HomeMy WebLinkAbout0609 IYANNOUGH ROAD/RTE 28 - Health 609 f**N"ffftff RD. ,HYANNIS
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.1 TOWN OF BARNSTABLE
LOCATION 6009 _veto �JOUG-4 eD. SEWAGE# ;zp20 -;64 12-
VILLAGE �I JA1441 S ASSESSOR'S MAP&PARCEL 311 d -]
INSTALLER'S NAME&PHONE NO. eOEG e' - B. QLAL I L5�$ )J]7-8877
SEPTIC TANK CAPACITY 1500 qGj
LEACHING FACILITY: (type)SD0!o.1. C H Air BQMsize)! x S•83
NO.OF BEDROOMS A `
OWNER :[9 QA j+l:M -r CKJ510 S . KOU N Arb 15
PERMIT DATE: 12 130 !Zo COMPLIANCE DATE' 1 t 3 1 Zi
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility I`to ® �2 Feet
Private Water Supply Well and Leaching Facility(If any wells exist on l
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
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FURNISHED BY �O6�ZT 0 e- (2o.
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LOCATION )`'"/)-V EWAGE PERMIT NO.
VI fl, AGS
INSTALLER'S: NAME Its ADDRESS
7- C,
BUILDER OR OWNER
DATE PE.It III IT ISSUED _
DATE C0MIPLIANCE ISSUED
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LOCATION SEWAGE PERIAIT NO.
l4 w A Nt-1 r S 5 i A 4Z WoTi: L
VILL GE
Ni4NA)I S
INSTALLER'S NAME i ADDRESS
t c
SOME
8 U I L D It OR OWNER
w.ua .�Ty+-rz �jG rr/
DA T E PER MIT ISSUED � �
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DA;TE COMPLIANCE ISSUED
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Town of Barnstable
Regulatory Services
t Richard V. Scali, Interim Director
= aUMSTnei.e.
MASS• Public Health Division
Thomas McKean, Director
200 Main Street,Hyannis,MA 02601 `
Office: 508-862-4644 `Fax: 508-790-6304
.Installer& Designer Certification Form 4
Date: 1-12-21 Sewage Permit# 7,020 At2-Assessor's Map\Parcel 311/07
G Ens t.neett�Designer: 1 �} S vac, Installer: Robert B. Our Co.,Inc. (RBO)
Address: 28Sy Croe&erry lltk�wa y Address: 363 Whites Path , __
E a5 4 WA d t 53 8 South Yannouth, MA'
On 1 1 RBO was issued a permit to install A,
(date) (installer)
septic stem at_609 Iyanough Road hasrd on a d.sign drawn by
p y _ }
(address)
dated 12-17-20
(designer)
1
X 1 certify that the septic system referenced above was installed substantially according.
to the design, which may include minor approved changes such as lateral relocation, of
the distribution box and/or septic tank. Strip out (if required) was inspected and the
soils were found satisfactory. i
I certify that the septic system referenced above was installed with major changes (i.e.
greater than 10' lateral relocation of the SAS or any vertical relocation of any component
of the septic system)but in accordance with State & Local Regulations. Plan revision or
certified as-built by designer to follow. Strip out(if required) was inspected and the soils
were found satisfactory. `
1:certify that the system referenced above was.constructed i iance with the terms
of the I\A approval letters (if applicable) Ptij;;; .
Or 4
CHURCHILL JR N ;
(Installer's nature) CML
.41
F
(D ner'<s Signature (Affix De i p Here)
PL- SE RETURN TO ARNSTABLE PUBLIC HEALTH D ..,: SION. CERTIFICATE
OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-
BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.
THANK YOU.
Q:\Septic\Designer Certification'Form Rev 8-14-13.doc
No. ( ' Fee
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
Application for IDisposal ,*pstrm Construction Permit
Application for a Permit to Construct( ) Repair Upgrade( ) Abandon( ) omplete System ❑Individual Components
Location Address or Lot No. &&q ZYAN W Rj> Owner's Name,Address and Tel No.
HY.4AINf�c C���ZtG�-C �4Mi� c!Ffr�?cssOCuvq�AAtS
Assessor's Map/Parcel 60
Installer's Name,Address,and Tel.No. S'og—LL47-1-98 77 Designer's Name,Address,and Tel.No.S®'s-,X7 3_0 S-n
P-000 r- 13 ckva do SC_ (510-Z.__ qJe;tW1a) :rA1X_
36 S r C)FbI
Type of Building:
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building 66 Aa tta tFIZO(dam No.of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow(min.required) ® gpd Design flow provided ;ZX5,S gpd
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank IC0015Qd C(Soo Type of S.A.S. :2)
Description of Soil M-6y 1 L) l��a,d1J�c D_ -70-k P` �eff.ZF Ae_x�
Nature of Repairs or Alterations(Answer when applicable)
v n G ca�- 14nio �tea_C cam 5"zzs `4u e
Date last inspected:
Agreement:
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certificate of
Compliance has been issued by this Boar,KKL'L
SignedDate
Application Approved by Date ). 3-A, Q
Application Disapproved by Date
for the following reasons
Permit No. a.y u//) Date Issued
No. f q... a Fee
—T✓
' C Entered in computer:THE COMMONWEALTH ORMASSACHUSETTS P Yes
PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS
01ppliration for MTsposal 6pstem Construction Permit
Application for a Permit to Construct( ) Repair'(;�4_Upgrade( ) Abandon( ) ❑Cplete System ❑Individual Components
Location Address or Lot No. (ppg rYi4N&t%A%$4 QP `Owner's Name,Address and Tel No.
