The URL can be used to link to this page

Home My WebLink About0035 IYANNOUGH ROAD/RTE 28 - Health 35 Iyannough Road/Routed Hvannis ` . A = 343 003 ` a 0 0 ° o 0 a ° , ° ° ° ° IJ n c 4 a f T R TRANSMITTAL BAXTER NYE ENGINEERING & SURVEYING Registered Professional Engineers and Land Surveyors /VI 78:North Street,3`d Floor,Hyannis,MA 02601 Tel:(508)771-7502 Fax:(508)771-7622 V Date: 12-9-08 TO: Mr.Thomas McKean,RS,CHO Total No.Pages: Director—Barnstable Health Division BN Job No.: 2007-071 200 Main St. ubject: d. Hyannis,MA 02601 — yannis-Guaranteed Fresh Produce Phone: cc: We are sending you ®Attached ❑Under Separate Cover ❑Via Fax(No. of pages including Transmittal Sheet) ❑First Class Mail/Registered#: ; ❑Overnight ❑Pick up E Hand Delivery The following documents: ❑Prints/Plans ❑ Specifications ❑Estimates/Proposal ❑ Change Order❑ Shop Drawings Reports/Calculations n Other DATE COPIES NO. PAGES DESCRIPTION 12/8/08 1 Cover Letter to Thomas McKean 1/4/08 1 Title 5 Report 11/26/01 1 Title 5 Report 8/22/08 1 1 Soil Suitability Form for Storm Water Management System 1 Copy of original septic s stem desie as provided by Board of Health These items are transmitted as checked below: ❑ For Your Use ❑As Requested ❑Returned For Corrections ® For Review And Comment ®For Approval ❑For Distribution Remarks: Please call with any questions or comments as necessary. Thank you. ra C Matthew W. Eddy, P.E. , c Managing Partner MWE/cad 0:\2007\2007-071\ADMIN\transmit\2007-071 T8 TM 12-9-08.doc r— Note: This transmittal contains privileged information.Please contact the sender immediately if this transmittal is illegible, incomplete or not intended for your use.Thank you. I:\document templates/transmittal template r BARTER NYE ENGINEERING & SURVEYING Registered Professional Engineers and Land Surveyors 78 North Street,3rd Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax: (508)771-7622 December 8,2008 Barnstable Board of Health c/o Mr.Thomas McKean,RS,CHO Director-Barnstable Health Division 200 Main Street, Hyannis,MA 02601 RE: Septic Inspection and Separation to Groundwater on Existing System 35 Iyannough Rd.,Hyannis—Guaranteed Fresh Produce Dear.Dr.Miller,Board Members,and Mr.McKean: Please accept this letter as follow up to our meeting on December 5`h with Mr.McKean and Junichi Sawayanagi,Board Member, at the Health Department office. We discussed the comments from the Health Dept.regarding the,- requirement of the existing septic system needing a four foot separation to high groundwater from the bottom of the SAS. Apparently the four foot separation concern arose from a passing Title 5 Inspection Report,dated January 4, 2008,performed by Green Seal Environmental,Inc., for the purposes of Real Estate Transfer of the subject site. Attorney Lawler has filed for a variance from this requirement which is the matter scheduled for the Board on December 9`s. We would like to offer the following points regarding this issue and we believe a variance may not be required. 1. The Jan. 2008 report indicates high groundwater(HGW)is determined by a redox feature located at 30 inches below the ground surface. The ground surface where the test pit was performed is approximately 14.88 feet which places the redox at elevation 12.38 according to the report..However,the redox is noted to occur within a medium to coarse sand layer. Additionally,the test pit only went to 36 inches deep and did not investigate the deeper soils. The report notes the bottom of the existing SAS at an elevation of 13.90 with which we concur. We believe the redox or graying observed in this report is not an indication of HGW but more likely a slowing of the water passing through the course sand by the properties of the underlying soils. As we have encountered this in the past in Barnstable,the Health Dept.has concurred that in these cases this does not indicate HGW. In our meeting with Mr. McKean,he seemed generally supportive of this conclusion as to the redox. We offer the additional information in support of this conclusion. 2. The Jan. 2008 report also notes a hand angered hole encountered groundwater at 7.5 feet below the surface. The report does not give an elevation of this auger but conservatively we estimate it at 16 feet based on the noted location. This would place groundwater at an approximate elevation of 8.5 feet. This provides a separation between the SAS bottom and groundwater of 5.4 feet. 3. Another passing Title 5 Inspection Report, dated November 26,2001, also notes a hand angered hole that did not encounter any groundwater to 8 feet(again,based on a conservative estimate of the auger hole at ground elevation of 16 feet,this would place no groundwater at 8 feet). This report places the SAS at 2.5 feet below the surface(in general agreement with the Jan 2008 report). This thereby provides a separation to GW of at least 5.5 feet. 4. We do agree,as the Jan. 2008 report notes, that the use of the"Frimpter"method(as noted in Cape Cod Commission Bulletin 92-001)is not appropriate(as noted by Frimpter)in this area due to the proximity of an expansive wetland system to the site. The wetland system, which is within less than 200 feet from the site, would be more indicative of providing a HGW elevation in the area. As a result of this inquiry, we surveyed the system on December 8`h to determine the elevation of any standing water. The system generally had no Land Surveys 9 Site Design • Subdivisions 9 Septic Design • Wetland Filings 9 Planning December 8,2008 Barnstable Board of Health Separation to Groundwater-35 Iyannough Rd.,Hyannis—Guaranteed Fresh Produce standing water at an elevation of 8.46. We further compared this to the Barnstable GIS basemap information - which notes this system having a downstream water elevation of 6.57. Using this wetland system to further the determination for HGW, this again puts the HGW elevation at approximately 8.5 feet. This would provide a separation of 5.4 feet. 5. We performed a groundwater elevation test to the rear of the building(upgradient for groundwater from the Inspection Report test pit locations)for stormwater management purposes on August 22,2008. This test resulted in a groundwater elevation of 9.67 in a medium to coarse sand layer with no signs of redox features. Using this upgradient GW elevation would still provide a separation from the bottom of the SAS of 4.23 feet. In conclusion,it seems apparent the redox elevation of 12.38,almost 4 feet above the nearby wetland system,is not indicative of HGW. Additionally,the proximity to the wetland minimizes the groundwater fluctuation above the wetland system elevation. The observed groundwater elevations would indicate HGW elevations. Therefore,using the most conservative information noted above,it appears there is at least a 4.23 foot separation between the bottom of the existing SAS and HGW. It should be noted the original design plans for this system on file with the Health Dept. show it designed with a 4 foot separation to groundwater. If the Health Dept.and Board feel a variance is still required,we would offer the economic and physical hardship of trying to raise the elevation of the existing septic system. It was originally constructed as a mounded system and is currently approximately 3 feet above the elevation of adjacent Rte.28. It should be further noted that the approved project,Guaranteed Fresh Produce(GFP),is providing a reduction in estimated septic flow over the prior existing use. It also has provided additional health benefits over the prior commercial use which stored significant quantities of pool chemicals on the site. GFP is a return to the original permitted use on this site as a produce retailer/wholesaler. Please contact me with any questions or comments you may have. Thank you for your time and consideration. Very truly yours, \,ZN OF Mq Baxter Nye Engineering&Surveying o� MATTHEW �G EDDY ``, I" CML N AMaew ddy,P. No.43183 ew Managing Partner D�Fo G/.STEVL Cc: Mr.David Lawler,Esq. �S`NAL ENG Mr.Adam Weiner,GFP I File a 0:\2007\2007-071\ADMIN\LETTERS\2007-071 Ll BOH septic-separation to gw.doc C"a - C) tom. r— Page 2 BARTER NYE ENGINEERING & SURVEYING 78 North Street,3rd Floor,Hyannis,MA 02601 Tel: (508)771-7502 Fax: (508)771-7622 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments w r` Subsurface Sewage Disposal System Form Inspection results must be submitted on this form or on the official Title 5 Inspection Form dated 611612000. Inspection forms may not be altered in any way. A. Certification Important: When filling out 1. Property Information: forms on the computer,use 35 lyannough Road, Hyannis only the tab key Property Address to move your Rafkin Realty Trust cursor-do not Owner's Name use the return key. 35 lyannough Road Owner's Address Hyannis MA 02601 City/Town State Zip Code Date of Inspection: December 29,2007 Date 2. Inspector: Terry F. Bauer, PG Name of Inspector Green Seal Environmental, Inc Company Name 28 Route 6A Company Address Sandwich MA 02563 Citylrown State Zip Code 508.888.6034 Telephone Number Certification Statement: 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 ❑ Need Lrtheraluuation the Local Approving Authority A. I- � January 4, 2008 Tn—spector—s-91ignature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system 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. Tremblay-35 lyannough Road,Hyannis.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 1 of 1 Commonwealth of Massachusetts r Title 5 Official Inspection Form Not for Voluntary Assessments r` Subsurface Sewage Disposal System Form A. Certification (cont.) 35 lyannough Road Property Address Hyannis MA 02601 Cityfrown State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ❑ 1 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: Tremblay-35 Iyannough Road,Hyannis.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 2 of 2 Commonwealth of Massachusetts Tale 5 Official Inspection Form Not for Voluntary Assessments ,r Subsurface Sewage Disposal System Form A. Certification (cons.) 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection B) System Conditionally Passes(cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ❑ distribution box is leveled or replaced ND Explain: ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: 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 16.303(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 Tremblay-35 lyannough Road,Hyannis.doc•1112004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 3 of 3 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form A. Certification (cont.) 351yannough Road Property Address Hyannis MA 02601 City/Town State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection C) Further Evaluation is Required by the Board of Health(cont.): 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. ❑ 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 and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Tremblay-35 lyannough Road,Hyannis.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 4 of 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form A. Certification (cont.) 351yannough Road Property Address Hyannis MA 02601 City/Town State ZipCode Rafkin Realty Trust December 29,2007 Owner's Name Date of Inspection 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 %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. ❑ ® 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this forma Yes No ❑ ❑ 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. Tremblay-35 lyannough Road,Hyannis.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 5 of 5 Commonwealth of Massachusetts _ r Title 5 Official Inspection Form Not for Voluntary Assessments w p Subsurface Sewage Disposal System Form A. Certification (cont.) 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection 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. Tremblay-351yannough Road,Hyannis.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 6 of 6 i Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form B. Checklist 35 lyannough Road Property Address - Hyannis MA 02601 City/Town State Zip Code Rafkin Realty Trust December 29,2007 Owners Name Date of Inspection 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(3)(b)j Tremblay-35 lyannough Road,Hyannis.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 7 of-7 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information 35 lyannough Road Property Address Hyannis MA 02601 City[Town State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of inspection Residential Flow Conditions: Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): Number of current residents: 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 Seasonaluse? ❑ Yes ❑ No Water meter readings, if available(last 2 years usage(gpd)): Sump pump? ❑ Yes ❑ No Last date of occupancy: Date Commercial/Industrial Flow Conditions: Type of Establishment: Retail/Warehouse Design flow(based on 310 CMR 15.203): 246 Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): ware feet 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: Unknown Last date of occupancy/use: Currently in use Date Other(describe): Tremblay-35 lyannough Road,Hyannis.doc-1112004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 8 of 8 iL Commonwealth of Massachusetts t Title 5 Official Inspection Form Not for Voluntary Assessments _ Subsurface Sewage Disposal System Form C. System Information (cont.) 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection General Information Pumping Records: Source of information: Bamstable Water Treatment Plant Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system(yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology.Attach a copy of the current operation and maintenance_contract(to be obtained from system owner) ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: System is 26 years old, installed in 1981 per Health Department records. Were sewage odors detected when arriving at the site? ❑ Yes ® No Tremblay-35 lyannough Road,Hyannis.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 9 of 9 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments ` Subsurface Sewage Disposal System Form C. System Information (cunt.) 35_1yannough Road Property Address Hyannis MA 02601 City/Town State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection Building Sewer(locate on site plan): Depth below grade: Unknown feet Material of construction: ®cast iron ❑40 PVC ❑other(explain): Distance from private water supply well or suction line: N/A feet Comments(on condition of joints,venting, evidence of leakage, etc.): Sewer is below building slab. As a result, no observations were able to be made. Septic Tank(locate on site plan): Depth below grade: 16 11 fe 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 ❑ Yes ❑ No certificate) Dimensions: 8'x5'x4.5' Sludge depth: 0.5 11 Distance from top of sludge to bottom of outlet tee or baffle 4' Scum thickness 0" Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A How were dimensions determined? Direct measurement Tremblay-351yannough Road,Hyannis.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 10 of 10 I� Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments �h Subsurface Sewage Disposal System Form C. System Information (cont.) 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage,etc.): No pumping recommended at this time, inlet and outlet tee's in good condition,tank not damaged, no leaks found, liquid level at outlet invert. Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑ polyethylene ❑other(explain): Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet tee or baffle N/A 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 ❑other(explain): Tremblay-35 lyannough Road,Hyannis.doc•11/2004 Title 5 Official Inspection Form;Subsurface Sewage Disposal System Page 11 of 11 Commonwealth of Massachusetts u Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form M C. System Information (cost.) 35 lyannough Road Property Address Hyannis MA 02601 Cityrrown T� State Zip Code Rafkin Realty Trust December 29,2007 Owner's Name Date of Inspection 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.): 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.): Box is level and distribution is equal. No evidence of solids carryover, no evidence of leakage Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Tremblay-35 lyannough Road,Hyannis.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 12 of 12 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Not for Voluntary Assessments Subsurface Sewage Disposal System Form M C. System Information (cont.) 35 lyannough Road Property Address Hyannis MA 02601 Cityrrown State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection 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: Type: ❑ leaching pits number: ❑ leaching chambers number. ® leaching galleries number. 6 ❑ 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.): No signs of hydraulic failure, ponding, etc. No lush vegetation. No signs of heavy bacterial growth on stone within SAS. Tremblay-35 lyannough Road,Nyannis.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 13 of 13 l Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments w Subsurface Sewage Disposal System Form C. System Information (cont.) 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection 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.): Tremblay-35 lyannough Road,Hyannis.doc•1112004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 14 of 14 V Commonwealth of Massachusetts N Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form i N C. System Information (cont.) 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. Tremblay-35 lyannough Road,Hyannis.doc-11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 15 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form M C. System Information (cont.) 35 lyannough Road Property Address Hyannis MA 02601 Cityrrown State Zip Code Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection Site Exam: Slope Surface water Check cellar Shallow wells Estimated depth to ground water: 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: See Below You must describe how you established the high ground water elevation: See attached narrative. Tremblay-35 lyannough Road,Hyannis.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 16 of 16 f Septic System Sketch I ann ou h Road y g .. :. ... . . . .:(Route 28) D Box Landscaped Area Soil Test Pit ► �_41 _ - -- Boring -. I _---• srs, �js, Handicap , ¢ SAS Covers Ramp ;� - 9.5 Entrance f i Wood= StaYrcase JSeptic Tan1c i I ¢ k i #35 OO I Y i - i Note: All septic system component covers are at the surface i �� 1• Location: 35 Iyannough Road Not To Scale Hyannis, Massachusetts Based on Visual Observations 08 `Date: December 29, 2007 L High Groundwater Narrative High groundwater was established using information from the USGS and an on-site investigation. A hand augered soil boring was excavated on-site adjacent to the SAS. Groundwater was encountered at a depth of 7.5' feet below the surface. The site is located in the area of USGS indicator well MIW-29 (Zone Q. The Town of Barnstable GIS Map for the site indicates that the elevation in the SAS area is approximately 16.4. The Cape Cod Commission website indicates that the latest water leavel measured in the indicator well in December 2007 to be 9.5 feet below the ground surface. The adjustment factor for Zone C is 5.1 feet upwards making the historic high elevation 2.7 feet below the ground surface, which is well above the SAS bottom and would flood the adjacent Route 28. To verify the historic groundwater elevation, a test pit was excavated approximately 25 feet from the SAS . Redoxymorphic features were identified by Gary James, PE, a certified MA Soil Evaluator, at an elevation of 2.5'below the surface. A subsequent level survey resulted in the top of redoxymorphic features to be at an elevation of 12.38 and the SAS bottom to be at an elevation of 13.90. Accordingly,the SAS bottom is 1.52 feet above high groundwater. I .C-\ Commonwealth of Massachusetts CityfTown of Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal MassDEP has provided this form for use by on-site professional and local Boards of Health,Other forms may be used,but the information must be substantially the same as provided here.Beforeusing this form,check with your local Board of Health to determine the form they use. A.Facility Info ation ate% Owner Name 6 va Street Add? # ' City Slate Zip Code B.Site Information 1. (Check one) ❑ New Construction ❑ Upgrade ❑ Repair 1,74 — 2. Published Soil Survey Available? Yes ❑ No If yes Year Pubgshed Publication Scale Soft Map unit Gid'•' ,(4.b"` _ _ 09:'0 0P Son Name Soil Limitations 3. Surflclal Geological Report Available?