HomeMy WebLinkAbout0008 MERION WAY - Health 8 MERION WAY,BARNSTABLE
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DATE: 3/26/98
r.
PROPERTY ADDRESS:-8 Merion_Way---_------- 3S'o
Cummaquid,Mass. v
------------------------
------------------------
On the above date, I inspected the septic system at the above address.
This system consists of the following:
1 . 1 -1000 gallon septic tank.
2 . 1 -Distribution box.
3 . 2-1000 gallon precast leaching pits . Packed in stone.
Based on my inspection, I certify the following conditions:
4 . This is a title five septic system. ( 78 Code )
5 . The septic system is in proper working order
at the present time.
SIGNATUR t
Name: J. P. Macomber Jr.
Son, Inc.
Company:Jos h M
�_� ��omber �
Address:__BQX Ek------------
C 4�
--(erLtgrYi-l1e-,_Ma._Q2.632-0066
Phone: 508-775_3338 r
THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY
rJOSEPH P. MACOMBER & SON, INC.
Tan ks-Cesspools-Leachfields
Pumped & Installed
Town Sewer Connections
P.O. Box 66 Centerville, MA 02632-0066
775-3338 775-6412
COMMONWEALTH OF MASSACHUSETTS
2 EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS z
i
DEPARTMENT OF ENVIRONMENTAL PROTECTION
ONE WINTER STREET, BOSTON, MA 02108 617-292.5500
W'ILLI.4ti1 F.WELD
TRL'DN'CC
Govcmor Sore
ARGEO PAUL CELLUCCI D.A\1D B STRI
Lt.Governor SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Commisso
PART A
CERTIFICATION
Property Address: 8 Merion Way Cummaquid,Mass . Address of Owner:
Date of Inspection:3/2 6/9 8 (If different)
Name of Inspector: ber Jr.
I am a DEP approved system inspector pursuant to Section 15.340 of Title 5 (310 CMR 15.000)
Company Name: J.P.Macomber & Son Inc.
Mailing Address: Box 66 ('Pnt-Prvi 1 1 P",Mass - 02632
Telephone Number: cS0 R_7'7 S_Z 3 3 2
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurat
and complete as of the time of inspection. The inspection was performed based on my training and experience in the proper function anc
maintenance of on-site sewage disposal systems. The system:
asses
_ Conditionally Passes
Needs Further Evaluation By the Local Approving Authority
_ Fails
Inspector's Signature: Date:
The System Inspect all submit a copy of this inspection report to the Approving Authority within thirty (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 submi
the report to the appropriate regional office of the Department of Environmental Protection. The original should be sent to (ire system owr
and copies sent to the buyer, if applicable, and the approving authority.
INSPECTION SUMMARY: Check A, B, C, or D:
A] SYSTEM PASSES:
I have not found any information which indicates that the system violates any of the failure criteria as defined in 310 CmR 15.30
Any failure criteria not evaluated are indicated below.
COMMENTS:
BI SYSTEM CONDITIONALLY PASSES:
4,,'jZ One or more system components as described in the "Conditional Pass" section need to be replaced or repaired. The system, up
completion of the replacement or repair, as approved by the Board of Health, will pass.
Indicate yes, no, or not determined (Y, N, or ND). Describe basis of determination in all instances. If"not determined", explain why not.
The septic tank is metal, unless the owner or operator has provided the system inspector with a copy of a Certificate of
Compliance (attached) indicating that the tank was installed within twenty (20) years prior to the date of the inspection;
` the septic tank, whether or not metal, is cracked, structurally unsound, shows substantial infiltration or exfiltranon, or tar
failure is imminent. The system will pass inspection if the existing septic tank is replaced with a conforming septic tank
as approved by the Board of Health.
(revised 04/25/97) Page 1 of 10
DEP on the World Wide Web: httpJtwww.mapnet.state.ma.usroep
Printed on Recycled Paper
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
- PART A
CERTIFICATION (continued) r..
iProperty Address: 8 Maerion Way Cummaquid,Mass.
Owner: Alice Blackburn
Date of Inspection:3/2 6/98
BJ SYSTEM CONDITIONALLY PASSES (continued)
AM Sewage backup or breakout or high static water level observed in the distribution box is due to broken or oos:•_c.e-J
pipe(s) or due to a broken, settled or uneven distribution box. The system will pass inspection if (with approval C r-.e
Board of Health). Describe observations:
broken pipe(s) are replaced
obstruction is removed
distribution box is levelled or replaced
AD The system required pumping more than four times a year due to broken or obstructed pipets). The system w,ll c3ss
inspection if(with approval of the Board of Healthy
broken pipets) are replaced
obstruction is removed
Cl FURTHER EVALUATION 15 REQUIRED BY THE BOARD OF HEALTH:
A)0 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing ;o prc,(&-o the
public health, safety and the environment.
1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER
WHICH WILL PROTECT THE PUBLIC HEALTH AND SAFETY AND THE ENVIRONMENT:
T ,
440 Cesspool or piny is within 50 feet of a surface water
AD 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 APPROPRIATES DEFTER`1iNES THAT
THE SYSTEM IS FUNCTIONING IN 'A MANNER THAT PROTECTS THE PUBLIC HEALTH AND SAFETY AND THE
ENVIRONMENT:
The"system has a septic tank and soil absorption system (SAS) and the SAS is within 100 feet (o a surface eater or
tributary to a surface water supply.
