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0089 SOUTH MAIN STREET - Health
ry9 South Main St 228-127 i i O �J fllf UPC'12543 � !' HASTINGS,Elfl I �d _0 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town(which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St.,Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI.,367 Main St., Hyannis,MA 02601 (Town Hall)and get the Business Certificate that is required by law. q DATE: D �4 rll i pl ease: FBt �{�n fc APPLICANT'S YOUR NAME/S: O TV IV D 2 �� 7 BUSINESS Y HO E A RESS: �LtY �5 �l o u m N s I Z n e - , joy TELEPHONE # Home Telephone Number NAME OF CORPORATION: NAME OF NEW BUSINESS r-j5(--rC--1VQt3KV M14WAIRV TYPE OF BUSINESS fr)RSO/V X V IS THIS A HOME OCCUPATIO 9 YES NO X ADDRESS OF BUSINESS 8�-.`J� p1A/N 5F-6-9— MAP/PARCEL NUMBER (Assessing) CCV1 fzV1Uz-, MA- OC193,-u— When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St.-(corner of Yarmouth Rd.&Main Street) to.make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO I SIO R' IC MUST COMPLY WITH HOME OCCUPATION This individ .,-h' . e n for e f pe e it e is pertain to this type'�Ut .AND REGULATIONS. FAILURE TO uth rized g to a �OMPLY MAY RESULT IN FINES. OM S: \ c-) J V 2. BOARD OF EALT 00 This individual has bee d of the permit requirements that pertain to this type of business. �l,t Q�,t' Min--- e Au orized Si tore** �� COMMENTS: GC 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) MUST COMPLY WITH ALL This individual has been informed of the licensing requirements that pertain to this type of business. HAZARDOUS MATERIALS REGULATIONS Authorized Signature* COMMENTS: No. Z (3 ——/5; I Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS application for Misposal 6pstrm Construction permit _Application for a Permit to Construct( ) Repair(t<*Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.t94? j lle441sj s�_ Owner's Name,Address,and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and TS1.No. Designer's Name,Address,and Tel.No. 06 qZ:? ZSoz lcr G,t �' ad Type of Building: 38P,°5 GI1,41K 69WVN �t69o�G..-F',� 5Z!�2182^f3`51 Dwelling No.of Bedrooms 1 6Rt 51N Lot Size sq.ft. Garbage Grinder( ) Other Type of Building ezloL No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ��/��y gpd Design flow provided_ _ _ �7�$, yl gpd Plan Date h—d/— -Zeal3 Number of sheets J Revision Date s,:9.A rf / /�/J 7 Gc� �le 1 de= Size of Septic Tanl;�.� �C�b Type of S.A.S. 55c>f .Di ��LS a 5� ✓�' Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and t to place the system in operation until a Certificate of Compliance has been issued by this Boar of H 1 ZS' ecd` Date 2 Application Approved byiyy Date ( /9 0 Application Disapprov Date for the following reasons Permit No. a!:5 — W1 4 Date Issued 11 f 1812y13 - - ------------------------------- - - - - THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS Certificate of Compliarrce THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(oor Upgraded( ) Abandoned( )by at Q s� M*itj Sr Cj&yW j Aj� has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.g&m t15 4 dated_'li 1�✓, 7v°3 Installer Designer #bedrooms 3 3 kx�1 C H�rA:S I P%4 C 6CW,4_ Approved design flow p gpd The issu cef f t is permit s all pQt be construed as a guarantee that the system d ' Inspector - - ----------------------------- -------------------------------------------- No.�' Fee I ' �,._ q , x�». /z THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH;DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS Yes ltlYicatiOYY fOr Zi$ D,$aY *p$teltt Construction 3 permit Application for a Permit to Construct( ) Repair(41/Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. ,� .��i'/ s Own is Name,Address,and Tel.No. Assessor's Map/Parcel Z2$ / Z } r� '� .v19i�/ter' � �/j�4 Installer's N e,A ress d .No. Desi ner's Name,Adair sand Tel.No. '4 Guaw c�'tn� � i�,�C 508 qZ:? Z507- Type of Building: 3SR 6 3 GN/I1K'54w N I WS 6ftW /`�6 �� •f I 51NIL1 COT Woalk 5►NK GC �tdicG� � . •' �-/3�/ :'€ t Dwelling a No.of Bedrooms Lot Size ��7�sq.ft. Garbage Grinder( ) Other 4 Type of Building No.of Persons Showers( ) Cafeteria( ) r Other Fixtures Dsign Flow(min.r quired) /,V4, T gpd Design flow provided l gpd PI lD-6/- Z�/3 / .Plan �Date ,,. Number of sheets Revision Date Size-of Septic Ta.0 `fS'C�b . Type of S.A.S. � 4 �Descri do f Soil �� 1 j n I Nature of Repairs or Alterations(Answer when applicable) * I 'Date last inspected: Agreement—ll- 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 an of to place the system in operation until a Certificate of t ;p Compliance has been issued by this Bo of 1 Date / ' r Application Approved b r Date Ill Application Disappro ed by - Date for the"following reasons f� r Permit No.20 3 7 y Date Issued -- ----------------------------------------- --------------------------------------------- - *'" t THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired(/'S Upgraded( ) Abandoned( .)by at Dtj I MAC S� �jq 5 �. CE.N7IL"I(,.