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HomeMy WebLinkAbout0100 POINT ISABELLA ROAD - Health 100 POINT ISABELLA K©ab - -- -- -- -- A=074.006 I� No.�� S Y Fee `�1400. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Ye PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE., MASSACHUSETTS Zipprication for M!6poof bp.5tem Construction Permit Application for a Permit to Construct( )Repair()6 Upgrade(�y)Abandon( ) El Complete System ❑Individual Components Location Address or Lot No./00 Rii h-f -Ts"e lla- fic e Y�� Owner's Name,Address and Tel.No. Co Assessor'sMap/Parcel /pQ om m ° 07Zf oa reld oo& e fu-O'f 4 oa,G,&S So,F- Y � Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. '�L liefey'Sv//1va-.h P.,t-/SUIT,',&n 6 34 t 0.6. 6oX GS% (�Sterv�'l/r �'h�3 od S5 SOS" 33S/S/ Type of Building: -- Dwelling No.of Bedrooms Lot Size .2 7i 43 sq.ft. Garbage Grinder(/�O Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures ' i Design Flow Y Z/U gallons per day. Calculated daily flow gallons. Plan Date ttl o Ooo Number of sheets' / Revision Date R12.3 D Title S ' c UP7 rO O .gym ro�e_r,,crrls � 10o Pe), � T S a- e--- -, r�lkj�s Size of Septic Tank / od a4_//" Type of S.A.S. Lg=ac�)-Eq Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been isij6Qy,this B d o alth Signed Date Application Approved by Date '7- Application Disapproved for the following reasons Permit No. _C� -1 Z 7 Date Issued 7- S4-v'n 24� S Fee ' No. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Y PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE., MASSACHUSETTS A ,,,Z[pplication for -Migpogal *pgtem Cottgtructiott Permit Application for a Permit to Construct( )Repair X)Upgrade )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No/UU /7-74 - Sec b 04 IV t Owner's Name,Address and Tel.No. Cufu �� pev,'n n'aher Assessor's Map/Pazcel/7? D 751 /aQ /0 f Installe��Naamr�e,Address,�nd Tel. Wiper' Name,Address and,Tel No. 1��Ct�o (-p+.-S� ( C11 u11,v�L �Sul1 w h L t :nc 3S �o y p,o- 604 ",S7 La.,.. - l� c �w� Qsfrrvolr, MH 4d�.55 30� �/a�-3;yy Type of Building: ,,11 Dwelling No.of Bedrooms T Lot Size 7j,y3 sq.ft. Garbage Grinder#9 Other Type of Building No. of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow YYO gallons per day. Falculated daily flow � gallons. Plan Date y � �00a N�nber of sheets Revision Date ����/1 p Titles e j 2r ro pate Lr���ra ven�crr+3 ct7" JOG K' JI �5 a e G(R, 2�1 , o , .l'j- 0I s- .. Size of Septic Tank _o a, Type of S.A.S. Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date.last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not to place the system in operation until a Certifi- cate of Compliance has been i by thi and Cfqgpalt . Signed Date Date Application Approved b i t Application"Disapproved for the following reasons dq Permit No. Date Issued 7 p-r --------------------------------------- THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS Certificate of Compliance THIS IS TO�$RTIY, that t�}e On-site Sewage Disposal System Constructed( )Repaired, )Upgraded ) Abandone rr`v- la at /0 ) D loihf 5a�b / O tel'7`' h P een constrUcted in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. dated 7— Installer Designer The issu n);L�7Uejmit shall not be construed as a guazant Inspector the s stem�wil�fu!c>tion as desi ned. Date �� pector 1Y �Y..�� r t�i --------------------------------------- No. Fee/o,O 1 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE: MASSACHUSETTS lwigogar *pgtem Cottgtruction Permit Permission is hereby gra ted to C�• struct(� )Repair(x Upgra e( )Aban n ) System located at l!7 t -Z7S�i? and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Coons cti must be completed within three years of the date of t it. Date: / �7�� Approved �� DATE:_1/7/0------ µ PROPERTY ADDRESS: 10.0 Point Isabella Cotuit .Mass L__________ 02635 On the above date, I Inspected the septic •system at the above address. This system consists of the following: CJ d 0 1 . 