The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water s,ppl, .-yell
The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private Nater s oo , ^e I
The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feel or more iror-) a
private water supply well, unless a well water analysis for coliform bacteria and volatile organic compounds ncica.es that
the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen :s e-1.,al to or
less than 5 ppm. Method used to determine distance _WW (approximation not valid)
3) OTHER
N� A.14 --
(revised 04/25/91) page 2 o1 10
J
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued) r
rroperty Address: 8 Merion Way Cummaquid,Mass.
Owner: Alice Blackburn
Date of Inspection: 3/2 6/9 8
D) SYSTEM FAILS:
You must indicate er:-.er "Yes" or "No" as to each of the following:
__,doI have determined that the system violates one or more of the following failure criteria as defined in 310 Cn1R 15.303, Tne basis
for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct
the failure.
Yes NO
Backup of sewage into facility or system component due to an 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 th distributi n bo above outlet invert ue to an overloaded or clogged SASr or cesspoo'
,t� "Wi / �i- �y /LP,ev.✓JT�Pb4AJw r'�vv�wr 4iW-
Liquid depth in ee"povl is less than 6" below inven or available volume is less than 112 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 ponion of the Soil Absorption System, cesspool or privy is below the high groundwater elevation.
Any portion of a cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply
2Z Any ponion of a cesspool or privy is within a Zone I of a public well.
Any ponion of a cesspool or privy is within 50 feet of a private water supply well.
Any ponion 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. If the well has been analyzed to be acceptable, attach copy of well water analysis for
coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen.
E) LARGE SYSTEM FAILS:
You must indicate either "Yes" or "No" as to each of the following:
The following criteria apply to large systems in addition to the criteria above:
The system serves a facility with a design flow of 10,000 gpd or greater (Large System) and the system is a significant threat to
public health and safety and the environment because one or more of the following conditions exist:
Yes No
/L41f 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 H of a
public water supply well)
The owner or operator of any such system shall bring the system and facility into full compliance with the groundwater treatment program
requirements of 314 CMR 5.00 and 6.00. Please consult the local regional office of the Department for funher information.
(rovlaed 11111111) P&y• 3 of 10
V\
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address:8 Merion Way Cummaquid,Mass .
Owner: Alice Blackburn
Date of Inspection: 3/2 6/9 8
Check if the following have been done: You must indicate either "Yes" or "No" as to each of the following:
Yes , No
Pumping information was provided by the6Doccupant, or Board of Health.
None of the system components have been pumped for at least two weeks and the system has been receiving normal
flow rates during that period. Large volumes of water have not been introduced into the system recently or
as part of this inspection.
_ As built plans have been obtained and examined. Note if they are not available with N/A.
_ The facility or dwelling was inspected for signs of sewage back-up.
_ The system does not receive non-sanitary or industrial waste flow.
_ The site was inspected for signs of breakout.
_ All system components,06 luding the Soil Absorption System, have been located on the site.
_ The septic tank manholes were uncovered, opened, and the interior of the septic tank was inspected for condition of
baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum.
— The size and location of the Soil Absorption System on the site has been determined based on:
The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of
Sub-Surface Disposal System.
_ Existing information. Ex. Plan at B.O.H.
_ Determined in the field (if any of the failure criteria related to Part C is at issue, approximation of distance is
unacceptable) 115.302(3)(b))
(revised 04/25/97) Pegs 4 of 10
I 5,
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION c r
Prd'perty Address: 8 Merion Way Cummaquid,Mass .
Owner: Alice Blackburn
Date of Inspection/2 6/9 8
FLOW CONDITIONS
RESIDENTIAL:
Design flow:!'/ g.p.d./bedroom for S.A.S.
Number of bedrooms:
Number of current residents:
Garbage grinder (yes or no):� �/
Laundry connected to system (yes or no):/_e
Seasonal use (yes or no): 2P >�y
Water meter readings, if available (last two (2) year usage (gpd): �99�` ��1 �/ ifl >Il�.// 6•��
Sump Pump (yes or no): 1
Last date of occupancy: 9�
COMMERCIAUINDUSTRIAL:
Type of establishment: /1J
Design flow:A1,4 allons/day
Grease trap present: (yes or no)AZ44
Industrial Waste Holding Tank present: (yes or no)&d
Non-sanitary waste discharged to the Title 5 system: (yes or no)A
Water meter readings, if available:
AIA
Last date of occupancy:_4 ,
OTHER: (Describe)
Last date of occupancy: /(/
GENERAL INFORMATION
PUMPING R CORDS ano sours of inform , n:
System pumped as part of inspection: (yes or no)�
If yes, volume pumped: gallons
Reason for pumping:
TYPE Of SYSTEM
_ A/Septic tank/distribution box/soil absorption system
AM Single cesspool
d-)A Overflow cesspool
d-YD Privy
_.&A, Shared system (yes or no) (if yes, attach previous inspection records, if any)
,CA VA Technology etc. Copy of up to date contract?
