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Home My WebLink About0025 PROSPECT AVE UNIT #A - Health -NTROSPECT AVENUE Centerville ry A = 226 - 019 EM E A D Na 2.10LOR UPC 12M nnwd,mn • Me&in USA rA v l S v y rJ CF THE Tp� do Town of Barnstable Department of Public Works p BAtov— www.town.bamstable.ma.us* sn MASS. * Water Pollution Control Division � MASS. � 1639• A.0 617 Bearses Way,Hyannis, MA. 02601 rED MAC Office: 508-790-6335 Andrew R Boul6 Fax: 508-790-6325 Supervisor Barnstable Water Pollution Control Division Fiscal Year 2017 Sewer Rates Hyannis Water Pollution Control Facility Residential Rate: $5.04/ccf Commercial 1 Rate: $5.04/ccf Commercial 2 Rate: $5.61/ccf Commercial 3 Rate: $6.27/ccf Fixture Rate: $52.00 per fixture Minimum Charge: $54.64 Septage Rates: $0.10493/gallon Note: Septage rate may be adjusted between the range of $0.08 cents per gallon to $0.11 cents per gallon during the . fiscal year as market conditions dictate Marstons Mills Wastewater Treatment Plant MMWWTP Sewer Rate: $14.96/ccf Red Lilly Pond Communal System RLP Flat Rate: $864.60/year Town of Barnstable `�sg��es°a°� P`pE 114E Tp�� Board of Health erieaC'i 6A MASS' 200 Main Street, Hyannis MA 02601 I 9 MASS. 0 ap i639. �0 pTf0 MAC p, 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi May 16, 2016 Ms. Cynthia Diggs C/o Mr. Jim Lane 86 Summerbell Ave. Centerville, MA 02632 RE: Variance Decision. Number of Occupants Authorized at:125 Ocean Avenue, 208 Lake Elizabeth Drive, 19 Prospect Aveiiue, and 39/45 Pr6spect Avenue Dear Ms. Diggs and Mr. Lane, �� You are granted variances from Section 105 CMR 410.400, of the State Sanitary Code, Chapter 2, Minimum Standards of Fitness for Human Habitation, which requires a minimum of 80 square feet of floor space for one occupant and 60 square feet of floor space per occupant within bedrooms which are used by more than one occupant. These variances are granted with the following conditions: 1) No more than eleven (11) occupants are allowed within The Groves building located at 125 Ocean Avenue. The applicant requested twelve occupants within the six sleeping rooms. This request was denied due to insufficient floor space in Room #7. Overall a maximum of eleven occupants are authorized within this building. 2) No more than forty-seven (47) occupants are allowed within The Lodge building located at 39/45 Prospect Avenue. Forty-six occupants were originally requested by the applicants within the twelve sleeping rooms. One additional person is allowed overall due to a reduction in Room #2 (from 6 to 5) and due to approved increases within two units; Room #1 (from 7 occupants to 8) and Room #10 (from 3 occupants to 4). Overall forty-seven occupants maximum are authorized in this building. 3) No more than twenty-three (23) occupants are allowed within The Manor building located at 19 Prospect Avenue. Twenty-four occupants were originally requested by the applicants within the nine sleeping rooms. This request was denied due to insufficient floor space within Rooms #7 and #8. However the Board approved an increase in Room #9 by one occupant (from 1 occupant to 2). Overall, twenty- three occupants maximum are authorized in this building. Q:\WPFILES\Craigville Retreat Center Room Size Variances 2016.docx_l 4) No more than fifty-five (55) occupants are allowed within The Inn building located at 208 Lake Elizabeth Drive. Fifty-five occupants were requested by the _ applicants within the thirty (30) sleeping rooms within this building. Two rooms were deficient in floor space. Therefore, the number of occupants within rooms# 1 and #24 must be decreased from two persons to one person within each room. However, the occupants within rooms #26 and 32 may be increased from one occupant to two within each room of these rooms. Overall fifty-five occupants maximum are authorized in this building. The variances are granted because these buildings will be used temporarily (i.e. on week-ends) by students for religious retreats. In some cases, the floor space calculations for the number of students exceeded, by no more than 20%, the space required based upon the square footage and floor space required by the State Sanitary Code for a rooming house. Also the septic systems for each building appear to be functional .at each site. The Board is of the opinion that these minimal exceedances should not result in a health 'hazard for most individuals occupying.these rooms on temporary basis. It would be manifestly unjust to require the applicants to construct additions to the sleeping rooms at these dwellings constructed more than fifty years ago, considering the projected cost to construct the additions. Sin rely yours, nxealth Town of Barnstable Q:WP//Craigville Retreat Center Room Size Variances 2016.docx " . l �::�S k, 4-4 ,. Jim B ane .