❑ Yes ❑ No If yes: Year Published Publication Scale Map Unit Geolo&Material Landforrn 4. Flood Rate Insurance Map �/ / Above the 500-year flood boundary? ❑ Yes LrT No Within the 100-year flood boundary? ❑ Yes 3 No Within the 500.year flood boundary? Yes ❑ No Within a vetocity zone? ❑ Yes 3 No 5. Wetland Area: National Wetland Inventory Map Map Unit Name Wetlands Conservancy Program Map Map Una Name t5forml t.doc-rev.111107 Form 1 t—S611 Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 i i I I SL\ Commonwealth of Massachusetts City/Town of Form 11 -Soil Suitability Assessment for On'-Site Sewage Disposal B.Site Information(continued) � + 6. Current Water Resource Conditions(USGS): M nf ear Range: ❑ Above Normal tvormai ❑ Below Normal 7. Other references reviewed: C. On-Site Review(minimum of two holes required at eve proposed primary and reserved disposal area) Dee Observation Hole Number: �A C7 qvo o P �DPate Time weather 1. Location jr 60q:A4v� fr /2c/ Ground Elevation at Surface f of Hale: / Location(identify on plan): Nl* 2. Land Use (y✓7rFi�?�'r w'� / O~3 (e.g.,vwodlaod,�grI itural field,vacant lot,etc.) Surface Stones Slope(%) vegetation /V// Landform Position on Landscape(attach sheet) 3. Distances from: Open Water Body feet Drainage Way feat Possible Wet Area feet Property Line feeS, Drinking Water Well feet Other feet 4. Parent Material: Unsuitable Materials Present: ❑ Yes ❑ No If Yes: ❑ Disturbed SON ❑ Fill Material ❑ impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock 5. Groundwater Observed: ❑ Yes ❑ No If yes: Depth weeping from Pit Depth Standing Water in Hole Estimated Depth to High Groundwater. inches elevation f t5form1l.doc-rev.10107 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 2 of 8 i t r S Commonwealth of Massachusetts Cityrrown of 3 p>-4 f� Form 11 -Soil Suitability.Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) Deep Observation Hole Number. -- itedoximorphic Features Coarse Fragments (mottles) Soil Texture %by Volume Sol] Soil oil Horizon oil Matrix;Color- Consistence Oticer Depth an.) Layer Molst(Munson) (USDA) Cobbles& Structure (Moist) Depth Color percent Gravel stones 2 Additional Notes: t5form1l.doc-rev.10/07 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal•Page 3 of 8 r <L' Commonwealth of Massachusetts Cityrfown of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F.Certification i certify that I am currently approved bythe Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct sbi evaluations and that the above analysis has been performed by mmonsistent with the required training,expertise and experiene described in 310 CMR 15.017. 1 further cerily that the results of my soil evaluation,as indicated in the attached Soil Evaluation Form, are accurate and in accordance with 310 CMR 15.100 through 15.107. { Si azure of oil Ev at �r Dam Typed or Printed Name of Bog EvaluQ&I License 0 Date of Soil Evaluator Fxam w� Name of Board of Health Witness Board of Health Note:In accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and to the designer and the property owner w8h Percolation Test Form 12. t5fono1l.doc•rev.10107 Form 11-Soil Suitability Assessment for on•Sita Sewage Disposal Page 7 of 8 1 r S\ Commonwealth of Massachusetts CitylTown of Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams Use this sheet for field diagrams: ol C� a t5 forms i.doc•rev,10107 dorm 11—Soil Suitability Assessment for On-Site Sewage Disposal •Pege 8 of 8 W PJ � . . �i COMMONWEALTH OF MMSACRUSETITS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS IftPARTmENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTIOINT FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CEiTCATION ]property Address: 35 IYANNOUGII RID HYANNIS,MA 02601 Owner's Name: ROBERT BUR } Owner's Address: 402 NORTH FALMOUTH HIGHWAY N.FALMOUTH MA.02556 Date of Inspection: 11/26/01 Name of Inspector:(please print) JOHN GRACI ECOVE� company Name: SEk TIC INSPECTIONS Mailing Address: P.O;BOX 2119 TEATICKET,MA.02536 FOR 0 6 x001 Telephone i�ittmbor:50"64-6513 FAX 508-504-'7270 T��v��pB� KEAI T MPT CERTMICATION STATEMENT I cent*that 1 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 GMR 15.000). The system: X Passes Conditionally Passes Needs Furth aluation by the Local Approving Authority Fails Inspector's Signature: Date: 11126101 The system inspector shall submit py of this'inspection report to the Approving Authority(Board of Health or DEP)within 30 days ofcompleflng this:inspecti n.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall'submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies out to the buyer,if applicable,and the approving authority. Notes and Comments THE SYSTEM PASSES TITLE V INSPECTION-RECOMNIID Pt,MPWO EVERY TWO YBATIS TO PROLONG THE SYST13M'S USESJLL LIFE. ***"This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspecdon does not address how the system will perform in the future under the same or different conditions of use. 6/t3'd .'62S"ON_.__�_.. Hi-lb3H -�O GdUGH 3-19diSHNUS Wd98:O T 8082'V 'Nuf . .Page 6 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 33 IYANNOUgj1 RD HYANNIS,MA 02604 Owner: ROBERT BURKE Date of Inspection: 11/201 1 W CONDITIONS RESIDENTIAL Number of bedrooms(design):0 Number of bedrooms(actual): n/a DESIGN flow based on 310 CMR 15.203(for example., 110 gpd x#of bedrooms):0 Number of current residents:n/a Does residence have a garbage grinder(yes or no):NO Is laundry on a separate sewage system(yes or no):NO [ryes separate inspection required] Laundry system inspected(yes or no):NO Seasonal use:(yes or no):NO Water meter readings,if available(last Z years usage(gpd)):n/a Sump pwnp(yes or no):NO Last date of occupancy:Ala COA9IAURCIALAMUSTRIAL Type of establishment:RETAILM'000 SQUARE FEE/9000 SQFEET VAREHOUSE Design flow(based on 310 CM .15.Z0�.):n/agpd Basis of design flow(seats/persons/sgfl,etc.):n/a Grease trap present(yes or no):NO ' . Industrial waste holding tank present�w or no):NO Non4anitary waste discharged to tli title 5 system{yes or no):NO Water meter readings,if available:n/a ' Last date of occupancy/use:n/a O'TMR(describe),n/a , GENERAL INFORMATION Pumping Records Source of information:n/a Was system pumped as part of the inspection(yes or no):NO if yes,volume pumped:n/agallons o How was quantity pumped determined?n/a Reason for pumping; n/a TYPE OF SYSTEM X Septic tank,distribution box,soil absorption system Single cesspool overflow cesspool _Privy _Shared system(yes or no)(if yes,attpch previous Inspection records,if any) innovative/Alternative technology,,attach a copy of the current operation and maintenance contract(to be obtained from ,a system owner) Ti&tact Attach a copy oi+�the 3EP Approval roval , Other(describe):n/a Approximate age of all Wmponeatse,date installed(if known)and source of information: AppRO tIMATELY 20 YEARS Were sewage odors detected when arriving at the site(yes or no):NO 6fS'd +62S'ON Hl-lU3H d0 adbOH 3-19UiSWNU9 WH90:ati 5002'# 'Ndr � s Page 7 of i'l OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART:C SYSTEM INFORMATION(continued) Property Address: 35 IYANNOUGH RD HYAN119%MA 02601 owner: ROBERT B11RKE Date of Inspeetion: 11/26/01 BUILDING SEWER(locate on site plan) Depth below grade:54" Materials of construction: cast iron 40 PVC Xother(explain):20 PVC Distance from private water supply wwell or suction line:n/a Comments(on condition of joints,venting,evidence of leakage,eto.): TOWN WATER SEPTIC TANK:X(locate on site plan) Depth below grade:48" Material of oonstruCtlan:XcancJrets_metal_fiberglass-polyethylene other(explain)n/a If tank is metal list age:n/a Is ege confirmed by a Certificate of Compliance(yes or no):NO(attach a copy of certificate) Dimensions:1000G L 81611 H 51711 W 4110110' Sludge depth:2" Distance from top of sludge to bottom of outlet tee or baffle:32" Scum thickness:0" Distance from top of scum to top of outlet tee or baffle:6" Distance from bottom of scum to bottom of outlet tee or baffle:n/a How were dimensions determined:MEASURED ;r Comments(on pumping recommendations,inlet and outlet tee or bafflo condition,structural integrity,liquid levels as relsed ^4, to outlet invert,evidence of leakage,etc.): THE SEPTIC TANK AND ALL COMPONENTS APPEAR To BE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. kE OMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEMS USEFUL LIFE GREASE TRAP:-41ocate on site plain, i Depth below grade:n/a Material of construction;,,concrete_metal fi rglass o]yethylene other(eajplaig}:nfa A11 l 4. Dimensions:n/a Scum thickness:n1a Distance from top of scum to top of outlet tee or baffle., n/a r Distance from bottom of scum to bottom of outlet tee or baffle:n/a Date of last pump*:n/a Comments(on pumping recommendations;inlet and outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.)°: g/a ,RCS 6/9"d cz�S'ON Hi-Id3H JO GdUGH 3-19UISNdUE WU90:OT 8002'b 'Ndt f OFFICIAL INSPECTION FORM--NOT FOR VOLUNTARY ASSESSMENTS ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 IYANNOUGH RD BYANNI%.MA 02601 Owner: ROBERT BURKE Date of Inspection: 11126/01 TIGHT or HOLDING TANK: (tank must be.pumped at time of inspection)(locate on site plan) Depth below grade:n/a NUterial of construction: concrete metal fiberflass_polyethylene other(explain): a/a Mlmensions: n/a Capacity:n/A gallons Design Flow:n/a gallons/day Alarm present(yes or no): NIA Alarm level:N/A Alarm in working order(yes or no):NO Date of last pumping: n/a .41 Comments(condition of alarm and float switches,etc.): n/a • 5 DISTRIBUTION DOX:S(if present must be opened)(locate on she plan) Depth of liquid level above outlet invert:LEVEL WITH BOTTOM OF PIPE Comments(note ifbox is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into or out of box,etc,): BOX IS STRUCTURALLY 5O$•TNI . PUMP CAMBER: (locate on site plan) { ' a Pumps in working order(yes or ao} NO' Alarms in working order(yes of oo):NO Comment(note condition of pump climber,condition of pumps and appurtenances,etc): a/$ '1 Syi. s { 6i2L'd EZS`0H Hi-ld3H 30 Q U09 3-19diSHNUE WdZ0:0 i 8002'b 'Nuf f . Pme9of11 4 OFFICIAL INSPECTION FORM NOT FOX VOLUNTARY ASSZSSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 I'YANNOUGH RD HYAN NIS,MA 02601 Owner: ROBERT BURKE Date of Inspection: 11126/01 SOIL A13SORPnON SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a Type n/a leaching pits, number: n/a FLOW DIFFUSERS leaching chambers,number: 0 n/a leaching galleries, number. n►a leaching trenches,number,length: n/a a/a Teaching fields,number: nia n/a overflow cesspool, number. n1a n/a innovativetaltemative system Type/name of technology: n/a Comments(Mote condition of soil,signs of hydraulic failure,level of pondinS damp soil,condition of vegetation,etc.): THE FLOW D)FFUSERS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.RECOA TD, NEW COVERS TO FLOW DIFFUSERS, SYSTEM SHOWS NO SIONS OF FAIURE-BOTTOM AT 21611 CESSPOOLS: (cesspool must be pumped as part of inspcetion)(locate On site plan) Number and configuration:n/a Depth top of liquid to inlet invert:n/a Depth of solids layer:n/a Depth of scum layer:n/a Dimensions of cesspool: n/a Materials of construction:n/a indication of groundwater inflow(yes or no):NO Coal v*(note condition of soil,signs of hydraulic fhihue,level of ponding,condition of vegetation,etc.): n/a PRIVY.- (locate on site plan) Materials of construction: n/a ]dimensions:n/a DqA of solids:nla Comments(note condition of soil,signs of hydraulic failure,level of goading,condition of vegetation,etc.): 6/8'd 82S''ON H11d3H 3O iQdUGH 3-1HJ1SHW9 wuzo:OZ 8002'v 'Huf �`. Page 10 oil OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBStWACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM WORMATION(continued) Property Address: 35 IYANNOUGH RD HYA19NNISt MA 02601 Owners ROBERT 13URKE Bate of Inspection: 11/26/01 SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or bencbmmks. Locate all wells within 100 feet,Locate where public water supply enters the building. f i o q 32 6/6'd EES'ON FH11d3H �O QNdOS 3-1Hd1SHNUS wuzo:O T 8005'V 'Nuf r OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 IYANNOUGH RD HYANNIS,MA 02601 Owner: ROBERT BURKE Date of Inspection: 11/26/01 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 8+feet Please indicate(check)all methods,used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board of Health-explain: n/a NO Checked with local excavators,installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: GROUNDWATER IS DETERMINED BY HAND AUGER-ON SITE-NO WATER AT 8' --BOTTOM OF FIELD C AT-2'V a , Rio z: CPF . x Commonwealth of Massachusetts City/Town of Form 11 - Soil Suitability Assessment fewi@ ea v. S "Ter. �r�.if.), th a.),I- �5,VtAv� t'v:) re-0- DEP has provided this form for use by on-site professionals and local Boards of Health. Other forms may be used, but the information must be substantially the same as provided here. Before using this form, check with your local Board of Health to determine the form they use. A. Facility Information 1. Facility Information Owner Namef� ?Nob Map/Lot Street Address N2 C>L(0 p City/Town State Zip Code B. Site Information s w ��s ��►.-, 1. (Check one) New Construction ( Upgrade ❑ Repair ❑ 2. Published Soil Survey available? Yes [ No ❑ If yes: l`�a(� ,2� 0®O 2 Year Published Publication Scale Soil Map Unit Soil Name vv`r>,_`Q x-►n QiC/�1*3c_g,i.)2 SO Soil limitations 3. Surficial Geological Report available? Yes No . If yes: Year Published Publication Scale Map Unit Geologic Material Landform 4. Flood Rate Insurance Map: Above the 500 year flood boundary? Yes ❑ No PQ Within the 100 year flood boundary? Yes ❑ No A Within the 500 year flood boundary? Yes ( No ❑ Within a Velocity Zone? Yes ❑ No 5. Wetland Area: National Wetland Inventory Map Map Unit Name Wetlands Conservancy Program Map o f Map Unit Name DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal-Page 1 of 7 Commonwealth of Massachusetts City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Cont.) Deep Observation Hole Number: de4w_ Date T'Ime Weather 1. Location Ground Elevation at Surface of Hole Location (identify on Plan \i4! tp�- 2. . Land Use: � , ��— �( (e.g.woodland,agricultural field,vacant lot,etc.) Surface Stones Slope Vegetation Landform Position on landscape(attach sheet) 3. Distances from: Open Water Body 2.,5_0'7- Drainage Way Possible Wet Area feet feet feet Property Line Drinking Water Well Other feet feet 4. Parent Material (9 C>i�t,ol , fW � Unsuitable Materials Present: Yes ❑ No If Yes: Disturbed Soil❑ Fill Material❑ Impervious Layer(s)[I Weathered/Fractured Rock[] Bedrock[] 5. Groundwater Observed: Yes X No ❑ ` If Yes: Depth Weeping from Pit Depth Standing Water in Hole y©N Estimated Depth to High Groundwater: inches elevation DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 4 of 7 - s [ ... • 1 L rt1 t Commonwealth of Massachusetts City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Deep Observation Hole Number: Soil Soil Matrix: Redoximorphic Features Soil Coarse Fragments Soil Soil Depth Horizon/ Color-Moist (mottles) Texture %by Volume Structure Consistence Other Layer (Munsell) (USDA) (Moist) (in.) Depth Color Percent Gravel Cobbles &Stones �prp,)r-l/Y(A S(tybce 10 0-Xe VL Additional Notes ��®`�h10 `l3�1 � ��o�a�n� c Co o i s �2�vy erect r�S Y'� is D D* Ac5 �� -� �'�� u vv� Cd c�:� S �Z C ems,►��°�vw 1- ' R � 0�1 rho "6� � v t �yE'�2 o LN DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 5 of 7 Commonwealth of Massachusetts Cityrrown of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal yY D. Determination of High Groundwater Elevation 1. Method used: ._Depth observed standing water in observation hole A. B. inches i he ❑ Depth weeping from side of observation hole A. B. Inches inc s ❑ Depth to soil redoximorphic features (mottles) A. B. inches in es ❑ Groundwater adjustment(USGS methodology) A. B. inches in es 2. Index Well Number Reading Date Index Well Level Adjustment Factor Adjusted Groundwater Level E. Depth of Pervious Material 1. Depth of Naturally Occurring Pervious Material a. Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the area proposed for the soil absorption system? Yes ❑ No❑ b. If yes, at what depth was it observed? Upper boundary: Lower boundary: inches inches F. Certification 0 Mq 1 certify that I am currently approved by the Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct soil evaluations and that �Za� ssgc the above analysis has been performed by me consistent with the required training,expertise and experience described in 310 CMR 15.017. 1 further STEPHEN yGN certify that a results of my soil as indicated in the attached Soil Evaluation Form,are accurate and in accordance with 310 CMR 15.100 D. h1 .1 7. ;valuation, D -` --- _ —" MATSON �, -�_ l��o t � �j) Z2/ ZO CIVIL �— o No.46345 Sig tuts f Soil Evaluat^or p cy Da � 'P p `� 'j"T�T1(7 fs�/ 1J• ,�l�,L�r��7/+ ��Z rD�( � �, �� d©�"r �G�S T ERA��' Typed or Printed Name of Soil Evaluator/License Number L "Date of Soif Evaluator Exam SS/ONAL ENG Name of Board of Health Witness Board of Health Note: in accordance with 310 CMR 15.018(2)this form must be submitted to the approving authority within 60 days of the date of field testing,and to the designer and the property owner with Percolation Test Form 12. DEP Form 11 Soil Suitability Assessment for On-Site Sewage Disposal•Page 6 of 7 June 10, 1977 Mr. Edwin F. Taylor Selectman; Town of Barnstable Hyannis, Massachusetts Dear Mr..-Taylor: Our records indicate that the Bedford Fruit Market has a' x ' se tic tank of 1250 gallons and six amerat on chambers, W.ith a leaching capacity of 336 feet, This system cars s .approved for office use and produce warehouse; `` The.,: Department; has never received plans For any ad- ditcns or alterations. We do not' know exactly what the owner ,proposes. There is a great �difference .in septic systems.;4esigned for office and warehouses and those designed for dwellings. It would appear ghat the :leac#*ng system- is inadequate for apartment additions. © Although, the owner apparently has' talked to ath`er people con- cerning whatever he proposes, he has never talked or presented plans to,.mb' congerning this. We would:. have to know the maxi- mum number-'of people using the building now and exactly. what he desires to do prior to a final decision. The Board has required a minimum of 400 siquare :feet aE leaching,assa minimum, in the" past for any dwelling« Please contact me if ::you: have_;any!questions, Very truly yours, John M�- Kelly Director of Public Health JMK/mm 1 THE COMMONWEALTH OF MASSACHUSETTS BOARD. OF HEALTH J . ......` : ..e.� .>... ..OF....,......B�IR.lYST1�iBLE.........................: No ...................... FEE ..................... jspa ttt ° >ark (nn tr r i>�at rr�ti# Permission is hereby granted ________________ " r' f -------------- ------- --•--`---------------------------------------- -------------------------------- to Construct ( ) or Repair (�' ) an Individual Sewage Disposal System r A�. at No. - -•--- --------------------------------------------- treet as shown on the application for Disposal Works Construction P` it E -___. Dated_ ,j - Y1 _ -- --- ',. .....may --•-- __.