construct (✓), Alter ( ), or Repair ( ) an Indivicjpal Well at: - — ----
o?l l YYI 4 l-e.r eat-- 217 s-R-rj ,Q L F
No. — - ------ ---- ---- - --------------------
Street
as shown on the application for a Well Construction Permit
No.- — __— D -----
DATE-- -- -
,� Board of-Health
�' 0�� -_ _ —
Massachusetts Department of Environmental Management 121880
Office of Water Resources
TYPE OR PRINT ONLY Well Completion Report
1. WELL LOCATION GPS(OPTIONAL) LATITUDE LONGITUDE
Address at.Well Location.
1<t 1� c T'Propery O(nrner. .>�+r—r -r 1
f Mailing Address ' 1i 1
Subdlyisior Name h
�- - .
Citylftiwn: �� �'i�7"'1 Gity/Town:. .-
' Assessors Map r ~Assessors LoY:4 NOTE Assessors Map and Lot# mandatory If/noa reet address available
Board-of Health permit obtained ' Yes E Not Required ❑ Permit Number,'(" �a `��Date`:Issue`d
2. WORK PERFORMED 3. 2ROPOSED USE 4. DRILLING METHOD
IM New Well ❑ Abandon E4 Domestic ❑ Irrigation ❑ Cable �_ ' .Auger
El Deepen El Recondition El Monitoring El Municipal ❑ Air Hammer b"❑j Direct Push
❑ Replace ❑ Other ❑ Industrial ❑ Other ❑ MudtRota , ' ❑ Other
5. WELL LOG Cr Unconsolidated Consolidated 6. SITE SKETCH (use permanent landmarks with distances)
W Permeability — y
t .,a
a
High �From (ft) To (ft)
m Other Rock Type k
to -,4o -T=-M-G k A
t=-/t'( ,
D o_-i t
MA Pt-e: ST2E F_
7.. WELL CONSTRUCTION S. CASING
Total Depth Drilled —CC— From (ft) To (ft) Casing Type and Material Size O.D. (in) Well Seal Type
Date Drilling Complete _+ PAC C�l -4 ii
�-a D-�� �.
9. SCREEN
From (ft) To (ft) Slot Size Screen Type and Material Screen Diameter
10. FILTER PACK/GROUT I ABANDONMENT MATERIAL 11. ADDITIONAL WELL INFORMATION'
From (ft) To(ft) Material Descriptiorl�-� t Purpose Developed? Yes El No
n n Fracture
Enhancement? ❑ Yes E� No
to Method -
,�> Disinfected? Yes ❑ No
12. WELL TEST DATA(PRODUCTION WELLS) 13. STATIC WATER LEVEL(ALL WELLS)
Yield-`Jimb Pumped Drawdown to Time Recovery to Depth Below
Date Method (GPM)i..'`''(his`&min) (Ft. BGS) (hrs & min) (Ft. BGS) Date Measured Ground Surface (FT)
14. PERMANENT PUMP (IF AVAILABLE) 15.NAMEIADDRESS OF PUMP INSTALLATION COMPANY
Pump Description eD Horsepower
Pump Intake Depth (ft) Nominal Pump Capacity (gpm) pL�> B X C�;)7 S_:3 4�
16. COMMENTS _\`�` m t::)
17. WELL DRILLER'S STATEMENT This well was drilled and/or abandoned under my supervision, according to applicable rules
and regulations, and this repo- s complete 41d correct to the best of my knowledge.
0
Driller: I k� '`� _TD��tLpervising Driller Signature: Registration .:1
171
Firm: r' v r + Date: '� —�'�"" 3 Ri Permit#: z� �1
NOTE: Well Completion Reports must be filed by the registered well driller within 30 days of well completion.
BOARD OF HEALTH COPY
f
l'IRO]IzCll7.ABOI?A7ORII:S, INC.
AIA CERT.NO.:h1-MA 063
449 Rte. 130 RECEIVED
Sand«ich, MA 02563
i 2 508(888-6460) 1-800-339-6460
MAR FAY(508)888-6446 MAY 0 5 2003_
PARCEL, '
TOWN Or BARwSTABLE
HEALTH DEPT.