� -I -4 � � #I ."If Widt as r i s Ic ,Its&,� r a o� i.Y i i i `�i "'j �3 s�1.1. �" �a' � �+dan01:. t'rK iia1. -4ic>0 ge� ?:pm% V a.. im,¢ y;v $id ' ., - - , b dca€ � ,-t o rs � "s�a9l r a # sus c o+�W is - 0�� Y; ' 11 39dSA!•4 1td(3 $r&'nH &91 l , ,h Z #� � the # t� a Pr...0 �t�� r�r ^� � � �� x ! ` ! i _ :V : ! 4 - - � I'll � � 1t� �. , y; C b pp,, 1. y �jj _ h Y' } �97 CiGs �' \ Nk „ccm, f m7 a` ( r �'� � Y � ,_ :: , -\ COMMONWEALTH OF MASSACHUSETTS' s EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS. EPAF�I'IMTiJIjTT OI`ENVIRONNIENTAL PROTECTION TITLE 5 TICI INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS amSURFACE SEWAGE DISPOSAL: SYSTEM FORM „®p PART A. CERTIFICATION Property Address: Owner's Name' Owner's Address: Date of lnspecdon: Name-of Inspect; plea e Printj �� •i tCIO �� ./ �� 0 Company Name a. %� ,o }L�ey�% Mailiris Address X0 & C` fj` j A Telephone Number: CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposal system at this address and that Q.information reported belowis true,accurate and.complete as ofthe time'of the inspection.The inspection was perforlmed based'on my': training and experience.in the proper function and maintenance of on.site sewage disposal systems. I arr a DEP� •approved system inspector pursuant to Section 15 3"40 of Title 5(310 C1MR 15:000).'The system: /Passes Conditionally Passes s Further Evaluation by the.Local Approving-Authority Fai s Inspector's Signature: Date:. ' , The system inspector shall submit a copy of this inspection,report to the Approving Authority(Board of Health or DEP)within 30 days of completing this.inspection.If the system is.a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to-the:appropriate regional office of the DEP.The original shouldbe sent to the system owner and-copies sent to the buyer,if applicable, and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection.and under.the conditions.of us "t that time.,Tliis inspection does not address'how the system will perform in the future under the sane or different conditions of use: / Title.5"Inspection Form 6/192000 page I t r Page 2.of I l . OFFIGIAI<INSPECTION FORM:-NOT FOR-VOLUNTARY AS SESSIY1Ei`dTS SUBSURFACE SEWA% GE.DISPOSA.L SYSTEM INSFECTI.ON FORM TART A. CERTIFICATION (continued) Property Address: �� ) Owner: J�'I ��.� � •�iE.> �� '�'� �y2 Date of Ins ecfi /. " Inspection;Su,mmary: .C:heck'A,B,C,D or E/AI;.WAYS complete.,all of Section:D A. ystem Passes: I have not found any information which.indicates that any of the{failure criteria described in 310:CMR 15,303 or in 310 CIvIR 15304 exist. Any failure criteria,not evaluated are indicated below. Comments: B. .. System Conditionally Passes: One or more system components as described in the"Conditional Pass"section need to be replaced or repaired.The system, upon completion of the replacement or repair;.as approved by the Board of Health,.will pass. Answer yes,no or not determined(Y,N;ND)in the for.the following statements. If"not deternuned''please explain. The septic tank is mefal:and over.20.years:.old* or the septic tank(whether metal or not)is structurally unsound, exhibits substantial infiltration or exf ltration or.iank failure is imminent:System will pass inspection if the existing tank is replaced with a complying septic tank.as approved by the Board of Health. *A metal septic tank will pass inspectionif it is structurally sound, not leaking and if a Certificate of Compliance' indicating that the tank is less than 20.years old is available: . ND explain: Observation of sewage backup or break out or high