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Home My WebLink About0295 PATRIOT WAY - Health 295 PATRIOTS WAY CENTERVILLE A = 193 177 SIl1__l _� �aFcvaEo q,rUPC 12534 AP o �� No. 2..� 1`rL OR �10 T-co Jen HASTINGS, MN I No. / Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: ' • Yes ' PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 0(ppYication for Migpogat *pgtem Congtruction Permit Application for a Permit to Construct( . )Repairs( )Upgrade y( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 0'1 C1S�( � I( �i Owner's Name,Address and Tel.No. a.O _ , Assessor's Map/Parcel --""�� o� �i m 3 cei 1` Za s R� � W 6VAk-f iK��e OZ63 Z Installer's Name,Address,and Tel.No. Designer's Name,Address and T.I.No., lia 60�c ( 71_7S%R10G Z-b13 Type of Building: C�hls Dwelling No.of Bedrooms ` rJ %Lot Size ft. Garbage Grinder(A/0 Other Type of Building No.of Persons Showers( / ) Cafeteria(. ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date a '_t b1CX33 Number of sheets l Revision Date y 121P-2/C33 Title Size of Septic Tank o`2�©O l�/D4 Type of S.A.S. 1� c -oc5 4 Vk Description of Soil Nature of Repairs or Alterations(Answer when applicable) J1 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 d not to ace th s m in operation until a Certifi- cate of Compliance has been iss this Boar _Heal �� T&1,8 o2®d Signed Date 3 O� Application Approved by Date Application Disapproved for the following reasons Permit No. a Ot)3—f f f Date Issued TOWN OF BARNSTABLE , LOCATION 95 lr LILIAI SEWAGE #o206-3 d/8g VILLAGE �Cr?��A ASSESSOR'S MAP & LOT 3 177 INSTALLER'S NAME&PHONE NO.—Yha r-�- 1,1%�- SEPTIC TANK CAPACITY 116y06-9/ /o ao6,/_T,�� -LEACHING FACILITY: (type) /116'(44 Ac, L--rlJ5-olk (size) 5 x�l NO. OF BEDROOMS 'BUILDER OR OARS% ten e UiJ PERMIT DATE: l 6` Y COMPLIANCE DATE: d 0 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 300 feet of leaching facility) Feet Furnished by � / G 6cha Li /oe - 1d z � v��p��C oT U OF BARNSTABLE 1N w, fION � 9"� C �+� SEWAGE # `v i1.>LAGE C 6t`w V�L�e- 1"��S ASSESSffOR'S MAP & LOT 19 3-1�7 INSTALLER'S NAME&PHONE NO.M%e°4.r,.��i �zl(''OC SEPTIC TANK CAPACITY UL �G�.1 LEACHING FACILITY: (type) Pt* (size) NO. OF BEDROOMS f BUILDER OR OWNER 6\Vl iA CO M PERMITDATE: COMPLIANCE DATE: CXD 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 �; �,� r � �►� ��' i �� f �� v�` � � �� _ s . TOWN OF BARNSTABLE LOCATION �i7 J� �4'�/�f®�S ,q SEWAGE # VILLAGE 2� 8Y l�s�� ASSESSOR'S MAP & LOT 7177 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY -- LEACHING FACILITY: (type) ��,fC J C`l�_ (size) /O � 3d k-2 NO.OF BEDROOMS 3 BUILDER OR OWNER -e^ PERMITDATE: COMPLIANCE DATE: 0 10� Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility 5 Feet .Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of leaching facility) W 0 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) ` 4 Feet Furnished by r /d F -3 `r) 1 2 t � , Fee It - THE COMMONWEALTH OF MASSACHUSETTS Entered in compute r: !� es. ' PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS a.," 0[ppYication for 30tgozal *pgtem QEongtr' ction� ermits;' Application for a Permit to Construct( )Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. a1 G S q>0 T,G� Owner's Name,Address and Tel.No. (5W q� -79 SW Q.h ,C V` LXf o rN Assessor'sMap/Pazcel ,^ 3 Lbc`cx—\ 19.:7t Zq S � ! &_t&�et LAIle A'd OZ&-3 Z / Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. t✓t/z R R� co,&�(\ac (Sa8) -775-�cBOG Type of Building: CEO h/s �p�, Dwelling No.of Bedrooms ��"ttot Size ft. Garbage Grinder(AV Other Type of Building A%QQ No.of Persons Showers( / ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons. Plan Date Cat ., , �.� ,ac�03 Number of sheets 1 Revision Date 1 67? Title . r� Size of Septic Tank o`ZOOO Gad dY- j' Type of S.A.S. 10(��Vi0_'D.C5 LA %�Dv� Description of SoilY ' Nature of Repairs or Alterations(Answer when applicable) 2 OJM 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 d not to place th s; s inin operation until a Certifi- cate of Compliance has been iss d-by this Board of Health. Signed Date 30 03 Application Approved by !- _ ____: t __, —_ '-Date Application Disapproved for the following reasons Permit No. 9-UJ 3 Date Issued --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO CERTIFY, that the On-site Sewage Disposal System Constructed( )Repaired (k,,'�Upgraded( ) Abandoned( )by 6( a f c�,,v, Cry n j at cl S f %� o i 6tJ (- // fir has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit/No. �Uo 3 /ci`� dated `/ u d Installer T I'l,C c l/a ca//.1/,' Designer ,i b n C�}Dr/� The issuance of this permit shall not be construed as a guarantee that the ustern wilfunction ts designed. Date Inspector -----p—r--------------------------------- No. _)0o 3. �Orf Fee lute — THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Mt5po!gai *pgtem Construction -Permit Permission is hereby gra tted�,�.,t/C�nstruct( )Repair(�pgrade )Abandon,( ) System located at �C/J I F�/iw wAi ti s and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construc,ion must be completed within three years of the date of this it. Date:_ '� U ti Approved by TOWN OF BARNSTABLE LOCATION �q5 77 7 SEWAGE # VILLAGE e ASSESSOR'S MAP &LOT �I � 1 INSTALLER'S NAME&PHONE NO.9' / 16aa6ej f%.�, - won /oQaG,,/-7A .SEPTIC TANK CAPACITY 1 e LEACHNG FACILITY:'(type) f iG i��9D�c�% _ (size) X A NO:OF BEDROOMS • BUILDER OR OW R PERMIT DATE: /—6`O Y COMPLIANCE DATE: g d a O N Separation Distance Between the: Feet Maximum Adjusted Groundwater Table t\0 the Bottom of Leaching Facility Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist Feet within,300 feet of leaching facility) Furnished by b Search for Map/Parcel 193177 Town of B ra nstable For Parce "rnber 193177 � Rental P operty(Y/Nj s Business Named Zone ofCont�ibution(Y/N) -, A'ITrea Number a ......... �CortammantfRel(�Y/N y ..: Phone -I Fuel Storaga Tank Permit a F Card On Fie Mls osaI Works lVRW �t fi Perc Test Well Permtt f uction �'ns File/Permit No > �x 2003188� Issuance°Date - �_404/30/2003! , CompletionyDate ;E Stzof Septic Type/Size of SAS. 8 infiltrators with 4 stone ! ( Tank£ 2000 � u Comments , „.. New septic system/5 Bedrooms and open office/ Amnesty Program mappar 193177 Owner 'LYON SWANTJE proploc 295 PATRIOT WAY 6 /r _ -N, fig' /. i a Innovative/Alternative Technology Septic Systems��£ ��Smgle or A ",Clustered,"', I/AType I/�A�Service4Type. I 77-77 77 add records a delete records i i i pFIKE Tw'ti Town of Barnstable Health Inspector o Office Hours Regulatory Services 8:00-9:30 BAMsTABM 1:00-2:00 9 MAss. $, Thomas F.Geiler,Director Q� zbgg. �0 Only Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT QUESTIONNAIRE 1. General Information: Address: 2 95 T&,� off- MA- Map M 3 Parcel (I Name: 3A,M v�\Q, 1._.a r oVN, Phone: /9-9-A-1 t 2. How many bedrooms exist on your property now? 2 2a. Please include a copy of your floor plans. 3. Is the dwelling connected to public sewer? YES or NCB If the dwelling is connected to public sewer, skip questions 4-9 below. 4. Location of dwelling is INSIDE or OUTSIDE Zone of Contribution to public supply wells? 5. Is the dwelling connected to an ONSITE WELL or to eUBLIC TER-. 6. Is a disposal works construction permit on file? YES or 6a.If yes,how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division?(YES r NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO -------------------------------------------------------------------------------------------------------------------- FOR OFFICE USE ONLY TO BE SIGNED BY A HEALTH INSPECTORIAGENT ONLY The Public Health Division has no objection to -)!S- bedrooms at this property. Signed: Date: yL _.4 Inspector �t SrC8 movol / V � 'rAliy72QJ' ROBERT & SWANTJE LYON September 3,2003 Town of Barnstable Public Health Division Thomas McKean 200 Main Street Hyannis,MA 02601 Reg Permit#2003-188 issued 4/30/03 located at 295 Patriot Way Centerville,MA 02632 Dear ML McKean, This letter is to follow up on our phone conversation, yesterday, while I was at Paulette McAuliffe's office. To reassure both you and me of all plans and forms being filed properly I have decided to resubmit copies of the following pieces: • Engineered Site Plan for new septic,proposed addition and parking • Perc • Floor Plan of Unit(existing and proposed) • Amnesty Program Applicant Questionnaire • Comprehensive Permit Decision and Notice by Zoning Board of Appeals • Quitclaim Deed/Deed restriction for permitted apartment has been entered with Barnstable Land Court As discussed With you over the telephone, the unit has not been constructed as of yet, and is therefore not rented. We expect construction to commence shortly. Thank you again for your help and please feel free to contact either Paulette McAuliffe or myself should you have any further questions regarding the matter Sincerely, Swantje K Lyon 295 PATRIOT WAY • CENTERVILLE, MA 02632 PHONE: 508-420-7971 n'F Y i OWN CLERK BARN MABL C, ., 21z13 AN 19 M 8: 51 Town of Barnstable Zoning Board of Appeals Comprehensive Permit Decision and Notice Appeal 2003- 40- Lyon Applicant: Swantje Lyon Property Address: 295 Patriot Way,Centerville,MA Assessor's Map/Parcel:- Map 193 Parcel 177 Zoning: Residential G3 Groundwater Overlay. AP Aquifer Protection Overlay District Applicant: The applicant is Swantje Lyon,who resides at 295 Patriot Way, Centerville,MA. Relief Requested: The applicant has applied for a Comprehensive Permit under the General Law of the Commonwealth of Massachusetts,Chapter 40B -§20-23 and in accordance with the General Ordinance of the Town of Barnstable Chapter III,Article LXV,"Pre-existing and Unpermitted Dwelling Units and for New Dwelling Units in Existing Structures," more commonly termed the"Accessory Affordable Housing Program." She wants to create an accessory affordable unit at a single-family owner-occupied residential dwelling in accordance with all the conditions of this permit. The issuance of this Comprehensive Permit would allow for an owner-occupied single-family residence with an accessory affordable apartment within the single-family dwelluig. Locus and Background: The property is a.36 acre lot that is developed with a 2-bedroom,2-bathroom,3,028 square feet single- family,Ranch style home. The applicant has owned the property for two years. The applicant heard about the program through other citizens in the community and has stepped forward to create an affordable unit. The proposed accessory unit will be attached to the side of the main structure. It will be a two-bedroom at approximately 800 square feet. The locus is in the AP Aquifer Protection Overlay District. Procedural Summary: This application for a Comprehensive Permit was filed at the Town Clerk's Office and the Office of the Zoning Board of Appeals. A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised and notice was sent to all abutters in accordance with MGL Chapter 40A. The heating was opened on June 4,2003 at which time the Hearing Officer,Gail Nightingale,took comments from the applicant's neighbors who spoke in opposition. There were comments from the following: Doreen Fingado,Martha McDonald,Scott Blazis,Louis Sault,and William Corbett. Most concerns centered around both changing the character of the neighborhood through allowing an affordable unit attached to a single-family home; and the impact of a two-family dwelling on TitleV/Septic system The Hearing Officer explained that Title V and local health regulations must be met before any application can be brought before the ZBA. She also explained that in it's efforts to address the need for more affordable housing, the Town Council passed the ordinance allowing two families to live at one property as long as the people in question follow the guidelines of the program. After explaining the application did meet all of the program requirements,the Hearing Officer approved it. Also present was Paulette Theresa-McAuliffe,Accessory Affordable Housing Program Coordinator. Findings as to Standing and The Comprehensive Permit: At the June.4,2003 hearing,the Hearing Officer made the following findings of fact: 1. The applicant is Swantje Lyon with an address of 295 Patriot Way, Centerville, MA. Ms. Lyon has owned the property since January 26,2001 as documented and recorded at the Registry of Deeds in Book 965,page 37. She is requesting a Comprehensive Permit to create an affordable rental apartment to be accessory to the single-family owner-occupied residential dwelling. The applicant has submitted a copy of a certified deed recorded at the Barnstable Registry of Deeds documenting her ownership of the property. In addition,she has submitted a certified plot plan dated April 15,2003. 2. The applicant was issued a Project Eligibility(site approval) letter dated May 1,2003 from Kevin Shea,Director,Office of Community&Economic Development,qualifying the application for the Accessory Affordable Housing Program The source of the subsidy is the federal Community Development Block Grant(CDBG)program. 3. The proposed rental unit will be approximately 800 square feet and will have two bedrooms. It will be attached to the side of the single-family Ranch style home. 4. According to the Assessor's record,there is a total of two bedrooms on the property. The property is in the AP Aquifer Protection Overlay District. The Public Health Division has: verified that the proposed property meets both the conditions of the State's Title V Environmental Code and local Board of Health requirements,plus,approved the septic system at the site for a total of five bedrooms as per the"Housing Amnesty/Public Health"Form dated April 30,2003. 5. The town of Barnstable completed an inspection of the property on February 11,2003. The applicant is aware that a final inspection by the Building Division will be required and that the Building Division also has to perform all necessary inspections to assure that the unit meets applicable minimum state and local code requirements before she is issued an Amnesty Certificate of Participation. 