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4766 FALMOUTH ROAD/RTE 28 - Health
4766 Falmouth Rhar! (route 28) Cotuit P A = 009 004 a I k i l' 6 PC f P i s, I' I 1 � V` f i 1 i Ren3tc^uasirva")Fax:(888)594-4555 To: Fax: (508)790-6304 Page 1 of 4 01/2212018 3:51 PM FAX D e: 01/22/2018 Pages including cover sheet: 4 1'0: From : J.Renato Dasilva Vn fPrime Dental Inc 3112 Cranberry Hwy East Wareham MA 02538 Phone Phone 15087437888 Fax Number (508) 790-6304 Fax Number (888) 594-4555 • PLEASE CALL ME IF YOU HAVE ANY QUESTIONS E7Health Department Drop-Off Hours: 8:00 AM —4:30 P.M Town of Barnstable Received by Health dFy Regulatory Services Department on Richard V.Scali,Director Public Health Division kr Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 _ Office: 508-862-4644 Fax: 508-790-6304 ACCESSORY AFFORDABLE APARTMENT SEPTIC QUESTIONNAIRE Property Address: � � 1�.k' -� � "-W- A1rn4j\4 AtA Assessor's Map/Parcel Number: G C`y� Applicant(s) Name: PfWaM ire c-64 LL(' )r)q Le. Phone: �S . y E-Mail: cw J ; w e ckn qn)LL, I C0 Size of Lot: 2a. How many bedrooms exist at your property now? 2b. How many bedroom are you planning to add as part of the Accessory Affordable Apartment Program application? 0 2c. How many bedrooms total are proposed at this property (including the Accessory unit)? 2e. Is the pr posed Accessory Apartment contained within: the main house; OR a detached structure 2f. Submit floor plans for all buildings on the entire property. Show all existing rooms in the dwelling and the proposed accessory apartment. Label each room clearly. Label measured width of all open doorways. Use straight edge for hand drawn plans and be sure all labeling is legible. Signe Date: I' k ell [ti✓th5 C ACCESSORY AFFORDABLE APARTMENT SEPTIC QUESTIONNAIRE FOR STAFF USE ONLY 1. Is the dwelling connected to Town sewer? ❑Yes M No 2. Dwelling located ❑ INSIDE E/OUTSIDE the Saltwater Estuary Protection Zone 3. Dwelling located ❑ INSIDE ❑ OUTSIDE public supply well Zone of Contribution 4. Dwellingis connected to ❑ ON-SITE WELL C, PUBLIC WATER 5.: Disposal works construction permit on file? ❑Yes rq o 6. If yes, how many bedrooms were allowed by this permit: bedrooms 7. Were building permits obtained for additional bedrooms? Yes ❑ No 8. Engineered septic system plan: a. On file at the Health Division? Yes ❑ No b. If proposed accessory unit is detached from principal dwelling,, is that plan on file? ❑Yes ❑ No 9. Existing septic system capacity isT� bedrooms For the accessory unit to receive approval from the Health Department the following action must occur: ®'�xistin system accommodates proposed additional bedroom s 9 Y P P ( ) ❑ Upgrade existing system to accommodate additional bedroom(s) ❑ Must remove a bedroom from the main house ❑Must connect detached structure to the existing septic system ❑Must install septic system for the detached structure ®'Other �.,aT`nca ropes Uri;[ is hoj - U .%,J tjr Sill v,v} be used -as z, ..,bet�n�ur►• '' Signed_ Date 6 I ( F �� -F 2 { 4 •pG� a I, Loop- A R ICED 2- VEfl 1 5� a P.� 1� Wl^� 0 M Ij L�l1�`J G I 9 v �� Cel Unit"AEI _ T rd Floor(over unit B) 3Vf• S-ff 97 � r 7'•3 B' b'-8' 3` ' 1��'�'■Ir r f4'rN' i � j � � n0'aM � r+',Pr M■rr y LI N k N 4 O,• b 'Bedroom � ,� Dining Room { M 5 ap,r�r � � r Living';Room . Kitchen co Q* b �J FTM d. Ex;+ S�i,CS McKean, Thomas From: McKean,Thomas on behalf of Health Sent: Monday,July 10, 2017 3:51 PM To: 'iRealty'; Health; Cadrin, Arden Subject: RE:4766 falmouth Good Afternoon, The application form was received but was incomplete. There was no floor plan submitted. Please submitted a neatly drawn sketch of the layout of the house. Sincerely, Thomas McKean From: iRealty [mailto:viviane dasi Iva @comcast.net] Sent: Monday, July 10, 2017 3:01 PM To: Health; Cadrin, Arden Subject: 4766 falmouth I 1 3 } I jy `j , _ - .M 4.30 R.M Health. Department Drop-Off Hours. 8.00 A 0 Town of Barnstable Received by Health Regulatory Services Department on Richard V.Scali,Director Public Health Division t6I¢ Thomas McKean,Director 200.Main Street,Hyannis;MA 02601 Office: 50062-4644 Fax: 508-790-6304 ACCESSORY AFFORDABLE APARTMENT SEPTIC QUESTIONNAIRE Property Address: 7 � - P Y j Assessor's Map/Parcel Number: 009 I OIL/ A licant . Name: ��� C�t- ke.A-L-r L c, PP �s) Phone: 5 S 7-f 3 --7883 E-Mail: SkOn_:S_ 1 Le'o—,g9 P, �10�►�'1 �I-r �. �xh Size of Lot: ' 2a. How many bedrooms exist.at your property now? 5 2b. Ho.w many bedroom are yo.0 planning. to add as part of the Accessory Affordable Apartment Program application? 0 2c. How many bedrooms total are proposed at this property (including the Accessory unit)? S .2e. Is=main 'house; ed Accessory Apartment contained within: OR a detached structure 2f. Submit floor plans for all buildings on the ng t re property. Show, all existing rooms in the dwelling and the proposed accessory apartment. Label each room clearly. Label measured width of all open doorways. Use straight edge for hand drawn plans and be sure all labeling is legible. Sign, Date: 7//, rl/j il-I i ACCESSORY AFFORDABLE APARTMENT SEPTIC QUESTIONNAIRE FOR STAFF USE ONLY 1. Is the dwelling connected to Town sewer? ❑ Yes ZN 2, Dwelling located ❑ INSIDE C9'OUTSIDE the Saltwater Estuary Protection Zone 3. Dwelling located ❑ INSIDE EAUTSIDE public s ,pply well Zone: of Contribution 4. Dwelling is connected to Q ON-SITE WELL PUBLIC WATER. 5. Disposal works :construction permit on file? ❑ Yes L'tl'No 6. It yes, how many bedrooms were allowed by this permit:. 4 edrooms 7. Were building permits obtained for additional bedrooms? Yes 0 No 8 Pre v i ous 8. Engineered septic system plan: 0" `le Y a. On file at the Health Division? C VYles 0 No b: If proposed accessory unit is detached from urincipal dwellinq, is that plan on file? ❑ Yes 01 No 9. Existing septic system capacity is S bedrooms For the accessory unit to receive approval from the Health Department the - foil` wing action must occur: Existing system accornmodates.proposed additional bedroom(s). `O Upgrade existing system to accommodate additional bedroom(s) ❑ Must remove a bedroom from.the main house ❑ Must connect detached structure to the existing septic system Must install septic system for the detached. structure ❑ Other-------------------------------------------- -- Signed Date �p 97 I e `A Health Department Drop-Off Hours: 8:00 AM - 4:30 P.M Town of Barnstable Received by Health Regulatory Services Department on Richard V.Scali,Director RAWMa "OM Public Health Division " Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-8624644 Fax: 508-790-6304 ACCESSORY AFFORDABLE APARTMENT SEPTIC QUESTIONNAIRE Property Address: LI rI G -rA LM o V Th i�A , Co+uj� _ mA Assessor's Map/Parcel Number: cri rC)0 Applicant(s) Name: P CA r�, P kA L L LC_ Phone: $ E-Mail: E N G _-T i N ) _?_e, g q tQ hof1M 1 ( C0 Size of Lot: 2a. How manj_bedroom4 exist at your property now? .S 2b. How many bedroom are you planning to add as part of the Accessory Affordable Apartment Program application? I 2c. How many bedrooms total are proposed at this property (including the Accessory unit)? _ 2e. Is the proposed Accessory Apartment contained within: the main house; OR a detached structure 2f. Submit floor plans for all buildings on the entire property. Show all existing rooms in the dwelling and the proposed accessory apartment. Label each room clearly. Label measured width of all open doorways. Use straight edge for hand drawn plans and be sure all labeling is legible. Signed: Date: . 1 ACCESSORY AFFORDABLE APARTMENT SEPTIC QUESTIONNAIRE FOR STAFF USE ONLY 1. Is the dwelling connected to Town sewer? ❑ Yes [ No 2. Dwelling located ❑.INSIDE [OUTSIDE the Saltwater Estuary Protection Zone 3. Dwelling located ❑ INSIDE ❑ OUTSIDE public supply well Zone of Contribution 4. Dwelling is connected to ❑ ON-SITE WELL dPUBLIC WATER 5. Disposal works construction permit on file? a'Yes ❑ NoZD �- 6. If yes, how many bedrooms were allowed by this permit: bedrooms owe 7. Were building permits obtained for additional bedrooms? L4Yes ❑ No 54 Previous owNeK 8. Engineered septic system plan: a. On file at the Health. Division? 