(rr has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No4i3- 45 4 dated I� 1 71,3 } Installer t ' Designer #bedrooms36 Vs 1.3 6Atvr1410R5 t Dk,9 Cp f Approved design flow / 10 4t gpd The iss c of his permits all not be construed as a guarantee that the system 11 �dh,as de§ig d. t Dat �'}.�7 lU1L�. Inspector �/ ---------Z--.��-115�---=o------------------------------------------------------------------=----------------Fee ----------------- 01 't THE•COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS i ]Disposal *pstem Construction i3erntit Permission is hereby.granted to Construct( Repair( Upgrade( ) Abandon( ) System located at { S o V TK, MA-IN "Si. (fZ N T IZ✓iLL& and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and.the following local provisions or special conditions. Provided-,Con truction must be completed within three years of the date of this permit. i' Date ( Z�13 Approved by -- i r� r TRANS.NO.: CITY/TOWN: APPLICANT: ADDRESS: DESIGN FLOW: gpd REVIEWED BY: DATE: . NIA OK NO GENERAL Legal boundaries denoted 310 CMR 15.220(4)(a)] Street, Lot,tax parcel number and lot number noted on plan [310 CMR 15.220(4)(u)] Locus Provided 310 CMR 15.2204(t)] Plan proper scale? (1"=40' for plot plans, 1"=20' or fewer for components 310 CMR 15.220(4)] ev Easements shown 310 CMR 15.220(4)(b)] System located totally on lot served [310 CMR 15.405(1)(a) for upgrades]- i f not, a variance is required 310 CMR 15.412(4)] Location of impervious surfaces (driveways,parking areas etc.) 310 CMR 15.220(4)(d)] Location all buildings existing and proposed 310 CMR 15.220(4)(c Location and dimensions of system•components and reserve areas. 310 CMR 15.220(4)(e)] System Calculations 310 CMR 15.220 4 daily flow septic tank capacity (required andprovided) r� soil absorption system(required andprovided) whether system designed for garbage grindet North arrow 310 CMR 15.220 4 Existing and ro osed contours 310 CMR 15.220 4 Location and log of deep observation holes(existing grade el. on each test) [310 CMR 15.220(4)(h)] Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h and i) Location and date of percolation tests(performed at proper elevation?) [310 CMR 15.220(4)(i)] Percolation test results match loading rate? 310 CMR 15.242 Certification statement by Soil Evaluator 310 CMR 15.220(4)0)]. Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR r� 15.220(4)(n Address Sheet 1 of 7 NIA OK NO Location of every water supply,public and private, [310 CMR 15.220(4)(k)] within 400 feet of the proposed system location in the case of surface water supplies and gravel packed public water supply within 250 feet of the proposed system location in the case within 150 feet of the proposed system location in the case of private water s2aly wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed in 310 CMR 15.211 and,any catch basins located within 50 ft. 310 CMR 15.220(4)(1)] Water lines and other subsurface utilities located [310 CMR. 15.220(4)(m)] if water line cross see 310 CMR 15.211 1 1 ) Profile of system showing invert elevations of all system components and the bottom of the SAS 310 CMR 15.220(4)(o)] p Stamp of designer 310 CMR 15.220 1 and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] 1� Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as approved for an upgrade under LUA at 310 CMR 15.405 1 (k Test hole adequate to demonstrate four feet of suitable material? 310 CMR 15.103(4)] Test Holes adequate to confirm adequate groundwater separation? 310 CMR 15.103(3)] Benchmark within 50-75' of system 310 CMR 15.220 4 Materials specifications noted? [various sections of 310 CMR 15.000 System components not> 36" deep(unless Local Upgra Approval or LUA requested) 310 CMR 15.405(1(b)] a Address Sheet 2 of 7 L N/A OK NO SEPTIC TANK Size OK? 310 CMR 15.223 1 Inlet tee located ten inches below flow line 310 CMR 15.227(6)] Outlet tee 14" or 14" + 5"per foot for increase ft depth [310 CMR 15.227(6)] Outlet tee with gas baffle or approved filter 310 CMR 15.227(4)] Note regarding installation on stable compacted base [310 CMR 15.228 1 Separation between inlet and outlet tees(no less than liquid depth) 310 CMR 15.227(2)] Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA 310 CMR 15.405 1 k) Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1)and 310 CMR 15.232 3 Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" b 7/07 310 CMR 15.228(2)] Access to within 6 " of grade - one port for systems<1000gpd, two fors stems>1000 gpd 310 CMR 15.228(2)] All at-grade covers secured to unauthorized access? [310 CMR 15.228(2)] > 10 ft from building foundation 310 CMR 15.211 1 Buoyancy calculation Required/Done 310 CMR 15.221(8)] 14-20 Where appropriate? 