1-H10-1000 gallon septic tank. 2 . 1-1000 gallon H-20 leaching pit . Based on my Inspection, I certify the.following conditions: 3. This is a title five se.ptic. system. ( 78 Code ) 4 . The septic system is in proper working order at the present time . 5 . Pumped septic tank at time of inspection . 5 . Installed cast iron rings and covers to grade . Two on the septic tank and one on the leaching pit . SIGNATURE:,f Name: Company: Joseeh_P_ Hacomber & Son, Inc . Address:_ Box_66__ CentervilleL Ha_. 02632-0066 Phone:___508 775_3338_______ THIS CERTIFICATION DOES NOT CONSTITUTE A GUARANTY OR WARRANTY • JOSEPH P. MACOMBER & SON, INC. Tanks-Ces:pool:-LeachfIeIds Pumped & Installed Town Sewer Connections P.O. Box 66 Centerville, MA 02632-0066 1 fl 775.3338 775.6412 1�' " __hq/ i JA N Z 5 200 l0WV OFgARN h n COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PRMQUQN ONE WINTER STREET, BOSTON MA 02108 (617) 292-5600 TRUDY CC Secret ARGEO PAUL CELLUCCI DAVID B. STRU Governor SUBSURFACE SEWAGE DISPOSAL SYST .WSPECTION FORAM ���EA PART A CERTIFICATION Property Address: 100 Point Isabella Nameofownw Evangelos Gikas Cotuit ,Mass . AddressofOwnw: 19—A f;ardnPr StrPPt Date of Inapection: 1/7/0 0 Peabody ,Mass . 01960 Narras of Inspector:(Please Print) .T_ P_M a r n m h P r I am a DEP I ovad syswn inspector to Section 15.340 of Title 5(310 CUR 15.000) Company Name: J. .Macomber A Son Inc . M&TuVAddress: Box 66 CPnttPrVl11P , Mncc _ n2632 Telephone N—ber: CERTIFICATION STATEMENT I certify that I have personally Inspected the sewage disposal system at this address and that the Information reported below Is true, accurate and complete as of the time of Inspection. The Inspection was performed based on my training and experience In the proper function and maintenance of on-site sewage disposal systems. The system: F Posses Conditionally Passes Needs Further Evaluation By the Local Approving Authority _ Foils Inspectors Sigrvture/3hall Dab: /t-Z`0 The System Inspectosubmit a copy of this Inspection report to the Approving Authority(Board of Health or DEP)wtWn thirty(30)days o1 completing this Inspection. If the system Is a shared system or has a design flow of 10,000 gpd or greater,the Inspe6tor and the system owns 'shall submit the report to the appropriate regional office of the Department oAEnvironmattul Protection. The original should'be.tent toVw system owner and copies sent to the buyer, It applicable,and the approving authority. . NOTES AND COMMENTS revised 9/2/98 Page IofII ��Printed on Recycled Paper SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIRCA71ON(continued) Property Address: 100 Point Isabella Cotuit ,Mass . Owner: Evangelos Gikas Date of tr► P--Wn: 1/7/0 0 INSPECTION SUMMARY: Check A, B, C, or A A. SYSTEM PASSES: 1-13 JU21 have not found any information which indicates that any of the failure conditions described in 310 CMR 16.303 exist. Any failure criteria not evaluated are Indicated below. COMMENTS: B. SYSTEM CONDITIONALLY PASSES: 4/2) 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. Indicate yes,no,or not determined(Y,N,or ND). Describe basis of determination in all instances. If "not determined",explain why not. The septic tank is metal,unless the owner or operator has provided the system inspector with a copy of a Certificate of Compliance(attached)indicating that the tank was installed within twenty(20)years prior to the date of the Inspection;or the septic tank, whether or not metal,is cracked,structurally unsound,shows substantial infiltration or exfUtration, or tank failure is Imminent. The system will pass Inspection if the existing septic tank is replaced with a complying septic tank as approved by the Board of Health. /L Sewage backup or breakout or high static water level observed in the`distribution box is due to