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HomeMy WebLinkAbout0100 NYES NECK ROAD - Health 0 0 �J e-c-L mot ,, Town of Barnstable Ins pectional i '�,� spect oval Services Department Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas McKean CHO FAX: 508-790-6304 Yvonne Cavallini-Mudge 100 Nye's Neck Road Centerville MA 02632 RE: IA Septic System 100 Nye's Neck Road, Centerville MA A= 233-066 Dear Yvonne Cavallini-Mudge, After a review of your IA septic system monitoring situation, the Health Division has determined that it is important to help your FAST septic system get back in compliance. We have reduced the O+M requirements to once per year and waived the sample testing for 2020-2021. We can reexamine the situation in December 2021. The goal in the future is to schedule the operation and maintenance check to twice a year with one annual testing of effluent. We have sent a copy of this letter to Wastewater Treatment Services Inc. and Tracy Long at the County Department of Health and Environment. If I can answer any questions do not hesitate to call me 508-862-4641 Best wishes, Karen Malkus-Benjamin Town of Barnstable Health Division 200 Main Street Hyannis, MA 02631 karen.malkus@town.barnstable.ma.us ORBCDHE BAR6tAELE COUWY DEFARILINT OF HEALTH ANo ENVi;CNM TT 1y PROMOTE-PROTECT-SUPPORT r" •# 1926-2016 4— March 6th, 2020 Yvonne Cavallini- Mudge 100 Nyes Neck Rd Centerville, MA 02632-1752 RE: Operation and Maintenance Contract for the Innovative/Alternative Septic System Installed at 100 Nyes Neck in the town of Barnstable. Dear Yvonne Cavallini- Mudge, Our records indicate that the operation and maintenance contract with Wastewater Treatment Services for your innovative/alternative wastewater treatment system may have expired or was canceled as of January 18th, 2019. To date we have not received evidence that you have entered into a new operation and maintenance contract. I am writing to remind you that the Massachusetts Department of Environmental Protection (MA DEP) and the Town of Barnstable require you to keep an operation and maintenance(0&M) contract in effect at all times for your system. Information about these requirements may be found at htt sp ://septic.barnstablecountyhealth,org. You can access the list of wastewater operators of whom we are aware do business in Barnstable County. This septic database also provides further explanation about your I/A septic system, as well as any sample and inspection history for the performance of your system, as entered by previous service providers. My department oversees I/A septic system management and compliance efforts for the Board of Health in your town. We are authorized by your Board of Health to contact you to inform you of the above requirement and to request your compliance. Accordingly, please forward a copy of a signed contract via mail, fax, or e-mail within fifteen (15) days of receipt of this letter. For your convenience, I have enclosed a list of wastewater operators we are aware of that do business in Barnstable County. The firms listed operate multiple types of I/A technologies and are not associated with any particular technology or vendor. Please be advised that if you do not respond within fifteen (15) days of your receipt of this letter by forwarding a copy of a signed contract, you may be referred to the Barnstable Board of Health for further enforcement action. I can be reached at 508-375-3645; my fax number is (508)362-2603. 1 can also be reached via email at tacy.long@barnstablecounty.org. Thank you for your prompt attention to this matter. Sincerely, Tracy Long CC: Barnstable Board of Health Enclosures (2): Certified Wastewater Treatment System Operators List, Inspection and Testing Requirements BARNSTABLE COUNTY COMPLEX 3195 MAIN STREET/PO BOX 427 BARNSTABLE,MASSACHUSETTS 02630 Phone:(508)375-6613 1 Fax:(508)362-2603 1 TDD:(508)362-5885 Web:barnstablecountyhealth.org I Twitter:@BCHDCapeCod `f!' iJ/`E'L�i�72P,/lf cJeiYX,l,P.6r, �2G. 44 Commercial Street Raynham, MA 02767 Tel: (508) 880-0233 Fax: (508) 880-7232 January 19, 2017 Barnstable Board of Health 200 Main Street Hyannis, MA 02601, Attention: Board of Health Agent Reference: BioMicrobics FAST Treatment System Serial Number: 0208438 To whom it may concern: Attached please find a copy of the Product Registration Report for the FAST Treatment System, for the startup performed on 1/18/2017 at the home of Yvonne Cavallini Mudge located at 100 Nyes Neck Road, Centerville, MA. Also, attached is a copy of the fully executed Operations& Maintenance Agreement. If you have any questions or require additional information please do not hesitate to call. Sincerely, Sharon M. Foster s Enclosures I C 0 R A T E D 8450 Cole Parkway Shawnee, KS 66227 Phone 913-422-0707 Fax: 912-422-0808 e-mail: onsite(a)biomicrobics.com *www.biomicrobics.com***800-753-FAST(3278) PRODUCT REGISTRATION PORT Product Registraltion eport must be completed and returned to Bio-Microbics, Inc. in order to effect warranty. Date of Start-Up Date Shipped to End User 10/14/16 Serial#0208438 OWNER NAME Yvonne Cavallini Mudge ADDRESS 100 Nyes Neck Road CITY/STATE/ZIP Centerville,MA 02632 PHONE/FAX BIO-MICROBICS DISTRIBUTOR NAME J&R Sales and Service,Inc. ADDRESS 44 Commercial Street CITY/STATE/ZIP Ra nham, MA 02767 PHONE/FAX 508-823-9566 FAX: 508-880-7232 INSTALLER NAME Bortolotti Construction ADDRESS P.O.Box 704 CITY/STATE/ZIP MARSTONS mILLS,ma 02648 PHONE/FAX 508-428-8926 CONSULTING ENGINEER if applicable) NAME Down Cape En ineerin ADDRESS 939 Main Street CITY/STATE/ZIP Yarmouthport,MA 02675 PHONE/FAX 508-362-4541 Good Bad NA Good Bad NA ELECTRICAL PANEL(S) TREATMENT UNIT(S) Visual Alarm Operating �/ Air vent clear M/ C3 Audio Alarm Operating r9/ o o Septic tank level gK C] BLOWER(S), Septic tank meets min. size 2/ C3 Wired for correct voltage Septic tank filled to 01- operating level Inlet/outlet piped correctly 9 Air Lift Operation Filter element installed 211, Recirculation tube in place Blower hood secure r3/ Fasteners tight Blower works correctly WATER-TIGHT JOINTS Blower located within 100' of �/ Treatment unit to septic tank treatment unit I Air line clear Entrance tube to insert cover g" 0 0 Air inlet screen clear Insert to insert cover / Blower hood vents clear Discharge line connection AA Factory Authorized Personnel: Title: Firm: Wastewater Treatment it es / Date: 44 Commercial Street Please complete all items marked Raynham, MA including three signatures. Mail 02767 signed original contract to: wastewater Treatment Swices.Inc. 44 Commercial Street Tel:(508)880-0233 R=ham.MA 02767 Fax:(508)880-7232 INSPECTION AND EFFLUENT TESTING AGREEMENT Agreement entered into by and between Wastewater Treatment Services,Inc.(herein called WTS)and the FAST®System OWNER(herein called OWNER)for the inspection by WTS of certain equipment of OWNER which is described below. Upon acceptance of this agreement at WTS's office,WTS will render the following services only: Equipment will be inspe t d a e# t 4 times per year that this Agreement remains in effect,with the first inspections beginning - These inspections will include: 1) Testing of the sludge depth in the septic tank. 2) Inspection,power testing and clean/replace intake filter of the air blower. 3) Inspection of the alarm system. 4) Inspect overall condition of FASTO System. 5) Notification to OWNER of any problems encountered. 6) Service other than routine maintenance will be billed at an hourly rate,plus travel and pants. WTS shall notify the local Board of Health and Department of Environmental Protection in writing within 24 horns of a system failure or alarm event including corrective measures that have been taken. OWNER will be billed standard WTS charges for any parts used in repairs or maintenance. Any additional labor time will be billed to the OWNER at current labor rates of$80.00 per hour. Emergency service between regular inspections will be provided at standard labor rates during normal business hours;at time and one-half after 5:00 PM and on Saturdays;and at double time on Sundays and holidays. Emergency service chargds will include a minimum four(4)hours of labor, plus standard WTS charges for parts,plus mileage and travel charges. The annual rate includes routine maintenance,but does not include