LOT `
CLIENT: Desmond Well Drilling LOCATION: 211 Maple St
ADDRESS: (Arne Ojala) W Barnstable MA
COLLECTED BY: Desmond Well Drilling SAMPLE DATE: 4/22/2003
SAMPLE TIME: 2:00
WATER SAMPLE TYPE: New Well Replacement DATE RECEIVED: 4/23/2003
LAB I.D. #: 0304390
WELL SPECS.:. 4" 35'/65'
RESULTS OF ANALYSIS:
Parameters Units Recommended Results Method Date Analyzed
Limits
Coliform bacteria /100 ml 0 0 9222 B 4/21/2003
pH pH units 6.5-8.5 6.05 4500 H+ 4/23/2003
Conductance umhos/cm 500 121 120.1 4/23/2003
Nitrate-N mg/L 10.0 4.16 300.0 4/23/2003
Nitrite-N mg/L 1.00 < 0.004 300.0 4/23/2003
Sodium mg/L 20.0 12.8 200.7 4/23/2003
Iron mg/L 0.3, < 0.1 200.7 4/23/2003
Manganese mg/L 0.05 r , < 0.008 200.7 4/23/2003
COMMENTS: pH is below recommended limit and may have corrosive characteristi l
WATER MEETS EPA STANDARDS AND IS SUITABLE FOR DRINKING PURPOSES
FOR PARAMETERS TESTED.
<=less than
>=greater than
TNTC=too numerous to count
Date_V 2
Ron ld J. Saari
Laboratory Director l 4
..Al
raE N�kys,.,
yL hf CERTIFICATE OF ANALYSIS Page: 1
Barnstable County Health Laboratory
Report Prepared For: Report Dated: 2/7/2003
Order Number: G0318814
Bob Norton
Box 156
Barnstable, MA 02630
Laboratory ID#: 0318814-01 Description:
Sample#: 18814 Sampline Location: 211 Maple Street,West Barnstable Collected 2/3/2003
collected by: Rita Wojcik 132-5 Received 2/3/2003
Routine
ITEM RESULT UNITS MCL Method# Tested
LAB: IC Lab
Nitrates 2.1 mg/L 10 EPA 300.0 2/4/2003
LAB: Metals
Copper 0.4 mg/L, 1.3 SM 3111B 2/6/2003
Iron IJ mg/L 0.3 SM 311113 2/6/2003
Sodium 12 mg/L 20 SM 3111B 2/6/2003
LAB: Microbiology
Total Coliform Absent P/A Absent 309 2/3/2003
LAB: Physical Chemistry
rY
Conductance 170 umohs/cm EPA 120.1 2/3/2003
pH 6.0 pH-units EPA 150.1 2/3/2003
Note: Based on the results of the parameters tested,the water is suitable for drinking,but may present aesthetic problems(taste,.;
odor,staining)due to Iron.
Approved By:
(Lab Director)
F EB 1 �. Zn03
TOWN Or u�;i1vb1ABLE
HEALTH DEPT.
Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605
COMMONWEALTH OF MASSACHUSETTS
s EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS
DEPARTMENT OF ENVIRONMENTAL PROTECTION
MAP
PARCEL.
LOT A
TITLE 5
OFFICIAL INSPECTION FORM—NOT f OR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM 0R — ®
PART'A
CERTIFICATION (� 2 6 20 02
Property-Address: or-A4 �JIJ L'�' �'j
t�lY�S7GV� TOWN OF BARivSTABLE
V 1 HEALTH DEPT.
Owner's Name: / rnt J<Jrol �6
Owner's Address: Zefil Y177
V
Date of Inspection: -f ;r-
Name of Inspector: (pleaseprint)/fie /l a A, k, 9_ KI-r-
Company Name: /C[.J r,t ;&c', 19
T� j
Mailing Address: NpF 2�0
Telephone Number: .C'®.P- y FATTgg
<F
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:
L/ Passes
Conditionally Passes
Needs Further Evaluation by the Local Approving Authority
Fails
Inspector's Signature:4,t Date: // i'. Z
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving
authority.
Notes and Comments
****This report only describes conditions at the time of inspection and under the conditions of use at that
time.This inspection does not address low 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 1 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: Z-/1 AI-Rf2j'C- 5 T'
Q`i A —Nas s1
Owner: dramsA "K L) r
Date of Inspection: 7-
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
System Passes:
�1 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
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 than20 years old is available.
