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0346 HOLLY POINT ROAD - Health
346 Holly Point Rd Centerville - A=232 - 024 v 1 P V 1 � 4 llll ,� No_ 1 �ts, .s�� NASTINGS.YN TOWN OF BARNSTABLE LOCATION , 14e o. B1 tsl SEWAGE# )6 d 3 VILLAGE ASSESSOR'S MAP&PARCEL - i INSTALLER'S NAME&PHONE NO. ° faz�at�s i SEPTIC TANK CAPACITYf s C LEACHING FACILITY:(typeI7� L�.9 (size) �>S •���kd- J 'NO.OF BEDROOMS cam - 12-- !2&- T— OWNER J<cZ4J NieIC_ zw PERMIT DATE: f - 0--1-2. COMPLIANCE DATE: I' 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 o 300 feet of leaching facility) eaf- +- NirFeet FURNISHED BY I- I 3� H 0 Use ❑ ❑ 2 Az= 'YO° J . .M• r Town of Barnstable Regulatory Services �. Richard V. Scali,Interim Director BARNSTABLE, - MASS.. Public Health Division iOrFn nn�" Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Form Date: Sewage Permit# ZO13 -41f 3 Assessor's Map\Parcel 23 2 2 y Designer: Installer: _&e+,,aLa W Cm4%i-. . Address: Address:- 9.0 l3a2c. 70q kHahhis 026o1 VKars4ms 1W,Its ozGYS- On 11—12- 13 f.�,r+.le W' Cons tnxlio n was issued,a permit to install a (date) installer septic system at. 3Y( l6ll y Perot RJR t 6,&N4cev,t(c based on a design drawn by (address) dated 7-3` 2013 (des' ner) ✓ I certify that the.septic system,referenced above was installed substantially..according to the design, which may include ininor approved changes such as lateral relocation of the distribution box and/or septic tank. Strip out (required) was inspected and the soils were found satisfactory: I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State& Local Regulations. Plan revision or certified as-built by designer to follow. Strip out (if required)was inspected and the soils were found satisfactory. I certify that the system referenced above was constructed liance with the terms of the I\A l letters (if applicable) 1H OF9Ssq STEPHEN CyC, . ALLYN m'}: (Installer's Signature) o WN-SON No.3021 S A�o ��GlSTER``���Q FS G\i e"signer's Signature) (Affix De p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF. COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU: Q:\Septic\Designer Certification Form Rev 8-14-13.doc (1 2 613— e28!0z) TOWN OF BARNSTABLE LOCATION , i4e L . d tee p;�_ SEWAGE# —4t 6:3 1f-z _., VILLAGE c a�� ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. � SEPTIC TANK CAPACITY C 7p(—n - r LEACHING FACILITY: (size) NO.OF BEDROOMS - cu- t v2 OWNER } PERMIT DATE: f I— CA—•iZ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within f ; 300 feet of leaching facility) - 4- 3 Feet FURNISHED BY - ----------- � 3 - '/0 is' .6 -3 r Town of Barnstable .oF` rokti Regulatory Services Richard V. Seali,Interim Director + BARNSrABLE l - Public Health Division MASS. 0. `b i639' Thomas McKean,Director AjFp�yl. 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 :Fax: 508-790-6304 Homeowner Certification Form for Alternative Sirstems Proper•tyAddress: ;2w, brinll.., R.P Assessor's Map\Parcel: Map 23Z ' 4.ce-,ts Zy t y?— Propery, Owners Name: 0m Qe-aAh?r`sue_ (d M k manic k .71— In accordance with Massachusetts DEP alternative system approval letters, the following certification information is required by the Owner of record. The Owner of' record must place an "x" in the applicable box next to each line certifying the information. Yes N\A ❑ I have been provided a copy of the Title 5 I/A technology Approval letters. (15 page Standard Conditions letter and the specific technology letter) I have been provided with the Owner's Manual 19 1 have been provided with the Operation and Maintenance Manual ❑ © For Systems installed under a Remedial Use Approval,I agree to fulfill my responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10) and the Approval i� For Systems installed under a Remedial Use Approval,I agree to fulfill my responsibilities to provide written notification of the Approval to any new Owner, as required by 310.CMR 15.287(5) ❑ If the design does not provide for the use of garbage grinders,the restriction is understood and accepted 5 ❑ Whether or not covered by a warranty,I understand the requirement to repair,replace, modify or take any other action as required by the Department or the LAA,if the Department or the LAA determines the System to be failing to protect public.health and safety and the environment, as defined in 310 CI%4R 15.303 I , � 1't,wo.% 1e-k Its. agree to comply with all terms and conditions above. Property Own rs printed name Prope I Twners signature Date V I u C sbteO- Z- Note: This form must be submitted along with the septic system disposal works permit application for all I\A systems includinZ nevi construction, reparrs\unfYradcs, with and without ajZgref4ate. (stone) and ivith conventional design criteria or credited desip criteria. Q:\Septic\IA homeowner certification,doe 2C 13 a 2 En:oZ i No. > r _ Fee THE COMMONWEALTH-OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftpliLatlon for Disposal *pStrm Construction Permit Application for a Permit to Construct( ) Repair W Upgrade( ) Abandon( ) ❑Complete System gendividual Components Location Address or Lot No.N6 I4ol iy Pol n+ f"5Cl_ wner's N Address,and Tel.No. ,/ dY1�r'YU+�I.Sf)i�:7'►"�4'. J�'�5•�s a'rus�- Assessor's Map/Parcel a3p� aR r 4 .Gd1 f eXV`lLej PJ2 • 09L Scat Installer's Ng Address,and T 1.No. ��' `�17/ „ S Designer's Name,Address,and Tel.No. /G9i'C'�rls�rran -zn�Q�s •' c N a 'n n F:r nx� ,s • Type of Building: Dwelling No.of Bedrooms Lot Size WO, 79V sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided j I gpd Plan Date 7i I Number of sheets d �yRevisionDate Title lam cjg6l4U 14 PC311 " An i• a"4—ru1,��Q. f Size of Septic Tank ex S im /O6o' Q _ Type of S.A.S. Description of Soil g5p n ��, p Q Nature of Repairs or Alterations(Answer when applicable) �• _ f. Will 4CMs in a- .S%. X Lxi s�-,'rw� ►air.K 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 Enviro al Code a not to place the system in operation until a Certificate of Compliance has been issued by this Board of h. Signed Date a Application Approved by L Date Application Disapproved by Date for the following reasons Permit No. j Date Issued •-^..-.:,, -*r•. �.+i.".+..r.,^s�"•r . -` .r-+v.� �� "+...,....+ ,....-...-._ ., ,,, - _..,..._- ?••'tea:.-+...,�-•+•-,.-,nr�-- ._. ,-w..-.�w,w�.w•.u^.,` P • No.� (!� �� I� � � W Fee '..•/IJ�r • N 4 Entered in computer: / _ THE COMMONEALTH-Of,3MASSACHUSETTS p PUBLIC HEALTH DIVISION'-TOWN OF BARNSTABLE, MASSACHUSETTS Yes Nplication for -Misposal *pstem Construction i9ermit Application for a Permit to Construct( ) Repair W Upgrade( ) Abandon( ) ❑Complete System Windividual Components Location Address or Lot No.346 Hod j� �a l a+ ��, Owner's Name,Address,and Tel.No.[e , _Ii�"�•f. i.,.)ine ��i Assessor's �"+'uSd•- Map/Parcel a.3o?? 0a y �t1 kc ru t le /1%Cefr'sv 1 oa e!571 Installer's Name,Address,and Tel.No. ` �S r1/ r't'3 Designer's Name,Address,and Tel.No. 6bS--%7 i k / r>rfp/ias' v«51�rt C �®n �S=r.tcrr�Pj J:' n ll� r Cry �',, r9'e'yf '� 5 r �5� ✓lA A 0-2,r,5/R CaD(�101J . Type of Building: r,. Dwelling No.of Bedrooms Lot Size q y; sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) 6' 1( Other Fixtures rr'°r Design Flow(min.required) O gpd Design flow provided 331 gpd Plan Date /?I 1 ` Number of sheets _.-.,,Revision Date 'rt • Title 1,5clIL-� p},e An 111 I-'lC.fri .j 7& 41 144 Size of Septic Tank eXt'S�,r I UGC �;�z Type of S.A.S. -3.3c)-A [ It 1•fr „,f,o n c,/, .�5 F r n n Description of Soil<s _j Nature of Repairs or Alterations(Answer when applicable) ';;�.,, : d-lo J 5;-;, 4 n h 7x 30 AL rkT s Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and"not to place the system in operation until a Certificate of Compliance has been issued by this Board Health. Signed '—' Date Application Approved by�l. 1�(- i�Zr Date Application Disapproved by Date for the following reasons Permit No. O ( 12j Date Issued _ - -- ----- - - -s- , r �- - - -- - - - - -- - - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS ' Certificate of Compliance TIES IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(0<') Upgraded( ) Abandoned( )byr at3 q6 R o¢- 81, om4g w Ile has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.,� Y '/'/- dated �i / j �� Installer Jnyj14.l,4, � Designer {�rv_.+C,_NL/p /_ p,r,- n�. �e'i iO ntC #bedrooms _3 Approved design flow % and- The issuance of this permit shall not be construed as a guarantee that the system will function ass designed. Date (I ' 10 /� Inspector . --. No. Q(/ (3 Fee /o THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS ]Disposal 6pstem Construction i3ermit Permission is hereby granted to Construct( ) Repair(4() Upgrade( ) Abandon( ) System Iocated at � �a ��l�s �7 C t l 6c f l►(t and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this permit. / Date f,� '/ �j Approved by ft)! 1 l 11 f/Gi 7 ,G >�Y��� �U-f ' C I Doo.: 1 r 234 s 914 11-08-2013 11 --34 GtfiT=201969 DARNSTABLE LAND COURT REGISTRY 1 k f k k i DEED E RAYMOND KWASNICK, Successor Trustee of The Vine Street Realty Trust u/d/t dated December 1, 1992 and filed with the Barnstable County Registry District of the Land Court("Registry District") as Document No. 571573 ("Grantor'),for consideration paid and in full consideration of under ONE HUNDRED DOLLARS ($100.00) grants to RAYMOND M. M KWASNICK,Trustee of the Vine Street 2013 Realty Trust u/d/t dated November z , -�, �013,with an address of 4 Battery Wharf Park,Unit 4403,Boston,MA 02109 ("Grantee")with QUITCLAIM COVENANTS,a certain parcel of land located in Barnstable, County of Barnstable,Massachusetts,being further described as follows: Northerly by Vine Street,two hundred thirty(230) feet; Southeasterly by Lot 23, one hundred thirty-nine and 53/100 (139.53)feet; Southwesterly by a portion of Lot 16 and Lot 17, about one hundred sixty-one (161) feet; Westerly by Wequaquet Lake; and again; Westerly by Lot 42, about three(3)feet; Said land is shown as Lot 22 on plan hereinafter mentioned; Northerly by Vine Street, one hundred(100)feet; Northeasterly by the junction of said Vine Street and Lakeside Drive, forty-seven and 12/100 (47.12)feet; GSDOCS\2.278852 I , Easterly by said Lakeside Drive, one hundred eighteen and 64/100 (118.64); Southwesterly by Lot 15 and a portion of Lot 16, one hundred forty-one and 19/100 (141.19)feet; and Northwesterly by Lot 22,one hundred thirty-nine and 53/100 (139.53)feet. Said land is shown as Lot 23 on said plan. i All of said boundaries are determined by the Court to be located as shown on subdivision plan 20239-C (Sheet 2) drawn by Gerald A.Mercer and Co.,Incorporated Engineers and filed in G the Land Registration Office dated February 1958, a copy of which is filed in said Registry District Book 150,Page 118 with Certificate of Title#2017 and said land is shown there as Lots 22 and 23. WHEREAS,the Grantor has 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 located on the property herein described 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; 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 said permit for the property herein described, is requiring that the agreement for the restriction on the number of bedrooms in any house on the property herein described be put on record with said Registry District by filing this document. WHEREAS,the Grantor does hereby place the following restriction on the property herein described, in accordance with the agreement with the Town of Barnstable Board of Health dated September 12, 2013 ("Agreement"),on behalf of itself and its successors and assigns and that the restrictions set forth in the Agreement restricting the use and occupancy of the property herein described to three (3)bedrooms maximum, and(i) shall be and are restrictions running with the property herein described; (ii) are not merely personal covenants of the Grantor; and (iii) shall bind the Grantor and its successors and assigns and all subsequent owners of the property herein described. Consideration is such that no revenue stamps are required by law. The Grantor voluntarily releases and relinquishes all of its rights of Homestead, if any, as set forth in Massachusetts General Laws, Chapter 188 and state that there are no other persons entitled to any Homestead rights. ' 2 GSDOCS\2278852 I c For Grantor's title, see deed dated December 1, 1992 and filed with the Barnstable County Registry District of the Land Court as Document No. 571572, Certificate of Title No. 128877. [Signatures are on the following page] k I 3 GSDOCS\2278852 Executed as an instrument under seal as of they of November,2013. Raymond Kwa 'ck,Trustee and not individually 4 f 4 COMMONWEALTH OF MASSACHUSETTS '€ COUNTY OF SUFFOLK ; On this,cloy of November, 2013,before me,the undersigned notary public, personally appeared the above named Raymond Kwasnick as Trustee aforesaid and proved to me through satisfactory evidence of identification,which was personal knowledge,to be the person whose name is signed on the preceding or attached document, and acknowledge to me that he signed it voluntarily for its stated purpose. N A R . E eo Notary Pub Commission Expires:Sq-r. a4 201� z� • r � .4 low SSACNUgEt••. 4 GSDOCS\2278852 r f i i THE VINE STREET REALTY TRUST Trustee Certificate The undersigned,Raymond Kwasnick as successor Trustee of The Vine Street Realty Trust established under declaration of trust dated December 1, 1992 and filed with the Barnstable County Registry District of the Land Court as Document No. 571573 ("Registry District')on December 30, 1992, as may be amended of record("the"Trust'), does hereby certify as follows: 1. That Raymond Kwasnick is the duly appointed, qualified and acting Trustee of the Trust. 2. That the aforesaid Trust is in full force and effect and has not been further amended, modified,revoked or terminated as of the date hereof. 3. The Trust is the owner of that certain property located in Barnstable, County of Barnstable,Massachusetts,being further described on Exhibit A attached hereto (the "PropertX„) 4. The Trustee has full power and authority and has been directed by the beneficiaries of the Trust and is authorized,as directed by the beneficiaries,to act in executing any and all instruments and documents necessary in connection with the conveyance of the property as described on Exhibit A to Raymond M. Kwasnick, Trustee of the Vine Street 2013 Realty Trust u/d/t dated November J_, 2013 and filed with said Registry District as Document No. , immediately herewith, for consideration under One Hundred Dollars. 5. In connection therewith the Trustee shall execute and deliver on behalf of the Trust, any and all documents with respect to the within described conveyance and the transactions contemplated therein, including but not limited to, any deeds, agreements, assignments, certificates, affidavits, settlement statement and other documents as may be necessary or desirable. i 2278876 6. The Trustee is not a foreign national. No beneficiary is a minor, incompetent, a personal representative of an estate subject to an estate tax lien, a Massachusetts corporation selling all of its assets within the Commonwealth, a debtor in bankruptcy case or a plaintiff or defendant in a divorce proceeding. Executed as a sealed instrument under the pains and penalties of perjury this day of November, 2013. Raymond Kwasn' k,Trustee and not individually COMMONWEALTH OF MASSACHUSETTS Suffolk, ss. On this 7?� day of November,2013,then personally appeared before me,the undersigned notary public,the above-named Raymond Kwasnick as Trustee aforesaid and proved to me,through satisfactory evidence of identification which was personal knowledge, to be the person whose name is signed on the preceding or attached document who swore or affirmed to me that she signed it voluntarily for its stated purpose. p111111Upp� A. � w �•• �y, Notary Publ l ?•, •; My Commission Expires: ,o2Y,a of S r 2 2278876 r r EXHIBIT A l s I. S i f 3 2278876 f certain parcel of land located in Barnstable, County of Barnstable,Massachusetts, being"further described as follows: Northerly by Vine Street,two hundred thirty (230)feet; Southeasterly by Lot 23, one hundred thirty-nine and 53/100 (139.53) feet; Southwesterly by a portion of Lot 16 and Lot 17, about onehundred sixty-one (161)feet; Westerly by Wequaquet Lake; and again; Westerly by Lot 42, about three(3)feet; Said land is shown as Lot 22 on plan hereinafter mentioned; Northerly by Vine Street, one hundred(100)feet; Northeasterly by the junction of said Vine Street and Lakeside Drive,forty-seven and 12/100 (47.12) feet; Easterly by said Lakeside Drive, one hundred eighteen and 64/100 (118,64); Southwesterly by Lot 15 and a portion of Lot 16,one hundred forty-one and 19/100 (141.19)feet; and Northwesterly by Lot 22, one hundred thirty-nine and 53/100 (139,53)feet. Said land is shown as Lot 23 on said plan. All of said boundaries are determined by the Court to be located as shown on subdivision plan 20239-C(Sheet 2) drawn by Gerald A.Mercer and Co.,Incorporated Engineers and filed in the Land Registration Office dated February 1958. a copy of which is filed in said Registry District Book 150, Page 118 with Certificate of Title#2017 and said land is shown there as Lots- 22 and 23. r` ( A Tp ) G° F BARNSTABLE REGISTRY OF DEEDS q t. Dor: 1 .234:913 11-08-2013 11 :34 BARNSTABLE LAND COURT REGISTRY Declaration of Trust Establishing VINE STREET 2013 REALTY TRUST This Declaration of Trust is made and entered into as of the 7th day of November,2013. RAYMOND M. KWASNICK of Boston, Suffolk County, Commonwealth of Massachusetts (together with his successors, the"Trustee(s)"),hereby declares that he and his successors in trust shall hold any and all property and interests in property,real and personal, conveyed or to be conveyed to him or them as the Trustee(s)hereunder(the "Trust Estate") in trust, solely as nominee, for the sole benefit of the individuals or entities listed in the Schedule of Beneficiaries in the proportions stated in said Schedule of Beneficiaries, which Schedule of Beneficiaries has this day been executed by the Beneficiaries (as defined below)and filed with the Trustee,with receipt acknowledged by the Trustee(hereafter, as it may be amended from time to time, "Schedule of Beneficiaries"). SECTION ONE Name and Purpose 1.1 This Trust shall be known as the VINE STREET 2013 REALTY TRUST and is intended to be a nominee trust, so-called, for federal and state income tax purposes and to hold the record legal title to the Trust Estate and perform such functions as are necessarily incidental thereto. SECTION TWO Trustee 2.1 There shall be one (1) original Trustee of the Trust. The original Trustee of the Trust is Raymond M. Kwasnick of Boston, Suffolk County, Commonwealth of Massachusetts. Up to two (2) additional Trustees may be appointed in the manner set forth in Section 7.2 hereof(so that at any one time there may be as few as one(1) and as many as three(3)Trustees hereunder), 2.2 Insofar as third persons dealing with the Trustee(s) are concerned, the following provisions shall govern: 2.2.1 Any action pursuant to this Declaration by any Trustee shall be treated as the action of the Trustees, and all references hereinafter in this Section 2.2 to the rights,power and authority of the Trustees shall be treated as referring to action taken by at least one (1) Trustee. 