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HomeMy WebLinkAbout0043 LONG POND CIRCLE - Health 43 LONG POND CIR., CENTERVILLE A= 209 031 �111� �*oYk% NoP2� 153 OR , vs�`� HASTINGS.MN I TOWN OF BARNSTABLE LOCATION NA IONJ CIRGl i SEWAGE 4t060 VILLAGE r am-LP. U o Ili ASSESSOR'S MAP & LOT2e9'03I INSTALLER'S NAME&PHONE NO._. Qy tA. o%lo SEPTIC TANK CAPACITY V LEACHING FACILITY: (type) 4&AC� IREA4 ' (s ze)X% NO. OF BEDROOMSID S� BUILDER OR OWNER ® 7` Aa?dN , UA PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200'feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet__of leaching facility) Feet Furnished by Cow 50 S-, 1Arok i .601 q UAC6 TRH xa TOWN OF BARNSTABLE LOCATION N -F�GN �DNr�I' clRG I � SEWAGE #��C� `3� VII.LAGE CS 1 S_P. G� J I� �ASSESSOR'S MAP & LOT��I C73 INSTALLER'S NAME&PHONE NO. US 4/a SEPTIC TANK CAPACITY LEACHING FACILITY: (type) Ac RCAF 'K ` LLP,,� (s ze) NO.OF BEDROOMS®zL�_� 1 BUILDER OR OWNERi1G� PERMITDATE: Cd6 COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility's Feet Private Water Supply Well'and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet,of leaching facility) Feet _.. _ Furnished-by �o �c .I Q 0 s �.�=,i—� _ �. •. ._'_ ,.is=, -� HARNMOM 7 MAH& Town of Barnstable Zoning Board of Appeals Decision and Notice Boduch -Appeal Number 2000-45 Special Permit Pursuant to Section 3-1.1(3)(D) - Family Apartment Summary: Granted with Conditions Petitioner: Thomas& Karen Boduch Property Address: 43 Long Pond Circle, Centerville, MA Assessor's Map/Parcel: Map 209, Parcel 031 Area: 0.92 acre Zoning: RD-1 Residential D-1 Zoning District Groundwater Overlay: AP Aquifer Protection District Background: The property consists of a 0.92-acre lot commonly addressed as 43 Long Pond Circle, Centerville. According to assessor's records, it is improved with a two-story, Colonial style residence of 3 bedrooms ^� 60 with a living area of approximately 2,137 sq. ft. and an attached garage of 572 sq.ft. The property is M located in a RD-1 Residential Zoning District and is serviced by public water and a private septic system. The property, in addition to fronting on Long Pond Circle, has 154 feet of frontage on Mother's Park Road and Phinney's Lane. The petitioner is proposing to construct a two-story 36 by 24 foot addition to the existing garage structure. exposed basement of the addition is to be a one car garage and the second floor is to be a one The lower, expo 9 9 bedroom family apartment unit. The family apartment is to be occupied by George and Jean Anderson, father and mother of Karen Boduch. The petitioners are requesting a Special Permit for a family apartment pursuant to Section 3-1.1(3)(D) of the Zoning Ordinance. Family apartments are allowed in RD-1 Residential Zoning Districts as a conditional use, provided a Special Permit is first obtained from the Zoning Board of Appeals. Procedural Summary: This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on May 03, 2000. A public hearing before the Zoning Board of Appeals was duly advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened on June 07, 2000 at which J time the Board granted the Special Permit requested. (� C Hearing Summary: Board Members hearing this appeal were Gene Burman, Gail Nightingale, Richard Boy, Tom DeRiemer (1 and Chairman Ron S. Jansson. Thomas and Karen Boduch represented themselves before the Board. 3 Ron Jansson disclosed he had discussed this application in a general way with the Petitioner's parents, but never represented them. 1 Mrs. Boduch explained the relief they are seeking. They will be constructing an addition that will include Family Apartment for her parents. They originally requested a two-car basement garage but it would infringe on the sideline so they are modifying their request to a one-car garage and it will not violate any Town of Barnstable-Zoning Board of Appeals-Decision and Notice Boduch-Appeal Number 2000-45 Special Permit Pursuant to Section 3-1.1(3)(D)-Family Apartment setbacks. This is in addition to the existing two-car garage servicing the main dwelling. The septic system will be in compliance with Title V. There are two means of egress from this lot.- The petitioners stated they understood the Zoning Ordinance with reference to Section 3-1.1(3)(D) - Family Apartments and are in compliance with all the requirements of that section. This will be the permanent year-round residence of all family members. There was a brief discussion about the elevations and a plan listing the elevations was submitted to the -file. The builder indicated the structure complies with the height limitations for the district. Public Comment: No one spoke in favor or in opposition to this appeal. Findings of Fact: At the hearing of June 07, 2000, the Board unanimously made the following findings of fact as related to Appeal Number 2000-45: 1. The Petitioners, Thomas & Karen Boduch, are seeking a Special Permit pursuant to Section 3- 1.1(3)(D)for a family apartment. .2. The property address is 43 Long Pond Circle, Centerville, MA, as shown on Assessor's Map 209, Parcel 031. The site is 0.92 acres and located in the RD-1 Residential D-1 Zoning District and the AP Aquifer Protection Overlay District. 