ND explain:
Observation of sewage backup or break out or high static water level in the distribution box due to broken or
obstructed pipe(s)or due to a broken,settled or uneven distribution box. System will pass inspection if(with
approval of Board of Health):
broken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will
pass inspection if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: Z// AIRP/e ,S
WR s -A& 6
Owner: :, ej )-e.
Date of Inspection: // Z5 ®'3-
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:
P
3
Page 4 of 1 I
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: Z//
Owner p A.t !-Gr
Date of Inspection: O�✓
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
v 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
14 Liquid depth in cesspool is less than 6"below invert or available volume is less than'/z 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.
L Any portion of a cesspool or privy is within 50 feet of a private water supply well.
,L 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.]
(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 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•
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.
Page 5 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address: 7-// /&Wle S
1-t--
Owner:
Date of Inspection: p'�
Check if the following have been done.You must indicate"yes"or"no"as to each of the followinQ-
Yes No
Pumping information was provided by th owne occupant,or Board of Health
V 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?
V _ 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?
d/ — 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.
_ Determined in the field(if any of the failure criteria related to Part Cis at issue approximation of distance
is unacceptable)[310 CMR 15.302(3)(b))
f
Page 6 of 11
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address: 2// H!W 4, 1
Owner: Mor.#,v arLs
Date of Inspection:
FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 3 3 0
Number of current residents:
Does residence have a garbage grinder(yes or no): 1,)o
Is laundry on a separate sewage system(yes or no): Ili a (if yes separate inspection required]
Laundry system inspected(yes or no): No
Seasonal use: (yes or no):/J u
Water meter readings, if available(last 2 years usage(gpd)): 1�rr UG In�e t
Sump pump(yes or no): NO
Last date of occupancy:
COMMERCIAL/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: L-A"'f- C>V^j tQ-e"V—
W as system pumped as part of the inspection(yes or no): /V o
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)
_Tight tank _Attach a copy of the DEP approval
Other(describe):
Approximate age of all compon nts, date installe (if known)and source of information:
Were sewage odors detected when arriving at the site(yes or no):_A),o
Page 7 of 1 1
OFFICIAL INSPECTIO —NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 1il) t'1A_ )e �T•
Owner: CX n i 4
Date of Inspection:
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: i V h
Material of construction: oncrete_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) ti . 4. A
.Dimensions: /Cd`ZL X' S`77 Y �7 1?, 0-}1
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle:
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:
How were dimensions determined: ���P/I.ox/rl?j¢yt� /r-1•e�s t,+�1� .,�,
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.):
lep,..�
GREASE TRAP:_(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 of 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.):
f
Page 8 of I I
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: Z/I /jA0/�.
Owner e
Date of Inspection: a �.
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/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: (if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert: 5
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.): �.� n
�-�-g a� e�!n n w�S ^j 0 S�Q.mil _ t C/9 r r4 Lf-C/1
PUMP CHAMBER: (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.):
Page 9 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: ��� 77
� �"��
)&n �Owner: m 4'1-0--
Date of Inspection:
SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required)
If SAS not located explain why:
Type
leaching pits,number:L
leaching chambers,numbe-:
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.):
..o.�� /.rJt3 s G�ior� fiU l i�® 1/s✓y�
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 or no);
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.):
0
f
Page 10 of I 1
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: Z// i"47"OlY 5:r
' Ar
Owner: ,'I�t. , ►�
Date of Inspection: 6-z,-
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.
7
is /
f
Page 11 of I 1
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFAC$SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: / Al K t.
26i'f r S
Owner: /Ulrl U,7,4 a y-H-e a-
Date of Inspection: //5 29 A3-I-
SITE EXAM `
Slope — S /)9 A T
Surface water N o
Check cellar
Shallow wells N o
Estimated depth to ground water egW feet
Please indicate(check)all methods used to determine the high ground water elevation:
l 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:
Checked with local excavators,installers-(attach documentation)
Accessed USGS database-explain:
You must describe how you/established the high ground water elevation:
�' •
i •
I��ec (
0 11 a � (�r��--..
sv �� �. II
ry
�UaVv V"� Y 1 s 'A � - aR �
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E'
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.•
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J
//,/
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� �' ��
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;��.