2.2.2 Subject to the provisions of Section 2.2.1,the Trustee(s) shall have full right,power and authority to deal with any property held by them as Trustee(s)hereunder, with the same force and effect as though such property were individually owned by them; and without limiting the generality of the foregoing, the Trustee(s), acting jointly or individually, shall have GSDOCS\2278847 full right, power and authority to execute any and all instruments, such as deeds,mortgages, leases, and the like, as the Trustee(s) shall from time to time determine. 2.2.3 Subject to the provisions of Section 2.2.1,the Trustee(s)shall have full power and authority to sign checks,drafts, notes,bills of exchange, acceptances, undertakings and other instruments or orders for the payment,transfer or withdrawal of money for whatever purpose and to whomsoever payable,including those drawn to the individual order of a signer, s and all waivers of demand,protest,notice of protest or dishonor of any check,note, bill, draft or other instrument made, drawn or endorsed in the name of this Trust, and to borrow money and to t execute and deliver notes or other evidence of such borrowing,to guaranty any obligation of the Beneficiaries, and to grant or acquire rights or easements and enter into agreements or arrangements with respect to the Trust property. I 2.2.4 Subject to the provisions of Section 2.2.1, no person dealing with the Trustee(s) shall be under any obligation to inquire as to the propriety of any action or omission by the Trustee(s), and every agreement, lease, deed,mortgage, note or other instrument or document executed or action taken by the person or persons appearing from the records of the Registry of Deeds to be the Trustee(s) shall be conclusive evidence in favor of every person relying thereon or claiming thereunder that at the time of the delivery thereof or of the taking of such action this Trust was in full force and effect,that the execution and delivery thereof or taking of such action was duly authorized, empowered and directed by the Beneficiaries. Subject to the provisions of Section 2.2.1, any person dealing with the Trust Estate or the Trustee(s)may always rely without further inquiry on a certificate signed by the person or persons appearing from the records of the Registry of Deeds to be the Trustee(s), as to who are the Trustee(s) or the Beneficiaries hereunder or as to the authority of the Trustee(s) to act or as to the existence or nonexistence of any fact or facts which constitute conditions precedent to action by the Trustee(s)or which are in any other manner germane to the affairs of the Trust. Execution, delivery or recording of such certificate shall not be a condition precedent to the validity of any transaction of the Trust. 2.2.5 Subject to the provisions of Section 2.2.1, the Trustee(s) shall have the right to delegate to any person or persons (natural or corporate)authority to execute any and all instruments or take any and all other action which the Trustee(s) are authorized and empowered so to do by the terms of this instrument. 2.2.6 Subject to the provisions of Section 2.2.1,the Trustee(s) may designate in writing an agent authorized to execute instruments on behalf of the Trustee(s)in connection with: (i) changes or modifications in the zoning classification pertaining to Trust property, (ii) applications for zoning variances, special permits and/or other approvals required under applicable zoning ordinances for the development of Trust property, and(iii)applications for permits and approvals incident to the development of Trust property, including,without limitation, wetlands, subdivision, environmental, utility, curb cut and all other permits and approvals which may be required from any and all applicable municipal, county, state or federal authorities. 2 GSDOCS12278847 i 2.3 No Trustee shall be required to furnish bond.No Trustee hereunder shall be liable for any action taken at the direction of the Beneficiaries, nor for any error of judgment nor for any loss arising out of any act or omission in the execution of the Trust so long as acting in good faith, but shall be responsible only for his or her own willful breach of trust. No license of court shall be requisite to the validity of any transaction entered into by the Trustee(s). No purchaser, transferee, pledgee, mortgagee or other lender shall be under any liability to see to the application of the purchase money or of any money or property loaned or delivered to any Trustee or to see that the terms and conditions of this Trust have been complied with. SECTION THREE i Beneficiaries 3.1 The term "Beneficiaries" shall mean the persons and entities listed as Beneficiaries in the Schedule of Beneficiaries, which Schedule of Beneficiaries may be amended from time to time by an instrument in writing, executed by all of the then current Beneficiaries and filed with the Trustee , with receipt eipt acknowledged by the Trustee, and, as between all current and future Beneficiaries and the Trustee(s)hereof, the Trustee(s) shall always be entitled to rely upon what appears from the records of the Trustee(s) to be the most recent Schedule of Beneficiaries in determining whether the action which it is directed to take is an action appropriately to be taken by them under Section 4 hereof. 3.2 Solely as between the Trustee(s) on the one hand, and the Beneficiaries on the other, it is understood and agreed that decisions made and actions taken hereunder (including without limitation, amendment of this Trust, appointment and removal of Trustee(s), directions and notices to the Trustee(s), and execution of documents) shall be made or taken, as the case may be,by all of the Beneficiaries, and further that the Trustee(s) shall, subject to Section 4.4 below: 3.2.1 Execute such instruments, including but without limitation, deeds, mortgages and leases of Trust property, as the Trustee(s)may from time to time be specifically directed so to do by the Beneficiaries; 3.2.2 Take any such action with respect to the Trust property as.may from time to time be specifically directed by the Beneficiaries; 3.2.3 Do any such other things as the Trustee(s)may be specifically authorized or specifically directed to do by the terms of this Trust; 3.2.4 Execute only such instruments and take only such action as shall have been authorized and directed by the Beneficiaries. 3.3 Any Trustee may without impropriety become a Beneficiary hereunder and exercise all rights of a Beneficiary with the same effect as though he or she or it were not a Trustee. The parties hereunder recognize that if a sole Trustee and a sole Beneficiary are one and the same person, legal and equitable title hereunder shall merge as a matter of law. SECTION FOUR 3 GSDOCS\2278847 L Powers of Trustee 4.1 The Trustee shall hold the principal of this Trust and receive the income therefrom, if any, for the benefit of the Beneficiaries, and shall pay over such principal and income pursuant to the direction of all of the Beneficiaries and without such direction shall pay such income to the Beneficiaries in proportion to their respective interests. 4.2 Except as hereinafter provided in case of the termination of this Trust, solely as between the Trustee(s) on the one-hand, and the Beneficiaries on the other, it is.understood and agreed 4 that the Trustee(s) shall have no power to deal in or with the Trust Estate except as directed by all of the Beneficiaries, and further that, as, if and to the extent specifically directed by all of the Beneficiaries,the Trustee shall: 4.2.1 Execute such instruments, including but without limitation, deeds, mortgages and leases of all or any part of the Trust Estate, as the Trustee(s)may from time to time be specifically directed so to do by the Beneficiaries; 4.2.2 Take any such action with respect to the Trust Estate as may from time to time be specifically directed by the Beneficiaries; 4.2.3 Do any such other things as the Trustee(s)may be specifically authorized or specifically directed to do by the terms of this Trust; 4.2.4 Execute only such instruments and take only such action as shall.have been authorized and directed by the Beneficiaries. The provisions of this Section 4.2 shall be applicable only as between the Trustee(s)on the one hand, and the Beneficiaries on the other; but the limitations set forth in this Section 4.2 shall in no way derogate from the absolute apparent authority conferred upon the Trustee(s), pursuant to the provisions of Section 2.2 above,insofar as third persons are concerned or the right of any third parties to rely on any certificate of the Trustee(s) under Section 2.2.4 above. 4.3 Any and all instruments executed pursuant to any direction of the Beneficiaries may create obligations extending over any periods of time, including periods extending beyond the date of any possible termination of the Trust. A direction to the Trustee by the Beneficiaries may be by a Durable Power of Attorney. 4.4 Notwithstanding any provisions contained herein,no Trustee shall be required to take any action which will, in the opinion of such Trustee, involve the Trustee in any personal liability unless first satisfactorily indemnified. 4.5 Any persons extending credit to, contracting with or having any claim against the Trustee(s) shall look only to the funds and property of this Trust for payment of any contract, or claim, or for the payment of any debt, damage,judgment, or decree, or for any money that may otherwise become due or payable to them from the Trustee(s), so that neither the Trustee(s) nor the Beneficiaries shall be personally liable therefore. If any Trustee shall at any time for any reason (other than for willful breach of trust) be held to be under any personal liability as such 4 GSDOCS\2278847 Trustee, then such Trustee shall be held harmless and indemnified by the Beneficiaries,jointly and severally, against all loss,costs, damage, or expense by reason of such liability. 4.6 As used in this Declaration of Trust, wherever the phrases "directed by the Beneficiaries" or "all of the Beneficiaries" or any phrase similar in import thereto is used, the same shall mean, where the sole or any Beneficiary is other than a natural person, the act, omission, vote, signature or approval of a partner, officer, manager, trustee or other person apparently authorized to act on behalf of any such entity, and the Trustee(s) and any third party dealing with the Trust shall be entitled to rely on such apparent authority without any obligation to inquire as to the propriety of any action or omission of such apparently authorized person, and the Trustee(s) and any such third party shall be conclusively protected in assuming without further inquiry that any such action or omission of an apparently authorized person or entity is valid and binding. SECTION FIVE Termination 5.1 This Trust may be terminated at any time by notice in writing from any Beneficiary, provided that such termination shall be effective only when a certificate thereof signed by the Trustee(s), shall be recorded with the Registry of Deeds. Notwithstanding any other provision of this Declaration of Trust, this Trust shall terminate in any event ninety (90) years from the date hereof, if not earlier terminated by action of a Beneficiary. 5.2 In the case of any termination of the Trust,the Trustee(s)shall transfer and convey the specific assets constituting the Trust Estate,subject to any leases, mortgages, contracts or other encumbrances on the Trust Estate,to the Beneficiaries as tenants in common in proportion to their respective interests hereunder,or as otherwise directed by all of the Beneficiaries,provided, however,the Trustee(s)may retain such portion thereof as is in their opinion necessary to discharge any expense or liability, determined or contingent,of the Trust. SECTION SIX Amendments 6.1 This Declaration of Trust may be amended from time to time by an instrument in writing signed by all of the Beneficiaries and delivered to the Trustee(s), provided in each case that the amendment shall not become effective until the instrument of amendment or a certificate setting forth the terms of such amendment, signed by the Trustee(s), is recorded with the Registry of Deeds. The filing of such a certificate shall conclusively establish such amendment, and such filing shall have the effect of a certification by the Trustee(s) as to such direction or approval of the Beneficiaries with respect to such amendment. SECTION SEVEN Resignation and Successor Trustee(s) 7.1 Any Trustee hereunder may resign at any time by an instrument in writing signed and acknowledged by such Trustee and delivered to all remaining Trustees and to each Beneficiary. s GSDOCS\2278847 Such resignation shall take effect on the later of the date specified therein or the date of the recording of such instrument with the Registry of Deeds. 7.2 Succeeding or additional Trustees may be appointed or any Trustee may be removed by an instrument or instruments in writing signed by all of the Beneficiaries, provided in each case that a certificate signed by any Trustee naming the Trustee or Trustee(s) appointed or removed and, in the case of an appointment, the acceptance in writing by the Trustee or Trustee(s) appointed, shall be recorded in the Registry of Deeds.Upon the recording of such instrument,the legal title to the Trust Estate shall, without the necessity of any conveyance, be vested in said succeeding or additional Trustee or Trustee(s), with all the rights, powers, authority and privileges as if named as an original Trustee hereunder. 7.3 In the event that there is no Trustee, either through the death or resignation of a sole Trustee without prior appointment of a successor Trustee or for any other cause, a person purporting to be a successor Trustee hereunder may record in the Registry of Deeds an affidavit, under pains and penalties of perjury, stating that he or she has been appointed by all of the Beneficiaries a successor Trustee. Such affidavit when recorded together with an attorney's certificate under M.G.L. c. 183, § 513, stating that such attorney has knowledge of the affairs of the Trust and that the person signing the affidavit has been appointed a Trustee by all of the Beneficiaries, shall have the same force and effect as if the certificate of a Trustee or Trustees required or permitted hereunder had been recorded and persons dealing with the Trust or Trust Estate may always rely without further inquiry upon such an affidavit as so executed and recorded as to the matters stated herein. SECTION EIGHT Governing Law 8.1 This Declaration of Trust shall be construed in accordance with the laws of the Commonwealth of Massachusetts SECTION NINE Registry of Deeds 9.1 The term "Registry of Deeds" shall mean the Registry of Deeds or Registry District of the Land Court for the district in the Commonwealth of Massachusetts in which the real estate which is the subject of this Trust is located, and in which this Declaration of Trust is recorded or registered [Remainder of page intentionally blank; signature appears on following page.] 6 GSDOCS\2278847 f WITNESS the execution hereof,under seal,in any number of counterpart copies,each of which counterpart copies shall be deemed an original for all purposes, as of the day and year first above written. 7�� Raymond M. K asnick as Trustee and not individuall I' l COMMONWEALTH OF MASSACHUSETTS ss. On this Aday of November,2013,then personally appeared before me,the undersigned notary public,the above-named Raymond M. Kwasnick as Trustee of the Vine Street 2013 Realty Trust and proved to me,through satisfactory evidence of identification which was personal knowledge,to be the person whose name is signed on the preceding or attached document who swore or affirmed to me that she signed it voluntarily for its stated purpose. Notary Pub i My Commission Expires:S aOIS 0cNusn S E P -- BARNSTABLE REGISTRY OF DEEDS [Signature Page to Declaration of Trust—Vine Street 2013 Realty Trust] i °F tHE Town of Barnstable pARIV,41'AOLE, "AS& Board of Health i6)9. AlFO A4A'�A 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 — Wayne Miller,W.D. FAx: 508-790-6304 . Paul Cannifl;D.W.D. Susan flask,R.S. September 12, 2013 Mr. Stephen Wilson,:P.E. Baxter Nye:Engineering and:Surveying - 78 North Street Hyannis, MA 02601 RE: 346 Holly Point Road, Centerville A= 232-024 and 072 Dear Mr..Wilson, You are granted a conditional:variance on behalf of your client, Raymond Kwasnick, to :. construct an onsite sewage disposal : system incorporating. innovative/alternative technology at:346 Holly:Point Road:Centerville. The variances granted are as follows. Section 360-1 of the Town of Barnstable Code: To install a soil absorption system 31.4 and 38 feet away from a wetland, in lieu:of the minimum 100 feet separation distance required. -- Section 360-1 of the Town.of Barnstable Code: To allow the existing septic tank to remain 17.5 feet away from a wetland, in.lieu of the minimum 100 feet separation distance required. 310 CMR 15.211 (1): To install a soil absorption system 6.5 feet away from a foundation, in lieu:of the minimum twenty (20j feet separation distance required: : _. 310 CMR 15.211 0): To install a soil absorption system.6.7 feet away from 6property line; in lieu of.the minimum ten(.10) feet separation distance required. 310 CMR 15.21.2 M To install a soil absorption system 4.1 feet above the maximum high groundwater table elevation, in lieu of the minimum five (5)feet _. minimum vertical separation required: : 310 CMR 15.211 ..