6. On February 19,2003,the applicant signed an Accessory Affordable Housing (Amnesty) Program Affidavit agreeing to comply with the programs requirements,including owner occupancy of the principal dwelling unit and further agreeing to comply with the provisions set. forth in Article LXV(65) of the Town Ordinances that include their signing and recording of the Regulatory Agreement&Declaration of Restrictive Covenants. The subsidizing agency has determined that the signing and recording of the regulatory agreement qualifies the applicant as a "limited dividend organization" as that term is used under M.G.L.c.40B %20-23. 7. Under Chapter 3,Article LXV(65) of the Town Ordinances,the affordable unit must be rented at an affordable rent to a person or family whose income is 80% or less of the Area Median Income (AMI) of Barnstable-Yarmouth Metropolitan Statistical Area(MSA). 8. According to the Massachusetts Department of Housing and Community Development,as of October 1,2001,4.7%of the town's year-round housing stock qualified as affordable housing units. 2 l V 1 The town has not reached the statutory minimum under M.G.L. c.40B 55 20-23 or its implementing regulations. Under the Town of Barnstable's Local Comprehensive Plan, the use of existing housing to create affordable units and the dispersal of these units throughout the town is encouraged. 9. Based upon the findings,the project is deemed consistent with local needs because it adequately promotes the objective of providing affordable housing for the Town of Barnstable without jeopardizing the health and safety of the occupants provided all conditions of the Comprehensive Permit are strictly followed. Ruling and Conditions: Based upon the findings,the applicant, Swange Lyon,is granted a Comprehensive Permit to permit the creation of an accessory apartment of 800 square feet within a single-family owner-occupied residential dwelling, subject to the following conditions: 1. The property owner shall occupy the principal dwelling as her year-round residence. 2. Occupancy of the affordable unit shall not exceed three adults or a familyof four. 3. This unit shall not be occupied by a family member. 4. To meet the requirements of affordability,the applicant must rent the unit to a person or family whose income is 80% or less of the Area Median Income (AM) of Barnstable-Yarmouth Metropolitan Statistical Area MA),adjusted by household size. The monthly rent.payable by a household inclusive of utilities shall not exceed 30% of the monthly household income of a household earning 80% of the median income,adjusted byhousehold size. In the event that utilities are separately metered,the utility allowance established by the town of Barnstable shall be deducted from rent level so calculated. 5. All leases shall have a minimum term of one year. 6. Before the issuance of an occupancy permit for the accessory affordable unit,the building commissioner must determine that the unit both conforms with the approved plans as submitted to the file(as per initialed by the ZBA Hearing Officer),and meets state building and fire codes,plus,complies with applicable state on-site wastewater discharge requirements. 7. The applicant may select their own tenant(s) provided the tenant(s) meet all requirements of the program and provided that person(s)income is reviewed and approved by the Office of Community&Economic Development of the town of Barnstable as a qualified individual. The applicant will be required to work with the town to provide information necessary to document that the tenant(s) qualify. To insure that the unit is rented in an open and fair basis to an income eligible individual or family,the unit must be listed with the town whenever a vacancy occurs. Also,the applicant must notify the Office of Community&Economic Development of a vacancy whenever it occurs. 8. Everytwelve months the applicant shall review the income eligibility of those individuals occupying the unit. No later than a year from the date of issuance of this Comprehensive Permit the applicant shall file with the Office of Community&Economic Development of the town of Barnstable an annual affidavit listing the rent charged and income level of the occupant(s) of the unit. The applicant shall provide the town any additional information it deems necessary to verify the information provided in the affidavit. Upon any report from the town that the terms and conditions of this permit are not being upheld,the Zoning Board of Appeals or it's Hearing Officer shall have the ability to hold a hearing to show cause as to why this permit should not be revoked. 3 J 9. The Accessory Affordable Unit shall be affordable in perpetuity(as affordable is defined herein) unless this Comprehensive Permit is rendered void. 10. This Comprehensive Permit shall not be transferable to any other person or entity without the prior approval of the Hearing Officer or Zoning Board of Appeals. This decision,the Regulatory Agreement and Declaration of Restrictive Covenants and all other necessary documents shall be filed at the Barnstable County Registry of Deeds. -If the ownership of the property is transferred,the town of Barnstable shall be notified within 60 days the name and address of the new owner. 11. All parking for the dwelling and accessory unit shall be accommodated on site,and no lodging shall be permitted on site for the duration of this Comprehensive Permit. 12. This Comprehensive Permit must be exercised and the unit occupied within 12 months of its issuance or it.shall expire. Transmission of the Decision of the Hearing Officer to the Barnstable Zoning Board of Appeals In accordance with Part II,Section 4.02 and Part III,Section 3.72 of the Town of Barnstable Administrative Code,the hearing officer transmitted her written decision to the Zoning Board of Appeals on April 23,20033 and fourteen days having elapsed since said transmittal with the Zoning Board of Appeals taking no action to reverse the decision,this decision becomes the decision for this Comprehensive Permit application. Ordered: Comprehensive Permit 2003-40 has been granted with conditions. Appeals of this decision,if any,shall be made to the Barnstable Superior Court 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 The applicant has the right to appeal this decision F outlined in MGL Chapter 40B,Section 22. Gja ghtingale wring&ficer Date Signed I, Hutche der,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 en f' the office of the Town Clerk Signed and sealed this DAyof o under the ains and. e_nalties of e� _� P P perjury. Linda Hutchenrider,Town Clerk 4 l McKean, Thomas From: McKean, Thomas Sent: Monday, August 25, 2003 2:15 PM To: Shea, Kevin Subject: 295 Patriot Way/Lyon Hi Kevin: Thanks for the FAX regarding the ZBA approval of the amnesty project at 295 Patriot Way. To date the septic system has no been upgraded to meet Title V for five bedrooms as originally proposed back in April. I was unable to find any conditions or requirements from the ZBA which instructs or directs the applicant to upgrade the inadequate septic system before occupancy of the rental rooms. Also, in my opinion, the finding on page 2 paragraph 4 is misleading in that it reads"The Public Health Division has verified the property meets both the conditions of the State's Title V Environmental Code and local Board of Health requirements, plus, approved the septic system at the site for a total of five bedrooms..." The finding does not indicate the present system is inadequate and the applicant proposes to upgrade the system for five bedrooms. 1 AU6,20.2003 2:05PM BARNSTABLE COM/ECO.DEVELOPMENT -N0.709-' 'P.6i6 Town of Barnstable Health Inspector �+ Officc Hours g Regulatory Services 8:00-9;30 16 Thomas F.Gefler,Director 1:00—2:00 lg. � Public Health Division Only Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office; 508-862-4644 Fax; 508-790-6304 AMNESTY PROGRAM APPLICANT QUESTIONNAIRE 1. General Information: Address: 12 95 ?al,�'Yl off- W av��P f I�� MA- Ma p� Parcel Name: Mi r�v1 � 1...�.r o� Phone: Z. How many bedrooms exist on your property now? aa. Please include a copy of your floor plans, 3. Is the dwelling connected to public sewer? YES or If the dwelling is connected to public sewer,skip questions 4-9 below. 4. Location of dwelling is INSIDE or OUTSIDE Zone of Contribution to public supply wells? S. Is the dwelling connected to an ONSITE WELL or to UBLIC WATER? 6. Is a disposal works construction permit on file? YES or 6a.If yes,how many bedrooms were approved according to this permit? Bedrooms. 7, Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division? YES r NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO ----------------------------------------------- FOR OFFICE USE ONLY TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY The Public Health Division has no objection to bedrooms at this property, Signed: Date. /3a Inspector(Print): � � AUG.20.2003 2:04PM BARNSTABLE COM/ECO.DEVELOPMENT NO.709 216ot ) TOWN CLERK BARNS FARKE, MA-SS, 1 � , 0 JUN 19 AM 8; 51 Town of Barnstable Zoning Board of Appeals Comprehensive Permit Decision and Notice Appeal 2003—40- Lyon Appficaar sv,?=je Iyoa Property Address: 295 Patriot Way,Gams,MA Assessors Map/Parcel: Map 193 Patrel 177 Zoning: Resideadd 03 Groundwater Overlay; AP Aquifer Protection OverlayDist t e , Applicant: The applicant is Swantje Lyon,who resides at 295 Patriot Way, Centerville,MA. Relief Requested: The applicant has applied for a Comprehensive Permit under the General Law of the Commonwealth of Massachusetts,Chapter 40B-S 20-23 and in accordance with the General OnUriance of the Town of Barnstable C*ter III,Article LXV,"Pn:•=Sung and Unpenrnitted Dwelling Units and for New Dwelling Units in Existing Structures," more commonlytermed the"Accessory Affordable Housing Program" She wants to create an accessory affordable unit at a single-family owner-occupied residential dwelling in accordance with all the conditions of this permit The issuance of this Comprehensive Permit would allow for an owner-occupied single-family residence with an accessory affordable apartment within the single-family dwelling. Locus and Background: The property is a.36 acre lot that is developed with a 2-bedroom,2-bathroom,3,028 squasc feet single- family,Ranch style home. The applicant has owned the property for two years, The applicant heard about the program through other citizens in the community and has stepped forward to create an affordable unit. The proposed accessory unit will be attached to the side of the main structure. It will be a two-bedroom at approximately 800 square feet. The locus is in the,AP Aquifer Protection Overlay District. Procedural Summary: This application for a Comprehensive Permit was filed at the Town Clerk's Office and the Office of the Zoning Board of.Appeals. A public hearing before the Zoning Board of Appeals Hearing Officer was duly advertised and notice was sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened on June 4, 2003 at which time the Hearing Officer,Gail Nightingale,took comments from the applicant's neighbors who spoke in opposition. There were corritnents from the following: Doreen Fingado,Martha McDonald,Scott Blazis, Louis Sault,and William Corbett. Most concerns centered around both changing the character of the neighborhood through allowing an affordable unit attached to a,single-family home; and the impact of a two-family dwelling on TitleV/Septic system. The Hear ng Officer explained that AUG.20.2003 2:04PM BARNSTABLE COM/ECO.DEVELOPMENT NO.709 P.3i6 Title V and local health regulations must be met before any application can be brought before the ZBA. She also explained that in it's efforts to address the need for more affordable housing, the Town.Council passed the ordinance allowing two families to live at one property as long as the people in question follow the guidelines of the program. After explaining the application did meet all of the program requirements,the Hearing Officer approved it. Also present was Paulette 'Theresa-McAuliffe,Accessory Affordable Housing Program Coordinator. Findings as to Standing and The Comprehensive Permit: At the June 4,2003 hearing,the Hearing Officer made the following findings of fact; 1. The applicant is Swantje Lyon with an address of 295 Patriot Way, Centerville, Mtn. Ms. Lyon has owned the property since January 26,2001 as documented and recorded at the Registry of Deeds in Book 965,page 37. She is requesting a Comprehensive Permit to create an affordable rental apartment to-be accessory to the single-family owner-occupied residential dwelling. The applicant has submitted a copy of a certified deed recorded at the Barnstable Registry of Deeds docuanenting her ownership of the property. In addition,she has submitted a certified plot plan dated April 15,2003. 2. The applicant ns issued a Project Eligibility(site approval)letter dated May 1,2003 from Kevin Shea,Director,Office of Community&Economic Development,qualifying the application for the Accessory Affordable Housing Program. 'Ihe source of the subsidyis the federal Coaummity Development Block Grant(®BG)program, 3. The proposed rental unit will be approximately 800 square feet and will have two bedrooms. It will be attached to the side of the single-familyRanch style home. 4. Accor g to a ssessor's record,there is a total of two bedrooms on the property. The property is in the AP Aquifer Protection Overlay District.The Public Health Division has; verified that the proposed pxopezry meets both the conditions of the State's Title V Environmental Code and local Board of Health requirements,plus, approved the septic system at the site for a total of five bedrooms as per the"HousingAuznesty/Public Health"Form date April 30,2003, 5. The town of Barnstable completed an inspection of the property on February 11, 2003. The applicant is aware that a final inspection by the Building Division will,be required and that the Building Division also has to perform all necessary inspections to assure that the unit meets applicable minimum-state and local code requirements before she is issued an Amnesty Certificate of Pa ticipauon. 