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TOWN OF BARNS T ABLE
LOCATION , SEWAGE # e
VILLAGE L% ASSESSOR'S MAP Sz.LOT /
'INSTALLER'S NAME Si PHONE NO. 6
`IEEPTIC TANK-CAPACITY
LEACHING FACILITY"type) —(size) l oed
R -
NO. OF BEDROOMS PRIVATE SVE L OR PUBLIC WATER '
-4f
BUILDER OR gVNNERJ
DATE PERMIT ISSUED:
DATE COZIPLIANCE ISSUED:
VARIANCE GRANTED: Yes No 10
� rA`'�-^
,h
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[� �,
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,i
// � � � `�
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4
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Ir
� F���Y4 1
No..... FEB... ��.'...
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALTH
.........................................:OF...........................----..........--------•---.....-----------._...................
Appliratiun for Diipuual Works Tuiiutrurtiuu ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
Sys a ------------
*.........
.---------•.........................•-----• •----•----..---••-----------------.------
Loc Address or Lot No:
ss
W O ner
........
staller Address
Ue of Building Size Lot............................Sq. feet
Dwelling=No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( )
Other—T e of Building a YP g ------••-•-----------••••--- No. of persons............................ Showers ( ) — Cafeteria ( )
d Other fixtures . ------------------------------
••--------•-•-•-----
W Design Flow.........;.A9.......................gallons per person per day. Total daily flow..............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ 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 ( )
aPercolation Test Results Performed by.......................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of-Test Pit.................... Depth to ground water........................
rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
9 -•----------•-••--------•--••••------•---------•-------------•••-------..........--------._........•........................................................
0 Description of Soil........................................................................................................................................................................
x
U .....................................-........•---.....-------•-•------------------------....------•--••------------------••----•--•---------.....-----------------------...........------••---...-----
UW •----- ---- - - ------------ ----------- ---- - ----------- •• •. ... --------. ---------
Nature of Repair or Alterations— ns er when applicable--
----------------------"� , .._�� �r �D
._ ._. ._.._e�P..........................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of i1Ti , 5 of the State Sanitary Code—The undersigned further agrees not to place the system in _
operation until a Certificate of Compliance has bee ssued by the bo d of health.
/ s�
Signed-- -- - --- -• --•------------ ---`.....------...------------•--- `��-----...._.....�=
Date
Application Approved BY s- `""� ---•-•-------------------
Date
Application Disapproved for the following reasons------------------------------------------------------------- ---------------------------------------------••----
.....................................•------------•--------•-•-•----------------------•--•--------------•---------------•------.-------------••---------•----•------•--------------------•-•...------
Date
PermitNo.......� _ .'.. _ ?................... Issued.......................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS FEE
BOARD OF HEALTH
.......................................---.OF.....................................
Applirtt#inn for 11ispnsttl Workii Tomitrurtinn Frrutit
Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
Syst at:
........Vie
..:...... ..... ................... ---- ------..._-•------------
Loc Address
--------or Lot No.
�4 I
a . ........
� staller Address
e of Building Size Lot............................Sq. feet
�-1 Dwelling No. of Bedrooms.........:..................................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( )
p-1 Other fixtures .---••-----...--••-•-----------•-•••-•----••_-----•-.--- - -
W Design Flow......_..v-.e.......................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity.......1....gallons Length................ Width...._........... Diameter.-,............. Depth................
x Disposal Trench—No..................... Width.................... Total Ilength.................... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
aPercolation Test Results Performed by........................................................................... Date........................................
Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water........................
f.4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
P4 .-••••••--•----•----•-••••••-•----•-••••--•-•-••-......----•........................................................•---•-•---••----•••--.........-----------
0 Description of Soil........................................................................................................................................................................
x
V ....--•••--•-••••-••------••••-••----.....--••••---•-•-••••------•----•.........................••••--•--------•-•••••----•••---•---•-•--•-------•••••--••---•--••••••••-•-•----•-•-----•......--••--••.
W -••-•-••-•••----------------------•--•••------••......-----------------....................................... ...................... •�
V Nature of Re .........4"Vo
pair or Alterations— ns er when applicable._________ ____ _____ 4
....................0
............................................
..
-------
_ •- .r`
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of'=ICE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been sued by the bo d of health.
Signed••. -----•--••---• '............................. "
Date
Application Approved BY .._... sir --------�---�
Date
Application Disapproved for the following reasons:---------•-----------•--•------------------------------•-------------•---------------------•••-••--•......------
..............•--•-••-•--.....--------.....---•-........•-•--......-•-•-------•----------....•----...•-----•---•-•---••-------------••••••--•••-•-•-•-••-•------•--•••••-•-----••-•-----•--••-----•-•---
Date
PermitNo....... •.............•------•-------------•------•--• Issued............----------------------.......------•--......