broken or obstructed pipes) or due to a broken,settled or uneven distribution bo_. The system will pass lnmpewdon if(with approval of the Board of Health). - broken pipe(s)are replaced obstruction Is removed distribution box is levelled or replaced - The system required pumpMg-more thanfour-times a yeardue to broken or obstructed pipets). The system vAtpeas— inspection if(with approval of the Board of Health): - -- broken pipe(s)are replaced obstruction is removed revised 9/2/98 Page 2of11 r 0 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) PropertyAddre": 100 Point Isabella -Cottlit ,Mass . Owner: Evangelos Gikas Date of Inspection: 1/7/0 0 C. FURTHER EVALUATION IS REQUIRED BY THE BOARD OF HEALTH: ill0 Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect the public health,safety and the environment. 1) SYSTEM WILL PASS UNLESS BOARD OF HEALTH DETERMINES W ACCORDANCE WITH 310 CMR 16.303(1)(b)THAT THE SYSTEM IS NOT FUNCTIONING IN A MANNER WHICH]MLLPROXECT THE PUBLIC HEALTUAND SAFETY AND.THE ENMIBONMENT: Cesspool or privy is within 50 feet of 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 AND SAFETY AND THE ENVIRONMENT: - VA The system has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. A0 The system has a septic tank and soil absorption system and the SAS is within a Zone I of a public water supply well. The system has a septic tank and soil absorption system and the SAS is within 50 feet of a private water supply well. The system has a septic tank and soil absorption system and the SAS is less than 100 feet but 50 feet or more from a private water supply well,unless a well water analysis 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. Method used to determine distance _(approximation not valid).- 31 OTHER revised 9/2/98 Page 3orit SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART"A CERTIFICATION(continued) Property Address:10 0 Point Isabella Owner Evangelos Gikas Dato of Inspection: 1/7/00 D. SYSTEM FAILS: You must indicate either'Yes"or"No" to each of the following: f y�� I have determined that one or more of the following failure conditions exist as described in 310 CMR 15.303. The basis for this determination is identified below. The Board of Health should be contacted to determine what will be necessary to correct the failure. Yes No Backup of•sewaga lrrtofeci8tyer-rtate+n component-due"'to an over{osdsd ormckgged'SA&orcaaspod. =j--'•' '" Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool. 11t101�� Static liquid level indthe distribution box above out invert due to an overloaded or clogged SAS or cesspool. Uquid depth imeesepeclas less than t3"below Invert or available volume is less than 1/2 day flow. lZ Required pumping more th 4 times In the last year NOT due to clogged or obstructed pipe(s). Number of times pumped. Soil Absorption System,cesspool or privy Is below the high groundwater elevation. Any portion of the S p y P P W g Any portion of a 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 i of a public well.. Any portion of a cesspool or privy Is within 60 feet of a private water supply well. IAny portion of a cesspool or privy is loss•than 100 feet but greater than 60 feet from a private water supply well with no acceptable water quality analysis. If the well has been analyzed to be acceptable,attach copy of well water analysis for •►coliform bacteria,volatile organio-compounds,ammonia nitrogen•and nitrate nitrogen. - E. LARGE SYSTEM FAILS: 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: ivv The system serves a facility with a design flow of 10,000 gpd or greater(Large System)and the system Is a significant threat to public health and safety and the environment because one or more of the following conditions exist: Yes No , •�/ the system is within 400 feat of a surface drinking water supply the system-is-within 200 f"t-o(•+�t+ibutarHo-o-ouFftoo"Finjelaill