Other 14;14
APPROXIMATE AGE f II compI'Lonents, date i talled,(if known) and source of information: fly %✓� 7/��
Sewage odors detected when arriving at the site: (yes or no).(r!O
(revised 04/25/97) Vay• 5 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
~ SYSTEM INFORMATION (continued) r
flroperty Addreis:8 Merion Way Cummaquid,Mass.
Owner: Alice Blackburn
Date of Inspection: 3/2 6/9 8
BUILDING SEWER:
(Locate on site plan)
Depth below grade:
Material of construction: _cast iron _r140 PVC _ other (explain)
Distance from private water supply well or suction line It//I_
Diameter
Comments: (condition of joints, v nting, evidence of leaka e, etc.)
SEPTIC.TANK:—&feropww A64,3
(locate on site plan) y
vc Depth below grader
Material of construction: concrete _metal _Fiberglass _Polyethylene _other(explain)
If tank is metal, list age Is age confirmed by Ce/nificajte of Compliance,2!14 (Yes/No)
Dimensions:
Sludge depth:_
Distance from tog of sludge to bosom of outlet tee or baffle:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle: f �1-5/—
Distance from bosom of scum to bosom of outlet tee or baffle:
How dimensions were determined:
Comments:
(recommendation for pumping, conditio of inlet and outlet tees or baffles, depth of liquid level in relation to outlet tnven, SuucL4
integrity, evidence of le loge, etc.)
,-4 i�
C
GREASE TRAP: �fto
(locate on site plan)
Depth below grade:AJ/�
Material of construction:.Cdconcrete4�,imetal�/,AFiberglass�/VPolyethylene#,?dother(explain)
AM
Dimensions:
Scum thickness:
Distance from top of scum to top of outlet tee or baffle:-14,2?
Distance from bosom of scum to bosom of outlet tee or baffle: 42e�
Date of last pumping: AIA
Comments:
(recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet inven,
integrity, evidence of leakage, etc.)
tr wl8*d 04/25197) P69• 6 of 10
I
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued) s
Property Address: 8 Merion Way Cummaquid,mass.
O..ner. Alice Blackburn
Date of Inspection:3/26/98
TIGHT OR HOLDING TANK:A6eV7ank must be pumped pr,ur to, or at Ume, of MspeClion)
lioCate on s.te plan)
Depth oelow grade:Vd
Material of construction:w/4oncretev4netal,v,4Fiberglass Mf' olyethylene0 .4other(explain)
Dimensions. NA
Capacrry ,///4 gallons
Des.gn flp".v��_ gallons day
Alarm level _ WI Alarm in working ordern/l1Yes:&L4-Nu
Date of prev.ous pumping.
Corn-ents
(cond.tron of inlet tee, condition of alarm and float switches, etc I
DISTRIBUTION BOX: /
tlocate on s'ie plan)
Depi� c: I c.-d level above outlet invert:��
Commer.:s
tnote,,i lev and distribu,yy�' n is equal, evidence of solids carryover, evidence of leakage into or out of boz, etc )
l rei 4t 1 AA s wg !� � OJC _
PUMP CHA.tisBER:/L;W
(Ioea(e on site plan)
Pumps r. working order: (Yes or No) !t1/¢
Alarms n orking order (Yes or No)—,dj9
Comments
mote condition of pump chamber, condition of pumps and appurtenances, etc.)
01/15/97) P.g. 7 of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued) '
- Property Address: 8 Merion Way Cummaquid,Mass.
Owner: Alice Blackburn
Date of Inspection:3/2 6/98
SOIL ABSORPTION SYSTEM (SAS):,_/''w q'446�
;locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods)
If not determined to be present, explain:
Type:
leaching pits, number: t
leaching chambers, number:
leaching galleries, number:
leaching trenches, number,length: t�
leaching fields, number, dimensions:
overflow cesspool, number- t
Alternative system:
Name of Technology:
Comments:
(note condition of soil, signs o h�draulic failure, level of pondin condition of vegetation, etc.)
/D /l� 6,� !z.
14
l d
CESSPOOLS: dZopG
(locate on site plan)
Number and configuration: AM r
Depth-top of liqujd,to inlet.invert_: AA4
Depth of solids layer:_ N4
Depth of scum layer: N.'?
Dimensions of cesspool: mud
Materials of construction: Nh?
Indication of groundwater: 4W
inflow (cesspool must be pumped as part of inspection)
�-_>Oo 11 AjC
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
PRIVY: /&z4/e
(locate on site plan)
Materials of construction: Dimensions: 'V14
Depth of solids:_
Comments:
(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.)
/4
(r.vs..a 04/25/97) P.9s a of 10
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address: 8 Merion Way Cummaquid,Mass.