310 CMR 15.226(3)] Setbacks from resources 310 CMR 15.211 Multi-Compartment Tanks Required when other than single-family dwelling or flow>1000 / d 310 CMR 15.223(1)(b)] First compartment 200%daily flow; Second compartment 100% daily flow 310 CMR 15.224(2) and 3 "U" pipe through or over baffle, outlet of each compartment with as baffle or approved filter 310 CMR 15.224(4)] Address Sheet 3 of 7 N/A OK NO BUILDING SEWER AND OTHER PIPING Located at least ten feet from any water line? [310 CMR 15.222(2)] Disposal piping at least 18" below water line (when water and sewer cross, see 310 CMR 15.211 1 [1] Cleanouts required/provided ? 310 CMR 15.222(8)] r Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches r/ and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] Siphonproblem/ leachfield below pump chamber r Endca s or vent manifoldspecified? r� Size and orientation of discharge holes specified?(not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 CMR 15.252(2)(h)] Materials specified (310 CMR 15.251(5) specifies various pipe types allowed DISTRIBUTION BOX Stable compacted base [310 CMR 15.221(2) and 310 CMR 15.232(2)(a)] Splash plate or baffle tee required on inlet/provided? (when pressure sewer to d-box or steep pitch of gravity sewer) [310 CMR 15.323(3)(a)] Riser if deeper than 9" 310 CMR 15.232(3)(f)] r Inside minimum dimension 12" 310 CMR 15.232(2)(b)] Minimum sum 6" 310 CMR15.232(3)(e)] t Watertight cover if<2000gpd); waterproof manhole if>2000gpd 310 CMR 15.232(3)(d)] PUMP CHAMBERS Capacity (emergency storage above working=design flow)? [310 CMR 231(2 Proper setbacks 310 CMR 15.211 same as septic tanks Watertight 20-in minium access manhole at least 20" MUST BE TO GRADE 310 CMR 15.231(5)] Service components accessible (not too deep with piping, disconnects accessible Alarm floats -alarm on circuit separate from pumps specified? Exceeds two units must have two pumps operating in lead-lag f mode. 310 CMR 15.231(6) and 8 Stable Compacted Base 310 CMR 15.221(2)] Buoyancy calculations needed ?Provided? 310 CMR 15.221 8 Address Sheet 4 of 7 N/A OK NO SOIL ABSORPTION SYSTEMS (SAS) GENERAL Calculations correct? 4 feet of naturally occurring material demonstrated? [310 CMR 15.240 1 Required separation togroundwater? 310 CMR 15.212)] Aggregate specified as double washed 310 CMR 15.247(2)] �.� System Venting required/provided? (system under driveway or >36" deep) 310 CMR 15.241 Inspection ports specified and within 3"final grade? [310 CMR 15.240 13 Breakout requirements met? (No violation of breakout elevation within 15 ft of SAS unless barrier) [310 CMR 15.211(1)[4] and Guidance Document GALLERIES,PITS,CHAMBERS 310 CMR 15.253 Chambers and Gal. in trench configuration supplied with inlet every 20 ft. 310 CMR 15.253(6)] Each structure with one inspection manhole(if>2000 gpd must / be tograde) 310 CMR 15.253 2 Aggregate I' minimum- 4' maximum. 310 CMR 15.253 1 b) 2' sidewall credit maximum 310 CMR 15.253 1 a In bed configuration, inlet every 40 s ._ft. 310 CMR 15.253(6)1 TRENCHES 310 CMR 15.251 Width 2' minimum 3' maximum 310 CMR 15.251 1 b 100 feet -maximum length 310 CMR 15.251 1 a Minimum separation 2x effective depth or width whichever greater Qx if reserve between trenches 310 CMR 251 1 d Situated along contours 310 CMR 15.251(2)] Breakout OK? 310 CMR 15.211 1 4 and Guidance Document BED.SAS (Maximum size of bed or field 5000 pd minimum 2 distribution lines 310 CMR 15.252(2)(a)] Maximum separation between lines 6' 310 CM R15.252(2)(d)] Maximum separation between lines and outside of bed 4' [310 CMR 15.252(2)(e)] Aggregate depth below discharge pipes 6" minimum, 12" maximum. 310 CMR 15.252 2 Separation between beds 10'minimum. 310 CMR 15.252(2) Bottom area used in calculations only 310 CMR 15.252(2)(i)] Address Sheet 5 of 7 fj t r N/A OK NO DID THE PLAN INVOLVE Pressure Dosed System ? Provided pump and piping calculations as required 310 CMR 15.220(4)(r)] Pressure dosing required on all systems>2000gpd or alternative systems under remedial approval [310 CMR 15.254(2) and I/A Remedial Use Approvals] If used in gravelless system-make sure jet is directed as not to scour soil interface Guidance Document Inspections once per year(systems<2000 gpd) or quarterly >2000 dgood to note on plan 310 CMR 15.254(2)(d)] Construction in fill - Did the plan specify that the fill shall meet the specification of 310 CMR 15.25 5 3 ? Impervious barrier and/or retaining wall ? [Guidance Document] Impervious barrier installation must be supervised by designer 310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer 310 CMR 15.255 2 a Side slope not exceed 3:1 ? 