6. On February 10,2003)the applicant signed an Accessory Affordable Housing (Amnesty) Program Affidavit agreeing to complywith the programs requirements,including owner occupancy of the principal dwelling unit and further agreeing to comply with the provisions set forth in Article LXV(65) of the Town Ordinances that include their signing and recording of the Regulatory Agreement&Declaration of Restrictive Covenants. The subsidizing agency has determined that the signing and recording of the regulatory agreement qualifies the applicant as a "limited dividend organization" as that term is used under M.G.L.c.40B §§20-23. 7. Under Chapter 3,Article LXV(65) of the Tower Ordinances,the affordable unit must be rented at an affordable rent to a person or familywhose income is 90% or less of the Area Median Income (Alva) of Barnstable-Yarmouth Metropolitan Statistical Area"A). 8, According to the Massachusetts Department of Housing and Community Development,as of October 1,2001,4.7% of the town's year-round housing stock qualified as affordable housing units, 2 ` AUG.20.2003 2:04PM BARNSTABLE COM/ECO.DEVELOPMENT NO.709 P.4i6 The town has not reached the statutory minimum under M,G.L, 0 40B §§20-23 or its implementing regulations. Under the Town of Bi mstable's Local Comprehensive Plan,the use of e4isting housing to create affordable units and the dispersal of these units throughout the town is encouraged. 9. Based upon the'findittgs,the project is deemed consistent with local needs because it adequately promotes the objective of roviding affordable housing for the Town of Barnstable without jeopardizing the health a1safety of the occupants provided all conditions of the Comprehensive Permit are strictlyfollowed, Ruling and Conditions: Based upon the findings,the applicant, Swangc Lyon,is granted a Comprehensive Permit to permit the creation of an accessory apartment of 800 square feet within a single-family owner-occupied residential dwelling,subject to the following conditions: 1. The property owner shall occupy the principal dwelling as her year-round residence. 2. Occupancy of the affordable unit shall not exceed three adults or a family of four. 3. This unit shall not be occupied by a family member. 4. To meet the requirements of affordability,the applicant must rent the unit to a person or family whose income is 80% or less of the Area Median Income (AM) of Barnstable-Yarmouth Metropolitan Statistical Area(ABA),adjusted by household size. The monthly rent payable by a household inclusive of utilities shall not exceed 30% of the monthlyhousehold income of a household earning 80% of the median income,adjusted by household size. In the event that utilities are separatelymetered,the utiliryallowance established bythe town of Barnstable shall be deducted from rent level so calculated, 5. All leases shall have a.minimum term of one year. 6. Before the issuance of an occupancyperrnit for the accessory affordable unit,the building commissioner must determine that the unit both conforms with the approved plans submitted to the file(as per initialed by the ZBA Hearing Officer), and meets state building and fire codes,,plus,complies with applicable state on-site wastewater discharge requirements. 7. The applicant may select their'own tenant(s)provided the tenant(s) meet all requirements of the program and provided that person(s)income is reviewed and approved by the Office of Community do Economic Development of the town of Barnstable as a qualified individual. The applicant will be regpired to work with the town to provide information necessary to document that the tenant(s) qualify. To insure that the unit is rented in an open and fair basis to an income eligible individual or family,the unit must be listed with the town whenever a vacancy occurs. Also,the applicant must notify the Office of Community&Economic Development of a vacancy whenever it occurs. S. Everytwelve months the applicant shall review the income eligibility of those individuals occupying the unit. No later than it year from the date of issuance of this Comprehensive Permit the applicant shall file with the Office of Community&Economic Development of the town of Barnstable an annual affidavit listing the rent charged and income level of the occupant(s) of the vnit. The applicant shall provide the town any additional information it deems necessary to verify the information provided in the affidavit. Upon any report from the town that the terms and conditions of this ppermit are not being upheld,the Zoning Board of Appear or it's Hearing Officer shall have the abilityto hold a hearing to show cause as to whythis permit should not be revoked. 3 ' AUG.20.2003 2:05PM BARNSTABLE COM/ECO.DEVELOPMENT NO.709 P.5i6 9. The Accessory Affordable Urnit shall be affordable in perpetuity(as affordable is defined here' unless this Comprehensive Permit is rendered void, 10, This Comprehensive Permit shall not be transferable to any other person or entity without the prior approval of the Hearing Officer or Zoning Board of Appeals, This decision,the Regulatory Agreement and Declaration of Restrictive Covenants and all other necessa ry documents shall be Bled at the Barnstable County Registry of Deeds. If the ownership of the property is transferred, the town of Barnstable shall be notified within 60 days the name and address of the new owner. 11. All parlang for the dwelling and accessoryunit shall be accommodated on site,and no lodging shall be permitted on site for the duration of this Comprehensive Permit. 12, This Comprehensive Permit must be exercised and the unit occupied within 12 months of its issuance or it shall expire. Transmission of the Decision of the Heating Officer to the Barnstable Zoning Board of Appeals In accordance with Pan II,Section 4.02 and Part III,Section 3.72 of the Town of Barnstable Administrative Code,the heating officer transmitted her written decision to the Zoning Board of appeals on April 23,2003, and fourteen days having elapsed since said transmittal with the Zoning Board of Appeals talang no action to reverse the decision,this decision becomes the decision for this Comprehensive Permit application. j Ordered: Comprehensive Permit 2003.40 has been granted with conditions. Appeals of this decision,if any,shall be made to the Barnstable Superior Court pursuant to MGL Chapter 40A,Section 17,within twenty(20) days after the date,of the filing of this decision is the office of the Town Clerk The applicant has the right to appeal this decision p outlined in MGL Chapter 40B,Section 22, YL CI' a ghtingale acing finer Dante Signed I, Htuche r,Clerk of the Town of Baraistable,Barnstable County,Massachusetts,hereby certo that twenty(20) days have elapsed since the Zoning Board of Appeals filed this decision And that no appeal of the decision has,�en f' the office of the Town Clerk ,. i Signed and sealed this O qla of _� Y under the pazns and p�rahlpea ,of. l � e �•��:�. 4� Cdb°� a�,� ' Linda Hutchenrider, own Clerk 9ARNSTrs1BLE COUNTY "•��.�� `,�y.�;;s;�� REGISTRY OF gEEDS A TTR�RU��E COPY,ATTEST JOHN _._. ___. SAMSTASLE REGISTRY OF DEEDS AUG.20.2003 2:03PM BARNSTABLE COM/ECO.DEVELOPMENT NO.709 P.1i6 Town of Barnstable �'¢ Office of Community and Economic Development 367 Main Street,Hyannis,MA 02601 Kevin J.Shea Office: 862-4695 Fax: 862-4782 Director IF,AX COVER SHEET Date: COMPANY: LjA- Time: oJAA ATTN. TO .- Fax: Phone: FROM: (Coo 11.-% " FAX: 1<-508 862-4782 Phone:1-508 862-4678; 862-4683 Number f Pages including cover sheet MESSAGE: f OT, L pFIME toy, Town of Barnstable Health Inspector Office Hours Regulatory Services 8:00—9:30 B"' E. � Thomas F.Geller,Director 1:00—2:00 MASS. y Mass., � gjA ie39. A10 rfo Public Health Division Only Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY .PROGRAM APPLICANT QUESTIONNAIRE 1. General Information:Address: 2 q 5 T&V-yi off- WM av��P-K\A e K-. Map Parcel Name: �Wftvt \�, -' ' !=' o'\ Phone: (5w 2. How many bedrooms exist on your property now? 2 2a. Please include a copy of your floor plans. 3. Is the dwelling connected to public sewer? YES or NO If the dwelling is connected to public sewer,skip questions 4-9 below. 4. Location of dwelling is INSIDE or OUTSIDE" Zone of Contribution to public supply wells? 5. Is the dwelling connected to an ONSITE WELL or to UBLIC WATER?' 6. Is a disposal works construction permit on file? YES orO ' 6a.If yes, how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division? YES r NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO FOR OFFICE USE ONLY TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY The Public Health Division has no objection to bedrooms at this property. Signed. Date: _ Inspector(Print MC �, 7 rV I P�oF.► .ow� Town of Barnstable P# 11044 Department of Regulatory Services 6ARNSTARI *�►� Public Health Division pate °lFo µr3 a 200 Main Street,Hyannis MA 02601 Date Scheduled o Time_LLn n 1 Fee Pd. 6-6- Soil Suitability Assessment for Sewage Disposal Performed By: /'GOA) A d/ Witnessed By: Location Address 29 S f A77�/D�-- Owner's Name S� tJC Address L ,4 g� / ZyS pw w . Assessor's Map/Parcel: (��7 7 Engineer's Name R.✓ CAdi X&C-, NSW CONSTRUCTION REPAIR Telephone N �d—7 7S 70t� Land Use !n gp Slopes(%) Surface Stones Distances from: Open Water Body 7�� ft Possible Wet Area 6 ft/ Drinking Water Well &O ft Drainage Way 7 ZS/ ft Property Line Other ft SI E,TCH:(Street name,dimensions of lot,exact locations of test holes&pert tests,locate wetlands in proximity to holes) � —H r- ' 0 w I Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water In Hole:— fZ 1/ Weeping from Pit Face Estimated Seasonal HBh Groundwater _ ' LIN Location Add ress Owner's Name w L 295 I2a77zrDT Gv 0 i,�` St.��i t c Address L D/v -� / 2 ys P.4 ,vT w Assessor's Map/Parcel: 19 j 7 7 Engineer's Name R J CAd�L��U NEW cONSTRUcHON REPAIR Telephone# (98—7 7S /00 Land Use 1 R R--b Slopes(%) Surface Stones / Drinking Water Well /t/a ft Distances from: Open Water Body 7 ft Possible Wet Area / j ft Drainage Way 25/ ft Property Line Other /D M ft SKETCH:(Street name,dimensions of lot,exact locations of test hole/s)&perc tests,locate wetlands In proximity to holes) /7O 77H 50 l ©rf Lor w ' CAPY f CP6�-bv Parent material(geologic) Depth to Bedrock ,`I I Depth to Groundwater: Standing Water in Hole: 132,11 Weeping from Pit Face Estimated Seasonal High Groundwater �I 6�� ' mti• t G Method Used: Depth Observed standing in obs.hole: in. Depth to soil mottles: in. Depth to weeping from side of obs.hole: in. Groundwater Ad'ustment ft. Index Well# S-Za�2 Reading Date:�j/b&Index Well level l-f�,- Adj.factor Adj.Groundwater Level•_ 1.5 Observation Time at9" - �7JL� Hole# / Depth of Per. p0ZL�Z Time at 6" / ! 11567 �/o /e Start Pre-soak Time® / T I'T�� Time(9"-6'7 E�it , End Pre-soak Rate Min./Inch Z / Site Suitabillty Assessment: Site Passed Site Failed: Additional Testing Needed(YIN) Tn Re Comuleted tin Back t TN 1 Sail Horizon Soil Texture Soil Co or Soil Other Depth from unselt Mottling Structore,Stones,Boulders. Surface(in.) (USDA) Consistenc `d/.Gravel ®/ A s OyY _ 1609Y,--: �D 1D 7e r 4*d� 3y '=3$" C/ .1�r C 2-s 6 h v 3�,, CZ 2.5 6 ¢ o Jx Z12�� p /32'� � Other } ° Soil Depth from Soil Horizon Soil Texture Soil Color Mottling Structure,Stones,Boulders. Surface(in.) (USDA) (Munseil) Consistenc °/.Grave Flood Insurance Rate Map: Above 500 year flood boundsry No_' Yes Within 500 year boundary" No Yes Within 1 o0 year flood boundary No Yes Deyth of Naturally Occurring Pervious Material. jai exist i Does at least four feet of naturally occurring pervious matern all areas observed throughout the -atea proposed for the soil absorption system? �S I not,what is the depth of naturally occurring pervious material? Certi�n ' ��' � � (date)T have passed the soil evaluator examination approved by the I certify that on Department of Environmental Protection acid that the above analysis w�Oper fo a co sisyte�nt with ex ertise and experience described in 310 CMR (�CU/ the•required training, P P <aA,A� r ` BENNETT ENVIRONMENTAL ASSOCIATES, INC. LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS,GEOLOGISTS,ENGINEERS 1573 Main Street,P.O.Box 1743 (§08)896-1706 Brewster,MA 02631 fax K08)596-5109 LETTER OF TRANSMITTAL -a; TO: DATE: JOB Mr.Robert Murphy,Case Officer Gn MA DEP,Southeast Regional Office 12/28/19 FEA16-10961 Bureau of Waste Site Cleanup/Emergency Response Section 20 Riverside Drive REGARDING: Lakeville,MA 02347 RETRACTION OF RELEASE NOTIFICATION Residential Property: RTN 4-26401 SHIPPING MIETHOID: 295 Patriot Way Centerville,MA Regular Mail ❑ Pick Up ❑ [Assessor's Map 193,Parcel 177] Priority Mail ❑ Hand Deliver ❑ Express Mail ❑ Other upload Certified Mail ❑ Green Card/RR ❑ COPIES DATE DESCRIPTION 1 12/22/16 Retraction Notification with enclosures,as noted For review and comment: For approval: As requested: For your use: � ARK ; CC,via CD:Robert(Swantje)Lyon,Property Owner Tom Heemsoth,Owner—Nor'east Comfort(PRP/Generator) CC,*Abbreviated Copy: Chief Michael Winn,COMM Fire Department(Centerville) Mark EIls,Barnstable Town Manager Thomas McKeon,Barnstable Health Director *As part of Public Notice requirements,the report Narrative,Transmittal and Site Plan are included,pursuant to paperwork reduction policy. The full report is available as public record on the MA DEP website database at http:/'/public.dep.state.ma.us/`SearchableSites/Search.asp or, ! upon written request to BEA,full copy(electronic or paper)will be provided. FROM: David C.Bennett,LSP,President/John Tadema-Wielandt,Senior Project Manager/Lezli Rowell,Administrative Assistant If enclosures are not as noted,kindly notify us at once -UENNETT ENVIRONMENTA1L AssociATEs9 NC. LICENSED SITE PROFESSIONALS A ENVIRONMENTAL SCIENTISTS & GEOLOGISTS 6 ENGINEERS 1573 Main Street-P.O. Box 1743, Brewster, MA 02631 & 508-896-1706 6 Fax 508-896-5109 6 www.benneft-ea.com BEA16-10961 December 22, 2016 Mr. Robert Murphy, Case Officer MA DEPARTMENT OF ENVIRONMENTAL PROTECTION(MA DEP) Southeast Regional Office (SERO) Bureau of Waste Site Cleanup/Emergency Response Section(BWSC/ERS) 20 Riverside Drive Lakeville, MA 02347 RE: RETRACTION OF RELEASE NOTIFICATION Residential Properly: RTN 4-26401 295 Patriot Way—Centerville,MA [Assessor's Map 193, Parcel 177] Dear Mr. Murphy, BENNETT ENVIRONMENTAL ASSOCIATES, INC. (BEA)has prepared the following narrative, and attached Supporting Documentation, as establishing the technical rationale and justification for Retracting a Release Notification in accordance with the provisions of 310 CMR 40.0335(1) (c) and 40.0335(2) (a-e). The release investigation has indicated that the amount of fuel oil release was less than 10 gallons and physical testing demonstrated there has been no release to the environment, as contained entirely in the basement of the subject dwelling.