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HomeMy WebLinkAbout0067 GLEN ROAD - Health 67, GLEN-ROAD,,HYANNIS A-267 r,107, a i i n a , I. v TOWN OF BARNSTABLE , LOCAT'16N ����`�� SEWAGE# D !� VILLAGE_ ��ycotS ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. ! S A SEPTIC TANK CAPACITY l SD® LEACHING FACILITY:(type) (size) NO.OF BEDROOMS -CC_� C}( � OWNER D")(CA1\ PERMIT DATE: 1019)p`r 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 -`V`s 1. on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet' FURNISHED BY b y cr. trs r Q . � 1 Z i Commonwealth of Massachusetts - ,Title 5 Official Inspection p Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '( 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS required for MA 02601 10/2/07 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Important:When filling out A. General Information forms on the computer,use 1. Inspector: only the tab key to move your DOUGLAS A. BROWN cursor-do not \ use the return Name of Inspector key. D.A. BROWN ��� lo� Company Name P.O. BOX 145 Company Address CENTERVILLE MA 02632 City/Town State Zip Code'-( ' 508-400-7159 S 14297 Telephone Number License Number B. Certification i1 I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system: ® Passes ❑ Conditionally Passes ❑ Fails , ❑ Needs Further Evaluation by the Local Approving Authority 10/02/07 Anspedof ature 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 shred 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 should be sent to/he systbm owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time. This inspection does not address how the system will;perform in the future under the same or different conditions of use. ° r Title V Inspection Form.doc•O&OS Title 5 Official Inspection Form:Subsurface Sewage Disp osal posal System•Page 1 of 15 Commonwealth of Massachusetts 9 ,Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS required for MA 02601 10/2/07 every page. Cltyrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 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 determined," please explain. ❑ The septic tank is metal and over 20 years old* or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank 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 inspection if 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 I Title V Inspection Form.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 2 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS required for MA 02601 10/2/07 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ 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: C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine 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 functioning in a manner which will protect public 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 salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a 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 SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS,is within 50 feet of a private water supply well. Title V inspection Form.dx•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments •'< 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS reg uired for MA 02601 10/2/07 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cunt.): ❑ 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: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent 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: D) System Failure Criteria Applicable to All Systems: You must indicate"Yes"or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than'/z day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Tide V Inspection Fonn.doc•QW08 Title 5 Official Inspection Form:Subsurface Sewage Disposal SysUam.•Page 4 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS required for MA 02601 10/2/07 every page. City/Town State Zip Code Date of Inspection B. Certification (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a 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 100 feet 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 fecal coliform bacteria indicates absent 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 and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 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) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes" or"no" to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) 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 owner 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. Title V Inspection Form.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS required for MA 02601 10/2/07 every page. Cityfrown State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ® ❑ Has the system received normal flows in the previous two week period? ❑ ® 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 note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ 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 sludge and depth of scum? ® ❑ 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 Soil Absorption System(SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ❑ ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] Titre V inspection Fonn.doc•08106 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '( 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS required for MA 02601 10/2/07 every page. Cdyrrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 2 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 330 Number of current residents: 2 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ❑ No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): 05-178/06-189 Sump pump? ❑ Yes" ® No Last date of occupancy: CURRENT Date Commercial/Industrial Flow Conditions: Type of Establishment: Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): Title V Inspection Form.doc•0&06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 67GLEN RD Property Address PARKER Owner Owners Name information is HYANNIS required for MA 02601 10/2/07 every page. CRy;Town State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: OWNER Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: 2500 gallons How was quantity pumped determined? Reason for pumping: MAINTENANCE 4/07 PASTORE EXCAVATION 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 a copy of the DEP approval. ❑ Other(describe): PUMP CHAMBER ALSO Approximate age of all components, date installed (if known)and source of information: 4/5/2001 OFF AS BUILT CARD Were sewage odors detected when arriving at the site? ❑ Yes ® No Title V Inspection Form.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 67GLEN RD Property Address PARKER Owner Owner's Name information is required for HYANNIS MA 02601 10/2/07 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑ cast iron ❑40 PVC ❑ other(explain): Distance from private water supply well or suction line: feet i Comments(on condition of joints, venting, evidence of leakage, etc.): Septic Tank (locate on site plan): Depth below grade: 1 feet Material of construction: , ® concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No ----------------------------------------------------------------------------------- --------------- Dimensions: 1500 - Sludge depth: TRACE Distance from top of sludge to bottom of outlet tee or baffle Scum thickness 0 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Title V Inspection Form.doc•08/06 Title 5 Official Inspec8on Form:Subsurface Sewage Disposal System•Page 9 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS required for MA 02601 10/2/07 every page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): TANK AND PUMP CHAMBER LOOK VERY CLEAN BOTH PUMPED IN APRIL OF 2007 Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene El other(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: Date Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene y ❑ other(explain): Title V Inspection Form.