�*'�--�-\-• - '- *................... .... Y ___-_-r�� ! r Board of Health DATE ..... . --.......................... s° a'• FORM 1.255 HOBBS & WARREN. INC.. PUBLISHERS' } APPLICATION PREREQUISITE TEXT TO signed off on per TM. No floor plans . TM told contractorm to bring in floor plans . CETRULO & CAPONE LLP COUNSELLORS AT LAW TWO SEAPORT LANE BOSTON,MASSACHUSETTS 02210 TEI PHONE(617)217-5500 FACSIMILE (617)217-5200 NEW PORK.NEW PORK � PROVIDENCE.RHODE ISLAND TELEPHONE(212)635-2230 eau mcetcap.com TELEPHONE(401)274-7850 (617) 217-5373 soneill@cetcap.com •September 30 , 2008 .VIA FIRST CLASS MAIL Town of Barnstable Health Division Attention: Ellen 200 Main St . Hyannis, MA 02601 Re: Request for Blueprints: 35 I anno h qu p y ug Road, Route 28, Hyannis, MA 02601 Our File: 01547-0445 Dear Ellen: Thank you for taking the time to assist me with my search for the blueprints to the building at the above-referenced address . Enclosed, please find a check made payable to the Town of Barnstable to cover the applicable fee and postage . Please send the blueprints to my attention at the address above . If you have any questions or concerns, please do not hesitate to contact me . Thanks again for your help with this matter. Sincerely, Cn P. Shane O'Neill cc SON Ln r- FORMAL SITE PLAN REVIEW AGENDA Meeting will be held April 24, 2008 Growth Management Department 9:00 am- 2"d Floor Hearing Room Regulatory Review SPR 014-08 Adam Weiner/Guaranteed Fresh Produce or nominee Regulatory 35 Iyannough Road (Route 28) Hyannis,MA 02601 Agreement Map 343, Parcel 003 Review Zoning District: Medical Services/WP Overlay District Proposal: Applicant proposes to rehabilitate existing building and site which may already encroach into setbacks. Relief requested is to authorize the use as a produce wholesale supply business with related small retail use, office, and produce warehouse in the Medical Services District. I STAFF MEETING SPR AGENDA Meeting will be held April 22, 2008 Growth Management Department 2:00 P.M.-4:30 P.M. -200 Main Street Regulatory Review SPR 014-08 Adam Weiner/Guaranteed Fresh Produce or nominee Regulatory 35 Iyannough Road (Route 28) Hyannis, MA 02601 Agreement Map 343, Parcel 003 Review Zoning District: Medical Services/WP Overlay District Proposal: Applicant proposes to rehabilitate existing building and site which may already encroach into setbacks. Relief requested is to authorize the use as a produce wholesale supply business with related small retail use, office, produce warehouse in the Medical Services District. Formal Site Plan Review April 24, 2008. SPR 015-08 Albertos Ristorante Informal 360 Main Street,Hyannis Review Map 327, Parcel 002 Zoning District: Hyannis Village Business District Proposal: Additional outside dining April 1 to October 15, 2008 in enclosed 16' x 32' patio with 32 seats proposed to the west side of the building. Town of Barnstable ` BARNSU ULGrowth Management Department Dh� Regulatory Review 200 Main Street,Hyannis,MA 02601 508-862-4679 fax 508-862-4725 Initial Site Plan Review Issues & Concerns Applicant: Guaranteed Fresh Produce SPR#: 014-08 Property Address: 35 Iyannough Road,Hyannis Regulatory Map/Parcel: Map 343,Parcel 003 Agreement Zoning: Medical Services/WP Overlay District Proposal: Applicant proposes to rehabilitate existing building and site which may already encroach into setbacks. Relief requested is to authorize the use as a produce wholesale supply business with related small retail use,office,and produce warehouse in the Medical Services District. The above application was reviewed by SPR staff on April 22, 2008 and the following comments and issues were raised: • Number of employees and description of business operation and hours of each employee and parking of each will need to be provided, ie: #of box truck drivers, hours,parking spaces provided, hours parked in spaces # of office and retail employees,hours,parking spaces, hours parked in spaces /• Applicant should consult with the Health Department regarding the existing septic system, as a change of use, especially one that is found to be more intense, usually triggers a septic system upgrade. A system upgrade or variance may need to be obtained. • Based upon s.f./uses, site may be limited by septic capacity to 5 employees or less. • The size of truck will need to be limited to box trucks or smaller. • Curb cut along Route 28 should be entirely closed with access taken from Medeiros Way. • The work along the Route 28 road lay out will need Mass Highway approval and should be upgraded to ADA compliant sidewalks with granite curbing and including 3 street trees. • The HP sign will need to be Town of Barnstable standard specs. Please contact Robin Giangregorio 508-862-4725 for assistance. �\j • Nature and quantity of the onsite cooling agent for refrigeration will need to be � J identified and may require registration with the Health Department. • Food permit from Health Department and wholesale license from State will be required. • Drainage plan will need to be provided. 1 • Groundwater elevations will need to be provided to assess impact on the ability of the septic and drainage to function property. f ii .�. �ptME B f tI r -r r 50 67A p`0 Town of Barnstable Planning Board Application for a Regulatory Agreement Hyannis Village Zoning Districts (Attach additional sheets if necessary) A regulatory agreement is a contract between the applicant and the Town, under which the applicant may agree to contribute public capital facilities to serve the proposed development-and the municipality or both, to build fair - affordable housing either on-site or off-site, to dedicate or reserve land for open-space community facilities or recreational use or to contribute funds for any of these purposes. The regulatory agreement shall establish the permitted uses, densities, and traffic within the development, the duration of the agreement, and any other terms or conditions mutually agreed upon between the applicant and the Town. A regulatory agreement shall vest land use development rights in the property for the duration of the agreement, and such rights shall not be subject to subsequent changes in local development ordinances. For office use only: RA# Date Received Town Clerk: Days Extended: Hearing Dates: Dated Submitted to Town Council The undersigned hereby applies to the Planning Board of the Town of Barnstable for a Regulatory Agreement, in the manner and for the reasons set forth below: 1. Applicant Name': Adam Weiner/Guaranteed Fresh Produce or nominee Phone: 508 778 0303 Applicant Address: 85 Old Yarmouth Road, Hyannis, MA 02601 Project Name: Guaranteed Fresh Produce Property Location: 35 Iyannough Road (Route 28) Hyannis, MA 02601 If applicant differs from owner, state nature of interest:2 2. Owners of Record. Provide the following information for all involved parcels (attach additional sheets if necessary and as required by item 13, Other Submissions): Owners Land Ct. Lot& Registry of Deeds #Years Lot/Parcel Name Certif. of Title# Plan Book/Page# Owners 1-4 John & Martha Tremblay = Trustees of Rafkin Realty Trust Ctf. 134196 11685-C 7 ' The Applicant Name will be the entity in whose name the Regulatory Agreement will issue. 2 If the applicant differs from owner,the applicant is required to submit one original notarized letter authorizing the application, a copy of an executed purchase&sales agreement or lease, or other documents to prove standing and interest in the property. file zba-f-extspb.doc Revised 07/12/99 f 'Owners Contact information (if different from applicant) Name Address Phone number: David V. Lawler, Esq. 336 South St., Hyannis, MA 02601 (508) 778 0303 3. Zoning District(s): MS, , WP OVERLAY DISTRICT Groundwater Overlay District: Yes [X] No [ ] Total land area subject to the Regulatory Agreement: 30,513 square feet Total land area upland: 30,513 square feet. Total land area wetland: not applicable Total estimated cost of construction: One Hundred Thousand Dollars (site work only) 4. Regulatory Agreement Requested: Yes Is the Cape Cod Commission a party to the proposed Regulatory Agreement? Yes [ ] No[X] Description of proposed agreement: 5. Existing Zoning of the Site and Proposed Zoning Relief Required by the Regulatory Agreement: Rehabilitate the existing building which may alreadv encroach on setbacks The relief requested under Barnstable Town Ordinance Section 240-24 is to authorize the use as a produce wholesale supply business with a small retail use. 6. List the local, state or Federal Agencies from which permits, funding, or other actions have been/will be sought: None but the Regulatory Process 7. Proposed duration of the Regulatory Agreement(by ordinance, the agreement with the Town cannot exceed 10 years): Ten years 8. A description of the public facilities and infrastructure to service the development, including whom shall provide such facilities and infrastructure, the date any new facilities will be constructed, a schedule and a commitment by the party providing such facilities and infrastructure to ensure public facilities adequate to serve the development are available concurrent with the impacts of the development: n/a 9. A description of any reservation or dedication of land for public purposes: r - Not applicable 10. Description of Construction Activity (if applicable), including any demolition, alteration or rehabilitation of existing buildings and a description of building(s),to be demolished, altered or rehabilitated: See attachment#10 . Attach additional sheet if necessary 11. Existing Level of Development- Number of Buildings: 1 Existing Gross Floor Area: 11,644 sq.ft., Present Use(s): Height of Present Uses: 1 story Density of Present Uses: 11,644 square feet of retail use Proposed Level of Development- Number of Buildings: 1 Existing Gross Floor Area: approx. 11,644 sq.ft. Proposed Use(s): office services, 1,816, square foot produce business retail 532 square foot and produce warehouse 9,296 (total 11,644 square feet and all uses relate to produce business) Height of Proposed Uses: (one story) no change. Density of Proposed Uses: One use for produce company, also warehouse and small retail outlet 12. Local agency subject matter jurisdiction: Is this proposal subject to the jurisdiction of the Conservation Commission.......................Yes ( ] No (X] Is this proposal subject to the jurisdiction of the Hyannis MSW Historic District.................Yes [ ] No [X]— parking lot only Does this proposal require relief from zoning...........................................................Yes [X] No [ ] • Does this proposal require relief from the Board of Health ................................Yes [ ] No [X ] 13. Submission Requirements: The following information must be submitted with the application at the time of filing, failure to do so may result in a denial of your request. Plan Submissions: All Plans submitted with an application shall comply with the requirements of Section 240-102 of the Zoning Ordinance. In addition the following shall be provided: • Twelve(12) copies of the completed application form, each with original signatures. • Eight(8) copies of a 'wet sealed' certified property survey(plot plan) and twelve (12) reduced copies (8 112" x 1 V or 11"x 17") showing the dimensions of the land, all wetlands, water bodies, surrounding roadways and the location of the existing improvements on the land. file zba-f-extspb.doc Revised 07/12/99 i r ATTACHMENT ANSWER TO QUESTION NUMBER 10 APPLICATION FOR REGULATORY AGREEMENT The Applicant respectfully requests to have the Town Counsel approve a Regulatory Agreement to convert the building to a prior use, that being a wholesale produce supply company. The property is located in the medical services district and due to the size of the building as compared to the size of the lot and the location of the building on the lot, it is ill suited for medical purpose and was, in fact, originally constructed as a wholesale produce business. Approximately ten years ago it was converted into a retail pool and patio business. The intent of the applicant is to re-landscape the front portion of the building removing the existing pressure treated-front decking system and replacing it with shrubs and other plantings with a simple walk-way to the front entrance. The Applicant proposes to relocate the main front entrance into the area as indicated on the plans. The building will be accessed through the proposed retail space of approximately 532 square feet which retail space is intended to be open from the hours of 10:00 a.m. until 3:00 p.m. to avoid both the morning and afternoon business traffic. Extensive renovations to the parking lot which presently is in a blighted condition are proposed as indicated on a plan. The project will provide additional parking to service the retail and commercial uses of the building. The building itself is already fitted with large walk-in refrigeration units which need to be revamped, however,they are pre- existing from the prior use approximately 10 years ago. It is submitted that from an environmental stand-point, the Applicant will be eliminating the present retail use which, in the Applicant's opinion creates a great risk to the Wellhead Protection Area since presently large amounts of pool chemicals are stored on site. Though the physical structure of the building is not intended to be altered, except for the entrance, the Applicant intends to cosmetically update the building as well as completely revamp the parking lot. It is expected that this redevelopment will substantially increase the curb-side appeal of the property and benefit the neighborhood as a whole. f • Twelve (12) copies of a proposed site improvement plan and building elevations and layout as may be required plus twelve (12) reduced copies (8 1/2" x 11" or 11"x 17") of each drawing. These plans must show the exact location of all proposed improvements and alterations on the land and to the structures. Other required submissions: • Review Fee(s) payable by certified check to the Town of Barnstable. • Deed(s)or Purchase and Sale Agreement(s)for all involved parcels. • Proof of filing of a Project Notification Form with the Massachusetts Historical Commission if the project is located outside of the Hyannis Main Street Waterfront Historic District. 14. Other: The applicant may submit a i onal /submi ments to assist the Board in making its determination. All supporting do 7ents mu eight days prior to the public hearing for distribution to the Board. Signature: Date: Applica is or ep tive' Print Name Da/dV' Lawler, o e nd authorized representative for Adam Weinder/Guaranteed Fresh Produce or nominee Representative's' 336 S th Phone: (508) 778 0303 Address: Hyanni ;MA 02601 Fax No.: _(508) 790 0072 3 Note: All correspondence on this application will be processed through the Representative named at that address and phone number provided. Except for Attorneys, if the Representative differs from the Applicant/Owner,a letter authorizing the Representative to act on behalf of the Applicant/Owner shall be required. e BARNBTABLB y MASS 41e +tea TFDMP'�A Town of Barnstable Planning Board Hyannis Village Zoning Districts Agreement to Extend Time Limits for Closing a Public Hearing on a Regulatory Agreement In the Matter of Adam Weiner the Applicant(s), seeking a Regulatory Agreement approval as requested in an application submitted to the Town Clerk's Office of the Town of Barnstable on , the applicant(s) and the Planning Board, pursuant to Section 168 of the Barnstable Code, agree to extend the time limits for closing of a public hearing for a period of days beyond that date the hearing was required to be closed. In executing this Agreement, the Applicant(s) hereto specifically waive any claim for a constructive grant of relief based upon time li;mitsaable prior to the execution of this Agreement. Applicant(s • Planning Board: Signat e: Signature: Applic nt(s or Apresentative Chairman or Acting Chairman Print: David V. L ler Date: Date: / Address of Applicant(s)or Applicant's Representative Adam Weiner, Guaranteed Fresh Produce Office of the Planning Board Or Nominee, c/o David V. Lawler, Esq. Planning Division 336 South St., Hyannis, MA 02601 200 Main Street, Street, Hyannis, MA 02601 (508)778 0303 Phone 508-862-4687 cc: Town Clerk Applicant(s) File file zba-f-extspb.doc Revised 07/12/99 f Doc= 1 Y 0 6 7 691 08-26-2002 12_03 BARNSTAQLE LAND COURT REGISTRY REGULATORY AGREEMENT 35 I annough Road, HYANNIS This Regulatory Agreement("Agreement") is entered into by and between ADAM WEINER,Trustee of 35 lyannough Road Realty Trust; and President and Treasurer 3 of Guaranteed Fresh Produce, Inc. ("Developer"),and the TOWN OF BARNSTABLE ("Town"), a municipal corporation, on this 23rd day of July, 2008 pursuant to Section 240-24.1 of the Barnstable Zoning Ordinance and Section 168 of the Barnstable Code; WITNESS: WHEREAS, the.Developer under this Agreement will mitigate traffic,stormwater, landscaping and streetscape impacts from redevelopment; WHEREAS, this Agreement shall establish the permitted uses and site design within the Development, the duration of the agreement,and any other terms or conditions mutually agreed upon between the Developer and the Town. WHEREAS, this Agreement shall vest land use development rights in the property for the duration of the agreement, and such rights shall not be subject to subsequent changes in local development ordinances,with the exception of changes necessary to protect the public health, safety or welfare. WHEREAS, the Town is authorized to enter into this Agreement pursuant to Chapters 168 and 240 of the Barnstable Code; WHEREAS,the Developer is not the legal owner of the property("Property")at 35 3 lyannough Road but has an agreement on file with the Town showing that property 0 owners John & Martha Tremblay,trustees of Rafkin Realty Trust have an agreement �. with Mr.Weiner to transfer the Property and authorize Mr.Weiner to pursue this 19 application for the Property consisting of approximately 30,513 sq ft,shown on Barnstable Assessor's Map 343 as Parcel 003, Lots 1, 2, 3 and 4 of Land Court Plan r 11685C by virtue of Land Court Certificate of Title#134196, and desires to develop the Property pursuant to a regulatory agreement, WHEREAS, Developer is willing to commit itself to the development of the project substantially in accordance with this Agreement and desires to have a reasonable amount of flexibility to carry out the Development and, therefore, considers this Agreement to be in its best interests;and WHEREAS, the Town and Developer desire to set forth in this Agreement their respective understandings and agreements with regard to development of the Property; WHEREAS, the Development will not require regulatory review under the Massachusetts Environmental Policy Act(MEPA)or the Cape Cod Commission Act; WHEREAS, the Developer has made application to the Planning Board pursuant to Section 168 of the Bamstable Code; WHEREAS, the Development is located in the Hyannis Growth Incentive Zone(GIZ)as approved by the Cape Cod Commission by decision dated April 6, 2006, as authorized JOHN G. SERINO DAMS, MALM A63WASOMNE ,of 6 on Boston Reoll Dee�ral, MA 021"70 by Barnstable County Ordinance 2005-13, Chapter G, Growth Incentive Zone Regulations of the Cape Cod Commission Regulations of General Application; WHEREAS, the Development is not subject to review by the Cape Cod Commission as a Development of Regional Impact due to its location in the GIZ and due to the adoption of Barnstable County Ordinance 2006-06 establishing a cumulative development threshold within the GIZ, under which this development may proceed and the Developer has submitted a Jurisdictional Determination to the Town of Barnstable Building Department to confirm the same; WHEREAS, the Development proposes to redevelop a blighted site; WHEREAS, the Development is located in a Wellhead Protection Overlay District and in an area of high groundwater where the Development proposes to contain an improved on-site septic system providing appropriate separation from groundwater; WHEREAS, the Development site does not impact resources protected by the Barnstable Conservation Commission; WHEREAS, the Development will operate a retail and wholesale use that will have complementary hours of operation to minimize site circulation conflicts and traffic conflicts; WHEREAS, the Development will close one of two existing curb'cuts on lyannough Road and so improves traffic circulation and provides some congestion relief; WHEREAS, the Development will improve stormwater on site and prevent stormwater generated on site from traveling off site onto adjacent properties or roadways; WHEREAS, the Development will provide streetscape improvements in the form of street tree and site design improvements through landscaping; WHEREAS,the Development will remove the existing pylon sign and install a new sign in a different location; WHEREAS, the Development will require zoning relief to continue the specialty retail and wholesale use in the Medical Services (MS) District; WHEREAS, the Development will require zoning relief to continue the existing non- conforming building in its present location such relief is sought from setbacks, street trees, natural state,impervious surface coverage and parking all as further defined in number 17 below; WHEREAS, Developer has undergone at least two public hearings on the Agreement application and received a majority vote from the Planning Board approving the application on June 9, 2008; WHEREAS, the Developer has undergone a public hearing on the Agreement application before the Town Council and received a 2/3rds vote approving the. application on July 17, 2008; 2 of 6 NOW, THEREFORE, in consideration of the agreements and covenants hereinafter set forth, and other good and valuable consideration, the receipt and sufficiency of which each of the parties hereto hereby acknowledge to the other,the Developer and the Town do enter into this Agreement, and hereby agree and covenant as follows; 1. if the Development rights granted hereunder are exercised, the Developer agrees to construct the Project in accordance with the plans and specifications submitted to and approved by the Town, listed as follows and made part of this Agreement by reference: a) Plans entitled"Site Development Construction Plans" sheets C-1 through C-7 stamped by Matthew W. Eddy, RPE#43183 and John Ellis PLS #29874 dated 5/12/08 b) Such other plans and plan revisions as may be required by the terms and conditions of this Agreement; 2. The Developer proposes to convert the existing 30,513 sq.ft.building at the property to suit the business plan of Guaranteed Fresh Produce; 3. Uses shall be the retail and wholesale of fresh produce, with accessory offices, storage, loading and unloading docks for trucks as necessary to service the wholesale and retail uses of the business as requested under the MS Zoning District, §240-24.1-4 of the Barnstable Code; 4. Developer proposes daily use of eight (8) 24'box trucks of 31'in length for the Guaranteed Fresh Produce business. Such use is authorized by this agreement. Any change to the length or number of these trucks shall require prior approval by the Planning Board. This condition shall not be construed to prevent vendor delivery trucks of any type or length from visiting the site for normal business purposes. 