(1). To install a soil absorption system 31.4 and 38 feet away from a wetland, in lieu of the minimum 50 feet separation distance required by the State Environmental.Code. 310 C.MR 15.211 (1): To-allow the existing septic tank to remain 17.5 feet away from a wetland,in lieu of the minimum 50 feet separation distance required by the State Environmental Code Q:kWPFILESIwilsoti Kwisnick346t iollyPointltoad20l 3.doc These variances are granted with the.following conditions: (1) No more.than three (3) bedrooms are. authorized at this property. Dens, study rooms, offices, finished attics, sleeping Iofts, and similar-type rooms are - considered "bedrooms" according to the MA Department of Environmental Protection: (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property,at the Barnstable County Registry of Deeds restricting the property to three bedrooms.maximum. A copy of the recorded deed restriction y' shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) The applicant, designing engineer, installer, and homeowner shall strictly adhere to all of the applicable conditionslisted within the Massachusetts Department of Environmental Protection (MA DEP) fifteen page document entitled "Standard Conditions for Alternative Soil Absorption Systems with General Use Certification and/or Approved.for Remedial Use" dated revised August27, 2013: (4) The septic system shall. be installed.in strict accordance with the engineered plans dated.July 31, 2013. (5) In the event the soil absorption system fails sometime in the future, the soil absorption system shall be replaced in the same location. (6) The designing engineer shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the engineered plans dated July31, 2013. These variances are granted because the proposed plan appears to meet the maximum feasible design standards contained within the State Environmental Code, Title 5 and local Health Regulations: The designing engineer. designed the septic system to be located in an area to attempt to maximize setbacks to wetlands: Sincerey, yours, Way a Mill , M.D. i Q:\WPFILESTWilsoiiKwisiiick346HollyPoiiitRoid2Ol3.doc Page 1 of 1 Stephen Wilson From: Stephen Wilson Sent: Monday, September 09, 2013 11:15 AM To: 'McKean, Thomas' Cc: 'Dudley, Brian (DEP)' Subject: 346 Holly Point Road Hi Tom, Just had a conversation with Brian Dudley. If I use Cultrecs with stone and the standard allowable leaching rates (310 CMR 15.242)their use doesn't fall under the category of Alternative Soil Absorption System. Therefore showing a reserve area is not required. Steve I 9/10/2013 4 T S 41TTAIJ BARTER NYE ENG EERIN VEYING Registered Professional Engineers and Land Surveyors 78 North Street,3rd Floor,Hyannis,MA 02601 Tel:(508)771-7502 Fax:(508)771-7622 Date: September 6 ,2013 TO: Board of Health Total No.Pages: 200 Main Street,Hyannis BN Job No.: 2013-026:02 Subject: Variance Request 346 Holly Point Road, Centerville Phone: cc: files We are sending you ® Attached ❑Under Separate Cover ❑ Via Fax(No. of pages including Transmittal Sheet) ❑ First Class Mail/Registered#: ; ❑ Overnight ❑Pick up ®Hand Delivery The following documents: ®Prints/Plans ❑ Specifications ❑ Estimates/Proposal ❑ Change Order❑ Shop Drawings n Reports/Calculations n Other DATE COPIES NO. PAGES DESCRIPTION 9-5-13 4 2 Septic Repair Plan-Revised These items are transmitted as checked below: For Your Use ❑As Requested ❑.Returned For Corrections ® For Review And Comment ®For Approval ❑ For Distribution Remarks: The revision consists of adding a proposed reserve area. Please call me with any questions or comments you may have. t i 3 Steve Wilson +� w� G� 0:T013\2013-028\ADMIN\TRANSMITTALS\2013-028 BOH Variance 9-5-13.pdf.doc Note: This transmittal contains privileged information.Please contact the sender immediately if this transmittal is illegible, incomplete or not intended for your use.Thank.you. I:\document templates/transmittal template i Town of Barnstable Barnstable Board of Health AS-Amefica0 * mmms-rABLE, ' 9 nAsS. g 200 Main Street, Hyannis MA 02601 qj 039. ATFb MA12007 rrD � Office: 508-862-4644 �� Wayne Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul Canniff,D.M.D. Agreement to Extend Time Limit For Acting Upon a Variance Request In the Matter of a variance request form received on the Petitioner(s), ,S regarding the property at ' �--- 2 the petitioner(s) and the Board of Health agree that the Boa d of Health has until 0 3 (insert date) to act upon the Petitioners' completed application for a variance. In executing this Agreement, the Petitioner(s)hereto specifically waive any claim for a constructive grant of relief based upon time limits applicable prior to the execution of this Agreement. Petitioner(s): Board of Health: Signature: Signature: e iti er(s or Petitioner's Representative Chairman Print: Print: Wayne Miller, M.D. Date: 8 zp —/3 Date: Address of Petitioner(s)or Petitioner's Representative Town of Barnstable Board of Health Public Health Division 200 Main Street Hyannis, MA 02601 Phone: 508-862-4644 Fax: 508-790-6304 Q:\AGENDAS BOH\BOH Agreement to Extend Time Limit to Act on Variance.doc I o Commonwealth of Massachusetts Executive Office of Energy &Environmental Affairs Department of Environmental Protection One Winter Street Boston, MA 02108.617-292-5500 DEVAL L PATRICK RICHARD K.SULLIVAN JR, Governor Secretary TIMOTHY P.MURRAY KENNETH L.KIMiMELL Lieutenant Governor Commissioner Standard Conditions for Alternative Soil Absorption Systems with General Use Certification and/or Approved for Remedial Use Revised: August 27, 2013 These Standard Conditions apply to Alternative Soil Absorption System (Alt. SAS) technologies for disposal-only as well as for technologies providing both treatment and disposal. Currently these approved alternative technologies include the following, Alt. SAS Disposal-Only, • Contactor, Field Drain Contactor, and Recharger Chambers, by Cultec, Inc. • Biodiffuser&ARC Chambers, by Infiltrator Systems, Inc. • Infiltrator Chambers, by Infiltrator Systems, Inc. • Eljen Mantis M5, by Eljen Corp. Alt. SAS Treatment with Disposal -Patented Sand Filters, • Eljen GSF Geotextile Sand Filter System,by Eljen Corp. • GEO-flow Pipe Leaching System,by ADS, Inc. • Enviro-Septic Wastewater Treatment System,by Presby Environmental Inc. • Advanced Enviro-Septic System, by Presby Environmental Inc. An alternative SAS may be appropriate for new construction, increases in flow, or for the upgrade of an existing failing, failed,or nonconforming system where reducing the disturbance of the site is desired. Alternative Disposal-Only technologies approved by the Department may be substituted for conventional SAS's allowed under Title 5. The alternative Chamber technologies,when compared to conventional Title 5 chambers,provide options from some of the Title 5 requirements such as offering plastic instead of concrete chambers and eliminating the need for stone aggregate around the chamber while allowing higher loading rates and reduced effective leaching area. Other options include Chambers installed with aggregate meeting the requirements of Title 5, however Alternative Chambers used with aggregate are not allowed higher loading rates which must remain the same as required by Title 5 for conventional chambers with aggregate. In addition to alternative Chambers, disposal-only approved Alt. SAS technologies also include the Mantis M5 pipe and sand System design. This information is available in alternate format.Call Michelle Waters-Ekanem,Diversity Director,at 617-292-5751.TDD#1-866-539-7622 or 1-617-574-6868 MassDEP Website:www.mass.gov/dep Printed on Recycled Paper I - Y Standard Conditions for Alternative Soil Absorption Systems Page 2 of 16 General Use and Remedial Use Approvals Revised Date: August 22,2013 Alternative Treatment with Disposal technologies approved by the Department refer to alternative leaching systems that have demonstrated higher removal of organics and suspended matter prior to the percolation of wastewater into underlying unsaturated pervious soils when compared to conventional leaching systems. Higher loading rates are allowed than would be permissible with a conventional design and additional relief from other design standards is permissible for upgrades. A System approved under these Standard Conditions consists of a septic tank conforming to the requirements of Title 5, either conventional or I/A approved, followed by the Alt. SAS which may provide for a reduced effective leaching area. The use of an approved Alt. SAS, subject to these Standard Conditions, requires, among other things: • A Disclosure Notice in the Deed to the property for systems installed under Remedial Use Approval (310 CMR 15.287(10)) (A Deed Notice template is available from the Department); • Certifications by the Designer and the Installer(310 CMR 15.021(3)); • Notification within 24 hours by the System Owner to the Local Approving Authority (LAA) of any System failure; • When pumping is required to discharge to the SAS, 24-hour emergency wastewater storage capacity above the elevation of the high level alarm; • System Owner Acknowledgement of Responsibilities, in accordance with these standard conditions and the Technology Approval's Special Conditions. This Approval does not address the use of the following alternative SAS's,which are covered under separate Title 5 I/A Program Approvals: a) Drip Dispersal Systems b) Bottomless Sand Filters Definitions and References The term "System" refers to the approved technology in combination with the other components of an on-site treatment and disposal system that may be required to serve a facility in accordance with 310 CMR 15.000. The term "Approval" or"Certification" refers to these Standard Conditions; the Special Conditions contained in the Technology Approval, the General Conditions of 310 CMR 15.287, and any Attachments. The phrase "new construction" always refers to construction of a new facility or any increase in actual or design flow to any existing system above the approved capacity. The phrase "upgrade of a system" or the term "upgrade" or the term"remedial site" refers to any repair, modification, or replacement of a whole system or a component of an existing failing, failed or nonconforming system where there is no increase in the actual or design flow to the system. I Standard Conditions for Alternative Soil Absorption Systems Page 3 of 16 General Use and Remedial Use Approvals Revised Date: August 22,2013 The Conditions contained herein MUST be read in conjunction with any Special Conditions that are technology-specific. I. Purpose 1. These Standard Conditions shall apply to all Alt. SAS technologies identified in a General Use Certification or a Remedial Use Approval as either a Disposal-Only technology or a Treatment with Disposal technology as listed above. In addition to the Special Conditions contained in the technology-specific Approvals,the System shall comply with all these "Standard Conditions for Alternative Soil Absorption Systems", except where stated otherwise in the Special Conditions. 2. The sale, design, installation, and use of the System shall be subject to these requirements for all systems that submit a complete Disposal System Construction Permit (DSCP) application after the effective date of these Standard Conditions. Existing systems and systems for which a complete DSCP application was submitted prior to the effective date of these requirements shall not be subject to the design and installation requirements, however, the System Owner, the Service Contractor, and the Company shall be subject to all other requirements contained herein. 3. With the other applicable permits or approvals that may be required by Title 5, the Approval authorizes the installation and use of the System in Massachusetts. All the provisions of Title 5, including the General Conditions for Alternative Systems (310 CMR 15.287), apply to the sale, design, installation, and use of the System, except those provisions that specifically have been varied by this Approval. 4. Provided that the Local Approving Authority (LAA) approves the System in conformance with the Department's Approval for the System, Department review and approval of the site-specific System design and installation is not required unless the Department determines on a case-by-case basis,pursuant to its authority at 310 CMR 15.003(2)(e),that the proposed System requires Department review and approval. II. Design and Installation Requirements 1. Where any contradiction may exist in design standards between the Company guidance and the requirements of Title 5 or this Approval,the design shall meet the standards of Title 5 and this Approval unless the Company guidance is more stringent. 2. In accordance with 310 CMR 15.240(6), absorption trenches should be used whenever possible. Accordingly, approved Disposal-Only and Treatment with Disposal Alt. SAS Systems shall be used in trench configuration whenever possible, unless a different configuration is allowed by the Approval(s) Special Conditions. 3. The Alternative System shall include a properly sized and constructed septic tank, designed in accordance with 310 CMR 15.223-15.229 or approved as an Alternative i Standard Conditions for Alternative Soil Absorption Systems Page 4 of 16 General Use and Remedial Use Approvals Revised Date:August 22,2013 technology per 15.280-15.288, connected to the building sewer and followed in series by the approved Alternative Soil Absorption System. 4. The Alternative System shall be installed in a manner which does not intrude on, replace, or adversely affect the operation of any other component of the subsurface sewage disposal system. 5. The Designer shall be a Massachusetts Registered Professional Engineer or a Massachusetts Registered Sanitarian, including when designing systems for repair, provided that such Sanitarian shall not design a system with a discharge greater than 2,000 gallons per day. 6. For new construction or increases in flow, the System shall be subject to the following: a) The System may only be installed in soils with a percolation rate of up to 60 minutes per inch (MPI); b) A site evaluation, in compliance with 310 CMR 15.100 through 15.107, must be approved by the Approving Authority and the site must meet the siting requirements for new construction; c) The record drawings, approved by the LAA, must clearly indicate an area for a full- sized conventional primary SAS and a full-sized conventional reserve area that are for the sole purpose of on-site sewage disposal; d) Where the System has reduced the effective leaching area, as allowed by the Standard Conditions, the installation shall not disturb the site in any manner that would preclude the future installation of the conventional full-sized primary SAS without encroaching on the reserve area; and e) Except for the installed SAS,the System Owner shall not construct any permanent buildings or structures or disturb the site in any manner that would encroach on the area approved for a full-sized conventional primary SAS or the area approved for a full-sized conventional reserve SAS. 7. For the upgrade of a system,the installation of the proposed System shall be subject to the following: a) The System may only be installed in soils with a percolation rate of up to 90 minutes per inch (MPI); b) The LAA must determine there is no increase in the actual or proposed design flow, and also that a conventional system with a reserve area, designed in accordance with the standards for new construction cannot feasibly be built on-site; c) The proposed System must include the approval by the LAA for the upgrade or replacement of all other existing components, as necessary, to comply with the standards of Maximum Feasible Compliance (MFC) of 310 CMR 15.404. d) The record drawings, approved by the LAA, must clearly indicate an area for the best feasible replacement system that could be installed in the event that the proposed Alternative Soil Absorption System fails or it is determined that it is not capable of providing equivalent environmental protection; Standard Conditions for Alternative Soil Absorption Systems Page 5 of 16 General Use and Remedial Use Approvals Revised Date:August 22,2013 e) When evaluating the best feasible replacement system that could installed in the event that the proposed Alternative Soil Absorption System fails or it is determined that it is not capable of providing equivalent environmental protection, the Designer shall consider these options in the following order: i. a conventional system designed in accordance with the standards of 310 CMR 15.100 through 15.255 that can be built feasibly, with the exception of providing a reserve area(15.248); ii. a conventional system that can only be built feasibly under a Local Upgrade Approval (LUA); iii. where a conventional system cannot be built feasibly under a LUA, a Bottomless Sand Filter, in conjunction with a Secondary Treatment Unit; iv. where a System can only be built feasibly with variances, a System that has been demonstrated to vary the design requirements of 310 CMR 15.000 to the least degree necessary and have the least effect on public health, safety, welfare and the environment (the System may be an Alternative System with variances); or v. a tight tank; f) The installation of the proposed System shall not disturb the site in any manner that would preclude the future installation of the best feasible replacement system that could be installed to replace the proposed System. Components of the proposed System may be sited in an area for the future installation of the best feasible replacement system, provided that it does not render the area unusable for a Y potential future replacement system; and p p g) Except for the installed SAS, the System Owner shall not construct any permanent buildings or structures in the area for the best feasible replacement system that could be installed to replace the proposed System and the System Owner shall not disturb the site in any other manner that would preclude the future installation of the best feasible replacement system. 