8/Yes ❑ No b. If proposed accessory unit is detached from principal dwelling, is that plan on file? ❑Yes ❑ No 9. Existing septic system capacity is bedrooms For the accessory unit to receive approval from the Health Department the following action must occur: ❑ Existing system accommodates proposed additional bedroom(s) ❑ Upgrade existing-system to accommodate additional bedrooms) ❑ Must remove a bedroom from the main house ❑Must connect detached structure to the existing septic system ❑Must install septic system for the detached structure ❑ Other ----------------------------------------------------- Signed Date � k4 McKean, Thomas From: McKean,Thomas Sent: Wednesday,April.26, 2017 9:37 AM To: Cadrin,Arden Subject: 4766 Falmouth Road/ Pro Care Realty LLC I received an accessory affordable apartment septic questionnaire application for six(6) bedrooms at 4766 Falmouth Road, Cotuit. (NOTE:There were no house (floor) plans provided.) This site is located within an Saltwater Estuary. Protection Zone and the parcel is only O.S acre. Six bedrooms are not allowed on a parcel of this small size within a Saltwater Estuary Protection Zone per Section 360- 45 of the Town of Barnstable Code which reads as follows: The maximum allowable discharge of sanitary sewage, based on the sewage design flow criteria listed in 310 CMR 15.203, Title 5, of the State Environmental Code, shall not exceed 440 gallons per 40,000 square feet of lot area, with the following exceptions: (a) For approved building lots on which no building currently exists and that are less than 30,000 square feet in area, the maximum allowable sewage discharge shall be 330 gallons. (b) For parcels with existing buildings, the maximum allowable flow shall be either 440 gallons per 40,000 square feet, except as described in Subsection B(1)(a) above or whatever is currently permitted, whichever is greater. Therefore,this application is not approved. 1 Unit 'Aff 30--0" rX.11" 5 41" T-3" 6=0" 5.6" 3.5" 3'-0•x44r 9-0•x4W 3'-0•x4A• 3Wx4.r 8'-0•x 4r CM x x• Cl) q Ili a G s Bedroom Dining Room Cn 8 x H . �B•xe�-+r N closet N r-rxOW r-•xe'e O 317 x 10.00"T iv �a � " b 4�8•xtlF' Y Living Room Kitchen o0 � o (J O ►� a N W 1 CA -a +3Uf,i L W-10" IST N s 4766 Falmouth Road Cotuit, Ma. rn rp to 000sc- Unit "B —31'-10" 6-8"— /r 7=5" j4t3" ra�a raise zaxea ro xAccessBedroom #1 to unit„A„ Be • � a {� T6'xBa I j 7axe'a N 10'-10" 96'-10" • rn („ ZE'x6'6 T 2`-99 2'-0"*-3q Closet Living Room . Bath soilrn rn to N to 4.3� 12-7 V a a Ni tp � - I - x i Kitchen a 4766 Falmouth Road N Cotuit, Ma. 0 a �a 4 Diming - Room e el• J 7 � 1 ��N Hoosr I YL Unit C 28'U" 0 LI x Bath ommon N G aundry Kitchen P x 3-9" G M chanical Closet rn Room CV) G IV rrxe e' z•-e•xf s 6V1'x8',8'CO Z 2 81 G 0 Bedroom Living Room P 1 N � M 8_6n. 61-5" 27-9.0" 4766 Falmouth Road "41OZ-,0 Nnf Cotuit, Mass. r . 4t Unit ►►D►► 0.. 2&0„ Closet 0 00 � N rs•Xe_e• I', --------------� 5'-10" 1'- „ CO x m Bath Studio 7=11" n� o 0 Kitchen 2:e•xe•-a• -------------- 5'-5„ 11-0" AL 5-8" X-11" 6 C�� s 4766 Falmouth Road 6 �r Cotuit, Mass. 2�� ��� LOCATION /Q"{-�FS CECO-) `- �C _ S" �S S ��•man N0. - 617 VILLAGE CO DATE APPLICANi q ya t e,( � FE 5 ADDRESS.=Q , a ; �� . • TELEPHONE N0. (Non-refundabl( .ENGINE L7 TELEPHONE NO. DATE SCHEDULED >A6 (Applicant' s signature ASSESSOR'S MAP' & LOT N0. CL SOIL .LOG ,. SUB-DIVISION DATE . -6F- 2fv Io TIME 'gyp' "' EXPANSION AREA; YES NO�^ eKL�%v4-", BYTC:K_ �A\1(5 (Qc, ENGINEER TQWN WATER • PRIVATE WELL BOARD OF HEALi EXCAVATOR SxPTCH: (Str_et n�e, etc. ,dimansions of lot, xact -iocation of test holes and • :,`percolation tests, locate wetlands NOTES : proximity to test holes) OTE : Ve[ex,�i�zyy� ,• 9;F r �.. � -i �•,. PERCOLATION RATE:_ Zyvivej ?G�i(`I'a�• TEST HOLE NO: ELEVATION TEST HOLE N0: _ ELEVATION: 1 2 L.OAJAA A�Q k1wi C 60M c 2 3 q A 7 7 8 8 2DFA.L ' 9 9 5'0AA t*aG ' 12 12 13 ' ' �3 13 14 14 15 ► 15 16 16 SUITABLE FOR SUB-SURFACE SEWAGE: LEACHING FIELD LEACHING PITS • LEACHING TRENCHES yy UNSUITABLE FOR SUB.-SURFACE SEWAGE. REASONS :.- NOTE: ENGINEERING PLANS MUST SHOW NUMBER ASSIGNED ON PERC TEST APPLICATION ORIGINAL: COMPLETED xN ENTIRETY BY P , E , AND RFTURNED TO BOARD OF HEALTH COPY: RETAINED' BY APPLICAN'P TOWN OF BARNSTABLE -I OCATION SEWAGE# () 17 a- U / VILLAGE 1 ASSESSOR'S MAP&PARCEL QQ G/ 60 y INSTALLER'S NAME&PHONE NO. ✓�rrhf-'5 = eAgalT7gl6- SEPTIC TANK CAPACITY�anp��tJc� �Q ;1?�I iyxjj LEACHING FACILITY:(type)$ -Sao G-A L c pJDA we/(size) D,jl NO.OF BEDROOMS OWNER z i PERMIT DATE: I COMPLIANCE DATE: 3 Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY I L v Ll No. Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: -� PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes ftphLation for 0sposal *pstrm Cunstrurtion Vermit Application for a Permit to Construct( ) Repair 0"00upgrade( ) Abandon( ) Complete System ❑Individual Components Location Address or Lot No. 4�7(j 6 L Nt7 r' X F> Owe 's Name,Address,and Tel fro. Al Assessor's MaOarcel 6® - a O �n�aller's e,Address,and No-3v0-6'q,'Z ,.faszo• est er's Na ddress and T 1. o. butt h �kVa`� z Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder.( Other Type of Building T Zx No.of Persons Showers( ) Cafeteria-j--- Other Fixtures �. Ar Design Flow(min.required) 6.t�_(j gpd Design flow provided X_�� gpd D L Plan Date /d / J 7 Number of s eets f Revision Date Title L P Size of Septic Tank 5—'00 Type of S.A.S ,C AtF Description of Soil C loe Nature of Repairs or Alterations(Answer when applicable) S c— R e Cc. p Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Cod d not to place the system in operation until a Certificate of Compliance has been issued by this Board o al Signed i Date Application Approved by Date — Application Disapproved by Date for the following reasons Permit No. s Date Issued U F No. � Fee % THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Zippfiration for Disposal 6pstrm Construrtiott 3dPrmit Application for a Permit to Construct( ) Repair(VKpgrade( ) Abandon( ) Complete System El Individual Components 1 Location Address or Lot No. 4'f 7 6 6 TA L N o U� Z® Owner's Name,Address and Tel No. Co Yu 17 .Assessor's Map/Parcel - 0 p `�- 6 p ' 7 70 m 4/A J 5770,-'7;5f Za-e ',2 V'S Inst ller's N . e Address,and el No.5v0`6'�;Z - 5-0�.. Designer's Nam �ddress,and T o. UT( 15 C'MVk ,q1 D b5 c 1!�O UPI t L Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. . Garbage Grinder(l)" Other. Type of Building 1�x JQT L No.of Persons Showers( ) Cafeteria.(----)---- ' Other Fixturesid - Design Flow(min.required) y � ��d gpd Design flow provided �(.l gpd /Plan «Date / Z /7 Number of sheets e Revision Date t Title S i rT-P-' Size of Septic Tank �`Ui'.� Typ of S.A.S.S'L f i'S PZ5- Description of Soil Nature of Repairs or Alterations(Answer when applicable) 'YJ_�1SV-h L L 1 000 / 1 f LUl S F'R�7G L C - J / C l� R fZ 6 V r ,_ ���c oe..i �v i Y4�e s- Cc 4' r l7 Date last inspected: t J Agreement: J I( 1 The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code d not to place the system in operation until a Certificate of . Compliance has been issued by this Board of Dealt ' Signed ! h Date Application Approved by ' Q Date -(/- /7- Application Disapproved by Date for the following reasons OY Permit No. 0 - ( Date Issued 2 - (U THE COMMONWEALTH-OF-MASSACHUSETTS BARNSTABLE MASSACHUSETTS CertifiratQ of Compliance THIS IS TO CCEERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired Upgraded( ) Aban��dfoned((',)by 1'/' at 7 66 ( -M o l 704 p (rd has been constructed in accordance , �t with the provisions of Title 5 and the for Disposal System Construction Permit No. -20 I1 dated �' f Installer �y��E r7 (��CI,llo-414- Designer ��,G. }lJt IRDIM�/V r{ Z #bedrooms 'i Approved design flow „"D SU gpd The issuance oft is permit shall not be construed as a guarantee that the system will fiuretio as/dIsigned. Date �� Inspector , ----- ------------------------- ------ ---------------------------------------------------------- ---------------------------------- No. 2U � 0(// Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION-BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction permit Permission is hereby gran ed too Co`nstruct( ) Repair( ( Upgrade( ) Abandon System located at / !�{0 1b /- /yQj/Ty won and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her,duty to comply with Title.5 and the following local provisions or special conditions. Y Provided:Construction must be completed within three years of the date of this permit. J' f Date c f - Approved by 1 , r a, Town of Barnstable ' ���►��°,,, Regulatory Services ti Thomas F. Geiler, Director MASS. ' Public Health Division 94'AiE a`0� Thomas McKean, Director 200 Main Street, Hyannis,MA 02601 Office: 508-862-4644 Fax: 5 8-790- 304 Date: �' J ' Sewage Permit# o C>54`Assessor's Map/Parcel ? Installer &Designer Certification Form Designer: ` �, Installer: � � Address: �>f C��}`'1�c� "� Address: � J � On 1-71 AU was issued a permit to install a (date)' r(installer) !' septic system at -1 1 AAWTH �, I i?