watw-0u'pIY•••• - --•- _ _ ._ the system is located in a nitrogen sensitive area(Interim Wellhead Protection Area:IWPA)or a mapped Zone 11 of a public water supply well) The owner or operator of any such system shall upgrade the system In accordance with 310 CMR 16.304(2). Please consult the local regional office of the Department for further Inforpation. revised 9/2/98 Page 4of11 j SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECMON FORM PART B CHIECKUST Property Address: 100 Point Isabella -Cotuit ,Mass . Owner: Evangelos Gikas Date of Inspection:l 7 0 0 Check if the following have been done:You must indicate either"Yes" or"No" as to each of the following: Yes No Pumping information was provided by the owner,occupant,or Board of Health. _ -None of the system-composants hasbeoaancei wwsal.flow rates during that period. Large volumes of water have not been introduced into the system recently or as part of this Inspection. X1 As built plans have been obtained and examined. Note if they are not available with NiA. _ The facility or dwelling was inspected for signs of sewage back-up. The system does not receive non-sanitary or industrial waste flow. _ The site was inspected for signs of breakout.. _ All system components;Akeluding the Soil Absorption Systemhave been located on the site. t _ The septic tank manholes were uncovered,opened,and the interior of the septic tank was inspected for condition of baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge,depth of scum. The size and location of the Soil Absorption System orrthe site has been determined based on:-- Existing information. For example, Plan at B.O.H. Determined in the field(if any of the failure criteria related to Part C is at issue,approximation of distance is unacceptable) 115.302(3)(b)) _ The facility owaar-(and.ocr-pant s.Jf differapt fraaLaawar),ware.prnyided.with.InMrInatioaon thA p.=par m sit j3taA&QCA.Qf SubSurface Disposal Systems. i I I revised 9/2/98 Page sof11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 100 Point Isabella . Cotuit ,Mass . O'"'mw' Evangelos Gikas Date of Inspectim:1/7/00 FLOW CONDITIONS RESIDENTIAL: Design flow: & g.p.d./bedro m. Number of bedrooms(desi : Number of bedrooms(actual).1 Total DESIGN flow — Number of current residents: Garbage grinder(yes or no): Laundry(separate system) (yes or no):_;. If yes,sepamte.1nspection.required _ Laundry system inspected as or no) Seasonal use(yes or no): Water meter readings,if available(last two year's usage(gpd): Sump Pump(yes or no):� Last date of occupancy: j_ �ti,;,j/ COMMERCIAL/INDUSTRIAL• ��`�' •�,G�` l" Type of establishment: Design flow: Ah4 cad ( Based on 16.203) Basis of design flow led Grease trap present: (yes or no) Industrial Waste Holding Tank present:(yes or noLea Non-sanitary waste discharged to the Title 6 system:(yes or no)AY _ Water meter readings,If available: Last date of occupancy: At4 OTHER:(Describe) AIA Last date of occupancy: 1' GENERAL INFORMATION PUMPING R CORDS and ou c of information: System pumped as part of inspection:(yes or no) If yes,volume pumped: gallons l/ J Reason for pumping: r43/Y / Szz, , yBrs /W TYPE O SYSTEM Septic tank/dietriieerbox/soil absorption system Single cesspool Overflow cesspool Privy Shared system(yes or no) (if yes,attach previous inspection records,if any) 1/A Technology etc.Attach copy of up to date operation and maintenance contract Tight Tank Copy of DEP Approval Other A1/� p OXA E1M GE of all components,date insta1led4if known)•and source 04Wormation: 10u� Sewage odors detected when arriving at the site:(yes or no) revised 9/2/98 Page 6of11 t� t SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) PropertyAddre": 100 Point isabella Cotuit ,Mass . O1M11w: Evangelos Gikas Date of hapection: 1/7/0 0 BUILDING SEWER: (Locate on site plan) Depth below grade:/ Material of construction: ast iron LZ410 