static-water level in the distribution box due to broken or . obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board.of Health): broken pipe(s)are replaced obstruction,is removed „distribution..box;is leveled or replaced ND explain:, The system required pumping more than.:'4 times,a year due to broken or obstructed pipe(s).The system will pass inspection if(with,approval:of the,Board of Health): broken pipe(s),are replaced obstruction-is:removed ND explain: f Paee 3 of 11 OFFICIAL INSPECTION FORM -.NOT FOR VOLUNTARYASSESSMENTS SUI3SU:RT+ACT+,'SF VYAGE DISPOSAL: SYSTEiV1 TNSPECTIOIV'FORM PART A CERTIFICATION,(continued) Property Address: Owner '�_ 4/�, Date oflnspectioi / C. Further.Evaluation is Required by the Board.of Health: Conditions exist which require further evaluation by the:Board of Health in order,to.deterrnine if the system is failing to protect public health, safety or the environment: 1. System will pass unless Board of.Health determines in accordance with 310 CMR 15:303(1)(b) that the system is not fuiictionmg in a manner which.will protectpublic health,safety and the environment: Cesspool or privy is within 50 feet of a'surface water Cesspool or privy is within 50 feet of a bordering vegetated wetland or a sal't'marsh 2. _ System will fail unless the Board of Health'(and Public.,Water.supplier, if any).determines that the system is functioning in z manner that.protects the public health,safety.and environment: _ The-system has a septic tank and soil absorption system (SAS)and the SAS�is.within'100 feet of a. surface water supply.or tributary to a surface water:supply: 'The system has a septic tank and SAS and the SASis.within a'Zone l of a.public water supply. — The system has"a septic tank:and SAS and the SAS i's.within 50.feet of a private.water supply well. _ The system.has a septic tank and SAS and the SAS is.less than 100 feet but 50 feet or more from a private water supply.well". Method used to determine.distance h "This system passes if the well water_analysis;performed at a DEP certified laboratory;for coliform bacteria and volatile organic compounds indicates that the well is.free from pollution from that facility,and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis:must be attached to this form. 3. Other: J. J Page 4.of. 11 OFFICiAI;;INS,PECTION,FQRI' NOT F.{O-It VOI71?i 'ARY:ASSESSiVZEi�tTS SUBSURFACE,SEWAGE DISPOSAL SYSTEM INSPECTION.FORhZ PART A CERTIFICATION(continued) Property.Address: Owner! �`'� `�� Date of Inspectio d 6 JOO 7 V D. System Failure.Criteria applicable to all systems: You must indicate"yes" or"no"to each.of the-following for all inspections: Yes No _ t�Backup of..sewage,,into:facility,or system component due to.overloaded or clogged SAS or cesspool Disctiare or ponding of effluent to the surface of the ground.or surface waters due to an overloaded or clogged SAS;or cesspool �. Static liquid 1evel;in the distribution-box above..outlet.invertdue to art,overloaded:or.clogged SAS or cesspool _ 1/ Liquid.depth ih cesspool is'less.than 6" below invert or available volume is less than %2 day flow Z Required pumping more than 4 times in.the last year NOT due to clogged or obstructed pipe(s).Number - of times pumped �y portion of the:SAS,cesspool or privy is..below high ground water elevation. Any.portion or cesspool`or privy is within lKfeet of a.surface.water supply or tributary to,a.surface water.supply:; Any portion of a cesspool.or,privy is within,a Zone 1 of&public well. Any portion of a.cesspool,or privy is within 50.feet of a.private water supply well:: Any portion of a cesspool or-privy is:less.than 1.00 fee't.but greater than.50:feet.from a private water supply well with.no acceptable.water quality analysis..