- Emergency response actions resulted in the containment and recovery of the fuel oil released to the basement floor during service of the heating system. The timely actions of the Nor'east Comfort oil burner technician prevented further release of additional oil, attributed to a defective gasket in the oil filter that was replaced. The personal belongings and building materials that were in contact with the cellar floor which became impacted, and absorbents, were removed from the basement and placed in a roll-off container for appropriate disposal by the restoration contractor, Oceanside Restoration, engaged by Nor'east Comfort. Additionally, clothing stored in the basement has been taken out for cleaning, and the painted basement floor washed.after additional absorbents applied. Notwithstanding the apparent integrity of the painted basement floor and wall, BEA subsequently conducted environmental assessment activities within the documented release area to investigate potential infiltration to underlying soils. The basement floor was cored in six (6) locations equally spaced along the area where the fuel oil traveled to investigate soils along the typical route of infiltration at the junction between the concrete basement floor and concrete foundation wall. With each boring, soil samples were collected to 6' below the basement floor, wherein field screening results and laboratory analytical data report concentrations of organic vapors and petroleum hydrocarbons as Non-Detect, consistent with background conditions. BEA 1 EMERGENCY SPILL RESPONSE 0 WASTE SITE CLEANUP 6 SITE ASSESSMENT A PERMITTING 6, SEPTIC DESIGN&INSPECTION WATER SUPPLY DEVELOPMENT,OPERATION&MAINTENANCE b WASTEWATER TREATMENT,OPERATION&MAINTENANCE DECEMBER 22,2016 RESIDENTIAL PROPERTYBEAI6-10961 PAGE 2 OF 11 RELEASE RETRACTION,RTN 4-26401 also collected a sample of the spent absorbents to document the degree of saturation, and used this information with the known volume of absorbents to calculate the estimated volume of release as less than 10 gallons. Based on estimated release of fuel oil was less than 10 gallons, under the context of 310 CMR 40.0311 and specific to 40.0313(4), neither a 2-Hour or 72-Hour condition would exist. Relative to the facts that physical testing and confirmation laboratory analysis reported no concentrations of fractional extractable petroleum hydrocarbons (EPH) or polynuclear aromatic hydrocarbons (PAHs) above the method detection limits as a release to the environment, under the provisions of 310 CMR 40.0317(19) (b), the release is not required to be reported nor is there need for Remedial Response Actions under the MA Contingency Plan (MCP). As such, a Retraction of a Previously Reported Notification is technically justified in support of project closure by the Potentially Responsible Party as the Generator for which Notification was made. The work represented herein has been conducted under my supervision in a manner consistent with the MCP Response Action Performance Standards, pursuant to 310 CMR 40.0191 and the QA/QC policies of BENNETT ENVIRONMENTAL ASSOCIATES, INC. The facts and statements herein are, to the best of our knowledge, a true and accurate representation of the site activities, remedial response actions and environmental conditions associated with the project. ENVIRONMENTAL CONDITIONS The subject property at 295 Patriot Way is noted as Map 193, Parcel 177 on the Barnstable Assessors Map. The subject property is located approximately 350' southwest of the intersection of Oak Street and Patriot Way in the village of Centerville, within the Town of Barnstable [Refer to Figure 1]. The UTM coordinates for the subject property is reported as Northing 4615041, Easting 613225. The subject property contains 0.36 acres of land area, and is developed by a single-story wood frame, ranch-style, residential dwelling. The surrounding area is similarly developed seasonal and year-round residential properties. Access to the, subject property is unrestricted with high frequency/high intensity of use, and children potentially present. Access to the area of release, located in the subject dwelling basement, is restricted with low frequency/low intensity of use, with children potentially present. The dwelling occupants and visitors to the property are identified as the primary potential human receptors to potential exposures. The subject property is entirely upland with the nearest zero-head boundary being a small, unnamed pond approximately 250. feet south of the subject property. Topography at the site ranges from 70 to 65' in elevation and slopes from the northeast to the southwest. Hydrogeologic references report groundwater at approximately 41' NGVD (+/-) as reported within 24' (+/-) of grade surface in the area of the basement release. Regional groundwater contours indicate an assumed easterly groundwater flow direction towards Wequaquet Lake [Refer to Figure 2]. As such, the small unnamed ponds and related wetlands to the south, and Wequaquet Lake to the DECEMBER 22,2016 RESIDENTIAL PROPERTYBEAI6-10961 PAGE 3 OF 11 RELEASE RETRACTION,RTN 4-26401 east, are considered the primary potential environmental receptors under Method 1 — Risk Characterization. According to the MA DEP BWSC GIS mapping program, the subject property is located within a Medium-Yield Potential Drinking Water Source Area (PDWSA). A Zone II Protective Radius of a Public Water Supply (PWS) well is located approximately 1,000 feet east of the site and another is located approximately 3,000 feet to the southwest. No private wells are known to exist within 500' of the Site, wherein the area is serviced by the Barnstable Municipal Water Supply. The subject property is also part of the EPA-designated Sole Source Aquifer for all of Cape Cod east of the Cape Cod Canal. Freshwater wetlands are shown west of the site and are also designated as NHESP Estimated Habitat of Rare Wildlife in Wetland Areas. Certified vernal pools are located to the east and west of the site, at distances greater than 1,000-feet away [Refer to Figure 3]. 4 s, ✓',� ��il 'II,i I i �sacoct i��`�� i s F'i�= �., a S,Jt. sANrnIF11J. ND ��; ' Iii.�{�� Ile SH(OF d .511 III.++ � �^'��. -.....�.*A °C- •��%�� f t �axaa Wawa Danz sc� �y�`o k .. i. /' fff YI i� � V. •Va. ^ a wrt m � i !uaOH cF1+ttr.Fyn"P tf4. IOOOh 'yD MA DEP BWSC GIS Mapping: The subject property at 295 Patriot Way is noted as Map 193,Parcel 177 on the Barnstable Assessors Map.The subject property is located approximately 350'southwest of the intersection of Oak Street and Patriot Way in the village of Centerville, within the Town of Barnstable. The subject property contains 0.36 acres of land area, and is developed by a single-story wood frame,ranch-style,residential dwelling. The figure shows priority resources as outside any Zone II wellhead protection but as within medium to high yield aquifer in a designated Sole Source Aquifer. DECEMBER 22,2016 RESIDENTIAL PROPERTY/BEA16-10961 PAGE 4 OF 11 RELEASE RETRACTION,RTN 4-26401 Based on this mapping, as well as the proximity to groundwater, the GW-1, GW-2 and GW-3 groundwater categories are applicable to Method 1 —Risk Characterization per 310 CMR 40.0974. Based on Site conditions relative to frequency/intensity of use and accessibility of soils, the S-1, S-2 and S-3 (GW-1/GW-2/GW-3) Method 1 — Risk Characterization standards are applicable to soil impact in accordance with the provisions of 310 CMR 40.0975. These standards were developed in consideration of potential environmental exposures, and in review of potential leaching of contaminants to groundwater (GW-1/GW-2/GW-3). For the purpose of risk characterization,the most restrictive S-1 (GW-1/GW-2/GW-3) criteria are applied to Method 1 Risk Characterization. BACKGROUND/PRELIMINARX RESPONSE ACTIONS On the afternoon of November 4, 2016, BEA received a call from Oceanside Restoration regarding call they had received regarding a release of fuel oil onto the basement floor of a private homeowner in Centerville. Based on the conditions reported wherein there was no estimated loss and the release occurred at a third party location at the time the heating system was being serviced, they were advised to contact the COMM Fire Department and make Notification on behalf of Nor'east Comfort. Late in the afternoon, BEA received a call from Nor'east Comfort(Tom Heemsoth)requesting LSP response to the property to oversee cleanup. BEA arrived at the subject property around 5:45 pm and was meet by Oceanside Restoration and the property owner, Robert (Swantje) Lyon. BEA initially discussed circumstances of release with the homeowner as associated with no heat call. The house is a second home and there is no automatic delivery. The last delivery was 100 gallons October 27, 2016. As a result of the no heat call, the burner was being serviced, wherein following replacement of the oil filter, the filter leaked an unknown volume of oil onto the basement floor. Based on the fact that the burner technician was still at the property when the release was identified, the leak was quickly repaired and absorbents applied to contain the oil. 1fy4' yj♦♦'k :0 )4 �1 gr; DECEMBER 22,2016 RESIDENTIAL PROPERTY/BEA16-10961 PAGE 5 OF 11 RELEASE RETRACTION,RTN 4-26401 \ A �a J n � � n Photographs 1 and 2: [Top] Showing area of release at tank where fuel shut off at valve and leaking fuel filter removed. [Bottom] Area along wall wherein oil traveled as involving household items and clothing. Note absorbents applied over affected area with no bleed through as would demonstrate saturation. BEA conducted initial indoor air screening of the first floor and basement apartment using a photoionization detector. All readings were reported as < 1.0 ppmv as a standard field protocol to absolve a condition of Imminent Hazard. Higher PID readings (< 10 ppmv) were initially noted in the basement release area and BEA reiterated need for Oceanside to prioritize the removal of all impacted household items, debris and building materials, and to set up fans to actively ventilate, and construct a vapor barrier around the release area. At around 6:00 pm, the MA DEP representative, Bob Murphy, arrived as work progressed [Refer to BWSC-101 Form]. Prior to BEA Departure at 6:45 pm, active ventilation and removal of impacted items had resulted in significantly improved indoor air conditions. Regardless, because there was no heat in the house, the owner and tenant were advised to make arrangements for alternative housing while Oceanside continued work through the weekend. An inspection of the oil burner was to be coordinated with the COMM Fire Department on Monday to return heat to the house while work continued to remove impacted contents, clean the release area, conduct assessment activities and determine if there had been a release to the environment. A meeting was coordinated with the property owner (Richard Lyons), Oceanside Restoration (Steve Jenny) and the representatives for the Insurer of Nor'east Comfort (Scott Masse/Jeffery Beals) on Wednesday, November 9, 2016. At this meeting work progress was documented with the removal of impacted debris (absorbents), household items and building materials and the cleaning of the basement floor and walls. The vapor barrier had been constructed and the building actively ventilated. Indoor air screening reported PID readings as Non-Detect (ND) throughout the first floor and basement areas. An inspection of the rear of the property found a lined roll-off in the rear driveway area filled with the removed impacted items including the absorbents used to contain the oil released to the floor. The covering was removed and a composite sample of the spent absorbents collected, in consideration of the volume of oil f DECEMBER 22,2016 RESIDENTIAL PROPERTY/BEA16-10961 PAGE 6 OF 11 RELEASE RETRACTION,RTN 4-26401 released. Wherein there was no automatic oil delivery and the tank had more than 100 gallons of oil remaining,there was no alternative way to calculate loss. At the end of the meeting, access to the property for BEA to conduct further assessment activities was discussed and permission granted by Mr. Lyon. BEA would also coordinate with the COMM Fire Department to have the fuel system inspected such that the burner could be fired and heat returned to the house, reliant on space heaters. BEA was scheduled to return the following day and advance cores through the basement floor for soil borings to determine whether there had been oil infiltration and a release to the environment. MOW 4 °qt r ii DECEMBER 22,2016 RESIDENTIAL PROPERTYIBEA16-10961 PAGE 7 OF 11 RELEASE RETRACTION,RTN 4-26401 7 fl I LA ff• Py��M 1 t Photographs 3,4 and 5: [Top] Showing area of release at tank following the removal of impacted items and cleaning of basement floor. Hand borings were conducted along the junction of the basement floor and foundation wall as typical areas of preferential pathway. The boring at the front of the oil tank (HB-6)was angled to intercept that area behind the tank. [Middle] Shows electrical ground in floor as area of preferential travel to underlying soils as investigated an adjacent hand boring location (HB-1). [Bottom] Area along wall wherein oil traveled wherein additional borings were conducted for soil sampling and analysis(HB-2,HB-3,HB-4 and HB-5). ENVIRONMENTAL ASSESSMENT BEA personnel returned to the subject property on November 10, 2016. Upon arrival, Oceanside Restoration personnel were at the site again cleaning and deodorizing the floor in the basement. BEA personnel inspected the basement floor within the release area and noted any potential areas of infiltration. The painted floor was noted to be in very good condition with few imperfections. The seam between the painted floor and foundation wall floor appeared to be tight with no expansion crack noted. There was an electrical ground rod that driven through the basement floor, the location chosen to start the investigation (HB-1). A hammer-drill and coring bit was used to core through the concrete basement floor to advance a 3" bucket auger for soil sampling. BEA personnel performed a series of six (6) hand borings in the basement of the subject building. Hand boring HB-1 was advanced near a grounding rod protruding from the basement floor. Hand borings HB-2 and HB-3 were advanced along the expansion joint along the eastern basement wall. Hand boring HB-4 was advanced in the area of a hairline crack in the floor. Hand boring HB-5 was advanced at the expansion joint in the southeast corner of the foundation. Hand boring HB-6 was advanced at an angle beneath the AST to intercept the junction of basement floor and foundation wall behind the tank. Each boring was advanced to a depth of six feet below grade. Soil samples were collected in two-foot intervals and placed in 8-ounce glass jars sealed with aluminum septa. The samples were agitated to develop organic vapors and field screened with a PID (ThermoEnvironmental OVM 580B, 11.8eV lamp, calibrated to 100 ppm benzene standard) by jar-headspace method DECEMBER 22,2016 RESIDENTIAL PROPERTYBEAI6-10961 PAGE 8 OF 11 RELEASE RETRACTION,RTN 4-26401 consistent with the Interim Soils Policy#WSC-94-400. Field screening of soil samples collected from all samples collected from each of the six hand borings reported no concentrations of organic vapors above the detection limit of the instrument (Non-Detect < 0.2 ppmv). Soil samples from each of the hand borings were placed in the appropriate containers and sent to Alpha Analytical for extractable petroleum hydrocarbon (EPH) analysis with target Polycyclic Aromatic Hydrocarbons (PAHs) analysis. Wherein the PID readings were ND at all intervals,the 0-2' sample was selected for analysis as a positively biased "worst case" interval at each of the six (6) locations. The laboratory analytical results for the composite absorbent sample was reported on November 17, 2016 with a Total Petroleum Hydrocarbon(TPH) concentration of 895 mg/kg, as a mass of petroleum hydrocarbons per unit of total weight. This value, as a measure of percent saturation 895/1,000,000 (0.09%) was used to estimate the amount of oil recovered from the total number of pounds of absorbents applied [Refer to Enclosed Mass Balance Computations]. Using a significant safety factor (20x), the estimated loss of fuel was less than 5-10 gallons originally reported. As per the provisions of MCP 310 CMR 40.0311 and 40.0313, the release volume calculated was not reportable under a 2-Hour or 72-Hour Condition. Laboratory analytical results for the soil borings were received on November 20, 2016. These results reported all EPH/PAH concentrations in all soil samples as Non-Detect (ND), wherein the reporting limits were less than the most restrictive S-1/GW-1, Method 1 Risk Characterization Standards as summarized on Table 1. .TABLE 1:Sample Results Comparisonwith Reportable Concentrations RCS,1 Criteria. ,_295 Patriot Way-Centernllc,hlA_(Release Retraction RTN¢-2tiA01) CLIIIVTSAINPLEID ! I I H&1 0 2_ HB-2:0 2 HBJ 0 2' HBd 0 2' HBS 0-2 Hltb:Jfi' -- .—_...___. ... .. _...._ .. ..r _ ._. r .._._- :e _.. .. .. SAWLNGDATE { 10-NOV-16 10-NOV-16 ! 30-NOV-1G ' 10-NOV-16 j]0-NOV-ti :r 1046V-16 LABSM'BLF;ID __. L7636752-01 L1636752-02: !L1636752-03 „L7636752-04 L1636752-05 -;L_1636752-06 _ .. If _ quail Q0r CS 1-J 'QatCAS NumbeR Unts Qn Qn - _ Qual.General Chendstry _ t i Solids,Total — % ' 96.2 972 953 97S 96.9 Lttr'aclaNe Petroleum Hythrocarbous _._ .. i .. .. i .. 1-Nlethylnaphthalene .i, 91 57S 0_7 ntgtkg 03J i U 0331 U 0336 U 0335 U 0339 U _' 0343 U Aeeoaphthene i 83-32-9 4 mg/kg 034 U 0331 U 0336 U 0335 U ; 0339 U = 0343 i U Aceoaphthylene_ 208 96-8 1, m,Jkg 034 U 0311 U 0336 U _0335 U 0339 U 0.343 U Anthracene 120 12-7 loco m„/kg 034 { U 0331 U 0336 U _ 0335 U 0339_ U 0 3J3 U Beozo(a)anth acena i 5655-3_ 7 ( mG/k8 Pi�. J ! U 0331 U ! .0336. U 0335 U 0339. U 03J3 U Bcnzo(-pyreue __.. ,- SOJ pfle8 2.8_ 2 m 034 _ U ! _0331 U 0336 U _; 0.335 U 0339 U : 0.343 U Benzq(brluoranthene .'i 205-99-2 7 ; -Whg 03J U 0331 U ! 0336 U 03.5 - U 0339 U ! 0_343 U __ __ ... .. _ ., ._ - Beorq(g�perylene_ 191 2J-2 loco { mg"kg _ 034 { U 0331 U 0336 U 0335 U 0339 U 0 3J3 U _. ____ __ .. .. ff Benzo(kj0uoranthene ! 207-08-9 70 j mg/Lg 034 U 0331 U `: 0336 U 0335 U 0339 U ! 0343 I U C11-C22 Aromatic f Cll-C22-ALPHA UI m,Jl.g 6- U 6_62 U 6 73 U 6.69 U. 6 78 U _ 6.86 ! U _ _ A. Cll C22 Aroma8cs�Adiusted !01-02 A1PBAJ loco ,Jlsg 68 ! U 6.62 U 673 U _ 669 _U 678 U 686_ j_LI C19-C36 AI ohm cs Cl9 C96 ALPHA ill V 3000 mg/_g 6 8 1 U 6_62 U U 6 86 U C9 C18 AI phahcs OC18 ALPHA-LU 1000 mg1kg 6 8 U ! 6_62 U 6 73 U 6.69 _U 6.78 _ U 6 8G_ U Chrysene 218-01 9 { 70 an i 03J U 0331 U 0336 _ U 0 335 U 0339 U 0.343 U D bmug(a,h)anthrxenc 53 70 3 4 O 7 WA9 03J U 0331 U 0336 U _0 335 - U 0339 U ! 6.343 U_ FluoranWene _ _ _ 20GAJ0 1000 mg/kg 03d U 0331 { U 0336_ U 0335 U t 0339 U 0343 U Fluomne ! 86 73 7 1 1000 { mg/-g 034 U 0331 U _ 0336 U - 0 335 U 0339 U i _0 3J3_ ! ,U —_ _.. _. .___... .. .__ .. Indcno(1,2s3cd)Py ne ! 19339-5 7 m,Jkg 034 U 0331 U 0336 U 0335 , U 0339 _U 0343 U Naphthalene 91-20-3 1 4 mg/kg 034 U 0331 U 0336 U 0,335 U 0 M 1 U 0.343 U Phenanthrene _,. _. 85-01-8 10_.; mg/kg 03J U 0331 1 U ; 0336. U 0335 ! U. 9339 U ` 0343 U Pf1'rene. j 119-00-0 loco mAg 03J D ! 0331 U ! 0336 U 0335 ! U 0.339 U ! 0.343 I U { U=_Non-Detuh,4hlalue shoan as Reporting limit ConcentFafion , RISK CHARACTERIZATION DECEMBER 22,2016 RESIDENTIAL PROPERTY/BEA16-10961 PAGE 9 OF 11 RELEASE RETRACTION,RTN 4-26401 SOIL The laboratory analysis of soil samples as representative of preferential travel and infiltration through the basement floor demonstrate background conditions wherein all fractional EPH and target analytes are reported as ND, and wherein the reporting limit concentrations are less than the applicable RCS-1 criteria, and as such represent No Significant Risk. This data indicates that there has been no release to the environment and in accordance with the above cited MCP provisions under 310 CMR 40.0311, 40.0313, and particularly 40.0317(19)(b), do not represent a Reportable Condition or need for any Remedial Response Actions, as the basis of Retraction requested herein. Groundwater In the absence of oil infiltration to the environment and impact to underlying soils, the subject release does not represent any potential impact to groundwater. As such, the installation and testing of monitoring wells was not deemed necessary or warranted to support a finding of No Significant Risk as the basis of Retraction requested herein. Indoor Air The subject release occurred was confined to the basement with no release to the environment and not subject to the provision of 310 CMR 40.0942(1)(d). Notwithstanding, field PID screening has reported Non-Detect TOV concentrations throughout the dwelling, wherein no persistent petroleum odor is reported. The removal of the contaminated household items, absorbents and impacted building materials from the subject basement has eliminated the sources of residual fuel oil vapors. Based on the absence any such source for vapor intrusion, nor a Reportable Condition or need for Remedial Response Actions, a Retraction is requested herein. CONCLUSIONS/RECOMMENDATION Emergency response actions undertaken by the PRP in stopping the leak in a timely fashion and in the containment of oil that was released to the basement floor minimized impact to the household belongings, building materials and prevented the oil from infiltrating through the basement floor. The subsequent work of Oceanside Restoration to set up active ventilation, establish and vapor barrier and remove and manage impacted items and debris as remedial waste further minimized impacts, an inconvenience to the homeowner that had to temporarily relocate with losses of personal property, as is being compensated. Notwithstanding, conditions documented herein indicate that the release of oil was overstated, as significantly less than 10 gallons and that there has been no release to the environment. In the absence of a Reportable Condition and Remedial Response liability as framed within the MCP, a Release Retraction is technically justified in support of regulatory project closure in accordance with the provisions of 310 CMR 40.0335 as requested by the PRP in the Release Retraction Transmittal Form (BWSC-103) submitted. DECEMBER 22,2016 RESIDENTIAL PROPERTYBEAI6-10961 PAGE 10 OF 11 RELEASE RETRACTION,RTN 4-26401 By copy to the homeowner, it is our specific recommendation that based on the age of the 275 gallon oil tank as almost 40 years old (1978), and the corrosion of the vessel observed, that the tank should be replaced immediately with a double walled tank and that he seek the "Escaped Liquids" endorsement for coverage for any future oil related loss as excluded on his current homeowner's policy. r s' AV IL OW Asi • ' � �jQ as �:# . ��r `'y�,}' '� ��c` 'I'. '°..I i'�� . ,q�' -? n i w(�i<�..SR,.t��.� �� star +�u,; ` +f, I �A ,�.'�► s �+ 4� �`�t l�.-L'�,< .. aF r ,q� x n+7Y �. 4 � +�e. ++ 'A. S,r` ��,4k.....+, ,tir.•��fr,. * a. t Photograph 6: Showing label on top of subject oil tank with date of manufacturing printed as 1978 [Blue Box upper Right] as indicating tank is almost 40 years old. Based on the age of the tank, and noted corrosion,it is the specific recommendation that the tank should be replaced. The findings of this investigation, as represented herein, set forth the rationale and technical justification for the Retraction of Release Notification as based on available data and regulations in effect at the time of this reporting specific to the subject Site. Should the Department have any questions regarding this project, please contact our office at your earliest convenience. DECEMBER 22,2016 RESIDENTIAL PROPERTYBEAI6-10961 PAGE 11 OF 11 RELEASE RETRACTION,RTN 4-26401 Sincerely, B ETT ENVIRONMENTAL ASSOCIATES, INC. "a Davi C nne ,LSP J Ta ma-Wielandt, ES I� Presid Senior Project Manager Encl. -Site Plan entitled"Release Retraction: 295 Patriot Way—Centerville, MA...", Prepared by BEA, Dated November 28, 2016. -Reference Maps: Figure 1 - Site Locus Map Figure 2 - Regional Groundwater Flow Map Figure 3 -MassGIS Priority Resource Map -COMM Fire Department Incident Report -BWSC-101: Release Log Form -BWSC-102: Release Amendment Form -BWSC-103: Release Notification Retraction Transmittal Form -Laboratory Analytical Results: Alpha Analytical L1636328 (absorbents) Alpha Analytical L1636752 (soil borings) -Estimated Loss—Mass Balance Computations Cc: Robert (Swantje)Lyon, Property Owner Tom Heemsoth, Owner—Nor'east Comfort(PRP/Generator) Chief Michael Winn, COMM Fire Department (Centerville) Mark Ells, Barnstable Town Manager Thomas McKeon, Barnstable Health Director REFERENCE BARNSTABLE, MA -PLAN TITLED°5UBDIV1510N PLAN OF LAND IN BARNSTABIF', PREPARED BY 13AMEP 4 NYE.INC.,5URVEYOR5.DATED DECEMBER 16.197G Lows n TOWN OF BAPJJ5TABLE A55E55OR'5 MAP 193 PARCEL 177 s NOTE:TH15 SITE PLAN WA5 NOT PREPARED FROM ANY IN5TRUMENT 5URVEY AND UNDER NO CIRCUM5TANCE5 5HOULD THE DISTANCES, BEARING AND/OR OTHER FEATURE5 5HOWN BE U5ED TO ESTABLISH PROPERTY LINE5. KEY MAP ); FURNACE a LEGEND 5EE DETAIL -1$1,1-113 HAND BORING 1 O CHIMNEY � 275-GAL HB-I i HB-2 .4 LOCUS 295 PATRIOT WAY H8-3 �. ...... .. APARTMENT CAP,N CROSB Y ROAD HB-4 AREA OF STAINING NB-5 RTN#4-26401 BASEMENT DETAIL Project TOM HEEMSOTH SCALE 1-5' P.O.BOX 16-HARWICH,MA 02645 Title: RELEASE NOTIFICATION RETRACTION 295 PATRIOT WAY-CENTERVILLE,MA 02632 BENNETT ENVIRONMENTAL SITE PLAN BEA ASSOCIATES, INC. O 30 60 90 LICENSED SITE PROFESSIONALS,ENVIRONMENTAL SCIENTISTS, GEOLOGISTS,ENGINEERS 1573 MAIN STREET,P.O.BOX 1743,BRE WSTER,MA 02631 5CALE 1-30' PHONE:(508)8961106 .vww.hmnc0-eacom PAX:(508)89 I W DATE I SCALE BY CHECK JOB NUMBER 11/28/16 As Noted SRF JTW BEA16-10961 L71Massachusetts Department of Environmental Protection eDEP Transaction Copy Here is the file you requested for your records. To retain a copy of this file you must save and/or print. Username: JTWIELANDT Transaction ID: 889688 Document: BWSC103 Release Notification &Retraction Form Size of File: 149.39K Status of Transaction: In Process Date and Time Created: 12/28/2016:1:34:43 PM Note: This file only includes forms that were part of your transaction as of the date and time indicated above. If you need a more current copy of your transaction, return to eDEP and select to "Download a Copy"from the Current Submittals page. Massachusetts Department of Environmental Protection BWSC 103 Bureau of Waste Site Cleanup .V Release Tracking Number ,,,�T t RELEASE NOTIFICATION&NOTIFICATION - RETRACTION FORM 4 26401 Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371(Subpart C) A.RELEASE OR THREAT OF RELEASE LOCATION: 1.Release Name/Location Aid: RESIDENCE 2.Street Address: 295 PATRIOT WAY 3.City/Town: CENTERMLLE 4.ZIP Code: 026320000 5.Coordinates: a.Latitude:N 41.67910 b.Longitude:W 70.36034 B.THIS FORM IS BEING USED TO: (check one) r 1.Submit a Release Notification r 2.Submit a Revised Release Notification r 3.Submit a Retraction of a Previously Reported Notification of a release or threat of release including supporting documentation required pursuant to 310 CMR 40.0335(Section C