Assessor's Map/Parcel Ws�dJN('s oP.G�>o3iM,n4� i_srd . KovNAPt�
Installer's Name,Address,and Tel.No. 50�•(V47-1-rS:&7'' Designer's Name,Address,and Tel.No.SrO%•aZ 3 0
Aoft
Type of Buildings
Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( )
Other Type of Building da pt0A G No.of Persons Showers( ) Cafeteria( ) t
Other Fixtures
Design Flow(min.required) �+Q® gpd Design flow provided ;�, 5.5 gpd
Plan Date ;�.�-t'T- >.4D;X A Number of sheets Revision Date
Title 60F =VA AJA/QC J(-='k A04co
Size of Septic Tank lc.�o/�c�to ('!Soo CAJ Type of S.A.S. �,� cc �
Description of Soil M,F-DtL;Xt f � �r �n(. �f r ,J>4.ow
r
it
- Nature of Repairs or Alterations(Answer when applicable) 27iJS- hk,LA Af f,..),e j 14';Xo j0e_)01Senn
45 (3q,Ge day/ 14- An 46;) h. lrn r of STD '<c 7 I&G•
Date•last inspected: P
Agreement:
The undersigned agrees to ensure the construction and maintenance of the.afore`descrilied on-site sewage disposal system in
accordance with the provisions of Title 5 of the Environmental Code and noYto place the system in operation until a Certificate of
Compliance has been-issued byahis Board of Healthi
Signed AVLALi Date D�„` "�O 10
Application Approved by t� C
// r f Date
- r
Application Disapproved by, _ Date '
for the following reasons
Permit No. a o 2 d / Date Issued t 2.
THE COMMONWEALTWOF MASSACHUSETTS
BARNSTABLE,MASSACHUSETTS
Certifirate of Compliance
THIS IS TO CERTIFY,that the On-site
Sewage Disposal system Constructed( ) Repaired(�4). Upgraded( )
Abandoned( )by Dy:X2-r . (? (..J UD— (I
at 609 -r y 0f_ AD HV has'been constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. a 2d k-fi)dated ) f r j?b?r✓
Installer RU)M_ A- OVIL do Designer' T4,
#bedrooms q-- Approved design flow Q gpd
The issuance of this/.permit shall not be construed as a guarantee that the system will function as de is gne/d.
Date j ''� V '? / Inspector -'' ,/ ,�
.----.---------------- -------r---------------------- '---------------------------' -------'- - - --=- ----------
t.}
` No. d -- { Fee `d y
THE COMMONWEALTH OF MASSACHUSETTS
r
PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS
't �1 Ur i Misposal *pstem Construrtion j3ermit
ermission is hereby granted to Construct( ) Repair( ) Upgrade( ) Abandon( )
System,locatedat 1,65? MY AO" 1^VOWN 4a;
and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with
Title 5 and the following local provisions or special conditions.
Provided:Construction in be completed within three years of the date of this permit.. ;f
Date 1 3 Approved by
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS THE BUSINESS
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, 1st FL., 367 Main Street,
Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law.
Fill in please: Date: — —/
'M K?`iAr APPLICANT'S NAME:
raV
r YOUR HOME ADDRESS: ST C�o�53(�
5C,S- �9U - BLS O S?' �3-7- 37 3
r
BUSINESS TELEPHONE # HOME TELELPHONE #:
NAME OF CORPORATION: FID # -2
NAME OF NEW BUSINESS, Etj�loY'1 s,_-, -5 (.l1,9a TYPE-OF-BUSINESS`t Xv&k e/*Z
IS THIS A HOME OCCUPATION? `YES NO
ADDRESS OF BUSINESS__foO� C�hDl,�G1 fI'>i'115 /�ao��0/ MAP/PARCEL NUMBER ) I- Wq (Assessing)
When starting a new business there are several things you must do to be in compliance with the rules and regulations of the Town of
Barnstable. This form is 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 town.
1. BUILDING COMMISSIONER'S OFFICE
This individual has been informed of any permit requirements that pertain to this type of business.
Authorized Signature**
COMMENTS:
2. BOARD OF HEALTH MUST COMPLY WITH ALL
This individual has been informed of the permit requirements that pertain to this type of business.' HAZARDOUS MATERIALS REGULATIONS
L - hdr✓1V1
Authorized Signature**
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY) -
This individual has been informed of the licensing requirements that pertain to this type of business.
f:a
Authorized Signature**
COMMENTS:
k— .
i
�
TOWN OF BARNSTABLE Date:o�/ 1Jl
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: �f?,L�/(���A4
BUSINESS LOCATION: 102 / S INVENTORY
MAILING ADDRESS: /5 (CJ/ TOTAL AMOUNT:
TELEPHONE NUMBER: 9C>— 1,5
CONTACT PERSON: �I�I• m -e !JS
EMERGENCY CONTACT TELEPAONE NUMBER: c:0ff-20'7—3 719 MSDS ON SITE?
TYPE OF BUSINESS: W
INFORMATION/RECOMMENDATIONS: odd- f M Q /S Fire District:
m n2 T � Ul1%� �i m s
a In af- his
o 00
Waste Transportation: �/�- Last shipment of hazardous waste:
Name of Hauler: Destination:
Waste Product: Licensed? Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use,
storage and disposal of 111 gallons or more a month requires a license from the Public Health Division.