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments '< 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS required for MA 02601 10/2/07 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments(condition of alarm and float switches, etc.): Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0 Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): Pump Chamber(locate on site plan): Pumps in working order: ® Yes ❑ No Alarms in working order: ® Yes ❑ No Title V Inspection Form.doc•08/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments i '( 67GLEN RD Property Address PARKER Owner Owner's Name information is required for HYANNIS MA 02601 10/2/07 every page. C41rown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS) (locate on site plan, excavation not required): If SAS not located, explain why: NO OBSERVATION PORT FOUND Type: ❑ leaching pits number: ® leaching chambers number: 5 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology.- Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): Title V Inspection Form.doc-08/06 Title 5 Official Insp ection Form:Subsurface Sewage Disposal System•Page 12 of 15 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS required for MA 02601 10/2/07 every page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments(note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, 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.): Title V Inspection Fonn.doc•0a/06 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 13 of 15 f . Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS required for MA 02601 10/2/07 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at,least two permanent reference landmarks or benchmarks. Locat all wells within 100 feet. Locate where public water supply enters the building. t S I SO©�c�i Im ti�c,�1c t 3�- ®' ®� I ooc> CA10t-'z' p�;�►pe�, 1�,�. Title V Inspection Forrn.doc-08/06 Title 5 Official Inspection Fort:Subsurface Sewage Disposal System•Page 14 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments '< 67GLEN RD Property Address PARKER Owner Owner's Name information is HYANNIS required for MA 02601 10/2/07 every page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) Site Exam: ® Check Slope ® Surface water ® Check cellar ® Shallow wells Estimated depth to ground water: 5.3 feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: Date ❑ 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 ground water elevation: OFF AS BUILT CARD DATED 4/5/01 Title V Inspection Form.doc•08/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 i , i Town of Barnstable + yP�ti� Regulatory Services B,, nM Thomas F.Geiler,Director 0.19. •0� Public Health.Division Thomas McKean',Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 ' Fax: 508-790-6304 This septic system inspection report was completed by a private inspector who is certified' by the State of Massachusetts, Department of Environmental Protection. Although the Town of Barnstable Health Division received the original/copy of this report; this Division does not warranty the functionality of the septic system in the future nor does this Division agree with any technical observation s and interpretations contained within this report. _. In addition, by receiving this report the Town of Barnstable Health Division does not automatically approve the number of bedrooms listed within this report. The actual number of bedrooms approved at a particular property would-be listed on the "Disposal Work Construction Permit". If you should have any questions regarding this report,please contact the certified Septic System Inspector who conducted the inspection. j TOWN OF BARNSTABLE LOCATION ,,Cep � ,✓ � SEWAGE #40,0 /C�r VILLAGE ASSESSOR'S MAP & LOT-X'Z /67 INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY /1'ao GrC S�P,�� t /,a�/G�C dump e4w LEACHING FACILITY: (type)ek4a •N�Anr�S �'� (size) NO. OF BEDROOMSS^�. BUILDER OR�WNF=_R 14J� PERMITDA COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility J,3 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 a € �- �� - - tJ - -. �. � � , i � i > � � � 1 r � ,, ' � I � � � � i u � �, �� � � t�� � � r� . �, , ;` 1 � � _ `tii 0 � 0 ...,.. C4` � ` �= e o o� �� ._ � � _ - � , a: i a n �a .. �^ 3 � ��. � C �"'+ V�". 1 No. `s) Fee �J 4 THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: es PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS application for Migpogal *pztem Cone;truction Permit Application for a Permit to Construct( )Repair(✓)Upgrade( )Abandon( ) lJ Complete System ❑Individual Components 1 Location Address or Lot No. / /�n y,„/ Owner's Name,Address and Tel.No. Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. Bo�'�C��i Co�s� Ca'R%1��'c� doh oP•S. - /CGS Type of Building: ; Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( G� Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow / gallons per day. Calculated daily flow D gallons. Plan Date 00 Number of sheets / Revision Date Title Size of Septic Tank l,5-00 �'/OGb�t/�i.� Type of S.A.S. Description of Soil 412, �X/O X G ,! Nature of Repairs or Alterations(Answer when applicable) 7—j7`e- 1.-0 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 y this B and o Health. / Signed Date Application Approved by Date 3 D Application Disapproved for the following reasons Permit No. Date Issued No. Fee r � THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: a • Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS application for �Dtzpotal *p,5tem Conkructton Permit Application for a Permit to Construct( )Repair( V)Upgrade( )Abandon( ) EP Complete System ❑Individual Components... Location Address or Lot No. y „/ Owner's Name,Address and Tel.No. b� Glen Assessor's Map/Parcel Installer's Name,Address,and Tel.No. Designer's Name Address and Tel.No. - � �d�t�l-ol�r C��S� Gaa��/arc', Groh i�-5. CGS � ;� �TM• Type of Building: Dwelling No.of Bedrooms Lot Size sq. ft:' Garbage Grinder Other' Type of Building. No. of Persons Showers( ) Cafeteria'( ) Other Fixtures Design Flow gallons per day. Calculated daily flow 330 gallons. Plan Date 4 _ ` DD Ny�mber of sheets / Revision Date Title S) e qq Y�/� l� /P 4 �I Size of Septic Tank` Type of S.A.S. 41 /?C' Description of Soil Nature of Repairs or Alterations(Answer when applicable) T1� F • 6l Date last inspected:' 1-•- a , Agreement:. The undersigned agrees to ensure the construction and maintenance of the"afore described on-site sewage disposal system in accordance 1141 the provisions of Title 5 of the Environmental Code and not tosplace�ttie system in operation until a Certifi- cate of Compliance"has been issued b this Board of4Health.Il _ r `Signed Date /1--5��� Application Approved by t� P,-P) Date/"3 0 Application Disapproved-for the following reasons Permit No. 14(b)— I U Date Issued 6. OFF, THE COMMONWEALTH OF MASSACHUSETTS lib 7 X� 7 BARNSTABLE, MASSACHUSETTS certificate of Compliance THIS IS TO CERTJFY, that the On-site Sew Disposal System Constructed( )Repaired( !/ Upgraded( ) Abandoned( )by wf at Me el rew, lam• /�3�C/�9/1%S�JD/% has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No.(POD �(pS dated Installer Designer The issuance of this e t shall not be construed as a guarantee that the systa" 'ill fun •ion as'designe Date d Inspector THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS ltzpozar *pMem Construction Permit Permission is hereby granted to Construct( )Repair( ✓SUpgrade( )Abandon( ) System located at 6 7 4/ell 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:Construction must be completed within three years of the date of this permit. Q /, Date:��� Approved by r �T T� � Town of Barnstable P# Department of Health,Safety,and Environmental Services 'THE Public Health Division Date ®® G. 367 Main Street,Hyannis MA 02601 • BARNBT E M • , MASS. A�ept� Date Scheduled D Time Fee Pd. Soil Suitability Assessment for Sewage Disposal Performed By: Witnessed By: I;O. AT ... F..... I.. N:::::::::.:.::...........:.:::::::.:::::::....... Location Address ........................................................................ O ner's Name Address Assessor's Map/Parcel: Engineer's Name NEW CONSTRUCTION _ REPAIR _ Telephone# y r Land Use Slopes(%) 2 Surface Stones ' 120 Distances from: Open Water Body ?-So:ft Possible Wet Area 230 ft Drinking Water Well ft I Drainage Way 4, ft Property Line V ft Other ft ' SKETCH:(Street name,dimensions of lot,exac locations of test holes&pert tests,locate wetlands in proximity to holes) Zo Ii0 _ �1 L�� r Parent material(geologic) &TWAdl `.2/IftlL Depth to Bedrock Q /� Depth to Groundwater: Standing Water in Hole: �- Weeping from Pit Face Estimated Seasonal High Groundwater .......::.. ..:. ...:..:..:..:.......;: y�� yet L ry Y ;;:........:... :. :......::::> ......... E3. iRtYd l7li d:A.> .. +Dl : ': :R:S] �SONA H]CG 3[.; All[ :.TAI :::>: <::>::>::>:::: : :.;:.;:.;:.;:.;:.;:.;:.;:.: ]Ll ::::::................ Method Used: Depth Observed standing in obs.hole: 8 in.' Depth to soil mottles! in. : Depth to weeping from side ofo s.hole: w in. Groundwater Ad'ustment �3, �_ft. Index Well#`j&¢�jivnadine Date: 512*X index Well level.,_. Adi.factor Adj.Groundwater Level fy% ''``:> :: :' ?i ;ii' z T�+ Observation Hole# 2 Time at 9" Depth of Perc 1 P � ��U/lt�� r , Time at 6" Start Pre-soak Time® Time(9"-6") End Pre-soak Rate Min./Inch Site Suitability Assessment: Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division Observation Hole Data`To Be Completed on Back j Copy: Applicant .. .::.;::>::>:> ..... .. :.:::............................�ER:.:ATION..HOLE.:Lb :>::::>::::>::::>::. ............:::::::: Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface,(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency,%Gravel Zal ti C Z Sim war , ............ . ... 0..::SERVATIO HOLE.;LQ ...::::;;:...::::::::::.H.o....l..e::.#:.:;:2:......::.;:.;:.;:.;:::..:......::..:.......: Depth from Soil Horizon SoiI Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. Consistency.° Gravel) /S- 26 /9 / Pam.• 'Sly ovrn I o D f)BSERV...ATION.HQh,E.:LO.C.... ::::::>«>:<:.:::::::: »::::::::::::::::.::::: Other Depth from Soil Honzon So,l Texture Soil Color Soil Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. nsistenc %Gravel) f DEEP:::OBSE V' T De th from>: f:.. >: ..... R. .A. .ION.HOLE..LOG:..:::::;::::<:.:.::;:> . p. So Horizon Soil Texture Soil Color Soil Other Surface(in) (USDA) (Munsell) Mottling (Structure,Stones,Boulderes. n i tenc °o ravel Flood Insurance Rate Mao: Above 500 year flood boundary No ZYes ` Within 500 year boundary No— Yes Within-100 year flood boundary.No k 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? S If not;what is the depth of naturally occurring pervious material? Certification I , I certify that on /UDU C' (date)I have passed the soil evaluator examination approved by,the Department of Environmental Protection and that the above analysis was performed by me consistent with. the required ,expertise and ex ience described in 310 CMR 15.017. Signature Date Ov RONALD J: CADILLAC, PLS, RS- Professional-land Surveyor & Registered Sanitarian . P.O. Box 258, West Yarmouth, MA 02673 (508) 775-9700 (800) 520-5591 April 5, 2001 Mr. Thomas McKean, Health Director Barnstable Board of Health - 367 Main Street Hyannis, MA 02601 Re: Rzasa4: 7-Glen-Road Dear Mr. McKean:- We have inspected the'septic system.installed at 67 -Glen Road by Bortolotti Construction,Inc and found it to be in substantial' compliance with the approved plans and Title 5. Call with any question. Sincerely, n, Ronald J. Cadillac Copies to: Rzasa & BCI TOWN OF BARNSTABLE J LOCATION 10 7 K-- / ------ SEWAGE # VILLAGE ASSESSOR'S MAP & LOTA--7 INSTALLER'S NAME &PHONE NO. SEPTIC TANK CAPACITY If 100 4,1 -5,. LEACHING.FACILITY: (type),f�Z/, t2 (size) NO. OF BEDROOMS 3 �17,R�V2 B TUMT DER OR 45"fflix-F) PER.MITDATE: 3*/_t//. COMPLIANCE DATE: Separation:Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water-supply Well and L]e aching Facility (If any wells exist - on'site or within 200 feet of leaching facility) .49 Feet I Edge of Wetland and Leaching Facility (If any wetlands exist within 300 feel,of leaching facility) Funiishbd by L7 ...... .......... q .2)' 7. - - t THET � Town of Barnstable snxNSTnsi.E Department of Health, Safety, and Environmental Services 9�At639. ,�� Public Health Division TFD MA't A 367 Main Street, Hyannis MA 02601 FAXDate: Number of pages to follow: Z To: From: Phone:. Phone: 508-790-6265 Fax phone: y13 --3 y— 7�1 7 Fax phone: 508-775-3344 CC: REMARKS: ❑ Urgent For your review Reply ASAP Please comment 7 G-� i i TOWN OF BARNSTABLE ;IN E OFFICE OF BARISTAM4 i BOARD OF HEALTH 7 MM& p °0 1639• `gym 367 MAIN STREET o MpY p HYANNIS,MASS.02601 .Jdlludly LJ, GVV 1 Ron Cadillac P. O. Box 258 West Yarmouth, MA 02673 RE: 67 Glen Road, Hyannisport Dear Mr. Cadillac: You are granted multiple variances, on behalf of your clients Mary and Ken Rzasa, to replace the onsite sewage disposal system at 67 Glen Road, 3 Hyannisport, Massachusetts. The following variances are granted: 310 CMR 15.211 (1): To install a leaching facility only six (6) feE •away from the property line, in lieu of the ten (1.0) feet minimum setback required. 310 CMR 15.211 (1}: To install a leaching facility only 8.8 feet away from a concrete slab foundation, in lieu of the tern (10) feet minimum setback required. 310 CMR 15.255 (5): To remove only 2 1/2 feet of impervious soils rather than 5 feet minimum required. 310 CMR 15.240 (9): To provide only 8 inches of cover over the top of the leaching facility in lieu of the 14 inch rnin'irrum of soil . cover required. The variances are granted with the following conditions: (1) 'No more than three (3) bedrooms total are authorized in the dwelling. Dens, study rooms, finished attics, sleeping.lofts, and similar t-pes of rooms with isolation or privacy are considered "bedrooms" according to the Massachusetts Department of Environmental Protection, Rzasa (2) The applicant shall record a properly worded deed restt�"tion at the Registry of Deeds, limiting the dwelling to three (3) bediY('I-nS rnaximurn. } (3) The septic system shall be Installed in strict accordancOvlth tfie revised plans dated December 29, 2000. (4) The designing registered sanitarium shaii supervise the !(,,,s,,ucl,on of the septic system and shall certify in writing to the Boar that the system was installed Jn substantial conformance with the revisal Plans dated December 29, 2000. (5). The existing cesspools shall be pumped and filled with,(:ir)on Sand, o.r. removed. These variances are granted because the proposed replacemt'�'I system meets the maximum feasible compliance standards contained within ','c' State Environmental Code, Title V. Sincerely yours, Susan G. RWk, R.S. Chairman Board of Health Town of Barnstable SGR/bcs Rzasa �3/19/2001 1&N9 • •5087904264 SQUIER CONST. PAGE 02 �• ,- 914 "13c►44 Op 153 #17520 03-19-2001 Q 09s426 DEED RESTRICTION WHEREASD �I � ��~l Cr ',_)MA (owws name) (address) ddL is the owner of located at r (address) MA (hereinafter referred to as _ ) and being shown on a plan entitled "Subdivision of Land in n't MA, Property of,. et al, duly recorded in Barnstable County-Registry of Deeds in Plan Book , Paged; tA� WHEREA011 s the owner of said lot has agreed with the Town of Barnstable Board of Health to a restriction as to the number of bedrooms which_ can be included in any home built on said lot as a pre-condition to obtaining a variance from the 310 CMR 15.214 State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage and to obtaining a building permit for this lot; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting the variance from 310 CMR 15.214, State Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing the issuance of a building permit for the construction of a single family home on this lot is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, NOW, THEREFORE, oes hereby place the following restriction on (owntie>'s name) his above-referenced land in ac9prdance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with the land and be binding upon all successors in title: deedr 03/19/2001 10P49 •- .