3. ' The-site is improved with a two-story, Colonial style residence of 3 bedrooms with a living area of approximately 2,137 square feet and an attached garage of 572 square feet. 4. The petitioner is proposing to construct a two-story 36 by 24 foot addition to the existing garage structure. The lower, exposed basement of the addition is to be a one car garage and the second floor is to be a one bedroom family apartment unit. The structure - as proposed-will be no higher than 29 feet from the existing grade to the ridge. 5. The family apartment is to be occupied by George and Jean Anderson; parent's of Karen Boduch. 6. The Petitioner understands the restrictions and conditions of the Zoning Ordinance pertaining to a family apartment. 7. The application falls within a category specifically excepted in the Zoning Ordinance for a grant of a Special Permit. 8. After evaluation of all the evidence presented, the proposal fulfills the spirit and intent of the Zoning Ordinance and would not represent a substantial detriment to the public good or the neighborhood affected 9. The proposed family apartment and the owners and occupants thereof will comply with Section 3-1.1(3)(D). Decision: Based on the findings of fact, a motion was duly made and seconded to grant the relief being sought in Appeal Number 2000-45 and subject to the following terms and conditions- 1. The family apartment shall comply with, and be maintained in accordance with, all restrictions of Section 3-1.1(3)(D) of the Zoning Ordinance and shall be the primary year-round residence of the family member(s) residing therein. 2. The family apartment shall be developed and maintained as per plans presented to the Board except that all construction shall comply with all required setbacks. 3. On-site septic shall comply with Title V. 4, The locus shall comply with all State Building Code, Town of Barnstable Board of Health and State Fire Prevention Regulations. The vote was as follows: AYE: Gene Burman, Gail Nightingale, Richard Boy, Tom DeRiemer, Chairman Ron S. Jansson NAY: None 2 3 Town of Barnstable-Zoning Board of Appeals-Decision and Notice Boduch-Appeal Number 2000-45 Special Permit Pursuant to Section 3-1.1(3)(D)-Family Apartment Order: Appeal Number 2000-45 has been Granted with Conditions. This decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, within twenty (20) days after the date of the filing of this decision in the office of the Town Clerk. Ron S. Jansso , h man Date Signed I Linda Hutchenrider, Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been in the of the Town Clerk. Signed and sealed this // day o oZ under the pains and penalties of perjury. Linda Hutchenrider, Town Clerk 3 •. Proof of Pukatm LEGAL NOTICES.: Town of Barnstable Zoning Board of Appeals Notice of Public Hearing Under The Zoning ordinance for Juno 07,2000 To all persons interested in,or affected by the Board of Appeals under Sec. 11 of Chapter 40A of the General Laws of the Commonwealth of Massachusetts, and all amendments thereto you are hereby notified that: Appeal Number 2000-45 7:30 PM Boduch Thomas 8 Karen Boduch have petitioned to the Zoning Board of Appeals for a Special Permit for a Family Apartment pursuant to Section 3-1.l(3XD) of the Zoning Ordinance. The property is shown on Assessor's Map 209,Parcel 031 and is commonly addressed as 43 Long Pond Circle,Centerville,MA in an RD-1 Residential D-1 Zoning District. 7:35 PM Boyle and Callahan Appeal Number 2000.45 Susan Boyle and Martha Callahan have applied to theZoning Board of Appeals for a Variance to Section 3-1.3(5)Bulk Regulations. The lot is 0.95 acres where 1 acre is required. The shown on Assessor's Map 207,Parcel 090.002.and is commonly addressed as property is 57 Seabury Lane,Centerville.MA in an RC Residential C Zoning District. Appeal Number 2000 47 7:45 PM Lowe King F.Lowe and Delores K.Lowe,Trustees have applied to the Zoning Board of Appeals for a Variance to Section 3-1.4(5)Bulk Regulations. The Applicant seeks a Variance to maintain each of two dwellings on two lots neither lot meeting the lot area, frontage and setback(s)requirements. The property is shown on Assessor's Map 020, Parcel 018 and is commonly addressed as 25 Lewis Pond Road.Cotuit,MA in an RF Residential F Zoning District. ll and Bums Appeal Number 2000.48 