5. Proposed signage shall conform to the height provisions of§240-12 and shall not be internally illuminated. 6. The development rights granted hereunder shall be exercised and development permits may be obtained hereunder for a period of one year from the effective date of the Agreement. The development rights granted under this agreement shall not transfer to another owner without the prior written permission of the Planning Board and the Town Manager; 7. The Developer has agreed to mitigate traffic impacts from the Development and shall establish hours of operation for the retail and wholesale use so that site circulation, parking and use conflicts are eliminated or minimized. Retail operations are proposed from the hours of 10 AM to 3 PM which avoid peak site and off site traffic conditions. Changes in retail operations that vary more than 60 minutes from these hours shall require an amendment to this agreement; 8. Developer has agreed to mitigate traffic impacts from the Development by seeking and obtaining all necessary permissions from local and state agencies to close the Property's easterly curb cut. The commencement of activities on this site pursuant to this agreement shall not occur before this curb cut has been 3of6 M redeveloped as landscaped buffer along lyannough Road as shown on the plans entitled: "Landscape Plan Sheet C-6"; 9. The Developer has agreed to mitigate stormwater impacts caused by existing and proposed impervious areas on site. Stormwater management shall,to the maximum extent feasible, utilize best management practices and shall prevent stormwater from traveling off site; 10.The Developer has agreed to mitigate community character impacts by providing additional site landscaping over what exits on the Property. The landscaping plan for the Property must be approved by the Planning Board, or its designee. All landscaping within the development shall be low water use and shall minimize the use of fertilizers and pesticides; 11.The Developer has agreed to mitigate impacts from arrangement of existing non- conforming parking by planting and maintaining street trees along the lyannough Road Property frontage. The tree size and the species shall be determined in consultation with the Tree Warden and approved by the Planning Board or its designee. The tree maintenance plan shall be submitted before the commencement of operations pursuant to this agreement. A tree replacement surety shall be held by the Town for one full growing season after tree planting as determined by the Tree Warden and Growth Management Department. Surety may be released after such time upon the receipt of an inspection report from the Tree Warden,satisfactory to the Planning Board or their designee; 12. Developer and its successors will participate in the Town of Barnstable's Transportation Management Association (TMA) upon its formation. Participation shall include: (a)distribution of materials provided by the Town to all employees of the development; and (b)the identification of a representative for the development who will serve as the contact between the inhabitants and tenants of the development and the Town's TMA; 13.Construction and demolition debris from the Development shall be removed and reused or recycled to the maximum extent possible; 14. Development uses shall not use, store, generate, treat or dispose of hazardous waste or hazardous materials in quantities greater than 25 gallons (or the dry weight equivalent) or less, and shall not generate hazardous waste in quantities greater than the Very Small Quantity Generator level as defined in the Massachusetts Hazardous Waste Regulations, 310 CMR Section 30.353; 15.To the extent that the referenced plans do not depict all of the findings and conditions as set forth in this Agreement, revised plans and/or notations shall be provided. In addition to permits, plans and approvals listed above, any and all permits and licenses required shall be obtained; 16.'Upon completion of all work, a registered engineer of land surveyor shall submit a letter of certification, made upon knowledge and belief in accordance with professional standards that all work has been done in substantial compliance with the approved site plan. This document shall be submitted prior to the issuance of the final certificate of occupancy; 4of6 I i - 17.Town hereby grants a waiver from the following zoning restrictions: Permitted Use: Relief is granted to continue but reduce the scope of the existing specialty retail and expand the use to include wholesale and storage operations of Guaranteed Fresh Produce in the Medical Services (MS) District as described on the approved plans and within this agreement. Building setbacks: Relief is granted from Section 240.24.1.4.0 (1) b, Setbacks and permission is granted to continue existing non-conforming building setbacks insofar as it is required to redevelop the site as shown on the approved Existing Conditions Plan Sheet C-3 and the Layout and Materials Plan Sheet C-4. Parking: Relief is granted from Section 240.24.1.10.A.4:a,c, d, and a and permission is granted for the construction of the number, length and location of parking spaces insofar as it is required to redevelop the site as shown on the approved plans. Street Trees: Relief is granted from Section 240.24.1.10.A(5) (f) to allow the street trees to be planted according to the approved landscape plan and as required herein. Natural State/Impervious Coverage: Relief is granted from Section 240.1.4.0 insofar as it is required to redevelop the site according to the approved plan and as required herein. IN WITNESS WHEREOF,the parties have hereunto caused this Agreement to be executed, on the day and year first above written. Dated this 23rd day of July,2008. Town of B nstable Deve1 er, By: John C. Klimm By: (David V. Lawler) Town Manager "°AP ROVED AS TO FORM t- ;. A AM ER, Trustee of 35 lyannough R ad Re n y Trust; and T"vsteee Pr¢s',&nt 1-lr=surer ` Guarantee Fresh Produce :�-„.443,-Rbth J.Weil -,_Toft Attorne r: 6of5 r as - �I COMMONWEALTH OF MASSACHUSETTS Cl I ( County, ss. 1 II On thi�day of. ,2008, before me, the undersigned notary �a public, personally appeared d1"A ✓ ta1j!j1, the trustee of Guaranteed Fresh Produce, proved to me through satisfactory evidence of identification,which was[a current driver's license][a current U.S. passport] my personal knowledge],to be the person whose name is signed on the preceding instrument and acknowledged to me that he/she signed se as Trustee of Guaranteed Fresh Produce. DE90RAH E RIGGS Notary Public ~ COMMONWEALTH OF MASSACHUSETTS My Commislron lxprros August 02,2013 11� Notary Public � 0 My commission expires: 0 COMMONWEALTH OF MASSACHUSETTS ►'r1�7��i County, ss. On this_'`"day of J? , 2008, before me, the undersigned notary public, personally appeared John C.Wlimm,Town Manager for the Town of Barnstable, Massachusetts, and proved to me through satisfactory evidence of identification, which was [a current driver's license] [a current U.S. passport][my personal knowledge],to be the person whose name is signed on the preceding instrument and acknowledged to me that he signed it voluntarily for its stated purpose as Town Manage aforesaid. Zk %4toxaw Notary Public My,commission a pires COMMONWEALTH OF MASSACHUSETTS ,, MNtM Barnstable County, ss. =y�\� G0 M-?2 On t 's 15th da of August, 2008, before m ersonally appeared Adam �aM w�s1 Air; cesue Weiner, the�t ee of�uara�eed Fresh Produce„�nd'Trustee of 35 lyannough Road � Realty Trust, and proved to me through satisfactory evidence of identification, whichv +►,.. OF [a current driver's license]to be the person whose name is signed on the prece ing %•orq"•y P ��G instrument and acknowledged to me that he signed it voluntar' s state urpose as"1 11„4p.M 11/l Trustee of Guaranteed Fresh Produce and Trustee of 3 anno Ro salty Tru t. ��•� :'; , ?n . Notary Pu i My co is ' n expires: DAVID V. LAWLER Notary Public COMMONWEALTH OF MASSACHUSETTS BARNSTABLE REGISTRY OF DEEDS Mr Comm"`"""'Plr•�October ss.2010 6 t3f�6 Ja�iK StuAl i P471,4 TR:,..7 b-,LCLV�R A510rov ill TV �, `4L�— t nrdse�scFiuseres Office of Water Resources Well Completion Report 20-DEC-07 14:01:58 WELL LOCATION 250938 3PS North: 410 39.5' GPS West: 700 16.313' Address: 35, Iyanough Road Property Owner/Client: c/o Green Seal Environmental Subdivision Name:Hyannis Mailing Address: 28 Route 6A City/Town:Barnstable City/Town, State:Sandwich MA ?assessors Map: Assessors Lot #: Permit Number: Board of Health permit obtained: N Date Issued: Work Performed Proposed use Drilling Method Overburden Drilling Method Bedrock New Well Monitoring - 3 wells at this location. Direct Push CASING From (ft) To (ft) Type Thickness Diameter .00 -2.00 PVC Schedule 40 2.00 0 SCREEN From (ft) To (ft) Type Slot Size Diameter -2.00 -12.00 Slotted PVC .010 2.00 WELL SEAL / FILTER PACK / ABANDONMENT MATERIAL From-:,(ft) To (ft); Material Description Purpose WELL TEST DATA (ALL SECTIONS MANDATORY FOR PRODUCTION WELLS) Date Method - Yield Time Pumped Pumping Level Time to Recover Recovery (GPM) (hrs & min) (Ft. BGS) (Hrs & Min) (Ft. BGS) tv STATIC WATER LEVEL (ALL WELLS) PERMANENT PUMP (IF AVAIL LE) ' ca �, Date Depth Below Ground Pump Description: C✓ Measured Surface (ft) Type: Ilghke be : � 11/27/2007 7 i p 1t�`h Nominal Pump Capacity: 116A we f WELL DRILL 'S ST EMENT ADDITIONAL WELL INFORMATION Driller: Patrick Desmond Developed: No Fracture Enhancement:No E5 Supervisor: Patrick Desmond tA S g #: 37 Disinfected:No Well Seal Type:Concrete t.) Firm: Desmond Well Drilling In Total Well Depth: 12.000 _Depth to Bedrock: Registration #: 877 Da a Complete:11/27/2007 Comments: OVERBURDEN From To Description Color Comment Water Loss/Add Drill Drill (ft) (ft) Zone of Fluid Stem Drop Rate .00 12:00--Fine!to Coarse,Sand,. `Brown Yes N/A ' BEDROCK From To Code Comment Water Drill Extra Drill Rust Loss/ # of (ft) (ft) Zone Stem Large Rate Stain Add of Frac Drop per ft -Septic sp16di" .Redo t 35'Iy nnoue1 Hyannis, Massachusetts ly 297,2007� ea , � PreparedFor =_q � 8`Xr # Raflan Realt9l.,x# e T!. r 5,jyannough Rc ad � Hyannis,.lVlassachusetts 02601 j i # r`, t �y of�:"l >��y r � '� ` l r "�-•, ��. ...a.s W , a _ [ 7 . • r a.. Id+, r me � .;� 3°t t e f r k E 3 � r i �`7` r � .,�,Js" � �+ ��Cc..-f, _ }^.rw.', � 4 J' r �rV k •. .tie i r ��„r , � � v ® •G �, *tt A" e ° C) r fig+ . , y F _ 4 {�e n '"Sep p ProvidingInnovative Solutions F,or * a Solid Waste r Health&'Safety '. .. r S -•� r r _ Hazardous Waste C ',. z ;, ,O Envir6nmental Monitoring GI r Materials`1Vlanagementi j }' Compliance Outsourcing - o:n m ti is z, ` �, OC r >d •,cam "' }, , �',.�'Y � a,imt e v s 't s. 3. i + r -r r .�� t ,. -,:� ! nr, lj�al/1 O ice r m A T h,� ry e Q� i 1 New Hampshire Office , x 28 Route 6A,Sandwich,MA 0`2563 `� 'e. f h } " ,>'' '' j 301'Daniel Webster Highway,:Merrimack;NH 03054 x Phone `(508)888 6034''•Fax `(S08)888 1506' } www'gseenv comp >> , Phone:.(603)424 3004 Fax: (603)424 3241 + ^+'t� z + ♦:. �' 4 '' l-�. a- r , 5 •- ��,- a �. rr z ^u' j3 �. .� 4 3Y,-. f -�Zr h q i .. ..w f� , �t�.F 5 H.^+ t S �' �l• ,,,.�, � i' .A 3_a r .t S# � & �_ .�`�,+ < •�� P� �rT� }'�''�' c �: "� •• v + � 1�" t 4 S' TOWN OF BARNSTABLE LOCATION 33 T rs�.,�..rn�R_ 04A SEWAGE # VILLAGE 1-I -JAAS ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. eta IGnroi,� SEPTIC TANK CAPACITY 13 0111 a A- r o i LEACHING FACILITY: (type) (-W d,f sFt2S+ (size) 24 x.3 k I NO.OF BEDROOMS BUILDER OR OWNER Quay Ta c PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility .Z 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) Iq® Feet Furnished by CFavE..i S INC. 'To-ite- AP°VTt^ -ro 6of, i ' Commonwealth of Massachusetts W Title 5 Official Inspection Form ' Not for Voluntary Assessments Subsurface Sewage Disposal System Form ' M ' Inspection results must be submitted on this form or on the official Title 5 Inspection Form dated 6/15/2000. Inspection forms may not be altered in any way. ' A. Certification Important: When filling out 1. Property Information:forms on the y f I 1 �a ' computer,use 35 lyannough Road Hyannis only the tab key Property Address to move your Rafkin Realty Trust d ' cursor-do not use the return Owner's Name key. 35 lyannough Road Owner's Address - Hyannis MA 02601 ' City/Town State Zip Code Date of Inspection: December 29, 2007 Date 2. Inspector: Terry F. Bauer PG ' Name of Inspector Green Seal Environmental, Inc Company Name ' 28 Route 6A Company Address Sandwich MA 02563 City/Town State Zip Code ' 508.888.6034 Telephone Number ' Certification Statement: 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(31-0 CMR 15.000).The system: ® Passes ❑ Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority ' January 4, 2008 Inspector's Signature Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board ' of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system 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. Tremblay-35 lyannough Road, Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System ' Page 1 of 2 ' Commonwealth of Massachusetts Title 5 official Inspection Form ' Not for Voluntary Assessments Subsurface Sewage Disposal System Form �M A. Certification (cont.) ' 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection 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: Tremblay-35 lyannough Road, Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 2 of 2 t rCommonwealth of Massachusetts Title 5 official Inspection Form a Not for Voluntary Assessments 1 M Subsurface Sewage Disposal System Form A. Certification (cont.) ' 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection B) System Conditionally Passes (cont.): ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will ' pass inspection if(with approval of Board of Health): ❑ broken pipe(s)are replaced ' ❑ obstruction is removed ❑ distribution box is leveled or replaced ' ND Explain: 1 r ❑ 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 r ❑ obstruction is removed ND Explain: r r 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 1 15.303(l)(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 � 1 Tremblay-35 lyannough Road,Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 3 of 3 1 ' Commonwealth of Massachusetts Title 5 Official Inspection Form ' Not for Voluntary Assessments Subsurface Sewage Disposal System Form 41N A. Certification (cont.) 35 lyannough Road ' Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection ' C) Further Evaluation is Required by the Board of Health (cont.): 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. ' ❑ 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 and volatile organic compounds indicates that the well is free from pollution from ' that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: Tremblay-35 lyannough Road, Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System ' Page 4 of 4 ' Commonwealth of Massachusetts Title 5 Official Inspection Form ' a Not for Voluntary Assessments Subsurface Sewage Disposal System Form 4M A. Certification (cont.) I ' 35 lyannough Road Property Address Hyannis MA 02601 Cityrrown State ZipCode Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection ' 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 El ® ' than Y2 day flow El ® 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 El ® tributary to a surface water supply. ❑ ® 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 coliform bacteria and volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] ' Yes No ❑ 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. Tremblay-35 lyannough Road,Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 5 of 5 ' Commonwealth of Massachusetts Title 5 official Inspection Form ' a Not for Voluntary Assessments Subsurface Sewage Disposal System Form 9c& M A. Certification (cont.) ' 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection ' 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. Tremblay-35 lyannough Road,Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System ' Page 6 of 6 1 Commonwealth of Massachusetts Title 5 official Inspection Form ' Not for Voluntary Assessments Subsurface Sewage Disposal System Form M ' B. Checklist 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection 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(3)(b)] Tremblay-35 lyannough Road,Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System ' Page 7 of 7 Commonwealth of Massachusetts title 5 ®fficial Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form �G M C. System Information ' 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection Residential Flow Conditions: Number of bedrooms (design): Number of bedrooms (actual): ' DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): Number of current residents: ' 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)): ' Sump pump? ❑ Yes ❑ No Last date of occupancy: Date ' Commercial/Industrial Flow Conditions: Retail/Warehouse ' Type of Establishment: 246 Design flow(based on 310 CM 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): square feet 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: Unknown ' Last date of occupancy/use: Currently in use Date Other(describe): i Tremblay-35 lyannough Road,Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System ' Page 8 of 8 ' Commonwealth of Massachusetts Title 5 official Inspection Form a Not for Voluntary Assessments Subsurface Sewage Disposal System Form M 1 C. System Information (cont.) 35 lyannough Road ' Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection General Information Pumping Records: Source of information: Barnstable Water Treatment Plant ' Was system pumped as part of the inspection? ❑ Yes No If yes, volume pumped: gallons How was quantity pumped determined? ' Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ' ❑ Single cesspool ❑ Overflow cesspool ' ❑ Privy ❑ Shared system (yes or no)(if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) ' ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): ' Approximate age of all components, date installed (if known)and source of information: System is 26 years old, installed in..1981 per Health Department records. ' Were sewage odors detected when arriving at the site? ❑ Yes ® No I Tremblay-35 lyannough Road,Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System ' Page 9 of 9 Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments °w Subsurface Sewage Disposal System Form M C. System Information (cont.) ' 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection Building Sewer(locate on site plan): ' Unknown Depth below grade: feet ' Material of construction: ® cast iron ❑ 40 PVC ❑ other(explain): ' Distance from private water supply well or suction line: N/A feet Comments(on condition of joints, venting, evidence of leakage, etc.): ' Sewer is below building slab. As a result no observations were able to be made. ' Septic Tank(locate on site plan): 1'2" Depth below grade: 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 ❑ Yes ❑ No certificate) 8'x5'x4.5' Dimensions: ' 0.5" Sludge depth: ' Distance from top of sludge to bottom of outlet tee or baffle 4 0" ' Scum thickness Distance from top of scum to top of outlet tee or baffle N/A Distance from bottom of scum to bottom of outlet.tee or baffle N/A Direct measurement How were dimensions determined? Tremblay-35 lyannough Road;Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System ' Page 10 of 10 Commonwealth of Massachusetts W Title 5 Official Inspection Fora Not for Voluntary Assessments Subsurface Sewage Disposal System Form i M 5ey`e ' C. System Information (cont.) 35 lyannough Road Property Address Hyannis MA 02601 Cityrrown State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, ' liquid levels as related to outlet invert, evidence of leakage, etc.): No pumping recommended at this time, inlet and outlet tee's in good condition, tank not damaged, no leaks found liquid level at outlet invert. Grease Trap(locate on site plan): ' Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): Dimensions: ' Scum thickness N/A Distance from top of scum to top of outlet tee or baffle ' Distance from bottom of scum to bottom of outlet tee or baffle N/A ' 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 ❑ other(explain): 1 Tremblay-35 lyannough Road,Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 11 of 11 �I ' Commonwealth of Massachusetts Title 5 Official Inspection Form - Not for Voluntary Assessments Subsurface Sewage Disposal System Form C. System Information (cont.) ' 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection 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.): ' Distribution Box(if present must be opened) (locate on site plan): 0.. ' Depth of liquid level above outlet invert 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.): ' Box is level and distribution is equal No evidence of solids carryover, no evidence of leakage. Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No ' Alarms in working order: ❑ Yes ❑ No Tremblay-35 lyannough Road,Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System- ' Page 12 of 12 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments Subsurface Sewage Disposal System Form '4 M ' C. System Information (cont.) ' 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection 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: ' Type: ❑ leaching pits number: ' ❑ leaching chambers number: ® leaching galleries number: 6 ' ❑ 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.): No signs of hydraulic failure, ponding, etc. No lush vegetation. No signs of heavy bacterial growth on stone within SAS. Tremblay-35 lyannough Road,Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System ' Page 13 of 13 ' Commonwealth of Massachusetts Title 5 Official Inspection Form Not for Voluntary Assessments C� Subsurface Sewage Disposal System Form N C. System Information (cont.) ' 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): i ' 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.): Tremblay-35 lyannough Road,Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System Page 14 of 14 ' Commonwealth of Massachusetts Title 5 official Inspection Form r - Not for Voluntary Assessments 1 M Subsurface Sewage Disposal System Form C. System Information (cont.) ' 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code ' Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties ' to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. 1 r 1 1 1 ` 1 r r r i r Tremblay-35 lyannough Road,Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System ' Page 15 of 15 rCommonwealth of Massachusetts Title 5 official Inspection Form r - Not for Voluntary Assessments Subsurface Sewage Disposal System Form rM C. System Information (cont.) ' 35 lyannough Road Property Address Hyannis MA 02601 City/Town State Zip Code r Rafkin Realty Trust December 29, 2007 Owner's Name Date of Inspection Site Exam: r Slope rSurface water Check cellar rShallow wells Estimated depth to ground water: rPlease indicate all methods used to determine the high ground water elevation: r ❑ Obtained from system design plans on record If checked, date of design plan reviewed: Date f` r ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: r r ❑ Checked with local excavators, installers-(attach documentation) ® Accessed USGS database-explain: See Below r You must describe how you established the high ground water elevation: ' See attached narrative. 1 r 1 Tremblay-35 lyannough Road, Hyannis.doc.doc•11/2004 Title 5 Official Inspection Form:Subsurface Sewage Disposal System rPage 16 of 16 1 ' nd t r High Groundwater Narrative g G u wa a High groundwater was established using information from the USGS and an on-site ' investigation. A hand augered soil boring was excavated on-site adjacent to the SAS. Groundwater was encountered at a depth of 7.5' feet below the surface. The site is located in the area of USGS indicator well MIW-29 (Zone Q. The Town of Barnstable GIS Map for the site indicates that the elevation in the SAS area is approximately 16.4. ' The Cape Cod Commission website indicates that the latest water leavel measured in the indicator well in December 2007 to be 9.5 feet below the ground surface. The adjustment factor for Zone C is 5.1 feet upwards making the historic high elevation 2.7 feet below ' the ground surface, which is well above the SAS bottom and would flood the adjacent Route 28. To verify the historic groundwater elevation, a test pit was excavated approximately 25 feet from the SAS . Redoxymorphic features were identified by Gary James, PE, a ' certified MA Soil Evaluator, at an elevation of 2.5' below the surface. A subsequent level survey resulted in the top of redoxymorphic features to be at an elevation of 12.38 and the SAS bottom to be at an elevation of 13.90. Accordingly, the SAS bottom is 1.52 feet above high groundwater. 1 ' _(.1\_ Commonwealth of Massachusetts CityrFown of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal MassDEP has provided this form for use by on-site professionat and local Boards of Health.Other forms may be used,but the information must be substantially the same as provided here:Before/sing this form,check with your local Board of Health to ' determine the form they use. A. Facility Info rination 12ed 7 77 ner Nam' Owe e1__1 ¢»n Map/Lot# Street Address Qa'KQ�b r State Zip Code ' City B. Site Information ' 1. (Check one) New Construction Upgrade [I Rep ❑ air ,�1 i P-54,oil D 2. Published Soil Survey Available? Yes ❑ No If yes: Year Published Publ'ation Scale Soil Map unit `C'I"@J C' Ip. &<: - Soil Limitations Soil Name 3. Surficial Geological Report Available?❑ Yes ❑ No If yes: year Published Publication Scale Map Unit Geologic Material Landfor m 4. Flood Rate Insurance Map Above the 500-year flood boundary? ❑ Yes LrJ,ryo Within the 100-year flood boundary? ❑ Yes DIN. P�rc. ❑ No ' Within the 500-year flood boundary? Yes ❑ No Within a velocity zone? Yes 5. Wetland Area: National Wetland Inventory Map Map unit Name Wetlands Conservancy Program Map Map unit Name Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 1 of 8 t5form1l.doc•rev.10/07 ' �L\ Commonwealth of Massachusetts City/Town of Form 11 -Soil Suitability Assessment for On-Site Sewage Disposal B. Site Information(Continued) 6. Current Water Resource Conditions(USGS): lvlontl�ryeear Range: ❑ Above Normal R<Ormal ❑ Below Normal 1 7. Other references reviewed: C. On-Site Review(minimum of two holes required at eve proposed primary and reserved disposal area) �2/za0 7 9doa ' Deep Observation Hole Number: Date Time Weather 1. Location 3� /�� Co/ ' Ground Elevation at Surface of Hole: Location(identify on plan): 2. Land Use (e.g.,woodland,aggculiural field,vacant lot etc.) Surface Stones Slope(%) - Vegetation 1' Lapdform. Position on Landscape(attach sheet)Z�}, 3. Distances from: Open Water Body `feet Drainage Way feet Possible Wet Area feet Property Line fee Drinking Water Well feet Other feet 4. Parent Material: Unsuitable Materials Present: ❑ Yes ❑ No If Yes: ❑ Disturbed Soil ❑ Fill Material ❑ Impervious Layer(s) ❑ Weathered/Fractured Rock ❑ Bedrock ' 5. Groundwater Observed: k Yes' ❑ No If yes: Depth Weeping from Pit Depth Standing Water in Hole Cie Estimated Depth to High Groundwater: inches elevation t5formI1.doc-rev.10/07 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal -Page 2 of 8 - ' S Commonwealth of Massachusetts Cityrrown of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal C. On-Site Review (Continued) ' Deep Observation Hole Number: �— Redoxlmorphic Features Coarse Fragments Soil Soil Horizon/Soil Matrix:Color- (mottles) Soil Texture %by Volume Soli Consistence Other Depth(in.) Layer Moist(Munsell) (USDA) Cobbles& Structure (Moist) Depth Color Percent Gravel Stones Z y .Pa ' Additional Notes: i t5forml1.doc•rev.10107 Form 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 3 of 8 !L\ Commonwealth of Massachusetts City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal F. Certification I certify that I am currently approved bythe Department of Environmental Protection pursuant to 310 CMR 15.017 to conduct smi ' evaluations and that the above analysis has been performed by me;onsistent with the required training,expertise and experiene described in 310 CMR 15.017. 1 further cerify that the results of my soil evaluation,as indicated in the attached Soil EvalLation Form, are accurate and in accordance with 310 CMR 15.100 through 15.107. ' gSiure of it Ev at /� Date Typed or Printed Name of Soil Evalu /License# Date of Soil Evaluator xam r Name of Board of Health Witness Board of Health Note:In accordance with 310 CMR 15.018(2)this forth must be submitted to the approving authority within 60 days of the date of field testing,and to the designer and the property owner with Percolation Test Form 12. • Form 11—^Soil Suitability Assessment for On-Site Sewage Disposal •Page 7 of 8 t5formll.doc•rev.10/07 • 1 i ' S—\ Commonwealth of Massachusetts City/Town of Form 11 - Soil Suitability Assessment for On-Site Sewage Disposal Field Diagrams ' Use this sheet for field diagrams: i t t�1�►nJ 1 orm 11—Soil Suitability Assessment for On-Site Sewage Disposal •Page 8 of 8 t5forml t.doc-rev.10l07 Ko - 1 Town of Barnstable Op IME rp� Regulatory Services BMWSTABLE ; Thomas F. Geiler,Director 63 .�� 9 Public Health ,Division ArEp��p 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. 1 ' Locus Nre AND Sernc SYSTEM SKETCH 1 1 1 1 1 1 �V. \�L.��z r- I; "Y�"u'rs''J�' y��3 G1�,� }�,� �'C�•,��``�� r^;-"a't�fy$� k;;��r � '..� :.:� "�f` _. .akiv`'^- s�`° t (� ( ✓ .p-Y ; �'''� `'`I� ^-. I.,.T �,✓' ' t _.�+ • r�'� �. " }� ,'lY` t t ! -: ,�/3 xt..srai2aAfD fib i-'`•t. Iif r � 1 1 t `4l nI3rYJ p}11 c 1 i.� : `.flj / ..[ ,ffff� 4 Q� JI -ru?7.f� .;-'C'/ k`• ir"'t1N '«'ri .✓� TMe j .. .«r• j'\ o ,tj '� 'A`•-e o"�- �ItZ� " -'-`"`.::::: wr !�/"'"",.. _- � _., �+� ��- ''f .,j rt��.5 -t`' " {t��i..:ie •T°T } 5ubsiatto �r u �} r O� � �`a,�: �"m"d�t"°„�.�.�.L..°`�:.fa.�"'� _ /`�_...,r.r,� f to a!{.-:..c , ..fk^.�.... i '`�5z� >k'v �, _ 'I � � /'��f1 1 � g •4r 7If+4 a%r� 4 / r �... Ci�, `�� 7%rower ''fa�Z r, /%� C...../'+f'; f /.:.�tt( .4�- r ✓ . 11, 8i-tL i'� 'A .\U L 111'tPA Alt t3ft>> >� - ;a ^--,..a .� \ � [ �a' .Q ? 1 L it "� e /t.P,Ai".,ri7�r�rx. r .-Yc:"`�"�r s, a, �y i �� > to ♦s k� t �- tSG?+fl f :.� r\` •r:��'�^�`�se} � Ltt"'�Q�t r ) �v ��1� ...._._._.- q�1�t+ �� rr�9_J"�� 8t2r �' I' Rr)_ ra+{.T'""'"7. >wt �V z.: _ ♦. ,... L r�• �rr � fj�78ve1" y't�M11t'l+f \ ��.j ..rk r r t{ ki J lf�„ VI ' - f}" t.._�g j3k `f r!�r- iltv.: '� n Lf,•� f �� _: r /' .:,.,,� �'1 Sl O - .- ar` / �: c �j • , / 2+ ri °'2`r 1 mar p�. 6 !t " � .• o ^:}` l/ t . 6r, vb� ✓%! Gtdve# a ) P;. � Fty.'f at-=,% _:/ 1 t S G .1 g� ,f 1 •�� P �t ' �ni'{ �- i r tt�.. /u•.4.:it,3 r3� FI/ rt. :�\r�1'.- ~ .r. `�. tr' „w,F�r\��..�.r t --,/ .:..e..d-$�,r r ! �e......�� f.�/ � x:. ._ -"�� _ , ?Se9jl /�'''��c $ t)�-- :...� •• '- 1 e r „tr t k J 3�ew is 11 i e.. .{ x? `j:i - S ... /` 4 r .J �•� H "f �t . t<- �I I yea• 44 f� - S.r. -t t ,!,! if a k;:: rJ., t: •' � 2` t Jsr;. �• 3LS 4/. ;,� '�•� is .il 11 +fi 0i I i / �" \ I fa� �1'+"y.�1 4`. `- .�:. t`' I.•, t' "--ir ^�-t'.. "-\ !r`, N Fib -y �., /'.• �' 1s'" lid--t?qa y -: { �pry x" 'S �' .S s Y.3. 1n01i�:I]Q� tr�..;� ,. . ;E p�•, k s �. 7 tom!` rry .T� 5-, \ ( F rr+��ra,{tE1e + Zp ' wt v PO -. �- J '� :-'t' .39 a.il�;r� a �� f\ `arf`$M��{ r`_ -•-...�,.(L � �y� ��yy',,`-.. �� I g � '.,y 1 + ,y / Y,�z.-- t\y�N Y'1 ST.•.`lr'3 �k 't`"tf1 t �f!'i f°"a" �``y 0, (� l �� i"i `,,�}✓y 3 •' y� +{a\ �' •- %j�'.�' lV ,4.-��^-ii• i,•S �J,`!}t`'•�-�--t-N a;� tY. f! *: ,,,�_ 't :{;Ov- O - ' n. T: k { i' .C ' Y!0 +Y /'�tia S •.,, .�-.{ ` "l._�� 3`SH:.. i i :�. �• � -+,. ,f e,1:i�ak �� er` _ , �� S. •k�� 1 .: ,r{✓�-'.1 el�.,e1 W' t�•+ty!' �� x }i..�t r^-�al ��i. 7F 11 !' •-/' ,',��'� � ...: tl jet_s"fi} � -'I Yf�Q �t..t` 23't .; �1�.., .� �y�r✓ � y/'AA j._; F / f -1 ,,. ia-r+'•�r � 5 ''",.rf`•' #51 p: Sl of '. f r3` 1.-1,� 1 ,-`'".'" ,,F' _`` . _ +; �1..�, �',_j;`•'a �.wf" .�'`c ;,'>.=- B l �`*..?;; ,{� \\ al' Aj d "a } ' y�}Ie,.l�\ 4i} fv tl g� •" ;Y' c.tft r 'ia 3r High �,F'F"' •„• /- +ea L :• C.'`7 `)•i•'..°.ti \: os4� 1~.. �•'�.^ r/ �r .y. -\Lf1,.`�;;..•a.. � e{+P(+° + Y,� �' Y�•y Lr�l- l.x / �:�� 4. C.u'7 ��a -1.% .l ''xs 4I � (a'.l.�� ( t qY c.,>! ^may ff.. �` ,t,�?O} f+' �" l � T— �,.• ��, .� t.. ;. '�t'��-'_ 7, � �.a �,,,,.�gy a•' „cH�1�T115.::.+ t 4 � L r, i'' m / ,./-✓'�r.l aE,i a'3'.`-^\C •.,r 5 �` t E`. +; x0 �.-✓\.�C^•r•-�' f t - P1>'�.,,,r,_.t.x 4� "`i'i✓ _,f } rf qqt Ir t/ 1 •w.�; 'Ail �i f/ �t a -�`��Qi•,` �._.�-,FF. 1't�i 1 t y��yi �Yh`�C�� r ' ^.-�- a >��:•P'�c r � �}, �.,.k t; �I ��.� ��a�el,+� t! `'s flat S /rl'� / yam` ��3h°��r�•-'-�'�0'��.�4+1. t i� :y,i �+..F' ��. � \�.�`t~, z �'' P AIuG L�Ri�'1! ��t•"'S�C}t i,l•�lf,.�i 11 \Grooe�l! aTr / GTY C HerbCit s t Neck a,✓ ,- .� I�, a s f err F L Cefn �Ce3 �0� 1 t ns— lit# �o7r Metziani+ i t y: °( 9 Park` W I S BI 110 tract ` ' a !:� 9 FiAd1e w,ead�• r Rock r,'r `: r r �\o Kalmus It 3> 7 �a��a^'rY"`$t `�`�� -,�. L`i-rPet,i' -- -' f R \ �.4.�..,..-•_-_�Iklp `7;xl �. �' B 4 I': Name: HYANNIS Location: 041'39'34.3" N 070°16'23.9" W Date: 1/15/2008 Caption: Locus Map Scale: 1 inch equals 2000 feet 35 lyannough Road Hyannis, MA I ' Copyright(C)1997,Maptech,Inc. 1 Septic System Sketch 1 1 Iyannough Road (Route 28) 1 D Box Landscaped Area- _ _ ,- -- I_- -_ , Soil Test Pit 441 i __ _ ' ' ® Boring - -- -+- , 0 _ g Handicap �D►�'23, i SAS Covers 49 1 Ramp .5 & Entrance ' Wood Staircase 1 Septic Tank i I 1 #35 1 •° 1 1 Note: All septic system component covers are at the surface NEB �1 Location: 35 Iyannough Road Not To Scale I �M pop Hyannis, Massachusetts . Based on Visual Observations y � �a Date: December 29, 2007 1 oFTHErph, DATE: FEE: BARNSTABLE, �p i6gq• ♦� REC. BY Town of Barnstable I SCHED. DATE: d� Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 I Paul J.Canniff,D.M.D. (aj(ML�� C-11 JunichiSawayanagi VARIANCE REQUEST FORM LOCATION Property Address: 35 Iyannough Road, Hyannis, .MA 02601 30,5134square feet 002 Assessor's Map and Parcel Number: 3431002 Size of Lot: Wetlands Within 300 Ft. Yes Business Name: Guaranteed Fresh Produce No Subdivision Name: n ia e C~' " s - APPLICANT'S NAME: Adam J Weiner,Trustee Phone 508 778 0303 c L(5 Atty lawle Did the owner of the property authorize you to represent him or her? Yes No a� PROPERTY OWNER'S NAME CONTACT PERSON c✓ Name: 35 Iyannough Road Realty Trust Name: David V',Lawler o Address: 35 Iyannough Road, Hyannis, MA Address: 540 Main Street, St4 8, Hyannis Phone: 508 771 0904 508 7.78 0303 Phone: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) Septic relief from groundwater See attached NATURE OF WORK: House Addition ❑❑❑❑❑❑ House Renovation El Repair of Failed Septic System Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in 4 separate completed sets. Four(4)copies of the.completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) Four(4)copies of labeled dimensional floor plans 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) Full menu submitted(for grease trap variance requests only) Variance request application fee collected (no fee for lifeguard modification renewals, grease trap variance renewals [same owner/leasee only], outside dining variance renewals [same owner/leasee only], and variances to repair failed sewage disposal systems [only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Paul J.Canniff,D.M.D. REASON FOR DISAPPROVAL Junichi Sawayanagi Q:\Application Forms\VARIREQ.DOC REASON FOR VARIANCE The Applicant recently took possession of the property and is converting the property from its prior use of a retail pool and patio store, (a substantial portion of the business was used for the storage and sale of harsh pool chemicals)which is being converted to a wholesale produce company with a small retail component. Based upon attached formulas, it is the position of the applicant that the use is far less detrimental to the public well-being and safety of the residents of the Town of Barnstable and the water flow usages is less detrimental. The Applicants main business is that of a wholesale produce company, with the majority of employees arriving early in the morning, stay for a very short period of time and are away from the premises virtually the entire day but for a warehouse manager and periodic laborer,bookkeeper and one retail staff person. The Applicant has no other employees and as such,the water usage is extremely diminimous. Due in part to the large size of the building and the relatively small amount of employees for the present use makes this a unique building and enterprise with respect to its shape, topography and the relief requested would have little or no impact upon the surrounding systems, areas and in fact, constitutes a reduction in the environmental impacts to the area. Furthermore, the costs and expense of putting the system in would be detrimental and harmful to the Applicant. This is due in large part to the upgrade and investment in the landscape and structure as provided for in the regulatory agreement approved by the Barnstable Town Council. The hardship which will be endured by the applicant if the variance is not approved, clearly outweigh the benefits an upgrade. i Baxter Nye Engineering Registered Professional Engineers and Land Surveyors Project Name Guaranteed Fresh Produce by: SDM Location 35 lyannough Road/ Route 28 Hyannis, MA Date: 5/21/2008 BN Project# 2007-071 Wastewater Design Flow Calculations: Existing conditions from inspection report Use Area Design Flow Unit Total Retail Space 5000 sf 0.05 gpd 250.0 gpd (from 314 CMR 15.00) Warehouse/Dry Storage 2 person 15 gpd 30.0 gpd (from 314 CMR 15.00) w/o cafetaria (Inspection report notes 8000 sf warehouse) Total Facility Flow 280.0 gpd ( 0.0003 mgpd) ( 0.000433 cfs) 2007-071 Sewer Flow Calculations.xls Baxter Nye Engineering Registered Professional Engineers and Land Surveyors Project Name Guaranteed Fresh Produce by: SDM Location 35 lyannough Road/ Route 28 Hyannis, MA Date: 5/21/2008 BN Project# 2007-071 Wastewater Design Flow Calculations: Proposed Conditions Use Area Design Flow Unit Total Retail Space 532 sf 0.05 gpd 26.6 gpd (from 314 CMR 15.00) Warehouse/Dry Storage 6 person 15 gpd 90.0 gpd (from 314 CMR 15.00} w/o cajetaria n Total Facility Flow 116.6 gpd ( 0.0001 mgpd) ( 0.000180 cfs) Proposed flow of 117 gpd < existing flow of 280 gpd 2007-071 Sewer Flow Calculations.xls COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS ki a. Z DEPARTMENT OF ENVIRONMENTAL PROTECTION . r y.Q JO A TITLE 5 x OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM Msk . PART A CERTIFICATION Property Address: 35 IYANNOUGH RD HYANNIS,MA 02601 :3"3 dd 3 (S-4— Owner's Name: ROBERT BURKE Owner's Address: 402 NORTH FALMOUTH HIGHWAY N.FALMOUTH MA.02556 A Date of Inspection: 11/26/01 } i Y Name of Inspector: (please print)A JOHN GRACI ��® "*'+ t� Company Name: SEPTIC INSPECTIONS ' Mailing Address: P.O: BOX 2119 TEATICKET,MA.02536 DEC ® s 2�01 Telephone Number: 508-564-6813 FAX 508-564-7270 9y TOWN OF BARNSTABLE HEALTH DEPT. CERTIFICATION STATEMENT 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 yA 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: X Passes Conditiona lly_ Y Passes Needs Furth aluation by the Local Approving Authority _ Fails T Inspector's Signature: Date: 11/26/01 'I The system inspector shall submit r opy of this inspection report to the Approving Authority(Board of Health or DEP)within $ ' 30 days of completing this inspecti n. If the system is a shared system or has a design flow of 10,000 gpd or greater,the ,� F, inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving authoritY Notes and Comments n THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE f . SYSTEM'S USEFULL LIFE. IC' ****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. t , 4k ' ryz-rtth3 ",•rKr Page 2 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A x CERTIFICATION(continued) Property Address: 35 IYANNOUGH RD HYANNIS,MA 02601 Owner: ROBERT BURKE Date of Inspection: 11/26/01 Inspection Summary: Check A,,B,C,D or E/ALWAYS complete all of Section D A. System Passes: lu X 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, u Comments: THE SYSTEM PASSES TITLE V INSPECTION.RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFULL LIFE. 