Owner: Alice Blackburn
Date of inspection:3/26/98
SKETCH OF SEWAGE DISPOSAL SYSTEM:
in;luoe ties to at least two permanent references landmarks or benchmarks
locale all wells within 100' (Locate where public water supply comes into house)
b
i lY '-
I
b/ ell
y
c
r
0
(Y"I"d ci/:s/97) P490 9 of 10
I
SUBSURFACE SEWAGE DISP,: l SYSTEM INSPECTION FORM
r. C
SYSTEM INFO):' , t iON (continued)
%Properly Address:8 Merion Way Cummaquid,Mass.
Owner: Alice Blackburn
1 Date of Inspectior3/2 6
t
Depth to Groundwater/ Feet
Please indicate all the methods used to determine High Groundwater EIL ation:
Obtained from Design Plans on record
bservation of Site (Abutting groESaAbservation hole, basemtrst'sump etc.)
Determine it from local conditions
Check with local Board of health
Check FEMA Maps
heck pumping records
�eck local excavators, installers
Use USGS Data
Describe in your own words how you established the High Grounc�wa*er•Elevation. Must be completed)
Used Water Contours Map.
Gahrety & Millar Model
12/16/94
(trvi..d 04/25/17) P&G. 900t 10
+��rnr+.—n+rr�-r-r' rnrmr•nmrrsTrt+�nmw.^.•s'+esn'�ner+sns+�tu na-�s+snt+TOWN OF Barnstable BOARD OF HEALTH
11I . SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D .- CERTIFICATION
!'^•T'�^T••.•••t-�.ItT.^.�TT1'T.TIT.'1TTTiQT1lTT.T'r'!'I�'4.Tr'\7Rllir^TmRR94R RT'TfRImTIiT7 JTTTiRTTTTTRSTJ'!TTTTI��.:�.�1'.-'r..�. �../
-TYPL OR PRINT CI.EARL1'-
PROPERTY INSPECTED
STREET ADDRESS 50 Country Club Drive Cummaquid,Mass . 02637 N
ASSESSORS MAP , BLOCK AND PARCEL # 3 d 0
OWNER' s NAME Alice Blackburn
PART D - CERTIFICATION
NAME OF INSPECTOR Joseph P.Macomber Jr.
COMPANY NAME J.P.Macomber & Solf Ync.
COMPANY ADDRESS Box 66 Centerville,Mass . 02632
Street Town or City Stat0 LIP
COMPANY TELEPHONE ( 50 8 ) 775 - 3338 FAX ( 508 ) 790 - 1578
CERTIFICATION STATEMENT
I certify that I have personally inspected the sewage disposal system at
this address and that the information reported is true , accurate , and
complete as of the time of -inspection . The inspection was performed and any
recommendations regarding upgrade , maintenance , and repair are consistent
with my training and. experience in the proper function and maintenance of on-
site sewage disposal systems .
Check one :
_Zsys teui PASSED
The inspection which I have conducted has not found any information
which indicates that the system fails to adequately protect public
health or the environment as defined in 310 CMR 16 . 303 , Any failure
criteria not evaluated are as stated in the FAILURE CRITERIA section of
this form.
System FAILED*
The inspection which I have con ticted has found that the system fails to
protect the j-)ublic health and the environment in accordance with 'title.
5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE
CRITERIA of this inspection for .
Inspector Signature Dater
One copy of this certification must be provided to the OWNER, the BUYER
( Where applicable ) and the I30ARD OF 11RAL1'Ji.
* If the inspection FAILED, the owner or"" 'Perator shall u
within one year of the date of the inspection , unless allowed dort required
he m
otherwise as provided in 3.10 CMR 16 . 305 .
partd . doc
TOWN OF BARN.STABLE
LOCATION SEWAGE #
_XIL GEt mmeplz i 5S- ASSESSOR'S MAP & LOT 31�Boaz
l�c9>r
INSTALLER'S NAME& PHONE NO.
SEPTIC TANK CAPACITY 1
LEACHING FACILITY: (type) Ad dr", (size) ���
NO. OF BEDROOMS
BUILDER OR OWNERil�.r��
PERMITDATE: COMPLIANCE DATE:
Separauon Distance Between the:
Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on sit ;within 200 feet of leaching facility) Feet
Edge o", -tland and Leaching Facihty (If any wetlands exist
=1 . withi . feet of leaching ciliry Feet
Furnished y
-_ cs
i�
,
P. .
TOWN OF BARNSpTABLE <
_SEWAGE # I
VILLAGE ASSESSOR'S MAP LOT ;�(3
INSTALLER'S NAME PHONE NO.
SEPTIC TANK CAPACITY
LEACHING FACILITY:(type) T (size) r/we;d1—
NO. OF BEDROOMS
j PRIVATE WELL OR PUBLIC WATER
BUILDER OR OWNER ,,d44
c
DATE PERMIT ISSUED: ) m,
DATE COMPLIANCE ISSUED:
VARIANCE GRANTED: Yes No �V�
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��-`�� $ 30.oo
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® OF HEALT q �
TOWN OF BARNSTABLE�
ApplirFation for Biiivaaal Works Toni Wiit ''-� -
Application is hereby made for a Permit to Construct ( ) or Repair i'X? an Individual Sewage Disposal
System at:
50 Country Club Drive Cummaquid
..--•--•----..................................................................................... ------------•---------•-.....----...-------------------•-•-•------.....--•-------......-----..----
Location-Address or Lot No.