8:00 PM Drisco Agnes D.Driscoll and Alexis C.Bums have petitioned to the Zoning Board of Appeals for a Special Permit pursuant to Section 4-4.2 Nonconforming Lots. The applicants meek to convey 0.37 acres of their lot at 801 Main Street,Cotuit MA to the abuttingroe owner The property seeking the permit is shown on Assessor's of 60 Nickerson Lane,Cotuit.MA d as 801 Main Street, Cotuit, MA in an RF Map 035, Parcel 103, commonly addresse Residential F Zoning District. Appeal Number 2000-49 8:05 PM Driscoll and Bums APP Agnes D.Driscoll and Alexis C. Bums have applied to the Zoning Board of Appeals for a Variance to Section 3-1.4(5)Bulk Regulations. The applicants seek to convey 0.37 acres of their lot at B01 Main Street,Cotuit MA to the abutting propertyrowner of 60 Nickerson Lane. Cotuit,MA.The property seeking the variance is shown on Assessor s Map 035,Parcel 103, commonly addressed as 801 Main Street,Cotuit.MA in an RF Residential FZoning District.. 8:30 PM Burke Appeal Number 2000-50 Russell J.Burke,Oxbow Realty has petitioned to the Zoning Board of Appeals for a Special Permit pursuant to Section 4-1.20)Special Permit Required/Certain Accessory Uses. The Special Permit request is for a new proposed dock on a non-buildable lot as an accessory use to the principal use that is immediately across the street and held in identical ownership.The principal use will be located on Assessor's Map 075,Parcel 007,commonly addressed as 431 Baxter Neck Road,Cotuit,MA and the accessory use will be located on Assessor's Map 075,Parcel 035,commonly addressed as 438 Baxter Neck Road,Cotuit,MA.both in an RF Residential F Zoning District. aring Room:Second Floor,Town Hall,367 Main These Public Hearings will be held in the He Street,Hyannis.Massachusetts on Wednesday,June 07.2000. All plans and applications may be reviewed at the Zoning Board of Appeals Office, Town of Barnstable, Planning Department,230 South Street.Hyannis,MA. ,on'3A8Pts£on, Chairman Zoo-ing BQerd o +ppeals The Barnstable Patriot May 18 May 25,2000 0.." ® "' Fee 1 � THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: V Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS appricatiou for Miopozal *potem Con5tructton Vermtt Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. V/3 441-Cr R­Ct C,@CJ Owner's Name,Address and Tel._N�' Assessor's Map/Parcel Q ? ��3 4ph. �G�(� p c 1 a y Installer'sNNaame,Address,and Tel.No. v Designer's Name,Address and Tel.No. & 1 `; aoq -d3 Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow f gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or AltW ations(Answer when applicable) `1,r R c, l X1r NC11 Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issueli by this Board Health. Signed Date 4l� Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued Iro: Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Application for Miopo!6ar *pztem Cougtructiou Permit y Application for a Permit to Construct( Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. y� LOn'E Pj t� Owner's Name,Address and Tel.N uc� Assessor's MapMap/Parcel �0 C , �,�3 p� L/�70A' 4 rAA� - Installer's Name,Address,and Tel.No. / T D7esigner's Name,Address and Tel.No. Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow �y� + gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank d[c�S4 ;4/ Type of S.A.S. Description of Soil: Nature of Repairs or Alterations(Answer when applicable) `/_/IC ACI 1 /kc k c2 A d - ra d .rA tiCk-Z c"T1, a fir; s&"E Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been issued by this Board af,Health. Signed ,� tr j © Date 4 M Application Approved by Date Application Disapproved for the following reasons Permit No. ..► Date Issued ------------------------------------ _ THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewa a sposal System Constructed(�()Repaired( )Upgraded( ) Abandoned( )by at 4, v h h s been constructed in accordance with the provisi s of Title 5 and a for Disposal System Construction Permit No dated Installer Designer t The issuan a of this permit sh n �e construed as a guarantee that the s em-will function ai desi t fed. Jf j� o _ �S� Date Inspector fin,?`�„ (''�� / /�f � --------------------------------------- No. Fee i THE COMMONWEALTH OF MASSACHUSETTS / PUBLIC HEALTH DIVISION - BARNSTABLE, MASSA6 ,7_ S� ,0 MtgpogaY *p!6tem Congtructton Permit Permission is hereby granted to Construct.(,Repai ( )Upgrad ( )Abandon( ) System located at �-� GOti-r %� G�pG and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. t' Provided:Constructi n ust b completed within three years of the date of this it. Date: Approved b Y G Usi99 NOTICE: This Form Is To Be Used For the Repair Of Failed Septic Systems Only. - CERTIFICATION OF SKETCH -N-D APPLIC 70N FOR A DISPOSAL WORKS CONSTRUCTION PERMIT (W=OTj-T DESIGNED PLAYS) /J hereby ce:tiiy that the application for disposal works construcrion pernit Sinned by me dated 113�y� concerning the grope-ty located at zoA.