PVGVr4 other(explain) Distance fromnprivate water supply well or suction line /� Diameter I Comments:(condition of joints,venting,evidence of feakase;-ota.) — -- S K: Ell the 11VUbU VU11t . (locate on site plan) Depth below grade:! q Material of construction !concrete/kmetai4IFiberglassN Polyethylene /fother(explain) 1114 If tank Is Instal,list age 4R. Js.age-confirmed by Certificate of Compliance (Yes/No) Dimensions: ' "' V/0"f/144, Sludge depth: Distance from top of sludge to bottom of outlet tee orbaffle: 64 Scum thickness:_ 0 Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bo m of out et tee or baffle: 40 How dimensions were determined: keA Comments: (recommendation for pumping,condition of inlet and outlet tees or-baffles,depth of liquid level in relation to outlet invert,structuraFintegrity, evidence of leakage,etc.) P u M p semp t i c tank a n n u a 1 1 y . G a r h a g a d i e-=n c a 1 is prasPnt Tha tank ; g str»cturn11 y soluaad and shows aze GREASE TRAP: (locate on site plan) Depth below grade:/ll� Material of con3tructionAgconcrets40metald4 Fiberglass!/iD Polyethylene lQother(explain) Dimensions: AI Scum thickness: Distance from top of scum to top of outlet tee or baffle:d� Distance from bottom of scum to bottom of outlet tee or baffle:,,"O Date of last pumping: 4W Comments: (recommendation for pumping,condition of Inlet and outlet tees or baffles,depth of liquid level in relation to outlet invert, structural integrity, evidence of leakage,etc.) Grease trap is not present wised 9 2 98 Page7oru re / / SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(contirwed) Property Address: 100 Point Isabella Cotuit ,Mass . miner: Evangelos Gikas Dots of Inspection: 1/7/0 0 TIGHT OR HOLDING TANK:f&[,(Tank must be pumped prior to, or at time of, inspection) (locate on site plan) Depth below grade:, Material of con3uuction,(�concreta,&metaW,44Fiberglas"APolyethylene,&other(explain) ,dA Dimensions: A114 — Capacity: V,* gallons Design flow:1_gallons/day Alarm present4/, Alarm level: Alarm in working order:Yes4A Nq. Date of previous pumping: i Comments: (condition of inlet tee,condition of alarm and float.switches,etc.) it? t or holding tanks are not present . DISTRIBUTION BOX--A" (locate on site plan) Depth of liquid level above outlet invert: Comments: (note-if level and distribution is equal,evidenoe of solids carryover,evidence of leakage into or out of box, etc.) - — Distribution box is not present . PUMP CHAMBER (locate on site plan) Pumps in working order:(Yes or Not Alarms in working order(Yes or No) Comments: (note condition of pump chamber,condition of pumps and appurtenances,etc.) Pump c'hambpr is net =rPGPnt _ revised 9/2/98 Page 8of11 SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPEC-RON FORM PART C SYSTEM INFORMATION(continued) PtopertyAddress: 100 Point Isabella Cotuit ,Mass . Owner: Evangelos Gikas Data of Inspection:1/7/0 0 SOIL ABSORPTION SYSTEM(SAS):.ice (locate on site plan,if possible;excavation not required,location may be approximated by non-Intrusive methods) N not located, explain: Type: leaching pits, number: leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields, number,dime sions overflow cesspool,number: Alternative system: Name of Technology: Comments: (note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.) Fine coarGP Rnnd Mn ciaan gL 4ydFa !4:e--rie4:jere o r. Sails a r--d Fes. s . CESSPOOLS: (locate on site plan) Number and configuration: a Depth-top of liquid to inlet invert: .tl Depth of solids layer: �lh� Depth of.scum layer: Dimensions of cesspool: Materials of construction: Indication of groundwater: Inflow(cesspool must be pumped as part of Inspection) eSSDOOls are not , recent Comments: (note condition of soil, signs of hydraulic failure,.level of ponding,condition of,vegetation, etc.) essnools are not nrPCPnt PRIVY: (locate on site plan) Matedals of