[This system passes if the well water analysis, performed at::a DEP certified laboratory,for colifornn.ba.cteria and:volatile organiccompounds indicates that the.well`•is free from pollution from that.facilit d P y an the-presence. resence of ammonia nitrogen andlnitr:a.te nitrogen is equal. o.or less than 5 ppm,provided that no other failure criteria are triggered..A:.copy of the analysis.must'be attached to:this form.] / r (Yes/No)The system fails. I have determined that one or more of the above failure criteria exist as described'in310 CMR 15.303,therefore the system fails..The.system owner should,contact the Board of Health to determine what will.be.necessary to correct the:failure: E. Lar e:SY stems: g To be considered a large system the system must serve,a facility-with a design flow of 10,000:gpd to.1.5,000 gPd• You must indicate either":yes" or"no"to each of the.following: (The following criteria apply to large systems.in addition.,to the criteria above) yes no the system is within 4.00 feet of a.surface drinking PP water supply -- 7the Y system is'within 200.feet.of a tributary-to a surface drinking water supply .. Y v the system,is located in a nitrogen sensitive area(Interim Wellhead Protection Area—1WPA PP or a mapped Zone II of a public water supply Well... if.you have.answered".yes"to any question in Section.E the system is considered a significant threat, or answered Yes"in Section D above the large system has failed. The owiler or operator of any large system considered a significant threat.under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner,should contact the appropriate regional office of the Department. i Page 5 of I OFFICIAL I°P4SPF:CTION FoRM.-NOT FOR VOLUNTARY:ASSESSMENTS SUBSURFACK SEWA GE I.SPOSAL SYSTEM INSPECTION FORM PART%B. CHE CKLhST Property Address: '' j r v ////)) Owner. gJ Date of Inspecti Check if the following have been done..You.must indicate"yes"or Ono"'as to each of the followine Yes o Pumping.information was.provided by the owner, occupant, or Board of Health, I Were"any of the systei, 'coinponents'pumped'out in the pr vious'two weeks ? Has the'systemreceived normal flows in the previous two week period? V Have large volumes of water been introduced to the system recently or as part of this inspection ? Were as built plans of the system obtained and examined? (If they were not available liot`e as N/A) Was the facility or dwelling inspected for signs.of sewage_back uP? ` v — Was the site inspected for sitrns of break out? V Were all system components, excluding the SAS,.located on site Were the septic tank manholes uncovered, opened, and the interior.of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid,.depth of sludgeland depth of scum _t:;;,/_. Was the facility owner(and occupants.if different from owner)'provided with.information.on the proper maintenance of subsurface sewage disposal systems The size and location of the SoilAbsorption System (SAS)on Ghe.site figs been'deterinine'd based on: Yes .no Existing information. For example, a plan at the Board of Health. V Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR l 5.302(3)(b)] 1 � r Page 6 of 11 OI•FICIAI, INSPECTION'.ORM.=NOT: OR VOLUNTARY:ASSESSMENTS SUBSURFACE.:SEWAGE I. MISPOSAL.SYSTEM INSPEC-_T[OIK FORM. PART:,O SYSTEM::INF.ORMATI ON Property Address: Owner: u Date of Inspectio 7 FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual).:. DESIGN flow based on 310 CMR' 15 203 (for example: I l.0 apd x#of bedrooms): Number of current residents:, Does residence have a .arbaae grinder g (yes or no): . Is laundry on.a separate:sewage system( es or no): .iif ves separate inspection required] Laundry system inspected(yes.or no), Seasonal use: (yes or Water meter readings,.if available,(last 2 years.usage:(gpd)): Sump pump (}res.or no): . U Last date of occupancy: ls COMMERCIAL/INDUSTRIAL.�tU Type of establishment:: Design flow(based on 310 CMR 15.203): Qpd Basis of design flow(seats/persons/sgft,etc.) „ Grease trap present(yes:or-no); Industrial waste holding:tank present(yes or no):— Non-sanitary waste discharged to the Title 5`system(yes or no):- Water meter readings, if available:- Last date of occupancy/use: OTHER(describe): GENERAL.INFORMATION Pumping Records Source of information: Was system pumped as part of the j spe fio (yes or noi): If yes, volume pumped: gallons-- ow was quantity pumped determined? F' Reason,for pumping- - TYPE OF SYSTEM —Septic tank, distribution box,soil absorption system _Single cesspool _Overflow cesspool _Privy Shared system (yes;or no)(if yes, attach previous inspection records, if any) Innovative/Alternative technology.Attach a copy of