LIST OF TOXIC AND HAZARDOUS MATERIALS
The board of health and the Public Health Division have determined that the following products exhibit toxic or
hazardous characteristics and must be registered regardless of volume.
Observed / Maximum Observed / Maximum
Antifreeze (for gasoline or coolant systems) Miscellaneous Corrosive
❑ NEW ❑ USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils Pesticides
❑ NEW ❑ USED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel,Aviation gas
Photochemicals (Fixers)
Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED
Miscellaneous petroleum products: grease,
Photochemicals (Developer)
lubricants, gear oil ❑ NEW ❑ USED
Degreasers for engines and metal Printing ink
Degreasers for driveways &garages Wood preservatives (creosote)
Caulk/Grout Swimming pool chlorine
Battery acid (electrolyte)/Batteries Lye or caustic soda
Rustproofers Miscellaneous Combustible
Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt& roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
Lacquer thinners (including carbon tetrachloride)
❑ NEW ❑ USED Any other products with "poison" labels
(including chloroform, formaldehyde,
Paint&varnish removers, deglossers hydrochloric acid, other acids)
Miscellaneous. Flammables Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous (please list):
Metal polishes
Laundry soil &stain removers
(including bleach)
Spot removers&cleaning fluids
(dry cleaners)
s' Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Applican Ili Staffs Initials
008/20/2008 13:15 FAX Z 001
* UM Facsimile
Date: 8/20/08 Page 1 of: 1
To; 1� (� ►-C_ S�•�{z{, l From: Amanda Bayne
Firm: `� � ,� �5, J 1 C2yS cc:
Facsimile:
Subject: 609 Route 132, Hyannis MA 02601
Message: Do you have any environmental or response records for the above referenced location including spill
Response or environmental concerns?
Thank you
�• 9 3�
S S c_ J 9
zoo, ��
URS Corporation CONFIDENTIALITY NOTICE
Foster Plaza 4 The information in this facsimile transmission is intended solely for
501 Holiday Drive, Suite 300 the stated recipient of this transmission.If you have received this fax
Pittsburgh, PA 15220 in error, please notify the sender immediately by telephone.If you
Tel: 412.503.4700 are not the intended recipient,please be advised that dissemination,
Fax: 412.503.4701 distribution,or copying of the information contained in this fax is
strictly prohibited.
www.urscorp.com ,
YOU WISH TO OPEN A BUSINESS? f� 'ZIdO
For Your Information: Business certificates (cost$30 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.) Business Certificates are available at the Town Clerk's Office, 1 FL., 367
Main Street, Hyannis, MA 02601 [Town Hall) _.
DATE:
=, ®RN? Fill in please:
APPLICANT'S YOUR NAME: ` : CC�a.
BUSINESS YOUR HOME ADDRESS:
.. TELEPHONE # Ho me Telephone Number` '�
NAME OF NEW BUSINESS 7--')L yC���k Y\-)QKL,`Q2 TYPE OF BUSINESS.
IS THIS A HOME OCCUPATION? YES NO �
9 Q� \ (?1 S . 0� 1
ADDRESS OF BUSINESS MAP/PARCEL NUMBER, ��
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 COM NER'S OFFICE .
This individual ha n-infor d f ny permit requirements that pertain to this type of business.
Authorized QW1atur
COMMENTS:
2. BOARD OF HEALTH
This individual has bb n informed o the permit requirements that pertain to this type of business.
Authorized Signature** (J b
COMMENTS:_JdW L14 C!{M �®Qf1r1,.�. �t S .l/ &izk &Z2zUje--06
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed of the licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
Dater Z/Iq 120('U
TOWN OF BARNSTABLE
TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM
NAME OF BUSINESS: f D �enjc,IS � C .
BUSINESS LOCATION: D q ��cMD���, , /1U� OZ601 INVENTORY
MAILING ADDRESS: unuS Sf- SG�� W��/� UZ�G3 TOTAL AMOUNT:
TELEPHONE NUMBER:
CONTACT PERSON: finir-c'-0
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS: � � ggnjl"JS
INFORMATION / RECOMMENDATIONS: Fire District:
Waste Transportation: Last shipment of hazardous waste:
Name of Hauler: Destination:
Waste Product: Licensed? Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous material use,
storage and disposal of 111 gallons or more a month requires a license from the Public Health Division.
LIST OF TOXIC AND HAZARDOUS MATERIALS
The Board of Health and the Public Health Division have determined that the following products exhibit toxic or
hazardous characteristics and must be registered regardless of volume.
Observed / Maximum Observed / Maximum
2 &,;I Antifreeze(for gasoline or coolant systems) Miscellaneous Corrosive
❑ NEW ❑ USED Cesspool cleaners
�g I Automatic transmission fluid Disinfectants
Engine and radiator flushes Road salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
(� Motor Oils Pesticides
❑ NEW ❑ USED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel,Aviation gas Photochemicals (Fixers)
Diesel Fuel, kerosene, #2 heating oil ❑ NEW ❑ USED
Miscellaneous petroleum products: grease, Photochemicals (Developer)
lubricants, gear oil ❑ NEW ❑ USED
Degreasers for engines and metal Printing ink
Degreasers for driveways &garages Wood preservatives (creosote)
Caulk/Grout Swimming pool chlorine
Battery acid (electrolyte)/Batteries Lye or caustic soda
Rustproofers Miscellaneous Combustible
Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt&roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
Lacquer thinners (including carbon tetrachloride)
❑ NEW ❑ USED Any other products with "poison" labels
(including chloroform, formaldehyde,
Paint&varnish removers, deglossers hydrochloric acid, other acids)
Miscellaneous. Flammables Other products not listed which you feel
Floor&furniture strippers may be toxic or hazardous (please list):
Metal polishes
Laundry soil &stain removers
(including bleach)
Spot removers &cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT I CANARY COPY-BUSINESS Applicant's Signature Staffs Initials
YOU W ]SH TO OPEN A BUSINESS?