is not required) (All sections of this transmittal form must be filled out unless otherwise noted above) C.INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE(TOR): 1.Date and time of Oral Notification,if applicable: Time: r-AM rpm mm/dd/yyyy hh:mm 2.Date and time you obtained knowledge of the Release or TOR: Time: r AM rpm mm/dd/yyyy hh:mm 3.Date and time release or TOR occurred,if known: Time: r AM rpm nun/dd/yyyy hli:mm Check all Notification Thresholds that apply to the Release or Threat of Release: (for more information see 310 CMR 40.0310-40.0315) 4.2 HOUR REPORTING CONDITIONS 5.72 HOUR REPORTING CONDITIONS 6.120 DAY REPORTING CONDITIONS r a.Sudden Release r a. Subsurface Non-Aqueous Phase T7 a.Release of Hazardous Material(s)to Liquid(NAPL)Equal to or Greater than Soil or Groundwater Exceeding 1/2 Inch(.04 feet) Reportable Concentration(s) r b.Threat of Sudden Release I— b.Underground Storage Tank(UST) r b.Release of Oil to Soil Exceeding Release Reportable Concentration(s)and Affecting More than 2 Cubic Yards j` c.Oil Sheen on Surface Water c.Threat of UST Release c.Release of Oil to Groundwater Exceeding Reportable Concentration(s) ►— d.Poses Imminent Hazard d.Release to Groundwater near Water , d.Subsurface Non-Aqueous Phase Supply Liquid(NAPL)Equal to or Greater than 1/8 Inch(.01 feet)and Less than 1/2 Inch (.04 feet) '. e.Could Pose Imminent Hazard r e.Substantial Release Migration f.Release Detected in Private Well r g.Release to Storm Drain r h.Sanitary Sewer Release (Irmmnent Hazard Only) Revised:07/18/2013 Page 1 of 3 Massachusetts Department of Environmental Protection BWSC 103 l- Bureau of Waste Site Cleanup _ RELEASE NOTIFICATION&NOTIFICATION Release Tracking Number ITa RETRACTION FORM - 26401 Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371(Subpart C) C.INFORMATION DESCRIBING THE RELEASE OR THREAT OF RELEASE(TOR): (cont.) 7.List below the Oils(0)or Hazardous Materials(HM)that exceed their Reportable Concentration(RC)or Reportable Quantity(RQ)by the greatest amount. r Check here if an amount or concentration is unknown or less than detectable. O or HM Released CAS Number, O or HM Amount or Units RCs Exceeded,if Applicable if known Concentration (RCS-1,RCS-2,RCGW-1, RCGW-2) Check here if a list of additional Oil and Hazardous Materials subject to reporting,or any other documentation relating to this notification is attached. D.PERSON REQUIRED TO NOTIFY: 1.Check all that apply: r:a.change in contact name r:b.change of address P c.change in the person notifying 2.Name of Organization: NOREAST COMFORT 3.Contact First Name: TOM 4.Last Name: HEEMSOTH 5.Street: P.O.BOX285 6.Title: OWNER 7.City/Town: EAST HARWICH 8.State: MA 9.ZIP Code: 026450000 10.Telephone: 508-432-4499 11.Ext: 12.Email: 13.Check here if attaching names and addresses of owners of properties affected by the Release or Threat of Release,other than an owner who is submitting this Release Notification(required). E.RELATIONSHIP OF PERSON TO RELEASE OR THREAT OF RELEASE: I-Check here to change relationship P'1.RP or PRP r a.Owner r-b.Operator r c.Generator r d.Transporter r e.Other RP or PRP Specify: r 2.Fiduciary,Secured Lender or Municipality with Exempt Status(as defined by M.G.L.c.21E,s.2) r 3.Agency or Public Utility on a Right of Way(as defined by M.G.L.c.21E,S.50)) r 4.Any Other Person Otherwise Required to Notify Specify Relationship: Revised:07/18/2013 Page 2 of 3 Massachusetts Department of Environmental Protection BWSC 103 L Bureau of Waste Site Cleanup RELEASE NOTIFICATION&NOTIFICATION Release Tracking Number ff RETRACTION FORM 4 1 - 26401 ` Pursuant to 310 CMR 40.0335 and 310 CMR 40.0371(Subpart C) F.CERTIFICATION OF PERSON REQUIRED TO NOTIFY: 1.I,TOM HEEMSOTH attest under the pains and penalties of perjury(i)that I have personally examined and am familiar with the information contained in this submittal,including any and all documents accompanying this transmittal form,(ii)that,based on my inquiry of those individuals immediately responsible for obtaining the information,the material information contained in this submittal is,to the best of my knowledge and belief,true,accurate and complete,and(iii)that I am fully authorized to make this attestation on behalf of the entity legally responsible for this submittal.1/the person or entity on whose behalf this submittal is made am/is aware that there are significant penalties,including,but not limited to,possible fines and imprisonment,for willfully submitting false, inaccurate,or incomplete information. 2.By: TOM HEEMSOTH 3.Title: OWNER Signature 4.For: NOR'EAST COMFORT 5.Date: 12/28/2016 (Name of person or entity recorded in Section D) mm/dd/yyyy r- 6.Check here if the address of the person providing certification is different from address recorded in Section D. 7.Street: 8.City/Town: 9.State: 10.ZIP Code: 11.Telephone: 12.Ext.: 13.Email: YOU ARE SUBJECT TO ANNUAL COMPLIANCE ASSURANCE FEES FOR EACH BILLABLE YEAR FOR TIER CLASSIFIED DISPOSAL SITES.YOU MUST LEGIBLY COMPLETE ALL RELEVANT SECTIONS OF TIRS FORM OR DEP MAY RETURN THE DOCUMENT AS INCOMPLETE.IF YOU SUBMIT AN INCOMPLETE FORM,YOU MAYBE PENALIZED FOR MISSING A REQUIRED DEADLINE. Date Stamp(DEP USE ONLY:) Received by DEP on 12/28/20161:30:34 PM Revised: 07/18/2013 Page 3 of 3 Kara Risk From: eDEPConfirmation@massmail.state.ma.us Sent: Wednesday, December 28, 2016 1:34 PM To: Kara Risk Subject: eDEP Submittal Confirmation for DEP Transaction ID: 889688 Thank you for using eDEP Online Filing from the Massachusetts Department of Environmental Protection.Your transaction is complete and has been submitted to MassDEP. This email is your receipt for the eDEP Online Filing transaction described below. Please review it and keep a copy for your records. Please do NOT reply to this message,this email address will not receive messages. For assistance with eDEP Online Filing, please email the EEA Help Desk at mailto:EEA.ServiceDesk@State.MA.US or call 617-626-1111. MassDEP is interested in how we can serve you better.To help us make improvements to eDEP, please take a minute to complete our eDEP Online Filing Survey at http://www.mass.gov/eea/agencies/massdep/service/online/edep-contacts- and-feed back.html. To contact MassDEP Programs, please see http://mass.gov/dep/about/contacts.htm. DEP Transaction ID: 889688 Date and Time Submitted: 12/28/2016 01:33:30 ************************************************************************************** Form Name: BWSC103 Release Notification & Retraction Form RTN:4-26401 Location: RESIDENCE Address: 295 PATRIOT WAY CENTERVILLE 026320000 Person Making Submittal N0R'EAST COMFORT TOM HEEMSOTH P.O. BOX 285 EAST HARWICH MA 026450000 Person Making Certification Tom Heemsoth Additional Forms Submitted Ancillary Document Uploaded/Mailed BWSC-103 SEC B Q.3 -Supporting Documentation for Release Retraction - Uploaded (BEA16-10961 Retraction of Release Notification 12.22.16.pdf) 1 ' EMAIL ID OF THE USER: krisk@bennett-ea.com 2 JUN. 5.2003 10:29AM BARNSTABLE COM/ECO.DEVELOPMENT NO.599 P.1i1 Town of Barnstable Health Inspector Office Hours Regulatory Services 8;00-9:30 WNSTABTA Thomas F.Gefler,Director 1:00—2:00 HAM Only 1 e19. Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office; 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT QUESTIONNAIRE 1, General Information: Address: 2q6 ?&,� off' WM 6A�t-,(\Atf- MA- Map1g3 Parcel ` " Name: Lr-lw aLAL , Phone: f5NO Yid q 1 2. How many bedrooms exist on your property now? 2a. Please include a copy of your floor plans. 3. Is the dwelling connected to public sewer? YES or If the dwelling is connected to public sewer, skip questions 4-9 below. 4. Location of dwelling is INSIDE or OUTSIDE Zone of Contribution to public supply wells? S. Is the dwelling connected to an ONSITE WELL or to �UBLIC WATER? 6. Is a disposal works construction permit on file? YES or 6a.If yes,how many bedrooms were approved according to this permit? Bedrooms, 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division? YES r NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO FOR OFFICB USE ONLY TO BE SIGNED BY A HEALTH INSPECTOR/AGENT ONLY The Public Health Division has no objection to bedrooms at this property. Signed: Date: 7/-1 Inspector(Print): ohs f4ceaa,, TNL`T - Town of Barnstable �ervi�RR 18 2003 Department of Regulatory N . Q K 19 E Public Health D ,�N OF BARNSTAB E ,K to MAR 9 „�, ivisign 200 Main Street,Hyannis MA 02601 HEALTH!DEPT. Date Scheduled ` ` Timeice"� Fee Pd. 1 t5•b' �- soil suitability Assessment for sewage Disposal <�„ �ti�� • 0A 1 �// U Witnessed By: Performed By: 1Q - a x Ir t,r rNl Ii jFjr 591'r + 1 L� ar .r�' r ,pl R I D::rL iLLlFll oi,f�cI�I'ra�It�i�IIE�fi'I 9�iI'ar�lJ;:��II:IiIltl4�r l��Il(il�I''.IIiM �I�MJJ!I.rI�hy�u�:5 �0. •4'7 II "�S._4-riw �/ Mr ner s1 8Name •r' D ' p,i. tj e on Address %S ��]�/p T/itJ� �j�l�(J l LLB Address �� aL/4'�►�T�� 7 ' � J C�j l�__1 Assessor's Map/Parcel: �9 7 Engineers Name _ 7 700 NEW CONSTRUCTION /REPAIR Telephone# � ? J Surface Stones Land Use I Slopes(%) ,/�_ Body 7�f ft Possible Wet Area /ICJ—ft Drinking Water Well �o ft Distances from: Open Water B Y ft Drainage Way e," 2�f ft Property Line --ft Olher SKETCH Street name,dimensions of lot,exact locations of test holes&pore tests,locate wetlands in proximity to holes) Cp Depth to Bedrock /U/ Parent material(geologic) J�Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face— Estimated Seasonal High Groundwater p� v x T�aI�ft�m r 1�8�:h"i�TI�i,.',I•i��..Iuq' (I x I ..R t �.: r4 l �4 r Method Used: in. • in. DepUt to soil mottles: ft. Depth Observed standing in obs.hole: in.in Groundwater Adjustment Depth to weeping from side of obs.hole: 4� Ad factor Adj.Groundwater Level�f ell# $-Z yt 2 Reading Date: Index Well level j' Index W al;t ;f a I�'yyI 11120, ;.�' yl' ., t fi I kkII gal 4 a. ! G161a "utd3 mg 1 I� ' a Observation Time•at9" ILLS 30 -- Hole# i/ Time at 6" °°S�_ — Depth of Perc �Ol— -- �—�� Time(9"-61 .may — Start Pre-soak Time End Pre-soak Rate Min./Inch Z AM Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) /v . e('nmvletedonBack -------- 1 ,..n.. ��: �".�....:,i,e. ...,:,:vr',.,,. :n :;;..,:r, •::�:,:• ,r!if'tiv, ,":M;d•.•!'r ``V' H4�1lC:Ip;� :';�'.:5�. ..•:��x. �,L:�r;:a ,r VIA r,•n;r ,la r ti .t 5 iy yr �'r 'F ,!'Ci I: lkt� i Fh'a'•'� u�tuyh� M r `ii �, Itilh�uiillkl, 4?ek a °�r !A a .t ;oil Other Soil Horizon Soil Texture Soil Color r DepUr from (USDA) ell) Mottling Structure,Stones,Boulders. Surface On.) Consistent a%Gravel © s- loll 2,5 6 1tJAv Gfr e CZ kiT 110 .:sr ky J"� riK I� ��.I�.rfl�� r•r11'�r �, � .,r� � S� r. � r•'�^3 �;�k� rtf:b Soil Other DepUr from Soil Horizon Soil Texture Soil Color Mottling Structure,Stones,Boulders. Surface(in.) (USDA) (Munsell) � Consistent %Gravel ... ...:. ..� ••ry ,. •.:,.. ..,:y,.,;,:.:.•.;• v�:n. r nn:.::'? Fl�n��c":"`. 'I,'lia'I". .p 'MJ'kt' .,i.'.';,n!�jl:k'I ,;';!'i.�itry7l�,l ��f1;�.4}.r,,,. Soil �tllef Depth from Soil Horizon Soil Texture Soil Color Mottling Structure,Stones,Boulders. Surface(In.) (USDA) (Munsell) Consisten %Gravel i :•rn r r. L`�'r r.Url Y ly�a k nil: i � r r ,�!t! !I.�rrh �rl'r..I:ill I�'��r rir n,�a;r!�{;��k; .50II Other 7.k�nro�'InP•y',� U4ll e Depth from Soil Horizon Soil Texture Soil Color Mottling Structure,Stones,Boulders. Surface(in.) (USDA) (Munsell) Consistent %Gravel -------------- Flood Insurance Rate Map: Above Soo year flood boundary No_ Yes t� Within 500 year boundary No Yes ' Within Ioo year flood boundary No�ZlYes - l Depth of Naturally Occurring Pervious Material. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the afea proposed for the soil absorption system?, S If not,what is the depth of naturally occurring pervious material? Certificate°n ��' � � (date)Y have passed the soil evaluator examination approved by the I certify that on f �e cos�istent with Department of Environmental Protection and that the above analysis was Per o CIYIR 15.017 the.required training,expertise and experience described in 310 . FEB-07-03 10 : 15 AM R. J. CADILLAC, PLS, RS 508 775 9700 P. 01 RONALD J, CADILLAC, PLS, RS Professional Land Surveyor Registered Sanitarian, P.O. Box 258, West Yarmouth, MA 02673 (508) 775-9700 February 7, 2003 Mr, Thomas McKeon, Health Director Barnstable Health Division 200 Main Street Hyannis, MA 02601 Re; Robert& Swantje Lyon-295 Patriot Way, Centerville-AM193/177 Dear Mr, McKeon: The Lyons have retained me to design a 5 bedroom septic design and show a proposed addition to their existing 3 bedroom house at 295 Patriot Way. I have conducted a site inspection and there appears to be enough room to site a 5 bedroom septic system. The Lyons indicate there is a percolation test on file for the locus, and we can use it for the upgrade if it is otherwise suitable. If so please forward or fax(508-775-9700) a copy to my office. If there is a charge, we have money on account with you for such purposes. Thank you. Please call with any question. Sincerely, Ronald J. Cadill - o 3 _ a _ ao - A CD _ _ .p m �vlV/�• �r V t��C. J � RJ - lD 3 m 4. ( w FROM PHONE NO. 5084207971 Feb. 10 2003 07:28AM P01 �VI)Cw 2q 5 �'"' ankro4le 1✓lA 63Z �"c�bruc r� 7 3003 Towvv aC (3A CAST&t1 x-p 0 W Yin r1 %5 Yr C�•n� ��"�.. hcnn C�� v Q o� iut � +r�U.c M�.:., 'u-e �}-a '�v, LLAna k,G M/11`h� �AOA A !1 0 �'`C� . ` 1N1,.� 1M.dk, J �(OL✓ sef AAA,V,aD o.&act OLAA.Cl slap (�ZV?S 4-z rou can s o W�-e h'wU � � � � �. ��. ahoy vK cam. o h'av, to .-ltA;s wattaf Stir �G � '�. I - o 3 ' i � f• - - _. _ - -77 N CD _j , i CeAA�l Vc l ,� i 0 N - m m s � s w m - O D � 3 O A FROM PHONE NO. : 5084207971 Feb. 10 2003 07:2eRm P02 SHE Town of Barnstable Health Inspector Office Hours Regulatory Services 8:00—9:30 e�arsereet�. 1:00—2:00 MASS' Thomas F.Geiler,Director Only Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT QUESTIONNAIRE 1. General Information: Address: 2915 T&Vn o�- W Ce,>n �� MA Map M 3 Parcel 17 1— Name: �V G,W \e oh Phone: (fDc 2. How many bedrooms exist on your property now? 2 2a. Please include a copy of your floor plans. 