-5087904264 SQUIER CONST. PAGE 03 1. n `may have constructed u (eddre�) pon the I of a house containing no more than( ) bedrooms. • -:A AA agrees that this shall be permanent deed restriction (WWv affecti;AMag. I.ted on 2AUA-&-, _MA, and being shown on the plan recorded in Plan Book,.,.—__ , Paged �C.o For titre of In the following deed: Book a11C , Page�Z(Q . ("WA Mint) Executed as a sealed instrument this day of. � � ► ..cry (d ) AFiEpTRuf9EIRY� O 1E418TER des& 9�RI�TAB[�REOtSTRY OF OLEOS RONALD J. CADILLAC, PLS, RS Professional Land Surveyor Registered Sanitarian P.O. Box 258, West Yarmouth, MA 02673 (508) 775-9700 (800) 520-5591 TRANSMITTAL FORM To: BAa2JST4-it L'a Bo fty-c" O�—' A-1 Re: 6-7 Gde� Ai CC" MPVL4 Q Zzas } Date: 00 Certified No: Enclosed: C ,) E S O 1— R-ea rt QAT '(2 (A22 . T s y re _ g -�►�ess�ge- L S w � Q-C— 0 N 12 IS Do -- ie eau ('00 Env Ci-r wL �o r A4.10 CA-.CA-M w Prh-j � UrO S TZ4J AJ Signed: NOV-22-00 10 :06 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 (800) 520-5591 TRANSMITTAL FORM Re: Date: Certified No: Enclosed: Message: - ; led ✓ '#rr � S r� ala4AMSigned: . NOV-22-00 10 :06 AM R. J. CADILLAC. PLS. RS 508 775 9700 P. 02 � t ,n • :Je f DATEt. I/ �Z Dd Q. FEE: BA RNWARLE �E M"& 6 Town of Barnstable REC. 8Y SCHRD. DATE: Board of Health 367 Main Street, Hyannis MA 02601 of icc: 508-862.4644 Susan G.Rask,R.S. FAX: 508.790.6304 Sumncr Kaufman,M.S.P.11. Ralph A.Murphy.M.D. VARIANCE REQUEST FORM LOCATION 6tclj �I'ropenyAddress: (e7 �d 1 Assessor's Map and Parcel Number: Z67 0 Size of Lot: Z42 7 S Wetlands Within 300 Ft. Yes 'Business Name: No Subdivision Name: 1-6 At/rvu th, 20 h/E74 do ra / iesi� LE APPLICANT'S NAME: one Did the owner of the property authorize y to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: Name:�Q/V C AG71 ( Address:1-4— hto &zk_ Address: .. leOX ZSB . W tr_CIL�L l +riR Phone: Phone. VARIANCE FROM REGULATION(ListRcZ.)' REASON FOR VARIANCE(May attach ifmora space needed) _ o cmff2 lS,2J( r 1 1C,e r —07 RA CIiec tst(to be completed by office staff-person receiving varianee'request app cation) Pour(4)copies of engineered plan submitted(e.g.septic system plans) Four(4)copies of floor plan submitted(e.g.house plans or restaurant kitchen plans) ✓,/ Signed letter stating that the property owner authorized you to represent him/her for this request _✓ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) Pull menu submitted(for grease trap variance requests only) Variance request application Fce collected(no rea fatifevw*ro eafri tio-.enat++b,ve..etnP vannncn renanl,fume 1--adim—„etyl,m ;Je " illnlny variance rencvrnli(eetre urneuleture only(.qnd rtuinnm to ropair failed smvege diepo.nl ayetumo(uny If n0 aPotttion to tbo building p+ovnsotll) r✓ . Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Coma r+.Rack. R C .r hairrnnn NO-l•APPROVED Sumner Kaufman,M.S.P.H. REASON FOR DISAPPROVAL _ Ralph A.Murphy,M.D. Q:/WP/VARIREO 01/10/1994 08:58 4137326358 KALMARCONSTINC PAGE 01 KENNETH A.RZASA MARY M. RZASA 74 WOODBROOK TERRACE WEST SPRINGFIELD, MA 01089 FAX CO'6EER SHEET I DATE: 11-22-00 TO- BABBARA, SULI�IVAN - BARNSTABLE BOARD OF HEALTH FROM: KENNETH A. & MARY M.RZASA St-WELT: NEW TITLE Yo SEPTIC SYSTEM FOR 67 GLEN ROAD, HYANNISPORT, MA PAGES. 3 LYCL GD V G TaIS O`E ) PHONE 1-413-739-600 • FAX# 1-413-731-9078 REXARKSI AS REQUESTED, THIS IS OUR STATEMENT . TO THE BOARD OF HEALTH THAT RONALD J. CADILAC, OLS, RS, IS OUR REPRESENTATIVE FOR ANY . DEALINGS CONCERNING OUR NEW TITLE V. SEPTIC SYSTEM TO BE INSTALLED AT 67 GLEN ROAD, HYANNISPORT. MR. .CADILLAC WILL BE OUR REPRESENTATIVE DURING THE BOARD OF HEALTH MEETING. INCLUDED IS THE FLOOR PLAN OF OUR HOUSE AT 67 . GLEN RD. Maw Yk- eao ,t-- � � bl/lb/lyyµ lift:bb 41J r;;'ZbJbd KALMAKI: NS I DIU PAGE 03 FLOOR PLAN: RZASA RESIDENCE,_ 67 GLEN RD. , RYANNISPOR f,I i �f c-,t li f I 01/10/1984 08:58 4137326358 KALMARCOh4STINC PAGE 02 RZASA RESIDENCE: 67 GLEN RD- , HYANNISPOE,T, MA ' I Z 4" s'a' .18•�1" 01 II`I ._ram lw F—ill. a : i OF BARNSTABLE. MASSACHUSETTS ASSE SOPS MAPS A It oaf- � A .+� 1 !T \\ 161r �•'r® '� 1' J 3 s 11 i y } • %C i IIq : \LLB, •!y ; � 190 ' ` A y01 +� y .106 AID' de CO.If. I � ���• r! C � 6 1 01. �s+•e�+ / � co. qq A `yto f.lO.0 4c e MITM ST.tQ I. W 7 M 'w- a •n� JdY ' Il�.t tf� (b • i 4� at a I / a4, no 'My I r ' IIQ 111/ b MA[ IN O / IT.L W r rt•: Iqp I REV.BY ' two //j QPIgII u AWE O TA406&V7 @410 14n' / N 0.1 �u,NL •I . SCAU r • � a I . ? y t.W.0 1 1 _ 535 - - -- ® 267 to wr m r• / sue•, TH9 DATE `. FEE: y, t3ARN5TA1?ILB, t MASS REC. 8Y�. Town of Barnstable �- - � �a. SCHfiD. DATE: �.GT Board of Health 367 Vlain Street, Hyannis CIA 01601 ,771 Ofce:.508-�90-6265 FAX 502-790.6304 Susan G.Rask.R.S. Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. n VARIANCE R ROSIEST FORM LOCATION Co Properry Address: LC l\I . a)� n n I S }7(-,)f2 Assessor's Map and Parcet Number: 2-(✓ Size of Lot: SF Wetlands Within 300 Ft. Yes Subdivision Name: �1LCr`i + tA—, U t LLA. = E Business Name: t�f R do 23L� ' W ell � +L P•-�n�-:;Eta If.��1,1.�y APPL(CAN r _ CONTACT PERSON'— — Name: E=ff,) Z/4 Name: pfO-_ 0C",, II <, iJ/A v Address: 7 )'VOOCj h roe I-,err-Ac_.E Address - P C�_ A30 ✓Yl A�l v dq �uL73 - Phone: Phone: � 13—732-103t�8(h� �t 13-73c1-[(lb�� FAX: 4X: -Smm.z VARIAiNCE FR0,,�1 REGULATION(Ui,Ray.) REASON FOR VARIANCE(May attach ifmore ipacc nccdcd) 311) Cm�- 15•Ztt (1) -4' ORr,A�,4 SK)aII keii - nc rrxm 1p,q L;,-i (.,z, i,V L.0 n 2 3 16 crn rt LS,212 - UA✓I h. �' TO 19 U0%'D A w/> era �,,S T6m Wr+tzuP (-41 0rk%;1!i.4) n — j it, i,.2 I .2-49 - I\i -�?z c:✓✓c t i i m b v.t `iJ, M r G� !f V-e A 14 I o '- 1��•-t_ y .31 o C tin 0- iZ;,2.4L) — 8 -M i 6&ce 'A rncvrvc CIle,,Cli ?� Lvlt¢rP q/g[p Tr Mr�✓irvrr2c hi G f lY7/�,Vr7' IC iecktisr(to he comp erect 61-ojrce srajJr person receiving variance request uppiicarionj S( Four(1)copies of plan submitted(including septic system plans and'or restaurant tloor plans) l/ Applicant understands that the abutters must be notified by certified mail at leas(ler,days prior to rtieeting i date at applicant's expense(for Title V andlor local sews`,,e regulation variances only) _ Full menu submined(for crease trap variances only) _ Variance request application fee collected ino ra rw t;raguaronooninuon ienn..yv vosc vaD.'aruacc rcnnals(nmeO—nofkame Ccl.<,•.anWc Jlmn1..o•ne+ •ne..•I.rune awnarlrun un.'r I.snJ••rw ee+io im•r iyl•J.•w•y Jupnul nn•m lo•ly i no c+p•m•un m he^wlJinµ progo.rJ)) Variance request submitted of least 15 days prior to meetinu date VARIANCE APPROVED Susan G. Rask, R.S., Chairman NOT APPROVED Sumner Kaufman, M.S.P.H. R11ASON FOR DISAPPROVAL Ralph A. Murphy,M.D. o ,.wp/vARrRrQ 4 ek G i RONALD J. CADILLAC, PLS, RS Professional Land Surveyor Registered Sanitarian P.O. Box 258, West Yarmouth, MA 02673 «nQ� 77;_07nn November 20, 2000 NOTICE OF HEARING FOR VARIANCES FROM BOARD OF HEALTH To: Abutters Project Location: 67 Glen Road, Hyannisport Applicant: M/M Kenneth A. & Mary M. Rzasa 74 Woodbrook Terrace West Springfield, MA 01089 Project Description: Applicant seeks to upgrade a septic system for real estate transfer of property. Variances requested are: Vary leaching to property line by up to 4' (6' provided). Vary leaching to slab by 1.2' (8.8' provided) Proposed leaching is 15' off of crawl space. 