the.current operation and maintenance contract(to be obtained from system owner) _Tight tank _Attach copy`of the.DEP approval Other(describe): "'. ./ n. /� proximate age of all components, date installed(if known)and source of information: Were sewage odors,detected when-arriving at the,site(yes or no): 6 Page 7 of l l OFFICIAL INSP'E.CTION FORM—NOT FOR' VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE_DISPOSAL SYSTEM INSPECTION FORM - PART::C SYSTEM.INFORMATION (continued) Property Address: , Owner: F Date bf Inspecti BUILDING SEWER(locate on site plan) Depth below grade: Materials of construction: cast iron 40 PVC_other(explain): Distance-from private water supply well or suction line: Comm nts(on condition'of joints, venting, evidence of leakage, etc.):' SEPTIC TANK: L (locate on site plan) Depth below wade: Material of construction: crete_metal_fiberglass Polyethylene —other(explain) If tank is metal last age:, .Is age:confirmed by a Certificate of Compliance(yes or nb).'_(attach..a copy of -certificate) Dimensions: rs�,.. Sludge depth: 4 Distance from top of sludge to bottom of outlet tee or.baffle:. Scum thickness: o e� Distance from top of scum to top:of outlet tee or baffle: r: Distance'from bottom of scum to bottom f outlet tee or baffle: How were dimensions determined: ,w, �i}i/. r Comments('on pumping recommend tions, • let and outlet tee or baffle condition, structural integrity, liquid levels as re eted to outlet invert, evidence of leakage, etc.):-TIT Pf (Up ' ��/�i rr J . �, GREASE TRAP:Aocate on site plan) , Depth below grade: Material of construction:_concrete_metal_fiberglass_polyethylene mother (explain): Dimensions: Scum thickness: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom'of outlet tee or baffle: Date of last pumping: Comments(on.pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): a/ -� 7 Page 8 of 1.1 .bFFICI`AL.INSPECTIO,N FORM.—NOT. OLUNTARY ASSESSMENTS >. SUBSURFACE.SEW-AGE DISPOSAL; SYSTEM INSPECTION FORM PART C.'. SYSTEM INFORNLA.TION(continued) Property Address: q Len Owner. � ( � �` . ` `�-� Date of Inspection, , 5d TIGHT or HOLDING TANK: (tank must be pumped at time ofinspection)(locat.e on.site plan) Depth,below grade: Material of construction: concrete- metal 'fiberglass_polyethvlene other(explain);• Dimensions:` Capacity: gallons Design Flow: ..,gallons/day Alarm present.(yes or no)-.. Alarm level: Alarm in working order(yes'or no): Date of last pumping: Commenm(condition of alarm and float switches,etc.): v e cafe on site plan) DISTRIBUTION BOX: (tfpresent must be open d)(lo st p ) Depth of liquid Level above outlet invert:. . Comments(note if box i's'level and distribution to outlets qual,.any evidence of solids carryover,any evidence of leakage into or out of box, ete.): a Y . + a .n - s' JIV PUMP CHAM.BER::)(locate on site plan): Pumps in working:orde'r(yes or-no): Alarms in working order(yes or no):. Comments(note:condition of pump chamber, condition of pumps and appurtenances, etc.): ., I Page 9 of 11 OFFICIAL INSPECTION FORM.—NOT FOR VOLUNTARY ASSESSMENTS 'SUBSIURSACE SFV/AGF`D'ISPOSAL SYSTElY1 INSPEECTION -FORNI •:` PART:C SYSTEM INFORMATION(continued) Property Address: 1 ° Owner Date of Inspectio SOIL ABSORPTION SYSTEM (SAS): 4 (locate on site plan, excavation not required) If SAS'not located explain why: Type leaching.pits,number:, chin-chambers,number: leaching.galleries,'number: leaching trenches, number, length: leaching fields,number, dimensions: overflow cesspool;number: innovative/altem,ati.ve system. Type/name of technology: Comments (note condition of soil, signs of hydraulic.failure,level of ponding, damp soil`condition of vegetation, etc. ,.--,. f/•� ��/ r �� J1 J YJ if AL CESSPOOLS: (cesspool must be pumped as part of inspect ion)(]ocate on site plan) Number and configuration: Depths—top of liquid to inlet invert: Depth of solids layer: Depth of scum layer: Dimensions of cesspool: Materials of construction: Indication of.groundwater inflow(yes or no): . Comments (note condition-of soil, signs of hydraulic failure,.level of.ponding, condition ofwegetation,'etc:): PRIVY: (locate on site plan) Materials of construction: Dimensions: Depth of solids: Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.):. 