repairs required for damages caused by abuse,accident,theft,acts of third persons,forces of nature, or alterations made to the equipment. WTS shall not be responsible for failure to render the agreed services if caused by strikes,labor disputes,non-cooperation by OWNER,or other factors beyond the control of WTS. OWNER understands and agrees that WTS is not responsible for special,incidental or consequential damages,including but not limited to loss of time,injury to person or property,or equipment failure. OWNER agrees that WTS may enter OWNER'S property and have acceptable access to all areas deemed by WTS to be necessary or appropriate for WTS to perform its duties hereunder. Current WTS practice is to send OWNER approximately 10 days before expiration of the term of the current contract an invoice for one year of service. It is OWNER's responsibility to timely return the payment. WTS must receive the payment before expiration of the current contract year to assure continuous contract coverage. Failure to return payment may result in suspension of service,cancellation of the contract and/or nullification of warranties,at the election of WTS. OWNER may not assign this contract without the prior written consent of WTS. It will remain in force until a party cancels by written notice to the other at the address given herein. MANUFACTURER MODEL NO. SERIAL NO. LOCATION ANNUAL RATE Bio-Microbics MicroFAST 0 Centerville,MA $460.00 EOUIPMENT OWNER Wastewater Treatment Services Inc. *Signed by OWNE cw� �i� 2`l�tt � � v Yvonne Cavallini Mud a Signed: T � *Address: 100 Nyes Neck Road 44 Commercial Street Raynham,MA 02767 Tele:(508)880-0233 *City: State: Zip: Fax:(508)880-7232 Centerville MA 02632 Effective Date of Agreement &Mail address:Y$/me OWNER understands that(1)ANNUAL RATE payment is for one year only commencing on the effective date set forth above and is non-refundable;and(2)Current DEP Regulations require OWNER to maintain a service agreement for the life of the TASV System. I HAVE READ AND UNDERSTAND THE FOREGOING. *Signed by OWNEI� � >r ��y � Effluent Testing Effluent sample taken 4 times per year for 2 years and delivered to a qualified testing lab for evaluation. Results sent to State and local Agencies as well as the OWNER. OWNER is responsible for providing acceptable access to effluent to enable a grab sample to be taken for laboratory testing performed. PERMIT: *(PLEASE CHECK ONE) ( )GENERAL { X )REMEDIAL ( )PROVISIONAL *SPECIAL CONDITIONS PER LOCAL BOARD OF HEALTH(Y)or(N)if YES,please attach copy of permit (X)pH,BOD5,TSS,Nitrate,Nitrite,TKN,Alkalinity ( }Other: *Cost for testing: $2290.00/Visit Operator assigned: Michael Moreau Telephone: (5081989-2744 *Approval for Effluent Testin rig Owner's Signature - — - J& r fv No I /i- ` Fee 7l./ THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:J1/ PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes RpPlication for Misposal *pstrm Construction Permit Application for a Permit to Construct( ) Repair X Upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No. /00 A1V &kck Qd Owner's Name,Addr ss,and Tel.No. ?*)41- 13WO Assessor'sMap/Parcel � n �V X0I��+n� ,� Instal er's Add''re ,,aai�d Tel.No. 5�-0 1#"7 37`9 Designer's Name,Address,and Tel.No. o ©°f�n$t> Ao•I ox 7e L/ Dc.,on C�c��¢_ s ex/i neeb-i Ix ITne- In rQ?4 i 7 S/,-- s Type of Building: � re f}��e.� Dwelling No.of Bedrooms Lot Size 39 I D& sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) 5,30 gpd Design flow provided 3,33 gpd Plan Date I�v a15,a0Ilo Number of sheets / Revision Date.,5.p"„$;atQjlE, Title' S' vo ru 1 Size of Septic Tank/y% pQ g, — 6 / � [ Type of S.A.S. '3X ° o�• Description of Soil Au Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code 7place the system in operation until a Certificate of Compliance has been issued by this Board of ealth. ,J Signed Date Sign er/C6 Application Approved by Date o Application Disapproved by Date for the following reasons Permit No. 2�f ,Y( Date Issued to t7111 --- ------------ ------ ------- - r 4 t J E No. 4� � .r✓ Fee t.t THE'COMMOI&ALTH OF MASSACHUSETTS Entered in;computer Yes _� �- PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS. Application for -Misposal 6pstrm Const action Permit Application for a Permit to Construct( ) Repair 4-Upgrade( ) Abandon( ) Complete System ❑Individual Components - Location Address or Lot No.100 AJ�0 (144 PJ Owner's Name,Address,and Tel.No. `���1-3a'I_ &a(6 Map/Parcel e.E'p/ e✓LRO-P y(JDII hL° CQ�xt.l j►n j /✓yo ILL IG Qp' P �r Assessor's Mali4fu;I I' On3 Installer's 1�Jgrye`,Addre qnd Tel.No. 5?