310CMR 15.211 (1). Vary separation to high groundwater by 1'(4' provided). 310 CMR 15.212 Use 8"of total cover over leaching. 310'CMR 15.240 (9) No reserve area is shown. 310 CMR 15.248 Vary local disposal regulation to meet 1995 code where applicable. Local Regulation. Applicants Agent: 'Ronald J. Cadillac Hearing Scheduled: A hearing for this project will beheld on Dec. 7 r-k, 'Tuesday evening, at 7 P.M. or later (call for time), at Barnstable Town Hall, 367 Main Street, Hyannis. Plans are on file with the Health Department at Town Hall, which is open Monday through Friday (excluding holidays), from 8:30 a.m. to 4:30 p.m. � � �� � o � , � �� � � � � � � � � � � � � � � � � � � a . . u FEE: � • 1?IANNt3rA13r8 — a•'. NA86 fbJ4 �� REC. BY Town of Barnstable r- SCHIRD. DATE: Board of Health A 367 Main Street,Hyannis MA 02601 ' Office: 508-790-6265 Susan G.Ravk.R.S. FAX: SOE-790-6304 Sumner Kaufman,M.S.P.H. Ralph A.Murphv,M.D. VARIANCE-REQUEST FORM LOCATION G� /' Property Address: 7 L_�lV loft)� I-� y n p S po(.;? ii• / Assessor's Map and Parcel Number: Size of Lot: tp � Wetlands Within 300 Ft. Yes Subdivision Name: C1LEn1 CI':aUEAJ U I if A�6 N0230 1t We�IL� +o P:�pr�SEt� 1�,4c Business Name: tj1pt w - > APPILICANT � / I f`1 CONTACT PERSON �/ Name: 1��N �1/'VI_ Z�SA Name: �N r /-1-CO, v Address: 7 4 �IJOOC1 t^00 �-,E r^Ae-E Add:ess: _ (� �p ,yA VmN t k Phone: "VJ ES'1 Spr-i NGtIIELb I VYlAo 08C? Phone: Uw�3 FAX: Ili-732—Co358(h) �fl2,-73ci-G�(W� 5 AX: VARIANCE FROy1 REGULATION(li3i Rey.) kEASON FOR VARIAiVCE 04 nuach irmore space needed! :r 310 CM>' ►S•21( C1) '-4'VA*r�^-t_ S�AII �o� , ncreo Lp-A A Loi livn.e. 1.2' L.P a rwo- Sic cmrt ts,21i - UAV' tr TO AUOfD A W4 It ej SVSTEAn _ Voy F J14A, , rv,IdLd)" _ lJ 3)OCw.l2 1S,149 - �j, )?e�ae✓ -- 'trr rr+6v .4 lo-I• -- Il-am.-tr 310 C J\A I2 I .'z40— 8"-MIA, C�,+��w�u1 c tT. !�rrw C T iv fr%W D w. II ' ��,5h �v�ds 5 U )oCA , Yv re 7'� riiivirn/Lc' hr of rri�vn>D Ir I' (to be comp erect by office sraff-person receivitrg variance request app(Icarion) Four(4)copies of plan submitted(including septic system plans and/or restaurant floor plans) V Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting i date at applicant's expense(for Title V and/or local sewage regulation variances only) "s. Full menu submitted(for grease trap variances only) F •• Variance request application fee collected�nar«rur��r.,,�d�,00n��„o�,m�.:u..we, ,r,v,•,,,�,«,�eM:,:ta�,�„wne,;0.auerc��•;,:.ouk t;µ J:n,ny r.d•nc.ienewd.;wne ownenleuee un:rl.•nd�orunut o rn+ir al•d•.mg.Ji.prnel•ynaef to•ly,I rro capanv,m io:he ba,ldiny Vroposedt) , ! Variance request submitted at least 15 days prior to meeting date 3c� e VARIANCE APPROVED Susan G. Rask, R.S., Chairman NOT APPROVED Sumner Kaufman, M,S.P.H. REASdN FOR DISAPPROVAL Ralph A. Murphy.M.D. +' Q:/WP/VARIREQ �� i'1 ��11 l/•�(Jt' 64P � y 1 RONALD J. CADILLAC, PLS, RS Professional Land Surveyor Registered Sanitarian P.O. Box 258, West Yarmouth, MA 02673 (508) 775-9700 November 20, 2000 NOTICE OF HEARING FOR VARIANCES FROM BOARD OF HEALTH To: Abutters Project Location: 67 Glen Road, Hyannisport Applicant: M/M Kenneth A. &Mary M. Rzasa 74 Woodbrook Terrace West Springfield, MA 01.089 Project Description: Applicant seeks to upgrade a septic system for real estate transfer of property. Variances requested are: Vary leaching to property line by up to 4' (6' provided). Vary leaching to slab by 1.2' (8.8' provided) Proposed leaching is 15' off of crawl space. 310CMR 15.211 (1). Vary separation to high groundwater by 1'(4' provided). 310 CMR 15.212 Use 8" of total cover over leaching. 310 CMR 15.240 (9) No reserve area is shown. 310 CMR 15.248 Vary local disposal regulation to meet 1995 code where applicable. Local Regulation. Applicants Agent: Ronald J. Cadillac Hearing Scheduled: A hearing for this project will be held on Dec. _ Tuesday evening, at 7 P.M. or later (call for time), at Barnstable Town Hall, 367 Main Street, Hyannis. Plans are on file with the Health Department at Town Hall, which is open Monday through Friday(excluding holidays), from 8:30 a.m. to 4:30 p.m. I - ' • 4 _ OF BARNSTABLE, MASSACHUSETTS ASSE SOBS NAGS s• A � j•f `y y MD =CYOOLI011�1. 1'. 9Y _t I•a •y•• = f a � \ i!6y r+� `Zz� YS is m 190 1 r Syr • ,a? (D T�L j �•.aD © 9 / � PIP �•y.l y'.. r47 y.r qp� 8 � n� yY r�r SS `��•� �1 + , 1 Co. e a D ® ♦�� �OcL) 8J p �Nr*'Co 99 LtoK \ / • / CO . y YIT. 7TII(tT ' - W I• ,o M n OZ 107 09 JOaC. .I•K. W + 0 • too b 11, .44c cy -ek 'aac. tta ~� IIO iA -le pw II[V.W /Y/!AVIS I /I/ jf II a,a rf eap 7—♦ ' _ / �T ILI �a 1,NL•.,) �I 17Y11�r► L Il[ I r . ? M I LW aG ' WU 1.. _ 535 L �9 299 aft in >� 1R 1M! ..i TOWN OF BARNSTABLE �FTNE Tp OFFICE OF e ^ i BARNSTAIME, o BOARD OF HEALTH y NAB& pj °p 039• 0� 367 MAIN STREET HYANNIS,MASS.02601 ja 1uai y LJ, 4uu 1 Ron Cadillac P. O. Box 258 West Yarmouth, MA 02673 RE: 67 Glen Road, Hyannisport Dear Mr. Cadillac: You are granted.multiple variances, on behalf of your clients Mary and Ken Rzasa, to replace the onsite sewage disposal system at 67 Glen Road, Hyannisport, Massachusetts. The following variances are granted: 310 CMR 15.211 (1): To install a leaching facility only six (6) feet away from the property.line, in lieu of the ten (10) feet minimum ` setback required. l 310 CMR 15.211 (1): To install a leaching facility only 8.8 feet away from a concrete slab foundation, in.lieu of the ten (10) feet minimum setback required. 310 CMR 15.255 (5): To remove only 2 1/2 feet of impervious soils rather than 5 feet minimum required. 310 CMR 15.240 (9): To provide only 8 inches of cover over the top of the leaching facility in lieu of the 14 inch minimum of soil cover required. The variances are granted with the following conditions: (1) No more than three (3) bedrooms total are authorized in the dwelling... Dens, study rooms, finished attics, sleeping lofts, and similar types of q; rooms with isolation or privacy are considered "bedrooms" according to the Massachusetts Department of Environmental Protection. Rzasa i (2) The applicant shall record a properly worded deed restriction at the Registry of Deeds, limiting the dwelling to three (3) bedrooms maximum. . (3) The septic system shall be installed in strict accordance with the revised plans dated December 29, 2000. (4) The designing registered sanitarium snaii supervise the construction of the septic system and shall certify in writing to the Board that the system was installed in substantial conformance with the revised plans dated December 29, 2000. (5). The existing cesspools shall be pumped and filled with clean sand, or removed. These variances are granted because the proposed replacement system meets the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sincerely yours, Susan G. R k, R.S. Chairman a` Board of Health Town of Barnstable SGR/bcs . Rzasa O Z Z WAL W V N W N � 0 O Q � W � O N N C N ..Z I Z O Z a W W O cc IL W W ci r Q t 9 W (� 4A �. ►� O• � Z a — - 1 �l _ r 8 $10.00 No........3 .._.' :3 Fi s............._............_ THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH . Town Barnstable ...........................................OF.......................................................................................... Appliration for Biip.as al Workii C ontitrur#ion amit Application is hereby made for a Permit to Construct ( ) or Repair (X ) an Individual Sewage Disposal System at: 1 67 Glen Rd. Hyannisport Ma 02647 ................_.. _..............---........_.......-•----.........._.................... •-•----••--••-•....................._.....-----j-•••-�-�-7•----..........