&ased on a design drawn by ,,A (address) MO ,q�2 dated (designer) I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation of the distribution box and/or s tic tank. Stripout (if required) was insp cted�nd the s ils were found satisfacto I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State & Local R- '-tions. Plan revision or certified as-built by designer to follow. Stripout (if ra- cted and the soils were found satisfactory. -�H OF DAVID 9�� B. 71, if<4 MASON i nstaller's Signature) � ,9 No.1066 0 �; '/sT esi er tu s Signare) ' PLEASE RETURN TO BARNSTABLE PUBL.- fE OF COMPLIANCE WILL NOT BE ISSUED UN i it, in i riiJ r ORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION. THANK YOU. gAoffice fonnMesignercertitication fonn.doc TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Q ® � Application 443=./7� � Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee �6 3, 20 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis Project Street Address 4�-(0 Village C of U L Yam. Owners Address F'l Q r,ca Telephone Permit Request r ' Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new F ' Zoning District 1 Flood Plain Groundwater Overlay ' I Project Valuation Ufa Construction Type Lot Size I Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type:i Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No z Basement Type: ❑ Full ❑Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ I Attached garage: ❑ existing ❑ new size _Shed: ❑existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No. If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number �) �. Address W jM License# 9 I i Home Improvement Contractor# Email I h��(1 J �GG� tic S ► C Worker's Compensation # C6 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Z-' F. McKean, Thomas From: McKean, Thomas Sent: Wednesday,April 26, 2017 9:37 AM To: Cadrin, Arden Subject: 4766 Falmouth Road/ Pro Care Realty LLC I received an accessory affordable apartment septic questionnaire application for six (6) bedrooms at 4766 Falmouth Road, Cotuit. (NOTE:There were no house (floor) plans provided.) This site is located within an Saltwater Estuary Protection Zone and the parcel is only 0.5 acre. Six bedrooms are not allowed on a parcel of this small size within a Saltwater Estuary Protection Zone per Section 360- 45 of the Town of Barnstable Code which reads as follows: The maximum allowable discharge of sanitary sewage, based on the sewage design flow criteria listed in 310 CMR 15.203, Title 5, of the State Environmental Code, shall not exceed 440 gallons per 40,000 square feet of lot area, with the following exceptions: �a For approved building lots on which no building currently exists and that are less than 30,000 square feet in area, the maximum allowable sewage discharge shall be 330 gallons. (b) For parcels with existing buildings, the maximum allowable flow shall be either 440 gallons per 40,000 square feet, except as described in Subsection B(I)(a) above or whatever is currently permitted, whichever is greater. Therefore,this application is not approved. 1 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.)- You must first obtain the necessary signatures on this form at 200 Main St., Hyannis.. Take the completed form to the Town Clerk's Office,.lst FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. n ttdy�� tltq � _ � DATE: Fill in please: + F Y APPLICANT'S YOUR NA\ E/ S:U VIfi BUSINESS YOUR HOME ADDRESS: << ' � rS4k� . TELEPHONE # Home Telephone Number _ NAME QF CORPOR TI0 77 NAME OF NEW BUSINESS U �'�h/ TYPE 0F'BU511VES8 IS THIS:A HOME OCCUPAiIQ _YES IUO /1DDRESS OFBUSLIVSS� : ^� MAP PARCEL NUMBER �� D (Assessing) When starting a new business there.are several things you must do in order to be in compliance with.the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1.. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 2. BOARD OF HEALTH ` This individual has bee of rmed of the m' requir nts that pertain to this type of business. ut rized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual ha . e formed of the licensing requirements that pertain to this type of business. uthorize i natur COMMENTS: _b � I ' . '+ I f ` TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date Time: In Out Owner Tenant Address 7-7 Address a 1 Comp!' ce Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities roved: 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing 18. Driveway Width 19. Number of Tenants Observed PART II l w 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here r � � TOWN OF BARNSTABLE BOARD OF HEALTH i ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date »1 17.0 l Time: In Out Owner- �c}�Z�125 i E't 11�1& Tenant 1 ACPcf Address -7�0 j!) Maw 5T Address n66 j rw KD A- r( Compliance Remarks or Regulation# Yes j NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities rove , fze �"�'" " 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities J 7. Lighting and Electrical Facilities / V 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural / Elements V 14. Insects and Rodents J 15. Garbage and Rubbish Storage and Disposal / 16. Sewage Disposal ✓ 17. Temporary Housing �4 18. Driveway Width 19. Number of Tenants Observed N PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allo x) Number of Persons Allowed (max) Person(s) Interviewed &Ayr Inspector r If Public Buildingsuch as Store or Hotel/Motel specify here p fY + ° TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date lZ �zo 1-Z— Time: In Out Owner I WIa b�2:5�1C,(1U2 Tenant Address 2ao N �( Address t �a rALy✓ t �1 Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply MD Cwt 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehicles Allowed (max) Number of Persons Allowed (max) 14 may Person(s) Interviewed f i Inspector If Public Building such as Store or Hotel/Motel specify here � TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date �� I�tZ Time: In Out Owner ))60% r= � p5 j ETi`f�� Tenant Address A It) S( Address �51�YL�1 t-VG 6V L R (� Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply MD OA,—-_ _. 5. Hot Water Facilities 6. Heating Facilities IJ 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service / 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural / Elements V 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17.Temporary Housing A)A 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms 1 Number of Vehi Ilowed Number of Persons Allowed (max) Z Person(s) Interviewed AIJ� Inspector If Public Building such as Store or Hotel/Motel specify here v � TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE IL MINIMUM STANDARDS FOR HUMAN HABITATION Date �ZZav Time: In Out Owner D,4(jlc"� Tenant AC,'qN Address :Iq© e) a'► it IJ 5T Address 4-4 6 d i�� 0 6 MA Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities 3. Bathroom Facilities 4. Water Supply V .� "Zv►z 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal V 16. Sewage Disposal 17. Temporary Housing N 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms 'C'�Ll'D1 O Number of Vehicles Allowed NA Number of Persons Allowed (max) � Person(s) Interviewed MOOT Inspector If Public Building such as Store or Hotel/Motel specify here Town of Barnstable P# -7 Department of Regulatory Services Public Health Division Date o ' , 2Op Main Street,Hyannis MA 02601 rn Date Scheduled .�• Time I ��.�I"� Fee Pd.� l D Dom• { Soil Suitability Assess-Ment for.:Si?*dpe Disposal A� QvJ w Performed By: 1 Witnessed By: _L_OCA_TION& GENERAL INFORMATION Location Address /_j7)_/ �jL191 1 'RDAP Owner's Name �t f' CJ�/ 1 r"f�tM r Address Assessor's Map/Parcel: /lGUo "Engineer's'Name—D• `��`" NEW CONSTRUCTION AIRI Telephone# `�—�✓ ��� � Land Use Slopes(%) Surface Stones Distances from: Open Water Body ft Possible Wet Area ft Drinking Water Well ft Drainage Way ft Property Line ft Other ft SKETCH:(Street name;dimensions of lot,exact locations of test ho ocate wetlands in proximity to holes) w Parent material(geologic) Depth to Bedrock Depth to Groundwater: Standing Water in Hole: Weeping from Pit Face Estimated Seasonal High Groundwater _ DETERMINATION FOR SEASONAL HIGH WATER TABLE Method Used: — Depth Observed standing in obs.hole: in. Depth to soil mottles: Depth to weeping from side of obs.hole: in. Groundwater Adjustment' ft. Index Well# Reading Date: Index Well level Adj.factor Adj.Groundwater Level PERCOLATION TEST Date Time Observation _ Hole# - y `t rc Tima at 9 Depth of Perc Time at 6" a Start Pre-soak Time @ Time(9"-6') End Pre-soak Rate Min./Inch Site Suitability Assessment: -Site Passed Site Failed: Additional Testing Needed(Y/N) Original: Public Health Division' 't` Observation Hole Data To Be Completed on Back ---- ***If percolation test is to be conducted within 100' of wetland,you must first notify the Barnstable Conservation Division at least one(1)week prior to beginning. Q:\SEPTIC\PERCFORM.DOC _ _ DEEP OBSERVATION HOLE LOG _ Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel 4 L-• 1 d _ DEEP OBS_E_RVATION HOLE LOG . Hole# _ Depth from Soil Horizon Soil Texture Soil Color - Soil, Other Surface(in.) (USDA) (Munsell) + ` Mottling (Structure,Stones,Boulders. Consistency, /o Gravel) DEEP OBSERVATION HOLE LOG _Hole# _ Depth from Soil Horizon Soil Texture Soil Color Soil Other µ Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency.%Gravel) _ DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) t J (USDA) (Munsell) - Mottling (Structure,Stones,Boulders. Consistency.%Gravel) Flood Insurance Rate May: Above 500 year flood boundary No_ Yes Within 500 year boundary No V es Within 100 year flood boundary No ' Yes Deotb of Naturally Occurring Pervious Material Does at least four feet of naturally occurring pe i material exist in-all areas observed throughout the area proposed for the soil absorption system. If not,what is the depth f na rally occurring pe ious material? _ Certification L I certify that on (date)I have passed the soil evaluator examination approved by the Department of Enviro ental Protection and that the above analysis was performe by me consistent with the re uired training, p rti an cper'ence described in 310 CMR 15.017. Signa Date Z J I QASEPTIC\PERCFORM.DOC a aCO FORM 30 Ii� HOBBSB WARREN'" THE COMMONWEALTH OF MASSACHUSETTS S BRD OF HEALTH CITY TOWN DEP RTMENT c AD SS W r9— G�M •y`0 ,n /�,, I TELEPHONE I, Address4 Q 61 _�_r.4 69�,4� Occupant_ . ✓ . I'T Floor Apartment No._ __- No. of Occupants-1 No.of Habitable Rooms No.Sleeping Rooms1___-___ No. dwelling or rooming un _ No.Stories _ � Name and address of owne L�� � y T[ MRW 6r 7 �Vto Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Lighting: STRUCTURE INT. Hall,Stairway: Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 -- _ Hot Water Facil. Sup.Ten., Gas, Oil, Elect.: Stacks, Flues,Vents,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin, Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR. (See Over) "THIS INSP CTION T IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENALTI I Ay. INSPECTORTITLE A. DATE TIME /` _ P•M• A.M. THE NEXT SCHEDULED REINSPECTION P.M. ``�.,.�.:.q...,.wy',.'•.. ;;.�t,,..t F.w+T+.,..'�„rv,,,-,ate:...:i�.�r��; .+7,i,+..y„r.r+%�•',i.cJh^t -a. ; ix `a.� '�ti.�1..�.a E..-r-••..--,..,,•� s�-.r' r 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the heaith, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall within this category. Nor shall failure fo include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold, to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410,254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1) and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash, which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests or otherwise contribute to accidents or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L. c. 111 @@ 190 through 199.) (K) Roof, foundation, or other,structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety. (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0) shall be deemed to be a con- dition which may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. J � sQ6u v �r ll Parcel Detail Page 1 of 3 1 9 } Logged In As: Parcel Detail Monday, A Parcel Lookup Parcel Info - - - r •-__ Parcel ID 009-004 Developer -- -- -- --- Location 4766 FALMOUTH ROAD/RTE 28 __ e Pri Frontage i150 Sec Road Sec - - -- ---- Frontage - - village COTUIT Fire District!COTUIT Sewer Acct ' _ - - _._.� Road Index `0522 —_Interactive `;� ��I:_a '•:�z- , Map - Owner Info owner HOSTETTER, DANIEL C JR I Co-owner, Streetl 770A MAIN ST Street2 City OSTERVILLE -� State�MA zip 02655 Country;US Land Info Acres 0.50-- __ � use '4-8 Units MDL-01 II zoning 'RF j Nghbd 0104 Topography Level Road Paved, Utilities Gas,Well,Septic Location I Construction Info Building 1 of 1 Year Roo Ext Built 1720 I S ruct Gable/Hip _ _ I wall Wood Shingle Effect 3390 I Roof Wood Shingle I AC Wood _I Area --- — -- Cover - Type -- - Be Style Colonial_____ I wall±Plastered I Rooms.6 Bedrooms --I I Int Bath Model Residential _ ;I Floor Hardwood 4 Full — - Rooms ---- _ ----_�I Grade'Custom Minus I Heat Hot Water Total 12 Rooms - - Type -------- ---- Rooms — -- - -- http://issql/intranet/propdata/ParcelDetail.aspx?ID=229 4/9/2007 Parcel Detail Page 2 of 3 _3f4 :FHS; 4, BAS,- 24 14' Heat Found- Bas' stories 2 Stories Gas Poured Conc. �I 7 Fuel ation 74 Eus ' BMT 34: Permit History Issue Date Purpose Permit# Amount Insp Date Comm( 6/28/2005 Remodel 85106 $4,000 1/27/2006 12:00:00 AM APT C 6/28/2005 Remodel 85102 $4,000 1/27/2006 12:00:00 AM 11/1/1986 1 B30128 $60,000 CO REI - Visit History Date Who Purpose 7/14/2006 12:00:00 AM Jeff Rudziak Permit+ Corrected List' 9 1/27/2006 12:00:00 AM GaryBrennan Drive b inspection only Y Y 8/12/2005 12:00:00 AM John Greene CO Issued 12/14/2004 12:00:00 AM Paul Talbot Drive by inspection only 1/20/2004 12:00:00 AM Paul Talbot Meas/Est 6/24/2002 12:00:00 AM Paul Talbot Meas/Listed 9/15/1987 12:00:00 AM Andrew Machado - Sales History Line Sale Date Owner Book/Page Sale P 1 9/18/2003 HOSTETTER, DANIEL C JR 17666/160 ; 2 7/15/1994 PACITTO, FRANK J TRUSTEE 9298/067 3 11/15/1993 PACITTO, FRANK J TRUSTEE 8882/176 4 9/15/1992 NATL CREDIT UNION ADM BOARD 8207/168 5 11/15/1990 PHINNEY, NANCY M TRS 7349/318 6 11/15/1990 BARN COMM FEDERAL CREDIT 7349/310 7 1/15/1990 LARGAY, CHRISTINA B TRS 7032/167 8 8/15/1987 CAPE HARBOR DEV CORP 5879/195 9 8/15/1986 HOSTETTER, DANIEL C & 5230/332 10 QUEEN, ANN A P58768 11 QUEEN, ANN A 41A 4497/257 Assessment History http://issql/intranet/propdata/PareelDetail.aspx?ID=229 4/9/2007 Parcel Detail Page 3 of 3 Save# Year Building Value XF Value OB Value Land Value Total Parc( 1 2007 $399,900 $23,000 $0 $118,300 " 2 2006 $349,500 $23,000 $0 $116,300 3 2005 $297,700 $14,400 $0 $109,000 4 2004 $185,100 $6,400 $0 $72,700 5 2003 $178,200 $2,600 $0 $41;300 6 2002 $178,200 $2,600 $0 $41,300 7 2001 $178,200 $2,700 $0 $41,300 8 2000 $160,300 $2,700 $0 $22,500 9 1999 $160,300 $2,700 $0 $22,500 10 1998 $160,300 $2,700 $0 $22,500 11 1997 $163,200 $0 $0 $22,500 12 1996 $163,200 $0 $0 $22,500 13 1995 $163,200 $0 $0 $22,500 15 1993 $155,000 $0 $0 $27,000 16 1992 $176,700 $0 $0 $30,000 17 1991 $172,800 $0 $0 $52,500 ; 18 1990 $172,800 $0 $0 $52,500 19 1989 $172,800 $0 $0 $52,500 20 1988 $88,200 $0 $0 $24,900 21 1987 $65,700 $0 $0 $24,900 22 1986 $65,700 $0 $0 $24,900 Photos http://issql/intranet/propdata/ParcelDetail.aspx?ID=229 4/9/2007 Barnstable Assessing Search Results 4 Page 1 of 2 t THE cif 6 PON 4s Home: Departments:Assessors Division: Property Assessment Search results �- 3MR4766 A / 2 Owner: HOSTETTER, DANIEL C JR Property Sketch Legend Map/Parcel/Parcel Extension s 009 /004/ Mailing Address HOSTETTER, DANIEL C JR I NO 30 BITTRSWEET LA OSTERVILLE, MA. 02655 n " 3�1f g •, . 2005 Assessed Values: ley 3�333� Appraised Value Assessed Value ;� m33 Building Value: $297,700 $297,700 y ' Extra Features: $ 14,400 $ 14,400 Outbuildings: $0 $0 Land Value: $ 109,000 $ 109,000 Interactive Property Map: ap requires Plug in: Totals:$421,100 $421,100 1 have visited the maps before Show Me The Map April 2001 photos available v Sales History: Owner: Sale Date Book/Page: Sale Price: PACITTO, FRANK J TRUSTEE 7/15/1994 9298/067 $ 1 PACITTO, FRANK J TRUSTEE 11/15/1993 8882/176 $ 120,000 NATL CREDIT UNION ADM BOARD 9/15/1992 8207/168 $ 108,750 PHINNEY, NANCY M TRS 11/15/1990 7349/318 $200,000 BARN COMM FEDERAL CREDIT 11/15/1990 7349/310 $ 168,000 LARGAY, CHRISTINA B TRS 1/15/1990 7032/167 $250 CAPE HARBOR DEV CORP 8/15/1987 5879/195 $ 1 HOSTETTER, DANIEL C& 8/15/1986 5230/332 $ 119,500 QUEEN,ANN A P58768 $0 QUEEN,ANN A 41A 4497/257 $0 HOSTETTER, DANIEL C JR 9/18/2003 17666/160 $365,000 Tax Information: Tax information is currently not available for this parcel http://www.town.barnstable.ma.us/tob02/Depts/AdministrativeS ervices/Finance/Assessin... 