310 CMR 15.25 5 2 Breakout requirements met? [310 CMR 15.252(2) and Guidance Document At least 5 ft. from impervious barrier to edge of SAS (10 ft. / recommended) [310 CMR 15.255 2 e Gravelless System UA Approval Letters) Check DEP Approval letters for credits and design conditions If used with pressure.dosing do not allow pressure discharge to scour soil interface Alternative Septic System[UA Approval-Letters] Was DEP Approval Letter provided and/or have you reviewed the letter for conditions? Is the technology being properly applied and does it meet all / DEP Approval Conditions? v Is there a note on the plan regarding the requirement for perpetual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Has applicant submitted a copy of a maintenance Variances Are the variances listed on the plan ? [310 CMR 15.220 4) RLS Stamp necessary on plan if a component is within five feet of proe line 3,10 CMR 15.412(4)] New construction or increased flow proposed- [Refer to 310 CMR 15.414 Address Sheet 6 of 7 N/A OK NO Nitrogen Sensitive Areas Is the system in a Designated Nitrogen Sensitive Area(Zone II for a public supply well)? [310 CMR 15.214, 310 CMR 15.215 and 310 CMR 15.216- also refer to Policy regarding upgrades of such existing systems] Is the system proposed on the same lot as served by private well ? 310 CMR 15.214(2)] Are the nitrogen loads proposed in compliance? [310 CMR 15.216 1 Miscellaneous Pumping to septic tank? 310 CMR 15.229 Shared System [310 CMR 15.290 Address Sheet 7 of 7 10 Town.of Barnstable r# Department of Regulatory Services " 1AItN8TAHIJE, Public Health Division Date hi ASSL r6,39. ��� 200 Main Street,Hyannis MA 02601 Date Scheduled— ime D Fee Pd. Soil Suitability Assessmentfor Se e wisp® Z h Performed By:_ /-9, Witnessed By: LOCATION& GENERAL I1 F1 ORMA'TION LocatiouGA�ddress� Owner's �Name� �4��T�Z /��- Address Assessor's Map/Parcel: Z2g Engineer'sNamee,� E� f'S NEW CONSTRUCTION REPAIR Telephone# Land Use � GtJZt a�uc`� C3� — Slopes(9t) Surface Stones 4j'©-.4,Z Distances from: Open Water DodZ � ft' Possible Wet Area ft Drinking Water Well >1 ft Drainage Way 7Z0 ft Property Line ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&perc tests,locate wetlands in proximity to holes) Parent material(geologic) Depth to Bedrock Depth to Grouudwater. Standing Water in Hole: Weeping froth Plt Rltee Estimated Seasonal High Groundwater DE Il YiRMI A.LL JIO FOR SEASONAL 111GH WY ATJ.R 1E,A119LE Method Used: Depth Observed standing in obs.hole: _ la. Depth to loll mottles: ln, Depth to weeping from side of obs.hole: fit. Groundwnter Adjustment ft. Index Well# Rcading Date: Index Well level Adj.fhetor— Adj.Clroutldwater Level_ PI♦RC®LATION TEST bateA'lind '� Observation / Hole# Time at 9" Depth of Pero `(/ .r Time at 6" Start Pre-soak Time @ Time(9"-6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed�_ Site Palled: Additional Testing Needed(YIN) Original: Public Health Division Observation Hole Data To Be Completed on Back-- ------ **q`If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conselrvation Division at least one (1) week prior to beginning. Q:\-3EI1I7--\PERCFORM.DOC DEEP-OBSERVATION HOLE LOG Dale#--� Depth from Soil Horizon Soil Texture Sdil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (5tnuchrre,Stones;Boulders. onsi tency 96(3ravei) 4-1 � a� DEEP OBSERVATION HOLE LOG Mole# 2�, Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. onsisten % ravel y/ y C ,rilS Z, 3 DEEP OBSERVATION MOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in-) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) DEEP OBSERVATION BOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure;Stones,Boulders, Consistency. a Flood Insurance Rate Ma : Above 500 year flood boundary No— Yes Within 500 year boundary No Yes Within 100 year flood boundary No✓ Yes Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring ervious material? Certification I I certify that on `O (date)I have passed the soil evaluator examination approved by the Departme Enviro mental Protection and that the above analysis was performed by me consistent with . the requir tra' i ,expwrtise d experience described in 10 CNM 15.017 Si natur I )[A" Date Q:w F-P"r1C\PERCPORM.D OC SECTIONSENDER: COMPLETE THIS .MPLETE THIS'SECTION ON DELIVERY ■ Compietd items 1,2,and 3.Also complete A. Si re Item 4 if Restricted Delivery,is desired. 0 Agent ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B. calved (.Printed Name) C. Date of Delivery ■ Attach this card to the,back of the mailplece, �ob �IC�� ^U or on the front if space permits. D. Is deliv ry address differe from item 1? Oyes 1. Article Addressed to: If YES,enter delivery address below: ❑No I i p S C t C v 1 1 l l rAN bZ to S S 3. Service Type MCertifled Mail ❑Egress Mail ❑Registered- !R Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 1 f (rmnsferfromservkeIaW i.! 70'06 =0810E:GOGOe 3524 923D PS Form 3811,February 2004 Domestic Return Receipt 1025e5-02-M-1540 I UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.0-10 • Sender: Please print your name, address; and ZIP+4 in.this box• I I I I I I I Town of Barnstable Health Division Foy 200 Main Street Hyannis,MA 02601 t t t t ! y l.S .. l4 i t..! _ ��{tillllt�t�i:i��t►1IsIII Ai lI{ItltiIt511tIsl lI sl{1%11111li I Certified Mail#7006 0810 0000 3524 9230 soft Tower Town of Barnstable Regulatory Services f x 41 BARNS'I'ABLE. ` 9 nnss• Thomas F. Geiler,Director 3.659. ArFD MAt� Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 April 4, 2007 Priscilla Hostetter Q 770A Main Street l