For Your hfDnn ation: Business certficates (cost$4 0 .00 fDr4 years). A business certificate ONLY REGBTERS YOUR NAM E iz town (ahhh you
mustdobyM G_L.-hdoesnotgie you perm issbntDoperate) 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 Fl., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required by law.
DATE: 12 I _ Fein please:
r APPLEANTS YOURNAME/S: eW
d BUSINESS YOUR HOM EADDRESS:
`?
TELEPHONE # H om e Telephone N um ber 15
NAM E OF CORPORATDN
NAM E O F N EW B U S N ES S- (sz t--C<_r an� - � -- - -� - - ----TY P E O F B U S N ES S._V:Z -----------------------
N THIS A HOM E OCCUPATDN? _ __ YES NO. _ OZGdi
ADDRESS OF BUSINESS cnllpUCh not �M� MAP/PARCEL NUM BER,3 1 1 . -f 00 (p.ssessiZg)
W hen starting a new business there are sejeralthhgs you m ustdo in ordertD be h corn plane w 1h the rules and reguhthns ofthe Town of
Barnstable. Thi;fDi n h intended tD assi tyou h obtaining the inform atDn you m ayneed. You M UST GO TO 2 00 M an St.- (coiner.ofYarmouth
Rd.& M asi Street) to make sure you have the appmprate permits and licenses required to legally operate yourbusiaess n tha town.
1 . BUILDING COMM ESDNER'S OFFDE
Ths indirdualhas been iifDrm ed ofanyperm krequkem ents thatpertasi tD tics type ofbushess.
Authored S#nat ne*
COM M EDTTS :
2 . BOARD OF HEALTH
This iidirdualhas be rm of the perm hi�equaem ents thatpertain tD thi;type ofbusiness. MUS I 0
L. iry(y1 RAZARDOUS Mr,
Authorind Smature** MUST,V;OM PLY WITH M
COM M EN TS : Fir'IZAR000S MATERIALS R€( ULATIo ee'
.3 . CONSUM ER AFFAIRS LrENSNG AUTHORHY)
Th-b indiiEuah-as been infbi n ed of the licensing requ±em ents thatpertah trD_thi3 qpe ofbushess.
~ Authorized Signature*
COM M EN TS
Y
TOWN OF BARNSTABLE Date: 7/2(�lO y
TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY
NAME OF BUSINESS: e k
BUSINESS LOCATION: INVENTORY
MAILING ADDRESS: �{ TOTAL AMOUNT:
TELEPHONE NUMBER: ��8 �0o�9--�
CONTACT PERSON: , a� �, 'D PAt a-t-Px,&,
EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE?
TYPE OF BUSINESS: N
INFORMATION/RECOMMENDATIONS: s Fire District:
Waste Transportation: nJ Last shipment of hazardous.waste:
Name of Hauler: Destination:
Waste Product: Licensed? Yes No
NOTE: Under the provisions of Ch. 111, Section 31, of the General Laws of MA, hazardous materials use,
storage and disposal of 111 gallons or more a month requires a license from the Public Health Division.
LIST OF TOXIC AND HAZARDOUS MATERIALS
The Board of Health and the Public Health Division have determined that the following products exhibit toxic
or hazardous characteristics and must be registered regardless of volume.
Observed/Maximum Observed/Maximum
Antifreeze (for gasoline or coolant systems) _ Misc. Corrosive
NEW USED Cesspool cleaners
Automatic transmission fluid Disinfectants
Engine and radiator flushes Road Salts (Halite)
Hydraulic fluid (including brake fluid) Refrigerants
Motor Oils Pesticides
NEW USED (insecticides, herbicides, rodenticides)
Gasoline, Jet fuel, Aviation gas Photochemicals (Fixers)
Diesel Fuel, kerosene, #2 heating oil NEW USED
Misc. petroleum products: grease, Photochemicals (Developer)
lubricants, gear oil NEW USED
Degreasers for engines and metal Printing ink
Degreasers for driveways & garages Wood preservatives (creosote)
Caulk/Grout Swimming pool chlorine
Battery acid (electrolyte)/Batteries Lye or caustic soda
Rustproofers Misc. Combustible
Car wash detergents Leather dyes
Car waxes and polishes Fertilizers
Asphalt & roofing tar PCB's
Paints, varnishes, stains, dyes Other chlorinated hydrocarbons,
Lacquer thinners (inc. carbon tetrachloride)
NEW USED Any other products with "poison" labels
Paint &varnish removers, deglossers (including chloroform, formaldehyde,
Misc. Flammables hydrochloric acid, other acids)
Floor &furniture strippers Other products not listed which you feel
Metal polishes may be toxic or hazardous (please list):
Laundry soil & stain removers
(including bleach)
Spot removers &cleaning fluids
(dry cleaners)
Other cleaning solvents
Bug and tar removers
Windshield wash
WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS
TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair
satisfactory
BOARD OF HEALTH 2.Printers3.Auto Body Shops
O unsatisfactory- 4.Manufacturers
COMPANY l,� "��— (see"Orders") 5.Retail Stores
6.Fuel Suppliers
ADDRESS `�' l3� *0--o k r) Class: c� 7.Miscellaneous
QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors)
MAJOR MATERIALS Case lots
Drums,
Above Tanks Underground Tanks
IN OUT IN OUT IN OUT #&gallons Age Test
Fuels:
Gasoline Jet Fuel(A)
Diesel, Kerosene, #2 (B)
Heavy Oils:
waste motor oil (C)
5Ld l �S �C
new motor oil(C)
transmission/hydraulic
Synthetic Organics:
degreasers
Miscellaneous: I-may D�
964b;
:fit ",
DISPOSAL'RECLAMATION REMARKS: 11-
1. Sanitary Sewage 2.Water Supply CASr_
Town Sewer Public TG
O On-site OPrivate
c(Qx sKe r a� /c Va
3. Indoor Floor Drains YES NO
O Holding tank:MDC ") �"-�"` ' {�3 "�,�'�
O Catch basin/Dry",well �j-&�� 0 Cvu. / Mira (VO-�—j
O On-site system a4,_ ;
4. Outdoor Surface drains:YES NO k ORDERS:
O Holding tank:MDC , 6A,-t,46V -,t/l j Af 0 J/ � rr
O Catch basin/Dry well � F
O On-site system
5.Waste Transporter
Name of Destination !d
1. YES INO
2.