�$-7�1�—�!39g Designer's Name,Address,and Tel.No. 5��6 3[0�- S/`JY/ rho ns�'v� lGr" -nc. -o•/�X 7ae/ tDcu�n Ompo- EuI i neer'; ,Tnc 13g X'lui� S¢ S s G, �G r . Type of Building: Dwelling No.of Bedrooms .f Lot Size 39 I o_U*3� sq.ft. Garbage Grinder( ) t Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures .i Design Flow(min.required) '530 gpd Design flow provided 333 ,gpd 8 0�! Plan Date �[�', 95,o`1Gl4 Number of sheets / Revision Date � Title I,t-1- ~S /UU 1 Q LJJ 0031 Size of Septic T or, 6.'S Type of S.A.S. SX _ yp , �� 1�Ga,r�T�,M,k e Description of Soil Nature of Repairs or Alterations(Answer when applicable) + r 1 r� 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 th se ystem in operation until a Certificate of ' Compliance has been•issued by this Board o ealth. / ` Signed / Date q/&-A� Application Approved by Date o 7 �6 Application Disapproved by Date ,J for the following reasons Permit No. �. O 3 S ( Date Issued /p �� 4 ------------------------------------------=-------------------------------------------------------------------------------------------- J J �� )o ux � THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Eeftificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( Upgraded( ) f~'t Abandoned( )by 0)'IrtO C_ at I UU M le.,� �A. �e r��e�tJ i(fie, has been constructed in accordance with the provisions of Title p5 and the for Disposal System Construction Permit No. Z U 16 --y3.-( dated Installer N1 to�Gt.1 CA11Sc tC G46 , r+%C . Designer 01 6n1C;1L1 A11"r, #bedrooms 3 Approved design flow A gpd The issuance oIlk this permit shall not be construed as a guarantee that the system will c on t designed. Date f, Inspector _> I 'I , Qj . V ------------------/--------------------------------------------------------------------------------------------------,-�------------------- No. G r / Fes ! THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE, MASSACHUSETTS Misposal 6potem ConBtrUction Permit Permission is hereby granted to Construct( ) Repair(�� Upgrade( ) Abandon( ) System located at �00 ldli./r 418e.1 s_l• CPZT k.°V,Ile 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 m t be completed within three years of the date of this permit. Date ( �' / �, Approved by TOWN OF BARNSTABLE LOCATION hC Vr-�� SEWAGE# Ib-35 VILLAGE C07 OALVCL-LA ASSESSOR'S MAP&PARCEL Q3, INSTALLER'S NAME&PHONE NO. 9- C J• SEPTIC TANK CAPACITY LEACHING FACILITY. (type) ;r t!Ej��? (size) AC l 5 NO.OF BEDROOMS d: � gC P dL^ , - �.l t& OWNER Ctu, LcLjgf N' d-b4ey PERMIT DATE: - 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) �-%4• Feet FURNISHED BY '�—Z— 77�sL tom" & A- I 43 ' fit '6 K V !^I O�PI o, i Page 1 of 1 TOWN OF BARNSTABLE LOCATION lad r,N t f t1I bZK 1;�h, ..SEWAGE ft IFS t6-35 _ VILLAGE C,=),r,L-,Zt ,ul ;7 -ASSESSOR'S MAP&PARCEL INSTALLER'S NAME&PHONE NO. 5re5"171.13" SEPTIC TANK CAPACITY i 5� /�. O �7(GC��A3 r LEACHING FACILITY:(type) xr k t2 (size) P�15 -NO.OF BEDROOM_S ¢(rJ 4- w( OWNER Lout—N d-b4C nt�r•c{e PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility eet Private Water Supply Well and Leaching Facility(lf any wells exist on site or within 200 feet of leaching facility) eet Edge of A'edand and leaching Facility(If any wetlands exist within 300 feet of leaching facility) -\4 Feet FURNISHED BY 6C 1- .. i ' I�r�_p•F �t�� f ` .�7 A-1 a3 rl'6~ r e �cc,;cnZ k=3 16 a- $-3 1_4 t- �- A--S B•s sow 4100 Oyer Neck, 01 https://itsgldb.town.bamstable.ma.us:8431/Home/ShowAsbuilt?mp=233066&sq=1, 8/19/2020 a° 7 Town ®f Barnstable IME "o Regulatory Services Thomas F.Geiler,Director HaEwsTABIN, �cb ' . ,0� Public Health Division 1639. '°rEaanos°' Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Installer&Designer Certification Forma Date: I1V1 Sewage Permit# Assessor's Map\Parcel " Designer: �o;,J� � � �—C�'�ii rwr1�,� installer: + J {l Address: L,)� Address: a ol< /�7v On /1116, 4J),) was issued a permit to install a (date) (ifikaller/) / septic system at ! 