8. Alternative Design Standard to 310 CMR 15.242(1)(a) Effluent Loading Rates For new construction or increases in flow,the required effective leaching area may be reduced up to 40 percent when using the loading rates for gravity systems of 310 CMR 15.242(1)(a), provided that: a) no variance is granted for a reduction in depth to groundwater; b) no variance is granted for a reduced depth of pervious material; and c) a minimum of 400 square feet of effective leaching area shall be installed if any proposed reduction in the leaching area would result in less than 400 square feet of effective leaching area; (Facilities with small flows that would not require 400 sq.ft. of effective leaching area, when designed in accordance with Title 5, may be built with less than 400 sq. ft. provided that no reduction in effective leaching area is taken). Standard Conditions for Alternative Soil Absorption Systems Page 6 of 16 General Use and Remedial Use Approvals Revised Date: August 22,2013 9. Alternative Design Standard to 310 CMR 15.242(1)(a) and 15.245(4), Effluent Loading Rates For the upgrade of a system: the System shall be subject to the following: a) For soils with a percolation rate of 60 minutes or less per inch,the size of the SAS may be sized with 40 percent less effective leaching area than required when using the loading rates for gravity systems of 310 CMR 15.242(1)(a); b) For soils with a percolation rate of between 60 and 90 minutes per inch, the size of the SAS may be sized with 40 percent less effective leaching area than required when using the loading rate of 0.15 gpd/square foot as specified by 310 CMR 15.245(4); c) Unless allowed under the Special Conditions for the Technology, no additional reduction in the effective leaching area is allowed under an LUA or a variance that would result in a reduction greater than 40%of that which would be required under 310 CMR 15.242(1)(a) and 15.245(4), respectively. Any other deviations to design standards, except the effective leaching area, may be granted under LUA or a variance; and d) A minimum of 400 square feet of effective leaching area shall be provided if any proposed reduction in the leaching area would result in less than 400 square feet of effective leaching area. Where 400 square feet of effective leaching is not feasible, the greatest effective leaching area shall be installed provided that no more than a 40 percent reduction is taken. 10. Specific Conditions for Treatment with Disposal Alt. SAS Technologies a) The use of aggregate as specified in 310 CMR 15.247 is not allowed with Patented Sand Filters. b) Unless determined necessary by the Designer or Company,the System shall not be used with pressure distribution for any design flow. When installed for a facility with a design flow of 2,000 gpd or greater, approved Patented Sand Filter Systems are exempt from the requirement for pressure distribution under 310 CMR 15.231. c) Patented Sand Filters shall not be installed in a Nitrogen Sensitive Area(NSA)to serve facilities with actual or design flows of 2,000 GPD or greater since those facilities require installation of a Recirculating Sand Filter(RSF) or equivalent technology. Patented Sand Filters may be installed as a disposal-only alternative technology when used in addition to an approved Secondary Treatment Unit (reduction of BOD/TSS). When a Patented Sand Filter is used in this type of septic system design, only the reductions permitted in the Secondary Treatment Unit's (STU) alternative technology approval, such as a reduction in SAS size, depth of naturally occurring pervious material or depth to groundwater, are allowed. 11. Specific Conditions for Disposal-Only Alt. SAS Technologies r Standard Conditions for Alternative Soil Absorption Systems Page 7 of 16 General Use and Remedial Use Approvals Revised Date:August 22,2013 a) In a NSA, as defined in 310 CMR 15.215, Alternative Systems serving facilities with actual or design flows of 2,000 GPD or greater must include treatment with a RSF or equivalent technology, as required by 310 CMR 15.202(l). Under this Approval, Disposal-Only Alt. SAS technologies shall not be installed in an NSA to serve facilities with actual or design flows of 2,000 GPD or greater unless installed in conjunction with a RSF or equivalent technology. b) For new construction or upgrades, a reduction in the effective leaching area may be taken in accordance with the conditions and limitations imposed by the approval of the Secondary Treatment Unit employed. (approved Alternative Chambers may be installed with or without aggregate for the disposal of effluent from an approved Secondary Treatment Unit, see paragraph I I(e) below.) For upgrades only, a reduction in the depth to groundwater and/or a reduction in the pervious material may be taken in accordance with the conditions and limitations imposed by the Remedial Use Approval of the Secondary Treatment Unit employed. In no case, shall the reductions allowed under the Secondary Treatment Unit approval be made less stringent. In no case, shall the reductions allowed under the Secondary Treatment Unit approval be combined with any reduction provided by this Approval or combined with any reduction that may be allowed under the procedures of Local Upgrade Approval or the variance procedures of 310 CMR 15.401-415. c) For the upgrade of a system, installations without secondary treatment are entitled to reductions in depth to groundwater or depth of naturally occurring pervious material only to the limits that may be allowed by the LAA under the procedures of Local Upgrade Approval or the variance procedures of 310 CMR 15.401-415. d) The use of aggregate as specified in Title 5, 310 CMR 15.247 is not required. Chambers Specific Standard Conditions, e) The installation of approved Alternative Chambers with aggregate is allowed provided that it complies with the aggregate requirements of 310 CMR 15.247. However, when approved Alternative Chambers are installed with aggregate the reduction in effective leaching area provided by Standard Conditions II (8) and (9) is not allowed. Only when upgrading a system, approved Alternative Chambers installed with aggregate may be allowed a reduction in effective leaching area(up to 25%) under the limitations and procedures of a Local Upgrade Approval (310 CMR 15.401-405). f) Effluent pressure distribution shall be provided for actual or design flows of 2,000 gpd or greater and shall be designed in accordance with Department guidance. The effluent loading rates provided in 310 CMR 15.242(1)(b) for pressure distribution may be utilized, but no reduction in the effective leaching area as may be provided under this Approval may be taken when using the loading rates for pressure distribution, as stated in the regulation. 12. All System control units,valve boxes, distribution piping,conveyance lines and other System appurtenances shall be designed and installed to prevent freezing. Standard Conditions for Alternative Soil Absorption Systems Page 8 of 16 General Use and Remedial Use Approvals Revised Date:August 22,2013 13. When pumping is required to discharge to the SAS, the System shall be equipped with sensors and high-level alarms to protect against high water due to pump failure, pump control failure, loss of power, system freeze ups, backups, etc. Emergency storage shall be provided when pumping to discharge is employed, including but not limited to, pressure distribution. Emergency storage capacity for wastewater above the high level alarm shall be provided equal to the daily design flow of the System including an additional allowance for the volume of all drainage which may flow back into the System when pumping has ceased. 14. For systems requiring pumping,the System control panel including alarms and controls shall be mounted in a location always accessible to the operator(Service Contractor). System malfunction and high water alarms shall be readily visible and audible for the facility occupants and the Service Contractor and shall be connected to circuits separate from the circuits serving the operating equipment and pumps. 15. The System shall not include any relief valve or outlet for the discharge of wastewater to prevent flooding of the system, back up or break out. 16. Any System structures with exterior piping connections located within 12 inches of or lower than the Estimated Seasonal High Groundwater elevation shall have the connections made watertight with neoprene seals or equivalent. 17. In compliance with 310 CMR 15.240(13), a minimum of one (1) inspection port shall be provided within the SAS consisting of a perforated four inch pipe placed vertically down to the elevation of the SAS interface with the underlying unsaturated pervious soils to enable monitoring for ponding. The pipe shall be capped with a screw type cap and accessible to within three inches of finish grade. (A locking cap at-grade is preferred) Facilities with multiple SAS's shall have an inspection port in each. 18. Upon submission of an application for a Disposal System Construction Permit (DSCP), the Designer shall provide to the Local Approving Authority: a) proof that the Designer has satisfactorily completed any required training by the Company for the design and installation of the Technology; b) certification of the design by the Company for any residential system with a design of 2,000 gpd or more or for any proposed non-residential system or if required by the Special Conditions for an approved Technology; c) certification by the Designer that the design conforms to the Approval, any Company Design Guidance, and 310 CMR 15.000; and d) a certification, signed by the Owner of record for the property to be served by the Technology, stating that the property Owner: i. has been provided a copy of the Title 5 I/A technology Approval, the Owner's Manual, and the Operation and Maintenance Manual, and the Owner agrees to comply with all terms and conditions; Standard Conditions for Alternative Soil Absorption Systems Page 9 of 16 General Use and Remedial Use Approvals Revised Date:August 22,2013 ii. for Systems installed under a Remedial Use Approval, the owner agrees to fulfill his responsibilities to provide written notification of the Approval to any new Owner, as required by 310 CMR 15.287(5); iii. if the design does not provide for the use of garbage grinders, the restriction is understood and accepted; and iv. whether or not covered by a warranty,the System Owner understands the requirement to repair, replace, modify or take any other action as required by the Department or the LAA, if the Department or the LAA determines the System to be failing to protect public health and safety and the environment, as defined in 310 CMR 15.303. 19. The System Owner and the Designer shall not submit to the LAA a DSCP application for the use of a Technology under this Approval if the Approval has been revised, reissued, suspended, or revoked by the Department prior to the date of application. The Approval continues in effect until the Department revises, reissues, suspends, or revokes the Approval. 20. The System Owner shall not authorize or allow the installation of the System other than by a locally approved Installer and, if required by the Company, a person certified or trained by the Company to install the System. 21. Prior to the commencement of construction, the System Installer must certify in writing to the Designer, the LAA, and the System Owner that(s)he is a locally approved System Installer and, if required by the Company, is certified by or has received appropriate training by the Company. 22. The Installer shall maintain on-site, at all times during construction, a copy of the approved plans, the Owner's manual,the O&M manual, and a copy of the Approval. 23. Prior to the issuance of a Certificate of Compliance the following shall be provided: a) the System Installer and Designer must provide certification in writing to the LAA that the System has been constructed in compliance with the terms of the Approval; and b) For System pgrades installed under a Remedial Use Approval the System Owner shall provide a copy of record and/or register the Deed Notice required by 310 CMR 15.287(10), to the LAA. The Deed Notice shall be completed as follows: i. a certified Registry copy of the Deed Notice bearing the book and page/or document number; and i Standard Conditions for Alternative Soil Absorption Systems Page 10 of 16 General Use and Remedial Use Approvals Revised Date:August 22,2013 ii. if the property is unregistered land, a copy of the System Owner's deed to the property as recorded at the Registry, bearing a marginal reference on the System Owner's deed to the property. The Notice to be recorded shall be in the form of the Notice provided by the Department. 24. The Department has not determined that the performance of the System will provide a level of protection to public health and safety and the environment that is at least equivalent to that of a sanitary sewer system. a) If it is feasible to connect a new or existing facility to the sewer, the Designer shall not propose an Alternative System to serve the facility and the facility Owner shall not install or use an Alternative System; and b) When a sanitary sewer connection becomes feasible after an Alternative System has been installed, the System Owner shall connect the facility served by the System to the sewer within 60 days of such feasibility and the System shall be abandoned in compliance with current Code requirements, unless a later time is allowed in writing by the Department or the LAA. III. Operation and Maintenance 1. For Systems with design flows of 2,000 gpd or greater where the effective leaching area installed is less than 75%of that required by Title 5 (310 CMR 15.240(4)), measurement of the depth of ponding within the SAS above the interface with the underlying unsaturated pervious soils shall be performed once per year by means of the inspection port(s) and any other available access to the distribution system. Inspector must be an Approved System Inspector. 2. Whenever an Alt. SAS system's inspection port ponding depth is measured and indicates the ponding level within the SAS is above the invert of the distribution system, an additional measurement shall be made 30 days later. If the subsequent reading indicates the elevation of ponding within the SAS is above the invert of the distribution system, the System Owner shall be responsible for the submittal to the LAA within 60 days of the follow-up inspection, a written evaluation of the System with recommendations for changes in the design, operation, and/or maintenance. The written evaluation with recommendations shall be prepared by a Designer and the submission shall include all monitoring data and inspection reports for the previous 3 years. Recommendations shall be implemented, as approved by the LAA, in accordance with an approved schedule,provided that all corrective measures are implemented consistent with the limitations described in Paragraph IV.5. 3. For Systems less than 2,000 gpd or facilities where the effective leaching area installed meets the requirements of Title 5,the System shall not be required to be Standard Conditions for Alternative Soil Absorption Systems Page 11 of 16 General Use and Remedial Use Approvals Revised Date:August 22,2013 inspected at any greater frequency than would be required if the facility was served by a conventional system, unless the LAA, Company, or Designer requires more frequent inspection. 4. If at any time a septic system with an Alt. SAS is inspected by a System Inspector, the following shall be recorded, at a minimum: a) date, time, air temperature, and weather conditions; b) observations for objectionable odors; c) observations for signs of breakout of sanitary sewage in the vicinity of the Alternative System; d) depth of ponding within the SAS; e) identification of any apparent violations of the Approval; f) since the last inspection, whether the system had been pumped with date(s) and volume(s)pumped; g) sludge depth and scum layer thickness, if measured; h) when responding to alarm events, the cause of the alarm and any steps taken to address the alarm and to prevent or reduce the likelihood of future similar alarm events; i) field testing results when performed as part of the site visit; j) samples taken for laboratory analysis and results of previous samples, if any k) any cleaning and lubrication performed; 1) any adjustments of control settings, as recommended or deemed necessary; m) any testing of pumps, switches, alarms, as recommended or deemed necessary; n) identification of any equipment failure or components not functioning as designed; o) parts replacements and reason for replacement, whether routine or for repair; and p) further corrective actions recommended, if any. 5. The System Owner shall maintain copies of any service records or inspection reports and all reports and notifications to the LAA for a minimum of three years. 6. Unless directed by the LAA to take other action, the System Owner shall immediately cease discharges or have wastewater hauled off-site, if at any time during the operation of the Alternative System the system is in failure as described in 310 CMR 15.303(1)(a), items 1 or 2 (sewage backing up into facilities or breaking out to the surface). IV Additional System Owner Requirements 1. For System upgrades installed under Remedial Use Approval, prior to signing any agreement to transfer any or all interest in the property served by the System, or any f Standard Conditions for Alternative Soil Absorption Systems Page 12 of 16 General Use and Remedial Use Approvals Revised Date:August 22,2013 portion of the property, including any possessory interest, the System Owner shall provide written notice, as required by 310 CMR 15.287(5), of all conditions contained in the Approval to the transferee(s). Any and all instruments of transfer and any leases or rental agreements shall include as an exhibit attached thereto and made a part of thereof a copy of the Approval for the System. The System Owner shall send a copy of such written notification(s)to the LAA within 10 days of giving such notice to the transferee(s). 2. The System Owner shall not install, modify, upgrade, or replace the System except in accordance with a valid DSCP issued by the LAA which covers the proposed work. 3. Upon determining that the System is failing to protect public health and safety and the environment, as defined in 310 CMR 15,303,the System Owner shall be responsible for the notification of the LAA within 24 hours of such determination. 