Person(s) Interviewed Inspeoftor Date
Invoice
Robert B.Our Co.,Inc.
363 Whites Path Date:, Invoice#
South Yarmouth,MA 02664
508-477-8877 6/18/2020 4109
i
►
John Lallberte John@CapewideEnterprises.com
Commercial Sales N1ana x {
Bill To, cap ewl e
Kounadis Enterprises 1
609 Route 132 _ ---�--a.>� _ . . . , ._ . .•. _ E.N�:E R P-R.I S!E S
Hyannis,MA 02601
J.P.Macomber& Son Since 1928
A Robert B.Our Co.,Inc.Coitiputy"Built on Trust"
f` Office:508.477.9877
153 Commercial St. Cell:774.994.1736
Mashpee,MA 02649 Fax:508.477.4977
Job No. I Terms
Note:A finance charge of 1.5%will be added to the unpaid balance after
thirty(30)days(18%per annum) ! Due on receipt
j
Quantity Description Rate Amount
l �
1 Locate leaching system 385.00 385.00
Pull toilet and locate leaching pit 1
al Pit empty with no sign of failure
Thank you for your business! '
Total $385.00
Payments/Credits $a.00
Please make checks payable to the Robert B.Our Co.
Mail to 363 Whites Path,South Yarmouth,MA 02664 Balance Due $385.00
TOF= 49.8'± 24"MIN. ACCESS PROVIDE PRECAST H-20 CONCRETE FINISH GRADE OVER D-BOX= 48.1't
PROP. VENT WITH CHARCOAL FILTER TO ABOVE GRADE GENERAL NOTE S
(TYPICAL FOR 3) EXTENSION RISER WITH WATER TIGHT j FINISH GRADE OVER CHAMBERS= 47.7' - 48.2' _ 3/4"TO 1-1/2" DOUBLE WASHED
FINISHED GRADE F.G. OVER
(C� FOUNDATION = 48,4'f + CAST IRON FRAME&COVER TO F.G. H-20 RISER WITH WATERTIGHT SLOPE @ 2/o MIN. OVER SYSTEM j 1. UNLESS OTHERWISE NOTED, ALL SYSTEM COMPONENTS AND CONSTRUCTION
TANK EL.= 48.1 t 1 FRAME AND COVER TO GRADE H-20 CONC. RISER WITH WATEP,TIGHT STONE TO CROWN OF PIPE METHODS SHALL BE IN ACCORDANCE WITH TITLE 5 OF THE STATE ENVIRONMENTAL
CAST IRON FRAME AND COVER TO INSPECTION PORT WITH ACCESS 2"OF 1/8"TO 1/2"DOUBLE WASHED CODE AND ANY APPLICABLE LOCAL RULES.
9"MIN. 5" DIA. OUTLET(S) GRADE OVER ALL PIPED CHAMBERS BOX TO F.G. (SEE NOTE 21)
36"+AX STONE OR GEOTEXTILE FILTER FABRIC 1 2. ANY CHANGES TO THIS PLAN MUST BE APPROVED BY THE BOARD OF HEALTH AND THE
PROP. SCH. 40 - -- -- DESIGN ENGINEER.
PVC SEWER 4"SCHEDULE 40 PVC
4"SCH. 40 PVC TO 0.5'MAX. MIN SLOPE 1% 4.0'MAX. TOP OF SAS=44.20' 3. 4"SCHEDULE 40 PVC PIPE WITH WATER TIGHT JOINTS SHALL BE USED IN DISPOSAL
2��DROP MIN. �. �. DISTRIBUTION BOX 4" PVC TEE SEE NOTE 23 , SEE NOTE 23 i SYSTEM UNLESS OTHERWISE NOTED.
MIN.SLOPE 0 1% 6 3 3 DROP MAX. 3 9 43.20
3 9 !. ,
- -- - - - --- _ MIN.SLOPE 196 BREAKOUT EL= 43.70
4. TO PREVENT BREAKOUT, THE PROPOSED FINISHED GRADE SHALL NOT BE LESS THAN
L=5't ELEVATION=43.70' FOR A DISTANCE OF 15'AROUND THE PERIMETER OF THE SAS. UNLESS A
�- *47.5't 14" 14" 45.25' PROVIDE WATERTIGHT 40 MIL GEOMEMBRANE LINER IS PLACE AT LEAST FIVE FEET FROM S.A.S. AND THE TOP OF
_- 4" PVC IN FROM JOINTS (TYP.) o � THE LINER IS NOT LESS THAN THE BREAKOUT ELEVATION.