Osterville, MA 02655 � 3J_ NOTICE TO ABATE VIOLATIONS OF 105 CMR .410.000, STATE SANITARY / CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE.CODE CHAPTER 170. The property owned by you located at 89 South Main Street Apt. A Centerville, was , inspected on March 22, 2007 by Timothy O'Connell, Health Inspector for the Town of �� Barnstable. This inspection was conducted on the basis of the rental registration in p g accordance with Chapter 170 of the Town of Barnstable Code. The following violations of the State Sanitary Code were observed: 105 CMR 410.503(D) —Protective Railings and Walls. Back deck needs balusters. You are directed to correct the violations listed above within thirty (30) days of your receipt of this notice by pulling building permits and installing balusters on deck that are no more then 4 1/2" apart. You may request a hearing before the Board of Health if written petition requesting same is received within ten (10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. Q:\Order letters\Housing violations\Rental ordinance\89 South Main Street Apt.A.doc Should you have any questions regarding the above violations, please contact the Town Health Division and ask to speak with the inspector who performed the inspection. =AMcKean, OARD OF HEALTH , CHO Director of Public Health Town of Barnstable Cc: Robert Gren, Tenant Cc: Timothy O'Connell, Health Inspector Q:\Order letters\Housing violations\Rental ordinance\89 South Main Street Apt.A.doc FORM36 c'_(,� HOBBSBWARREN'" THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH CITY/TOWN W o DEPARTMENT TELEPHONE Address �� � ___. Occupant_To "� Floor- W 11` _Apartment No.�4— _. No. of Occupanj��, 9 No.of Habitable Rooms I No.Sleeping Rooms-----I_� _ No. dwelling or rooming units�t1_'12— _. I'Jjo.Stone Name and address of owner --- — Z 0 ^ -� , Remarks Reg. Vio. YARD Out Bld s.: Fences: ©Z6 S 5 Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress: and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs.- Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen.Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den —Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Hot Water Facil. '° Sup.Ten.,Gas, Oil, Elect.: ks, FI es,VenjF,Safeties.- Kitchen Facilities ink ove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSPECTION REPO IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTIES OF PERJUR INSPECTOR TITLE r� DATE o� TIME A.M. THE NEXT SCHEDULED REINSPECTION P.M. 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105'CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0) shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. '13 C ��v�� � � � f �� i L_ _ 6?GIs Y Ao V 2 -� beet'oc W-5 I f Parcel Detail Page 1 of 3 u � 114 a Logged '"As: "i t€Er ,zl'f r .f":FS "S r ce a - Parcellnfo Developer Parcel ID 228-127 Lot LOT 1 Location£89 SOUTH MAIN STREET Pri Frontage 1189 Sec Road Sec~... ..... ...... . . _.._..._. .....,, ...r.._. ....._ Frontage . ......_. _,....,._u _ "..... Village CENTERVILLE Fire District'C-O-MM "__..."_-.. ___".__"__._._"_". _.. ._-_,." _ ...._,M._. "...-- Sewer Acct I Road Index 11507 gj Interactive = Map Owner Info ....... .._ __... owner'HOSTETTER, PRISCILLA M TR Co-owner ADAMS COUNTRY PLACE REALTY __... ......... ...... Streetl 770A MAIN ST Street2 _. ....... City=OSTERVILLE State MA Zip 02655 Country US Land Info Zoning RC Nghbd�Ci09 Acres 11.26 Use STORE/SHOP MDL 9 Topography; Road ; Utilities 3 Location Construction Info Building Year _ _.._.. ._.._ _._ __ Roof ___ "."."". . . .., .. Ext Built 1900 ."".j Struct;� Wall WOOD FRAME Effect _._. RoofF AC Area i5600 Cover . __._ Type NONE StyleStores/Apt Int _ __ Bed w w, Wall J Rooms Int Bath Floor , . . ..... _.. ,...._....... Model;Commercial Vinyl/Asphait Rooms 0 Full Grade i Avera_e Plus Heat Total 9 _. Type Rooms http://issgl/Intranet/propdata/ParcelDetail.aspx?ID=16092 2/22/2007 Parcel Detail Page 2 of 3 .. Stories Fuel OiI. Found-ation TYpical ;k Permit History ............ Issue Date Far ose Permit# A ount i s Date CEM: of ss Visit History - _._ Date so Purpose Sales History Life Sale Date Owner Booklpage Sale p 1 10/29/1999 HOSTETTER, PRISCILLA M TR 12632/028 2 9/15/1992 HOSTETTER, PRISCILLA& HIRSHBERG 8219/301 3 11/15/1991 HOSTETTER, PRISCILLA M TR& 7768/127 4 5/15/1981 HOSTETTER, DANIEL C & 3283/226 Assessment History ......... ......... . Save# Year Building alue Value OB Value Land Value Total Parci 1 2007 $360,800 $0 $21,000 $261,400 ; 2 2006 $480,500 $0 $4,500 $259,400 3 2005 $358,000 $0 $4,500 $267,600 4 2004 $188,400 $0 $4,500 $267,600 ; 5 2003 $110,900 $0 $4,500 $180,000 ; 6 2002 $110,900 $0 $4,500 $180,000 7 2001 $110,900 $0 $4,500 $180,000 8 2000 $182,400 $0 $4,500 $90,100 9 1999 $182,400 $0 $4,500 $90,100 10 1998 $182,400 $0 $4,500 $90,100 ; 11 1997 $164,000 $0 $0 $90,100 12 1996 $164,000 $0 $0 $90,100 ; 13 1995 $164,000 $0 $0 $90,100 14 1994 $180,800 $0 $0 $106,400 ; 15 1993 $180,800 $0 $0 $107,700 16 