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Home My WebLink About0042 PINEWOOD AVENUE - Health 42 PINEWOOD AVENUB,'HYANNiS A=289 - 159 a l �p THE l ATE: Z ci ftv • BARNSPABLE. • ' 1r� 059. `�MASS. � SEC Noll BY 1 1 Town of Barnstable J l006FB. ,% 5CHED. �FE`PT. Board of Health 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Susan G.Rask,R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION 2mw �Property Address: Assessor's Map and Parcel Number: 2!99 — Size of Lot: O e. Wetlands Within 300 Ft. Yes Subdivision Name: No Business Name: APPLICANT. \ CONTACT PERSON— Name: IVLlL`( �1��i Name:�"�'bAtD Address: q ( ( k— t- U�g A (;, Address: A�(Z Phone: Phone: FAX: FAX: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) 1�7:=, SEC71 ON 8 06 0c"(-�, D F t-t Zti-r--z* "33o" �-�rL rA FICA Re,J�c� z 11 v� M Cleecklist(to be completed by office staff-person receiving variance request application) Four(4) copies of plan submitted(including septic system plans and/or restaurant floor plans) 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 variances only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/leasee onlyl,Outside dining variance renewals[same owner/leasee onlv],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 Susan G. Rask, R.S., Chairman NOT APPROVED Sumner Kaufman, M.S.P.H. REASON FOR DISAPPROVAL Ralph A. Murphy, M.D. )Q _ � ( Apo,,) (� t I Q:/WP/VARIREQ fJok1 �� fr— - ``^'d•. �S HERS �I ;� n 8 �-�' to_ ';1c. r• =-� �,' t° w za to � ` 0 0IAo a ow ., r<.'•` ' 0 tit \ •� "1f rra UW pnt. �1`90 Oa 0 � / 00J 8 o p e' ++ $ O IAUl 8 f 8 04 Nb 9 _ 4 N� vN da o p•?i C _. L 0 03 44`J 't t IA IV 0 IA �A O I V e 1V � O n NFL FTME Tp� DATE': ZEE: BARNSTABLE,iN �1 n I/ s ASS. -.REC.1 IB/Y Town of Barnstable .SCHED. LOAM. Board of Health c� 367 Main Street, Hyannis MA 02601 Office: 508-790-6265 Susan G.Rask.R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION Property Address: �7-! ^Q�?QC(� A Q,4uQ. Assess6r's Map and Parcel Number: 2!99 — 15 Size of Lot: 0, 3`�� C rQ- Wetlands Within 300 Ft. Yes Subdivision Name: No Business Name: APPLICANT \\ CONTACT PERSON-- Name: _I.VI �i S ��/JC Name: �j c `y�rt.�,�sE(r Address: �J Address: �. -rl Phone: Phone: sb,9 L 1 FAX: FAX: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) 7 t( t Sc C71O/U 8- Ob 10unrgP rD F tA7tt -r t "330 Checklist(to be completed by office staff-person receiving variance request application) Four(4) copies of plan submitted(including septic system plans and/or restaurant floor plans) 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 variances only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same ownerileasee only].outside dining variance renewals(same ownerileasee onlyl,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 Susan G. Rask, R.S., Chairman NOT APPROVED Sumner Kaufman, M.S.P.H. REASON FOR DISAPPROVAL Ralph A. Murphy, iVI.D. Q:/WP/VARIREQ PANT VIII ONSITE SEWAGE DISPOSAL REGULATIONS SECTION 8.00 INTERIM REGULATION FOR THE PROTECTION OF THE GROUNDWATER QUALITY WITHIN ZONES OF CONTRIBUTION TO PUBLIC SUPPLY WELLS P�oF'THE ro� ADOPTED 2/19/85, BECAME EFFECTIVE 2/21/85, REVISED 4/17/85 OFFICE OF HAHd9TSBL$ p A88. : BOARD OF HEALTH ` 'gyp s63"q. \e� 367 MAIN STREET �'0 YAY k• HYANNIS, MASS. 02601 LEGAL NOTICE INTERIM REGULATION FOR THE PROTECTION OF THE GROUNDWATER QUALITY WITHIN ZONES OF CONTRIBUTION TO PUBLIC SUPPLY WELLS The Board of Health, Town of Barnstable, Massachusetts, in accordance with and under the