4. In the case of a System that has been determined to be failing to protect public health and safety and the environment, an equipment failure, alarm event, components not functioning as designed, components not functioning in accordance with manufacturers' specifications, or violations of the Approval, the System Owner shall provide written notification within five days, describing corrective measures to the local board of health and the Company and may only propose or take corrective measures provided that: a) all emergency repairs, including pumping, shall be in accordance with the limitations and permitting requirements of 310 CMR 15.353; b) the design of any repairs or upgrades are consistent with the System Approval; c) the design of any repairs or upgrades requiring a DSCP shall be performed by a Designer who is a Massachusetts Registered Professional Engineer or a Massachusetts Registered Sanitarian,provided that such Sanitarian shall not design a system with a discharge greater than 2,000 gallons per day. d) the installation of any repairs or upgrades requiring a DSCP shall be done by an Installer with a currently valid Disposal System Installers Permit and, if training is required, the Installer shall be certified by the Company as qualified to install the System. 5. To determine whether cause exists for modifying, revoking, or suspending the Approval or to determine whether the conditions of the Approval have been met, the System Owner shall furnish the Department any information that the Department requests regarding the System, within 21 days of the date of receipt of that request. 6. The Approval shall be binding on the System Owner and on its agents, contractors, successors, and assigns, including but not limited to the Designer, Installer, and Service Contractor. Violation of the terms and conditions of the Approval by any of the foregoing persons or entities, respectively, shall constitute violation of the Approval by the System Owner unless the Department determines otherwise. Standard Conditions for Alternative Soil Absorption Systems Page 13 of 16 General Use and Remedial Use Approvals Revised Date:August 22,2013 V. Company Requirements 1. The Approval shall only apply to the model unit(s) with the same model designation(s) specified in the System Approval and meet the same specifications, operating requirements, and plans, as provided by the Company or its authorized agent at the time of the application. Any proposed modifications of the unit(s), installation requirements, or operating requirements shall be subject to the review of the Department for inclusion under a modification of the Approval. The Designer shall be responsible for the selection of the appropriate model unit(s) as applicable. The Company shall be responsible for verification of the appropriate model unit(s) as part of any review of proposed installations that may be required by Paragraph V.3 of these Standard Conditions or the Special Conditions in the Approval. 2. Prior to submission of an application for a DSCP, the Company or its authorized agent shall provide to the Designer and the System Owner: a) All design and installation specifications and requirements; b) An owner's manual and, if alarms are provided, including response procedures; c) A copy of the Company's warranty; and d) If training or certification is required by the Company, lists of qualified Designers, Installers, and Service Contractors. 3. Prior to the submission of an application for a DSCP, for all nonresidential Systems and any System with a design flow of 2,000 gpd or greater, the Company shall submit to the Designer and the System Owner, a certification by the Company or its authorized agent that the design conforms to the Approval and all Company requirements and that the proposed use of the System is consistent with the Technology's capabilities. The authorized agent of the Company responsible for the design review shall have received technical training in the Company's products. 4. If the Company requires trained or certified Designers, Installers, or Service Contractors, the Company or its authorized agent shall make available programs of training and continuing education, as necessary. The Company or its authorized agent shall maintain, annually update, and make available by February 15`h ofeach year, lists of trained or certified Designers, Installers, and Service Contractors. If training or certification is required, the Company shall not sell the Technology to an Installer unless the Installer is trained or certified to install the System by the Company. Similarly, if training is required, the Company shall ensure distributors and resellers of the Technology shall not sell the Technology to an Installer unless the Installer is trained or certified to install the System by the Company. 5. As part of any training programs for Designers, Installers, or Service Contractors,the Company or its authorized agent shall provide each trainee with a copy of this i Standard Conditions for Alternative Soil Absorption Systems Page 14 of 16 General Use and Remedial Use Approvals Revised Date: August 22,2013 Approval with the design, installation, O&M, and owner's manuals that were submitted as part of the Approval. 6. The Company shall provide, in printed or electronic format, the System design, installation, O&M, and Owner's manuals, and any updates associated with this System Approval, to the System Owners, Designers, Installers, Service Contractors, vendors, resellers, and distributors of the System. Prior to publication or distribution in Massachusetts, the Company shall submit to the Department for review a copy of any proposed changes to the manual(s)with reasons for each change, at least 30 days prior to issuance. The Company shall request Department approval for any substantive changes which may require a modification of the Approval. 7. Prior to its sale of any System that may be used in Massachusetts, the Company shall provide the purchaser with a copy of this Approval with the System design, installation, O&M, and Owner's manuals. In any contract for distribution or sale of the System, the Company shall require the distributor or seller to provide the purchaser of a System for use in Massachusetts with copies of these documents, prior to any sale of the System. 8. To determine whether cause exists for modifying, revoking, or suspending the Approval or to determine whether the conditions of the Approval have been met, the Company shall furnish the Department any information that the Department requests regarding the Technology within 21 days of the date of receipt of that request. 9. Within 60 days of issuance by the Department of these Conditions and any other revisions to the Approval,the Company shall provide written notification of changes to the Approval to all distributors and resellers of the System. 10. The Company shall provide written notification to the Department's Director of the Wastewater Management Program at least 30 days in advance of the proposed transfer of ownership of the technology for which this Approval is issued. Said notification shall include the name and address of the proposed owner containing a specific date of transfer of ownership, responsibility, coverage and liability between them. All provisions of this Approval applicable to the Company shall be applicable to successors and assigns of the Company, unless the Department determines otherwise. 11. The Company shall maintain copies of: a) the Approval; b) the installation manual specifically detailing procedures for installation of its System; c) an owner's manual and, if alarms are required, including alarm response procedures; d) a copy of the Company's warranty; and Standard Conditions for Alternative Soil Absorption Systems Page 15 of 16 General Use and Remedial Use Approvals Revised Date:August 22,2013 e) if training or certification is required, lists of qualified Designers and Installers. 12. By_April 15th of each year,the Company shall submit a report to the Department, signed by a corporate officer, general partner or Company owner that identifies the specific alternative technology approval for which the annual report is being filed and contains, for the previous calendar year,the following information with the date and address of each event: a) all known violations of the Approval, including Systems not designed, installed, or serviced by qualified contractors; b) any System failures or malfunctions; and c) corrective actions taken, including but not limited to: design changes; installation changes; operation/maintenance changes; monitoring changes; and/or changes in roles and responsibilities for the manufacturer, vendors, designers, installers, operators, and owners. In the absence of any system failures, system malfunctions, or violations,the Company shall submit a letter certifying, to the best of their knowledge, all installed Systems are in compliance. 13. The Company shall maintain the following additional information for `Treatment with Disposal' Systems installed in Massachusetts, and make it available to the Department within 30 days of a request by the Department: a) the address of each facility where the System was installed, the Owner's name and mailing address (if different),the type of use (e.g. residential, commercial, institutional, etc.), the design flow, the model installed; and b) the installation date, start-up date, current operational status. 14. The Approval shall be binding on the Company and its officers, employees, agents, contractors, successors, and assigns, including but not limited to dealers, distributors, and resellers. Violation of the terms and conditions of the Approval by any of the foregoing persons or entities, respectively, shall constitute violation of the Approval by the Company unless the Department determines otherwise. VI. General Requirements 1. Any System for which a complete Disposal System Construction Permit("DSCP") Application is submitted while the Approval is in effect, may be permitted, installed, and used in accordance with the Approval, unless and until: a) the Department issues modifications or amendments to the Approval which specifically affect the installation or use of a System installed under the Approval for the System; or Standard Conditions for Alternative Soil Absorption Systems Page 16 of 16 General Use and Remedial Use Approvals Revised Date:August 22,2013 b) the Department,the local approval authority, or a court requires the System to be modified or removed or requires discharges to the System to cease. 2. All notices and documents required to be submitted to the Department by the Approval shall be submitted to: Director Wastewater Management Program Department of Environmental Protection One Winter Street- 5th floor Boston, Massachusetts 02108 3. The Department may suspend, modify or revoke the Approval for cause, including, but not limited to, non-compliance with the terms of the Approval, for obtaining the Approval by misrepresentation or failure to disclose fully all relevant facts or any change in or discovery of conditions that would constitute grounds for discontinuance of the Approval, or as necessary for the protection of public health, safety, welfare or the environment, and as authorized by applicable law. The Department reserves its rights to take any enforcement action authorized by law with respect to the Approval and/or the System against the Company, a System Owner, a Designer, an Installer, and/or Service Contractor. Engineer/installer certification Page 1 of 1 Miorandi, Donna From: Bob Goodrich [rgoodrich@cultec.com] Sent: Friday, August 16, 2013 7:25 AM To: Miorandi, Donna Subject: RE: Engineer/installer certification Hi Donna, Only the installers/contractors are required to be certified in Mass to install septic projects. The installer should contact us to receive the CERTIFICATION. Thank you for your inquiry and if you have any further question please contact me. Have a good day. Bob Bob Goodrich CULTEC, Inc. 203-948-0234 From: Miorandi, Donna [mailto:Donna.Miorandi@town.barnstable.ma.us] Sent: Thursday, August 15, 2013 4:16 PM To: rgoodrich@cultec.com Subject: Engineer/installer certification Hi Bob: Do you require certified designers and/or installers for Cultec units? I have an engineer coming before the Board of Health for variances and he has designed for cultecs. Thank you for your attention to this matter. Donna CONFIDENTIALITY NOTICE:This email may contain confidential and privileged material for the sole use of the intended recipient(s)-Any review,use,distribution or disclosure by others is strictly prohibited.If you have received this communication in error,please notify the sender immediately by email and delete the message and any file attachments from your computer. -;� 8/16/2013 d" �b tNE DATE: S FEE: + RARNsmBLE •. atass. REC. BY �,� �EDMA�p Town of Barnstable. SCHED. DATE: ? Board.of Health /3 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul J.Cannifl,D.M.D. VARIANCE REQUEST FORM LOCATION Property Address: {-�c,l/4 �0 '��,. .-.►./lp Assessor's Map and Parcel Numbers 1 a 2 yZC72 Size of Lot: Wetlands Within 300 Ft. Yes ✓ Business Name: No Subdivision Name: APPLICANT'S NAME: R4X mgmCA i Phone Did the owner of the.property au orize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: \/Ime Shtt,- ' GujI�+on'SStd Name: 5�yhe,, A. � 1/era4 Address: 406 4 lc /1 0 211 B Address: Phone: Phone: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) new 4 it1; NATURE OF WORK: House Addition El House Renovation 13 Repair of Failed Seplid SystemCD y Checklist to be corp leted b office staff-person receivin variance request application) � P Y .� g 4 PP ) .Please submit copies in 4 separate completed sets. _ Four(4)copies of the completed variance request form ar) Four(4)copies of engineered plan submitted(e.g.septic system plans) <�> Completed.seven(7)page checklist confirming review of engineered septic system plan by.submitting engineer or regiy eyed sanitarianrr Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) . r— Signed letter stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail.at least ten days prior to meeting date at applicant's expense (for Title' V and/or local sewage,regulation variances only) _ Full menu submitted(for grease trap variance requests only) _ Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], . outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if.no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Cannifl;D.M.D. Co\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BAj9P9B7\VARIREQ.DOC VARIANCES REQUESTED: 15.211:(1) TO ALLOW 6.5':SETBACK FROM A FOUNDATION IN LIEU OF 20' FOR A SEPTIC TANK. TO ALLOW 6.7' SETBACK FROM A PROPERTY LINE IN LIEU OF 10' FOR A SEPTIC TANK. TO ALLOW A SAS TO BE 31.4' AND 38' FROM A BORDERING VEGETATED WETLAND IN LIEU OF 50'. TO ALLOW AN EXISTING SEPTIC TANK TO REMAIN AT 17.5 FEET FROM A BORDERING VEGETATED .WETLAND IN LIEU OF 25.. 15.212:(1) TO ALLOW 4.1:' SEPARATION BETWEEN ADJUSTED HIGH GROUNDWATER AND BOTTOM OF SAS IN LIEU OF 5'.. TOWN OF BARNSTABLE 360-1 TO ALLOW THE SAS TO BE 31.4'. AND 38' FROM A BORDERING VEGETATED.WETLAND IN LIEU OF 100.'. : TO,ALLOW EXISTING SEPTIC TANK .TO BE 17.5' FROM A BORDERING VEGETATED WETLAND IN LIEU OF 100'.. II �' ire\ ', ....-� ,4 � •�_ go MC2101%� a tq• IMP i e� -� �� •., �/Ids � ' ` 1 IGO 14 30 .. 31 32_. .35AC.. 46 AC 314C pD111T .4a, 46 ,+ q. 34Ac 6. 41 AC 7D - 93AC' . 167 .. ® 26 d . '. � � 7 4r je . Z Pc / a3 1. .. o' 39AL ;9 66 G-7 n e �I Aso SITE •. 4 � 50 � Ipa � ��Ip .� ito - PF- .U&M za Ia CW�T, _ o . 51 �. LOCUS MAP BAXTER NYE ENGINEERING & SURVEYING . i TRANSMITTAL BAXTER NYE ENGINEERING & SURVEYING Registered Professional Engineers and Land Surveyors 78 North Street,3`d Floor,Hyannis,MA 02601 Tel:(508)771-7502 Fax:(508)771-7622 Date: August 5 th,2013 TO: Board of Health Total No.Pages: 200 Main Street,Hyannis BN Job No.: 2013-026:02 Subject: Variance Request 346 Holly Point Road, Centerville Phone: J cc: files We are sending you ®Attached ❑Under Separate Cover ❑Via Fax(No. of pages including Transmittal Sheet) ❑First Class Mail/Registered#: ❑ Overnight ❑Pick up ® Hand Delivery The following documents: ❑Prints/Plans ❑ Specifications ❑Estimates/Proposal ❑ Change Order❑ Shop Drawings n Reports/Calculations M Other DATE COPIES NO. PAGES DESCRIPTION 8-5-13 1 2 Abutter Notification Letter&Abutters List These items are transmitted as checked below: ® For Your Use ❑As Requested ❑ Returned For Corrections ❑ For Review And Comment ❑For Approval ❑For Distribution Remarks: Please call Steve Wilson with any questions or comments as necessary. Thank you. C7 CO •u._.e :cam � U l: c:• W 0:\2013\2613-028\ADMIN\TRANSMITTALS\2013-028 BOH Variance Abutter 8-5-13.pdf.doc j r a-- Note: This transmittal contains privileged information.Please contact the sender immediately if this transmittal is illegible,, - incomplete or not intended for your use. Thank you. I:\document templates/transmittal template ABUTTOR NOTIFICATION LETTER Date: August 5th, 2013 Re: Variance Request As an abutter please be advised that a Variance Request has been filed with.the Barnstable Board of Health. Additional details are below: Applicant: Raymond Kwasnick, Trs. Address: c/o Goulston& Storrs 400 Atlantic Avenue Boston, Mass. 02110 Project Location: 346 Holly Point Road, Centerville Assessor's Map & Parcel: Map 232; Parcels 24 & 72 Project Description: Upgrade failed septic system. Variance Requested: Please refer to attached list. Applicant's Agent: Stephen A. Wilson,P.E. Baxter Nye Engineering & Surveying 78 North Street Hyannis,Massachusetts 02601 Public Hearing: Hearing Room Town.Hall—2nd Floor 367 Main Street Hyannis, Massachusetts 02601 August 20th, 2013; 3:00 pm #2013-028:02 BOHVarianceAbuttor.doe VARIANCES REQUESTED: TITLE 15.211: 1 �' TO ALLOW 6.5 R A SEPTIC TANK. SETBACK 0 FOUNDATION IN LIEU OF 20 FO O FROM F N TO ALLOW 6.7' SETBACK FROM A PROPERTY LINE:IN LIEU OF 10' FOR A SEPTIC TANK. TO ALLOW A SAS TO BE 31.4' AND 38' FROM A BORDERING VEGETATED WETLAND IN LIEU`OF 50'. TO ALLOW AN EXISTING SEPTIC TANK TO REMAIN AT 17.5 FEET FROM A BORDERING. VEGETATED WETLAND IN LIEU OF 25'. .15.212:(1) TO ALLOW 4.1',SEPARATION BETWEEN ADJUSTED HIGH GROUNDWATER AND BOTTOM OF SAS IN LIEU OF 5'. TOWN OF BARNSTABLE �. 