0 0 I !/�t , based on a design drawn by (address) aA,r f -/ L a. P,9 dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or septic tank. i 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 m) but in accordance with State'&Local Regulations. Plan revision or certifie s-builfby designer to follow. �0 k OF 4fq 9� DANIELA. o OJALA s , {Installer's Signature) CIVIL N� o No.46502 �Y ` r n G1STti9- NNAL (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUEID UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. Q:Health/Septic/Designer Certification Form 3-26-04.doe r ' oFTHETowti Town of Barnstable Barnstable P Board of Health Ale-AmeriCaChy� BARN STABLE, MASS. a 200 Main Street,Hyannis MA 02601 rao 1 679 `�Ib AlE0 MPt° 2007 Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Junichi Sawayanagi Donald A.Guadagnoli,M.D. September 12, 2016 Mr. Daniel A. Ojala, P.E., P.L.S. Down Cape Engineering 939 Main Street, Route 6A Yarmouth Port, MA 02675 RE: 100 Nye's Neck-Road, Centerville, MA -A 233-066 Dear Mr Ojala, You are granted variances, on behalf of your client, Yvonne Cavallina-Mudge, to construct areplacement onsite sewage disposal system at 100 Nye's Neck Road, Centerville, Massachusetts. The variances granted are as follows: 310 CMR 15.211: The soil absorption system will be located 5.0 feet away from the property line, in lieu of the ten (10) feet minimum setback required. Section 360-1, Town of Barnstable Code: To construct a soil absorption system 21.9 feet away from the edge of a wetland, in lieu of the minimum 100 feet separation distance required. 310 CMR 15.405: The soil absorption system will be located four feet above the groundwater, in lieu of the five feet minimum setback required. Section 397-8, Town of Barnstable Code: To install a soil absorption system 101 feet away from the neighbor's well, in lieu of the minimum 150 feet separation distance required. Section 397-8, Town of Barnstable Code: To install a soil absorption system 146.8 feet away from the onsite well, in lieu of the minimum 150 feet separation distance required. Q:\WPFILES\Ojala 100 Nyes Neck Road Cent Aug20l6.docx v � Section 397-8, Town of Barnstable Code: To install a septic tank 59.4 feet away from the neighbor's well, in lieu of the minimum 100 feet separation distance required. The variances are granted with the following conditions: (1) The engineered plans shall be revised to show the location of the existing leaching pit. (2) The existing leaching pit shall be abandoned properly. (3) No more than three (3) bedrooms maximum are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (4) 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 (3) bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (5) The system shall be installed in strict accordance with the revised engineered plans. (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 revised plans. These variances are granted because the physical constraints at the site severely restrict the location of the soil absorption system due to its close proximity to wetlands and private wells. Sincerely yours, 4 "IC M Chairman Q:\WPFILES\Ojala 100 Nyes Neck Road Cent Aug20l6.docx SECTION' SENDER: COMPLETE THIS SECTION COMPLETE THIS ON DELIVERY ■ Complete items 1,2,and 3. A signature ■ Print your name and address on the reverse X•, , ❑Agent so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, B. Received by din Name) C.Date of Delivery or on the front if space permits. 