3. Is the dwelling connected to public sewer? YES or NO If the dwelling is connected to public sewer, skip questions 4-9 below. 4. Location of dwelling is INSIDE or OUTSIDE Zone of Contribution to public supply wells? LIC S. Is the dwelling connected to an ONSITE WELL or to UBLWATER? 6. Is a disposal works construction permit on file? YES . or O 6a.If yes,how many bedrooms were approved according to this permit? Bedrooms. 7. Were any building permits obtained for construction of additional bedrooms? YES or NO 8. Is there an engineered septic system plan on file at the Health Division? YES r NO 9. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO --------------- Fox OFFICE USE ONLY TO BE SIGNI3D BY A HEALTH 1NSPrCTOR/AGENT ONLY The Public Health Division has no objection to bedrooms at this property. Signed: Date: _ a DociWE9765 01-26-ENI 11811 ct M 16S495 BARNSTABLE LAND COURT REGISTRY QUITCLAIM DEED I,JOHN H.BERGSTROM,JR.,of Lenox,Berkshire County,Massachusetts, Trustee under a Declaration of Trust entitled Bergstrom Realty Trust,dated July 1, 1987,filed with the Registered Land Division of the Barnstable County Registry of Deeds,as Document No, gr6 4/9'7 and filed with Certificate of Title No. ,for consideration paid,and in full consideration of One Hundred Eighty-Five Th4 Finloliars($185,000.00)grant to SWANTJE LYON, having an address of: 295 Patriot Way,Centerville,Massachusetts 02632 WITH QUITCLAIM.COVENANTS the land,in Centerville,Barnstable County,Massachusetts,together with any improvements thereon,bounded and described as follows: EASTERLY by Patriot Way,one hundred twenty-nine and 43/100(129.43)feet; SOUTHEASTERLY by the junction of said Patriot Way and Cap'n.Crosby Road,forty-four and 14/100(44.14)feet; SOUTHERLY by Cap'n Crosby Road,fifty-nine and 29/100(59.29)feet; SOUTHWESTERLY by said Cap'n Crosby Road,forty-seven and 381100(47.38)feet; WESTERLY by Lot 52 and a portion of Lot 55,one hundred seventeen and 02/100 (117.02)feet;and NORTHERLY by Lot 54,one hundred eleven and 71/100(111.71)feet. All of said boundaries are determined by the Court to be located as shown on subdivision plan 385079(Sheet 2),dated December 16, 1976,drawn by Baxter&Nye,Inc.,Surveyors,and filed in the Land Registration Office at Boston,a copy of which is filed in Barnstable County Registry of Deeds in Land Registration Book 558,Page 114,with Certificate of Title No.69154. Said land is known thereon as LOT 53. Said land is subject to the easements set forth in two grants made by Zebina H.Jenkins: one to Marconi Telegraph-Cable Company,Inc.,dated June 30, 1951,duly recorded in Book 362,Page 311,which by mesne conveyances is now held by RCA Communications,Inc.,by Assignment from Radio Corporation of America,dated August 3, 1956,duly recorded in Book 958,Page 459,and one to Buzzards Bay Electric Company(now New Bedford Gas&Edison Light Company)dated April 14, 1920,duly recorded in Book 370,Page 378. .t Said Land is subject to restrictions dated May 11, 1977,being Document No.221,279. There is appurtenant to said land a right-of-way over the ways as shown on said plan in common with others who are now or may hereafter be entitled thereto The premises are conveyed subject to and with the benefit of all other easements, restrictions,rights of way,takings,reservations,exceptions and covenants contained in the Certificate of Title of the grantor herein and in all other instruments of record,to the extent now in force and applicable,but not intending hereby to recreate or extend restrictions,reservations, exceptions and covenants previously terminated or expired. Meaning and intending to convey all the same premises shown on Certificate of Title No. -'0i�1d with the Barnstable Registry District of the Land Court,in Book !Ur �,Page . WITNESS my hand and seal this ;� _day of 4&Y&,6g-t"' ,2000. .S.) ejo �A—B—EAGSJROM,4JRr�—u4ee COMMONWEALTH OF MASSACHUSETTS County of ,ss: " i Before me,personally appeared the said JOHN H.BERGSTROM,Jr,as Trustee,and acknowledged that he executed the same as his free act and deed. Date: )6ord-14/142000 •• '• Notky P&lic. M '•P� My Commission Expires: j� L O C U S: 295 PATRIOT WAY,CENTERVILLE,MA 02632 / p0154• 1 I v1 trnRl sr`�n �7�. p � �+ i t� xw [f C�a. In{"j J t'r! 7G D 9 D M 1 O erf 9 1 ter, i� rn ,. '� V, X i 1 LO 4'1 .. E 1 In s 40 40 W)- �aa, f�l ry v 1 3> t= —44 "r7 1 x 'n K f J r` f_J �" ey TRUSTEE'S CERTIFICATE 1,JOHN 11.BERGSTROM,JR.,of Lenox,Massachusetts,do hereby state that I am the sole trustee of BERGSTROM REALTY TRUST u/d/t dated July 1, 1987,recorded with the Barry bl�e 1 istrict of the Land Court as Document No.��G noted on Certificate of Title No.!/AIL in Book ��0 r_,Page 3 7 , and further that: 1. I have been directed by all the beneficiaries of said trust,who are of full age and legal capacity, to the extent required under said trust, to execute and deliver the deed to Il0B11R1I 8AV"SWANTJE LYON inconsideration for One Hundred Eighty-Five Thousand Dollars ($185,000.00), the said deed to be recorded or filed with said Deeds herewith; 2. 1 have not been removed from office by said beneficiaries as of the date hereof; 3. Said trust has not been altered,amended or revoked as of the date hereof. IN WI SS WHEREOF,I have hereunto set my hand and seal this day of 1 2000. _(L.S.) ?OHN H.BER TROM, ,Trustee COMMONWEALTH OF MASSACHUSETTS i County Befo me,personally appeared the said JOHN H.BERGSTROM,JR.,as Tnistee and acknowledged that he executed the same as his free act and deed. Date: 2000 Notky ublic X44ry }�. . , ,P Y" "`•`' My Commission Expires:4: '••. pO2261e f• Q; e c!,LE COUNTY A``i4 COPY,ATTEST I BARNSTABLE REGISTRY OF DEEDS w: No. �'�O'(_0 l ( Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Z(ppYication for IDigpogal *pgtem Construction Permit Application for a Permit to Construct( )Repair(V)Upgrade( )Abandon( ) ❑Complete System FIndividual Components Location Address or Lot No. Owner's Name,Address and Tel.No, Assessor's Map/Parcel il al �®"', l7li/r�✓c�`�/�J Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. �JD�ya�l�i G��s7L Type of Building: Dwelling No.of Bedrooms _ Lot Size sq.ft. Garbage Grinder( � Other Type of Building f<G:5/Ole412�eNo.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow /Z gallons per day. Calculated daily flow ✓r� gallons. Plan Date .. Number of sheets Revision Date Title Size of Septic Tank OW Type of S.A.S. /oX3AeZ Description of Soil —/�i'q�CCt/� y ��`r!!�`®!"$ Nature of Repairs or Alterations(Answer when applicable) 6 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 t 's Bo d of ea Signed Date //6— Application Approved by i Date 2 G✓ Application Disapproved for the following reasons Permit No. �� Date Issued I %L �--�w No. O Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zippfication for Digogaf *pgtem Congtruction Permit Application for a Permit to Construct( )Repair(V)Upgrade'( )Abandon( ) O Complete System Individual Components Location Address or Lot No. " ��+y j�fs Owner's Name,Address Address and Tel.No. (�5 Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No... - A4r�`O&1141 C1/D/J57�% J7 E Type of Building: g Dwelling No.of Bedrooms—> Lot Size s"qft.� ^ Garbage Grinder Other Type of Building A!�_7 iu e'025?No.of Persons - Showers( ) Cafeteria( ) Other Fixtures f Design Flow gallons per day. Calculated daily flow. 3 A52 gallons. Plan Date / ; . Number of sheets Revision Date Title Size of Septic Tank 9P Type of S.A.S. Description of Soil Natit a of Repairs or Alterations(Answer when applicable) �7�1sQq/� � y 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- cafe of Compliance has been issued by this Bqgr d o Hea kt.Signed Date ljl/Z2f /D Application Approved by --�•..._ Date w 2 2 �✓ ; Application Disapproved for the following reasons Permit No. Date Issued ————————— THE COMMONWEALTH OF MASSACHUSETTS H3 V 7 7 BARNSTABLE, MASSACHUSETTS (Certificate of (Compliance THIS IS TO CERTIFY,that the On-site ewa a Disposal System Constructed( )Repaired(Upgraded( ) Abandoned( )by 4f � C9�i'Sy"- at 2 5 71B S waz I ee gull e has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer A Al.A A ,--y The issuance of this permit shall nob co strued as a guarantee that the sy t m will functi n�asldesign d`. Date y� Inspector r4 1 v V --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS Migpool *pgtem (flongtruction Permit Permission is hereby granted to Con ct( )Repair(V Upgrade( )Abandon( ) System located at Z 2 S : /. ,0 and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construc on mu t be completed within three years of the date of this permit. Date: 2 'LOG-' Approved 11�6f99 . NOTICE: This Form Is To Be'Used For the Repair Of Failed 'Septic Systems. Only. _ CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL WORKS CONSTRIICTION PERMIT(WITHOUT DESIGNED PLANS) Aereby certify that the application for works disposal p o ks construction permit signed by me dated /Z/Z Zl�a concerning the property located.at 7 ��`j^�� G�q �/ � �� e all of the following criteria:. 6 :he failed system is connected to a residential dwelin;only. There are no comme:cal or business 1/uses associated with the dwelling. +� i tie soil is classified as CLASS I and the oe '/ --coianon rate is less than or equal :o inures per nc:i • +' 7per a are no wetlands within 100 feet of he proposed septic stem :tie:a are no private wets within.I40 feet of he nroposed septic s�sem. ly 7-here is no increase in flow and/or champ in sse proposed +� There are no variances.requested or needed. +/ The bottom of the proposed leaching facility will not be located le ss than five tees above the maximum adjusted groundwater table elevation. [Adjust the groundwater table using the;=," ptor method when applicableJ. /if the S.A.S. will be located with 250 feet of any vegetated ,,..tired welands, the bottom of the proposed leaching facility will not be located less than fourteen(14)feet above the ma..-dmum adjusted groundwater table elevation, Please complete the following: A) Top of Ground Surface EIevation(using GIS information) — -- B) G.W.Elevation 12� the MAX.High G.W.Adjustment. 3 1_ 3 i3't Z DIFFERENCE BETWEEN A and B SIGNED : ` l0� _ DATE: (Sketch proposed plan of system on back]. ¢haft so+k cert fa o �c�� TOWN OF BARNSTABLE LOCATION _ 7i7 �a'�/�4�5 �Q� S/ SEWAGE # VIILAGE__ ASSESSOR'S MAP & LOT �. INSTALLER'S NAME&PHONE NO. 7 7/- _ SEPTIC TANK CAPACITY //do �j G iLEACHING FACMrFY: (type) 1m C y4�, •,j [`J A3d X,1 (size) /O NO. OF BEDROOMS BUILDER ORSOWNF_R 1 i 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 300 feet of leaching facility) �9 Feet Edge of Wetland and Leaching Facility (If.any wetlands exist within 300 feet of leaching facility)- 00, Feet { . ..Furnished by M AC I.. . w Cam'I I i V I i ol!� M AA I -. .. MM " , n Add;. ec) V � i- N Ire 0 � O � C LOCH d.r4 SEWAGE PERMIT N0'. VILLAGE IN.STA LLER'S , NAME & ADDRESS P cat +, aiG� 7� Gccyr� [cam c �i e" �vll t,k e B U I'L D E R OR OWNER S k JL5-7— DATE P ER MIT. ISSUED DATE COMPLIANCE ISSUED — ��- (�f 5�— -- ya h� - a o - No...........` ....... Fzes..s�.Y�?.................. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH V .:.......... .............:0F.......................................................................................... Applika#iun for Uiipuutal Workii Tunitrnstiun Famit Application is hereby made for_a Permit to Construct (L-I-or Repair ( ) an Individual Sewage Disposal System at: r. ? �v...¢ G� .g.� i4' fi.<............................................................ ..S _._ location-Address or No. :G.... ...............-- °. jO/�Jner d� 1�h40 Address a '�� • " ¢ . ------......•••...............•........_.....- Installer Address Type of Building Size Lot..1'9j.i.Q .......Sq. feet U Dwelling No. of Bedrooms...._ .Expansion Attic Wo Garbage Grinder pa, Other—Type of Building ............................ No. of persons........................_--- Showers ( ) — Cafeteria ( ) a4 Other fisgfu�pes........... W Design Flow.........../��X�-:--gallons per person per day. Total daily flow �'r�€?.._�.:�'.:. 9?................._gallons. WSeptic Tank—Liquid capacity gallons Length................ Width................ Diameter................ Depth................ x Disposal Trench—Ng. ....:-------........ Width----____-..-______-- Total Length.................... Total leaching area-___--_--•--._____--sq. ft. Seepage Pit No---------�.t........ Diameter.................... Depth below inlet ............... Total 1 ching area..................sq. ft. Other Distribution box Dosingtank l a Percolation Test Results Performed by._-.f4114r'_..__�t` --------- _ 1✓? ............ Date...1 _-. Test Pit No. 1.../...._minutes per inch Depth of est Pit.................... Depth to ground water........................ f� Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ Description of Soil------•--- 1= __/- -) y - "--5 ��c/'--------- ?leaf'-_ � �� '`� -- ......_.. 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 TITU 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has sued by the board of health. Sign d 1�= Dats Application Approved B r/ ------ ate Application Disapproved for the following reasons-------------------------------------------------------------------------------------' ...........••-------------------•....-••---••-------•-....__....-------•-••---•---------•••--••--....-•-•-••--------------------•-•-•--------•----•......------•---..................................... D"ate PermitNo......................................................... Issued_---- �------------•--•---�-----------•-------- Date No........... ....... FEs.... ✓r ..... THE COMMONWEALTH OF MASSACHUSETTS BOAR '`OFF H—fEALTH .. �.- .......................OF.....:'ti ........... ................................................. , lir than f nr� t n jai arks Tonstrnrtwu ramit Application is hereby made f6f..a Pefth;it.t0'- Constr t I" or Repair ( ) an Individual• Sewage Disposal System at: } F�« 1-•-• ----•- � '�r ..� ..... ' ..................................................... �f �r Location-Address yew �r�y logo Owner Address �. nstaller' :,.,� Address Type of Building Size Lot4j_6Q ......Sq. feet U : t-, Dwelling—' No. of Bedrooms.