construction: /lily Dimensions: Depth of solids:AIW Comments: (note condition of soil, signs of hydraulic failure,level of ponding, condition of vagetation;etc.) Privy lR not nreQQnt ■ revised 9/2/98 page 9orli ti r SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPtCTION FORM 40 PART C SYSTEM INFORMATION(continued) PropertyAddress:100 Point Isabella .Cotuit ,Mass . owner: Evangelos Gikas Date of Inspection: 1/7/0 0 SKETCH OF SEWAGE DISPOSAL SYSTEM: Include ties to at least two permanent reference landmarks or benchmarks locate all wells within 100'(Locate where public water supply comes Into house) i 0 IV oZoXN O revised 9/2/98 Page loorn i f A SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM , PART C SYSTEM INFORMATION(continued) P,.p.rtyAddr..100 Point Isabella Cotuit ,Mass . owner: Evangelos Gikas Daft ofkmPoctkn1/7/00 NRCS Report name Soil Type_ Typical depth to groundwater USGS Date website visited Observation Wells checked Groundwater depth: Shallow Moderate Deep _ SITE EXAM Slope Surface water Check Cellar Shallow wells Estimated Depth to Groundwater[Feet Please indicate all the methods used to determine High Groundwater Elevation: /Obtained from Design Plans on record ' / Observed.Site(Abutting props observation hole,basement sump etc.) Determined from local conditions Checked with local Board of health Checked FEMA Maps y/"Checked pumping records !�Checked local excavators,installers Used USGS Data Describe how you established the High Groundwater Elevation. (Must be completed) Used water contours map . Gahrety & Miller Model 12/16/94 revised 9/2/98 Page 11of11 4 A t •...InP...—n 1TIr.7T' .t►rant•neP►TT.r.7n.InnfnT`T.►In►JT.�...�AR«1 nrl��llw �TTPT�.7rnr'..R•.r•� 'I'OwN OF Barnstable WARD OF HEALTH SUASUNFACR SFHACF, VISPOSAL SYSTEM INSPECTION FORM - PART D •- CERTIFICATION - •TI'1 T•: ::1—T./lI.�.T7TTT:w1'l1.Tri T+II�JRY/TnT.:r�t7 T'{tTR��T�r�►.�.�.��'7 /w11 VT1I"rT•1+1. -TYPE OR PRINT CLEARLY- PROPERTY INSPEC7'ED STREET ADDRESS 100 Point Isabella Cotuit ,Mass . ' ASSESSORS MAP, BLOCK AND PARCEL # 74-6 OWNER' s NAME Evangelosp Gikas PART D - CERTIFICATION NAME OF INSPECTOR Joseph P.Macomber Jr. COMPANY NAME J. P.Macomber & Sdfi' Inc. COMPANY ADDRESS Box 66 Centerville ,Mass . 02632 Street Town or City State Lip COMPANY TELEPHONE ( 50.8 ) 775 - 3338 FAX ( 508 .) 790 - 1578 CERTIFICATION STATEMENT I certify that I have personally inspected the sewage disposa`1 system at this address and that t))e information reported is true , accurate, and omplete as of the time of .inspection. The inspection was performed and any recommendations regarding upgrade , maintenance , and repair are consistent with my training and experience in the proper function and maintenance of on- site sewage disposal systems . Check one: �S stem PASSED r The inspection which I have conducted has not found any information which indicates that the system fails to adequately protect public health or the environment as defined in 310 CMR 15 . 303 . Any failure criteria not evaluated are as stated in the FAILURE CRITERIA section of this form . ` System FAILED* The inspection which I have conaMted has found that the system fails to protect the public health and the environment in accordance with Title 5 , 310 CMR 15 . 303, and as specifically noted on PART C - FAILURE CRITERIA of this inspection form. Inspector SignatureV Date copy of tills c rtification must be provided to the OWNER, the BUYER Oni Where applicable ) and the 130ARD OF HEALTII. * If the inspection FAILED, the owner or operator shall upgrade ' the system within one ,year of the date of the inspection, unless allowed or required otherwise as provided in 3.10 CMR 16 , 306 , partd.doc = Cotuit Fire Department T U Fire, Rescue & Emergency Services canny / 64 High St. - P.O. Box 1632 U 1926 Cotuit, MA 02635 �. RES� Paul A. Frazier Phone (508) 428-2210 Chief of Department