10/15/2004 Barnstable Assessing Search Results Page 2 of 2 Land and Building Information Land Building Lot Size(Acres) 0.5 Year Built 1720 Appraised Value $ 109,000 Living Area 3206 Assessed Value $ 109,000 Replacement Cost$372,122 Depreciation 20 Building Value 297,700 Construction Details Style Colonial Interior Floors CarpetHardwood Model Residential Interior Walls Plastered Drywall Grade Custom Minus Heat Fuel Gas Stories 2 Stories Heat Type Hot Water Exterior Walls Wood Shingle AC Type Central Roof Structure Gable/Hip Bedrooms 6 Bedrooms Roof Cover Wood Shingle Bathrooms 4 Bathrooms Total Rooms 12 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value APTX Extra Apartmt 3 $ 12,000 $ 12,000 FPL2 Fireplace 1 $2,400 $2,400 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area (Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area (Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessin... 10/15/2004 ACCESSORY AFFORDABLE APARTMENT SEPTIC QUESTIONNAIRE FOR STAFF USE ONLY 1. Is the dwelling connected to Town sewer? ❑ Yes E!(No 2. Dwelling located ❑ INSIDE [OUTSIDE the Saltwater.Estuary Protection Zo ne 3. Dwelling located ❑ INSIDE ❑ OUTSIDE public supply well Zone.of Contribution 4. Dwelling is connected to ❑ ON-SITE WELL dPUBLIC WATER 5. Disposal works construction permit on file? Cd"Yes ❑ No OM �-- O 6. If yes, how many bedrooms were allowed by this permit: 5— bedrooms bH o woe- 7. Were building permits obtained for additional bedrooms? LY1Yes ❑ No ay Previous oWNeK 8. Engineered septic system plan: a. On file at the Health Division? ❑ Yes ❑ No- b. If proposed accessory unit is detached from principal dwelling, is that plan on file? ❑Yes ❑ No 9. Existing septic system capacity is bedrooms For the accessory unit to receive approval from the Health Department the following action must occur: ❑ Existing system accommodates proposed additional bedroom(s) ❑ Upgrade existing system to acco mmodate additional bedrooms) ❑ Must remove a bedroom from the main house ❑Must connect detached structure to the existing septic system ❑Must install septic system for the detached structure ❑ Other ----------------------------------------------------- Signed Date i i Health Department Drop-Off Hours: 8:00 AA — 4:30 PA Town of Barnstable Received by Health Regulatory Services Department on _ Richard V.Scali,Director '� ,� Public Health Division Thomas McKean,Director 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 ACCESSORY AFFORDABLE APARTMENT SEPTIC QUESTIONNAIRE Property Address: L4 r7G 15*A tin 0 V f 11 9, , C 0-+-u Assessor's Map/Parcel Number: D C,-Pi 0® �{ Applicant(s) Name: Pro L1_..0 Phone: _501 T A 3_91 E-Mail: SPANa a i N L.,C 9q 0, Wtm i c Size of Lot: 2a. How many oom-` exist at your property now? .S 2b. How many bedroom are you planning to add as part of the Accessory Affordable Apartment Program application? I 2c. How many bedrooms total are proposed at this property (including the Accessory unit)? 2e. Is the proposed Accessory Apartment contained within: the main house; OR a detached structure 2f. Submit floor plans for all buildings on the entire property. Show all existing rooms in the dwelling and the proposed accessory apartment. Label each room clearly. Label measured width of all open doorways. Use straightedge for hand drawn plans and be sure all labeling is legible. Signed: Dater 1 Town of Barnstable office HaWuzs Regulatory Services 8:30—s:30 1:00—2:00 Thom"F.Geller,Director T re�a Public Health MUM ThomasMclGean,Director 200 Main Strome iiydmus.MA 02601 Fax: 608-,790.6304 OMp,a: 508462.4644 ANN7ESI Y PROGRAM Y' ICANT iSUM—C Q1 1LO-1'RT_ � 1. General Yssfonslation' Size of Praporty-_ s 9C, Address: 0��1a✓ ��, �+2$ (-o Map u b Pezael �® os 1'2t /c �12• Phone#• $8�� y20-O6`!� 2a. How many bedrooms exist at your propa V nova? . 2b. Arc you p launln8 to add any bedrooms? o if yea,bow mangy NIA 2c. How many bedrooms total are proposed of this property(inaludinir the an ne sty unit)' 2d.Please include a copy of the floor plans for the&UM property•showing tke slitting rooms In the home plgr,the proposed amnesty oportment and/or addition. Iplease label eacb room clearly on the plan,. 3. 1%the dv"I in8 coaaeoted to pnblio sue? YES or NO Ittha dvrwellia col meow cneow to Lmbllc Svwa,64 TMtims#4*r h 44 below. 4. yceation of tlwolling is INSIDE or OV;rSLDE a Zone of Contribution to pmblie supply wells" S. Is the dwellial cO=cOtad to as Oh�!?g�YiE or to pUBLIC MATER? 6. Is a disposal works w0truadon permit ou 361m? YES of NO bedrooms�•sre a roved accordi'g to*U pormit? TE_Badroo�s. �. Ifyzs,boartt+auy � 7. Were say building pots is obwwd for cooatatctioa Of additionsl bedrooms' y1s 8. Is duce an enSineex4 septic system Plan on file at%a Haab pixidon? YES W NO 9. Has&:septic tyst=bees hopmsd by a DEP emilfled bnspector witbin the left two yoaus? or NO wYl�r�lYllNr.�J!lw�l�+�H�..I�YM�rl1Yl..w��M�N�ww�lY!/1�.��11!!• . FOR E3RF_3 Us,ONLY T public Health Division has ran objection to�bedrooms at this propzrty. he Special Ox4itions: Sigrlod: Date: Q;/moo itlr�.�Jt►��a�erriopp Unit ►► B►► 31'40" 4'--9" 5'--3" 6=8" 7'-5" 4'-3"- X. 3'-0'x dA' 76-x 6'8' T-O' 4te 3'-0'x4A' i�- e N ty O C'p E9, Access h 0 Bedroom #1 to unit Bedroom #2 ►►A►► e -� N 10'-10" 16-10" 3 V-6" rn (n 76'x B'B T--11" 2,0"A--3,4" a m � �p Closet Living Roomz Bath 4 M T--1" 4'-3" CV b 4 F Kitchen 4766 Falmouth Road o N Cotuit, Ma. 0 s 0 4 Diming Room A � fn Al N x Unit "A„ 32-0 3=11" 5`41" 7-3" 6'--0" 5`--6" 3-5" 3'-0"x 4'-S" 3'-0"z 4'8" - 3'-0"x 4'-r 3'-0"x 4'-8".: 3'-0"x 4'-8" CY) - 1 � m ; CO LO } N m N• Y x Q W b K a m LO �1 Cb Bedroom , Dining Room m b >< K Q a M closet N N - 2=6"x 6'-8" 2'-6"x 6=8" x 10.00"T N IN- ------------ x a - v 1- N7 21 Living Room Kitchen N Ct1 W-10" 15-2„ 4766 Falmouth Road Cotuit, Ma. f'ntfi A) Unit „C►, 28'-0" CD F47 CO x ; N x �I BathX Common N Laundry Kitchen m T k O 3-9" M chanical Room Closet IV 2=6"x6'4" 2'-6"x 6'-8" h 5'-0"xB e-co x ------------ `� ---------------------_ - 3 2 5'4" N5'-10" 7k 3'-4" 2 8' N V Bedroom Living Room �-� m a x m � N 04 M 8-6" 12-11 n 6r 5rr 2T-1.0" 4766 Falmouth Road Cotuit, Mass. Unit ►►D►► o„ 26'-0" Closet CO � N 2'-6"x 6=8' --------------� 5=10' 1' 1" bto m Bath N N Studio T11" N a � - o Kitchen 2 6'x 6'8' -------------- 5_5,. 11'-011 I� 5, 8" X-11" ' 26'-0" 4 766 Falmouth Road Cotuit, Mass. 2ndo�� D 3 LOCATION MAP / ae......... dD r'1AZBBBu.E s. Auoatcaou '� j y• � za 'k ,C pN / •d, I / ✓0°9 '� '�. rp c,o Dz ~•'"o.. / so a>'Az w'° \. + a�at sus` PLAN OF LAND 1y S2r I� SANTUIT BARNSTABLE MASS. FOR DORA M.NICKERSON SCALE I INCH 40 FEET FEBRUARY 1972 A-0—UNDER aueoEB Roe care ceo auxvcr eoxauu:xn enw Nor RroulReo Vsr xrANxls.«Ass , I} YANOUGH Roso BARNBTABLE PLANNING BOARD ue DAlRy Op DE DlY-ON of sOarox IEY erAITa lxeoxxoRAreo LE [ 'I''i A DEGDS sDRxe FED171972 i io re,f.Swa eny COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PR, ON REC SEP 2 f �OWHEOALTH DEPT. TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: l 6 b i/mou f// &/11—)' MAP o 0014 ARCEh `p0 at- Owner's Name: 1C 1L+n L�' O LOT , Owner's Address: 7 o.t -� o � Date of Inspection: 0 3 // Name of Inspector. lease print) Gl v `sic //t Company Name: !ii / EG Mailing Address: 07A /0)" Telephone Number. S70f _ —��-44 CERTIFICATION STATEMENT I certify that I have personally inspected the sewag e 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. 1 am a DEP approved system inspector pursuant to ' n 15.340 of Title 5(310 CMR 15.000). The system: Paws Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: ZDate: 6 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 now 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. Notes and Comments ****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. Page 2 of l I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Property Address: / )� G�(/�'! /��c% , 3� Owner: Date of Inspection: Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. Sysstt Passes: `� I have not found any information which indite that of the failure cri any tens described in 310 CMR 15303 or in 310 CMR 15,304 exist Any failure Criteria nqt evaluated ate 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 mfdtration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND explain: Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken,settled or uneven distril)utign bqx, System will pass inspection if(with approval of Board of Health): broken pipc(s)are replaced obstruction is removed distribution box is leveled or replaced ND explain: The system required pmpmg 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: Page 3 pf 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: `T fob Fel-(4MCLAI /2ci Owner: ei c, Date of Inspection: G. 14;r6er Evaluation is Required by the Board of HIM* _,'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-W(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: Cesspool or privy is within 50 feet of a surface water _ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is functioning in a manner that protects the public health,safety and environment: _ The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water suppiy 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: Page 4 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR_ M PART A CERTIFICATION(continued) Property Addras: / Ct 4'110-t r'1 wcj 6 r Owner. ��L, j Date of Inspection: - D. System Failure Criteria applicable to all systems: You must in sate`fires'or"no"to each of the following for illI inspections: Yes No/ saE/ ckup of sewage into facility or system component due to overloaded or clogged SAS or cesspool srharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or ` /clogged$AS or cesspool t/ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or /cesspool d depth in cesspool is less than 6"below invert or available volume is less than%:day flow Requireri pumping more than_4 times in the last year NOT due to clogged or obstructed pipe(s),Number of times pumped A y portion of the SAS,cesspool or privy is below high ground water elevation. V 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. _ �/ y portion of a cesspool or privy is within 50 feet of a private water supply well. �y 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. 