authority granted by Section 31, of Chapter 111, of the General Laws of the Commonwealth of Massachusetts, hereby adopted the following rules and regulations after a public hearing at a meeting of the Board held on February 19, 1985. Revised at a Board of Health meeting April 17, 1985: PURPOSE The initial findings of a townwide hydrogeologic investigation indicate that a substantial portion of the Town's water supply may be in jeopardy from the long term build-up of nitrate-nitrogen, primarily from the subsurface discharge of sewage effluent. It has been proven that nitrate contamination in drinking water can be a serious public health problem. Based on these findings, three of the nine zones of contribution to public supply wells are considered to be "at risk" zones requiring immediate measures to mitigate the adverse impact to the groundwater from such discharges. These regulations are temporary and will be in effect only until the Town adopts a ground water and water resource protection program. RESTRICTIONS No permit for the construction of an individual sewage disposal system shall be granted within the zones of contribution to public supply wells identified as zones 1,2, and 3 on a map entitled, "Town of Barnstable, Public Supply Wells Zones of Contribution, dated February 19, 1985, and prepared by SEA Consultants, Inc., Boston, Ma., which map is on file with the Board of Health, unless the following standards are met: A. The maximum allowable discharge of sanitary sewage based on the sewage flow estimates listed in Regulation 15.02 (13) of 310 CMR 15.00, Title 5, of the State Environmental Code, shall not exceed 330 gallons per acre per day; however, a permit may be issued if the applicant demonstrates that the total concentration of nitrate-nitrogen in the groundwater resulting from the proposed use will not exceed 5 mg./I. This determination shall consider the total predicted concentration of nitrate-nitrogen at the down gradient property line of the lot upon which the proposed use is to be located. B. Nothing in this regulation shall prohibit the approval by the Board of Health of any application involving the maintenance, repair or alteration of an existing individual sewage disposal system, providing that said application does not involve a change of use as defined by existing Board of Health regulations. Where a change of use is involved, the applicant must demonstrate compliance with this regulation. Variance to this regulation may be granted by the Board of Health only if the applicant "can demonstrate that: 1. Connection to Town sewer is not available; and 2. That enforcement thereof would ,do manifest injustice; however, the applicant must prove that the installation of on-site sewage disposal systems will not have a significant adverse effect on surface or sub-surface public or private water resources. f INTERIM REGULATION (Continued) In granting variances, the Board shall take into consideration the direction of the ground water flow, population density, soil conditions, depth to ground water, size, shape and slope of the lot, existing and known future water supplies and other information deemed pertinent. Thi re lation is to take fect on the date of publication of this notice. I L. C ds, C ai man Ann J e shbaugh Ar!'F` AS, IQ F rover arr . Town Cet;. sei BOARD OF HEALTH TOWN OF BARNSTABLE I> ' OF THE TOE DATE-:— �"' ICE: R&A'�cl 9 enarrrr IL&$ i N Q I Q7 1639• �0 REC. BY ? ) �f�MA�s 'Town of Barnstable � TOtHr�FQ,A�,�� '•,,SICHED. Dp�it Board of Health ��,0o 367 Main Street, Hyannis MA 02601 m. Office: 508-790-6265 Susan G.Rask.R.S. FAX: 508-790-6304 Sumner Kaufman,M.S.P.H. Ralph A.Murphy,M.D. VARIANCE REQUEST FORM LOCATION J QQ�� Property Address: L-1 2. 