360-1 TO ALLOW THE SAS TO BE 31.4' AND 38' FROM A BORDERING VEGETATED WETLAND IN LIEU OF 100'. TO ALLOW DOSTING SEPTIC. TANK.TO BE 17.5' FROM A BORDERING VEGETATED WETLAND IN LIEU OF 100'. BAXTER NYE ENGINEERING & SURVEYING Registered Professional Engineers and Land Surveyors 78 North Street, 3rd Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax: (508)771-7622 . August 2;2013 Abutters List for 346 Holly Point Road,Centerville Proiect Number: 2013=028 ABUTTERS LIST: Name: Map: Parcel: Peter D. &Catherine A.Murray 232 026 Barnstable Conservation Commission 232 066 Todd A.Piknick 232 067 Estate of Anita H.Kumin 232 068 Joseph Falkson 232 074 Susan Falkson 232 075 Alan J. Green 232 059 Barnstable Conservation Commission 232 065 Laura J.Theodor 232 073 2013-028 Abutters List ` I I Land Surveys Site Design • Subdivisions • Septic Design • Wetland Filings • Planning III BAXTER NYE ENGINEERING & SURVEYING Registered Professional Engineers and Land.Surveyors 78 North Street,31d Floor;Hyannis,MA 0260.1 Tel: (508)771-7502 Fax: (508)771-7622 � _ 3 July 31 St, 2013 Board of Health �j 200 Main Street �d Hyannis, MA 02601 ReNariance Request 1`t Holly Point Road, Centerville ;goy Members of the Board, , On behalf of our client,Raymond Kwasnick, Trs.we are filing a variance request for a repair.to the existing septic system. The site has very limited access for construction equipment to get to the end of the house where the existing septic system is located. I request that the members of the Board of Health visit the site prior to the public hearing. The site consists of two assessor's parcels that have been merged, creating one lot of 40,994 square feet. The house is a three bedroom house and the proposed repair is designed for this flow. If you have any questions or comments,please contact me at 508-771-7502,ext. 13. Very truly yours, Step en A. Wilson, P.E. - n N aJ'1 SAW/s k P 2013-028-BOH..Var. :Req.-7731-13 boil Land Surveys Site Design • Subdivisions • Septic Design,• Wetland Filings Planning, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION T D���f Map �r3.��� Parcel Health Division N1'Q e Issuer��lF Conservation Division Appli6ati8h Fee (A 3 Planning Dept. Permit Fee 3y Date Definitive Plan Approved by.Planning Board Historic - OKH Preservation/ Hyannis Project Street Address �� Village &69ZVYd- X-2 -� Owner �IN► �C�� ®/�'l1L Address Telephone Permit Request �`/YJv��a/ 0 Opp ©/4 i . Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 1�- .Project Valuation U Construction Type _ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Y' Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new, size _ Barn: ❑ existing ❑ new size_' Attached garage: ❑ existing ❑ new size.—Shed- ❑ existing ❑ new size Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER). Name d 1AA0 Telephone Number Address Iq �l� (�� License # 6 l 1�'fyWil I` �- ( ✓� Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO DATE SIGNATURE jJ `�� THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I M ^C&L DATA THE Regulatory Services / Z 11ARMUSIX Thomas F.Geiler,Director b. . Building Division �D Tom Perry,Building Commissioner 200 Main Street,Ham,MA 02601 www.town.barnstable ma.us Fax: 508-790-6230 office: 508-862-4038 Property Owner Must Complete and Sign This Sectiot, If Usi_fi¢ A'Builder 1 v"A 5/\V/ as Ownex.of the subject property lieteby authorize to act on my behalf,. F in all matters relative to work authorized by this budding permit A (Ad ess of Job) ,i Bj B **Poo1 fences and alarms are the responsibility of the applicant. Pools V are not to be filled or utilized before fence is �.nstalled and -all fin Jta inspections are performed and accepted. bt lei i er Signature of Applicant Signature of.Ownet to Print Name Print Name - m TE Date 0LS 62012 Q:F0R W:0WNERPERMMSIONP0 Town of Barnstable P#" �y� � Department of Regulatory Services Public Health Division Date A.nKAM c" �e� 200 "n Street,Hyannis MA 02601� " Date Scheduled W16 Time �l Fee Pd. /0 S �is uitability AssessynenP for Sew a Dis osal PerforrnedBy: WimmedBy: i mLOCATION&:'GENERAL INFORMATION Location Address iL n, Owner's Name ' n rt0LL , ni I t� v)NG �C .... I Address ,�'� lU +&)4� AL--OAIpll ��a� Lj3` �xI�C,To�J, OA Assessor's Map/Parcel: Engineer's Naive NEW CONSTRUCTION REPAIR Telephone# v S 1)I'LV�I 1'LLC/ Land Use Q I G{t 1 4-1 cj Slopes(%) Surface Stones \j .OL50Nt Distances from: Open Water Body 50 ft Possible Wet AreaQ. ft Drinking Water Well ft Drainage Way a Property Line ft Other ft SKETCH:(Street name,dimensions of lot,e.xa�7ct locations of test holes&perc tests,locate wetlands in pioxiinity to holes) at_a r,1 [.t 3 Aw _ t.,tit iLm.. P--4 CV Parent material{geologic) G l oC��+-9 ©u -t..MS9 - Depth to Bedrock - - Depth to Groundwater: Standing Water in Hale: Weeping from Pit Face Estimated Seasonal High Groundwater DETERNIL�TATION FOR SEASONAL HIGI3 WATER TABU Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in Depth to weeping from side of obs.hole: in. Groundwater Adjustment ft. - Index Well# :Reading Date: index Well level Adj.f ictdr Adj.Groundwater Level_ µ PERCOLATION TEST Hate T;me - Observation .. _.. ., . . "Hole# - - ._ Time at 9" Depth-ofPerc - 4L(9/` - - Time at F O - Start Pre-soak Time @ I I:Z O Time(9"4") End Pre-soak. :Rate WMAnch. �s ►r1,�/w�C S - . . Site Suitability Assessment'. Site Passed" Site Failed: Additional Testing Needed(Y/N) Original:Public Health Division Observation Hole Data To Be Completed on Back ***If percolation test is to be conducted within 100'of wetland,you must first notify.the Barnstable Conservation Division at least one(1)week prior to beginning.. Q`.VS=C\PERCFORM.DOC DEEP OBSERVATION HOLE LOG Hole# / Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistencv.%Oraveh 2-V 3-, 1! / • ik6e -Flvt�— Io.�' �4 Y 3 UA,C'�)'6j.•G.5 . 5�of r'/6' Y✓I e cQ..S o'"i i;� IN cjt'OI`- 132s C3 W1col, 5C' l0 DEEP OBSERVATION HOLE LOG Hole# 2 Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders: Consistency,to Gravel 1to �A 3/3 $ — A.ia (..o4N+ �c.cJl I.CJ y/ 321j. 561'' G� VI'Icol�w�t paGQ I(r� YIR, IN W/G.c.,66U4 Soy_ �o` Cz h'Ice(IbM So"fJ j1U �fl T13 /Co��l� {NlerAu. and( to `iw�Co�b Cu AID �If3 z 3 DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color" Soil Other Surface(In.) (USDA) ( (Munsell) Mottling (Structure,Stones;Boulders. Cons' e c °°Gravel) i .. T::��� DEEP OBSER VATION HOHOLELO G Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(In.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,°°Gravel) Flood Insurance Rate Man: Above 500 year flood boundary No Yes Within 500 year boundary No t/"' Yes Within 100 year flood boundary No ✓ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? y�. If not,what is the depth of Naturally occurring pervious material? Certification I certify that on12,,' (date)I have passed the soil evaluator examination approved by the Department'of Envirorunental ProtectioN and that the above analysis was performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017., Signature 2�2 Date i Q:1JEALTH/WP/PERCF0RM o t 3- 0Z 8�. t Town of Barnstable Barnstable Regulatory Services Department WAMCactiv snx MAM xsTAB1.E. A,�$ Public Health Division 2007 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO CERTIFIED MAIL #7012 1010 0000 2850 7640 April 17, 2013 • Paul Kwasnick.TR % Vine Street Realty Trust 1010 Waltham Street#D 534 Lexington, MA 02421 RE: 346 Holly Point Road, Centerville ORDER TO COMPLY WITH STATE ENVIRONMENTAL CODE, TITLE 5 The septic system located at 346 Holly Point Road, Centerville, MA was last inspected on 3/29/2013 by James D. Sears, a certified septic inspector for the State of Massachusetts. The inspection of the septic system showed that the system "Needed Further Evaluation" under the guidelines of the 1995 TITLE 5 (310 CMR 15.00). After reviewing the septic system inspection report; it was determined that the leaching pit is in the groundwater table during times of seasonal high groundwater., Therefore; The distribution-box and leaching pit needs to be replaced. You are ordered to repair or replace the septic system within one (1) year from the date you receive this notification. i • Q:\SEPTIC\L.etters Septic Inspection Failures or Future Eval\.346 Holly Point Rd Cent Apr 2013.doc I ' Failure to repair/replace the septic system within the deadline period will result in future enforcement action. Also, you are reminded that this property is only permitted for three bedrooms PER ORDER OFI'HE BOARD OF HEALTH as McKean, R.S. CHO Agent of the Board of Health • • Q:\SEPTIC\Letters Septic Inspection Failures or Future Eval\346 Holly Point Rd Cent Apr 2013.doc Parcel Detail http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=16552 44 \ AIASS 9 L113 arm a y �y w Logged In As: Parcel Detail Tuesday,April 9 2013 Parcel Lookup Parcel Info Parcel ID 232-024 I Developeer LOT 22 Lo Location 346 HOLLY POINT ROAD Pri Frontage I Sec 1 Sec Road IVINE STREET I Frontage240 I Village CENTERVILLE ..I Fire District Town sewer exists at this address I NO I Road Index 1073� 1 Asbuilt Septic Scan: Interactive 232024_1 Owner Info _ Owner KWASNICK, PAUL TR _ I Co-owner NINE STREET REALTY TRUST I Streets1010 WALTHAM ST, D534 I Street2 City LEXINGTON I State!MA zip(0242� 1 Country I 7 Land Info Acres 10.47 Use Single Fam M6L-01 I zoning RD-1 J Nghbd 10114 �� Topography Level Road Paved Utilities I Public Water,Gas,Septic Location Lake/Pond Front,Excel View • Construction Info Building 1 of 1 Year[1976 I Roof Gable/Hip I Ext'W doo Shin le , Built Struct Wall( g G/ATERSIDE Living[1611 I Roof Asph/F GIs/Cmp I AC Central A ' Area I Cover, Type p Style Ranch In Drywall Bed 5 Bedrooms s gym_ �.__.�.._ Wall I ry Rooms F a tit . ial I Int Hard oow d Bath 3�Full Model Resident I , I Floor Rooms! � ''A , Grade!Average Plus I Heat Hot Air ( Total.11 Rooms I � ` Type I Rooms Heat Found- Stories 11 Story I Fuel{Gas ation iPoured Conc. Gross 14541 Area Permit History _ http://issgl2/intranct/propdata/ParcelDetail.aspx?ID=16552 4/9/2013 %� � ��� �� � .�. �'�" sail-��'l Commonwealth of Massachusetts Title 5 Official Inspection Form A Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 346 Holly.Point Rd. Property Address Ray Kwasnick Owner Owners Name information is required for every Centerville MA 02632 3-29-13 page. Cityfrown 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 A. General Information filling out forms \`\\aruruulpq11�� on the computer, use only the tab 1. Inspector: I ��`\`��\'�N DF�jgssgc�% key to move your IBC 1 I I Cj - - .y cursor-do not l 'I II 1 =_: - JAMES ,' James D. Sears »I 317 "`(YY/ _z• •m use the return — :—+-. ke Name of Inspector = ; y CapewideEnterprises,LLC o o 'Company Name .� 153 Commercial St. ��/F 5 INSPFG��\�`�\ ��Il1IIgI11ti11L\\ Company Address Mashpee, MA 02649 Cityfrown State Zip Code 508-477-8877 S1623 Telephone Number License Number B. Certification Q I certify that I have personally inspected the sewage disposal system at this address and that4he 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 m9intenance-of on site sewage disposal systems, 1 am a DEP approved system inspector pursuant to Section 45.340�411 Title 5(310 CMR 15-000). The system: 'w +;:i r ❑ Passes ❑ Conditionally Passes ❑ Fails ~— r~,n ® Needs Further Evaluation by the Local Approving Authority 3-29-13 nspector'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. ., Id Ll lbh_lul� 15ins•3113 Title 5 016dar hs�dti•n Form Subsurlsce Sewage Disposal System•Page 1 of 17 Commonwealth of Massachusetts Title 5 official Inspection Form 31 Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owner's Name information is Centerville MA 02632 3-29-13 required far every _ page, City/Town State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E!always complete all of Section D A) System Passes: ❑ t 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): 'o. 15ns-3113 Title 5 Official I rspection Forth:Subsurface Sewage Dirf al System-Page 2 of 17 Z•d d90:90 E6 1-EaeW Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick _ Owner Owners Name information is required for every Centerville MA 02632 3-29-13 page. CitylTown State Zip Code Date of Inspection B. Certification (cont.) ❑ Pump Chamber pumpslalarms 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 bracken 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 ISins•3/13 nue s Official Inspedicn Form:Subsurface Sewage Disiosal System-Page 3 of 17 £'d dL0:90C[ [Caen Commonwealth of Massachusetts Title 5 Official InspectionForm Subsurface Sewage Disposal System Form -Not for Voluntary Assessments vew 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owner's Name information is required for every Centerville MA 02632 3-29-13 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 feel 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. Pit within 50' of wetlands and maybe in groundwater. System need's further evaluation by Barn. B.O.H.. 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 iseeppool is less than 6" below invert or available volume is less than%=day flow Py T t5lns-3fl3 Tide 5 Official Inspection Fcnn:Stbsurface Sewage Oispcsal System•Page 4 of 17 V-d dL0:80£6 6£aeN Commonwealth of Massachusetts _ Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner OwneYs Name information is required for every Centerville MA 02632 3-29-13 page. CitylTown 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: 1Y7 19 '�'� 1-3 ❑ ❑ 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_ A• /4 ❑ ❑ 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 faci[ity 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 11 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. t5i;s.3113 Title 5 Official Inspect art Porn Subsume Sewage Disposal System•Page 5 of 17 9'd dL0:80£l. l£ae" Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owner's Name information is Centerville MA 02632 3-29-13 required for 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 a ❑ ® 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)1310 CMR 15.302(5)1 D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms(actual): 3 DESIGN flow based on 310 CMR 15.263(for example: 110 gpd x#of bedrooms): 330 15ins•3113 Title 5 Official Inspection Form Sub rfaoe Sewage Disposal System-Page 6 of 17 9,d d80:80CI, I•£ievy Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owne(s Name information is required for every Centerville MA 02632 3-29-13 page. City[Town State Zip Code Date of Inspection D. System Information Description: The system is a 1000 Gal tank D Box and pit. Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes [ No information in this report) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes 0 No Water meter readings, if available (last 2 years usage(gpd)): 2011-25,000Gals 2012-34,00OGa1 s Detail: Sump pump? ❑ Yes ® No Last date of occupancy: NA _ Date . CommerciaVlndustrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) ,Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: t5ins•3113 Ttle 5 Official tnsoection Form Subsurface Selvage Disposal Sysle:r-Page 7 of 17 L'd d80:90£I- l£aeN Commonwealth of Massachusetts Title 5 Official Inspection Form - Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owner's Name informrequired tion s Centerville MA 02632 3-29-13 required for every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: NA 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/Altemative 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•3113 _ Title 5 Official Inspection Fom:Subsurface Sewage Disposal System•Page 8 of 17 g•d d80:90£l lEie" Commonwealth of Massachusetts Title 5 Official Inspection Form P Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owner's Name information is Centerville MA 02632 3-29-13 required for every page. Cityr town State Zip Code Date of Inspection D. System Information (cost.) Approximate age of all components,date installed(if known) and source of information: 1976 Permit 76-552 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 2 feet Material of construction: ❑ cast iron ❑40 PVC ® other(explain): Distance from private water supply well or suction line: feet Comments (on condition of joints, venting, evidence of leakage, etc.): 4" PVC SCH 20 Septic Tank(locate on site plan): 16" 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 1000Gal Dimensions: 2" Sludge depth: 15ins•3P13 Title 5 official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 6'd d60:90£I. 1,C 18 I Commonwealth of Massachusetts �i Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owner's Name informrequired is Centerville MA 02632 3-29-13 required for every page, Cityrrown state Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.f . Distance from_top of sludge to bottom of outlet tee or baffle 28" 2" Scum thickness Distance from top of scum to top of outlet tee or baffle 12„, Distance from bottom of scum to bottom of outlet tee or baffle 16" How were dimensions determined? Asbuilt-Tape Sludge Judge 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 at working level wl outlet baffle. Tanis and cover's at 16" below grade. No sign of leakage or over loading. i Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene Q 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 t5hs•3113 Title 5 Officlai Inspection Form:.SubsJrrace Sewage Disposal System•Page 10 of 17. 06'd d60:20Cl, 1,CA13A Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owner's Name information is required for every Centerville MA 02632 3-29-13 page. Citylrown State Zip Code Date of Inspection D. System Information (cunt.) 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: gations 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 D sposal System-Page 11 of 17 1,1,A d60:90£l• 6£aeW Commonwealth of Massachusetts Title 5 official Inspection Form qw'�' Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owner's Name information,s required for every Centerville MA 02632 3-29-13 page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) 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 is 16"x16"-20"below grade w/one line out. Wall's on box are gone. Need to replace D Box. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑. No* Alarms in working order: ❑ Yes ❑ No* Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5im•W13 Title 5 official trnpertion Form subsurface sewage Disposal System•Page 12 of 17 z� Zt,d d06:90£6 1.