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• 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 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"ves"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 uldmptactla n t Page 5 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B Preperty Address: Owner. !wit L �` tbo Date of Inspection: a Check if the following have been done.You most indicate`yes"or"no"as to each of the following: Yes No — ' g information was provided by the owner,occupant,or Board of Health Were a�of the system components pumped out in the previous two weeks f e 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 for signs f inspected gas o break out Were all system components,excluding the SAS,located on site r Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of es 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: Yes no 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 CNM 15.302(3)(b)] Page 6 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C „ r SYSTEM INFORMATION Property Address: Owner: ���I tN Date of Inspection: FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): -� Number of brooms(actual):-� DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): JT0 Number of current residents:_/ Does residence have a garbage grinder(yes or no): Is laundry on a separate sewage system(yes or no):" [if yes separate inspection required] Laundry system inspected(yes or no):�� Seasonal use:(yes or no):/lam Water meter readings,if av;flab le(last 2 years usage Sump Pump(Yes or no): �i Lust date of occupancy:�(�✓��� COMMERCIAL/INDUSTRIAL Type of establishment: Design flow(based on 310 CMR 15.203): spd Basis of design flow(seats/persons/sgft,etc.): Grease trap present(yes or no): Industrial waste holding tank present(yes or no):_ Non-sanitary waste discharged to the Title 5 system(yes or no): Water meter readings,if available: Last date of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records / Source of information: ko Was system pumped as part of the inspection(yes or no): If yes,volume pumped:___gallons—How was quantity pumped determined? Reason for pumping: F SYSTEM _ 'c tank,distribution box,soil absorption system _Single cesspool _Overflow cesspool —Rivy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _InnovatnWAlternative 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- Were sewage odors detected when arriving at the site(yes or no): !! ,y Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSM]MM SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C f /SYSTEM INFORMATION( Property Address f i Owner. Date of Inspection: a3 BIIII,DING SEWER(locate///site plan) Depth below grade: 19 Materials of construction iron -4 PVC_other(explain): Distance from private water supply well or suction line: Comments(on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK._(locate on site plan) Depth below grade: Material of construction:_concrete metal fiberglass_polyethylene _other(explain) i If tank is metal list age:_ Is age confirmed by a Certificate of Compliance(yes or no):—(attach a copy of certificate) Dimensions: X to Sludge depth: Distance from top of sloe to bottom of outlet tee or bale: aZ 91 Scum thiclmess: 49 7 Distance from top of scum to top of outlet tee or bale: Distance fmm bottom of scum to bottom oj;oytlet tee or baffle: How were dimensions determined o G - Comments(on pumping recommendations,inlet and outlet t06 or baffle condition, structural integrity,liquid levels as re4ted to outlet invert,evince ofleakagp,e�.): � / � ✓h / �cJl vl rt G h/' GREASE TRAP:-�to on site plan) Depth below grade: Material of construction:_concrete_metal_fiberglass_polyethylene_other (explain): Dimensions: Scum thidmess: Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or bale: Date of last pumping Comments(on pumping recommendations,inlet and outlet tee or bale condition,structural integrity,liquid levels as related to outlet invert,evidence of leakage,etc.): Page 8 of 11 OFFICIAL INSPECTION FORM NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Fo Owner, f'it p Date of Inspection: d, TIGHT or HOLDING TANK:LIB(tank must be pumped at time of inspection)(locate on site plan) Depth below grade: Material of construction: concrete metal fiberglass polyethylene other(explain): Dimensions: Capacity: gallons Design Flow: pllons/day Alarm present(yes or no): Alarm level: Alarm in working order(yes or no): Date of last pumping 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: ,/` G Comments(note if box is level and distribution to outlets equal;any evidence of solids carryover,any evidence of leakage to or out of x,etc.): a bey-/. &0 4 PUMP CHAMBER: (locate on site plan) Pumps in working order(yes or no): Alarms in working order(yes or no): Comments(note condition of pump chamber,condition of pumps and appurtenances,etc.): r. Page 9 of I I OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: Owner. ldkral� Date of Inspection: SOIL ABSORPTION SYSTEM(SAS): (locate on site plan,excavation not required) If SAS not located explain why: Type leaching pits,number: ��l - leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/altemative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): 6/7 J,H 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 or 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.): ' Page l0 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY AS-SESSMI NTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Imfinued) Property Aaaamc t�7 4 1 I FG(VIC u Omer. DXteothispertion: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a r-krtch of the sewage disposal system including ties to at least two perms reference landmarks or Locate all wells within 100 feet Locate whore public water supply enters the baildin. /�lraa ' lfa210 � y. J3 ' �� r e. ` Page 11 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PAIN'C SYSTEM INFORMATION(continued) Property Address: "7' � ©�'� erc' owner: Date of Inspection: SITE EXAM Slope, Surface water Check cellar Shallow wells / Estimated depth to ground water feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole within 150 feet of SAS) Checked wi&local Roar,-f Hea1d1-0*ain: Checked with local excavators,installers-(attach documentation) Accessed USGS database-explain: You st describe how you shed the h ground water ation. - 7 'd� c,� v� Gt vt D✓ - Q V o L4 k-C/w�.�c r /O CG d 0 0 �t © e� / ' O G✓ ,' p� /D libtal N q ✓ ��-- SI�Gt/�so� /or' 17 O 0 - 4� pOD � o C3 f �, qJ toolV V + =' CERTIFICATE OF ANALYSI Page. M 1 Barnstable County Health Laboratory EP 2 2 2003 Report Dated: 9/18/2003 o"OF�Ah; S. Report Prepared For: HEALTH DE Order Number: G03 Frank J.Pacitto 4766 Falmouth Rd. $�Ce, MA 02649 nn �1 0 DLl Co-t tk;1 Laboratory ID#: 0322828-01 Description: Water-Drinking Water n Sample#: 22828 Sampling Location: 4766 Falmouth Rd.,�e t w t, Collected 9/16/2003 Collected by: F.Pacitto 009-004 Received . 9/16/2003 Routine ITEM RESULT UNITS MCL Method# Tested LAB: IC Lab Nitrates <0.1 mg/L 10 EPA 300.0 9/18/2003 LAB:Metals Copper 0.1 mg/L 1.3 SM 3111E 9/18/2003 Iron <0.1 mg/L 0.3 SM 311113 9/18/2003 Sodium 12 mg/L 20 SM 3111B 9/18/2003 LAB: Microbiology Total Coliform Absent P/A Absent 307 9/16/2003 LAB: Physical Chemistry Conductance 85 umohs/cm EPA 120.1 9/16/2003 pH 5.7 pH-units EPA 150.1 9/16/2003 Note: Water sample meets the recommended limits for drinking water of all above tested parameters. i Approved By: (Lab Director) p .. ... i ..ti..