-•-••-•--•--•------•------•-• , Leon Shrank Location-Address 321 North Ave.East ISa'Z2o• 111 Cranford N.J. ......-•...................•-•-••-••---.......---.....-•----------------......_..--•---••-••-•. -•----....---•.............-•-•...----•---•••-•-•--•.....•--•••--•.........._..............-...--- W A & B Cesspool 216YVice 128 Bishop's terrac&dity&nnis, Ma 02601 Installer Address d Type.of Building Size Lot............................Sq. feet U DwellingX—No, of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons........2 ..... Showers ( ) — Cafeteria ( ) dOther fixtures ..---------•-•--•-•-----•-----------------------------•--------•-•----------•--•----------------------•-------•-•---------------------........._••••-- W Design Flow............................................gallons per person per day. Total daily flow............................................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 leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date........................................ a Test Pit No. 1.................minutes per inch Depth of Test Pit.................... Depth to ground water.......----............. Gz, Test Pit No. 2................minutes per inch Depth of Test Pit-:--................ Depth to ground water.....---...........----. a ---------------------------------------•----------------------------............--------------.............-----•-----•-----------............------.....•... Description of Soil Sand ......... ------------------- V ---------------- W ------------ -- ----•- x Install three �3)__ `lowdiffusors anc�......... U Nature of Repairs or Alt rations—Answer when applicable............................................................................................... replace line from house -----------------------------------------------------•-------------•-------------•...............-•--------....------------------------------------------------------...---------------............••-• 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 Complianc issued by the board ealth. 4/19/83 Sig ___.-.--- ... ............. ...° --- .......................... Application Approved By......................................................................... 4/19/ te Date Application Disapproved for the following reasons:.............................................................................................................. ....••-•••-••-------•----.....-••---•--•-••-------•-----•-••••---•••••-••--••.......--••---•-••--•-•....----•--•-•---. --------•---------•---•-•••---------•--------•-•-•-•--•-•----------------------- Date PermitNo......83 ----------------------------•-------•--•--- Issued....................................................... Date 8 No.......83*13 G.... Fs$...�10.00........ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Tom............. oF,,....Barnstable_........................ { ApplirFa#ion for Uispas al Works Tonstrnrtiun "rrmit ty .t4A Application is hereby made for a Permit to Construct ( ) or Repair (x ) an Individual Sewage Disposal System at: 67 Glen Rd. Hyannisport Ma 02647 ..... ..... ...... --............... .....----•-.........•---•---•------•-----.......-------•-----•--•------------------............... Location-Address o t No. Leon Shrank 321 North Ave.East- u�te 111 Cranford N.J. ......................_.......................................................................... ••--••.......----------••----..................---•-----------........---........---•--------..... W A & B Cesspool service 128 Bishop's terracedeyannis, Ma 02601 Installer Address d Type of Building Size Lot....... ..................Sq. feet U DwellirigX—No. of Bedrooms....2.....................................Expansion Attic ( ) Garbage Grinder ( ) '04 4 Other—T e of Building No. of persons........2................. Showers — Cafeteria a' Other fixtures -------------------------------- W Design Flow............................................gallons per person per day. Total daily flow............................................. gallons. WSeptic Tank—Liquid'ca.pacity.........__.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 leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) aPercolation Test Results Performed by.......................................................................... Date........................................ Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... G4 Test Pit No. 2................minutes per inch,-.Depth of Test Pit.................... Depth to ground water........................ (li ---•---------------------------------=------------•---...-•---------.............................................................'.......................... 0 Description of Soil---Sand............................................•------••----------...------------------------------...-----------------------------------------•------------. x W U Nature of Repairs or Alterations—Answer when applicable..Install thzee �3.. Flowdiffusors and replace line from house ----------------------------•-------------------------------------------•--... -------..............------------------------------------•----------------------------------------------- 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-ham issued the board -health. Sig / --=-�-...-------- ...------------ ----------- /14�83 ApplicationApproved By.................................................................................................. ......4/.19�0. .............. n Date Application Disapproved for the following reasons:........................................................................................... ................... T ..............-------•---------------•--------------------....------------------...•••••----------........---------------------------------------------------------------------------------------....... 4 " Date 41 — 'Permit No......................................................... Issued_......1...$3----------•------------------...... f Date THE,COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Town Barnstable ..........................................OF..................................................................................... T T T 0rrtif irab of Tomph anrr T ylk Y Ges p of I el�v3 ce nth Zi-Individual op�s erra e yaMnis astx b cj ( ) or Repaired (X ) ' by..................•---------•---------•--•--•-----......------------...........--•-----------------•--------------•--•---------------------------..................---------------------...........- 67 Glen Rd. Hyannisport, Ma 02647 Installer has been installed in accordance with the provisions"bf f as described in the application for Disposal Works Construction Permit No.P.=........�;./.............. da- 4A9/.-$3_.....__._............_...._... THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM W9 LL FUNCTION SATISFACTORY. ` �\ ` DATE...................•--$3.....---*.3.4.._............................ Inspector--••--..'..-�'}------•------- ............. ........... ...--•...... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF-, HEi LTH Town - Barnstable :Z.3L ........................ F 83 ....<.................................. �.. 10.00 NO......................... FEE........................ F" � t: soouttl orki 'uung#raion "permit A & B Cesspool Service Permissionis hereby granted.....------.i.....-----d------------••-- ....------------------•----------....-----.._.-..------------•--.......•----------------------------- to Con6jucl8n . %766 sp�Of T' '�Z ewage -D..isposal System atNo.------•--------•................•--------...---------..........................-•-•--------....------------------------------------..._....-------------------------------`---..........