SEPTIC TANK O 4" PVC OUT TO 0 0 Q 0 0 0 0 12.(0'
D O O 0 0 5. SLOPE ALL SOLID PIPE AT 1.0% MINIMUM.
O LEACHING FACILITY oo 9 o
45.50' 48 12" oo = = = 6. THIS SYSTEM IS NOT DESIGNED FOR A GARBAGE DISPOSAL.
GAS BAFFLE GAS BAFFLE 43.60' MIN. 43.43' 2' o � o o0 7. LOCAL BOARD OF HEALTH AND DESIGN ENGINEER TO BE NOTIFIED PRIOR TO BACK
00 0o FILLING WHEN SYSTEM IS NEARLY COMPLETE AND READY FOR INSPECTION. SYSTEM IS
�_247TO FND 1000 GAL. 500 GAL. 6"CRUSHED STONE ° o o oo NOT TO BE BACK FILLED WITHOUT FIRST OBTAINING APPROVAL FROM BOARD OF HEALTH
(48 HRS DETENTION) (24 HRS DETENTION) OVER MECHANICALLY oo ° _ o AND DESIGN ENGINEER.
'CONTRACTOR TO VERIFY EXISTING COMPACTED BASE
s a Tn ti p 6"CRUSHED STONE 3 2.0' 8.5' (TYP) -I 2.(1' 2.0'
ELEVATION PRO« ,w ANY J�JOP.K �. OUTLET DISTRIBUTION BOX 4 83' 8• ELEVATIONS BASED ON APPROXIMATE M.S.L. DATUM. BENCHMARK ELEVATION OF 53.22'
NOTIFY ENGINEER IF DINY WO T OVER MECHANICALLY ESTABLISHED ON TOP OF HYDRANT BONNET BOLT AS SHOWN ON PLAN.
COMPACTED BASE TO BE INSTALLED ON A LEVEL STABLE 21.0' (NP.)
BASE. FIRST TWO FEET OF OUTLET , GROUND WATER ELEV.- < 35.70' 9. CONTRACTOR SHALL VERIFY ALL UTILITY LOCATIONS PRIOR TO CONSTRUCTION
PROPOSED 1000/500 GALLON TWO COMPARTMENT SEPTIC TANK (H-20) PIPES TO BE LAID LEVEL. 41 .2O 8.83' THROUGH DIG-SAFE AT LEAST 72 HOURS PRIOR TO COMMENCING WORK ON SITE AT
LENGTH 11'-0" WIDTH 6'-2" DEPTH 6'-011 1-888-DIG-SAFE AND ANY OTHER APPLICABLE AGENCIES. REPORT ANY DISCREPANCIES
(Dimensions per CROSS SECTION VIEW 2 - 50Q GALLON H-2O CHAIVI�itl-�5 5'MIN. lrt-IHIVI�Cr� i=1VL� V Itw� TO THE DESIGN ENGINEER.
AOL TEES SHALL BE DIRECTLY UNDER SEPTIC ,� PROF ACME/Shorey) _ (-. DTI , X DETAIL TYPICAL CHAMBER PROFILE �� , , „ ,� ,�,-, �- DETAILS10, ALL JOINTS WHERE PIPE ENTERS AND EXITS CONC. STRUCTURES SHALL BE MADE WATERTIGHT.
ITS RESPECTIVE ACCESS COVER NOT TO SCALE NOT TO SCALE NOT TO SCALE 11. NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH DEEDED OR ZONING
TEST PIT DATA APPROPRI ATE AUTHORITY.OWNERIAPPLICANT IS TO OBTAIN SUCH DETERMINATION
PERC NO. TPT-20-254
mw_tom. 12. ALL SEPTIC SYSTEM COMPONENTS SHALL WITHSTAND H-10 LOADING UNLESS LOCATED
SWING-TIES = INSPECTOR: Donald Desmarais(BOH) UNDER MORE THAN 3 FEET OF COVER OR LOCATED UNDER PAVEMENT, DRIVES, OR
EVALUATOR: Michael Pimentel, EIT, CSE " TRAVELED WAYS IN WHICH CASE THEY SHALL WITHSTAND H-20 LOADING.
DESCRIPTION HCA HC-2 -
C.S.E. APPROVAL DATE: Oct- 27, 1999 13. DOUBLE WASHED CRUSHED STONE SHALL BE FREE OF ALL DIRT, DUST AND FINES.
✓ - Q ` „ December 3, 2020 SEPTIC COVER IN (1) 30.6' 31.4' � ,...�...v.:•
DATE: 14. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL LOAM, SUBSOIL AND UNSUITABLE
SEPTIC COVER OUT(2) 37.9' 38.2' U.P. ;�6°' , �. TEST PIT#: 1 &2 MATERIAL IN AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF LEACHING FACILITY.
�. REPLACE ALL UNSUITABLE MATERIAL WITH CLEAN COARSE SAND FREE FROM CLAY,
CORNER OF STONE(3) 45.9 49.3' ,'50vz40.5 Benchmark ELEV TOP= 48.00' FINES OR OTHER UNSUITABLE MATERIAL IN ACCORDANCE WITH 310 CMR 15.255(3).