9 Page 1.0 of 1.1, OFFICIAL INSPECTION FORM N.OT FOR VOLU-N ARY ASSESSMENTS . SUBSURFACE SEWAGE;DISPOSA:L SYS'I ,_M.INSPEC'I ION FORM, PART,C SXSTEM JNFORMATION(continued). Property Address: Owner l Date of Inspection.. / _ �0 SKETCH-OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the;sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all:wells within 100.feet:Locate.where public water supply enters the building.,1.x' Page 11 of 11 OFFICIAL INSPECTION FORM —NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM.INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property .ddregs: 19 i//� Owner Date oflnspecti CZ SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water_ 19 f et. Please.indicate (check) all methods used to determine the high ground water elevation: Obtained from system design plans on record -If checked, date of design plan'reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) , Checked with local Board of Health-explain: Checked with.local excavators, installers-(attach documentation) Accessed USGS database-explain: You must describe how you established the high groundwater elevation: ,g^ ✓U icr / �� . 11 . flo < cgqj QD � 4) r h. L r3 4 v --2 a(n c a (lGn cc. P 'c, ls: S n LOOPIC1,0 �i J me � 6n Permit Number: Date: Completed by: �� HIGH GROUND-WATER LEVEL COMPUTATION Site Location: j� (, /�"/ Lot No. Owner: Address: Contractor: 6 C Address: �J�z1�1r1 1 Notes: STEP 1 Measure depth to water table tonearest 1/10 ft. .......................................:....................................... .Date month/day/year STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: OA Appropriate index well..................... OB Water-level range zone ..................................................... STEP 3 Using monthly report "Current Water Resources Conditions" determine current depth to water level for index well ........................... month/Year ' STEP 4 Using Table of Water-level Adjustments. for index well (STEP 2A), current depth to water level for index well (STEP 3), and water-level zone (STEP 2B) determine water-level adjustment .............................. 46 ............................................................ ' STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) from measured depth to water level at site (STEP 1) ................. ,7 Figure 13.7-Reproducible computation form. J 00 2 IF oaf tic l r a'� CP/ I � �4 THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH v P�Q_J TOWN OF BARNSTABLE Appliratiutt for Di►ivwial lVnrk,i Tomitrurttnn Vrrmit Application is hereby made for a Permit to Construct (1,1 S or Repair ( ) an Individual Sewage Disposal System at: A, pS,gcFtiT 7W /311741; A?i0 Ps��.c _. vE,��l-hid r&Y,4b" f/o�/e 0, ,-0�a� C/_ ........................ Locltion-Address or Lot No. T�w.v_ j.__/.�� .�/T4.f.................................. �iiH....I�%�_.i`�!frt• ti ��_ ZI. . o,cner Address a . :...NT1iY00]/ ----LGN1T....vcT/Gs/;,� Installer Address UType of Building Size Lot............................Sq. feet �-, Dwelling—No. of Bedrooms..-..--.- -----------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ----------------------- --- No. of persons---------------------------- Showers ( ) — Cafeteria ( ) d Other fixtures W Design Flow.............I/..r1-.......................gallons per person per day. Total daily flow........6_9.3d................gallons. • 70�o e 4 W a Septic Tank�Liquid capacity.r.....---.g�lons Length..--_--.-.---- Width................ Diameter................ Depth................ x G91CD�Fsal Trench—No. ...........� . Width------------------- Total Length....--...... ..... Total leaching area....................sq. ft. 3 -- �eepage Pit No---- — �� ---.-.- -S!X yX-y--- Depth below inlet....-_`�_.......... Total leaching area.6.. ?_9.sq. ft. a Other Distribution box (3) Dosing tank ( ) a Percolation Test Results Performed by...7?�t�a�1.E-'L16orL'________�________,��_-_-•-__-•_-- Date.e.u'�:/f� 9�c Test Pit No. 1 G.a----minutes per inch Depth of Test Pit ,6- .7a._ Depth to ground water.Z�-'..he f.4 74, (T4 Test Pit N0012..-Z. .-minutes per inch Depth of Test Pit. ..`.�' Depth to ground water-zz.