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH --,-� I
.......... GR kt. ,., ........OF.............. !°'....� q........................................
Cnrr#ifirtt�.� of (�nut�littnrr
THIS IS,TO CERTIFY, That he Individual.Sewage Disposal System constructed ( ) or Repaired S..I
b "
K ---- -.-- --•-----------------------------•----•-•--•------•------------••-•--------•--•------------•-•--------------•-----------
In t 1 er
at. '�1 �� 11'✓7.1:w>.. .. ,..._.. c!}�. ' i�!�!±4+ ..............................................
has been installed in accordance with the provisions of T " I E 5 of The State Sanitary Code as described in the
application for Disposal Works Construction Permit No........ ........ dated................................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE.CONSTRUE® AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE.............................. ....`......................................... Inspector................. J----•-----...-•--------....------......--••----
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALT
............. •......... FEE.. ..
Disposal nrku Twnnn Sinn rruti#
Permissionis hereby granted............... ---••- -----...._.....-••'•. -•-...............................................................................
to Construct ( ) r�Repair ( an Individual Sewage Dispo System
Street
as shown on the application for Disposal Works Construction Permit N .7�.'?_VfDated..........................................
.----•--•-------------- . ----------------------------------------------------------
to
• ,; � „
DATE.................!r2in�L-L_-` Board of Aealtfi- -._.....
FORM 1255 HOBBS & WARREN. INC., PUBLISHERS
-71,2c,110 j&421 L 2 `�Ye
RTE 6A
RqI
CRpAD
wmN
f �
LOCUS
LOCATION MAP (NTS)
ASSESSORS MAP 132 PARCEL 5
/#4 SETBACKS:
/ FRONT: 30'
OLD SIDE. 15'
CRANBERRY S0' REAR: 15'
BOG S / FLOODZONE: C
�� 24"TOAK
cam. Q" PARCEL 6
UNDE LOPE a
LAND E JOHN R. MURELLE
_ JOHN F. CARAFOLI
\
PO BOX 273�� W. BARNSTABLE
#3�m ¢'
/ / 5°,0/�°�
C 0 \ /
/ JO AH & MA D. / P N
` KUTO ITZ PAR - �5� Lot Area �
EXIST. \�0,055 SX�
EX. \ DWELL. \
SCREENED
PORCH
2 / o? EXIST FF= 54.5'
EX. BRIPATICO TF =. 53.6' -
24' ro E R� K R W LL T 8 ��� ROOM
F-LOC6iTED
N
m EXISTING GARAGE.
/ 52
R (2) 8/P. PI�YS T�B SLAB
CD RO \ w '
SST (9N �5' 12 DE)' PROP. 2' HIGH
CTF�J ✓ FL ROCK RET. WALL \ /,
EL
P. WOR 50.0' EXISTING �� r
LIMIT NE PEASTONE (, J
RE—LOCAT D ROCK. EXISTING -4- DRIVEWAY /
RETAINING WALL LAWN 0/ 'Illy® _� REMAIN O 50
RE-LOCATE RAIL � O
FENCING ) O �R /
- fi1 LP (/
24" oA
NOTE: ADD'N. TO BE ON
I Spy STD 8\ SONG TUBES
NOTES:
1. DATUM: APPROXIMATE NGVD
2. ALL DOWNSPOUTS TO BE DIRECTED TO DRYWELLS OR DRIP
LINES TO STONE TRENCHES 3 SITE E P LAN
V. WETLAND FLAGGED BY HAMLYN CONSULTING
SHOWING PROPOSED ADDITION
AT
21 1 MAPLE STREET
e\ °F^fS (WEST) BARNSTABLE
ARNE
s9O PREPARED FOR
H
���,
g `� ARNE AND SARAH OJALA
o .
OJALA N
�No.26348P� 1 " = 20' FEBRUARY 2, 2010
OF✓;
O �
ARNE H. OJALA, PE, PLS DATE
mud Div ,
room scr. porch �
10x12 10x14 S
El
garage °� °�
Ncz�,
24x24 patio kit .
5
Din , 0
' I
S b t h .' '
0 5 10 20 25 = 0
bed . � o
proposed existing
bed .