---•-- "'f Street 8 _ 4 as shown on,theapplication for Disposal Works`Construction Permit No...3_...,.�{ D d. �19�83 ..................................... /I-��'!�� ................................. DATE............ ---- ........................................... i;/////Board of Health FORM 1255 A. M.*SIILKIN• INC.. BOSTON ' r.• w ■■■■■■■■■■ MOM■■■■■■ ■■ d ■ ■ . ■■■■■■■■■■■■ ■■■ �' ■■■■ ■■ ■ ■ ■! b ■ _ M■■■■■■■■■■■ ■■■ ■®■■ M■ ■■ ■■ ■ ■ d ■■■■■■■■■ ■■ ■■■ MEMO No NiONE ■EOii■■ MOM mom No 0 M■EN�■■�■MM so NONE ■ ■ ■■■■■■■■■ No so ONO M ®®■OM®®®MEN EO■EEE■MO ■ O ■■EEEE■■O ■■MN MEN No ■ ■NNE■■ ■NN■EOMME NONE No i■ NEENEE■NEso ME ON ■■N ■■■■■■■■ ■■■■■■■ �eN■■■■■NNE 0 ME ME mom 0 mom so 0 mom ME ME so 00 MEN NENNE■NE■NNE MEMNEMNMMEE■MMEE MMMMMEMNo ON 0 EE so 0 No ME N■®EEENN■■M■ENMi■ ii■EEE■ ■EEE■■NEMEN E EE■■■E■EEMMEEEMiM■ EEiMM■ ■■■■NNE■ ■■NM■MEE■MMMMEE■MM No so NEE ■EEM■MOM■EEEEEME■E MENi■MMEi■ ■ ■ ■■■ ■■so mom ■■sE■■■■■■E■■■ME SEE■■■ s■■M MEM NE■■MEN■NEE E■ EM EE M ■ NEE■MEOEOOM EE■■■■■s■EE ®®EOEMEMO E■® EMS` MEE■ ■■i■ME■EEE ®®■®■M■EEiiM ENM OEMMME EEEE ill■0 OEM ■ o No No 0 MEN MEME No mom 0 � �■■■■■■NEE■■■■■■NEE■■■■■■■EEEE■■■ ■■EEE ' ■MEMO ENONE ■■■■■■■E■■■■■■■■MMEMEE ■O IEEE■ ■■MMNM■EiMEMiiMME■MME■E■■■MMEE■E■ ' ■■■■NEE ■■■■■■■■■NEE■E■M■■■■ENE■■■■MEO■M■ ■■■■■E■ SECTI�, /� /� JOB NO. BOO ON A�-A . Prop. grade=14.7 �ff��'�� RZASA.L`1'WG »� 2 Use 410 filter fabric over stone w ® Top stone=14.0Top C4 Knits 1. LOCUS NOT TO (V Pea stoney not needed Existing Grade S IS A.M. 267, 'IU7. SCALE " 2. ELEVATIONS SHOWN ARE ASSIGNED. ruro v�lte z DECK 3. LOCUS IS IN FLOOD ZONE B ON FIRM DATED J!tLY 2, 1992. 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED ,AT 1 4" PER FOOT. `UNLESS NOTED) 14.0 BENCH MARK-TOP NW CORNER / t Rd• - fM 12 0 CONC. SLAB= 12.9:3 ASSIGNED 5. MUNICIPAL WATR IS AVAILABLE. LOTS WITHIN 100' ARE ON TOWN WATER.00 2.5' Around & Under �" 6. COMPONENTS TO' BE AASHTO H-10, UNLESS NOTED. 7. INLET TEE TO PROJECT �" OUTLET TEE DOWN 14".a:i Removal T DOWN 1�,. , L` -- -- - WATER TEST D�-BOX FOR EQUAL FLOW �' Impervious Barrier 8. IF TWO OR MORE LINES, ` / D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. A ` 9. DEPTH OF COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. Required fill will BUILD UP COVERS TO WITHIN 1' OF GRADE. MORTAR CHIMNEYS IN PLACE, impact end of ONE !:OVER OF TANK TO BE WITHIN 6" OF GRADE. � Exist. Deck ��y 10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2'" MIN. 1/8 TO 1/2" PEA STONE ON TOP. �" ''�' noN MAP N/F` �y5� 11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE: SOIL LOG ARE FOUND, 11,98 +;:: :: :::': :.:.:: 12. FONTACT THE; BOARD OF HEALTH, OR,R.J. CADILLAC. ,APF�LEMAN ..:.. ,� ,� ., ^ �, 12.3 :..... GA AN CVERDIG IS CALLED FOR BELOW FILL MATERIAL FOR � AROUND UNDER LEACHING TEST HOLE 1 IS TO BE CLEAN GRANULAR SAND MEETING SPECIFICATIONS OF 310 C 5 INSPECTION/PERC SCHEDULE S B RgGf :: 13. PUMP AND FILL ANY EXISTING CESSPOfOLS. REMOVE ANY CLOGGED SOIL, BLOCK, AND 'STONE IN BOARD OF HEALTH REQUIRES Qc ��\325��� \\ LEACH AREA, AND DISPOSE OF AS DIRECTED BY HEALTH AGENT. DEPTH (inches) ELEV.(feet) R,.l. CADILLAC, TO INSPECT; V �' F` 14. ALL ; ONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS; 0 12.9 1. AFTER SOILS REMOVED �Q 11i,9(i � x 12,3 ��` 7,�4� , � �iE- ' TEST HOLE DATE: August 24, 2000 AND PRIOR TO PLACING a °� + �� 6 N A BENCH MARK---TOP WOOD SXAIGE PERFiJRMED BY; Ron Cadillac, Soil Evaluator Fill CLEAN SAND--PERC COARSE 13.7 SET FLUSH= 13.85 ASSIGNED 13.06t WITNESSED BY: Donna Miaran��i, RS " :,.SAND �� �,� 6 (STaME IS 2Y- 1/2" taFF GAtAGE CpRN.) PERC RATE: <2'/in.(assurrled in coarse sand) 60 ri 12.5 .7 x 13.7 F/S-1/4 . StO1L SURVE Y(1'993): Corner coarse sand Ot payer 2. FINAL INSPECTION PRIOR ,�� B 11.E 1 GEOLOGIC MA.P(1986): Barnstable plain deposits bands of peat TO BACKFILL. /� `` ,� x 13,8 and other` un- / 12 5 y3 ..... � C 11.11 suitable material �- - > x 14 N/F ;- Invert 10.66 / •: pipe 11.86 0 ,/ 1;2,5 ` `:: :k MELLEN rsee Gass Baffle Invert 13,63 5 CULTEC C-4 UNITI()B --r 2.5y � s. 12 44�k �a �' �" � '•v;/Y. " Prr�pose pr4Vlde $" Crt7ViBr Crrledturrl C arse , k ::' I x '.41 �.� in. min. Cover detail 14.0-T�:p C4 unit sand w/water x 11.66 11 / W / 1 13(l ? i (MAKE Top Stone use TH 2' for ��'/ A , 3,3 �` ,�. (�, I Invert 10.91 FACTOR wafer elevation I w Sr '�►; " 1500 Gal. P /� �/ c cr. N ✓ ` Proposed WATER PROOF 0.1 C✓ 1:3,3 y Sanit�ryS q/� tw 11 2,(i / 'p I I Bottom + .41 Tee U ' < q�,q x 11,,48 x 1' 3 ce ::.2 / tz4cr: i I Proposed Invert 13.80 13.3 L3,f3 „ vert 1._.3 Tea' HOLE .� E3-14 Stone �c r corn act Pro o ed I J I Bottom p O S. rTt ., 1<3,3 13 t' IMPERVIOUS ( , �.- 4 , p� : IPrI hgle5. El. 8.0= observed water (inches) V.(feet) tL J x 3 DEEP IMPERVIOJ a 15 3 11 0 i h.�s ELE LOT 13,2 r 4 C-10 � I I f -21 0 1 .4 r 12•�8 e BARRIER---12s� L.F. OF ^` in swam 'on 12 15: 0!� X 1L40 11,71 1.2.1 �� ,q`hr 40 MIL AFCO VINYL Day after heavy rain t5„ Fill W FLASHING, OR EQUAL. 9 b 5o S. F. �, DESIGN DATA " A sand 'learp 3.2 3, TOP FLASHING=TOP __ 26 L.2�j / 2 x 1e'_. N STONE=14.0, GRADE OBSERVED WATER-6.7 H layer 1O 5 8 ABOVE BARRIER-14.5 BEDROOMS: 3 Y yr / e'l'9e of~� >: t o 12.79 x 13.3 NO ,S40PES_STEEPER LEACH ARE _�5" 8.13 _ uQ,,p 4.97• THAN 3:1 OUTSIDE GARBAGE GRINDER: No I otirrl y •sand i ">enf 94 40 v THE BARRIER. GRADE REQUIRED CAPACITY: 330 GPD USE 5 CULTEC C, 4 UNITS WITH TH 1 ABOVE LEACH=14.7 SEPTIC TANK: 5, t`; 3 OF STONE ON THE SIDES AND 1 1�OO AL. C layer 2.5y 6/6 11,72 12- 3 123 12 43 ,d` BOTTOM LEACHING AREA; 420 Sir 4N THE ENDS, FOR A 42 course sand 1 13,0 (42' X 10')] BY '1 Q' BY 4" DEEP LEACH AREA. �¢9 x 13 4 'SIDE LEACHING AREA: 34.3 SF 2.5' REMOVAL " observed water 00 N F [2(1Ci+ 42 ) X 0.33 DEEP)) � 80 ... � T 6.7 2.`, 5 $. 3.) x 14,c TAYLOR DE`,SIGN CAPAO,TY: 33ti CPU D{3 2.5 ALL AROUND REMOVAL c, DOWN 55"f TO COARSE SAND. �� 4.1 MAXIMUMEEASIE3LE C�IIP�LlA, N,CE P'I�OVA�:S. SEC) �: �, � [(�420 .F + 34,3 SF) X .74 GPD/'SF� � 112" �-- ,E I�. 1:-4 i0 x 13.4 PUMP CHAMBER STORAGE CAPACITY: 330 GAL.. `I. VARY LEACH AREA TO PROPERTY LINE BY 4' (6' PROVIDED,). 13.40 DOSES PER DAY: > 4 PUQYAN;Y CALCULATIONS 15QOt GAL H-'1 VARY LEACH TO SLAB BY 1.2 ($0 PROVIDED). WEIGHT OF EMPTY SEPTIC TANK AND Si" OF COVER PROPOSED LEACH IS 15' OFF OF CRAWL `I PACE, But YAt�CY.CALCULAT NS--P MP C`,H6Mf R TANK= 5.74 TONI (PER SHOREY) X 13.37 �' �� '` 9" MOVER=35' X 5.67' X 10.5' X 0.055 TON/CU. FT. 310 CMR 15.211 {1;. ALARM PUMP NOTES WEIGHT OF EMPTY CHAMBER AND 12" OF COVER 9" COVER=2.45 TON 2. VARY 2 1/2' OF REMOVAL (2 1/2' PROVIDED). 310 CMR 1$.25r$ (5). CHAMBER= 4,12 TON (PER SHOREY) TOTAL- 5.74 TON + 2.45 TON �= 8.19 TON VARY COVER OVER LEACHING TO BE 8" TOTAL:. '310CMR 15.240 13.19. ALARM TO BE WIRED BY ELECTRICIAN ON 12" COVER- V X 4.83' X 8.5 x 0.0$5 TON/CU. FT, WEIGHT OF WATER--HIGH GROUNDWATER DOWN SEPARATE CIRCUIT FROM PUMP. �713.4 12" CCIVER--2.25 TON 10.2 -6.41 X 5.67' X 10.5' X 0.0312 TON CV. FT. 2. ELECTRICAL WORK TO BE 4NSI�ECTEO BY (� } j WRING INSPECTOR. TOTAL- 4.12 TON + 2.25 TON - 6.37 'TON WEIGHT WATER'= 7,04 TWIN :S. ALARM TO BE LOCATED IN HOUSE. WEIGHT OF WATER--•HIGH GROUNDWATER DOWN TANK AND 9" COVER ARE HEAVIER BY 1.1 TON. H-1C} 11QU (,AL. PUMP CHAMBER 4. PUMP TO BE CAPABLE OF PASSING (10.2 •�6,1} X 4.83' X 8,5' X 0.0312 TONjCI . FT, 1-1/4" SOLIDS AND INSTALLED IN STRICT WEIGHT WATER= 5.25 TON MAKE FACTORY WATER PROOF;DRILL 3/$" WEEP/VENT HOLE CONFORMANCE WITH MANUFAC:TVRER'S TANK AND 12" COVER ARE HEAVIER BY 1.1 TON.SPEOIFtCATIONS• I 5. USE MEYER M1W54, 1/2 Hi' PUMP, OR C�0 TE PLAN 2' L%O EQUIVALENT. Invert 10,6A ALARM 32" CHECK VALVE FAR Invert ON 28" THIS PLAN IS A VALID COPY ONLY IF IT BEARS OFF - 24"[ AN ORIGINAL RED STAMP AND SIGNATURE. E`` ETH A. & MAR M . RZASA Bottom 6,10 6" STONE. LINDER LEGEHQ OF MgSS � UFMASSq LOT 13, 67 GLEN ROAD, W. HYANNISPORT, MA qC C RONA D R 714 I TE13T HOLE LOCATION, NUMBER 1�5 y� SEP TEM E 26, 2000 SCALE: 1 �'=20f o JAM, �.o / J i'> �' -W WATER LINE MARKINGS AD! GAS LINE MARKINGS (IF SHOWN) � r `: ` a � �0 3 � �Q A-- E OVERHEAD ELECTRIC WIRES (IF SHOWN) a1ST0L tq ��Ss\°a� 9.5 x 8.7 EXISTING tie PROPOSED ELEVATIONS ('X' MARKS POINT) SgNITAR\N' �a SUR\40 RONAI,LD J. CADILLAC, PL. , IDS - -� EXISTING CONTOUR � Z�, PROPE S�IONAL. LAND SURVEYOR & REGISTERED SANITARIAN �....8= PROPOSED CONTOUR P.O. BOX 25$ UTILITY POLE (IF 'SHOWN) --= x --'- FENCE (IF SHOWN, NOT ALL SHOWN) WEST YARIMOUTH, MA 02673 TREE (IF SHOWN, NOT ALL SHOWN) REV. 12/29/001--LEACHING, RESERVE, PERC. HEALTH AGENT APPROVAL DATE �'S08) 775-9700 � REV. 10j05/00--A19LITTIN!G HOU$E ADDED �C�2000 BY R.J. CADILLAC PAGE 1 OF .. 