�_._.._....�� 0y T�.rfA%f --2 a �� moo''- -1.2 �� 22/ T.¢/7`0'j Z .-...--•--••---r� ---------------7/-------•-•-•-- 2y�F rya r.............�J.......... --------2Z.�--------..`;. O Description off Soil....---------••--••---•-----••-•--• ....-----•------. .-----••••....-•••-- •-••••••-•-•...................•-•._....... UT !� C..............................................�L �'/o-, .......a' ..................._/�c� G�P�c r��`��ti_:............. w x --•-------------------- .............................................................................................................. . . ...... ..... . .....��61EZ) van//Fyc >'? e-e€-Re airy-er-Alersiefzs j� :----•-------------------•------•-----••----------------------------------------.....--•------------------._....---------------------------------------------•-----------------.................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complia e h een issue the board of health. Signed ......... ...... V...'. .. .................................... ......4................................. Dace Application Approved By ..........) ..... ... 1....-....gY ^Due Application Disapproved for the following reasons: .................... ............ ---................ ...................... . ............................... ............................................................................................................. .......................... . . . . ... ............................. ........................................ PermitNo. ...........fie'/.7 ....../..3. Issued................. .....................--Dare............-.....-..........te...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE((..�� TErtifirate of Compliance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired�C) ........... ........ . .by - -......... - .._..... -..... _.......... - ...................................................... .. ............. Incr.Jlc• at has been installed fn accord ce with the P1rovision�LE 5 of T e S Itate Environm tal Code as described in the application for Disposal Works Construction Permit No. .............................._.._........... dated ---------..._..........:.......... ....__.... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE._... ........._..._.. .. .. ... . ..........._.._........._.._..._........------.. Inspector ---------------------... ........---------------------------------------------... THE COMMONWEALTH OF MASSACHUSE17S i BOARD OF HEALTH TOWN OF BARNSTABLE Cer#if rate of (foraptiance THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( .) by -.. �..ti -------F z.' ....- - .... ._-------------_--------------------------------------------------....._------------------------- ........_....... ................ ° ^Installer at ........... �... �.............y�.�.� ' ........ ........"�..... � _./... - -- ..........�lc -�-------.............................................. has been installed in accord with the provisions of TITLE 5 of T8 State Environmevital Code as described in the application for Disposal Works Construction Permit No. ._._............._..._.... ------------- dated ..........................------------------- THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE...... ............_.............._.................._..._._._............................... Inspector ......_.. ........................... ....................... . ..... .......... ------------------_ ------------__----_ ------._,-,_ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOWN OF BARNSTABLE j _ �� No../ �----.,/:.:�.� FEE--------------••-----•-•�-�-� Dispasa1 uxk� dun �ts#Uan rrmtf Permissionis hereby granted---------------- -- ^----•-- w ............................................... ................................. to Construct or Repair ( ) an Inf(�al Sewage Disposal System atNo.......................................... -•-•--•---•---------• --•---------••--•--•---------._.....----------...----•--••-••......---------------•--. -•--------• ..................... Street C� as shown on the application for Disposal \Torlcs Construction Permit No._j L1*L3__Z Dated....__ _. ..y..