____.................__________________Expansion Attic (Alo Garbage Grinder aOther—Type of Building ............................. No.,.of persons.....................:...... Showers ( ) - Cafeteria Otherr�"s. •-------------- -------.....------•--•-•---------------- ..... W Design Flow........... per person'per day. Total daily flow-----: d.... _......gallons. WSeptic Tank—Liquid'capacity. gallons Length.••---•••--_.... Width................ Diameter................ Depth................ x` Disposal Trench No Width ................... Total Length.................... Total•leaching area sq..ft. Seepage.Pit No .. Diameter ,:_. __:._.. Depth below Inlet ... Total leachin area„ t s ft. Z- Other Distribution.box ( ) D,o'sing to ( V 1. pr ` / A1:= 7 7 `-' Percolation Test Results Performed by...�- ,,.:_ ....... ______:__ Date___ a Test Pit No. ....mmutes per inch Depth o Test Pit............ .:... Depth to ground water _.__._.._.:. 1-4 fs, Test'Pit No. 2__.._. 4.',_niinut6s per inch Depth of Test Pit °Depth-to ground water ...................... Oa i . , �� fi Description of Soil,.----- ' _ ,. � ct/ � ' _ j - -t 1 -------------------------- t -- E t r • (U�: r •x Nature of Repairs or Alterations„ Answer when applicable ` ,___ .__.. ......... ................ ......... ......... ......... ..... ..... ........ ........ .__�_ �C .................. ,.. _... _.. ; ...... S. i _ Rl A� Agreement: . ' The .undersigned agrees to install the aforedescribed Individual Sewage_Disposal System In;accordarice�:witI the provisions of TITLi� 5 of the State.Sanitary Cote- he undersigned further agrees riot,to place the system in OP eration until a Certificate of.Compliance h as beeissued:by the board of health. .i Signe; s xPpl�ction._APPxc�vedr ng eans . --••-••. , Application Disapproved for the folloun ----------- ------ --------------------- ------- Zzt. t'rDate. i. Permit No.............. '.---• ---•-•--- u i -. Iss ed.. ------ •. Date x{ v ;.w a - U r; THE COMMONWEALTH' OF MASSACHU$ET,TS -,, 130j RD OF A 16 EALTH - y ` :.. .... ., (Irrtifirtt#le of fauntrltanrr ` THI IS TO E�? I Y, That the,Individual Sewage Disposal S�stein constructed `(„'n or Repaired ( ) } by --- . fr Instalr t at ...... ♦ //".. -- ra .,has been installed in accordance with the ions of TI F ,j d� he State Sanitary.Code as-descri ed m the =application for Disposal Works Construction Permit No..' :.7 ..... ....................... dated .._:___H_.-.7 ................ . THE ISSUANCE OF THIS'CERTIFICATE„SHALLaNOT BE CONSTRUE AS A GUAR WEE THAT THE SYSTEM WILL "FUNCTION SA iSF�►CTORY.'." DATE............... .......�--......-• ...... Inspector:..: THE COWL 6NWEALTH OF MASSACHUSETTS BQAR.D,;.O HEALTH .... ZS No.. FEE........................ i r.a� � gx~ ion Permission i eby granted .`..' . .......... . ---- •••. •••••. to:Constru ( or Rep '� an divid 1 Sewage os .� 3 =- 4 _ __ ' k at IVo.. ------ ---•-•-- •-- .---------•• •...--- ---� y. Street r'" as shown on the application for Disposal Works 7hstru�tion Permit Dated..__._�__..�....�.�......... ...... �--------------------------- > A. Board of Health DATE----------= . FORM 1258 HOBBS & WARREN, INC.. PUBLISHERS •, m�t`' t� �n`�il� ►'�'t err `�,L�+[''{'�1�- ��`•��` = ��C�.r 1�7G % = Gl-gr7 G. D. 1 uSE. IG'cao GA-L- - - 51 c%T"MW 40 t_A- a;�C> ST- t L 1 Z "CcrrA L T3 = :425 TOT4 kuo G. Z fi t ' � s r box I u1U Z�r�►,J 1UU y GC, ZI WiLLIAM � �NNY `;•J yJ.'° ; r ,�. I� C /�'' �" sl..) CYI.J✓�j� fCJD yty�4� iL TO'P �N U = I P O.O ,""., GU�1M J'iive loci luv.��s •:.� tuv., q'��O a 4'pp� 1w. (SAIL. INN;f. /5 - TSox ��' L SE+✓rlc 1 ri �.,. �� ✓�Z I 000 PST i I WASNE.D SToti� I zv�' 1=G' t_tl--1c D _ PLC+iAj 'L F'QcaF 1 LE- -_ -- A T I c.)1v1 A,-"T Cam: ' tib ►�J/a-T�2 iy Gt;tZ-ri Iz `( Ti-(A"f- T1-1G 'C>L,)►�vld,TtUA! S[lchc.i►.l S--'t_. L>t�l T�i-_1=��_1:�.ic C� - l' k?l�r�t_1 "t"« ;in, -t►_iL L.n—r— S as,,c� �.iY-rtr.nctG ti:rlr�1.��M�-'-1T. ar= z•►-�[.:: i ;-� R # 1-10 .j. l_ Az! 1-17 Ut .! /-a1 (i'�'t[_( �/Il_l_G_ v '4r�•S`i, �Ml•r��,?':J.�✓1t _>..i't� '�t�, �ii �{ %. C�{L. c {- l-"'�iC-ter Pi1ft_ItS'� t?( "t l;i`:A1::_s � -- L)FPf L ;�---�-- . n :r k��[_ l: zC , t�, t>1.- 1G:1_A�,�ti.lt_ 1_c:;- t_tt.t..: - Sf� IC-, ( • JOB NO. B03-01 GIUGGIO N/F NOTES Lyon.dwg 1. LOCUS IS A.M. 193, PARCEL 177. 2. ELEVATIONS SHOWN ARE TOWN GIS ±0.5'. (BASED UPON ROAD SPOT ELEVATIONS.) Oak Street boot 0� N 89'40'46" E 3. LOCUS IS IN FLOOD ZONE C ON FIRM DATED AUGUST 19, 1985. Long Crosby - ' x 111.71' 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED) a '� 5. MUNICIPAL WATER IS AVAILABLE. LOTS WITHIN 100' ARE ON TOWN WATER. -o Rd• N x 67.7 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. o BENCH MARK-TOP REAR CENTER N 7. INLET TEE TO PROJECT DOWN 13", OUTLET TEE DOWN 14". SEPTIC TANK = 61.12 TOWN GIS± L 0 T 53 _ 8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR EQUAL FLOW �7 L C x 67,5 D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. NOT TO 5 / 8 0-r- S.. I 9. DEPTH OF COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. SCALE BUILD UP COVERS TO WITHIN 1 OF GRADE. MORTAR CHIMNEYS IN PLACE. 0 34 Jam' 37 5' 67,51 ONE COVER OF TANK TO BE WITHIN 6" OF GRADE. LOCATION MAP 10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2' MIN. 1/8 TO 1/2" PEA STONE ON TOP. 00 EXIST. PA pRIV 11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE FOUND, 66. 0o CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC. zit EXISTING SEPTIC N � 12. IF AN OVERDIG IS CALLED FOR BELOW, FILL MATERIAL FOR 5' AROUND AND UNDER LEACHING TEST HOLE 1 SYSTEM LOCATION o � II 67 46 IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS OF 310 CMR 15.255(3). FROM ASBUILT r 5 7 c a 70 13. PUMP AND FILL ANY EXISTING CESSPOOLS. REMOVE ANY CLOGGED SOIL, BLOCK, AND STONE IN U CARD w W O LEACH AREA, AND DISPOSE OF AS DIRECTED BY HEALTH AGENT. DEPTH (inches) ELEV.(feet) iv z 0 14. ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS. 0 A layer 10yr 3/3 63.1 N/F o 31'2o67.4 TEST HOLE DATE: April 1, 2003 10" sandy loam or •�' BENCH MARK-TOP REAR CENTER PERFORMED BY: Ron Cadillac, Soil Evaluator B layer 10yr 5/6 f x sandy loam MCDONALD 10 O W o SEPTIC TANK = 61.12 TOWN GIS± WITNESSED BY: Sam White--P-10,443 Z ...'."' = 34" O r M N PERC RATE: <2'-00"/inch (C2 layer) C1 layer 2.5y 6/4 SOIL SURVEY(1993): Carver loamy coarse sand 4. N sandy loam GEOLOGIC MAP(1986): Sandwich moraine deposits 38" 59.9 w/10% gravel at top 21 0 31.81 g Invert 61.87± Invert 61.55 "a X L 8 HIGH CAPACITY 52 LL.I o (-"' Use Gas Baffle Pso osedBaffle Invert 61.20 INFILTRATORS C2 layer 2.5y 6/4 I I 42-1 4 I Existing P fine sand Proposed I I W Top Conc.=60.7 F 7 0 I 35.4 O J61,80 S=1/2"/ft Top Peastone=60.4 6r -'Proposed 22, N PROPOSED....... x 66,7 p S=8"/ft. observed water ADDITION 1000 Gal. - - -_ -- 132" - - - - - s2.1 66.5 142' 28' 37' I _ 15" 150" 50.6 I Proposed T Invert 61.37 Invert 59.85 TH 1' 6 ,4 F 6" Stone i l or compact Proposed Proposed 1 5.1 58.6 1 1 1 N I I Bottom 3,6 d' S.2 r 21 -4 I I - 1 2- El. 53.5 62,3 '6 m 1.4' USGS Adjustment ,o DESIGN DATA CDZone B Usin DW252-March 03 �0 dN' D Observed Water=52.1 �s - - E F BEDROOMS: 5 % �zj 'p 2 F - GARBAGE GRINDER: No �s O � - xJ 66.0 REQUIRED CAPACITY: 550 GPD LEACH AREA C 65.1 x 65 SEPTIC TANKS: 2000 GAL. USE 8 HIGH CAPACITY INFILTRATORS WITH R=182 77' 4c P�°c�.� BOTTOM LEACHING AREA: 605 SF APPROXIMATELY 4' OF STONE ON THE SIDES � A�9. 29' %g' 3 eJ AND 2 1/2' OF STONE ON THE ENDS AND 5" SIDE LEACHING AREA: 165 SF [(11' X OF STONE UNDER TO MAKE A 55' X 11' X 15" [2(11'+ 55') X 1.25' DEEP)] DEEP LEACH AREA. DESIGN CAPACITY: 569 GPD PARTIAL 5' REMOVAL .� C O S [(605 SF + 165 SF) X .74 GPD/SF] REMOVE ALL CLOGGED SOIL AND STONE WITHIN [35' OF NEW LEACHING. REPLACE WITH CLEAN SAND. P P D G . ZONING DISTRICTS: RC & AP REQUIRED YARDS: FRONT 20' BENCH MARK--TOP OF MAG. NAIL SIDE 1 0' SET IN BERM = 63.20 TOWN GIS± REAR 10, SITE PLAN FOR THIS PLAN IS A VALID COPY ONLY IF IT BEARS AN ORIGINAL RED STAMP AND SIGNATURE. ROBERT & SWANTJE LYON LEGEND LOT 53, 295 PATRIOT WAY, CENTERVILLE, MA TEST HOLE LOCATION NUMBER jN OF M�SSq ti ��N')F n1 11ssgcG " WATER LINE MARKINGS /�' RON EL c c ��'``' APRIL 15, 2003 SCALE: 1 =20' E OVERHEAD ELECTRIC WIRES (IF SHOWN) 0 x 9.5 X 8.7 EXISTING & PROPOSED ELEVATIONS ( X MARKS POINT) A EXISTING CONTOUR �o,� $-- PROPOSED CONTOUR ScisTER� �gtiuRVE'�o� gN1TA0 0 s � _-. RONALD J. CADILLAC, PLS, RS 0 UTILITY POLE (IF SHOWN) x FENCE (IF SHOWN, NOT ALL SHOWN) C� PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN 0 TREE (IF SHOWN, NOT ALL SHOWN) P.O. BOX 258 WEST YARMOUTH, MA 02673 HEALTH AGENT APPROVAL DATE C (508) 775-9700 REVISED 4/28/03--ARROW POINTING TO EXISTING SEPTIC MOVED. 2003 BY R.J. CADILLAC PAGE 1 OF 1 JOB NO. B03-01 N/F NOTES Lyon.dwg GIUGGIO 1. LOCUS IS A.M. 193, PARCEL 177. 0 2. ELEVATIONS SHOWN ARE TOWN GIS ±0.5'. (BASED UPON ROAD SPOT ELEVATIONS.) Oak Street boo{ r• N 89'40'46" E 3. LOCUS IS IN FLOOD ZONE C ON FIRM DATED AUGUST 19, 1985. Loo9 Gr gby 111.71' 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED) a 'r ° Y 5. MUNICIPAL WATER IS AVAILABLE. LOTS WITHIN 100' ARE ON TOWN WATER. d N 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. o o R BENCH MARK-TOP REAR CENTER N 7. INLET TEE TO PROJECT DOWN 13", OUTLET TEE DOWN 14". SEPTIC TANK = 61.12 TOWN GIS± 67 LOT 5 - (A8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR EQUAL FLOW I / D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. NOT TO 15 8 0 S.. f . ; 9. DEPTH OF COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. SCALE _ 9 BUILD UP COVERS TO WITHIN 1' OF GRADE. MORTAR CHIMNEYS IN PLACE. 3� ONE COVER OF TANK TO BE WITHIN 6" OF GRADE. 0 34 5, LOCATION MAP Jc 67.51 10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2" MIN. 1/8 TO 1/2" PEA STONE ON TOP. LO 6' EXIST, p,4V 11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE FOUND, 66.� 6 3 '�' ED DR/ CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC. z °s Cn Co 12. IF AN OVERDIG IS CALLED FOR BELOW, FILL MATERIAL FOR 5' AROUND AND UNDER LEACHING TEST HOLE 1 t�-- _o i CV jD 67.8 ,7.4F, IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS OF 310 CMR 15.255(3). a ° ° 13. PUMP AND FILL ANY EXISTING CESSPOOLS. REMOVE ANY CLOGGED SOIL, BLOCK, AND STONE IN v W r, __65 7 W a O LEACH AREA, AND DISPOSE OF AS DIRECTED BY HEALTH AGENT. DEPTH (inches) ELEV.(feet) -i ° N r-, z�0 14. ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS. 0 A layer 10yr 3/3 63.1 bi sandy loam r 31,2' TEST HOLE DATE: April 1, 2003 10" _::.. N/F o BENCH MARK-TOP REAR CENTER PERFORMED BY: Ron Cadillac, Soil Evaluator B layer 10yr 5/6 MCDONALD 2 O w o SEPTIC TANK = 61.12 TOWN GIS± WITNESSED BY: Sam White--P-10,443 sandy loam - - 2 o PERC RATE: G2'-00"/inch (C2 layer) 34" C1 layer 2.5y 6/4 ; SOIL SURVEY(1993): Carver loamy coarse sand f 4, 0 c N N sandy loam EXISTING SEPTIC f:: :::` : :: :� _Z Q' u u GEOLOGIC MAP(1986): Sandwich moraine deposits 38" 59.9 a_ .CC Q w/10% gravel at top SYSTEM LOCATION � 66.83 U FROM ASBUILT 21" \ 0 31.8' f`........� ~ Invert 61.87± Invert 61.55 52"� < ` ;: CARD �- X Q Use Gas Baffle Use Gas Baffle 42' W ° Existin Proposed Invert 61.20 INFILTRATORS 4 ~ I g Proposed fine sand Top Conc.=60.7 °'--- 35.4' w O Existing S=1/2"/ft Top Peastone=60.4 0 N PROP S x 66.7 �'� Proposed 1Ooo Gal.1000 Gal. / 132" observed water 52.1 PROPOSED s=8" ft. 22� ADDITION - - - - -- `t 66,5 42, 28' 37, I Proposed PInvert 61.80 . _ 15" 150" 50.6 ' 0� - � Invert 61.37 Invert 59.85 TH 1' 6 A '"'� 6�� Stone or compact Proposed Proposed 1 5.1' 58.6 x 66 I ( I I N I I Bottom � 2' �-4' 2' El. 53.5 ,6 _ 3'6 co 1.4' USGS Adjustment i_ < Using SDW252-March 03 ,o n DESIGN DATA Zone B 0 � , Observed Water=52.1 9 A s�O O - - F I BEDROOMS: 5 �a ,yp� �� SRO 631 6 ,8 GARBAGE GRINDER: No LEACH AREA .ems ,�� /� x I 66.0 REQUIRED CAPACITY: 550 GPD G�gyp 65.1 x 65.8 USE 8 HIGH CAPACITY INFILTRATORS WITH SEPTIC TANKS: 2000 GAL. R-182. 77' \ BOTTOM LEACHING AREA: 605 SF APPROXIMATELY 4' OF STONE ON THE SIDES 065,9 [(11' X 55')] AND 2 1/2' OF STONE ON THE ENDS AND 5" n X, SIDE LEACHING AREA: 165 SF OF STONE UNDER TO MAKE A 55' X 11' X 15" ' DEEP LEACH AREA. _ [2(11 + 55') X 1.25' DEEP)] DESIGN CAPACITY: 569 GPD PARTIAL 5' REMOVAL [(605 SF + 165 SF) X .74 GPD/SF] REMOVE ALL CLOGGED SOIL AND STONE WITHIN CROSBy 5' OF NEW LEACHING. REPLACE WITH CLEAN SAND. G P D ZONING DISTRICTS: RC & AP REQUIRED YARDS: FRONT 20' BENCH MARK--TOP OF MAG. NAIL SIDE 10' SET IN BERM = 63.20 TOWN GIS± REAR 10, SITE PLAN FOR THIS PLAN IS A VALID COPY ONLY IF IT BEARS AN ORIGINAL RED STAMP AND SIGNATURE. ROBERT & SWANTJE LYON �I\AOF1,1, s ZN°F MgSs9cy LOT 53, 295 PATRIOT WAY, CENTERVILLE, MA �� 9 LEGEND _s A L ��° R G� APRIL 15, 2003 SCALE: 1 "=20' -1;�- TH 1 TEST HOLE LOCATION, NUMBER # 106 n #35779 W WATER LINE MARKINGS �FGISTER 0 ',Fs5\0 E OVERHEAD ELECTRIC WIRES (IF SHOWN) SgNirAr `^`'- "� SUR\1E�° RONALD J. CADILLAC, PLS, RS x 8.7 EXISTING & PROPOSED ELEVATIONS ('X' MARKS POINT) �-� EXISTING CONTOUR PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN _8- PROPOSED CONTOUR P.O. BOX 258 0 UTILITY POLE (IF SHOWN) WEST YARMOUTH, MA 02673 FENCE (IF SHOWN, NOT ALL SHOWN) 0 TREE (IF SHOWN, NOT ALL SHOWN) HEALTH AGENT APPROVAL DATE (508) 775-9700 C 2003 BY R.J. CADILLAC PAGE 1 OF 1 �M 2A( a. � I � YL s f � Arw 20 Iry t t � 1t — L k" - 3 e IL JO Z�� ,�,•.T�-tom u/n.� APPROVED BY: DRAWN.BY DATE:4f)c.t • DRAWINC3 NUMBER _ l 7wvAt, -Twa A(. y r , -Sir— toR ¢utM.:kct r�Do e la Qxr - 1" 71ru--.14 - - - N t4 tar F i Y F + s - f i t,v-� ems`-cam �'-2�" - 7�- t" •�4,�3'� i SCALE:Yj; `�' APPROVED BY: •..,:u„ ,� ;, DRAWN BY .. DATE: �'A Z003 'J��erG'V�St'�1 DRAWING NUMBER i • 2)ek0 Q lbw' 19 is ii I I� •j ,,. I I I tn Zvt Qt pw II Ile vow -Y41:9`1114 s +fS • � Oyu .. zq5 AMu. ,. SCAIE:� C\�� w APPROVED BY: DRAWN BY DATE: `1 DRAWING NUMBER J . i A 1 M M 3 10 `t��.a�'a► TCt�4-1�.► ,�h'!�off. �►I ,,\ a � ' 1 1 �yCiw ra w►4s NWIT— 49 10 0oe e) �y�t g�' Nei►�oµ ter �out 't� . IV 1 w SCALE: 4 ..11 0M 'APPROVED BY: ... DRAWN BY DATE: ��.�``.ZtX"►'�g \�� ON ')>LAW DRAWING NUMBER