1 _ 8�0 » B . SECTION A"""A Prop. grade=14.1 � I• RZASA.JOB NO. 8 q q '1 r- w 1 1 Required fill will � NOT TOc.I U; irrlpoct end of Existing Grad.. 1. LOCUS IS A.M. 267, 107, i DECK ( Exist. Deck 2. ELEVATIONS MOWN ARE ASSIGNED. (,ra SCALE lle . LOCUS IS IN FLOOD ZONE B ON FIRM DATED JULY 2, 1992. Beoch 0- - - 14.,0 BENCH MARK--TOP NW CORNER 4. ALL PIPES TO BE 4" '-SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED) Rc_ mith c;t to -- -- - CONC. SLAB= 12.93 ASSIGNED 5. MUNICIPAL. WATER IS AVAILABLE. LOTS "THIN 100' ARE ON TOWN WATER. S__ __ 12 D 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED 0- ._. 5' Around & Under Removal f ro 7. INLET TEE TO PROJECT DOWN 13" OUTLET TEE DOWN 14". �-- .- ,-- - - -� - --- -� -- -- NOTE LOCATION OF FENCE--RECOMMEND YOU HAVE US - ° Impervious Barrier 8. IF TWO OR MORE LINES, WATER TEST D�-BOX FOR (EQUAL FLOW ', o p- STAKE LOT LINE AND PUT FENCE BACK 1' INSIDE THE PROPERTY LINE. 9. D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. DEPTH OF COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. BUILD LIP COVERS 'TO WITHIN 1' OF GRADE. MORTAR CHIMNEYS IN PLACE. ONE COVER OF TANK TO BE WITHIN 6" OF GRADE. Lt3�ATl�'30�0 �IIIAP \� 10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2" MIN. 1/8 'TO 1/ " PEA STONE ON Tl?P. 11,98 N/I' � 11. 1F UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE F NO, 11.69 APPLI��I.AN � CONTACT THE BOARD OF HEALTH, OR R.J, CADILLAC.�_Z. : 12. IF AN OVERDID IS CALLED FOR BELOW, FILL. MATERIAL FOR 5' AROI! D AND UNDER LIEA►:HIN �S"1)" H 1 :. 12,3 :.... G'�RAC TO BE CLEAN GRANULAR SAND MEETING SPEC FICATIONS OF 31 rCMR 1:5.255(3). IS 13. PUMP AND FILL ANY EXISTING CESSPO! NY CLOGG D SOIL, BLOCK, AND STON IN LEACH AREA, AND DISPOSE OF G ItRECTED BY HE H AGENT DEPTH (inches) ELEV.(feet) 14. ALL CONSTRUCTION TO MEET TLE 5 AND LOCAL RE tLATION ;s 12.9 11,90. h x 12,3 1 �G¢ �. p� TEST HOLE DATE: At gust 2 , 2CI00 PERFORMED BY: R n Cadillac, Snit Evaluator Fin 0 0' 4 A r' BENCH MARK--TO' WOOD STAKE as °`• �• �`' ✓ x 13,7 SET FLUSH= 13.85 ASSIGNED 13.0:6t WITNESSED BY: onno Mi-orandi, RS " 3, 6�J PERC RATE: 2' in. oSsumd in coarse :tend} 2,6 7 x 13,7 (STAKE IS 22"-8 1f2" OAF GARY►GE CORN.) TOP F NO. t ! ( ' 12,.E Ci SOIL SURVEY( 993p. arver coarse send C1 layer "`^'• x GEOLOGIC M (198b) Barnstable plain deposit, bondother ofpeat 133 Invert B 1'1.6'1 A- �.... Invert C 111Pf 1C,5 �„ suitable b ma C► x x 4 NY F Exist. pike Invert 1s?.G6 1 5 �, ; MELLEN , 11,8€� :•�,,, 'fH '�``'��,,, Use Gas Baffle Inver 'i.1J4 `� CONTACTOR 140 S 108" � 3,9 x 12,4 ba �; �,,. �• �•�. .�.q 8" cover C2 layer 2.�y 6/8 12 �k Q t `�^ Proposed re medium coarse LET 0 C S=1/4 resin. cover See detail 13.4 sands w/ x 11,65 water I MAKE TOP PEA STONE use TW 2 for /q "� 3 3 :` FACTOR S='1/8"/ft ruin. :'' :' No Barrier her., Invert 10.91 water elevation ,.. �� o' 1500 Gt�l I `-" 1i' Ala 13 I Proposed WATER PROOF - -- -- 156" -0.1 "o� 6,> ous Sanitary x 11,48 2.0 x 1 iY1 S O F RS Bottom 6.49 Tee I 3 31 F`: Proposed HOLE 2 ,d 2, ' ` /O x 13 8 I I�pa red in '13.21 Invert 13,00 12 5 TEST H x 13.3 Storle or ;w��mp�ac:t Proposed i 4.O ea°ttarr� 113 1 13.5 I � Proposed r*1 r+� , 15 ^B--1'4 I , ,I 1 " 1 2' DEPTH (inches) ELEV.(feet} 11,6 Ca 12,98 13.2 3 DEEP IMPERVIOUS r 4' -1 ' 3 1 [1 1 1 -- I El. 8.5 n 13.4 BARRIER--120 L.F.. OF rD 1.l3 of o 3.5 ad'u fitment 4M Fill x 11,40 12,1 h 40 MIL AFCO VINYL M y " 1171 x h' ,'� ! is provided, using Mash23 15 a, FLASHING, OR ECG IAL. DESIGN �� �" Zone: B/C boundary Aug. OO A I ye� 14 arr3/2 x �3,.2, TOP FLASHING-TOP 1,20 7 \ r x 12, 4 � '3' N� PEASTONE=13.4, GRADE OBSERVED WATER-6.7 16" ABOVE BARRIER-13.9 BEDROOMS: 3 B layer 10yr 5/8 laamy sand ke �\ $ . ORES STEEPER LE/4{�'kI AREA 8.$ o 7 rn 12.79 x 13,3 N SL 55" 64' 49X' THAN .3,1 OUTSIDE GARBAGE GRINDER.-, Na / 1/ "►ear 94 �¢? 7H 1 THE BARRIER. GRADE REQUIRED CAPACITY: 330 GPD USE 5 CONTACTOR 100'S WITH 1� / ABOVE LEACH=14.1 SEPTIC. TAW: 1500 GAL. 3 1/2' OF 'STONE ON THE 'SKIES �`t` 1, ,9 / C layer 2•5;,y 6/8 1 . ,3 AND 4 STONE ON THE ENDS FOR A 11,'12 lt'_43 � BOTTOM LEACHING AREA: 41.5 SF „ y " coarse sand 1�D,� 13.0 � [(41,5' X 10')) 41 --6 X 10 X 8 DEEP LEACH AREA. 12.20 q'Atlf 98 x 1.3 4 SIDE LEACHING AREA: 5,1.5 SF 5� REMOVALx 12,11 �y 00 N/ / (2(10'+ 41,,!V X +0.5' DEEP)) so" - observed water 6.7 12.55 • 4 3.0 x 14,2 TAYLOR DESIGN CAPACITY: 345 GPD DO 5` ALL AROUND REMOVAL DOWN 55"t TO COARSE SAND. [(41;~i SF + 5�1,.`.i SF) X .74 GPD/SF] 112" 4.1 X 12.4.0 x 13.4 PUMP CHAMBER STORAGE CAPACITY: 330 GAL. 13,40 DOSES PER DAY: > 4 BUOYANCY �CALC-LILATIONS 1500 GAL, H-10 1. VARY LEACH AREA TO PROPERTY LANE BY 4' (6' PROVIDED). � ' � 13 66 VARY LEACH TO SLAB BY 1.2 (8.8 PROVIDED). WEIGHT OF EMPTY SEPTIC TANK AND I" OF COVER PROPOSED LEACH IS 1`'�' OFF OF CRAWL SPACE, BUOYANCY 1CALCIJ4AT10b15-PUMP CHA_MDER TANK= 5.74 TON (PER SHOREY) 310 CMR 15,211 (1). � - � � � x 3,37 Agri �f�U-ItA;P NOTES WEIGHT OF CHAMBER AND 12" OF COVER 9' COWER=2.4ra TON r �, - r'E' TON/CU. fi T. L AL 9 COVER=.75 X 5.57 X 10.,.E X 0.0 2. VARY SEPARATION T� HIGH GROUNDWATER BY 1 4 PROVIDED). t.,HAMBER 4,1.2 TON PER SHJREY} TOTAL-• ,a. � r 310 CMR 15.212. 13,19. ALARM TO fBE WIRED BY ELECTRICIAN ON ( 74 TON + 2.4,.. TON = 8.19 TON SEPARATE CIRCUIT FROM PUMP. 12" 'COVER= 1' X 4.83' X 8.5' X 0.055 TON/CU. FT, WEIGHT '1F WATER---HIGH GROOI NDWATER DOWN 3. NO RESERVE AREA COULD BE P A V 'D. 310 CMR `t5.24,9. 13'4 2. ELECTRICAL WORK TO BE INSPECTED BY 12" COVER=2.25 TON (10.2 -5.41) X 5.67' X 10.5' X 0.0312 TON/CU. FT. 4.. VARY COVER OVER LEACHING TO BE " TOTAL. 310CMR 1 .240 TOTAL- 4.12 TON + 2.25 TON = 6.37 TON WEIGHT WATER= 7,04 TON WIRING INSPECTOR.3. ALARM `TO BE LOCATED IN HOUSE. WEIGHT 'OF WATER---HIr,:H GROONDWATER DOWN TANK AND 9" COVER ARE HEAVIER BY 1.1 TON. H-- Q 100 ' GAL, MP CHA,MBE 4. PUMP TO BE ]CAPABLE OF PASSING �10,2 -$.1) X 4,83' X 8.5' X 10..0312 TON/CU. FT. 1-1/4" -SOLIDS yAND INSTALLED IN STRICT WEIGHT WATER 5.25 TON MAKE FAI' OR'Y WA ER PR OFDRILL `/ WEEP/VENT HOL CONFORMANCE WITH MANUFACTURER'S TANK AND 12" COVER ARE HEAVIER BY 1.1 TON. SPEt91FICATIONS.5. SITE PLAN `- 1„►r�e USE MEYER MW�, 1,/2 HP POMP, OR2 EQUIVALENT. Inv rt 1G. AL RM 3 ,R 6HE+CK V E O 28" THIS PLAN IS A VALID COPY ONLY IF IT BEARS FOR 0 F 24" AN ORIGINAL RED STAMP ANC SIGNATURE. N A. MAR` ASA Bottom 6,10 1 STO UNDER HOFMgssq�y �SHOFMg81? LOT 1 , 67 GLEN ROACH, W. HYANNISPORT, MA TH 1 TEST HOLE LOCATION, NUMBER S° ONALD G`Pc� Fir° RONALD yG� E�-r ��� p 2000 SCALE.- � CoJAME , o MES20 W'--'-- WATER LINE MARKINGS aI CAD11 I " C_ IL _G'^-" GAS LINE MARKINGS (IF SHOWN) E- OVERHEAD ELECTRIC WIRES (IF SHOWN) gNITAR x 9.5 x 8.7 EXISTING & PROPOSED ELEVATIONS ( X MARKS POINT) SURVE RONALD J. CADILLAC, PLS RS EXI"STING CONTOUR i PROPOSED CONTOUR d 1�Jac PROFESSIONAL LAN[ SURVEYOR & REGISTERED SANITARIAN P.O. gOX5 UTILITY POLE (IF SHOWN) WEST YARI�C�JTH, AAA Q�fi73 ---- x --- FENCE (IF SHOWN, NOT ALL SHOWN) � TREE, (IF 'SHOWN, NOT ALL SHOWN) HEALTH AGENT APPROVAL DATE 508) 775--97QIQ REV. 1O/5/0^---ABUTTING HOUSE ADDED ems'' �OQ BY R,J. CADILLACt� PAGE 1 �..� F 1