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. n/a The septic tank is metal and over 10 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 ass ins ection,if it is structural) sound not leaking and if a Certificate of Compliance indicating ' P P P Y g P g , �.. that the tank is less than 20 years old`is available. 6i Kjr> ND explain: n/a � n/a Observation of sewage backup or lireak out or high static water level in the distribution box due to broken or obstructed $t 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 4- _ obstruction is removed ` _ distribution box is leveled or replaced 4r ' ND explain: n/a n/a The system required pumping more than 4 times a year due to broken or obstructed pipe(s).The system will pass v } Y 1 inspection if(with approval of the Board of Health): _broken pipe(s)are replaced !i ', _obstruction is removed �h t ND explain: n/a LL41 �yY �`isyx F } ,i � Page 3 of 11 , rRy • r OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS A ' SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A �' M CERTIFICATION.(continued) ra r; Property Address: 35 IYANNOUGH RD HYANNIS,MA 02601 ! Owner: ROBERT BURKEr �1 Date of Inspection: 11/26/01 , 5P C. Further Evaluation is Required by the Board of Health: "�i ul TN _ 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(l)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: t r _ 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 d•5 a 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: e� r _ 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. ,! H." _ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The system has a septic tank`and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well". Method used.to determine distance n/a i any F '�iR "This system passes if the well"water analysis,performed at a DEP certified laboratory,for coliform bacteria and b ' volatile organic compounds indicates that the well is free from pollution from that facility and the presence of ammonia fir, w 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: �s #AIL � �. n/a iv yy.. i Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) 4 Property Address: 35 IYANNOUGH RD HYANNIS,MA 02601 F N Owner: ROBERT BURKE :' Date of Inspection: 11/26/01 D. System Failure Criteria applicable to all systems: You must indicate"yes"or"no"to each of the following for all-inspections: F r T SY Yes No " X Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool , ,A X Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or cloggedirttir SAS or cesspool _ X Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool 4 , } _ X Liquid depth in cesspool is less than 6"below invert or available volume is less than ''/z day flow ;; ;, X Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s).Number of times 1 ` pumped nla. X Any portion of the SAS,cesspool or privy is below high ground water elevation. k ; X Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply._ 1; X Any portion of a cesspool or,privy is within a Zone I of a public well. ° {] _ X Any portion of a cesspool or privy is within 50 feet of a private water supply well.{; ; X 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 vy , certified laboratory,for coliform bacteria and volatile organic.compounds indicates that the well is free ' r from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or , less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.] is ;t> ,li2 y � �F _ (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as described in 310 f ,} 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. �;;� a You must indicate either"yes"or"no"to each of the following: (The following criteria apply to large`systems in addition to the criteria above) yes no X the system is within 400 feet of a surface drinkingsupply water X the system is within 200 feet of a tributary to a surface drinking water supplyr< ,. _ X 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 zz; under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304.The system owner4;� :' should contact the appropriate regional office of the Department. ,: 1 ,} Page 5 of 11 ^; OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM ' PART B #g a� CHECKLIST Property Address: 35 IYANNOUGH RD HYANNIS,MA 02601 Owner: ROBERT BURKE Date of Inspection: 11/26/01 Check if the following have been done. You must indicate"yes"or"no"as to each of the following: top Yes No X _ Pumping information was,provided by the owner,occupant,or Board of Health t X Were any of the system,coiriponents pumped out in the previous two weeks? a X Has the system received normal flows in the previous two week period? _ X Have large volumes of water been introduced to the system recently or as part of this inspection? X _ Were as built plans of the system obtained and examined?(If they were not available note as N/A) `,( r :, at X _ Was the facility or dwelling inspected for signs of sewage back up? ` X _ Was the site inspected for signs of break out? X _ Were all system components,excluding the SAS, located on site? ; X _ Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of thee , , baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? } X _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenanceN�= of subsurface sewage disposal systems The size and location of the Soil Absorption System(SAS)on the site has been determined based on: M E$p Yes no _ X Existing information. For example,a plan at the Board of Health. X _ Determined in the field if an of the failure criteria related to Part C is at issue approximation of distance is ( Y pP unacceptable)[310 CMR 15.302(3)(b)] t 9T� s �x ry k S . L Page 6 of 11 g. 1 b rY OFFICIAL INSPECTION FORM-NOT FOR'VOLUNTARY ASSESSMENTS r _ t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 35 IYANNOUGR"HYANNIS,MA 02601 Owner: ROBERT BURKE Date of Inspection: 11/26/01 FLOW CONDITIONS RESIDENTIAL >' Number of bedrooms(design): 0 Number of bedrooms(actual): n/a DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 0 Number of current residents: n/a Does residence have a garbage grinder(yes or no):NO _. Is laundry on a separate sewage system(yes or no):NO [if yes separate inspection required] '" Laundry system inspected(yes or no): NO to Seasonal use:(yes or no): NO ` Water meter readings, if available(last 2 years usage(gpd)): n/a t x � Sump pump(yes or no): NO Last date of occupancy: n/a7777 s4r COMMERCIAL/INDUSTRIAL ; Type of establishment: RETAIL=e5,00,0 SQUARE FEE/8000 SQFEET WAREHOUSE . Design flow(based on 310 CMR�15:203): n/agpd ky Basis of design flow(seats/persons/sgftetc.): n/a olv Grease trap present(yes or no): NO d Industrial waste holding tank resent( es or no): NO Non-sanitary waste discharged to the7itle�5 system(yes or no): NO , Water meter readings,if available: n/a, R `r• Last date of occupancy/use: n/a OTHER(describe): n/a GENERAL INFORMATION ` Pumping Records Source of information: n/a 1 ' Was system pumped as part of the inspection(yes or no):NO If yes,volume pumped: n/agallons--How was quantity pumped determined?n/a ' Reason for pumping: n/a 4"�f TYPE OF SYSTEM t9r ` X Septic tank,distribution box,soil absorption system Single cesspools _Overflow cesspool _Privy t . _Shared system(yes or no)(if yes,attach previous inspection records,if any) �n _Innovative/Alternative technology;Attach a copy of the current operation and maintenance contract(to be obtained from �:°„p R, system owner) _Tight tank Attach a copy of the DEP approval Other(describe): n/a r Approximate age of all components,,date installed(if known)and source of information: ,} { APPROXIMATELY 20 YEARS y ' Were sewage odors detected when arriving at the site(yes or no): NO a ¢` Page 7 of 11 , y V:`a:: OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS ) SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 IYANNOUGH RD HYANNIS,MA 02601 . ?F Owner: ROBERT BURKE "f Z Date of Inspection: 11/26/01 ip;yam a BUILDING SEWER(locate on site plan) Depth below grade: 54" Materials of construction:_cast iron''_40 PVC Xother(explain): 20 PVC { t" Distance from private water supply well or suction line: n/a k Comments(on condition of joints,venting,evidence of leakage,etc.): l j TOWN WATER SEPTIC TANK: X(locate on site plan) "b 7.4 Depth below grade: 48" Material of construction:Xconcrete_metal_fiberglass_polyethylene other(explain)n/a If tank is metal list age: n/a Is age confirmed b a Certificate of Compliance es or no :NO attach a co of certificate g g Y P (Y ) ( PY ) Dimensions: 1000G L 8'6" H 5'7"W 4',J0"" Sludge depth:2" Distance from top of sludge to bottom of outlet tee or baffle:32" Scum thickness:0" �g„ Distance from top of scum to top of outlet tee or baffle:6" s� Distance from bottom of scum to bottom of outlet tee or baffle: n/a How were dimensions determined: MEASURED Comments on pumping recommendations inlet and outlet tee or baffle condition structural integrity,liquid levels as related ( P P g g►'�h', q to outlet invert,evidence of leakage,etc.): THE SEPTIC TANK AND ALL COMPONENTS APPEAR TO BE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY. RECOMMEND PUMPING EVERY TWO YEARS TO PROLONG THE SYSTEM'S USEFUL LIFE " GREASE TRAP:_(locate on site plan)` ; Depth below grade: n/a Material of construction:_concrete_metal_fiberglass_polyethylene_other(explain): n/a r; Dimensions: n/a Scum thickness: n/a '�° Distance from top of scum to top of outlet tee or baffle: n/aE Distance from bottom of scum to bottom'of outlet tee or baffle: n/a t , Date of last pumping: n/a Comments(on pumping recommendations', inlet and outlet tee or baffle'condition,structural integrity,liquid levels as related ; ' t to outlet invert,evidence of leakage,etc.)`: n/a ,rt�fi t 9y q Page 8 of 11 �#a OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS � � SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM a � PART C SYSTEM INFORMATION(continued) Property Address: 35 IYANNOUGH RD HYANNIS,MA 02601 ," 3; Owner: ROBERT BURKE Date of Inspection: 11/26/01 ' {, TIGHT or HOLDING TANK: (tank must be pumped at time of inspection)(locate on site plan) Depth below grade: n/a Material of construction: concrete metal fiberglass_polyethylene_other(explain): n/a Dimensions: n/a Capacity: n/a gallons f t' Design Flow: n/a gallons/day Alarm present(yes or no): N/A Alarm level:N/A Alarm in working order(yes or no): NO w) "� Date of last pumping: n/a y w : Comments(condition of alarm and float switches,etc.): n/a DISTRIBUTION BOX: X(if present.must be opened)(locate on site plan Depth of liquid level above outlet invert, LEVEL WITH BOTTOM OF PIPE € zgk Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover,any evidence of leakage into ,x r or out of box,etc.): BOX IS STRUCTURALLY SOUND. PUMP CHAMBER:_(locate on site plan) Pumps in working order(yes or no):NO"'! Alarms in working order(yes or no):NOr.' Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): 4, n/a �'� b Mi t . q . x 4 + l7 `A t , . S 4h: Page 9 of 11 Y OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM � . PART C x SYSTEM INFORMATION(continued) Property Address: 351YANNOUGH RD HYANNIS,MA 02601 x Owner: ROBERT BURKE Date of Inspection: 11/26/01 rl SOIL ABSORPTION SYSTEM(SAS): X (locate on site plan,excavation not required) If SAS not located explain why: n/a " Type ,k. n/a leaching pits, number: n/a °a< FLOW DIFFUSERS leaching chambers, number: 6 n/a leaching galleries, number: n/a n/a leaching trenches, number,.length: n/a n/a leaching fields, number: n/a kFA F` n/a overflow cesspool, number: n/a n/a ,innovative/alternative system Type/name of technology: n/a _dpp u-v Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation,etc.): THE FLOW DIFFUSERS ARE STRUCTURALLY SOUND AND FUNCTIONING PROPERLY.RECOMMEND. NEW COVERS TO FLOW DIFFUSERS. SYSTEM SHOWS NO SIGNS OF FAIURE-BOTTOM AT 2' 6" } CESSPOOLS: (cesspool must be pumped as part of inspection)(locate on site plan) Yn , Number and configuration: n/a g Depth—top of liquid to inlet invert: n/a Depth of solids layer: n/a + Depth of scum layer: n/a e Dimensions of cesspool: n/a Materials of construction: n/a Indication of groundwater inflow(yes or no): NO Comments(note condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): +� n/a ay. PRIVY: (locate on site plan) Materials of construction: n/a d . Dimensions: n/a Depth of solids: n/a5�t Comments(note condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): '. ,.,a. n/a ; 4,y 7 ` Page 10 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS <, SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C i SYSTEM INFORMATION(continued) x, Property Address: 35 IYANNOUGH RD HYANNIS,MA 02601 Owner: ROBERT BURKE Date of Inspection: 11/26/01 SKETCH OF SEWAGE DISPOSAL SYSTEMk Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. K l Locate all wells within 100 feet. Locate where public water supply enters the building. { I f ' 'V I tiT ; 1 0 L 1 �i n pf lis 4 A Cie ; r v p v., f. i s1 t y;; a r � y t 4 r7 t. f 4 ff rF I t Page I 1 of 11 •ka'� OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 35 IYANNOUGH RD HYANNIS,MA 02601 Owner: ROBERT BURKE Date of Inspection: 11/26/01 SITE EXAM _Slope _Surface water _Check cellar Shallow wells Estimated depth to ground water 8+feet, Please indicate(check)all methods,,used to determine the high ground water elevation: NO Obtained from system design plans on record-If checked,date of design plan reviewed: n/a d YES Observed site(abutting property/observation hole within 150 feet of SAS) NO Checked with local Board•of Health-explain: n/a NO Checked with local excavators,installers-(attach documentation) NO Accessed USGS database-explain: n/a You must describe how you established the high ground water elevation: GROUNDWATER IS DETERMINED BY HAND AUGER ON SITE-NO WATER AT 8' --BOTTOM OF FIELD AT 2'6" s,. )n OC7 -�7 5o 1 a`3 No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: . Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS ZIpplitation for Oiopooar bpotem Construction Permit Application for a Permit to Construct Q()Repair( )Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.A. 00(j Owner's Name,Address and Tel.No. �µNAl: y Y Assessor's Map/Parce14 b6 stauer' e, mess, d 1. To. DesWY9 ame,Address and Tel.No. rU �mC Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other TI pe of Building Pn&M£¢.QAA No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow gallons per day. Calculated daily flow gallons'. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees toe the cons cti n and maintenance a afore described on-site sewage disposal s stem in accordance with the provi 'toe of Title 5 f nme ode not to place the system in operation until f erti - cate of Compliance has bee is d b Bar f lth. �1 Signe Date t/ Application Approved by L Date Application Disapproved for the following reasons Permit No. �� "1�� Date Issued it F-No. /�� Fee �J _ i f THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: �/. -. PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Yes F 01pplicatiou for Digozaf 6"mem Cougtructton Permit Application for a Permit to ConstructX Repair( )Upgrade( )Abandon( ) El Complete System El Individual Components , _ Location Address or Lot No.`j`j S ,`p ,O�U� n� Owner's Name,Address and Tel.No. Assessor's Map/Parcel t' l�6 - statler' e; dress, d e1. 0. / '�� Designer ame,Address and Tel.No. 19 IW-1p&Biiilding: Dwelling No.of Bedrooms Lot.Size sq.ft. Garbage Grinder( ) Other Type of Building L)N t yr tM No.of Persons, Showers( ) Cafeteria( ) Other Fixtures a Design Flow gallons per day. Calculated daily flow JaMirons. Plan Date Number of sheets Revision Date Title Size of Septic Tank Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) � 4 Date last inspected: Agreement: The undersigned agrees to ensure the constucti n and maintenance g a afore described on-site sewage disposal s stem in accordance with the provi iv sn of Title 5 f 11 Qnmen ode fid'not to place the system in operation until a erti - cate of Compliance has bee is d b .tins B ar�of �alth. p� # � V Signed I k Date Application Approved by Date Application Disapproved for the following reasons Permit No. Date Issued t' THE COMMONWEALTH OF MASSACHUSETTS B.ARNSTABLE, MASSACHUSETTS Certificate of (Compliance THIS IS TO CERT�,_that e O -site S age osal System Constructed O Repaired ( )Upgraded( ) Abandoned( )by e w -of .� at ,4 k3o,j c t. has been constructed in accordance with the p�i$io s o i 5 and the fo isposal System Construction Permit No. t 11 ^I��dated (I 121 ��> Installer 0 n 9 C. Designer The issuance of thi�j permit shall not be construed as a guarantee that the sys ern will f nction a niesigned. Date 1 117 /;-Od I Inspector % !�^ sl' 4N N. ✓L �—T/ Fee U THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE., MASSACHUSETTS Migaaf *pgtem Coneaructiou Permit Permission is hereby granted.to Construct(x)Rep 'r(--)_1j rade( )Abandon( ) System located at /R 0 and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date of this pen rut. Date: ~Z 1 C� Approved by TOWN OF BARNSTABLE TOXIC AND HAZARDOUS MATERIALS ON-S INVENTORY NAME OF BUSINESS: LTTa gQ01 Q.nlx. PG{.t7 D,_TK C . BUSINESS LOCATION: IZ aef INVENTORY MAILING ADDRESS: " TOTAL AMOUNT. TELEPHONE NUMBER: �� //7 ®Y)jj CONTACT PERSON: lTb-kki ey Uaj-t ) anno b EMERGENCY CONTACT TELEPHONE NUMBER: MSDS ON SITE? TYPE OF BUSINESS: P 0 01 J U-02b 1 LA INFORMATION/RECOMM NDATIONS. &/-t7hXjX" Fire District: lS e Waste Transportation: '�d� ' 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 1 CA�� 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 ��122 (dry cleaners) OJ Other cleaning solvents Bug and tar removers Windshield wash WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS Town of Barnstable Regulatory Services °s Thomas F. Geiler,Director OF BA RINS TABLE Public Health Division 'Eo n Thomas McKean,Director 7095-MAY 23 PM 4: 09 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 _ Fax: 508-790-6304 _...�_.,...� DIVISIONApplication Fee: $100.00, ASSESSORS MAP AND PARCEL NO. DATE 5-a O-O 5 APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME.OF APPLICANT C M- q RT H A �"T R t M f3!,J)\1 NAME,OF ESTABLISHMENT 71 S�O O 1 4- `�0►�l O )C ADDRESS OF ESTABLISHMENT 3 5 SL4 a n n oU Q h �d TELEPHONE NUMBER 5 O SOLE OWNER: YES - NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS OF ALL PARTNERS: IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. O K 3- 30 5-3 a STATE OF INCORPORATION tM t-A FULL NAME AND HOME ADDRESS OF: . (� �,� (1� PRESIDENT S - &nTr-embinu Szsp u:� R (M � 1�1 A pr �ons xkks R TREASURER 11 ki 0 « CLERK _Mar ki-In Trr.minlc►ll 530 Qn�t A s knells MVR SIGNATURt OF APPLICANT RESTRICTIONS: HOME ADDRESS Z 30014 M Marc HOME TELEPHONE#_5 tag- %IA a-a 4 h1 D Hu.doc/wp/q Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: JT's Pool&Patio Inc. Fax: _. Corp Name: Mailing Address Location: 35 lyanough Rd.,Hyannis Street: 35 lyanough Road mappar: City: Hyannis Contact: !John Tremblay/�YUr ,I State: Ma Telephone: (508)862-2440 Zip: 0260 ;1 Emergency: .