2.12,00x� hjQ_-1uQ_. Assessor's Map and Parcel Number: 9 Size of Lot: 0, C r Q_ Wetlands Within 300 Ft. Yes Subdivision Name: No Business Name: APPLICANT \\ (� CONTACT PERSO Name: —1V01.t S I;1�/�/JC Name: i��dGK',Q�� Address: �} ( C� , +. I Address: Phone: Phone: 15706 FAX: FAX: VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) 7: 0 , SECTION 8. 00 OQpor p pt= t-t7ti-rzµ "33o" L Checklist(to be completed by office staff-person receiving variance request application) Four(4)copies of plan submitted(including septic system plans and/or restaurant floor plans) 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 variances only) Variance request application fee collected(no fce for fireguard modi station renewals,grease trap variance renewals(same owner/I easee on Iv ours ide dining variance renewals[same ownerrleasee only],and variances to repair failed sewage disposal systems(only if no expansion to the building proposedl) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Susan G. Rask, R.S., Chairman NOT APPROVED Sumner Kaufman, M.S.P.H. REASON FOR DISAPPROVAL Ralph A. Murphy, NI.D. Q:/wP/VARIREQ ,tN4 11 q(,)1L VX.kLUATOR, F01'M I of 3 No Commonwealth of Massachusetts Massachusetts 5j2:..*7 Suitability nt fgr Disnosal Date: V1 \Cff\ ......... Performed By: .�........... ....... ......... .............. Witnessed By: .... ......................................................................................................... ......... 0.='s NVTe Locauon Addf=S Of Lot 0 4Z U T Address.and YE%5A Telephone V�(o 0 ew construction Repair ❑ Office Review Published Soil Survey Available: No ❑ Yes -%S Q'00 Map..Unit ................... Year.-Published- -Scale- .......... . Soil M ons . ..... Drainage Class .................. Soil Limitations .'-A;vailable: No 13 it Yes Surficial Geologic Report" Year Published Publication Scale Geologic Material (M. ap.Unit) .......Q ..................Q .................................................................... Landform'* ............................................................................................................................................................................................ Flood Insurance Rate Map: Above 500 year flood boundary No: EYes ❑ IyVith;n 500 year food boundary No 7yes 7 Within 100 year flood boundary No 7yes ❑ Wetland Area: National Wetland Inventory Map (map unit) ............................................................................... Wetlands Conservancy Program Map (map unit) ................................ ......................................... Current Water Resource Conditions*CUTS S): Month Bd'lc,.v Normal, Range :Aboye ❑Normal 11N.ormal ..... .. ❑ ;Other, References Reviewed:,. DEr APPROVED FORM- 1-2/07/95 f So)1, FVjkLUA7'0 t I OIZ-N1 1-orn.alion Address or Lm igo. Cv6acl:a On-site -Review Deep Hole Numberi �A Time:.:�:.'� .. Weather Location (identify on site plan) fu...,...): .�.�^�T.. ��4:.:.__..... .._ .:......_...__..:.... . .... . . ...... ....... .. Land Use .:.Y P:- ^t- Slope (%) O Surface Stones .. .N ....:. ....:..:.. Vegetation Landform ....... :...:.:.:.. ..::.... ..:..: . _ :..._...... ...,............ ............. ... . .. .. Position on landscape (sketch on the back) .:.:.... . . . :...... .. .. .::.::::. Distances from: Open Water Sody . feet Drainage way feet Possible Wet Area . :..... feet Property Line ......... feet Drinking-Water Well . .:.:. .,.. feet Other . .,.._ .:. .,..........:.:::. DEEP. OBSERVATION HOLE LOG' Depth from Soii Horizon Soil Texture Soil Color Soil Other Surface (Inches) (USDA) (Munsell) Mottling (Structure, Stones, Boulders, Consistency, % Gravel 0 CS uaa"N C, C 7AiL 57; Z.Sy 7 N14NECb - J..7�E. �•n�3i1 ��yZt..£' cj` — 132 �Z SAN,7 L.,S•4t.�Ll CoL..7! I HOL--6 HrUUIriLUi EVE—EVE-HY rIKUPOSEDIS c Parent Material (geologic) OyIV�CA>Vt DepthtoBedrock: >13�• Depth to Groundwater: Standing Water in the Hole: Weeping from Pit Face: N.-. Estimated Seasonal High Ground Water: _ DEP APPROVED FOP.%t- 12/07,195 ){)Q[vjl] ' S011. EYALJ]/\T(lj( FOR-M � l`. 1c Z of, � ^�» � \ loca\mo AddossorLot /�n. ^f� T� Deep Hole Number ��- _ Date:. Tirne:\ ��` - VVaothor«��-""`�� Location (identi y on site plan) Land Use S\opa (96) Surface Stones .. Y�l^��_- -__ ' - ' Vegetation --=��\� _ _ __. _ - ^____,_~~,___,_~^_,_,,_ __ ...... ' ' - Landform -_� _,~_ __ _ _ ' � �~____ _. `-- | Position onlandscape (sketch on the back) | � Distances from: ' ^^ O pen Water Bo |y � fee- D�ainaQevvoy feet ^Possible Wet Area - ' feet Property Line -. ~-'-- foet ~ � Drinking-Water Well .� feet Other DEEP. OBSERVATION HOLELOG* Depth from I Soii Horizon Soil Texture Soil Color Soil Other Surface (inches) (USDA) (M Mottling (Structure, Stones, Boulders, Consistency, % I Gravel) | � | � � � Parent material (geologic) oepm, Depth to Groundwater: Standing Water i. the Hole: N Weeping from Pit Face: 11stimood Seasonal High Ground Water- DE P APPROVED FORM- 12,107,'9 FORM L-FERCOLATION TF-r Locaticn Address or L, No. 42 �;N��,.,� �YE. 1-Ay,,NNs COMMONWEALTH OF MASSAC_ HUSETTS' t-� iNN� s , Massac��se Percolation 'hest' Date: �' ►� 9�-- Time:._ ._ n one�-in Hole I Der cf Ferr- I - 3s • I 32 star: F-�saak I End Fre-soak T �li . Time Q-6 12 � ��: �� : I 1 Z • �2 . T►me al E" Time (?'-o"� �� ,Ci��.��.is z�3 k CiovLcc 1v�cS�TvYr.T� � ��L� N�r�dsc•:-2.� •� Aare Min./Inch40, I z 2 R: `• YirirrLrt of t percaiaucn test mi stz to perfumed in hctt t�e primary area AND - • reserve area. : Site sassed Site . 'Sits ra��ed` � . - . .. Fe creed 3y: �S rA 1 lyv ,pk Q_ WTvte�ed 3y: Ccmmer= DC A!?Ixcvm foal.tzjsrns . ' - C�1zvr1 Li -Jvu... L.►ru_ut11Vt'C rl,1PClY1 Page 3 of 3 '�y1r-7r/• 1 YF \yAN�v�S ~Lo=dmn address or Lac `(o. 1` • `�,EvYoJ� P �—'",' Determ�ra:-�on for Seasona.T High Water Table Methad Used- C Oegth ecserved standine in ccsarvaden hole inches C Cep-th weerir,c from side cI ccservadcr, hele.NR14S� inches Q Oepth tc scii me"es N��:� inches L� Ground water adjustment __2L.__ feet. lydex Weil Numier Oa:e Index well level Atdjus=ent factor Adjusted•cmund water level Oerth o` Nanirally occurinc y=_rvic��s Mst=ral Cc es at least -a ur f eat a F naturally Ccc:,r,inS pervious rra`e^al exist .in all areas ocserved threuchcut 4 e area prcccsed fer u e sail acscrPticn system? 11 nct, what is the de^th w na�raY ecc:u;lI n erricus mateftl? r � F Cer~rca cr, • I ceru;y that en tA oY. kc�fA (date) 1 have Gassed the soil evaluator exarr'inat c,,, accrcved cy'the Oecar.,:,enta� nvir^nrerta!'?r;�tec^crt and at a above an=_lys;s was.:er,cr;; ed cy'r^e ccnsisterrCwi�-t the required zaininc, ex;errsa and exrener;ce desc:iced in sZa cm Z 5.o 17. Sicr:a�.:r: Cate 1/ i7 7 i 0 I J Q 1 i' 35 I / /r \ i / � I f ; i