Harr B_.Mc C orMick ...................... ................•--•-•---_..----
W J.P.Macomber Jr. Owner Address
Installer Address
UType of Building Size Lot............................Sq. feet ,
DwellZ No. of Bedrooms............ ..............................Expansion Attic ( ) Garbage Grinder ( )
a a Other—T e of Building g ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( )
Other fixtures
W Design Flow............................................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 ( )
Percolation Test Results Performed by.......................................................................... Date.......................................
W
Test Pit No. 1----------------minutes per inch Depth of Test Pit.................... Depth to ground water........................
44 Test Pit No. 2................minutes per inch Depth of.Test Pit---:................ Depth to ground water........._.............. t
P4 -----------•--------------------------------------•---•----•---...-----...------..........--••---•--•-•-----
0 Desc9d okS 1...........
'
W Wn'o8 ]
v ----••--•------------------- ---------•--------......----------------•--•---------••---------•--------- •-------------------------•-•-------------------••---------------_...
W
•- --------------••-- ----•--------------------•-----•---•........-----------------------------•---•---------•-----------------•---------•-----------------..........................................
Nature of Re ai s or Al ratio s—Answerwhen h'ca le...............................................................................................
U 1-1000 -alon leaching pi paced in stone.
•--------------------------------•-••-------------•--------•------------•-----------•-••----••-------------------------------------------------•-------•- ..............................................
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Complia ce has ben ' sued by the board of lth.
Signed .. . . -. 11 2
/ /92
Date
Application Approved BY .. .......... .... =_ l.. .. h��'..". -
Date
Application Disapproved for the following rearonr: --------- ..... ---------- --------------- -------------- ------------- ------------------------------------
------------ -.................................. ----------------f------------....------------.....---.-..-.-..-------------------------------------------------------------------------- --------------------------------------
/ are
y� +�
Permit No. ------ --------- . : Issued ----------/�.---- .
/ Date
No.i9'V...:�:'. Fz$.....A.30_s 00
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
Appliration for Disp.ati al Works Tonsiurtiun Permit
Application is hereby made for a Permit to Construct ( ) or Repair PT an Individual Sewage Disposal
System at:
50 Country Club Drive Cummaquid
........- ... -------•-------• ..... - - .......................... ..........•.....-•-••-----•-•------•----•----• ---.... ._.......-- ..
Location-Address or
Harry B McCormick
W J.P.Macomber Jr. Owner Address
Installer Address
Type of Building Size Lot.............................Sq. feet
DwellingXX No. of Bedrooms...........3..............................Expansion Attic ( ) Garbage Grinder ( )
a4 Other—T e of Building No. of persons............................ Showers
YP g ---------------------------- P ( )--- Cafeteria ( )
dQ Other fixtures ----------------------------------------------------------••--------•-------••-----------------•-•--••---•--------. ...........
W Design Flow............................................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.
3 Seepage Pit No--------------------- Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.................... -•--•---••---••-••---------•--------•-----------•---- Date........................................
aTest Pit No. I................minutes per inch Depth of Test Pit.................... Depth to ground water........................
44 Test Pit No. 2................minutes per inch Depth of.Test Pit.................... Depth to ground water........................
a --•----••-----•--•---------••-----------------------•----...-•-------.........•-•---......••-•-••............................................................
0 Description of Soil--------
Sand & Gravel
W
UNature of Repairs or Alterations—Answer when applicable...............................................................................................
1-1000 -allon leaching pit packed in stone.
------------•--------------------------------•---•••.....-•--
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the
system in operation until a Certificate of Complia,ce has been issued by the board of h4a lth.
Sign ed .! .1...... f/,A'-� -� ---------------- ------11� 92---------
A Application Approved B �^ '---� �� �' � •/./� ..le'�'
PP PP y ----- --------- --------= Date
Application Disapproved for the following reasons- ----------------------------------------------
Date
Permit No. - Issued ----------` / ...........
Date
THE COMMONWEALTH OF MASSACHUSETTS
- --—BOARD OF HEALTH
TOWN OF BARNSTABLE
Cferttfiutt#e of (gomyliattre
THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired)(XX )
by ""' —J,P.Mac oml;e r..... .--------------------------------------------- - --
r ------------------------------------------------------------- -----------'-------------------------------------------------------
Installer
at ....5C..-.Country Club Dri,re Cummaquid
--- ---- ------------- ---.....--- . ---------- --------------------------------------------------------------------------------------..............----------_-------_--
has been installed in accordance with the provisions of TITLE 55 of The State Environmental Code as described in
the application for Disposal Works Construction Permit No. ....7. � �... a � :.... dated --r '�'-�-"- .
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT KBE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
DATE--------------------- I.t 9 ' a ,_".1
----- -------------------- Inspector .-----------. ----•-------------------------------------------------.
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
�
••-•-- FEE TOWN OF BARNSTABLE ----E 30 00
No..,••-••- ---------'.........