� meets a1i of she following criteria: or • T'ne failed system is conner ed co a residential dwelling crtiy. i Here are no ccmme:c:sl ar business uses associated with the dwellins. • The sail is classified as CUSS I and the percolation rate is less than or equal to 5 minutes per inch. • 7,lere are no wetlands within 100 fee;of the proposed septic sIsem • T'nere are no orivate wets within tfm fe`;of the proposed septic sJse n • There is no increase in flow and/or change in use proposed • There are no varianc= requested or ne_ded. • i fie bottom of the proposed leacain;facility•viil not be located less than five fee;above the maximum adjusted�ouJadwate:table e'.r�ation (?djust the oundwater cable using the F imptor method when applicable] • if the S.A.S. will be located with 250 e_;of any vege=ced wetlands. the baaam of Lhe proposed leaching facilicr will net be lccated less than fourteen(1 1) fee;soave the ma cimum adiused z*oundwater cable e!cvaeon. Please complete the followin;: A) Too of Ground Surface =it/aeon(using GIS information) 1 V B) G.W. Elcvation -the:'YLA2C. High G.W. Adjusmenc . C 17 ZENCE 8 E7,VEEN a,and 3 slGy�� 3 6 Da.i�. 6 (Sketch procosed plan of 5-.Te-n on oac:c;. q:::cakh;aidc- 1 „ mob\ i CERTIFIED SEPTIC SYSTEM REPORT FMWWSMAANSTAB[1]E D w® 2 8 1 7 Ma LOCATION LTH[CEP.4. 43 LONG POND CIRCLE CENTERVILLE, MA MAP 209 PARCEL 031 PREPARED FOR SELLER ATTY. JAMES WILSON ✓�� 6 P.O. BOX 279 HYANNIS, MA 02601 �19 � BUYER � T MR. & MRS. THOMAS L. BODUCH 31 WEST MINISTER RD . CENTERVILLE, MA 02632 PREPARED BY HILLIARD HILLER, JR. . P .O. BOX 250 CENTERVILLE, MA 02632 508-778-1472 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM Address of property 113 LovG �o,�o C/2GL�' owner's name '11,4yrs 4",/c6a0" Date of Inspection (-1jy/yS" -& PART A CHECKLIST Check if the following have been done: 1/ Pumping information was requested of the owner, occupant, and Board of Health. None of the system components have been pumped for at least two weeks and the system has been receiving normal flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this inspection. As built plans have been obtained and examined. Note if they are not available with N/A. The facility or dwelling was inspected for signs of sewage back-up. r/ The site was inspected for signs of breakout. All system components, excluding the SAS, have been located on the site. The septic tank manholes were uncovered, •opened, and the interior of the septic tank was inspected for condition of baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge, depth of scum. The size and location of the SAS on the site has been determined based on existing information or approximated by non-intrusive methods. The facility owner (and occupants, if different from owner) were provided with information on the proper maintenance of SSDS. SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION FLOW CONDITIONS If residential y number of bedrooms o number of current residents W. garbage grinder, yes or no YSS laundry connected to system, yes or no _A seasonal use, yes or no If nonresidential, calculated flow: Water meter readings, if available: 199y yo�oo� �r9G 1a143 y7�o Gift Last date of occupancy1"A GENERAL INFORMATION Pumping records and source of information: .uo RmcoQO /,DPiv nleu�/1 past c��,v. /Z _ System pumped as part of inspection, yes or no if yes, volume pumped Reason for pumping: Type of system r/ 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) Other (explain) Approximate age of all components. Date installed, if known. Source of information: DATE o,61 L��l1T/��,e1T`� O.� Cyh c'Gl�.riGF l(JD Sewage odors detected when arriving at the site, yes or no SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SEPTIC TANK: 4-111 (locate on site plan) depth below grade: 6" material of construction: concrete metal FRP other(explain) dimensions: _8�34' k 3 a�� �o4 y'O%y ,tiC O /O" sludge depth y" distance from top of sludge to bottom of outlet tee or baffle 3 scum thickness 73'a" distance from top of scum to top of outlet tee or baffle Vla' distance from bottom of scum to bottom of outlet tee or baffle Comments: (recommendation for pumping, condition of inlet and outlet tees or baffles, depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage, recommendations for repairs, etc. ) 7'11 VA- .4,vo 719,6S G129,r40 60120 4Z4.t.1GZ DISTRIBUTION BOX: (locate on site plan) r o- depth of liquid level above outlet invert Comments: (note if level and distribution is equal, evidence of solids carryover, evidence of leakage into or out of box, recommendation