1. Article Addressed to: D. Is deliveli Ar item 1? ❑Yes If YES,er>f Lrlry add r ow: ❑N 1 `�✓ 6, pa63k3. Service Type 0 Priority Mail Express@ ❑Adult Signature ❑Registered Mallrm ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted 9590 9402 1843 6104 6802 70 �CertifiedMail® Delivery Ch Certified Mail Restricted Delivery ❑Return Receipt for ❑Collect on Delivery Merchandise 2. Article Number_(Cransfer_from_service labell_ �_�; ❑collect on Delivery Restricted Delivery ❑Signature Confirmation7m �1 4 117 016'D 7 5 0''0'0 0 0 18 9 5 213 4 9 8�1 1 1(;Delivery ❑Restricted Deliverture y l PS Form 3811,July 2015 PSN 7530-02-000-9053 6ov-`I CAv� 0o tt Domestic Return Receipt USPS TRACKING# First-Class Mail Postage&Fees Paid USPS Permit No.G-10 9590 9402 1843 6104 6802 70 United States •Sender:Please print your name,address,and ZIP+4®in this box• Postal Service A Down Cape En ►neerirl939 Main Street 9, incIrt reet Suite � Yarmouth Port. MA 02675 so}iI ilj!'FI:dl F ! i I't ! �•i'jf i??i �FiFi:l' •F ii � I SECTIONSENDER: COMPLETE THIS SECTION COMPLETE THIS DELIVEPY ■ Complete items 1,2,and 3. A. Signature ■ Print your name and address on the reverse X ❑Agent so that we can return the card to you. fA ❑Addressee ■ Attach this card to the back of the mailpiece; B. R d (Prin C. ate o vev or on thii front if space permits. 1. Article Addressed to: D. Is de tivery dadres; ifferent from item 1? ❑Yes If YES,enter delivery address below: ❑No old (Blk, , ae !M G M � va�d II I II�III illl III I II I I I�I I II I I I I II I II I I I I III Service Type ❑Priority Mail la ® 113. ❑❑Adult Signature Registered MaHTiIT" ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted Certified Mail® Delivery 9590 9402 1843 6104 6802 87 Certified Mail Restricted Delivery ❑Return Racalpt for ❑Collect on Delivery Merchandise 2. Article.Numher(transfer from_servlr.P,lahell — O Collect on Delivery Restricted Delivery ❑Signature ConfirmationTM 7 016 0750 0000 8952 3481 W Delivery ❑Restricted Deliveryture Confirmation PS Form 3811,July 2015 PSN 7530-02-000-9053 QAr. CAA(- l90 tt Domestic Return Receipt 3-• '" First-Class Mail Postage&Fees Paid, USPS Permit No.GAD 9590 9402 1843 6104 6802 87 United States •Sender:Please print your name,address,and ZIP+4®in this box• Postal Service Down Cape Engineering, Inc. 939 Main Street, Suite C Yarmouth Port, MA 02675 ::, •Ffi if�i!e3Eii t3i'�iE f ::,s :i EEi3f Ira I ii I r ii� }'-tttEa I E�j'1i�E1 i1i► � � i � '�� �FTHE a lv� DATE: FEE: BARNSTABM y 6 9. CIA Town of Barnstable CT} 5CHED. DATE: , Board of Health 0 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 JunichiSawayanagi Paul J.Canniff,D.M.D. VARIANCE REOUEST FORM LOCATION Property Address: Assessor's Map and Parcel Number: 2Z3 - / C-- Size of Lot: Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name: APPLICANT'S NAME: ! ��`-�+�"b /'i 2 Phone '�'� T 3�-j Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON�( Name: IVot�W9 CkVA,L iAW/A -Mc &,C, Name: *7%50aTVL-41—n Address: wo N ve S 1JEl AL-- (&9- Address: 0o QC73o -I-0-+ M` �t LLZ7 Phone: Phone: -1 v ot3 `2 cl VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) NATURE OF WORK: House Addition ❑ House.Renovation ❑ Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) / Please submit copies in 4 separate completed sets. ✓ Four(4)copies of the completed variance request form 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 registered sanitarian Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) 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) WA-— Full 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.Canniff,D.M.D. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content_Outlook\BAJ9P9B7\VARIREQ.DOC AUG-02-2016 04:33 From: To:15083629880 Paee:1/1 Yvonne M.Cavallini (aka Yvonne M_Cavallini-Mudge) 100 Nyes Neck Road Centerville,Massachusetts 02632 (774)327-8210 To whom it may concern: I,Yvonne M.Cavallini,here by give permission to Down Cape Engineering to represent me at the Board of Health Meeting for approval of my septic design,for 100 Nyes Neck Road,Centerville,MA 02632. Sincerely, nn Yvonne M Cavallini I_ Yvonne M.Cavallini-Mudge r._:.-. -. - �.f .-..,..n... , .e.:::.a.:.�.'......::::�.,..:.:.:..a-:%:..:t:r:•: � _- - - - -- ...r.........r......................r_.............. 30.0' • o ri ! o 16.0' Wood Deck { I � r Dining Kitchen . 5 'To] 8 b B Area Bath Bath Bedroom 0 N closet n� � o �. Q Living Room n c Office Bedroom ' 16.0' � First Floor 21.0 c CV f , y 25.0' U N� ' ad Bedroom C r r :.`;::y ,~ :°,;: •;, yJ�:. Bath Additional Living Space 16.01 Eaves > es tr- Comments: a' is..