£aeN Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owner's Name information is required for every Centerville MA 02632 3-29-13 page. C4'rrown State Zip Code Date of inspection D. System Information (cons.) Type: ® leaching pits number: 1 — ❑ leaching chambers number: — ❑ leaching galleries number: ❑' leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Leaching is one 1000 Gal precast pit. Pit and cover at 18" below grade. 14"water in pit wl stain line 8"above water Ievel.Pit may be in G.W. or A.D.J. high G_W.. 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 t5ris•3I1 3 Title 5 Official Inspection Form:Subsurface Seexage Disposal System-Page 13 of 17 £l'd d01.:80£6 6£aeW Commonwealth of Massachusetts ugTitle 5 Official Inspection Form , 1 Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Ownez's Name information is required for every Centerville MA 02632 3-29-13 page. Cilylrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction_ Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): t5ins-3113 Title 5 official Inspection Form SL6surfsce Sewage Disposal System-Page 14 of 17 tq'd d06:80£l• [Caen Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owner's Name information is required for every Centerville MA 02632 3-29-13 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 03 -a = �� ' ° a L01 3.: 5Y � Y c 15ins•W 3 Tille 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 9l d dt 180£l l£aeW Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 346 Holly Point Rd. Property Address Ray Kwasnick Owner Owner's Name information is Centerville MA 02632 3-29-13 required for every page. Citylrown 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: NA 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: G.W. May be at aroun d 6 1/2-7'due to lake and wet land's. Could not do auger hole due to rocky area. Before filing this Inspection Report,please see Report Completeness Checklist on next page. t5ins•3113 Tile 5 Official Inspection=orm:subsurface sewege Disposa"system-Page 16 of 17 9L,d d66:80£I• l•£aen Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments ,5 346 Holly Point Rd. Property Address Ray Kwasnick _ Owner owners Name `- - information is required for every Centerville MA 02632 3-29-13 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•Pace'7 of 17 L6'd d6i 8086 lBaaW 4 LO4CAT10N SEWAGE PERMIT NO. 76- .:fir 10- VILLA Lo'1 as Cly) VineS7 INSTA LLER'S NAME & A.DDRESS `S044 ���IX�-�►.00.e• ���SP '�3� E;A!-Jyss/T'/Y B UI*LDE R OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED j �.... � # � i .� �� .LoT �2 :7� '�°�j' P''� -- f -� `- - - GAS• No.. ........ ........- �-___.�__r F ........0.......6. -COMMONWEALTH OFM�ALTH 3q TS H _� .. . . .. ... .: F.. . .... ... ................... .................................................. �App Irtt — i >axt� r rti�Yt fPrm�it Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: --------------------------- Location Address or Lot No. - DX.....3.ylr.......ge .Wmd t . Owner Address ----------- Installer Address U Type of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder aOther—Type of Building ---------------------------- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures ----- ------------------------------------------------ ---------------------------------------------------�------......--------•--•-••---•---.---- W Design Flow........................—5'0............gallons per person per day. Total daily flow............% .....................gallons. WSeptic Tank—Liquid capacity/LfQ -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 ttre:t___,sfS __sq. ft. z Other Distribution box ( ) Dosing tank ( ) '— Percolation Test Results Performed by------- l/Q50,104---45 ,"J,4'�'PW.....�4.r. Date---- 74 ..____.. 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.-.---_--_--._..-___.... P4 --------------------......................................................................................................................................... 0 Description of Soil---------------- "JAA-#D__J"v. v ....�3rJ _��1 "� .rz�sr --.-..mil!" l '�...C4VPJL W x ••--•--------•-----------•-------------------------------------------------•-•-----•-•••---------------------•-•. ----------------------------------------------------------------------------------- V Nature of Repairs or Alterations—Answer when applicable.-.-__-...............____..........___.__..._.._.._........_..........._..._.___.___..___. --.---•-----•----•-•--------------------------------------------•--------_------------------.---.------------------------•.-._.-. Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued byte oard of health. Signer,-;;;;4; Nf. M -•--••• ----- ------------------------- Date Application Approved By----- / ----------------------••--• ..•--••- Date Application Disapproved for the following reasons:................................................................................................................ ---------------------------------------------------------------------...................-------------------------------------------------------------------------------------------------------------- --Date-•_-•- PermitNo......................................................... Issued...................... ---•--•--•--•---- Date No....... ......... FEs................:....... --- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ......... .OF..................................... .............................. Appliration -for M,npoottl Worko Tomitrurtion Vrroiit Application is hereby made for a Permit to Construct ( ) or Repair ( } an Individual Sewage Disposal System at: . -•---�d rod"- 2..2 -tc: .�? � - �`------•••• Location-Address or Lot No. ...?a. .. 0...R............................. •-----•-------- -----�9_�C...... te'7 Owner Address ��`4e ' ce �sreeViV Installer Address UType of Building Size Lot----------------------------Sq. feet Dwelling—No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder pa, Other—Type of Building ____________________________ No. of persons....._...................... Showers ( ) — Cafeteria ( ) dOther fixtures ----------------------------------------------------------_-------------------- -------------------------•-------------------------------------------- Design Flow------_-------------- d__________-_gallons per person per day. Total daily flow_____________•1 W ----------------------gallons. WSeptic Tank—Liquid capacity./_?4 ?gallons Length---------------- Width_.... Diameter---------------- Depth................ x Disposal Trench—No- ____________________ Width------------_------- Total Length,................... Total leaching area_______._.__-_______sq. ft. Seepage Pit No_____________ ____ Diameter------------4.... Depth below inlet.................... Total leaching area.__,i_4t _.sq. ft. z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.--------- ?�?! ___GAO,, �;1'f1r4�t1____� Date----- -%J._5Z3--------- Test Pit No. L_____�__minutes per inch Depth of Test Pit_-----�?'.'i......... Depth to ground water....... __.... _______ w Test Pit No. 2.................minutes per inch Depth of Test Pit-------------------- Depth to ground water______.__..-_____------ ---------------------------------------------------••--•-•--------------------•----•-•---------------------•------------------------------------------------- O Description of Soil j/� '� .. . .. ...- �.—, J`c�r°Sr�,L. " ��N �r�yf -1�`�, `� U ...........,J •�--r'------ 61 _�.��X Jam-'•`-=,�j/`ZYLA/,--�----.--...:•..2Y__p- V-_1y.... ---cdW"q'JD' W VNature of Repairs or Alterations—Answer when applicable.___________________............................................................................ -•------------------------------------------ ---;-----•--------•-------------••-•-----•---------------- .-___----------------------•---------------•----------------------------•-------••-- Agreement: The undersigned agrees to install the. aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the oard of health. Signed fir.` ----------- -----/f.._60_7_74� �t l Date Application Approved BY .................. ----•---•- -------------- . Date Application Disapproved for the following reasons------------------------------------------------------------------------------------•-------•--------••-•-_----- ••...._...--•-•-----.._.._•-----•-----------•------------•---------••-•-------•-••---•--•_ •--••-•---•---------------------•----••---•---•-----•-------•-------------------•-••- -------------...__----- .5 Date PermitNo......................................................... Issued-------------------------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS P BOARD OF HEALTH 171-u ........................ ....... ........... OF..............d......`........T6s ......:..:...................................... CIrrtifirate of T"Umpliattre THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) f _ j. i r Cr' / �i Installer at......................... 1' ---------------------- has been installed in accordance with the provisions of Article XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No....... '------ _____________________ dated------------------- ...... /___..___.____. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE_ A/ 11_ ram.. Inspector... ---------------- -- ---•-••---- THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 6 t'- �i/.. .... .........O F ��1. , /` s✓1/ y. ................... .......... ................_......_.........._... ............................... l No. ................. �i�po,�ttl ork,� �on�trnrtioat rrntit Permission is hereby granted--------- --------All, •�' �� � -------------------•----•----------- •--•- --._._._---••••- to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at No.. �=== =f "1 r- �----------- -�y--•-----•,•---� o f Street------- as shown on the application for Disposal Works Construction Permit No....7:_;----------- Dated...._ _____:_ - ----------------••--•-•-•-•----------•----.....----------------••--------••----.....----•----•••---_•••- $oard of IIealth DATE. FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS .Co T Ar Z47 /6 gotrN 2'I7avi �� l 2a 4 aU d � /Sto a+�a 6 s6prK S3 t �/q�C LdEQUi9QUET +� rAaac o M b, • M � _J/ CPO iN7'" ,eo.ti /3 76 N (IF ,qAS -ZO SS MAN P•.S • ���� ���, I � NORMAN v ....OIMN t'�A' . H o.�_._. i"_L.�,y�?_!F�.✓' G G fi P. �.__............_..._.__.r�......___..�_T.—.,____..__._._..._ _. __._ __. AsBuilt Page 1 of 1 J/L0•CATION SEWAGE PERMIT NO. VILLA Go7 ?a (Iy) V+nes� INSTALLER'S NAME & ADDRESS �rNlp Tz) I;Ardwlylfvr/f/ 8 UI'L0ER OR OWNER DATE PERMIT ISSUED DATE COMPLIANCE ISSUED 14 7b • w 2r .LoT.22 • �/��Y t�.CD 91 i C.09 http://issgl2/intranet/propdata/prebuilt.aspx?mappar=232024&seq=1 8/15/2013 IV� � �����- ����� + M 40 HOLLY POINT RD 4- , :: ;:•::::.. ,•..:. •;.'4T26� O SS 4p v Lake Wequaquet ao.as Lu f- W 39.06 X -� 40 � p0 �O ............. Map b�� Page 1 of 1 �� a � Town of Barnstable Geographic Information System New Search Home Help Parcel Viewer Custom Map Abutters Map Size ■ Zoom Out u L➢ Q �,In Turn map layers on/offby ( ® -7PG selecting check boxes below 1 • - -� r' Town Boundaries Ir. rs� � 1 ao Road Names Voter Precincts it 1 - r Map&Parcel Numbers � 4126 f Parcels f 0 1 ❑ }aP E r FEMA Q3 Flood Zones(Current Maps) 4 Not for official flood hazard determination. Lale tNegrmquet r �`.� AE(100 yr flood) t9 111 ®AO(100 yr flood) p VE(100 yr flood w/wave action) x, 39_0 13X500(500 yr flood) - (- FEMA Preliminary Proposed Zones(subject to change) 0 Expected Adoption:Summer 2013 ❑AE-100 year flood AO-100-year flood 0� 37 Feet - / 10 AH-100-year flood .41 ../ 13 VE-Velocity Zone 13 0.2%Annual Chance Flood Cam. Set Scale 1° = 87___j I Aerial.Photos, _ I MAP DISCLAIMER Copyright 2005-2010 Town of Barnstable,MA All rights reserved.Send questions or comments to GIS BarnstableMA v1.2.4748(Production] http://66.203.95.236/arcims/appgeoapp/map.aspx?propertyID=232024 3/29/2013 ��.... :_ ll"A.rll�.IJK SIZE .. �.........„` .._-ww._.,,+........••.,.,.•....a.,.x.....,,w.....,.r.w..,s.«.....,....,.........,...._...-._..r..,. _ 8'�'' .. ,w._ ,.•. ..�... ..+W.I..r,r ., 'N.t.nnC:fl! ..!d31j, T.. .P ., i €M i i tT,pp #C5`U k/i t , i�f.vC rf ALL PUMP 1IN i_i;:At ,i:..dfi�lC ..................... _ R VV NIV,' Goj�� ........... 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C �L -E- lp --------------- c a C L P F -__.__-"II o 0 f— I ° 0 I O ° I O I rpITTMG ALGA — 0. — I ____J pGrJ�Oprl•1 I 0 I I Andcrscnm AW 2 5 UII 1 m a pi O i 1 1 �N Y ae:om ° d o Nrcm . � Y- I I I r_____ ® I 3 1 GLoheT —I ol LL ------------- o 1' • wx __— _ _ _ _•-__•__ __•____-- P - � I A hEGONt�FLOO(z PLAN I w.o dcsi din w000rdwwc wi+h — �ooz This Plwn wws 9eslden+Iwl Goda 2 009 0 3 S \\r }he In+ernesticnwl Usa#+.] ' I Bdi+ion wad tha rlwcswLh �c�v� \ 'r N\ wit on+o h ma :Zup" 7 Q Wlndnw.prn+ec+ion+oc rm n Yoo°'uoi �p01.1.1.2 Protea+ion of oPemn°s. Lm u C [ C 6 w 3 o 0 m °m � Ncw walls_ N�`o�oE Z 3ra� ' m _r °r P P� Ohmokova+aator od;, _ s E •r •q s ?ei °S Vra`oy 701 a a o. QFAsq �p rc�oln�J S�C DANIEL yG�� DRAWING TYPE: C+ U CIVIL EA to v�eaand Floor Pls�n Q" No. 46253 y 4•_O y Z._9. I 'p'NG!$TE t�t�' �� SHEET NUMBER: B o `� � B•_o. 5•-�q" B-p" O��ss �aG\ lQNAI O O Y l I � BAXTER NYE Z. ENGINEERING & SURVEYING � . . 2._ � .Registced ProfesiimDl.Engineers _� :s ' C- and Lmld Surveyors rr\ rj O- _ - 78 North Street-3Td Floor 1 a _:.. dv' Hy—Is,Mass O,.tte 026W Phme-(506)771-7502 F•-'� imZ& TO I \ v 6 r tD+ --�_ .�1 " vKK' -� �- v w .b=tw-ny -76Z2 11 ¢ - - .wt -.-t _ HOLLY .POINT � _ II STAMP STAMP (40'1WOq RO I mo' LLANDS wE.Ba r. LOCUS MAP ` SCALE N.T.S.y IqA AL b t�6N I tAM05C.NE nI¢FJ¢ ; C \ �� CONSULT-ANT (s0'moE` Nm CON m s e /4 :.\ YAe'NAt srr N wvD°Dlr .s�.l STRUCTED) - - - : LEGEND ABBREVIATIONS CONSULTANT . - } / e.� S I - NOoo ''y .a .. UTILITY POLE � - - CUT WwpOLE - .. - '- ` .b 1-��\ gym•` ]_n ._ IN =UTCH 134SIN - . WATER CATF,/SHUfOFF . n ELECTRIC SIX . A. - A§SfSSOR'S 1 GAS NELER PREPARED FOR: MAD P32 PARCELS 02d k U2 a.' I `�*' , `_ . - - _� iDrE GAS LINE - Raymond,M.Xwasnick,Trustee - UPLAND AREA e I ` f_ T --�.— Vine Street Real Trust T3,0758 SF.I I ,'\ -h < ---- ` ,6t .Dm ' _ - TREE OVERHEAD INE G/o Goulston&Storrs NT s b wtDRaasTs i 1 ® r =.ELEVATION 400 Atlantic Avenue 4 - q, , I :' �� a• { ' 4 �n ... T.O.F. ..TOP OF FOUNDATION mM ty E I 3' h EOP EDGE OF PAVEMENT Boston,MA_Q2l 10 m. t . " (� GENERAL NOTES; A � I � z - lR1R P, I 't A 1J ASSmrtS W 14 - - 1 'z. _ wrtuTc �nvB°r IrWaivir '� a-.B w mass r WAa - / � U sme I'aD-eNnve O S� 5' �1.8./ _ 1 :L: - 4 g IC.LOf 11ARtE ID'Y.oWV•R.®.SF� •O �V , - .� � . "1 R .. . '. BmrBtara.YlIIerA>W VD•li/li � - i WIIotE®Ts64 v,LAKE BEQUAQUET elW aF8l>9wa®ff O IPE aarmmDI9Wo®LA r,F mmEntIDCaQY.®' - jyL . - `v`� .. U nc zatver Ix an.Bmcsoel a BBm u aaFOB racsr Ia�o o .�} C . Cy51ND. '' �'APPBWaAh - �iT.G. - rT}. R� `. \ .�� 2''3 - LIE D®IC WB¢ES 9Clf Hlanl IFE WAY®Tavl M W OE DY°a0 f@D ' A STNI6 LANIC6+E � - - - % 'I-BBDA(IIL(p DFlTlt. �. 2 � L `J,��� q S\ .Tf mYl°tR�v1�¢IIIaHS C®I�t eML1DF W.IW EL PIl '. ... ... IM01 SNOBID 'i' ,-. . . / Ii/AWnIP14�A,..-_ .• LDf.�.ASI> �. � '!Y'�' '� � M RDW N°vwlE IsIE W D6M3➢a Nu Af PIE B[C i LNA15IyPE 1°®a a DEQ BFl AW 1. Dung / u®a EnNO WIYnmI IFan°ED roMrAFl14 mm[YC.A�cu[W' . - _ _ ' A - -I .. BFLDi 6 f P°L !i ' ` -1 Da•E9 1t I SL IDU FD M6 I(nYfB Bf BBFY IIIE DQ®i[A9E W YR SS. - , i ve a or wom.n Accc fm o'wsa elra.el�mrs+°0. . - ! ! 1 - .• 'FRyT�plr p YEv W oaI®I L mlz Tmr®Ncv¢o-Ba.mac ..' - . _ '� _ _ _ %% _ I �Bw AqC - 1- _ mrz 1WnFED WvoL zm¢• - . Ti Ic w5¢ancr s'at. - .sa a Ynr A vmlr Nroa ra rEr Nr oav®I L m¢140Wf kk ' AL :1 n BE aYI1r A5RE Pam mEzama Bmzffawlffl� .. 1� \ - rE a Illlr A ntE ff O)•I®Iml m A alYNa ESnIBa.IrDaLffE I SHEET.TITLE .i .. .. .s . ..e, ue;' -' _ mrt 6 BR�?I'_-_ _�>__.: �!' - YG Bs d ' - - .LLmrevr nDJOem6RcrlN.uWcmv Umm IIB IRvIia vSffo a A arIstr YaBlw®6Wml'nm R IeI uIIEtRuRu aam 9 o[D<r¢m1 ImmEmaaaI FuAaw9.A DNBaE 6I°z E®mSm°AaIffF WIE lscauo�.r rI®t.w11E.B®IsD.eOw ur°a!mI t IBK6.W Existing Conditions Plan X 1pZX ------- J W LL FIRS Yal It¢rt E 1m19t2°r TIE mv�]¢f3 HInE A ImK 9W S'_D,N.-FF�p. _ I I ag16sOG�F YO OM6 ORIIL i WtD mPln6 BRiA fY.HN aF�BIR LIE . W SHEET NO 'u La'IBDnW 9lLL K FIaBH uEYBDT R PAL -' wv T37JWPFRCFi 076 X X- -' - - - �a lama rp°°amBffialnvim Ir i Dc�..IaEC a . - f ./_. � � .EtanC S�IC'S'WII'ai9N1BD11 l9nIED FRW¢PLC STSTEN IDYFL1aN DSD'a D A 7 E: 6/3/13 r rEsasTAs vr.DvavaE Dn�Bi'UG'I>�s-m-Is a raE Ar Sox '1D D 10 2D SCALE. _ mr Ylel a-Ba wn Fa stnvl��rr-r D�V14m IN FEET ... ._ .. .. roa ' .WP LSt/PAtCp OI4 .Nzt�� SCALE:4•='1 D' � .IDSEPN�FAU6'ON .- . •-� ®�JW. �®B��� - ORAYINfDE61GN:B T: YDI CNECFED BT:9B YIBa. -0F UABm r Bt6 ..� laWF Aala a l mBR�ff T ...... .........___._._. .. . BAXTER NYE MGM"IM 1. ALL SYSTEM COMPONENTS %RILL BE INSTALLED N ACCORDy+cE WTHENGINEERING & TIRE V OF THE STATE SANTARY CODE DATED APRIL 21, 2006. AS AMNETDED THRObxi*I THE DATE OF TM PLAN, & ANY LOCAL RULES & REGULATIONS ... TYPICAL SYSTEM PRQL.E APPLICARE SURVEYING L � 2. ANY CHANGE TO THIS PLAN M W BE APPROVED N WRITING Ff THE ENGINEER ELEVATION NFORMATiON MUST NOT BE CHANGED WITHOUT *VTHEN f E30SRNG FINISHED FLOOR = 45.17 PRIOR APPROVAL Br THE ENGINEER , Registered Professional Engineers and Land Surveyors 3. WHEN COINSTRU(,'7K)NI IS COMPLETED. PRIOR TO BACKFI.LNG. NOW THE 90 ARD OF HEALTH AGENT AND ENMM? FOR INSPECiION. 78 North Street - 3rd Floor '. 4 SYSTEM PiINC TO BE 4" SCHED 40 PVC- UNLESS Hyannis, Massachusetts 02601 Sff Al MOM Cv%M TO r MW i"M ma OTHEIMISE NOTED HEREIN. I caOxs sou WE WO ff SET CDM TO 6" BMW FINM GRADE 5. EXCAVATE UNSWAR E MATERIAL AS NOTED. TO THE 'C HORIZON" . FOR A Phone - 508 771-7502 ' RISER do CUTER SHAM BE Uk7ERiiGW HORIZ DISTANCE OF 5 ND THE LEACHM HELD. A REPi" ( ) WiTH CLEAN SAND PER 310 CUR 15.255 TO THE TOP ELEVATION OF THE SAS. Fax - (508) 771-7622 �-- FIN1SHEDIZ OVER TAN( = 44.0E /-FWNSN GRADE N 43.Ot 6. INSULATE AL PIES AGAINST' FREEZING AS REGUIRID WHEN LETS THAN 3 www.boxter-nye.com / OF COVER. FINISHED GRADE OVER LfACH/NG TRE]NCHi = 43.Of 3��-�O'� � 7 THE SEPTIC SYSTEM DESM DOES- INCLUDE CARBAMGRINDER STAMP STAMP DISPOSALS4" SCH 40 PVC ;• :; 9" (min) Cover tk10> A,y ElfE70ST>1NG NV OUT = 4314 EASE 2, � 36" (max) Cover 8. �(j THE CONTRACTOR SHAH CONTACT DIG SAFE (AT ��L '�Ssy E)oSTING NV N = 41.6 NV OUT-41 3 r 2"l dyer 1�8"to1�2" 1-888-DIG-SAM AND unm C%FANIES TO LOCATE ALL DWNG U ILITES. d I, EN PVC TEE 2" 4 9CH. 40 PVC Peastone AT LEAST 72 HOURS BEFORE THE START OF THE CONTRACTOR SFWl DETERMINE THE EXACT LOCATION. BOTH HORIZONTALLY AND VERTICALLY �. BIISEME7Nf FLOOR = 38.08 GAS BAFFLE ' �)� OF ALL DOSTNG UTILITIES SS BMW THE START OF ANY WORK THE LOCATION No.30216 WIN 412 OF DaSTNG UNDERGROUND UHNJHES ARE SHOWN N AN APPROXMATE IIUY lu • . lNV OUT 41.0 ONLY, MAY NOT BE LIMITED TO THOSE SHfXIM HEREON AND HAVE NOT BEEN �p A �S REN FORCED CONICRETE •.