Hydrant Bonnets �, ELEV WATER= <36.00'
15. CONTRACTOR SHALL NOTIFY DESIGN ENGINEER OF ANY DISCREPANCIES FOUND IN
CORNER OF STONE(4) 51.9' 41.T Elevation =53.22' ZONE-_.
`� Approx. M.S.L. _ `i ! PERC RATE_ <2 min./inch SITE CONDITIONS FROM THOSE SHOWN PRIOR TO CONTINUATION OF WORK.
CORNER OF STONE (5) 59.7 50.5 0 ��
�y LOCUS " �~
16. PROPOSED PROJECT IS LOCATED WITHIN:
CORNER OF STONE(6) 53.7 56.9 51_v, _ \ ,qA' . DEPTH OF PERC= 72"-90"
'VV \ ASSESSOR'S MAP 311 LOT 7
4 ��\ �80•�i�Q� ': /�,, s TEXTURAL CLASS: 1 OWNER OF RECORD: GEORGE IBRAHIM&CHRISTOS G. KOUNADIS, TRUSTEES
A l�
ADDRESS: 60 MELLO DRIVE
1'Y,9�Q `/� 0" 48.00' TAUNTON, MA 02780
`lOti J • 5 FEMA FLOOD ZONE X
COMMUNITY PANEL# 25001CO566J
h� _ s► Y V r 17. DEED REFERENCE: BOOK 32832, PAGE 121
/ NIGHTINGALE _ W •�
1 Fill 18 PLAN REFERENCE: PLAN BOOK 216, PAGE 137-2
'LANE SIGN - �
l -BIT. PARKING LOT �� /"` ; 19. ALL DISTURBED AREAS SHALL BE RESTORED TO ORIGINAL CONDITION.
MAP 311 ' l �l� �� 20. PROPERTY LINE INFORMATION IS ONLY APPROXIMATE. THIS PLAN IS TO BE USED ONLY
LOT 4 #150I40/ , ,J 72" 42.00' FOR SEPTIC SYSTEM UPGRADE. JC ENGINEERING WILL NOT ASSUME ANY LIABILITY
FOR USES OF THIS PLAN OTHER THAN ITS INTENDED PURPOSE.
lu
AS �O0 50 21. A 4"PERFORATED SCH. t0 PVC PIPE SHALL BE PLACED IN A VERTICAL POSITION TO A
x�,
� �/ 49 � . i DEPTH OF THE BOTTOM OF THE SAS AND EXTEND TO WITHIN 3 OF FINISH GRADE. A
REMOVABLE THREADED CAP SHALL BE PLACED ON THE TOP TO ALLOW FOR INSPECTIONS.
--....J
N 2 `�' r�.' o` ! �. `_„ ,t __T--�.-- i �► _. _ Med. to Coarse Sand
C 22 OWNER/APPLICANT/CONTRACTOR SHALL BE RESPONSIBLE TO OBTAIN ANY AND ALL
EX INV.=47.�a:w �'\� ,� ,� ` l / 2.5Y 6/1 REQUIRED PERMITS AND APPROVALS FOR THIS PROJECT.
0 #609 `
�, + EXISTING
23. IN ACCORDANCE WITH 310 CMR 16.401 -16.405,THE FOLLOWING LOCAL UPGRADE
�- � � LOCUS PLAN
( EXISTING CESSPOOL TO BE PUMPED, ° BUILDING `/ -CBN APPROVALS ARE REQUESTED FROM 310 CMR 15.221(7):
RIM=48.03'
N FILLED w/ CLEAN SAND &ABANDONED-., / (661 S.F.) SCALE: 1"= 1000' (1.) A 0.5' WAIVER (3.0'-3.5') FOR THE MAXIMUM COVER OVER THE H-20 D-BOX.
m *, �;
a i + TOF-49.8'± GAS LINE(APPROX. LOCATION) 144" 36.00' (2.) A 1.0' WAIVER(3.0'-4.0-) FOR THE MAXIMUM COVER OVER THE H-20 SAS.