1992 $200,800 $0 $0 $118,200 http://issql/Intranet/propdata/ParcelDetail.aspx?ID=16092 2/22/2007 Parcel Detail Page 3 of 3 1 i 17" 1991 $246,900 $0 $0 $168,900 18 1990 $246,900 $0 $0 $168,900 19 1989 $246,900 $0 $0 $168,900 20 1988 $210,500 $0 $0 $128,400 21 1987 $210,500 $0 $0 $128,400 22 1986 $210,500 $0 $0 $128,400 Photos http://issql/Intranet/propdata/ParcelDetail.aspx?ID=l 6092 2/22/2007 /'_ 1 // (/�! i G i f �` '� w i` ^' �IKEA Town of Barnstable j Growth Management Department-Ruth J.Weil,Director 1 BAMSTABM • 367 Main Street,Hyannis,Massachusetts 02601 MAMC QED MAr p Regulatory Review Services—Site Plan Review 200 Main Street,Hyannis,Massachusetts 02601 Phone(508)862-4785 Fax(508)862-4725 April 18, 2006 Priscilla Hostetter, Trustee c/o William Weller P. O. Box 417 Centerville, MA 02632 Reference: 89 South Main Street—SPR# 009-06—Map 228,Par. 127 Proposal: Dog groomer to move into existing space currently occupied by a caterer. Dear Ms Hostetter: Please be advised that the Building Commissioner, Tom Perry,has administratively approved your R proposal for a dog grooming business to occupy an existing space at 89 South Main Street, Centerville with the following conditions: • Septic inspection and approval will be required by the Board of Health due to change of use. • Modification of Special Permit 1981-013 will need to be granted from the Zoning Board of Appeals for this use. • All permits and licenses as required must be obtained. If you have any questions or required further assistance,my direct telephone number is 508-862-4679. Sincerely, d a Ellen M. Swiniarski Site Plan Review Coordinator CC: SPR File Tom Perry,Building Commissioner Board of Health3 ZBA File .Y. 39 ' xf f 9.1.7 a f o — _1.1:' el' 4.1 -1 s TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: 670/71P66X/a1V G Mail To: BUSINESS LOCATION: ;?,? �_W/-zf owAl/,///v/T relu/-Feirlezc a.4 . Board of Health MAILING ADDRESS: Is1 Q b3 Town of Barnstable P.O. Box 534 TELEPHONE NUMBER: Hyannis, MA 02601 CONTACT PERSON: —C! ) /lq 1�7r_' iIleA/� EMERGENCY CONTACT TELEPHONE ONE NUMBER: 8-775"YO�� Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, , YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid —CA Toilet cleaners Engine and radiator flushes ,� �� C)) Cesspool cleaners Hydraulic fluid (including brake fluid) l` Disinfectants Motor oils/waste oils - �� Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, C AZ Laundry soil & stain removers hydrochloric acid, other acids)✓� (including bleach) Other products not listed which you feel may Y Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners Cyr Q White Copy-Health Department/ Canary Copy-Business TOXIC AND HAZARDOUS MATER�I/ LS REGISTRATION FORM NAME OF BUSINESS: y'l P Mail To: BUSINESS LOCATION: Board of Health : �j�m..�. Town of Barnstable MAILING ADDRESS �y P.O. Box 534 TELEPHONE NUMBER: 1S — 0 3 Hyannis, MA 02601 CONTACT PERSON: L EMERGENCY CONTACT TELEPHONE NUMBER. Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quantities t tailing, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants - Motor oils/waste oils Road Salt (Halite) '^ Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with "Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business 1. r, ' f E*GSM OF OF 80 r THE COMM. AVEAL'�H OF MASSACHUSETTS A # G N BOAR® OF HEALTH H TLEY �o E�4; No.2 97 O ....---- Town.... 0F........Barnstable �1 NA6 � ........................................... .......... GISTS �O lrpfira ion for Uispvii al Works (foustrnrt' rm Application is hereby made for a Permit to Construct ( ) or Repair ( x) an I 'vi ual Sewage Disposal System at: South Main St. Centerville � � ---•---------------------•-•--•---- Location-Address Daniel Hostetter _ c10 limp Restaurants•._Osterville W Owner Address ..............................................................................`................ ._._.................._......................:......._...................o o o................. Installer Address Type of Building Size Lot...._59.... ....Sq. feet U Dwelling No. of Bedrooms.............. ._...Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Buildings t qr 2... _.Off a of persons............................ Showers ( ) — Cafeteria ( ) Other fixtures ..............--•----------i -----------•--------•- Des .... .. W gn Flow._... ... ,�.,�........................gallons per person per day. Total daily flow..............545.�..5................gallons. WLe S iic Tank— quid capacitya.OQQgallons Length.. ............ Width...... °..... Diameter................ Depth..7.�......... x —No._.�k............ Width..�........ Total Length...-3. ........Total leaching area.r_. 8_.._-_..sq. ft. 3 Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water...-------.............. fxq Test Pit No. 2................minutes per inch Depth of Test Pit a__.........__...... Depth to ground water........................ ,...0x -•••-------••--• -----------•-----------------•--------• ---------•--•---•_..... D ri tion of Soil...