•. +.:. A-/ INDEPEHDENRY VERFEU BY THE OWNER OR iTS REPRESENTATIVE THE WIN CONTRACTOR AGREES 70 EE FU LY RESPONSIBLE FOR ANY AND ALL DAMA(ESWHICH WH T BE OCCASIONED BY THE CONTRACTOR'S FAILURE TO LOCATE THE S7 UTIlTlfS EXACTLY. F ELEVATION INFORMATION OFFERS FROM PLAN TONE BASE INFORMATION. THE CONTRACTOR SHALL NOTIFY THE OM ER MWNED1ATELY FOR POSSOU REDESIGN. AT UTILITY CROSSINGS% VERIFY N FIELD THE LOCATION / CONSULTANT 03S NG 1~000 GALLON SELF TANG PROP 83)Delmul10N BOX BOTTOM OF SYSTEM = 38.90 4.1' AVERTS OF ELECTRIC, GAS, TELEPHONE & DATA/COMM AHD RELOCATE F IAtEPLACE 7ET� (F NLE�) AND LIDO GAS BAFFLE CONFLICTING WITH PROPOSED INVERTS PER THE l7Nc�NEERS DIRECTION. THE Estimated HEigh Groundwater O Bev. 34.8 CONTRACTOR SHALL PRESERVE ALL UNiERIMM UWrIES AS REOURED. (Wequvquet Lake observed high water) 9. THE PROPOSED 0111Y CON NEC710NS SHOWN HEREON ARE SCHEMATIC. FINAL LAYOUT SHALL BE AS DETERMINED BY THE APPROPRIATE unm COMPANY. CONSULTANT PREPARED FOR : Raymond M. Kwasnick, Trustee Vine Street Realty Trust 12' % Goulston & Storrs FINISHED GRADE VARIANCES REQUESTED: 400 Atlantic Avenue 36"MAX.-9"MIN. \ \ COMPACTED FILL Alston, MA 02110 2" OF PEA STONE DOUBIl: sk `N OR FILTER FABRIC Nwze-n�n ri / " TO 1 / " 3 CU.1EC FMIAF XN 33M N 30.5". DOUBLE 15211:(1) TO ALLOW 6.5' SETIELCI( FROM A FDINQATION IN LIEU OF 20' FOR A SEPTIC TANK 24" EFFECTIVE DEPTHLQM i=ff f'LU--L WASHED STONE TO ALLOW 6.7' SETBACI( FROM A PROPERTY LIE IN LIEU OF 10' FOR A SEPTIC TAM( 'd• TO ALLOW A SAS TO BE 31.4' AND 38' FROM A BORDERING VEGETATED WETLAND N LIEU OF 50: 4' 4, 4' TO ALLOW AN 00STNG SEPTIC TAM( TO REMAIN AT 17.5 FEET FROM A BORDERING VEGETATED WETLAND N LIEU OF 25'. 21' 15.212•(1) TO ALLOW 4.1' SEPARATION BETWEEN AD&WED NO GRO(MOTLR AND BOTTOM OF SAS IN LIEU OF 5'. •---- 25' PLASTIC LEACHING CHAMBER DETAIL PLAN VXW 100 Of CULTEC 330XL OR EQUAL TAB1E NO SCALE 360-1 TO ALLOW THE SAS TO BE 31.4' AND W FROM A BORDERING VEGETATED WETLAND IN LEU OF 100'. 70 ALLOW OWING SEPTIC TANK TO BE 175' FROM A BORDERING VEGETATED WETLAND 01 ILLU OF 100'. VARIANCES APPROVED: � N LFJIt NO iiFEA i OIL I$ W c IAL: 3 MDRO0YS SOIL EVALUATOR: BARNSTABLE Rt�DOY 110 GPD/W�0011 I' •?'' � SIEVE WILSON, P.E. BOARD OF HEALTH AGENT: _ DAVID W. STANTON, R.S. cGORCE QWW (NN ) - N/A 0 TEST PIT 1 TEST PIT 2 PERC RATE - cs W / IMM (CLASS 1) LIAR - a74 GM/S.F W. Ow G.S.E. = 43.0± ow G.S.E. = 43.81 _ 33o GPO/ 0.74 GPO/S.F. - 4" SF. INn a M c� MULCH do SAND FILL MULCH & SAND FILL PIWOSM STS M& 4 CULtoc 33MCL Cl1AMKRS WIN 4' STONE ON ALL SW 4" 180 SDENU NMA: (25' + 12jx 2x2 - i60 S.F. Ap ; 10YR 3/2 ; LOAMY SAND Ap ; 10YR 3/3 ; LOAMY SAND BOTTOM ARC 125' Y 123 - 320 SF: z TOTAL AWA- 4M SF. 0 28" 26" 4M SF. x a74 WD/S F: = 331 00 CL CL B ; 10YR 4/6 ; LOAMY SAND B ; 1OYR 4/4 ; LOAMY SAND U 32" 32" w 0 C1; I OYR 4/3 ; DENSE FINE C1; 1 OYR 4/4 ; MED. SAND SAND W/ CORXES W/COBBLES w 48" 50" DE" ELRAMM � a C ; 10YR 5/4 ; MED. SAND C ; 10YR 5/3 ; MED. SAND 0 2 W/COBBLES 2 w/COMES EXISTING INVERT o FOINNDATiOON 43.24 >- 96" No" DWNG INVERT INTO OF S6 M TANK 41.60 a C3; 10YR 6/4 ; MED. SAND 3: 10YR 6/6 ; MED. SAND D7(►IM INVERT OUT OF SEPTIC TANK 41.30 z SEWER AVERT INTO D6rRDU11ON BOX 41.20 W/COBBLES w/cOeeLEs SEWER NVERf OUT OF D61RIBUWN BOX 41.00 S H E E T T I T L E 132" 132" SEWER AVERT INTO SAS 40.90 - BOTTOM OF SAS. X90 NO WATER OBSERVED NO WATER OBSERVED ESTIMATED GROUNDrMATER AT ELEVATHON 34 pep#ic Repair Plan - ® EL. 32.0 O EL 32.0 : Estimated Wo Groundwater O Elev. 34.8 Detail Sheet fi (Wequaquet L.oke observed high water) (PERC TEST D 66 <5 MIN/INCH) SHEET NO M 1 CERTiFY THAT IN APRIL 1995, 1 HAVE PASSED THE SOIL EVTbLLLATOR EXAMMMi01 APPi{AAZD BY 1FE %SfPw2 DEPARi W OF EIMVROM*]iTAL PROTECTION AND MT THE ABOVE ANALYSIS INKS PERFORMED BY ME CON,St-W WITH THE RE"FO TRAINING, WER LSE AND DfPERENCE DESCRIBED IN 310 CAN? 15.017 DATE : 7 31 13 m SIGNIATLN?E DATE 3lf3 0 CL (SE-2622) J S C A L E : NOT TO SCALE o DRAWN/DESIGN BY: MTM CHECKED BY. SAW M rl J O B N O: 2013-028 C A D D FILE: 2013-O2LWE1� M r�1 O � � 1•L9tl' • fi �, 0 BAXTER NYE L slt�dt i6 11Y uk '" mw w ti= ✓r ; r ENGINEERING y. hirWand iey 4 -' ✓ SURVEYING (, d, N T --- "" G G---- \ `. ' - . Registered Professional Engineers � . G �' .• w:;� and Land Surveyors - w ...' ""• -. ...,.,_, `' `� G "'•'----.- < PL C'O1�'"1Q�5 Cfi ! �. +"ir'. S�OrI+� , ,• � �'" • AIN -- w -_ - 78 North Street 3rd. Floor --- Y w °f<.�� �''` G G , , r ay . .'• Hyannis, Massachusetts 02601 � a `� w __ " � *• { Ls1atl+d 1. r - . �y ter w 4 WATER M41 - 4wv'rs ; h • •••.. Phone (508) 771-7502 N w a�1III1• s a Fax -- (508) 771--7622 40.3 /f xT w """' t - " \ r q +• « •' www.baxter-n)oe.com Way Poi&7WATFF{ l ...+• r,••, "" / •""• ,.... FF + Q� \ \\ � 58.6 EiH1Jj4..OFF ' r.- .- "' "' � ~""""ram- ,,,,, t.r c � +�` "" • * �'.: . 4 'M (40 WfDE • i>•-. 4 \ r �y`/ r r 3T.8 -..._ + t . STAMP Jew C,RA` t OR 4(}3 !// MR 16 _� - • '' �r ' i 1� f .� • r• •, ~ P43N 0 �qS,S 4�\�� OF MqS S / [/�j+. �...4 f • r.t m �'. 'W .....'..`f& • y'36. \ \ { ' i' • ® SHANE M.38.5 ! . Uy \\ !! ` ,� ! !rl ,' • ` f Na,3p21g c; BRENNER No.45917 • \,'"' p� ��'�• .J x 40.6 � !' ,r I �: . , • ; ; � . �.U..- 9"' p�Q �G� �p��' ��G.T_r�F� \39.6 �. '�p / \_5�3 !! i - '- !j • i QiUAI \ 1 r LANDSCAPE E AREA cn d+ (W/ADDITIONAL . / ! /r U_ / LANDSCAPE TIMBERS N OF/41qS NOT SHOWN 0 U ! ! I P r r ! \ ) t ! / �' l ��" `2�0 .CONSLTANT t� ! 39. > 1 i WF 15 / r ` WIDE' N f . 5. !!! /! O r I v ` / MBNAL SET IN PAt+EAIEIVT 1 !! I! 3f+,3 t/ NOT CO ' WF 2 ! s !! �x,. ' EL = 41.62 NGVD29 1 ! , / x 3�.1 ��) I No.s0216 ( ) ! uSTE Il� /V •�' �.y er.� x 4'`> \39.i r// ///r �'/! LEGENDr ! N ONAL CONSULTANT "'. ; `r- 1 `• •"' , }9OD f/ !' _ow = UTILITY POLE l/i/ (✓� •� .. -�--4,Z----cs, � V'JhiLK'NAY !! !r '�;`. ----') m / rn--, .� ' r GUY WIRE POLE CATCH BASIN WATER M GATE/SHUT-Off yA ' \ a % /'( ELECTRIC BOX • 1 �S- / r` �� ,_ ° 38. -' ! � RSA = GAS METER PREPARED FOR : SESStR 1 'v t x 40. !' x 35.8 ME 232 P.} CO2c n2 •• ^��� \ -g 1 1 + �� ! �, /! .WF 1?F 100.00 "`"""�••.. W w = LINE RaymondU. wasnic Trustee. i L17 `� AAA \ / €. .. �_3T ; I """�* w. TER LINE I Tt�TAL AREA � / a � �� � Trust ' -�- 40,994$ S.F. 1 ,' " �' , - , , -- a3-- -\ \` , _ ° ; OHW-----c HW- 0VERHEAD WIRES ' OR r i r !! y� Ei.4 WOOD if == TREE LINE w3 1 0.94t ACID,' ' , DECK c/o sonStorrs 35.4 ° �= t I !�$ i \ T 38.4 ' i EL = ELEVATION • u ,AREl1, 1 ay l i �' is Avenue I I �13,02 t S.K 1 � ! `, `\ \ � i i' � � T.O.E. = TOP OF FOUNDATION a r , CONCRETE v% 4- 6 ° ' r f i r 1 //// 27.2" / "� -,\ ! ! � .T / EDGE OF PAVEMENT 43 GARAGE 3k / , { v ° , 1.4`_ G.F.E = 43.76 / 1NF 4 ';5.7 5.4 &. . GENEW �: NIF'•' 12 ) IACLI�S AREA 6 OOM D OF. SNOOP SEPTOC REPAIRS AT LOC1� • r, I{ i \ ` _- - -- / W 1. TIE M 0E1r<I'OF 0O PL'L�I IS TO i ,3.3 \4 ; {` { x y7 , 2j MIP 232 35.4 ck PARCELS 24 AND 72 3 \\\ LAID OOIWlT GERIIF1C.�lE Na 12'�TJ { a_ LAND COUKT LOIS 22 AND 23 SI MN ON 8Mp OOLMTT P1AN No M39C - SHEET Na 2 `7,4 APPLfKW RAYRM N k1M15MM TRUSTEE Jul L f f' 43.6 1w SIREET KAM I'm\\ C/O Gas" & STOOIRS ° i GRAVEL / F , { , \ ` . r.� 4M ARAN11C AVET�IOE' { I N AREA I ` \ \\ \\ \ C14 BO6TOOi INO21 fO BRICK AREA /,r _ > `\ \\ , Q \ o / \ n I Z 1) PRD.CCT AS SON ON THISPLMI � �ESS C0 v7 ,tilts ' WF 5 T- - / I a `\ �\ \\ `} �ti ,\ O 4.) IMIIVC WUIRINTM ` • NTDOOR i4_ du. �\ 7' r 44.1 x 48\ \\\ r, ti{� { \, , k. Q iG 0157R1Cf RD-1 \ \ ` W LOT AREA 435W S.F. 8712D S.F. 35.2 A9N lAT FRONTAGE2D' < in i v v v vv COIN. LOT OM . 125' tt1 FRONT YARD 3d sDE$ wA YARDicr i 1 � 9.3' 1.`i'�, /./ I \� \\ \\ '''v� cry ^ ~ LA /� / OVERLAY DfSBRm ww PROiEC7DIi OVERLAY DLSi�1CI j F. .. l JL'1 � / (� r f ti ✓ 4 4.4 \\ \\ \ \ v* ALown ` c Of Dp.USH LitP1 n•e' i + �// r " \\ \\ \`W 90 t \\ a J U 4t (�M Q �l �` y�l,,�,"�''/' /r !' � BUh�P OU7 AT °' i/ \\ \\ \i \ \,, (�°' � Q 5.)A TITLE SE)IRC11 WlS NOT BE1aN PF�1FOiMED FOR SI1E. F OEIERMED x i4 !! ! !! x 3 .6 DECK LEVEL_ + \\ �\ \\ `\ t`rA TO BE t1ECESSARI',A TITLE SEJIRCH SI Ml BE PERF0R 0 BY MWS. w A GPEAT POND � ! r � \\ wo \ _\\ rNj N 42 9 \ `\ v, 04 N &j Tw PwVw uw pIFIRE 710N 9M 1S am ON CUleff M"BLE REt w 0 /+ !' / \\ \ \ \\ �, �, cP 4 INFORAMMM OONSI K OF P1ANS AND DEERS OC E?�ISr7"tiG .. /� !! & APPRO;�#IAATE /'l i x 37.6 .7 /346 r \ ti\ \\ r\ o� WOOD PLATFORM ! LIMIT t�1� - �/ 4 , \ \ THE FEATURES SHOMN MERE OBTAINED FROM AN ON THE GROW FIELD 1 \x 4 4.2 \{ \ ` ��' SURVEY PERFORMED BY EWER NYE� SLMRVEYNC ON MAY 23. 2DiI &. STAiRS LAND,'$CAPE ! 1-STORY WOOD DWELLING �:_ \ { MET11�F�\Sxs 1E \ (NO7 SHOW J) !r ti AREA /r - LANDSCAPE !1R[A___ T.O.F. = 45.17 �i Q "� \' ' l".9�T IF ` 7.) OOaNdM PANEL K*M 2500D1 0006 C yr� 1 E n= INS RANCE RATE IMP OEM 1NS AREA AS ZONE 8 Q / (W/AODITIQl4AL I f'J B.F.E. = 38.0$ { i `\. \ \ \\� }�Itc 1�t_ `\- LANDSCAPE TiMEEERS WOOD DECK � CZ) ALr/ 6.9 NOT SFIOWN) `� z i 11!; \\\ x 4 \\\ Q) ._ f ti INV M-41.6O + \ !! r/ GRAVEL / le ti WIETIM DFLINE470 BY DVMROI111�7ft OOO�UL.TMRG E RES1OiRiUROM, LLC ON a. BELOW / S • r't A 'TER �\ \\ 38 9 $MY 21, 2013 AND FLAGS LOWED BY BMXIEIi NYE DOMMMiB a SLIRYFYM ON MAY 2A X NrV OUT=43.24-�� W/LANFCAFE f: 41.9\r T Oi TIMBERS ( , / 1 39.6 6.2 1 • SITE IS NOT WM AN ACED (AREA OF O TM AL COMM04 CO) ! ! t LANDSCAPE TIMBERS / �/ { 1 { 1NF 9 WEILAND SOILS • SW is W INNI AN AREA OF ESTYNIED WV9W OF RARE WDW PER w w ! , OF'PEST PiT � ' MiP OCTOIER 1. 2012 'TSIiwiATE11 WABRAIS RARE MILDUFE" r/ 'i`` ti , /24,7' `4 ti t OLD`(D-8d9�� s , 3 FOR LIZ KAI 7W M4 MIEIIA M PWIE;CIION ACT MWWM (310 CAM? 10�- !!! A!C UNITS v 44.t rr i SET NE °0- (\ • SITE DOES Idf,7T CONfMI A CER19"ED 1EAIMl. POOL PER N1*3P'WP OCi�? 1. ! 1 • 5 2012 'LERWLTED VERNAL POOLS' u.ti /1 /` r f) `,� iq � � ti SITE 6WI NI A FWW WRTAT PER MW AW OC'R(M 1, 2012 'M91Y M ti W1 MIS OF'RARE SPER2rSa FOR 51TM 1MDER THE MAS'S+ACNUSEM ENDVCIERED ct • SF'ECMMS AC1; RE611iA110NS (321 CMR1Oj. x 44~` 4 ' g A • SITE 6 WO A STALE APPRINED ZONE M(xI01 W MM1ER REIMW PRINFE ON \ S 12` METAL SlLF211EY Spn tiE ARE/l ! \ \ TP �aET EL = }�3 70 (NGVD29) }�� SITE 1S MNl A ZONE OF CONIRD4liiON TO A SALTMMIER EST M MWRNSDABLE ora u _ • / ! / ` \ -- spy «� - {} 5 // / 9.) iC�1NAl1�RiidI1(I�l.��Fl( 8 I I 39.6 SHEET TITLE /! ! 38.5 \\ \` \t\ NYC EDGE OF ! VYF 8 •THE CONTRACTOR SHALL OONTACT DIG SAFE(AT 1 S#1)AND Ui M COMPANIES TO LOCATE r r ' ALL EXISTING Ui TES AT LEM 72 HOLDS PRIOR 10 1W START OF CONSIRUCIN9N. THE MUM OF �' Repair 38' .3- '!r f 2.� C AN SAM EXL` W INFIRC111 i URN; UiI[InM OOFM3MITS AND LMES ARE 901W IN AN APPROXIMATE APPFIOXM\tA iE r I / WAY ONLY, MAY NOT BE LUIED TO USE% MN HEREIN AND WiVE BEEN RESFiiWO BM51D ON iW X -----._ \ - LOCATION OF S P11C / AUNABLE UIM.IfY REQORD6 NOTED HEREDN. 1W ODNfA1 W� 5 TO OE FULLY RE"ME FOR COMPONENTS� X ANY AND ALL DAAiW WOW M 1T BE OCCIASIOIED BY THE CONiTtAC='S FAILURE 10 LOW SAD d X . 8 g C,�IAIN LINK ffNC ___ !ti o�i OiiffRMKW OR Si AND UM 11E F] LY IF FIELD FIEDNTELCOMMFROM FILM /FUNNO M, IW X � _ __ __ I _ __--' / SOMIX M FIOW K)N FROM PLANS HAS BEEN COMB 0 WN 09SOM OF UTlI1Ll:AT 10 SHEET NO DEVELOP A W N OF RM LMDFId61R M UMIRES HOKVM LACKING El6C4010N, THE EXACT LOCAIRON MAP 232/PARCEL 075 �"'- X+►�••..,,, of 1E1DUMUND FEATURES QWVr BE AC WELY, 0OMR[EiELY AND RELWY WTIEU. MRQiE N/F � T``w• ADDITIONAL OR MORE DE'OIMM MEDRMOM IS RIMWR IW CLAW iS AOVOSTD THAT 00Al111ION MAY S;Pwl � SUSAN FALKSON � x .-'� � 7 BE NacEssARY , N o ��`""'■ 39.2 A4 • VOSTMIG SEPTIC SYSTEM IN°ORIw4ATON 001'AMED FROM SEPW SYSTEM NESPECTION REPORT DATE : 7 31 13 8Y 44CS D. SEARS OF CAPEWIDE ENTERPRISES. WC, DATIED 3-29-13 ON FILE AT B.O.H. 10 O 10 20 r ""*r•.,,,� •T%w wER SERVICE 9m ON THIS PLAN now SIfE7CN 0-45174 DOTED 4/19/77 AND MMTER GUM/M-OPT LOCATED BY THIS MU LIURMNG FIELD SURVEY. MAP 232/PARCEL 074 a"��^-•� SCALE IN FEET . • GAS SOMM SHOIM IS A OOII691101110N OF DOE-SAFE AIMRKMIGS FELD LOCATED BY IM SCALE : 1 w= 10' .iOSEPH FALKSON WM AND N4IOONAL CRID SI(EIL'Ii SM271N ON MAY 1B. 2013. DRAWN/DESIGN BY: WM CHECKED BY: SANK .-a J 0 B NO: 2013-M CADD iF11_E: 201 0 u BAXTER NYE I. SYSTEM COMPONENTS SHALL BE OWNIED IN ACCORDANCE WITH �1 TITLE V OF THE STATE SANITARY CODE DATED APRIL 21, 2006, AS AMENDED ENGINEERING + ` THRO" THE DATE OF THIS PLAN, & ANY LOCAL RULES A: REGULATIONS AL SY APPLICABLE SURVEYING NOIT TO WALE 2 ANY CHANGE TO TM PLAN MUST BE APPROVED IN Wff11 NG BY THE ENGINEER. ELEVATION INFOWTION MUST NOT BE CHANGED WITHOUT WRITTEN , 1 EXISTING FINISHED FLOOR - 45.17 PRIOR APPROVAL BY THE ENGINEER. Registered Professional Engineers and Land Surveyors � 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKnu NG, NOTIFY THE t BOARD OF HEALTH AGENT AND ENGINEER FOR INSPECTION. 78 North Street - 3rd Floor -1 = A � sYs � PIPING T° 4' +ED 4° Prc• �" EssOTHERWISE MTO Hyannis, Massachusetts 02601 1 SET coVFx TO s' BELOW FNS1 (MADE 5. EXCAVATE U1+I:S(I1ABi.E MATERIAL AS NOTED, TO THE c HORIZON- . FOR A Phone - (508) 771-7502 RISER & COVER SHALL BE WATTR1 ff HORIZ DISTANCE OF 5' SURROLRNDING THE LEACHING FIELD, AND REPLACE � 1 WITH CLEAN SAND PER 310 CUR 15.255 TO THE TOP ELEVATION OF THE SAS. Fax -- (508) 771-7622 www.boxter-nye.com FILED OVER TANK 44.0# FINISH GRADE - 43.0t 6. INSULATE ALL PIPES AGAINST FREEZING AS REMWD WHEN LESS THAN 3' ye 1 INSPECTION PORT TO OF COVER. F7INf�fED GRADE OVER LEACHING 1RE1NL�i = 43.0# 3' BELOW GRADE 4• SCH 40 PVC •y r , • •' 9" (min) Cover 7. THE SEPTIC SYSTEM DESIGN j INCLUDE GARBM;E (�INOER STAMP, STAMP } DISPOSALS. EXISTING INV OUT = 43.24 36" (max) Cover '- """ FIRST 2 (TO � LEVEL) t3. , THE CONTRACTOR SHALL CONTACT DIG SAFE (AT F,P�'j�OF Mq�S EXISTING W Id = 41.6 15W NV OLIT-41.3 � 2`Layer 1/8"tot/2' 1-888-DIG-SAFE) AND UTILITY COMPANIES TO LOCATE ALL EXISTING UTILITIES, �. 4" SCH. 40 PVC PVC TEE 2' Peastone LEACHING AT LEAST 72 HOURS BEFORE THE START OF t?DtlViT1RUCTION. THE CONTRACTOR • TEPHEN yG BASEMENT FLOOR = 38.08 ADC GAS BAFFLE SHALL DETERMINE THE EXACT LOCATION, 80TH HORIZONTALLY AND VERTICALLY, 6• SUMP OF ALL IXISTMIG UTILITIE'S BEFORE THE START OF • � ANY WORK. THE LOCATION INN {N = 41.2 • OF EXISTING t)NOERGROUNO UfKJTTES ARE SHOWN IN AN APPROXNMATE WAY • INV OUT = 41.0 " ONLY, MAY NOT BE LIMITED TO THOSE SHOWN HEREON AND HAVE NOT BEEN REINFORCED CONCRETE--, ,: :•-vr� �.:. 4 PVj-/ INDEPENDENTLY VERIFIED BY THE OWNER OR ITS ROWSENTATIVE. THE ��.c �'U�ST• \ a - _ CONTRACTOR AGREES TO BE FULLY � FOR ANY Fps 7. INN IN 40. AND ALL DAIIIAGES oOIVAL�N " CRUSHED WHICH MIGHT BE OCCASIONED BY THE CONTRACTOR'S FAILURE TO LOCATE THE STONE BASES uwnES EXACTLY. IF ELEVATION INFORMATION OFFERS FROM PLAN INFORMATION, THE CONTRACTOR SHALL NOTIFY THE ENGINEER IMMEDIATELY FOR POSSIBLE REDESIGN. AT UTILITY CROSSINGS, VERIFY IN FIELD THE LOCATION / CONSULTANT EXGt1NG�000 GALLON SBYW TAW Ppax)Eff)D08'IFOMM BOX DOTTOM OF SYSTEM = 38.90 .1' INVERTS OF ELECTRIC, GAS, TELEPHONE & faATA/COMaO AND RELOCATE IF RFRACE TEES (IF NEEDED) RIND ADD GAS BAFFLE CONFLICTING WITH PROPOSED INVERTS PEI? THE ENGNEERS DIRECTION. THE Estimated High Groundwater O Elev. 34.8 CONTRACTOR SMALL PRESERVE ALL UND07GMW UTTLf TES AS REQUIRED (Wequoquet Lake observed high water) 9. THE PROPOSED UTILITY CONNECTIONS SHOWN HEREON ARE SCHEMATIC. FINAL LAYOUT SHALL BE AS DETERMINED BY THE APPROPRIATE UTILITY COMPANY. CONSULTANT PREPARED FOR : Raymond wasnick, Trustee Vine Street Really Trust 12 An LC/o Goulston & Storrs �! FINISHED GRADE 400 V CES UQMTED: Atlantic Avenue 36"MAx.--9"MIN. \�j\ �/�. 1� COMPACTED FILL Boston, MA 02110 2" OF PEA STONE DOi.►BLE WASHED STD OR FILTER FABRIC 3/4" TO 1 112 7IDF_Y 3 CULTEC RECWGM 33OXL N 30.5" DOUBLE 15.211:(1) TO ALLOW 6.5' SETBACK FROM A FOUICATION IN M OF 20' FOR A SAS. 24" EFFECTIVE DEPTH WASHED STONE lO ALLOW 6.7' SETBACK FROAI A PROPERTY LW IN MOF 10' FOR A SAS. _ mat TO ALLOW A SAS TO BE 31.4' AND ,W FROM A BORDERING VEGETATED *nAND IN LIEN/ OF 50'. 4' 4, F 4. TO ALLOW AN EXISTING SEPTIC TAIL( TO RE" AT 17.5 FEET FROM A BORDERING VEGETATED WETLAND IN LIEU OF 25'. 21' 1-fL 25' 15.21Z(i) TO ALLOW 4.1' SEPARATION BETWEEN ADJUSTED HM GROUNDWATER AND BOTTOM OF SAS. IN LIEU OF 5'. . "PLASTIC LEACHING CHAMBER DETAIL. PIAN VIEW CULTEC 330XL OR EQUAL TOWN ' 7 NO SCALE 360-1 TO ALLOW THE SAS. TO BE 31.4' AND 38' FROM A BORDIRW VEGETATED WETLAND IN LIEU OF 100'. TO ALLOW EXISTING SEPTIC TAW TO BE 17.5' FROM A BORDERING VEGETATED WETLAND IN M OF 100'. VARIANCES APPROVED: 1-/2-•zo 13 : 6 UE " G AAEA R EL0IE �S • SOL L GATE "' C� 6/ /13 J rsu� f-Koz 13ARNSTABLE R1ESIo0f 3 e0)Roau �,►, SOIL EVALUATOR: x-Ittz GM[ tuWAN SIEVE WILSON, P.E. BOARD OF HEALTH AGENT. TUI L DE" FLOW - 3M GM DAVID W. STANTON, R.S. GARBAGE asNorR (WTM) - N/A U TEST PIT 1 TEST PIT 2 PERC RATE - K5 WL I (CLASS 1) W LTAR - 0.74 GPD/S.F. -' Q . + ' G.S.E. = 43.0f G.S.E. = 43.8t O 330 GPI/ 0.74 GPD/S.f: - 40 S.F. WL � MULCH & SAND FILL MULCH & SAND FILL M SMELL 4 CULTEC 330XL CaNiIRERS IITH 4' SII ON ALL Sages 4" 18" Ap IOYR 3/2 LOAMY SAND Ap 1OYR 3/3 LOAMY SAND ARFA (25- + 12�r 2'x2 - ass SF !IS?IIS?!L_AREA-. 115' x 12'l = ..�ZO_S,E_ TOTAL AREA: AIM S.F. O 28" 26" ►- 4M S_F. x 0.74 GM/S.F. = 331 Gaff 0_ B : 10YR 4/6 ; LOAMY SAND B ; IOYR 4/4 ; LOAMY SAND U 32' 32" w r� C1; I OYR 413 ; DENSE FINE C1; I OYR 4/4 ; MED. SAND, SAND W/ COBBLES W/COBBLES LU 48" 50" Ilk- C2; I OYR 5/4 ; MED. SAND C2; 10YR 5/3 ; MED. SAND o W/COBBLES W/COBBLES EXISTING INVERT O FOUNDATION 43.24 y 96" g0" EXISTING INVERT INTO OF SEPTIC TANK 41.60 M MED. SAND EXISTING INVERT OUT OF SEPTIC TANK 41.30 U C3; 10YR 6/4 ; MED. SAND C3; l OYR 6/6 ; SEWER INVERT INTO DISTRIBUTION BOX 41.20 W/COBBLES W/COBBLES SEWER INVERT OUT OF DISTRIBUTION BOX 41.00 SHEET TITLE 132" 132" SEWER INVERT INTO s.As 40.90 '�' BOTTOM OF S.A.S. 3&90Qoeptolc pair Pian NO WATER OBSERVED NO WATER OBSERVED ESTIMATED GROUNDWATER AT ELEVATION 34.80 • 0 EL 32.0 0 EL 32.0 • Estimated High Groundwater * Elev. 34.8 Detail Sk"a-eet (Wequaquet Lake observed high water) :J 0 (PERC TEST 0 66"; <5 MIN/INCH) SHEET NO 6 1 CERTIFY THAT IN APRIL 1995, 1 HAVE PASSED THE SOIL EVALUATOR EXAMMI' N APPROVED BY THE SPn2 :3UUPARTMEMT OF ENVIRONMENTAL PROTECTION AND THAT THE ABOVE ANALYSIS WAS PERFORMED BY ME C0NS1STL7+IT WITH THE REM?ED TRAINING, F.J(PERTISE AND EXPERiW DESCRIBED IN 310 CMR 15.017. ,v DATE : 7 31 13 C> SJGNATURE -�-Y DATE (SE-2622) S C A L E : NOT TO SCALE IN DRAWN/DESIGN BY: MIA! CHECKED BY: SAW c: .Ta JOB N O: 2013-028 CARD F I L.E: 2013-02 ey iy