Disposal Works Tonstrnrtion rrmit
Permission is hereby granted._ J.P.Ma e o mb e r J r.
to Construct ( ) or Repair (X ) an Individual Sewage Disposal System
at No.52...Country -Club Drive Cummaquid
T StreeIt
as shown on the application for Disposal Vl orks Construction Pernut. o__ ______________•-- Dated_._ ''-
/ �� r� Boar��d of Health a f/
DATE----------------......................;. .......C------------------------------
FORM 36508 HOBBS 6 WARREN.INC..PUBLISHERS
N PE W AGEPERMI N0OCou elw '-AT10
VILLAGE
INSTALLER'S NAME &' ADDRESS
BUILDER OR OWNE fie�m
C� en/2 c� 8 OW,
DATE P E R M ITT`"' I S S,.0 E D
-D,AT E COMPLIANCE ISSUED
--
A. v �
ere /woe
t 3
2y'
�9 r ..
No... ...= - ---• F�s..: i.................
THE COMMONWEALTH OF.MASSACHUSETTS
A..
BOAR® OF, HEALTH
............ ...OF............. ...........................................
ApplirFation for llhipos ai Works Ton.strnrtion ramit
Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal-
System at:
_ 1
...............�E�.L®`.% ..... .......... ...j�( Location-Address / .... or t No.
l..C.l .( 1�. ........fa(�s?a..� 14x- _._. t �2. .. (,tuef11 f�s.�l .. e.es►/�t
�yy -Address
a •---------••--•....-•------k.b.-6 r r I----...[3_,......��-a........... .............2 eA.......... _ ..... ' '........AL ...............
Installer Address
QType of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms._......_._I............................Expansion Attic ( ) Garbage Grinder (4 7
'_l Other—Type of Building No. of persons............................ Showers — Cafeteria
Q, Other fixtures ------------------------
W Design Flow................/.f.Q...................gallons per person per day. Total daily flow.......... 0.....................
WSeptic Tank-t Liquid capacity.71_090gallons Length................ Width---------------- Diameter................ Depth................
x Disposal Trench—No..................... Width.................... Total Length...........;..... .. Total leaching area............_.......sq. ft.
Seepage Pit No--------(------------ Diameter...... ---Y Depth below inlet..... ... Total leaching area... .....sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Resul'ts Performed by----------------- --•-----------•--------••------------------------------ Date........................................
Test Pit No. 1__.__ minutes per inch Depth of Test Pit......4.`9�__..... Depth to ground water--------- .
f=, Test Pit No. 2...L/,?_minutes per inch Depth of Test Pit..... ....... Depth to ground water..._
94 - -
Description of Soil.... i%S�•. --------..•-•� � �� Q� � 1& ��` �!'�'�'�
-- --
�� --��...........Q-...20........./-AIA -�-C,1�------.g.�..`�--.1.�_
d. ^_�_3 -------...........• . -�----
U Nature of Repairs or Alterations—Answer when applicable_______ —__ _ _ __ ______ __
f S' �
Agreement: �-
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITLE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has beR issued by the board of health.
igned.... --- _ . ..........!a._4.................................... .................................
Datep
Application'Approved BY -- D7�F
Application Disapproved for the following reasons:..............................
....................•-•----•-•-•----------•-•----------------•---------------................---------------•-•----------------------------------------------------------------------------------------
f Date
Permit No. --------------------------------•-- Issued.1. �=-e _... -
. Daze trl
�J 1 ry'p �• �I•�`
00
No... ....... .. ....... Flcs... . _ .........
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
Appliration for Disposal Works Tonstrnrtiun Prrmit
Application is hereby made`for a.Permit to Construct ( ) or Repair ( ) an' Individual Sewage Disposal_
System at
a 12 t 0 ti t�v►�! ,ram
_.__.. ........ .. ..... .... sf' Mn � j1 ... .._ ...... _.._._.....
���l Location-Address r Lot No.
------------------1"!_ed1.t41 _ � :r3a..# .. ._.... 5 .... <► *./.�r./ ?r"
M. Vca ; ^r• b IM1
F Address
rL
A el-
Installer Address
Type of Building Size Lot............................Sq. feet
Dwelling—No. of Bedrooms___..______............................Expansion Attic ( ) Garbage Grinder (A--o
aOther—Type of Building _______________--______.____ No. of persons............................ Showers ( ) — Cafeteria ( )
Otherfixtures ---------=-----------------------------•----•-----------••-•••-••-•••----•--•--------------------••-••-----•--•---•-••-•••••-•----••-•••••----•----•-
W Design Flow-*.............110...................7gal,,lons per person per day. Total daily flow.......... _+ ......................gallons.
WSeptic Tank-t Liquid capacity__l_0ti'-'gallons Length................ Width................ Diameter____...__._.____ Depth................
Disposal Trench—No_ ____________________ Width__ _._.____._.___._ Total Length............ _ Total leaching are a____.________..._.__sq. ft.
x Seepage Pit No._.__.__ Diameter____.__. Depth below inlet___.______./. Total leaching area__ .! C s ft.
P� E ( ( ) ••• g .. q
Z Other Distribution box Dosing tank
aPercolation Test Results Performed by.....................................-.................................... Date.........................................