for repairs, etc. ) LC GiZd�� , Nd SoL/,QS ���b S,Ei��•C�TD� � TI.r/.CL.t> PUMP CHAMBER: NV (locate on site plan) pumps in working order, yes or no Comments: (note condition of pump chamber, condition of pumps and appurtenances, recommendations for maintenance or repairs, etc. ) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued, SOIL ABSORPTION SYSTEM (SAS) : (locate on site plan, if possible; excavation not required, but may be approximated by non-intrusive methods) If not determined to. be present, explain: Type G�leaching pits and number leaching chambers and number leaching galleries and number leaching trenches, number, length leaching fields, number, dimensions overflow cesspool, number Comments: (note condition of soil , signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,etc. ) p/T ,y�i Or07Z,►/LlD �� S�G.y o� ,4o�V.b/.r�G U/C ,eXc�Ss . CESSPOOLS (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 (cesspool must be pumped as part of inspection) Comments: (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, recommendations for maintenance or repairs,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, recommendations for maintenance or repairs, etc. ) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B SYSTEM INFORMATION continued SKETCH OF SEWAGE DISPOSAL SYSTEM• y3 L avG .40�o Gs2cG,� ��.r//L'itvlLG/c' include ties to at least two permanent references landmarks or benchmarks locate all wells within 100 ' N�sE G/t/L.9lfh d I W I LI _ DEPTH TO GROUNDWATER 6,011 depth to groundwater method of determination or approximation: LIM S ?c3 7'H o p THE 11V41 'r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C FAILURE CRITERIA Indicate yes, no, or not determined (Y, N, or ND) . Describe basis of determination in all instances. If "not determined" , explain why not) o Backup of sewage into facility? No Discharge or ponding of effluent to the surface of the ground or surface waters? w )V4 Static liquid level in the distribution box above outlet invert? 111 Liquid depth in cesspool <6" below invert or available volume< 1/2 day flow? W Required pumping 4 times or more in the last year? number of times pumped —A-Ly Septic tank is metal? cracked? structurally unsound? substantial infiltration? substantial exfiltration? tank failure imminent? Is any portion of the SAS, cesspool or privy: 1W below the high groundwater elevation. _ U2 within 50 feet of a surface water? _ within. 100 feet of a surface water supply or tributary to a surface water supply? U�;' within a Zone I of a public well? within 50 feet of a bordering vegetated wetland or salt marsh (cesspools and privies only, not the SAS) ? W within 50 feet of a private water supply well? N� less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis? If the well has been analyzed to be acceptable, attach copy of well water analysi, for coliform bacteria, volatile organic compounds, ammonia nitrogen and nitrate nitrogen. TOWN OF BOARD OF HEALTH SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM - PART D - CERTIFICATION -TYPE OR PRINT CLEARLY- PROPERTY INSPECTED STREET ADDRESS 413 Love /6o, IQ Gi/1GG,C ASSESSORS MAP, BLOCK AND PARCEL OWNER' s NAME Tf1�s R L�/GSow PORT D - CERTIFICATION NAME OF INSPECTOR COMPANY NAME COMPANY ADDRESS /JO /34l,< Street Town or City State ZIP COMPANY TELEPHONE ( � ) �)� - ��172 FAX CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system ai this address and that the information reported is true , accurate , and complete as of the time of -inspection . The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one : L/ System PASSED The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form. System FAILED* The inspection which I have conducted has found that the system fails tc protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303 , and as specifically noted on PART C - FAILURE CRITERIA of this inspection form . Inspector Signature12 Date 7 {' One copy of this certification must be provided to the OWNER, the BUYER ( where applicable ) and the BOARD OF HEALTH. * If the inspection FAILED, the owner or operator shall upgrade the system within one year of the date of the inspection, unless allowed or required otherwise as provided in 310 CMR 15 . 305 . partd.doc 1 / ' �_ 7S F$s....... v�... THE COMMONWEA"H OF MASSACHUSETTS BOARC OF. HEALTH lD.W.... j............'OF...../ ,t91LN..S.7ii..13. .E.................................. AvOiratiutt for D..p,nlittl orku Towitrurtiun Urrutit Application is hereby made for a P-rmit to Construct (✓) -or Repair ( ) an Individual Sewage Disposal System at .0A1_Cx..../�o N.D....e!-RQ'A --•......................... .............L U .e.Ns r Lo Loeption•AddresJ o ,r 4R LEnJ' d ��-Sv'J ......14!�.RL14b?.H.!�!�.1�. ....... fY_ .!11.!STI ..---....