211 MAPLE ST. WEST BARNSTABLE c I . O
2 4 ' 2 ' 14 '
M u d Screen
F or _ o r c h 10 '
24 " x24 " ( crowl )
Co � . Ftg . J
l 5
�0 -
err: ,~, e
( sicb )
existing dweHing
10 " Conc . WaHs on
I 8 � � wide xl 2 " Footings
Foundction Pl ,cn 1 j' 4 " " = 1
'
24 1 2 14 '
10 '
� � beam pocketADD 837 S . F .
\ 2x 10@ 16 c — c
I i
existing dweHing
Flog Frcming Plcn
24 . 12 ' 14 '
. 10
2x8Q) 16 c c
2x6 rafters 16 " cc
existing dwelhng
11 4-IL-l-L 1 11
Framing �garage � I r , 9
u rnudrocrn ,iporch roof
AH framing 16 " renter
SECT ON THROUGH ADD ' I'J .
1 / 4 _ 1 , - shed roof rrudroo -n
cnd screened porch
L i+
. � 7eklSt I"Ig b dg . profiIe
I.010
frcming north
7 . 5 ' v`J C7 Ci I` C ri
11 11 11 P III
� v
x 10 exist
f � oor
FIF
2
9 10 e 5 4 . 5
a 111 Tl�
-----------------—---------
1
t
— 2x I
Becim
� exist front grcide
SLAB EL . - 52 . 2 ---
exist recr grcde
12
2X8
R c f t e r s
2xB ce � . -1st .
- J
✓ —_ I ! Z — 2x1 0 � ,. .J Y'. C . slcb
Becim
slope 4 " to
Lally col . f ront .
c o m p c c t e d
s c n d 4 ' cover
-1—
12x18 FOOTING TYP 24 " x24 " x footing
S -- CTIOPI THROUGH G ,ARAGE 1 / 4
'I
100
NORTHEAST SIDE
1 r
FRONT ELEVATION
SOUTHWEST SIDE
F[M]
REAR ELEVATION
211 MAPLE ST.
1 /8"= 1 ' WEST BARNSTABLE
RTE BA
• � LOCUS ti
,. . #5
OVERGROWN CRANBERRY BOG I LOCATION MAP (NTS)
IASSESSORS MAP 132 PARCEL 5
#4 SETBACKS:
FRONT: 30'
Epp' SIDE: 15'
00o Sp' � REAR: 15'
4 FLOODZONE: C
W
c4' 3 R
G? �p PARCEL 6
o� 00' N/F WILLIAM AND
PARCEL 36-1 DONNA MEADOR
o" #3 N/F MIKUTOWITZ
o
10" \ P<v
( EMOVE)
2 Q EXI T, t
��• DWELL.
5" Q �•�JO St
\ �O
CH RY IST
BRICK
a .
M v Q ti� PATI F = 53.6'
2� Q o
/ M� �o
• • /
�
00 52 °
9" o
(RE OVE) a SLAB AT EL AG EXIST.REMOVEDco
_TO BE
J `t SD PROP. STONE
DRIV
SHED (TO BE /.
REMOVED `V
PROP. STONE Qv
PROP D'BOX�a REF. WALL wQ'
PROP. 1500
GAL. POLY
SEPTIC TANK
L
s
ed')• EXI LEAC
PIT /
SITE PLAN
SHOWING PROPOSED ADDITION
NOTES: AT 211 MAPLE STREET
1. DATUM: APPROXIMATE NGVD IN THE TOWN OF:
2. ALL DOWNSPOUTS TO BE DIRECTED TO DRYwF 11 S OR DRIP (WEST) BARNSTABLE
LINES TO STONE TRENCHES
3. WORK LIMIT LINE TO CONSIST OF STAKED SILT FENCE
BACKED BY HAYBALES. UPON JOB COMPLETION, IT SHALL
BE REPLACED WITH SPLIT RAIL OR ROUND RAIL FENCING PREPARED FOR: AR N E AND SARAH OJALA
4. PROPOSED SCREENED PORCH TO BE ON SONO TUBES;
MUDROOM AND GARAGE TO BE ON SLAB FOUNDATIONS
SCALE: 1" — 20' DATE FEBRUARY 2, 2003
TIMOTHY H. COVELL, PLS DATE
I
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ASSESSORS MAP 132 PARCEL 5 ARNE P.E., P.L.S. DATE