(508)428-4548 Person Interviewed: / Business Contact Letter Date: 6/2/2004 Category: Miscellaneous Inventory Site Visit Date _9ZI2004✓(�j/ l V t Type: Follow Up/Inspection Date: 0 public water ❑ indoor floor drains ❑ outdoor surface drains ❑d license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc ❑d currently licensed ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir - - -6/3❑� 301- - --2006 60 on-site sewage ❑ indoor on-site syste ❑ date: 0/outdoor onsite system ---- s X Ih �� Remarks: 6/5/96 BC Fire extingusiher&ABC. Chemtrec&Fire Dept.for compliance: [ emergency response. Has MSDS Sheets. H2 02=24 gal. Remarks: Satisfactory �] Pool chemicals stored in one room. MSDS sheets on site.Chem.Tech V " for spills. Note: See 97 inspection report for current list of chem. REMARKS: 6/4/98-MSDS in file. Acids moved away from oxidizers/alkaline chemicals during v� indpection. No liquid chlorine. Back-up storage in sicond bay. 275 AST outside dumped illegally. ORDERS: Remove AST,275 gal within 30 days. Illegally dumped AST / p 3 removed from property. 6/7/04 Retail pool chemical hl.j�l�p�,� andpai*wfurn+tore.,-Zwoon%ployeas4ownecaid*i%i.,r.hamiea J_.. Q,,:.• I , stored property. MSDS onsite. ill mail license'app•with'new'l rvento sheet. Nor. C o_Qc�u:m `1 D Q5`c S�dIll.irl GA,4`�zs�o. i8 I I 10 Ptiu-ce,t(jan m M o �(' 3 � � Rio fit'u.�r► d w c.�l �a��t� � IS 5 Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials ❑ gty's>25 Ibs dry or 50 gals liquid but less than 111 gals ❑d gty's 111 gals or more swimming pool chlorine ? 428gallons _.._.._..___..._....._.__.._._._. ____..._._._.._....._._....._......._...._...__._._.._.._..__.._.._.._..___..__._._._._...____._..._._.__........_..._.._._._...._.._.._.........__.....__....... Misc._Acid 48.5 gallons Misc.Corrosive — 56.25ggallons v Misc.Poison ( 172.5 gallons ......._____.._.___.._...._.._._.....__..... _....._._.__.._.........._........_...................................__..._.....__ _.__._...._..........._._._._....._................_..____. Fungicide 46.75 gallons other cleaning solvents 14.5 gallons Misc.Reactive E 10 gallons Misc.Oxidizer T_497.25 gallons _._........_..................._ spot removers&cleaning fluids(dry cleaners) 3.5 gallons paint,varnishes,stains,dyes 1.75 gallons Toxic 345.5 gallons Misc.Flammable 23.25 gallons antifreeze(for gasoline or coolant systems) 16 gallons Soaps&Cond. 1 3 gallons disinfectants ; 38 gallons Waste Transporter: Fire District: ',Hyannis Last HW Shipment Date: Waste Hauler Licensed: No v C))ua�`u_v- Poo I —'s"M o C� Town of Barnstable-Health Department Page 1 HAZARDOUS MATERIALS INVENTORY SITE VISITS DBA: JT's Pool&Patio,Inc. Fax: Corp Name: Mailing Address - �E Location: '35 lyanough Rd.,Hyannis Street: 35 lyanough Road mappar. City: Hyannis Contact: John or Martha Tremblay State: Ma Telephone: (508)862-2440 Zip: 02601 Emergency: (508)428-4548 Person Interviewed: Business Contact Letter Date: 6/16/2005 ..... ........ Category: Miscellaneous Invento r y isit Date: 6/29/2005 Type: Follow Up/Inspection Date: public water ❑ indoor floor drains ❑ outdoor surface drains license required ❑ private water ❑ indoor holding tank mdc ❑ outdoor holding tank mdc currently licensed ❑ town sewage ❑ indoor catch basin/drywell ❑ outdoor catch basin/drywell expir -- - -- -date: 6/30/2006 ❑d on-site sewage ❑ indoor on-site syste ❑ outdoor onsite system -- - Remarks: 615/96 BC Fire extingusiher&ABC. Chemtrec&Fire Dept.for compliance: emergency response. Has MSDS Sheets. H2 02=24 gal. Remarks: Satisfactory Pool chemicals stored in one room. MSDS sheets on site.Chem.Tech for spills. Note: See 97 inspection report for current list of chem. REMARKS: 6/4198-MSDS in file. Acids moved away from oxidizers/alkaline chemicals during indpection. No liquid chlorine. Back-up storage in sicond bay. 275 AST outside dumped illegally. ORDERS: Remove AST,275 gal within 30 days. Illegally dumped AST removed from property. 6/7/04 Retail pool chemical and patio furniture. Two employees(owner and wife). Chemicals stored properly. MSDS onsite. Will mail license app with new inventory sheet.6/29/05 alp remarks: msds on site,all chemicals are properly stored. Page 2 Town of Barnstable-Health Department HAZARDOUS MATERIALS INVENTORY Chemicals: ❑ Zero Toxic Waste Materials ❑ gty's>25 Ibs dry or 50 gals liquid but less than 111 gals ❑d gty's 111 gals or more unfit'of mpasurE r, ��v.. __.._a9allon.all �..._....... ......_.._._......_..__._.._.. Misc_Poison_._..___..____.._............._.__. 271 s Fungicide 761gallons other cleaning solvents 23`gallons Misc.Oxidizer 535jgallons Y Misc.Combustible ; 6 gallons Waste Transporter: Fire District: :Hyannis Last HW Shipment Date: Waste Hauler Licensed: No February 28,.2008 John Klimm Town Manager TOWN OF:BARNSTABLE 367 Main Street Hyannis,Massachusetts 02601 RE: Notice of Downgradient Property Status ` 35 Iyannough Road 1 Hyannis, Massachusetts 7J Mr. Klimin: This letter is being sent to you to comply with Massachusetts Contingency Plan public info ation requirements and to inform you of the completion of a determination of Down gradient Property Status for the property at 35 Iyannough Road and.the availability of supporting documents .for the above referenced site. Documentation is available for your review at the Massachusetts Department of Environmental Protection, (MassDEP) Southeast Regional Office in Lakeville, Massachusetts. If you have any questions or require additional information regarding this matter,,please call. Sincerely, GREEN SEAL ENVIRONMENTAL Terry Bauer, P.G. Senior Project Manager cc: Thomas A. McKean, Health Director, Town of Barnstable,Massachusetts ell TONN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair . satisfactory 2. Printers BOARD OF HEALTH 3.Auto Body Shops _ Q unsatisfactory- 4. Manufacturers COMPANY V\ 'L \ V��-�i (see"Orders") 5. Retail Stores 6.Fuel Suppliers ADDRESS C18SS: / 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) r ;e�iV*04i - zae:tc 5 L]r� Synthetic Organics: 1 degreasers _ y) IC i3'S A\(.__'At:C..i\ fDA z ID L Miscellaneous: Q-A 1US Co L� . (I zis.iL S ,. DISPOSALIRECLAMATION REMAR.K/S:, __._.__� ` `1-. Sanitary Sewage ' 2:Wat uPP1Y _.` ` O Tgavn Sewer ublic O On-site OPrivattee '� 3. Indoor Floor Drains YES � NO O Holding tank:MDC_ 'Catch basin/Dry well dJort O On-site system 4. Outdoor Surface drains:YES NO ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system /,_--1— 5.Waste Transporter Qy� IINarne of Hauler Destination Waste Product •d YES -NO 1. 2. 1 —Perso (s) Interviewed Inspector Date r V 16'WN OF BARNSTABLE COMPUANCE: CLASS: 1. Marine,Gas Stations, Repair t BOARD OF HEALTH ) satisfactory 2. Printers 3.Auto Body Shops unsatisfactory- 4.Manufacturers COMPANY IT �C 4--� �� (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS '15 u��f�(;IgSS: � 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT-outdoors) MAJOR MATERIALS IN OUT IN OUT IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel Diesel, Kerose/e, 2 (B) Heavy Oils waste m or oil (C) .. , a new motor oil-(e /tran\smission/hydraulic Synthetic Organics: degreasers Miscellaneous: 1 sPA Ics ca , DISPOSAIJRE(7I.AMATION REMARKS: _ 1.Sanitary Sewage 2. Water Supply - O Town Sewer OPublic 11P On-site OPrivate 3. Indoor Floor Drains YES'X/—NO '0_Holding tank:MDC V,4u f_12 O Catch basin/Dry well 2 O On-site system ..� 4. Outdoor Surface drains:YES—No S ORDERS: O Holding tank:MDC O Catch basin/Dry well O On-site system i 5.Waste Transporter 6--40 Name of Hauler Destination Waste Product YES NO 1. 2. ' (,% Person (s) Interviewed Inspector Date TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1. Marine,Gas Stations,Repair Q satisfactory 2. Printers BOARD OF HEALTH 3.Auto Body Shops O unsatisfactory- 4.Manufacturers COMPANY � �a�C. �i 7-iof (see"Orders") 5.Retail Stores _ 6. Fuel Suppliers ADDRESS -36— 1v,+Aooe,y4 Class: J' 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS , -round 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) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers ,A,1Q�: '5 a/I-bIA!C� SoZ,D AG 6 L fi A /G i3 tS/� COOS/AJ& i Aj/ r V Miscellaneous: f G. e/ es C ZC„ A! dJ S T h " C,� tW ` P> 6, /�I/Sc��ZL ;�1�'"7! IJd C �2P>/� 1/�c SAP 7�� ,�c• ., 4, ,:TzJAl"rk3 >`C eU b bl 0 D 611+ L D.0 Roo cts i/fit 7-0 ;rAL CA' 5 i i /� 2 /�-r� �J�S �- f e4 S i !/ r2j/ rS �v A.I'S . Alb 4 Ale H X&V n E-(j /� �c�0Aij JS DISPOSALMECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply i#E P17 b i-/.qz5 e-e U7;VC /-YARInA TP-t�l O own Sewer OPublic o ��i5.- ,� Tf/C f'�sy� GL /tf FC 9 Pg�cA t�n-site OPrivate /J1_'.RdSAL. /o-4/A) N/ `;b pa,-z_ c ff&7YIC t5. 3. Indoor Floor Drains YES NO O Holding tank:MDC NCAj /Si °` O Catch basin/Dry well AA/b L41J " r/4 O On-site system P/20v/aFL DA) 17>C Pic 5PC_r_r70 Jv• 4. Outdoor Surface drains:YES NO ORDERS: Q Holding tank:MDC u 13l-i c- O Catch basin/Dry well ; n/op, "-r, O On-site system 5-0-: ,P V E-P A:�1 CA o,tJ v 1�- M JC S 1->OS,4 5.Waste Transporter Name of Hauler Des 6 n lition Waste Product Licensed? YES NO 1. 2. Person(s) Interviewed Inspector Dat Date: & `7 4 TOXIC AND HAZARDOUS MATERIALS ON-SITE INVENTORY NAMEOFBUSINESS: f��a-1 �p,�l-c'0 =r-vc. BUSINESS LOCATION: v7-6- S , �ZIGZrJt ,yLts .MAILING ADDRESS: i� ``' INVENTORY TELEPHONE NUMBER: 508 - S(o Z - Z`l L'1 a TOTAL AMOUNT: CONTACTPERSON: 64 EMERGENCY CONTACT TELEPHONE NUMBER: Flt�E pt 51�-- TYPE OF BUSINESS: ct -a OTHER INFORMATION: S ,Oe.� �z4_7" aza4's,7ctin�— e. . -' CAe s Waste Transportation• Name of Hauler: d i4w. Destination: Waste Product: A11A Licensed? Yes No LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. . . NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Observed ( Al ons V/ Antifreeze(for gasoline or coolant systems) Drain cleaners f .NEW USED Cesspool cleaners Automatic transmission fluid `5` Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils 6,'7.5 Pesticides , 6-u n *cider NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) "Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways& garages Wood preservatives (creosote) Battery acid (electrolyte) �catSwimming pool chlorine Rustproofers Lye or caustic soda Car wash.detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt& roofing tar Fertilizers =�a Paints, varnishes, stains, dyes PCB's 51 Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride)- Paint&varnish removers, deglossers as Any products roducts with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, � Floor�&furniture strippers Metal polishes hydrochloric acid, other acids Laundry soil &stain removers —� Other products not listed which you feel (including bleach) may be toxic or hazardous (please list): So�S �"_ 3 Spot removers & cleaning fluids Misc.: Cz Sb 2 S (dry cleaners) eat v C, `1. Other cleaning solvents �2CioCc'��" "9°7. _!9 � Bug and tar removers ® �•c 34A5- la �j 3, 2"S-& V TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAME OF BUSINESS: rs Po o L V- T-rO Mail To: BUSINESS LOCATION: 3S YAK S 0 J oa`o/Board of Health NGf� iP��'A��✓if�L' /ylA MAILING ADDRESS: -9A4E Town of BarnstableP.O. Box 534 TELEPHONE NUMBER: 5r49 — 6 � -axy-3 Hyannis, MA 02601 CONTACT PERSON: 1 O k n ►im b IV EMERGENCY CONTACT TELEPHONE NUMBE : Sod-S3/-339( Does your firm store any of the toxic or hazardous materials listed below, either for sale or for your own use, in quanty'ties totalling, at any time, more than 50 gallons liquid volume or 25 pounds dry weight? YES t,/ NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site other than your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store: Quantity/Case Quantity/Case Antifreeze (for gasoline or coolant systems) Drain cleaners Automatic transmission fluid Toilet cleaners Engine and radiator flushes Cesspool cleaners Hydraulic fluid (including brake fluid) Disinfectants Motor oils/waste oils Road Salt (Halite) Gasoline, Jet fuel Refrigerants Diesel fuel, kerosene, #2 heating oil Pesticides (insecticides, herbicides, Other petroleum products: grease, lubricants rodenticides) Degreasers for engines and metal Photochemicals (fixers and developers) Degreasers for driveways & garages Printing ink Battery acid (electrolyte) Wood preservatives (creosote) Rustproofers Swimming pool chlorine Car wash detergents Lye or caustic soda Car waxes and polishes Jewelry cleaners Asphalt & roofing tar Leather dyes Paints, varnishes, stains, dyes Fertilizers (if stored outdoors) Paint & lacquer thinners PCB's Paint & varnish removers, deglossers Other chlorinated hydrocarbons, Paint brush cleaners (inc. carbon tetrachloride) Floor & furniture strippers Any other products with Poison" labels Metal polishes (including chloroform, formaldehyde, Laundry soil & stain removers hydrochloric acid, other acids) (including bleach) Other products not listed which you feel may Spot removers & cleaning fluids be toxic or hazardous (please list): (dry cleaners) Other cleaning solvents Bug and tar removers Household cleansers, oven cleaners White Copy- Health Department/ Canary Copy-Business i TOWN F B Essa O ARNSTABLECOMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops satisfactory- 4.Manufacturers COMPANY.� �S � e"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS 33� U Class• 7.Miscellaneous UANTITIES AND STORAGE (IN= indoors; OUT=outdoors) MAJOR MATERIALS 1 IN OUT IN OUTI IN JOUTI#&gallons Age Test Fuels: Gasoline Jet Fuel(A) Diesel, Kerosene, #2(B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: f v-r_- Z e, 1-a 3 DISPOSAURECLAMATIONREMARKS: 1. Sanitary Sewage 2.Water Supply Cr e 1 O Town Sewer *ublic U "n-site OPrivate 3. Indoor Floor Drains YES N0__�L ? O Holding tank:MDC -� O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES_YNO OPT RS: O Holding tank:MDC Catch basin/Dry well On-site system 5.Waste Transporter YES NO 1. 2. ` Pe s Interviewed Inspector Date L . V Date: � (� (, TOXIC AND HAZARDOUS MATERIALS REGISTRATION FORM NAMEOFBUSINESS: � � ® skoaLIPA-Poo 0 BUSINESS LOCATION: Y6 Al 0 q )W/0 V MAILINGADDRESS: Mail To: TELEPHONE NUMBER: Board of Health . � Town of Barnstable CONTACTPERSON: P.O. Box 534 EMERGENCY CONTAC TELEPHONE NUMBER: Hyannis, MA 02601 TYPE OF BUSINESS: OD Does your firm store any of the toxic or hazardous materials listed below, either for sale or for you own use? YES NO This form must be returned to the Board of Health regardless of a yes or no answer. Use the enclosed envelope for your convenience. If you answered YES above, please indicate if the materials are stored at a site otherthan your mailing address: ADDRESS: TELEPHONE: LIST OF TOXIC AND HAZARDOUS MATERIALS The Board of Health has determined that the following products exhibit toxic or hazardous character- istics and must be registered regardless of volume. Please estimate the quantity beside the product that you store. NOTE: LIST IN TOTAL LIQUID VOLUME OR POUNDS. Quantity Quantity Antifreeze(forgasoline orcoolant systems) Drain cleaners NEW USED Cesspool cleaners Automatic transmission fluid Disinfectants Engine and radiator flushes Road Salt (Halite) Hydraulic fluid (including brake fluid) Refrigerants Motor oils Pesticides NEW USED (insecticides, herbicides, rodenticides) Gasoline, Jet Fuel Photochemicals (Fixers) Diesel fuel, kerosene, #2 heating oil NEW USED Other petroleum products: grease, Photochemicals (Developer) lubricants, gear oil NEW USED Degreasers for engines and metal Printing ink Degreasers for driveways & garages Wood preservatives (creosote) Battery acid (electrolyte) wimming pool chlorine Rustproofers Lye or caustic soda Car wash detergents Jewelry cleaners Car waxes and polishes Leather dyes Asphalt & roofing tar Fertilizers Paints, varnishes, stains, dyes PCB's Lacquer thinners Other chlorinated hydrocarbons, NEW USED (inc. carbon tetrachloride) Paint & varnish removers, deglossers Any other products with "poison" labels Paint brush cleaners (including chloroform, formaldehyde, Floor & furniture strippers hydrochloric acid, other acids) Metal polishes Laundry soil & stain removers Other products not listed which you feel (including bleach) may be toxic or hazardous (pleas%list): Spot removers & cleaning fluids (dry cleaners) 4 0 Other cleaning solvents Bug and tar removers WHITE COPY-HEALTH DEPARTMENT/CANARY COPY-BUSINESS s � w ME Pool& Patio,Inc. 35 IyAM9h RoGdAtouto 28 HAnfib,MA 02601Did 4— ox fir► ,� P x �y a. 4 k e 'pace 4 5� J 5i ` �I J -F r �c.,.� h .•i��::J �' 4 � OIL I I r r eW dtt,,�fr • �` d� erJ i 1t cL b e. tk 4 �r yo �. 4 i& Q/1 Ca rro s)ve. �q • �� .....c. e..'xsfiS�9"� 6?#'h, ! /t-KV."'Ot+w.XS".k'g1". L �. -.riFy??,F"tM`'y,,^2.67�' '}" r` y,• y�!B}�'� M�'" Rt'4MY!°1A1Kwri apt: tt yy t E4&"`. f �Cx'\I `� . . `,"'�L P8�"i r,•' # A4�3��.s '�K'�'��'�,�`yYd+�� "';i�y .. �z �rl � , $; ! a, 1 J )01"Itt o xi �y1 1 d roCh oric jai d torresi Vit s, yd JO-h paa~axi�e o><3J;zer X1, $ t`c rC'h /oro —s - r � �+ri one — on;ifJter tih '.i�P F .0 d a oA = eXi �te•� , t d7�lnoCl1lOhe — drMC — C y/1� � � � .x6a n err 3 a p t,f.? gg' 7w,t a w WANNISI R VENTION BUR b R1'MENr YANK �t R0. a �80J A a fix 508.962.0269 phone 1.900.817.2440 phone 308.862.4440 q, `� fir&p+ fl :fir TOWN OF BARNSTABLE O LdANCE: CLASS: 1.Marine,Gas Stations,Repair BOARD 2.Printers F HEAL H© factory 3.Auto Body Shops p nsatisfactory- 4.Manufacturers COMP 0 0� POOl, 0\6V (see"Orders") 5.Retail Stores 6.Fuel Suppliers ADDRESS Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN=indoors;OUT=outdoors) utTd MAJOR MA�IALS / ; nks IN OUT IN OUTI IN OUT #&gallons Age Test Fuels: Gasoline,Jet Fuel (A) Diesel, Kerosene, #2 (B) Heavy Oils: waste motor oil (C) new motor oil(C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: U , c;;,,— DISPOSAIJRECLAMATION REMARKS' / o �� &A 0 C� 1. Sanitary Sewage ater Supply C" / l I Town Sewer ublic On-site OPrivate 3. Indoor Floor Drains YES N0 O Holding tank: MDC O Catch basin/Dry well O On-site system 4. Outdoor Surface drains:YES NO O R o b O Holding tank: MDC1,0A O Catch basin/Dry well O On-site system 5. Waste Transporter Name of Hauler Destination Waste Product YES 4 NO 1. 2. ers n (s) terviewed Inspector` ate �l 1n 4 of,to . JT's POOL & PATIO, INC. 35 lyanough Rd.-Rte.28 Hyannis,MA 02601 John Tremblay 508-862-2440 800-817-2440 Fax 508-862-0269 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Statim4Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops t O unsatisfactory- 4.Manufacturers COMPANY T� �� f (see"Orders") 5.Retail Stores -par)1 j 6.Fuel Suppliers ADDRESS 15 �,tt-c.�.4.; t Class: 7.Miscellaneous QUANTITIES AND STORAGE (IN= indoors;OUT=outdoors) MAJOR MATERIALS ,. IN OUT IN OUTI IN OUT #&gallons Age Test Fuels: Gasoline Jet Fuel(A) Diesel, Kerosene, #2(B) Heavy Oils: waste motor oil (C) new motor oil (C) transmission/hydraulic Synthetic Organics: degreasers Miscellaneous: -h' p( C('4 40�,kp_w L� .,4 f5 ��. 9'a lS 1�1 Q,ck DISPOSALIRECLAMATION REMARKS : 1. Sanitary Sewage 2.Water Supply O Town Sewer 1ublic (- ` ,t--f A / r, �� ^�q Won-site ()Private r l' I s .jec f1d C Ci ��'e t.Q n. ��C _c/ 3. Indoor Floor Drains YES N0 S t SQ d Z 0 Holding tank:MDC� 0 Catch basin/Dry well QV7' Qf 0 On-site system 4. Outdoor Surface drains:YES_)!� _NO ORDERS: 0 Holding tank:MDC Z ! r„ To clav f. 0 Catch basin/Dry well Yon-site system 5.Waste Transporter Name t t � YES TO 1. 2. IAMA r.60 %yam erson erviewed Inspector Date nu y. J JT's POOL & PATIO, Ific. 35 lyanough Rd.