1 Test Pit No. L__.���p._minutes per inch Depth of Test Pit j ` ..... Depth to ground water._'-"'"
(i Test Pit No. 2...I../?,.minutes per inch Depth of Test Pit.........`" ....... Depth to ground water______..................
• ..............................................
¢ r�
O Description of Soil ........ ------------- f " .. ¢
c
W �4 -G/q, � _ ( �'�o•c, C��r�tf _F. tl-# � f - -- �
� -: � /c
U Nature of Repairs or Alterations—Answer when applicable. __ ?F.. -
Agreement:
•. �''�- ----�dt --.-,:•--- - � ;:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of TITIE 5 of the State Sanitary Code—The undersigned further agrees not to place the system in
)operation until a Certificate of Compliance has beR issued by the board of health. '
edp: ..... -�L----••--==------••-••-••-------•--- Date
.✓ ign --•• .. . .
Application Approved BY • ----- '" D �
ate
i
Application Disapproved for the following reasons:...................................................................--.....................'.....................
.......................................... -••--•••-•-•--.._.................................................................
,,
Date
Permit No....... .. ...... Issued.........................................................
-----•------•---------------•--
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
......../n . .............OF....... .... .....................
f9rdifiratr TumpliFanrr
THI S T/ ,C Lff, That the Individual Swage Disposal System constructed ( or Repaired ( )
by - J `3 ' - --•----• ............................................. -•- .......
_---------•---------•---•---
Inst
k
has been installed in accordance with the provisiO s of T 7 5 � -��--of The tate Sanitary C e as descrriibred in the
application for Disposal Works Construction Permit No:_ 7 dated---- --3'`-.��'--=7
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GU ANTEE THAT THE
SYSTEM WILL FUNCTION .SATISFACTORY.71
DATE................. .........--- •••-- Inspector : - ••-••• :
THE COMMONWEALTH OF MASSACHUSETTS
BOARD T F HEA H
N ............. FEE..................
�i��nr 1 n � �nn��rlan >Qrmi�
Permission is hereby granted;_- ' ._.....-.----•••• •------ ••• --•--•-•-....__.._ ...-
•'.` to Constr xxc�t�� or *r.(x ) an In ividual SeviT e Dispos Sys
at No. .�Y.-.1 ... *F- ....
Street
V....... -----
as shown on the application for Disposal W ks Construction Per No________ ________gDated..__ .._....__'...
� --•••...--c "' ....................
(" /'. v... o. oaf d of Healt
DATE..... . J ...................:..............::.
FORM 1255 HOBBS:& WARREN, INC., PUBLISHERS ..
V- 'A k!-L-
aNJ T�: k C \&(t 14 7-"- N D �-i To
A
Z
r
T E,ST-
0,41
Si
T -p,T-
S 5 3
tr 11
Zq.c
V;
7
7 Ic P
ZZ.0
3e-v
3AI.Cc I
Le
L-OT 99
3AI-Z7.
:5
Scale : 0. a,
7
Horiz/Vert
1yl-401 MER ) OIN \/VA Y
Section
�39
A-A 7
PROPOSED LAYOUT OF LitNi) la ilaali
✓ 1:1ASS.
for CHERRYWOOD BUILDERS, INC. , HAIX11ICH,
Beinc- lot -J' 98 as shown on a plan by Barnstable Survey.,
TF
Consultants, Inc. , dated Jan. 1969.
Date 7-23-79
---------------------------------------------------
Date Agent, Barnstable Board of Health
NIE
Note: Elevations
WAY Nol shown 39.6 are in feet above an assumed
datum.
Scale 1"-51
! Test hole 1 Test hole 2 t le 3
Loam Loam Loam CF
and
Subsoil
Subsoil
Subsoi and and
Cla
rn
ClayJ,CItSONi
y
78?1
9011 96 AL
Ped.San
10211
Clay
Fine
Sand '1381t Fine
'Iron Ux de Sand 150rr water
-md I-Daird A.
68,1150" Water
J7
Paul Murray, Barnstable
Board of Health
Thomas E. Kelley, P.E.
Edward E. "Kelley, A.L.S.
IES-r MADE F(=-G, 9, /97v7 ?rjZc RATE 16tESSTHkH ZM1P-i. PF-1L INCH DVO
i
i.
�A..\
- --- 17'-411 f`0 o
o -
P, , 0
Cfl 7 p N _
d N II
M Q..
a a)
-
- - - - - - - - - - - - - - - - - - v�
°
Beam C-See Report I I
Proposed Deck
o i II
3.. /yyx Ile
CD
I �"LVL Above I I _ CO
j Beam -See Repo I I op Cy
C j -p N> Co
Co
BATH Proposed Open Porch I i m o o
TW 2452 1 FWG 6068 R TW 2452 A 251 'C M
L
Apo
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N - G� °� o
Q 1 j � � �
LO
2-1 3/4"x 9 1/ LVL Above
I Prop. Bath 3068 Q
Beam B-See Report l =� Prop. Dining _ _ _ _ _ _ _ _
o Expansion - - - - - - - n, A JL
C�
oo
Q I 1 II J
I I` I I Line of Existing Garage kCD
CV
' I I M
Exist. I I Walls Removed- I
I Beams Installed Above
Kitchen
6'-3'1 S
I I
p Ca
i EXISTING.GARAGE D � E
EXISTING DINING oo :3
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1 �
PLAN VIEW LM
Property of George.Davis Builders, Inc.