••---...-•---- .....---.............. ........_._. .....€.... ..9. J.....1�.............. - Owner nadr... W N!.4CEe,�� ..._.! l`1!..�Q ��r� 02LE �?,I_�./'7!�:.... Installer dress Type of Building ... Type feet Size Lot....-... U Dwelling—No. of Bedrooms..............9...........................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons-__---__--__--__-.--__._.-- Showers ( ) — Cafeteria ( ) a Other fixtures .................................... . bCdr o0 Design Flow..../1.0..•-= g P 1 1� Y Y 3 . ......................gallons. W ............. allons er er day. Total daily flow..__...... .... WSeptic Tank—Liquid capacityJQQ:6gallons Length................ Width.._......._..... Diameter.........._._... llepth._..._. ........ x Disposal Trench—No..................... Width................... Total Length..........._...... Total leaching area....................sq. ft. Seepage Pit No...._./.............. Diameter.....8........... Depth below inlet.....�p........... Total leaching area.. 4? .....sq. ft. Z Other Distribution box ( ) Dosing tank '~ Percolation Test Results Performed by.... ../?_Y..4.,62.....L�. ............................... Date.... ............... Test Pit No. I................minutes per inch Depth of Test Pit.....1.2...._..... Depth to ground water..iY�T.Foun!� 2 .. Test Pit No. 2_kS.S_......nminutes per inch Depth of Test Pit...../..z...__.... Depth to ground water........................ TPsrP.r 3 .._wafrr ......................................................... O Description of Soil....._2.�../S?9.r'1.�...,la�. �?'..L'O�!�,5�... .Mc°�r.S�. ?.....i Q o o.(C5 ..T. v4`.1.as�m.y.. .Q0.r. ...---4--`--�'oar..zc..:!a�d..._t?a _...Tr..N�_.19E. . ---.....----•--•-------••...................................... W --- •--•..................................•--••••••...........••--••-•-•----•-----•---....-•----...._..---------•----••--.._.......-•--•••-•--•-•-------•••-•---••---.......---........,........._...... UNature 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 TITLS; 5 of the. State Sanitary Code— The undersigned further agrees not to place the system in ope atio n ' rtific to Compliance has been is ed by the board of health. L�� / ......... - Signed_.... ...._,. ......... .._ o-� Date App'cation Approved BY•--•-.--- -.••-Q-e• C7��-�t..................................•--••------ 1.1..-.�.S-.?. .... Date Application Disapproved for the following reasons----------------•--------------------------.---------------------.-..------------.------------------------------- ................. . . ......................................................................................----•-•---•......•--.....-- ._... ,_... = Date ..... Issued-:...--= ....Permit No.--•.............. ............................ Date THE COMMONWEALTH OF MAS$ACHUSETTS - BOARD OF HEALTH ........ "o..�v."d..........OF......... /4!z,l✓..S;eefa.Z e............................ &rtif iratr of Tontpliattrle THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( �r Repaired ( ) by...........4k__C_/1........ ....................................................................................................................................... Installer at....... T........., /........... -4,4✓ ......... O,hI D C.Ik t1,C...._..-CEO/ 1,2Lc/L.G. .................................... has been installer) in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the. application for Disposal Works Construction Permit No, .._.7- s............. dated..................................................... - THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTI? ,SATISFACTORY. t Y�-./� .......................... Inspector..........� ... .._..----..............----.............. DATE............ .............-----............ � .--------•-------•- .C. Fr� C.T. l'.'�:`;•,_.�LE. E3.VFRs J � To 04 R S14 �✓�, `/5S/ ri,7!/ _ ♦ f � :, i v r i>., R i �oi 5 ~ -'_ _ _-• ' _,� �..�$" fie.. � ;.. � . . 4,,. ,.• - / ..' .. /�. , •�~ , t aC�f* } `1 4 Wv '.�/`,7l(FJ'?':'.J ..?I"C ��„l I'c) D /;•. 5 oX •y t d i SrJ . �TFE. . SN�tIL PF cA St (FONr�. 1-0 $E WS7-ALA.&p'.ON A TV P-E hV 5TA L l_ F.D ON 4. L St 9 ti `. LF_-VEL ST.�BL.. BASE ` ,/ ' /yY �t rrr 91 �'. Y�'Y d•i f •�••—.` •mow � i � 1' aj �� . 3 gas A 4 D!• 3 1. X i^ Y I / •� ;' ,rT�Sf �.Y+".t' '= P,f r =��.3�, +K '"sf'Jr = /.. � .,� • '' ,. S -.)�ar��� -.....'�. .` -..;....+� �` a t^'�' �" r > � � 1,t_ fit' t e•/• --r- •`'> 2� ����s i��.��.f 3,�'�`4•.\ VE`P/1 r' • a r .r 'E �ftF'�!r� a l. 1 y _ .._. ._.__.17 )4Tf� I T- 7q a. -17,5 EcEL✓ �IEV, 1 L _ tA AJ P 5yN.L tirJ 7 jr- 1 AJO W a rye TERRY A. RYDER 029656 +► CIVIL Yb" Y p f/j 0. f I j P -� w A \. ! (7��.�,..� r Tj �,p r� j £ - . 10 Xv • -.