-Rte.28 Hyannis, MA 02601 Martha Tremblay 800-817-2440 508-862-2440 Fax 508-862-0269 TOWN OF BARNSTABLE COMPLIANCE: CLASS: 1.Marine,Gas Stations,Repair satisfactory 2.Printers BOARD OF HEALTH 3.Auto Body Shops „ � unsatisfactory- 4.Manufacturers sI COMPANY V✓ -'5 � � �a ® (see"Orders") 5.Retail Stores �,�^ 6.Fuel Suppliers ADDRESS �_ �/ r�c�ll� � .J Class: � 7•Miscellaneous NTITIES AND STORAGE (IN=indoors;OUT=outdoors) MAJOR MA RIALS AAw IN OUT IN OUT IN OUT #&gallons Age Test G a-- ' . waste-mvtePvl -(C) Le 5 t s y�aulic� degreasers' Miscellaneous: CA JJL�� --4'jt 4_9 ,A DISPOSALIR.ECLAMATION REMARKS: 1. Sanitary Sewage 2.Water Supply 9 i O own Sewer 4fublic On-site OPrivate Indoor Floor Drains YES ENO 0 Holding tank: MDC_ Catch basin/Dry well 0 On-site system 4. Outdoor Surface drains:YES—ZNO ORDERS: 0 Holding tank:MDC atch basin/Dry well 0 On-site system 5.Waste Transporter YES NO 2. erson (s) InterviewA Inspector Date SENT 6- 4-96 ;11 :07AM ; 5087785448-► ;# 1 HYA100 FIRS DUA►RTAUM = 95 HIGH Sqi MROAD WIMIDM - - HYANNIS, MASS. 0=11 PAUL ACRISHOUACM FIFE PREVENTION BUREAU LT. DONALD H. CHASE,JR, LT. ERIC HURLER UaPector Inspector TELECOPIER TRANSMISSION COVER LETTER SENT TO: �' rAW4 440;*041 a/,O,` SENT FROM: z . 30'v,� SUBJECT: s L NUMBER OF PAGES, INCLUDING COVER LETTER, BEING TRANSMITTED PLEASE CALL 775.1300 TO CONFIRM THIS TRANSMISSION [1 YES [] NO This fax transmission may contain confidential information belonging to the eider which is legally privileged and which is intended only for the um of the individual or entity mmed above. Atny eo�yT&dbdosum distribution,or dissemination of this information or the taking of any action barred on the mntent o this communication is strictly prohibited.cri+etYu you vteoved this tranamisaion is eater,please notify vs immediately by telephone and return the brigutal y snail or delivery at our address above,the out of which shall be paid by us. Thanks I FIRE DEPT. 775.1300 I TOWN LINE 790.6328 1 EMERGENCY 77S.2323 FAX 508.778-8448 J SENT BY: 6- 4-9.6 ;11 :08AM --50877864484 ;g 1 jrs Pool & Patio,Inc. 35 Iyanough RogdAtwte 28 Hyannis,MA 02601 'ylann Is 9s" #14 k Dab 0 betv- Dolt r I arc �j� axid i a.cr.r lowr ' ,, p l.%�1emi ca / t".hi ole oxi Ji tter -cc Is, p+ ro eh eraXi�e -- cX)Jizer I -�p4,7-Ike, dr ,Qro ir►o C��O he d�� 1 y �/ Aaars Fj#j � vENrroH eu M 74 JKJ ooc rmENr YANN �' � . MA OZ601 fax 508,962,0269 phone 1.900,817,2440 phone 509.862,2440 Town of Barnstable . �o�tNE 10�ti Regulatory Services Thomas F. Geiler,Director BARNSPABM ' Public Health Division r i639' �0 '°rFnnn�+°i Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 - Office: 508-862-4644 Fax: 508-790-6304 Application Fee: $100.00 ASSESSORS MAP AND PARCEL NO. DATE APPLICATION FOR PERMIT TO STORE AND/OR UTILIZE MORE THAN 111 GALLONS OF HAZARDOUS MATERIALS FULL NAME OF APPLICANT Y , NAME OF ESTABLISHMENT -T'( 5 Pont g. LAth ADDRESS OF ESTABLISHMENT 35 ak cx n Q OU TELEPHONE NUMBER S C S t 6 r a N (� ' SOLE OWNER: YES NO IF APPLICANT IS A PARTNERSHIP,FULL NAME AND HOME ADDRESS7-'.Wr-60Vff—D PARTNERS: N 2 3 2002 OWN OF BARNSTABLE HEALTH DEPT. IF APPLICANT IS A CORPORATION: FEDERAL IDENTIFICATION NO. O14:3- 3 Q 5- Al STATE OF INCORPORATION CYl�I i FULL NAME AND HOME ADDRESS OF: PRESIDENT -tl(1 I ieCtl I C°�,� 530 CC��i )�� (� Oaf Ot15 �'f1111,s 01(l A TREASURER " CLERK 1 SIGNATUREUFAP�PLIANT RESTRICTIONS: HOME ADDRESS.6 �6 Naf.1)05-hM3 s I HOME TELEPHONE# E e SUa r Haz.doc/wp/q CI No.. �5 ...... F�m....Z............ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH 3 / __..._�0-Wk/.---OF.................. T Apphration -fur Biuvuual Workii Touutrurtiuu Prrutit Application is ereby made for a Permit to Construct ( ) or Repair ( an Individual Sewage Disposal System t / /P�ocati - ddress or Lot No. ------------------------------------ ` �y Ajer Address Installer Address dType of Building Size Lot --------------------------Sq. feet U Dwellin —No. of Bedrooms -- ---•-•• _ ausion Attic ( ) Garbage Grinder ( ) aOther-�"Type of Building .. . 1Vo. of persons. Showers ( ) — Cafeteria ( ) Otherfixtures --••-- -------•-••--•--------•-•-------------------- -------------------•------------------------•••--•---------------•----•---------------•------- W Design Flow........................................ gallons per person per day. Total daily flow.........................................---gallons. 9 Septic Tank Liquid capacity/ allons Length________________ Width................ Diameter---------------- Depth---------------- Disposal Trench—No. _-- "- idth-------------------- 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........................ 1 Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water------------------------ --------- 0 VIr--------------••- ------------ - - g ---- ---------------- Description o oil---- -----•---- • 0. . --- ---- ------- ---/40--------- •-- U - ----- - - Of, ------- w At-------- -- - -- U Nature of epairs or Alter. ons Answer when plicable_____ .. --- ______ --- __J____f_ .._ - - Agreement: f�� The undersigned agrees to install the aforedescribed Indivi al Sewage Disposal System in accordance with the provisions of Article \I of the State Sanitary ode The u signed further agrees not to place the system in operation until a Certificate of Compliance has bee iss e by t b rd of health. Signd-- •••-- ---- •-------- ------------------------- ------------ ------ ------------ Dat q�7.Ye Application Approved By._ ' �.__ f. l _ Date Application Disapproved for the following reasons:--------------------•----7--•---------------------------•--•------------------------•-------•--------- ..............•----------••---------_._...--•-------------•---•-••......--•-•--------•--••-••----•-•-•-•-...-------------_....---•-•----•-•-•-------------------------•----_...._.......•----••••--.----- Date PermitNo......................................................... Issued---------------------- ----------------------------•_ Date No.... w THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _ - BARNSMABLE......... ....................... , pphrtttion -fur Uiupuuttl Works Towitrurtiutt Vantit Application is hereby made for a Permit to Construct ( ) or Repair (/` an Individual Sewage Disposal System att: ....................................................' �,...-/..t..__.._......_..................... ......._.._____._............................................................................... , (/ j Location-Address or Lot No. Owner Address ----------------------------------------------------------------------------- V _ Installer — Address dType of Building Size Lot_ ________________________Sq. feet Dwelling—No. of Bedrooms.._.............. ...... L pansion Attic (- ) Garbage Grinder ( ) `4 Other yT e of Buildin �t dam® v�� a YP Building� 4_e No. of persons-•----------------•-•._-.--- Showers ( ) — Cafeteria ( ) Other fixtures ....... ----- ----------------•--------- --•--•--•------- -------------------------------- .--.------------•-------•---•-------•-----.-------•-••-•----- W Design Flow. ......................................,.i..gallons per person per day. Total daily flow.............._.__-_-_______-_____--.--._...gallons. WSeptic Tank—Liquid capacity ltgallons Length________________ Width................ Diameter................ Depth:.---_-___.----- x Disposal Trench—No. .................... 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 "Pest Pit.................... Depth to ground water_.-__---__.--._------- 1:14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water__.-.._--_---_-__-_--__. ------------- r - - ° ------- --- --- ------•--•--- ..... •.........__......._.. -••--•-} / 1 ----- -- _ G D Description of Soil-----�._..-_�°r-d�-�------..__!_..�� .�ft�-�__�._�_-'(�-�z----'-------'�r...........----- �L�•-- x V" � '`' � :�_ ! /_ = = f r � ?�° < 1`�' � M ' ------------r v .:- � ry= J ... V Nature of Repairs or Alterations—Answer when applicable.----------------------------------------------------------------------------------------------- -----------------•------------••--•------ -------.-------------------------••---•-----•-----------------•------------------------.._-_-..------•----•-••--•-•--•-----------------------------------•--- Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary Code-)The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by hX board of health. ,. Signed ti `i' _.. � `,�"-•�. - t -�J_ter ----------------------- •. •---••---••------- ----_----- Date A lication Approved B %%< . r" i� ... = ��--' PP PP Y... �r -.Application Disapproved for the following reasons___________________________ _________________________________ ------------------------- Date-----•-------- -------•--•-•---------------------•-••----•-------------------•----------•---------------•-•------------•--------•-•----•---•--••--••---•-------------------------------------------------------------•- Date A ,, . PermitNo........................................................ Issued---------------------------------------------------------- Date THE COMMONWEALTH OF MASSACHUSETTS ' BOARD OF HEALTH ................ ...1-t�.c. .......OF.................. BARI�ISTABLE............................. Cnrdifirttte of VTomphaurr THIS IS TO CE-RTIFY_,That the Individual Sewage Disposal System constructed ( ) or Repaired by. ---------- . ..................................................-------------------------------------------------------------------------------•----••-•---•----- � / / i+" ��yr_ Installer eyat.---•••--•_.>d...a,------------- -----------------•-•------•---------•-------•----•--•-•-•---•-••-------------------------------•--------------------------•---.----- �° has;,heen installed in accordance with the provisions of Article XI of The State Sanitary Co e a described in the apglic«tion for Disposal Works Construction Permit No._-__ Jr(,¢_____________________ dated:.. . •.? '�_._._.................. . . .. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A ARANTEE THAT THE SYSTEM' WILL FUNCTIO1 SATISFACTORY. DATE------. -. ° -- .7.3;--------------------•--------•-. Inspector------ ---- - ------------- THE COMMONWEALTH OF MASSACHUSETTS BOARD, OF HEALTH 11Z :.�. ......O F...........BA1�lYSTABLE................... . No. ��•- --•-•••• FEE-- `:................... M£: �� i��u�ttl furk,�";(nu�t�trttr�i�it �rrmit Permission is hereby granted /-- - "F�.._.. ...��. •--------•................. -•-------•-••----•-•--- _._ _.__F _____...................................... -........ to Constructs( ) or Repair,,( an Individual Sewage Disposal System atNo. ? . ,' -- ----- ------------------------------ -------------- ---- - --- -- ---------,. {' treet as shown on the application for Disposal Works Construction P it Dated_ ............... r 1, Board of Health DATE........ —------2-- � ............................ i, FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS ° c3'K a sel rib CL y 4 - k{4 p ++ 41 0� IK o� a CP 'ff ' ® ♦♦♦ 0 N ` 0co / ui h% ,�,• �, N M Z 00 AD T\I ehy r-X --AA ,r`po N M y0 � r r <. aka ps 110 � r„ „';.. ;: ,,, ..M.:.,l .e:.��x ','.- '�� + �;�. w ,+s t�"^' '�ar+,-•-�. :�'-r'�.}^v' '�"��"`SV+.i�C^'TN'a.��'.v� � ��,x:k R .. a #� r 7 ,� �s:•�; t �yd�l: •,a. N'-+- ,,i - d f n 44 �. - a' �r• .�ne� s •Gow d3$ :Rs?,.'' pA'', *'.S;,s�,2. " ; 4�± �s. w r �� r:x�'"tea�� a ��" �� `:. � • #S'., +c. •. .,;. ._:F• "- a`r 'A'�`gg;� s3 is 'rr.,. «z e n �.. � w �0. (Sys e�rn � . v. � Y ,.r Cfi 4 �� - .'` ° $ EN::@ 'Y `.#3 .^4 Yj fig. «4.. L. - f � t t:'ar to S'�'✓.i '"� a��.t:tN�� ' x ,._." ry � �:} .,a'>ki'�, - � ��q` � �,:° "�F- tY��*.� :c�..,�a h`t:e,< °'4,.a��:«.,•�("t '":S'', '*c. n `Ft_ f'�.-Fo yr ,�y�.. , `i `�> u�µ t'$,. : � »� ^_� ' ,r �,7.#,�::: °. -g..i ss 4 'a•'g, - 4a . :.9r _ i4" tR r,e * ;'35iP.,m. -f.,'Se' �, ....:3i '. t '� _ E .� fi" ._ .a a - 'a *z '.- - :,- a d. £ N p #sue �` e. � 't,d #y �`6�&€[4 ;? ; �3. !a. e_ '+_, y dr >F ti;*..;R .4 b �:ar�•5�«��:.'�_ �'u', -�`-. f�k i _ R �``�•.,., n:D _ .s& .r ''", _s �p 4^i i_.: -,,...t` . T _ „ >�. _... r' r-4.`.Yg'�'; r4'Y�S�d'�,�,,,ay�,,.,yK ,S,�nh��k�]' .-.^...�' f _"'"6•:,� 1• � S �..+Y, 1 Y {: +� rye,yjrr L'4'?i t'S""�: � '� ;��a � �m3'7° - a. �i:�. '"�t,� _•� u�., �y�R : 4 I\!II \\PI 0T\007 .07'1 PUT.dw(,, •6 j 5/.200(9 10: 15'28 AM,. 1: 2.26093, f,, 1 AT Y J LAND COURT PLAN 11685C tA \ '`, • \ •, ,'O -9i \ r Z-1O ,pry 13 at ir EM \ �l � / � / ��if, r,,•`' _ _ � — — ,\ .;�• /; !, ,//•,te, iD mil. a r , ABBREMTKM EXCAVATIONJILL NOTES: GRADING AND DRAINAGE NOTES: am Bottom OF GE1m 1. SNP SLOPES OF TRENCH EXCAVATIONS DEEPER THAN 4 FEET SHOULD 1. THE PROJECT ELEVATIONS ARE BASED ON AN ASSUMED VERTICAL BOB BOTMM OF SLOPE BE FLATTENED (AS REQUIRED BY SITE CONDITIONS) TO AT LEAST 1HAV OR DATUM (FROM GIS MAPPING). onSUPPORTED WITH TRENCH BOX OR SIMILAR DEVICE. ALL WORK SHALL BE PERFORMED SAFELY AND IN ACCORDANCE WITH OSHA AND MOSHA 2 DEBRIS, STUMPS, EXCESS, AND UNSUITABLE MATERIALS FROM THE FF FINIM FLOOR ELEVATION REQUIREMENTS. CLEARING & DEMOLITION OPERATIONS SHALL BE REMOVED FROM THE SITE AND DISPOSED OF IN A LEGAL MANNER BY THE GB GRME BREAK 2. AFTER REMOVAL OF TOPSOIL AND INADEQUATE MATERIALS, GENERAL FILL CONTRACTOR 1P H(il PONT SUBGRADE SHOULD BE PROOF-ROLLED WITH A LOADED 10-WHEEL LP LM PWrT TANDEM-AXLE DUMP TRUCK. THE PROOF-ROLLING SHOULD BE PERFORMED 3. DISTURBED AREAS SHALL BE PROTECTED AT ALL TIMES TO AS DIRECTED BY A GEOTECHNICAL ENGINEER, NO FILL SHOULD BE PLACED CONTROL SEDIMENT TRANSPORT BEYOND THE LIMIT OF WORK. Ta TO OF CURB UNTIL THE SUBGRADE IS APPROVED BY A GEOTECHNICAL ENGINEER. TOY 7OP OF IMIL BORROW MATERIALS FOR FILL OPERATIONS FOR GENERAL SITE GRADING 4. DISTURBED AREAS SHALL BE TREATED MATH WATER DURING SHOULD MEET AASHTO DESIGNATION A-2-4 (CLASS 111) OR MORE EXCAVATION, OR APPROVED ALTERNATIVE, TO CONTROL THE DUST. GRANULAR AND BE APPROVED BY A GEOTECHNICAL ENGINEER. ALL FILLS SHOULD BE CONSTRUCTED IN 8' LOOSE LIFTS AND COMPACTED AS S. ALL DISTURBED AREAS NOT OTHERWISE TREATED SHALL BE STABILIZED FOLLOWS, UNLESS OTHERWISE NOTED IN PROJECT SPECIFICATIONS:. 6' LOAM, SEED, & MULCH. THE CONTRACTOR FILLS SUPPORTING FOUNDATIONS AND FLOOR SLABS, 95% OF ASTM SHALL BE RESPONSIBLE ONSIBLE FOR AREAS UNTIL VEGETATION HAS BEEN D-1557 (AASHTO T-180) PERMANENTLY ESTABLISHED. SLOPES IN EXCESS OF3:1 SHALL BE -` TOP 12 INCHES OF ROADWAY SUBGRADE, 95% OF ASTM D-1557 FURTHER STABILIZED WITH EROSION CONTROL BLANKETS (ECB) OF L. (AASHTO T-180) CURLEX OR EQUAL. \ - RETAINING WALLS AND FILLS WITHIN ROADWAY (BELOW TOP 12 INCHES), 6. ALL DRAINAGE STRUCTURES AND PIPING SHALL BE DESIGNED AND Oil- �\� ,� 92% OF ASTM D-1557 AA.SHTO T-180 ` ( ) INSTALLED FOR H-20 LOADING. - FILLS IN GREEN SPACE, 85% OF ASTM D-1557 (AASHTO T-180) FILLS FOR PIPE EMBEDMENT (BEDDING, HAUNCHING AND INITIAL 7. A 25' MINIMUM SEPARATION SHALL BE MAINTAINED BETWEEN ALL BACKFILL),952 OF ASIM D-1557 (AASHTO T-180) PROPOSED STORM WATER MANAGEMENT INFILTRATION FACILITIES AND SANITARY SEWER/SEPTIC SYSTEMS., 8. CONTRACTOR TO VERIFY IN FIELD, WITH ENGINEER PRESENT, SOIL Ilnl� NOTES: INFILTRATION RATE PRIOR TO COMMENCEMENT OF CONSTRUCTION P,_�r (ASSUMED 6 MIN./IN. INFILTRATION RATE). IF RATE VARIES FROM 1. CAUTION: THE CONTRACTOR SHALL CONTACT DIG SAFE (A7 ASSUMPTION, SYSTEM MAY HAVE TO BE REDESIGNED AS DETERMINED Yl rn� 1-888-DIG-SAFE) AND UTILITY COMPANIES TO LOCATE ALL EXISTING BY THE ENGINEER. UTILITIES, AT LEAST 72 HOURS PRIOR TO THE START OF 9. CPP - HIGH DENSITY POLYETHYLENE CORRUGATED PIPE WITH CONSTRUCTION. THE CONTRACTOR SHALL DETERMINE THE EXACT SMOOTH INTERIOR WALL TO MEET ADS N-12 PIPE SPECIFICATION OR LOCATION, BOTH HORIZONTALLY AND VERTICALLY, OF ALL EXISTING EQUAL. CPP PIPE USE SHALL BE ALLOWED AS NOTED, WITH A r1 UTILITIES BEFORE THE START OF ANY WORK. THE LOCATION OF DIAMETER UP TO AND INCLUDING 24. BACKFIWNG CPP MUST EXISTING UNDERGROUND SYSTEMS, INFRASTRUCTURE, UTILITIES, FOLLOW MANUFACTURER'S RECOMMENDATIONS AND SPECIAL CARE MAYDNOT BE LIMITED TO THOSE SHOWN HEREIN AND HAVE NOTLBEEN UITS AND LINES ARE SHOWN IN AN APPROXIMATE WAY Y. MUST BE EXERCISED (SEE ADS PRODUCT NOTE 3.115). P<_iE c_A INDEPENDENTLY VERIFIED BY THE OWNER, THE ENGINEER, OR ITS REPRESENTATIVE. THE CONTRACTOR AGREES TO BE FULLY RESPONSIBLE SPECIFICATIONS ALL PIPE INSTALLATIONS PIPE SHALL FOLLOW PROJECT FOR ANY AND ALL DAMAGES WHICH MIGHT BE OCCASIONED BY THE SPECIFICATIONS AND PIPE MANUFACTURER RECOMMENDATIONS. CONTRACTOR'S FAILURE TO LOCATE SAID SYSTEMS, INFRASTRUCTURE 11. UNSUITABLE MATERIALS ENCOUNTERED ADJACENT TO SOIL �LE�_-_-i5.OD AND UTILITIES EXACTLY. IF ELEVATION INFORMATION DIFFERS FROM INFILTRATION LAYERS SHALL BE REMOVED FOR 5 FT AROUND THE PLAN INFORMATION, THE CONTRACTOR SHALL NOTIFY THE ENGINEER. INFILTRATION SYSTEMS AND REPLACED WITH SAND BORROW PER MHD \. IMMEDIATELY FOR POSSIBLE REDESIGN. AT UTILITY CROSSINGS, VERIFY M T G4 0 TYPE S. IN FIELD THE LOCATION AND INVERTS OF WATER, ELECTRIC, GAS, TELEPHONE & DATA/COMM AND RELOCATE IF CONFLICTING WITH 12. IN ORDER TO PRESERVE THE INFILTRATION RATE OF THE SOILS PROPOSED INVERTS PER THE ENGINEERS DIRECTION. THE CONTRACTOR IN THE BASINS, ALL AREAS CONTRIBUTING RUNOFF TO THE \� SHALL PRESERVE ALL UNDERGROUND SYSTEMS, INFRASTRUCTURE AND PROPOSED INFILTRATION DEVICE MUST BE STABILIZED PRIOR TO THE iI UTILITIES AS.REOUIRED. DEVICE RECEIVING SURFACE RUNOFF. 2. 12' MINIMUM VERTICAL CLEARANCE SHALL BE MAINTAINED BETWEEN 13. MAINTENANCE OF THE STORMWATER MANAGEMENT FACILITIES ALL UTILITY CROSSINGS. SHALL BE IN ACCORDANCE WITH THE EXECUTED INSPECTION AND MAINTENANCE AGREEMENT FOR PRIVATE.STORMWATER MANAGEMENT 3. SEWER, WATER, GAS, ELECTRIC &, DATA/COM IS SHOWN FACILITIES AND SHALL BE THE RESPONSIBILITY,OF 1HE OWNER AND SCHEMATICALLY HEREON. NO WORK.IS CURRENTLY PROPOSED FOR THE ASSIGNEES. THESE UTILITIES. 16. THE CONTRACTOR MUST NOTIFY THE BUILDING DEPARTMENT AT 4. ALL UTILITY CUTS THROUGH EXISTING CONCRETE OR BITUMINOUS CONCRETE PAVED SURFACES SHALL BE SAW CUT. BACK FILLING OF LEAST TWO (2) DAYS PRIOR TO THE START OF CONSTRUCTION. TRENCH SHALL INCLUDE 12' IN DEPTH FLOWABLE FILL TO THE BASE COURSE OF THE SURFACE TREATMENT. THE SURFACE TREATMENT SHALL THEN BE REPLACED IN KIND. Kr CEL-2 CONSTRUCTION SEQUENCE 1. CLEAR AND PERFORM DEMO OPERATIONS FOR SITE WITHIN THE LIMIT OF WORK. 2. ESTABLISH ROUGH SUB GRADES FOR PARKING AREA AND ROADWAY. 3. PERFORM BUILDING AND SITE CONSTRUCTION 4. ONCE ALL DRAINAGE STRUCTURES ARE INSTALLED. INSTALL INLET PROTECTION AND MAINTAIN THEM UNTIL PAVEMENT IS,IN PLACE AND ^� -- VEGETATION IS ESTABLISHED. • �.. SFTE LOCAipN: •T 4Cr S. INSPECT AND MAINTAIN EROSION CONTROL MEASURES AFTER GUARANTEED EED FRESH PRODUCE RAINFALL EVENTS AND A MINIMUM OF ONCE PER WEEK. 35 IYAMMOUGH ROAD/ROUTE 20 6. REMOVE SEDIMENT BUILDUP AT EROSION CONTROL DEVICES AS NEEDED, REDISTRIBUTE MATERIAL OVER SITE IN CONFORMANCE,WITH, EARTHWORK EARTHWORK SPECIFICATIONS_ ADM WEINER 7. ALL CUT AND FILL SLOPES SHALL BE TEMPORARILY STABILIZED WITH 85 OLD YARMOUTH ROAD HYAMMIS,MA OMi TOP SOIL, SEED AND MULCH OR CURLEX AS REQUIRED IF CONSTRUCTION ACTIVITY CEASES ON SAID SLOPES FOR A PERIOD OF (SM)77149N I , FOURTEEN.DAYS OR GREATER. ALL SLOPES SHALL BE PERMANENTLY ST ABILIZED DINNZED AS REWIRED IMMEDIATELY UPON COMPLETION of FINAL GRADING, DRAINAGE AND UTILITY PLAN. B. COMPLETE FINISH GRADING AND STABILIZATION OF SITE. PLACE FINAL PAVING COURSE. 9. REMOVE SEDIMENT FROM ALL DRAINAGE STRUCTURES, DRAIN BAXTER NYE ENGINEERING&SURVEYING MANHOLES. PIPES AFTER COMPLETION OF CONSTRUCTION. Registered Professional Engineers and Land Surveyors, 10. REMOVE INLET PROTECTION UPON ESTABLISHMENT OF PERMANENT 78 North Street-3rd Floor,Hyannis,Massachusensowl GROUNDCOVER. ' Phone-(508)771-7502 Fax-(508)7714622 20 0 20 40 SCALE IN FEET Fn DATE:.03/19/08 ® SOM AZAN REQ'AWMIENT FILM Cm5 NO. BY DATE REMARKS 0:\2007\2007-071\CML\PLoT\2007-071 Our dw9 2Do7-071 1 { I l I , j1 -4 I { 7 tu 17 I of } ++II 4 All J • � � h l� i:1.� C�, t J � I 1 �-n 1 ', I o �.1 _ g I) .� ..� :..•<,.... -�,�. -� n,H.ro;�- Ma:.' :-.¢ 4, tBta .. .,...a.. _. uF::.. .aN. a ..:..e .-- *am _ .. •v- •, -::'.-vim. w ''•' �,: - ,� wa wN Xt tissv:am-sn.'wr>�+?wiu w uwra,rti 7 C.' .. t;4A .P �,.p ft,4'or,•�.Y fSE..3�+per o.`: •Y,O/+W:4-.;,t . 4 __ .. ._._... a— i p + 1 ki Q �J � �_... •_ :�� Nam---_ ,��x r ` ` _ �� o T oi�,E '°vy DU"` _L_ 336. 35 t r . VE Af i i i B 1 i `� A r ` �L .� l .. /, a ".':.� ?C P ! t°.4 w`,. 'G •'i:;.i,jj 1 �-�i �.� / 6 � ��/ r � --,e-----c „, ,�`,,,.— / � � C� f -J r� /�r. �I r r ' � r a i T Y Il f - I L ..t: V/C7 1 e fi S_(' - — ..-.-- ---- ----- -.._. - - _ ._.._ - -.. - ------�. - - ------- ---- - 1 I ii - . /Od0 ydC. TA�,C � f .._.,. .- .--...J t 't ✓ � �-_'__. .r.. Here..,.u�.w.:r.�o+...,«,w.....k«..r•.:,.w....W,.,�w..�.,•,w„ww.*.weu*.�..+..Rr-.w...:wra,�,n«.wr.=,.uw..,:.•�� ..,_,w-,... 1 Te t 1. a. VA 9 0 fo M Q C * ) 14V A44 °1i F N¢, , EV)GAR y F- F- � T _ ��.i f t r F°t' 4�� "+�. lit r_ r4. .:'.ixr.. 'x �k i', � ' Pr��"`' �•r'".�b� .i �� , ,^t*a �''�ua�is��"ab7aMr8�a�ee"�� e.�� ,'�:".s a1F R.