-- •Repai of existi-.__ . ng.-s stem.: ... -------- ... :( _ W < UNature of Repairs or Alterations—Answer when ap icable__ ------- ...----•-----------------------•--••---------------•---•---------...-•---------•------..........------•--...------------------------....-----------•--------------------------........................ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TI'L 11 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Sig Date ned------------•------•--•-----•-/-------------------••------••--•-----•...----------- Application Approved By.._. '.- --•-. � j��;'/---------------- Date Application Disapproved for the following reasons:--•-----•--------•--•--------------•----•-----•-----•--••-----•--•--•-•--------•--------•-••--•-------........-- ......................................•-•-•--------...------...-------•-•-•------....---.......----•-•---............----•--- ------------------------•------•--•-------•--------•-------•---•-...------ Date PermitNo......................................................... Issued....................................................... Date �1V0 ICHARD y ': tH OF M� �, •. e........ F s� ....:....... .. �y s0YN70 THE COMMONWEALTH OF MASSACHUSETTS gVZ RUSE opF� d BOARD OF HEALTH ...----.......Town...............OF.........Barnstabl e------------......---.........------------------ Appliration for Disposal Works Tonstrurtinn rr Application is hereby made for a Permit to Construct ( ) or Repair ( X) an Individual a Disposal. System at a ......SQuth Main St. , Centerville . Location-Daniel Hostetter C�O Wi 1 y s •ResMIMni#. Osterville ... ................_.._........_. ..............- ............................._. Owner Address W __ � Installer Address " �OQ � Type of Building �,, Size Lot...........................Sq. feet . U Dwelling—No. of Bedrooms.................................._------Expansion Attic ( ) Garbage Grinder ( ) `k Other—T e of Buildin Store & Off @ a —Type g ............................ $d1e. of persons............................. Showers ( ) — Cafeteria ( ). d . Other fixtures ..---•-----------------••-•---------------------....------------...........................................598... . .._.:_...__......_.. Design Flow............... .......................gallons per person per day. Total daily flow..__..:__.__.._....__....................-_gallons. r 7� Le S c Ta uid capacity 104Qgallons Iren gth................ Width.= 5 Diameter................ 1 _____........ l� —No. .......... ....... Width............__._ Total Length....- .".......Total leaching ar .... ...:........sq. ft. Seepage Pit No------------- ----- Diameter.................... Depth below inlet.................... Total leaching area.............:....sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. I.:...............minutes per inch Depth of Test Pit.................... Depth to ground water........................ f14 Test Pit No. 2................minutes.per inch Depth of Test Pit.................... Depth .to ground water........................ --------••---------------------- ••-------.........----•--•--------........-••----•------•---.........•-- >on of Soil �$�-r of e .stn system. ' x -- "t.^ . escr esa�✓ . � .. . U Nature of Repairs or Alterations—Answer when appli '`lei....__.._ _. ...: - ..... :..:.............. ---- - . e`1a.st�,t r ............................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of health. Signed........•----------•--••-_-----r..........................=......................... Date Approved By---• r >` � � ...............ate Application A � - PP Application Disapproved for the following reasons---------------------------------•----------------------•----•---------------......------------..._......._----•- ---------------------•-------•--------------•------------------------•--•-•••----•---.........------••••-------------------------------................................................................ PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ..........................................OF..................................................................................... (9rdifiratr of Toanph anrr THIS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by -----------------/ -----------------... -------- ----- 0Installer at .. ------- l has been installed in accordance with the provisions of TITL 5 of The ate Sanitary Code af 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 SATIS,FACTORY. ® 5 6l-••----•...--- Inspector .......................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town OF Barnstable .......................... .........---.................................................. No._.�1. .��-- ;. 'FEE........................ Disposal Prkn Tnn#rur#ion Vprrmit Permission' i�s,,hereby granted........ --tir....----------•--•-------•-------------••........................................................ to Construct I/) or Repair ( ) an ndividual.S 'age Disposal System atNo - ---------------••---•---------------------------••-•-----.....---................ Street as shown on the application for Disposal Works Constructio mit 1 d N'-o__ _____ ________oDated .......................................... o - f- -----------•------ ----------• .- DATE............... ...................................... __ _ d Health FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS INSTALL RISERS CAST IRON - N N FRAMES 4 COVERS (H-20) PIPES TO BE LAID LEVEL FOR 2 OUT OF DISTRIBUTION BOX TO FINISH GRADE w 2 LAYER OF DOUBLE WASHED PEASTONE OVER �9 (SEE"PLAN VIEW FOR LOCATIONS) 3/4" - 1 %2" DOUBLE WASHED STONE ALL AROUND uj PINE STREET WATER TEST D-BOX FOR LEVELNESS *- FLOW 'f EQUALIZATION 0 - EL. 52 .4 _ _ EL. 52 .0 - - - -- -- .- EL. 52.0 �- W T.O. F. @ - - - 4" scH - - - - - - - - - - - - .- - - - - - - - LOCUS u Gj EL. 52 . 5 4" SCH 40 PVC 3000 I 1 500 40 PVC TOP @ EL. 48. 2 -vx\FF - + -, dGAL. 4" SCH 40 PVC 10, GALLONS x , 29" (7) 500 GAL. PRECAST DRYWELL5 (H-20) TANK # ! : 49 50 P SCN40 Q 48.00 BOTTOM @ EL. 4G.50 �y PVC U-PIPE 4V 17 v TANK #2 : 49.00 �INSTALL� GAS BAFFLE TANK # 1 : 49. 25 47.50 i TAN K #2 : 47 8. 5 i 52.7 1 DB-9 ' 1 6.5 LOT AREA: 59G35.8 S.F. (H-20) • 11 4500 GALLON PRECAST --- \ (2) COMPARTMENT INSTALL TANK * D-BOX . BOTTOM OF TEST HOLE ON 6 LAYER OF CRUSHED 0.0 SEPTIC TANK (H-20) STONE @ L. 4 , \ 1 \ 1 \ 1 \ t \ 1 \ 1 \ 101 \ 1 0000 \ 1 \ 1 � \ \ I 1 \ 1 \\ I 11 \ 1 \ I 1 \ 1 \ \\ 5 2.4+ I I , DESIGN DATA EXISTING TANK TO \ BE PUMPED DRY t \' I � I , DAILY FLOW: BEAUTY SALON - 3 CHAIRS x 100 GAL. = 300 GPD REMOVED \,' \ EXISTING TANK TO + `, , ( ) ��,, • ;'\\\ - \�``BE PUMPEDbRY �� ll Ghf� W� DOG GROOMER: I SINK x 100 G AL._ 100 GPD r� °,-' ` \\ �\ REMOVED t CAT GROOMER: I SINK x 100 GAL. - 100 GPD • \,. ,- N '\.O (2) APARTMENTS (3 BDRMS) x I 10 GPD/BDRM = 330 GPD TOTAL DAILY FLOW: 830 GPD • \�.. ,\ \\ f SEPTIC TANK: 830 GPD x 200% = I GGO GPD 0 52.4+ • ; USE: 4500 GALLON (2) COMPARTMENT SEPTIC TANK (H-20) #► `� • ,� I5T COMPARTMENT: 3000 GALLON ' 4500 GALLON \ f. _ 2ND COMPARTMENT: 1 500 GALLON "(2) COMPARTMENT \ TAN^:#2 �, •. 4:�U7 G '�N DISTRIBUTION BOX: 5E TIC TANK (1.1-203 ALL (7) 500 GAL. PREGA5T DKYU✓ELLS « . ,. USE: DB-9 (H-20), _ LINED wl-+' Of C;0UF3LE WA5HF-D 5TONZ IC TP,N` ( i-20)-� __m OIL ABSORPTION SYSTEM: / �` USE: (2) ROWS OF (7) 500 GALLON PRECAST DRYWELL5 } ' / w/4' O� \ -•'' -°' LINE F DOUBLE WA STONE ALL AROUND D SHED TON TBM = EL. 52.5 / • CAPACITY: s � N,% 'PAS /.100 • / SIDEWALL: 1 6 I x 2 x 0.74 = 238.3 GPD • BOTTOM 13 x G7.5 x 0.74 = G49.4 GPD , ! , I . - ✓/ • // rH TOTAL: 887.7 x 2 = 1775.4 GPD / / ®#2 52 - _ � // - � __ _ 52 W Eta VENT�''� N / �-�- TH® �O �s #I - \\ // \ / • • /.0-* (7) 500 GAL. PRECA5T DRYWELL5 LINED w/4' OF DOUBLE WA5HED STONE VENT ` // O O O +50.9 50 DEEP OB5ERVATION HOLE LOGS i7 DATE: 08-09-201 3 P- 14 1 17 _ TEST BY: D. MEYER, RS 1140 WITNESS: D. MIORANDI, HEALTH AGENT PERC RATE: < 2 MIN. / INCH DEEP OBSERVATION HOLE #I EL. 52.0 DEPTH SOIL SOIL OIL 51TE 5EWAGE PLAN SOIL COLOR S \ / FROM HORIZON TEXTURE (MUNSELL) MOTTLING OTHER FOR ( ��� I GENERAL NOTES SOl 0] FILL FILL 89 SOUTH MAIN 5T. , CENTERVILLE, MA � \3� 52 G" - 1211 A LOAMY 5AND I 0YR3/I PERC TE5T: 40" - 50" 1 2" - 39" B LOAMY SAND I OYR5/8 24 GAL. < 15 MIN. PREPARED FOR 1 . SEPTIC SYSTEM IS TO BE INSTALLED IN ACCORDANCE WITH 39" - 144" C MEDIUM SAND 2.5Y7/3 H05TETTER REALTY , 310 CMR 1 5.00: TITLE V SCALE: DATE: DRAWN BY: +52. 1 2. THIS SEPTIC SYSTEM IS NOT DESIGNED FOR THE USE OF A 1 " = 20' 1 0-0 1 -201 3 TM W \ , GARBAGE DISPOSAL J05 NUMBER: ®G-® I I REV15I0N: SHEET NUMBER: \ i 3. THIS PLAN IS NOT TO BE USED FOR PROPERTY LINE DETERMINATION. DEEP OBSERVATION HOLE #2 EL. 52.0 SP- ! 52 4. CONTRACTOR SHALL PROVIDE 48 HOUR NOTICE TO DESIGN DEFT SOIL SOIL SOIL COLOR SOIL OTHER WELLE� A55®ClATES ENGINEER FOR ANY REQUIRED INSPECTIONS. HORIZON TEXTURE (MUNSELL) MOTTLING 5. CONTRACTOR TO BE RESPONSIBLE FOR THE LOCATION OF ANY SURFACE O" - 6" FILL FILL I G45 FALMOU'TH RD., SUITE F9 UTILITY, ABOVE OR UNDERGROUND, PRIOR TO ANY EXCAVATION G" - 1211 A LOAMY SAND I OYR3/1 P.O. BOX 417 CENTERVILLE, MA 02G32 50 OR CONSTRUCTION. 1 2" - 39" B LOAMY SAND I OYR5/8 TELEPHONE: (508) 328-4G92 G. EXISTING LEACH PITS TO BE PUMPED DRY FILLED IN 39" - 144" C MEDIUM SAND 2.5Y7/3 EMAIL: trlsweller@gmall.com � WITH CLEAN SAND. NOTE: NO GROUNDWATER ENCOUNTERED IN ANY OBSERVATION HOLE REGISTERED LAND SURVEYORS ENVIRONMENTAL CONSULTANT Tra terse PG . _ � • t ' to(� r!a�*s•:..'-1r.'t+t•�r'r�,��M+�.T1•^'-i`•••r.'r•- - •.. rJ���./ ��.'�M�� AL IA •� 00 A F. _ �. sw AI �_. A;z;" r� •. .,^ . ' •. :.' '1 •. .t I wF`•fir .: , . : . .. 1`s a,. / Sr .y. .>rl�i�w '�� 1 ^.• ,fir 7„ la.: +� '�{ rtr: � i � er . ,. 1 t 1 III , `,,� •'�{ r _ -. • • i ..G•7�F1 —_.... , •1sls�a�//J/ O i11 1`V ,. •._ .. S ta.r•=4..w.'•-J _.,• .. f7L _.__. _� Bvz . •Aq avo 00 •• ' . 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