•, 2 __, ` ass. . , ' ., . e HsE , LOCATION - �3 SEW _ E PERMIT NO;. VILLAGE INSTA LLER'S NAME & ADDRESS D U-ILDE R OR OWNER C 6 DATE PER IT ISSU 'D DATE COMPLIANCE ISSUED �. KEY NUMBER <6385 > NAME .<WILSON, JAMES R > B-C , 1 B-C 2 B-C 3 B-C 4 STREET P 0 BOX 279 CITY HYANNIS ST MA ZIP 02601-0279 REF 1 REF 2 PHONE ( ) REF 3 REF 4 METER NO. < 5938> DATE READING CONS STREET <LONG POND CIR NO. 43> 12/31/94 54. 24^ CITY CEN K ST LOC 06/30/94 30 16 `/` . PHONE (508 ) 771-4406 12/31/93 14 29 09/14/93 0 0 ROUTE NUMBER 22 09/14/93 855 15 �7 SERVICE DATE 12/26/79 06/30/93 840 3 METER DATE 09/14/93 12/31/92 837 6 � CAPACITY 7 06/30/92 831 3 STYLE T10 SIZE 1 RATE SCHEDULE KEY PIT PLASTIC NOTE RR LEFT SIDE ADDITIONAL CONS 0 ALTERNATE MIN 0 TOWN OF BARNSTABLE LUCA i iON _IY3 Ld. /S.eo G1/I64X SEWAGE # 79 -75r a VILLAGE ASSESSOR'S MAP & LOT 2Ef/C�3i INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) 41 T (size) xL NO.OF BEDROOMS 41 FOR OWNER /I/7Y JSDI1s14S PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater.Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet Furnished by b 7l��jq!r f - o�rod �i o 7 Ch v a-0 N .:�.��.. ... S . .. `: Fis....... �. ... THE COMMONWEALTH OF MASSACHUSETTS BOAR® rOF HEALTH ....-TOW..hJ..............o F.Z f 1�,.A N.-S.-rA.73 6.46.�------------............--------- Appliratiun for Disposal Works Tuntrnrtiun ramit Application is hereby made for a Permit to Construct `V ) or Repair ( ) an Individual Sewage Disposal System at ........ ......................... ------•----•-------•----------•-- -------------------------•--------•-----------•---•----....--.------------..-..-..---------------- Location-Address' or Lot No, •-----•--- ieL, �l ..... °_9.�'? ,� !Ls�-------------------- ------1 ................ .... Owner Address a , �o0v s ( r O2L� Installer Address Type of Building Size Lot... ------Sq. feet Dwelling—No. of Bedrooms.............3_._................__......Expansion Attic ( ) Garbage Grinder ( ) Other—T e of Building No. of persons............................ Showers a YP g ---------------------------- P ( ) — Cafeteria ( ) Otherfixtures �d�oo:;,----•----------------------------------------------------------------------------•---------------- W Design Flow..../La..............................gallons per 1 per day. Total daily flow.........�_-.p......................gallons. WSeptic Tank—Liquid capacity./QS�gallons Length................ Width................ Diameter---------------- Depth................ x Disposal Trench—No....:................ Width.................... Total Length.................... Total leaching area--------------------sq. ft. Seepage Pit No....../.............. Diameter-----8_...._..... Depth below inlet.....6........... Total leaching area.ZQ9._...sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.... 7•/Z P4-lC..-..f'•_ :.............................. Date....g1ZB 17?.........._.... Test Pit No. 1................2 minutes per inch Depth of Test Pit....d-2......... Depth to ground water..Ya�F®t?tNv 44 Test Pit No. 2�W�+2nlmutes per inch Depth of Test Pit-----/1......... Depth to ground water........................ Ix -reJ 'T 3 Sr O j"ci✓!� GJQfPr O Description-of Soil...... W x ---------------------------------------------------------------------------------------•-----------------------•--••-•-•••-----------•----•-••--------•-•-•--•----•••••-------••----••--------------•-- U 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 TITi 1Z 5 of the State Sanitary Code— The undersigned further agrees not to place the system in ope n�rtih tej4 Compliance has been is ed by the board of health. r � Signed----- -•----,----•-• -•--�--�'-'�"•'�•---------••------------------ ..... --•- pal--`-` "_V914 Date ApprovedBy...... � { /....-•----....---••..............•--------- 11 Dot ------------ Application Disapproved for the following reasons:---- •----------------------•---------------------------------------------------•-------- ...................... ------------------------------------- •••----------••--•--•----------•---••••---.......------.....•---.._.....---•---•-------------•-••....---•-..................................................... Date Permit No......................................................... Issued-.' Dat--e---------------------•-------- N ........ ............. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Apfira#ion for Bisps al Warks Toaasirurfion permit Application is herby made for a.Permit to Construct (V� or Repair ,( ) an Individual Sewage Disposal System at: ............................. .....•------•- "fir- ---��-'-�--�� ----------------------•-------....----..............-- - t Loc tion-Address or Lot N ..........lie �c cs -------------- JL..Atet��.' .