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REAR ELEVATION C
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Property of George Davis Builders, Inc. �e
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RIGHT ELEVATION �- Q
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ca o Cr
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$ U
Property of George Davis Builders, Inc.
Do Not Reproduce
I
Approx. location of 10" sonna-tubes
- � - o 0
oLO
N
1 O I 1 O I N N II
M
- - I - - - - - - - o - CL
(aj(D
- - - - �
12" Sonna-Tubes on 36" Big Feet
o
1 II O /I
20 -2 P.T. Beam Below U —
- - o ,^n
- 5'-011 10'-21 �- Q
Cellar Sash Cellar Sash _ 00
_
— — — — — — — — — — — _ — — — — I m L
I
:r oo vi
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I I %`� I sl
wl I0moo
— — — —
LO
I 5
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- -
X N
31-6„ I 61711 3161 1
Z
S I O
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EXISTING ENTRY
I
FOUNDATION & FOOTING PLAN 1lIEW
a
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CTJ
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I �
ENTRY PLAN VIE
Property of George Davis Builders, Inc. L
Do Not Reproduce
�•- nk3i6�C9 61 a1�A 1 �iG'61
EXIST. - ~ Q
'BEDROOM 'LIN. - - o N —
"� EXIST. � L(') '
°BATH - IL
00
EXIST. (Q Q
° --
DECK a co
ossr.. -
;g cLos. nos
40S msi EXIST. _ -
° °KITCHE _
■
EXIST. EXIST.
°DINING °GARAGE
EXIST. -
LIVING
EXIST. wsi CO
ENTRY
--(Los � � N
.� SON
L < O
�(EkSi'Rx61 N�w61 I6'��63 I�RN61 _ m Q
1
IE�Ts�61 }G� N��sq - ce
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FA6i - Q > LO
EXISTING FIRST FLOOR PLAN o Z o
EXIST. }■�� (n
Nruart °BEDROOM _ - vr■
.. oust /\ 'UN
°n05.
EXIST. L
*HALL
DN.
EXIST. 6P6i. EXIST. ❑❑ EXIST.
SNN6Nf
*BEDROOM °W.I.C. °ATTIC e
i
CU
1 c C
o Cr
CU
E
I6 61 �wf}IN61 I6$sIGl61 S E
'a L°O U
EXISTING 2ND FLOOR PLAN _
Im
C
Property of George Davis Builders, Inc. i
Do Not Reproduce
O
O
p N
L
N N
0)
Roof Assembly: a)
2 x 12 Ledger on roof (n
2 x 8 Rafters-16"o.c.
1/2"CDX sheathing
1/2"structo deck
EDPM Rubber Roof
2 x 8 Ceil.Joists-16"o.c. ■
1 x 3 strapping- 16"o.c. V
R-30 Fiberglass Batt Insulation
1/2"gypsum board
Existing Attic Beam
r~
2-2x10's 1 3/4"x14"LVL L +_ O
Max. Span T-0" See Report _-- T.O.W._ C
Field Determine N
11 Existing Ceil.Joists I I O N
Wall Assembly Q co
Remove Wall Remove Wall 2 x 4 Shoe MM i. O
Insall LVL beam-Flush W
Install Beam Above-Flush 2-2 x 6 Top Plates
Hang Ceiling Joists to Beam Hang Rafters&Ceil. Joists 2 x 4 Studs- 16"o.c. N N 0)
1/2"CDX Sheathing C M
House Wrap Applied > 4-
Existing Entry 1 , Proposed Dining Expansion Cedar Shingles-5"t.t.w. �, °' °O
Existing Dining R-13 Fiberglass batt insulation > LO
I 1/2"Gypsum Board. 0 `�
II II
I Floor Assembly 11 Proposed Replacement Deck z 0
I I Sill Sill on Foundation 1 I �
2 x 6 pt,mud sill-Anchored L
2 x 8 Band Joists
2 x 8 Floor Joists-16"o.c. 11
5/8"CDX Sheathing-field confirm
Existing Slab on Grade R-19 Fiberglass Batt Insulation Deck Details:
Red Rosin Paper 10"Concete Footings-48"below grade
2 1/4"x 3/4"Oak Flooring 4 x 4 pt posts-anchored
Proposed Crawl Space 2 x 10 ledger Joists-bolted to house
2-2 x 10 band Joists
2 x 10 Floor Joist- 16"o.c.
1 x 4 sq. edge mahogany
Mahogany railing-36"high
Foundation Details:
8"x 16"Continuous Footing
8"x8"x16"CMUWall ~ Q
Re-inforce every other course
Set 10"anchor bolts in top course-per code _
Dampproofing Applied below grade
3" Dust Cover Placed in Crawl r C
36"x 36"Tradesmens'Access from Existing (� s
�L
E
STRUCTURAL CROSS SECTION
- cv
Property of George Davis Builders, Inc.
Do Not Reproduce