-.... .L�J. ----------------------- Board of Health DATE..................... .._-. //'f/-._- FORM 36508 H088S&WARREN,INC.,PU8l.i3HERS y �._�.. .. _ .. -.�, yr EJ .. ♦!-.r ♦ +' THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _-TOWN OF BARNSTABLE Appliration for Dirpooul Worlio Towitrurtion ramit Application is hereby made for a Permit to Construct (I, ) or Repair ( ) an Individual Sewage Disposal System at: A 9_TA6F,T 70 Z?1,,TGi=/� �J A/fiv '%F I = ...............a..---------•-.• .........-----.....•-•--•-•-•--•-•--•------•..._....... •••----••-•-•--•••----f-r---•--------•-----•--•--..�...................... .................... Location-Address or Lot No. 7 ?w,V hL >n..�rr.�/T,4 H - T--------•-----------•----- ------ ? 7 '''' '�N.._.f?�; Hf r9.. .. 1`, owner Address _TIiJ DOQ----Co..VJToIlrc/"/o•tf Installer Address UType of Building Size Lot.................... q. feet Dwelling—No. of Bedrooms---------- -Z------------------------Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) dOther fixtures -------------------------------------------------------------------------•••--•---•---.....-•-...-•--------•-••-•---•............-•--•-•............. W Design Flow............1/2......................gallons per person per day. Total daily flow..__.-_6--.`�''. 4................gallons. Wa Septic Tank s Liquid capacitv�.GpPgallons Length________________ Width................ Diameter................ Depth................ x r Dis osal Trench—No. ................... Width.................... Total Length.................... Total leaching area....................sq.ft. 3�A«Seepage Pit No.--- - - -----fVaz; c' yx yX r p g 9-- q• -�c�. . I�.Ia.Lnetex. .___.__. �--- Depth below inlet___..y_____..__.. Total leaching area_6.._.3�'.._s ft. II, Z Other Distribution box (3) Dosing tank ( ) aPercolation Test Results Performed by._.D�< rr�./.f.'L!a�,�c. .......... Date.At��.c.�.�_F�,..� a Test Pit No. 1 G a--_-_minutes per inch Depth of Test PIt 6 ��.. Depth to ground water. .:.w.G4/ (i, Test Pit No/62...3!r._minutes per inch Depth of Test Pit ZC:._.`/d'Depth to ground water_2 .�....._..._�. a Y-C r t O;f c �� // �T °2'' i' i 0 ? Q/,f/l { G z ---------------i/........... / X.G :.!-Y/1-e-------•----..'T./.........---.....---... .........--•.%- Descriptionof Soil................................................................................................................................................. U ..........................� — fC- foi ............................................................. c'�............... x ----.------•....................... ......................................•-•---•--....---•---•---•------.......---•----------••-----.....---------•-•-•-•-•------•-•-•-•--•---•-•••--•-•-••-•--........ U Natur-e---of Repair-s-er—A4-ter-a-t-ier3'sAnever—when-applicably.-.f E_5_----- /?s"" •L.. v 1/�7i1/ c_ ------------------- -------------------------------•------...---------•••--••-••-••-•................_....-•••••--------•--------•-----•----••••••------•----••••••••-•••-••......•-•-------........•... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in'accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place,the system in operation until a Certificate of Compiia-ce h �beenl!issue ,y the board of health. Signed ...... ._.... ........................... .......................................... ................................... Date Application Approved By ............ ...... -ate.. -- .................................................................. .......�:/..-.. / i...-...... .G... � Date Application Disapproved for the following reasons: . ..............................' .......................-_...---.................--........................................ ........................................................ . ' ._..--..... ' ...................................--..... . ..........................................--......--...--. ............... ..--..--.............. G / Date PermitNo. ............�L..7/ 1....�5.._7.......... Issued .......................Dare....................................... I i • : 7 Gf I I v �i tJ (57 TA rill, f; � uS6 '✓vim>�( T +i►�' •i' ; HWHARD 1 ! 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