__...: _A_cu_n)a...................... ,Owner A� - r� Address ............... � !969 _.....0719:......................................... Installer Address UType of Building Size Lot---- t_Q _U.....Sq. feet Dwelling—No. of Bedrooms_____________..___________________..____Expansion Attic ( ) Garbage Grinder ( ) a Other"—Type of Building ____________________________ No. of persons............................. Showers (, ) — Cafeteria ( ) Other fixtures rGai ............ % W Design Flow____1 ________________________________ gallons per Ter day. Total daily fl w ________-3_�4" .....................gallons. WSeptic Tank—Liquid capacity allons Length________________ Width__ ____:Diameter_____-__________ Depth................ x Disposal Tench=.No::`__________ Width.................... Total L ngth Total•leaching area.....__________...._sq. ft. r Seepage fit No._.___y/.....__.___ Diameter..__.___.__._.._ Depth below inlet ;tea. :._._... Total leaching area__2.Q....sq. ft. Other Distribution box f Dosing tank a Percoldtion Test Results Performed by..... _ )9Q _'.....� ��•_�________________ _________ Date____.1A 9.17?__..___.:_ Test Pit .No. I................minutes per inch Depth of Test Pit.....i.V..... Depth to ground water....d'XAkT_ QgNV 44 Test Pit No. 2434 64iiiinutesper inch Depth of Te t'Pit______ . '`_._._ Depth to ground water......................... opt I D Description of Soil........ ._ t?st_rx3- --J'P.&e .---�! '44s^',1 ._._ M..t1_u_!e� S pras _ -- - ,-- `• ---f.. ----7-/E...� .•------•------•-------- ... h„ U 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 TITLE 5 of the State Sanitary Code— The undersigned further agreesnot to place the system in ope do n rtifi to , Compliance has been is d by the board of health. w - $gned yam' / APP icarion Approved BY - � I // f D27 ----• w Date • Application Disapproved for the following reasons:,"' :-----•---------------•------•---- ;. ---•-•-•-•----•--------------------••---......--•----=---•----------..---------...-------...--------•-••----•-•--•---------------•--------------------------------------------= == Date,. Permit No..._... Issued.......�':` , Date THE COMMONWEALTH OF MASSACHUSETTS } BOARD OF HEALTH ........ .,V.........oF.........� a I</1LS � '3Lje............................ I� Trr#ifiratr of from Iia r � or THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) � 6 by............ C,-r�°�-••----- ----------------------------------------------------------------------------------------------------------------------------------------- Installer AP has been installed in accordance with the provisions of TITLE j of The State Sanitary Code as described in the application for Disposal Works Construction Permit No(" .....;755_------------- dated THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTI - ATI'SFACTORY.. � _ �,� DATE------------- ! Inspector -•-•--• ........................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH O._ ... .......... 4.,.,)-AJ............OF....._.._. i/Y ICIJ- -/-•� ........................ FEE...... d �io�oo�t1,{� �x�k� C�oa�o�rion rrutii Permission is hereby granted----•----�,Y ecc/ -.......... �11J !--------------------------------------------••---------....._......---•-•--- to Construct ( Uor Repair ( ) an Individual Sewage Disposal System atNo.....4d-�� ✓' ........4 -�______ ---------------------•----......---•-- Street as shown on the application for Disposal Works Construction Permit No...............J__._ Dated............ rd of Health DATE......... L ........................................... FORM 1255 HOBBS & WARREN, INC., PUBLISHERS / - T -: ,,y}.. �(JlJtlllltOtt 1G"PILCt� G �t�J�z�ftc�J�ff,L Ilel •A--e7lal/lmflc�n- it Llt%s���zG e liu �G �irrPh• •la//.�nilAl!JJiti�ir'iir�, �6r�(lrnrn��c!�ll(irltr August 2 , 1979 Terry 'A . Ryder , P . E . Box 1145 , 167 Pleasant St South Chatham, ,"ta 02659 Re : -Appl . 35682 P . E . ( Refer to this number in 'a ] I correspondence . ) Dea r Mr. Ryde r: In accordance with Section 81R- (c) of Chapter 112 of the General Laws , you are hereby granted permission to practice engineering in the Commonwealth of Massachusetts for a period of thirty (30) days from August ] , 1979 or until such time as the Board needs for final action on your application for registration in the Commonwealth . It is the recommendation of this Board that when you have to use your California Sea ] on a document in Massachusetts a photocopy of this letter should be attached to the document . Very(�trunlyQy urs (° G . Dale Sheckels , P . E . Secretary GDS/ fm w. ._..... .--.. .+.nrre-.....w°..... .,..._......,. .._..,.... ..-..:....w_—_.,_..—...,._......... ..._...i.-...+.+,....d..+ems.,. A. - ��¢'�,� � __ � i , ?�,• !'©i�'�R`. ,,� _ err '� ;;,, ' i t E f r, t r!�tJ f /°` 1 i r E+9tN i it/ ER, �M Y H Y 7,._ ii lie- 1 i�rV. 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