`�•�� ; No Mottling, Standing or Weeping Observed
yWATER LINE
PROPOSED 1,000/500 GAL. TWO /� ��vs 1J // (APPROX LOCATION) DESIGN DATA I ro I HI ) bti Ii H ! LE 317N
COMPARTMENT H-20 SEPTIC TANK s s �,� cq (.1
,/ TPT-20-254
O s QPERC NO. 50x0' EXISTING SPOT GRADE
yZ DESIGN FLOW: INSPECTOR: Donald Desmarais(BOH)
/ EVALUATOR: Michael Pimentel, EIT, CS
- 50 -- -- EXISTING CONTOUR
PROPOSED H-20 a __
DISTRIBUTION BOX- . / \ �, .�i s� EXISTING USE:
40�Q OFFICE BUILDING(i.e.661 s.f. of office space used for a used car dealership) C.S.E. APPROVAL DATE: Oct. 27, 1999 PROPOSED CONTOUR
` , ; Q DESIGN FLOW 75 GAUDAY per'1,000 s.f. of office area DATE: December 3, 2020 50 PROPOSED SPOT GRADE
-GRAVEL- , Fr f Q TOTAL DESIGN FLOW 50 GAUDAY(i.e. (661 sf/ 1,000)x 75) TEST PIT#: 3&4
O 4U TOTAL MIN. ALLOWABLE DESIGN FLOW 200 PER 310 CMR 15.203(3) GAS - EXISTING UNDERGROUND GAS
C^ ,4� �_- ELEV TOP= 47.70'
0
` U' o ELEV WATER= <35.70' ❑/H/W - EXISTING OVER-HEAD WIRES
PROPOSED 4"' SCH 40 PVC VENT PIPE: 0 / � � t � � SEPTIC TANK SIZING �
EXACT LOCATION PER OWNER - /' TP 1 �' QQ CS PERC PERC RATE_ ---- E/T/C EXISTING UNDERGROUND UTILITIES
T� USE PROPOSED 1000/500 GAL. 2-COMPARTMENT H-20 SEPTIC TANK
4ax0 ;� DEPTH OF PERC= W W -- EXISTING WATER LINE
PROPOSED TWO (2) 500 47x7 A \ COMPARTMENT 1:
GALLON H-20 LEACHING /' TP TP 4 ' CO j 2 DESIGN FLOW x 200%=200 x 2=400 GAUDAY MIN. REQUIRED TEXTURAL CLASS: I
( ) li TEST PIT LOCATION
CHAMBERS w STONE - + ,�W DESIGN CAPACITY = 1,000 GAUDAY(PROPOSED)
46x0 " '�tv r PROPOSED 1,000/500 GALLON
47x7 COMPARTMENT 2: C H-20 SEPTIC TANK
111 o _ 0" 47.70' TWO-COMPARTMENT
J s DESIGN FLOW x 100/o - 400 x 1 =400 GAUDAY (MIN. REQUIRED)
REMOVE ALL UNSUITABLE � �cc
MATERIAL DOWN TO"C"SOIL& LU PROPOSED INSPECTION PORT ' 10 DESIGN CAPACITY =500 GAUDAY (PROPOSED) PROPOSED 4"SOLID SCHEDULE 40 PVC PIPE
REPLACE w/CLEAN COARSE C�
SAND PER 310 CMR 255(3) Uj -GRAVEL-" . '� , W #609 - 13 PROPOSED H-20 DISTRIBUTION BOX
W J EXISTING
a / MAP 31 BUILDING INSTALL 2 - 500 GAL. H-20 CHAMBERS W/ STONE Fill �'
15 006t S.F. �+ DMH t661 S.F.) PROPOSED 500 GALLON H-20 LEACHING CHAMBER
/ RIM=47.61'
BC-11 TOF=49.$'t � ' SIDEWALL CAPACITY
_.r.
(LENGTH + WIDTH) (2 SIDES) (2' HIGH) (0.74 GPD/S.F.) - GAUDAY
DMH - RE
J -GRAVEL.- V. DATE BY APP'D. DESCRIPTION
(21.0'+8.83')(2) (2' ) (0.74 GPD/S.F.) = 88.3 GAUDAY
- _o
RIM=47.50' 72" 41.70' PROPOSED SEPTIC SYSTEM UPGRADE
Bc 2 BOTTOM CAPACITY
-CB o�' `�-a. (LENGTH x WIDTH) (0.74 GPD/S.F.) = GAUDAY
PREPARED FOR:
RIM=4� 38'
�g�s. '(' �`� A �� (21.0'x 8.83') (0.74 GPD/S.F.) = 137.2 GAUDAY ROBERT B. OUR CO., INC.
CB
J�
~` \ I � +/ RIM=47 44' (1
NOTES: MAP 311 U. - TOTALS: Med. to Coarse Sand
LOT 89 #3161 i- (2 TOTAL NUMBER OF CHAMBERS 2 _ C 2.5Y 6/1 LOCATED AT
1.) MAGNETIC MARKING TAPE SHALL BE PLACED ALONG THE TOP EDGE OF ,; fr�OS. TOTAL LEACHING AREA 304.7 _ SQ.FT. 609 IYANNOUGH ROAD
EACH SEPTIC SYSTEM COMPONENT. 3) TOTAL LEACHING CAPACITY 225.5 _ GAL./DAY HYANNIS, MA
�.
2.) CONTRACTOR SHALL VERIFY SOIL CONDITIONS IN THE LOCATION OF THE ^" (6 4)
PROPOSED LEACHING FACILITY TO ENSURE CONSISTENCY WITH TEST PIT = SCALE: 1 INCH = 20 FT. DATE: DECEMBER 17, 2020
DATA SHOWN ON THIS PLAN. REPORT TO ENGINEER AND LOCAL BOARD OF 26.4' 144 35.70
0 10 20 40 80 FEET
21 No Mottling, Standing or Weeping Observed ZN of
HEALTH IF SOILS ARE NOT CONSISTENT WITH TEST PIT DATA. 0'
5) JOHN L. PREPARED BY:
3.) PROPERTY IS LOCATED WITHIN THE GROUNDWATER PROTECTION RESERVED FOR BOARD OF HEALTH USE U CHUR`C�AIL JR. N JC ENGINEERING, INC.
OVERLAY DISTRICT AND A DEP APPROVED ZONE I1.
NO. 41807 2854 CRANBERRY HIGHWAY
4.) SWING TIES SHOWN ON THIS PLAN ARE PROVIDED ONLY AS A COURTESY EAST WAREHAM, MA 02538
SWING TIES PLAN
FOR THE INSTALLER. INSTALLER SHALL VERIFY SWING TIE MEASUREMENTS SITE PLAN � 508.273.0377
IN THE FIELD PRIOR TO INSTALLING THE SYSTEM. CONTRACTOR SHALL
NOTIFY ENGINEER IF MEASUREMENTS APPEAR TO BE INCORRECT. SCALE: 1"=20' SCALE.- 1"=20' Drawn By: MCP Designed By:MCP Checked By:JLC JOB No.4806-1