�X'T e 1 Superior Court House, PO.Box 427, Barnstable, MA 02630 Ph: 508-375-6605 Maclaket Place B12 Route 28 Mashpee MA 02649 k ; e N d � 704 RNI • • ■ January 11, 1988 617 477 2525 Jerry Dunning Barnstable Board of Health 647 Main St. Barnstable Town Hall Hyannis, MA 02601 Gentlemen: On December 15, 1987 this office inspected the installation of a septic system at Lot 2 in the Willowbend Subdivision. We checked the system prior to it being backfilled and found it to comply with our design drawing # 1230 dated January 6 , 1987 . Very truly yours, THE BSC GROUP-CAPE COD INC. David A. Johnson, P.E. Environmental 1DAJ 3 6/rah Scientists Engineers Architects Planners Surveyors The BSC Group—Cape Cod Inc s r` �- s� 7G 6 TOWN OF BARNSTABLE ��7 ( LOCATION ,y�p ` b� `mob 2d SEWAGE VILLAGE ASSESSOR'S MAP Cz LOT 00q-v. INSTALLER'S NAME & PHONE NO.x w - �4c SEPTIC TANK CAPACITY `LEACHING FACILITY:(type) 4*OO ao (size) �NO. OF BEDROOMS PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER ,q�✓ , �f DATE PERMIT ISSUED: ______.,?//-2 W2 DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes , No l 3� 1 r di ® ���D�. _.. �� THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) IM ^� C DATA A 1 Depirtmentof Environmental Management/Division of Water Resources 4 ` WATER WELL COMPLETION REPORT WELL LOCATION Address— City/Town -` '• C S �.'+e)rF G.S.Quadrangle Map Grid Location Owner ear,,,z r'e" �• , 'r 72 a Address 7;74;; WELL USE CONSOLIDATED WELL Domestic r Public ❑ Industrial❑ Type of Water-bearing Rock Other Water-bearing Zones Method Drilled 1) From To 2) From To Date Drilled "- 3) From To 4) From To CASING Al r Depth to Bedrock Length t' Diameter Type t'rft 1 / C. UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials / Feet below land surface Sand: fine❑ medium Q' coarse 0 Date measured ,)_ 'r Gravel: fine❑ medium❑ coarse❑ GRAVEL PACK WELL Screen: Slot# /!r length� ; 'from to Yes El No COD Split Screen (or 2nd screen) WATER QUALITY TESTS MADE Slot# length from to i Chemical 0 Biological ❑ Depth To Bedrock PUMP TEST r Drawdown r 7 feet after pumping days hours at :�l a GPM. How measured Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To o m e !r ,r_f � rr DRILLER m Firm 7�,`'Y,P -t, « .n �I b,' 1. � 1.-r-, \ Address city , ,, I ? Registration No. Aerator sSignature' Please print firmly BOARD. OF. HEALTH COPY 15M-2 63-176171 Department of Environmental Management'Division of Water Resources I�!J WATER WELL COMPLETION REPORT WELL LOCATION Address City/Town G.S.Quadrangle Map Grid Location Owner Address WELL USE CONSOLIDATED WELL Domestic❑ Public ❑ Industrial ❑ Type of Water-bearing Rock Other Water-bearing Zones Method Drilled 1) From To_ 2) From To Date Drilled 3) From To 4) From To CASING Depth to Bedrock Length Diameter Type UNCONSOLIDATED WELL STATIC WATER LEVEL Water-bearing Materials Feet below land surface Sand: fine❑ medium❑ coarse❑ Date measured Gravel: fine❑ medium❑ coarse❑ Screen: GRAVEL PACK WELL Slot# length-from-to- Yes ❑ No ❑ Split Screen (or 2nd screen) WATER QUALITY TESTS MADE Slot# length from to Chemical ❑ Biological ❑ Depth To Bedrock PUMP TEST Drawdown feet after pumping days hours at GPM. How measured Recovery feet after hours. LOG of FORMATIONS COMMENTS: (On well or water) Materials From To 0 m DRILLER y m Firm ° Address \ City Registration No. ignature Please print irm y Operator's BOARD OF HEALTH COPY ISN7 2 84 176-1 A. , Sisa:;:ass;:asssssali;::;n;:as::p:; :n sssi::ssa;:::ansss:::::::rn�rsa s::n: ssss:::•sin:n ssn a::a:ass::•sr.:ssmsssasssasssa::a :as::ns s:sss::rs: ,:: la ,1 _ ENVIROTECH LABORATORIES 66 Lewis Bay Road • Massachusetts 02601 • (617)•,771-7265 CLIENT: S. iolmes Cape Harbor Dev• LOCATION: Lot 2 Route 28 77,JA Main Street ADDRESS: Santuit,MA Qsterville,MA 02655 COLLECTED BY: Ed Meehan SAMPLE DATE: 2/3/87 TIME: 2:20PM DATE RECEIVED: 2/4/87 SAMPLE ID:465 =: JOB #: Well WELL DEPTH: 80 ft .'= RESULTS OF ANALYSIS: Parameter Units ..Recommended limit Result - Coliform bacteria/100 ml (MF Method) 0 0 BE pH pH units 6.0-8.5 5.53 Conductance umhos/cm 500 104 Sodium mg/L 20.0 14.0 Nitrate-N mg/L 10.0 .35 Iron mg/L 0.3 .33 Manganese mg/L 0.05 - Ei Hardness mg/L as CaCO 3 500 Sulfate mg/L 250 Potassium mg/L 20.0 Alkalinity mg/L 200, Chloride mg/L 250 COMMENT: Iron content is not considered a health hazard. - Water is suitable for drinking purposes for all parameters tested. DATE .«i'i'i"iiiii:::iiiiiiii.i.i.i.«i.iii•«Si•I:3i:iii:iiiiii.i•i.ii.3.•i«iii•i••iii...i.•.iii.l.iii...i«ii::ifiiii.iii..•iiiiiiii.....•SSi.3iii'•i.'ii'ifil.:ii.iiiii.iiilti"""'1i13ii21:::iii::ifiii""i"'i'i'i"li""{'l."'8"Saa3bb L L A G E PiUiLDE0 OR Q HiR DATE C0MPLiANCE 15SUE4�i u b w, , �� d.�1" ,p, , ,Q �:� . I. _�/ ;f �3 ,;� .. �'8 ti _ 4,.: Oftdw No.�ee�.1./:7 -__... Fmm.............`7 .. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH � CVJ. .. ...oF. .CZI ( ................................ Apphration for Uhip gal Works Tomilrurtivit ramit Application is hereby made for a Permit to Construct ( ) or Repair ()() an Individual Sewage Disposal System at: ...M(e.(,eQ-.2T .F------•-...-y..-,!?,aS:' U..=................. ..•-••-------•--•---•------------.........................---••---....................•........---�` Lot _.?1 .. C! t� pSt. .........' . Owner Address .. Installer Address .; Type of Building Size Lot_#7-L,5;.�17_._...Sq. f t Dwelling—No. of Bedrooms..._......______________________________Expansion Attic X� Garbage Grinder Other—T e of Building .. No. of persons............................ Showers — Cafeteria Q' Other fixtures _______________________•-_---__-_ . W Design Flow............. .......................gallons per person per day. Total daily flow....-AA-0........................... 1:4 Septic Tank—Liquid capacity_._l1�Ogallons Length__0. _(v.. Width..5-jEx... Diameter_---- Depth_.S._:!4__. Disposal Trench—No._.... ....... Width..................:. Total Length............__.......Total leaching area-----------_--_-----sq. ft. Seepage Pit No-------2........... Diameter......lb........ Depth below inlet....... Total leaching area... ....sq. ft. Z Other Distribution box (Ya5 Dosing tank (43D '-' Percolation Test Results Performed by. 1t'C .. ..� L..........-. Date d .`'_ _ ......_.. Test Pit No. 1__j4-_Z:.....minutes per inch Depth of Test Pit...0..._...._.. Depth to ground water_).� oT-544Z s"Tmet, Test Pit No. 2...G .._._minutes per inch Depth of Test Pit----!.v_.......... Depth to ground water....":................ tx -((l-4'-I----------Q.-.'&T...Lo.& ..................................... ODescription of Soil............ ...... _s4jP-37_--ij...................................................----------------------------------------•---•---•-----------=-------••---•---•---•-----•-----------•----------------------- --•--- VNature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to st 11 the aforedescribed Individual Sewage Disposal System in accordance with the provisions of iT' E 5 of the State Sanitary Code—Th u e igned furt. r rees not to place the system in . operation until a Certificate of Compliance has been issue t a f t A PP pp roved A roved B ------------------��-.�--................==---------•--•------. ---- �Y Date Application Disapproved for the following reasons:................................................................................................................ --------•-•------•-•--•••-••-•---....•--••--•----------•-•---••--•----........•---------•-••--•••--•--•-•-----------•-•--•••-----•-•---------•--•-----•----------•-------------•----------••------------ � I Date Permi ...1.1-3-_��............................ Issued........................................................ Date J _4 Fes$..........................._ r1. THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....7o\k/.+ , .........oF r-�,�2 �.`�. �� --------------------------------- ApplirFa#ion for Bi.4pntittl Works Tonstratrtion ramit Application is hereby made for a Permit to Construct ( ). or Repair (K) an Individual Sewage Disposal System at ..q t ?....__.. _e!�t lU_.1..�...................•. ._...... -----------------------------•----- Location_t� Lot No p Owner/ Address Installer Address Type of Building Size Lot... Vi..--_---•._.-------Sq' feet U Dwelling No. of Bedrooms.........A................. .....Ex Expansion Attic a g— __._.__._ p (a'.�t�) Garbage Grinder � c}> aOther—Type of Building ............................ No. of persons............................ Showers ( ) — Cafeteria ( ) Otherfixtures ----------•-•-- -•---------•--•-•-•-----------•----•....••--------------------------------------•---•--- ....---------- W Design Flow..:.......:5_S_.•--•••.__-•-•--.----_-gallons per person per day. Total daily flow.._AAU.............. ...........Vlons. WSeptic Tank—Liquid capacity..l.iZX__?.gallons Length.lU~_.(_-_ Width. '. 2._.. Diameter.:-"'.._.._. Depth_-D-.'(.... x Disposal Trench"—NTo. .....—:........ Width................. Total.Length........._._........ Total leaching area.....=:.......sq. ft. Seepage Pit No------- .......... Diameter___-•A.0........ Depth below inlet..... .......... Total leaching area._�7U....sq. ft. Z Other Distribution box (ye)s Dosing tank (4 0 '-' Percolation Test Results Performed `l....._-_ L_.__.__..-.- Date_yb Z T L ? P P , P g 1,oV'EJ1JLO Test Pit ;�o. 1.......:........minutes er Inch Depth of Test Pit.__._ ._...._.._. Depth to ground water..___._______-__-____- - uroLEp f? Test Pit No. 2...4.. .....minutes per inch Depth of Test Pit...!.Q........... Depth to ground water....'`.__...._...`_... Ri -•-t-n- -k---------•Q.' .. � — D Description of Soil-------------- = ------•1��1 :.a? � .h-l.t�.. i`lo wJ.: .........................-.......... U --•------------------ = ( 1. W UNature 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 TT�'I E 5 of the State Sanitary Code—Th u e signed 'fur .er rees not to place the system in operation until a Certificate of Compliance has been issu �f 3 /i Application Approved BY ` �!�....- === - � G ` Date Application Disapproved for the following reasons------------------------------------•.......................................................................... ..............••-•-•------•.....-•--•-----•-----•-...---••----------•--•--........-----.......--------------•----•------•----••-•---•••......--•---------------•-------•----------------•-••---------- Date Permrt�----/._r ^ ---- ................ Issued--...----•---•-------------------------••-•---•........ ` Date THE COMMONWEALTH OF MASSACHUSETTS BOARD EALTH _DNS ..........................................OF.................................................................................... %lurrtifirtttr of ToutpliFaata TH,�IS CIS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( } by........... Installer at-----------. .-----------------------------•-----------------------------...---•---•---•-------------------------- has been installed in accordance with the provisions of Ti T'r_ 7 of The State Sanitary Code a es r .in the application for Disposal Works Construction Permit 'No. _� l --. _r-� dated --------------------•--------- THE ISSUANCE OF THIS CERTIFICATE SHALT. NOT BE CONSTRUED AS A GUARANTEE THAT YHE SYSTEM WILL FUNCTION SATISFACTORY. DATE.................: '.�.�?...-..�5. �..........-•----....---•---- Inspector-•-•-- ",--,,, ----------------------------- --SIGNING EN , Iv,UST SUPERVISE THLC)OMMONWEALTH OF MASSACHUS,ETT i LATIOR4 ~RT1PY IN WRITING BOARD OF HEALTH 'HE �,YSTEM _r 1-twr._D IN STRICT ........©F.........-- '.,.,":� .._........ c a� / Tj No......�P.-I......... FEE............. MoVostal Works ��at fri irrat lerttti Permission is hereby granted........... G` �- .-•--.-••------------••• .•---••..........•----•....................•... to Construct ( ) or Repair an Individual Sewage Disposal System at i�To. 7_�111.1a_ .. �'�'r�....._.-� i�'� ------------------------•------------......--•- ---- • ............ ...- ....................... Street / / as shown on the application for Disposal Works Construction Permit INe `2._1_.!:_ �_Dated....................Jg?,............... - - .y. C... Board of Health DATE................................................................................ FORM 1255 HOBBS & WARREN, INC., PUBLISHERS r� v' CAT10N SIWACE PERt�1r �6Q, VILLAGE --- eNSTA LLE �'S 1~ 1 At D $ S p101d r ------------ aiLDER OWNjR ' A1 E R M I T FSS '10 DATE C0MPIiAHCE iSSUE1a hb I ---- T*I yy ��.. PETER 7+ No. 29743 t +,_.. f t + y i •-+F. l `O�.�SSG1STfi �G`���Q• \ ' ON , 1 r -} I t }L ► T1N Cie, ,'� .?C1G. . .77 L I - 151.41 �• 1 T i 4 +.I , N ' 44 � I N sci�-r�►:..�G� M� � • Ala 2�auSGt, , J } -. ; . n , 9 �. - _ g bAec �-L;Y F _ . ., Iplr i { �-(L'-tC�� � G��4(.„„'�;��;s�'� r�M, >✓t-rt:cLTI.V� �-�t O���- .-- __ W l,j„/ .. 4j 14�' S i � 1 NS�CF. � o�Cam' �2, Rp p - i-- i 1 I Z gyp . G1s'i; If.,Y 1NJ 7�6 - �1e CI,; •, C lluV �� 1MV CAt_ . ' twX _ tJV TANK ��cC t t - _ -�I--�. +�� Tom' ��E $'ZCn•F fo - 01 , , TAR YE r t\Ic. Y • - � D.ESEGNING ENGINEER MUST SUPERVISE. ,...........:__.._.._.._..i_ � --- -- -- ... `{ 5 ..LATION AND CERTIFY IN WRITING r THLr:`:,Y,-;TEM :WAS INSTALLED IN STRICT AC ;' .ONCE TO PLAN. - . . dtJ , r lam-© �5 H t...p=7- i IMU- It 4766 R 8) Road JL LLLI Unit `B" Unit «A�� sr„ 2nd Floor (over unit B) 1 ;Floor (under unit A) 32-0 =11 5'-11" T-3 6'-0" 5'-6" 3=5" 31-10 4_0. 5t3^ 6=8'---- aa-.4$ ra:4-r = rc:4a aa,�r rv-rrr � � �S ; NCO � LID : Bedroom #? to un Bedroom #2 to _ '�A - o Bedroom Dining Room CI Cn O ,• \ zr,rr N = j za,rr C, �e�k it �- i In 31 r i1 o m `O Bath ,�-T-0"- Closet Living Room 2.r� 9 \ Kitchen 4_3^ Living Roorn i 00 rn LU o_ d CO <o 9 I CJ1 II � r I 4766_Falmouth Road I Kitchen a Cotuit Ma, ,s'-,o" 15'-r N � O - Dining Room , . 15'4D''"" ` 2 ndFloor over unl . Unit " Is' Floor (under unit D) 0 26'-0° 28CO =0" �., e " "' Closet CO a Bath .......... N Kitchen Ot1mon r 5=10+ undrY Studio I Bath o ' 13 _ 1 - •� M chanical closet Cl) rv,ercQ. ' i ••---•-••_--_--_• - A -► Room 3 4 7-11" N r.r,ra N N5--10N 3'2 5#40 2 8 ,, o o ' I Kitchen Room i r • Living d m - _ Be roo II 24'tCi' r N 5'-5" 26'-0"Cn �C ...► ---r 6'-5"—' _ -12'-11" -- 8'-6" _ ----27'-10" ASSESSORS MAP: TEST I-10LE LOGS PARCEL: DC7_ _ _ _.___... _ _. _.._s_ Q 1) The ins(allalion shall comply with Tille V aukl "town of*t10#jl,&hmlyd 01 SOIL EVALUATQR: I I �J, C5ti I lealth Itegulalions. FLOOD ZONE: /D ' T -" -�- WITNESS : . 1 ) 2) The inslailer shall verify the location of utililies, sewer inverts and septic REFERENCE: DATE: components prior to installation !uu1 setting hose elevations. `�'�� .___Q1���� - .._ ��---,-.-_ . -- + 3 All !ravil septic piping� to he q inch Scl � 0 PVC at I " per toot. "l�hc first .-- PERCOLAT I ON RATE: G- l l ) ! Y I I I b ! I /8 A �! TM two Icet ont of the d-box to the Icuching shall be level. • ) 4ty ' `��'� q) This plan is not to be utilized for property line determination nor any other Y � _—. � TH- I TH-2 purpose oilier than the proposed.system installation. 5) All septic components must meet Title V specifications. 6) Parking shall not be constructed over I I10 septic components. j 7) The property is bounded by property corners and property lines. 8) The property owner shall review design considerations to approve of total design Clow and number ofbedrooins to be considered for design. Receipt LOCATION MAP of payment for the plan and installation based on the plan shall be deemed approval of the design flow by the owner. G � 1r 9) The existing leaching or cesspools shall be pumped and filled with material per Title`✓ abandonment procedures. Those within the proposed SAS shall ILI be removed along with contaminated soil and replaced with clean sand per t b 'Title V specs. 10)System components to be 10 feet from water line. Sewer lines crossing the 0 a' �►`�� _ _ � water line,shall be sleeved with 4 inch SCI 140 PVC with ends grouted if ' j applicable. The proposed SAS is being installed below the water service line. The line is to be sleeved as aforementioned and maintained in place. SEPT I C SYSTEM DES I ON 11) If a garbage grinder exists it is to be removed and is the responsibility of the - --r----- — - owner to cns!ire such. FLOW ESTIMATE 12)The installer is to take caution in excavation around the gas line il's!ich exists. UEDR04MS AT GAL/DAY/BEDROOM - � GALIDAY 13)"I ne installer shall verify the location, quantity and elevation of the sewer lines exiting the dwelling prior to the installation. lq)This plan is representative only that a system can fit on a property inceting ' SEPTIC TANKNObOk, Title V requirements. �� O GAL/DAY x 2 DAYS - ` GAL i USE �L GALLON SEPTIC TANK S h.!( � / 50; _food1 L AOSOR i ON SYSTEM o t� P Q kry nA `"� a t?A ID l.. vl SIDE AREA: �C. ��, -r IL., r I k! BOTTOM AREA: p ;� " �z-1-�-`TC MAsoMASONh; E . YNo. 1065 -� v � ti 1 U P'a �0 � SEPTIC SYSTEM SECTION (21 q bo o o 1 L ►L1. h 0GAL _ SEPTIC TANK > TTb too X tie, tpo S 1 TE AND SEWAGE . PLAN LOCAT I ON :0 V': �____. PREPARED FOR : 'polTezTvc 01 G�4Y `fl o / , zo XIV, DAV I D B . MASONtR.5 DATE: 2 ► Q DBC ENVIRONMENTAL DESIGNS EAST SANDWICH . MA W - DATE HEALTH AGENT � ( 508 ) 533- 2I77 Z