FAX (508) 428-0202 TO: Tom McKean; Director of Public Health Town of Barnstable, Board of Health P.O. Box 534 Hyannis, MA. 02601 FROM: Chief Frazier, Cotuit Fire Department SUBJECT: Tank Removals, et all DATE: June.5, 2000 The following tanks have been removed/abandoned since my letter dated March 10, 2000. If you should have any questions or require additional information, please feel free to call. Thank you. NAME ADDRESS DATE NOTES Gikas 100 Point Isabella Rd. 04/11/00 1000 gal.tank 4'x11' Cotuit, MA 02635 abandoned in place due to potential structure damage, soil vapor test negative, filled with concrete. No contamination or odor present . Peterson 100 Oregon Way 05/24/00 1000 gal. tank removed, Cotuit, MA 02635 no contamination or odor present. TOWN OF BARNSTABLE LOCATION' �B� /��' �/��s e�/s>~ SEWAGE # „ 4A0-3'0?7 VILLAGE s��Ui T ASSESSOR'S MAP & LOT 0-7 y 0®(.0 INSTALLER'S NAME&PHONE NO. l/`/c-, e,Y SEPTIC TANK CAPACITY A�✓® LEACHING FACILPI`Y: (type) (size) 7.- V vie, NO. OF BEDROOMS BUILDER OR OWNER kes-i e i PERMIT DATE: q VC_PC 0 COMPLIANCE DATE:�'I/�I/O) 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 }tic y_eu Co"n-ocnow &.4411 411 Vs,lf i a_ �1 11 �j TOWN OF BARNSTABLE LOCAT-jON ! ./71/.d1f�! ' �.�i4 SEWAGE # VILLAGE WeleA< ASSESSOR'S MAP &LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY L�f� LEACHING FACILITY: (type) (size) /�9 NO.OF BEDROOMS BUILDER OR OWNER G PERMTTDATE:_ COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and 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' 'xist within 300'feet o le §un facility) Feet Furnished b �/ j O � , GENERAL o NOTES z w p oc a o= w p ioe ALL DIMENSIONS ARE MEASURED FROM THE EXTERIOR FACE OF z, 5 O O Z O EXTERIOR FRAMING TO THE CENTERLINE OF INTERIOR PARTITIONS / t!O J! o v>!O h!O o W) POSTS ARE NON-STRUCTURAL �'!OJ AND TO THE CENTERLINE OF OPENINGS UNLESS OTHERWISE NOTED. can 'u.' (� O F p u- C9 EXACT DESIGN WILL BE PROVIDED `- "- v w W AT LATER DATE 0 y WORK @ GARAGE 6 BREEZEWAY SHALL NOT BE STARTED ILI GC O OL 0= O 1!C OG UNTIL FURTHER NOTICE. 4 U. �,® LL 3'-0 I/2 �� " *2'-10 1/2' w 18'-6 1/2" e 18'-6 1/2" 31'-10" Co 2'-2" I6'-4 I/2" DASHED LINE SHOWS '7'-3" 8'-8" 8'-8" 7'-3'' ---SECOND FLOOR OVERHANG --_ ---- ------ -- C C _ --_I -- —�— ---- [� I� Ib'-b 1/2" 2X6 WALL ! D ` D D F D D D 2X6 WALL J Dill ACE OF STUQao ors , �ur,xoae�c� FIRST FLOOR G Ey r ' I er1 W PLACE WINDOWS � ! 10 SINGLE STUD SINGLE STUD I I H ! ADJOINING JAMBS EQUALTO ACHIEVE H ((� N `�.� MULLION MULLION i i � � `' W zpq a D I I SINGLE STUD MULLION —� ! N 3'-0" ! I CASEWORK: z i I I WET BAR WI INE STORAGE 2" f I i I � Ma Of MAMA HEET A5.5 I I 1 FOR FIREPLACE DETAILS I i i CASEWORK:0ABINET ;� G ' p PROJECT #: 2013.00 SCREENED PORCH I ° LIVING ROOM I I I BREAKFST ROOM © - O v� O DRAWN BY: PNC 1- 107 I ( ' 1@8 u-a O� U(°� VAN BEREZED 20 <1 LL NICK ASSOC., INC. U-1 a N I I ! DASHED LINE SHOWSNG A5.3 Id M ALIGN FACE �,.��` 1-_._. .. ...``�-I- - ALIGN OPENING - ` — 4'-II" 4'-7" 4'-7„ — ------- _--------- WITH FRENCH DOOR = .N _ L _ 3'_3" i I'-8" _ _ _ _--_--- 3' 3„ V F 4„ _ _ _ _ _ _ _ _ i RIDGE LINE @ OPP. END — ------ -------1=----- T::: - - ' - - -- - - - - - - µ — ----•�----------- ------------ y.` , i aM 7 -- --- `� �- — --------- �, p �— p, rS CENTER DOOR IN HALL cO$ M x5. o s U BUILT IN CASEWORK -z ' �, o W J ( ! i I I .b , i p oG '-8"x b'-8" 7 ' `� " ( t _l— m,p (EWER DOOR L _6'-7"_ ` 1 HALL#102 � ENTRY F SIM o 2'_0' #1 5'-4" <- 3'_2" h!O OPP SIDE 102 LL y " o HALL KITCHEN N BREEZEWAY ————— -� w'oe ❑ I ! 109 - O 113 U U. y- N. T.; UPy — ' POWDER10 :I I ( ! ROOM I DINING ROOM I CY, i ! i i I -4" II'-b" 8,-6„ 5,-8„ o N 10 ( i 111 C, I I Q ]00 CE OF STUDGUEST BEDROOM , _ i„ — d4 9 3/4 9 2 4 7 ),Fj 4 FIRST FLOOR _ .. .. ,. " o , i L I C I OAS : = BENCH C�2 PLACE WINDOWS { TO ACHIEVE EQUA - - ' " UP ( I I I ( I I L iJ11TDRY �, a ,y, f,,r n,,, ADJOINING JAMBS y FRAMI N ! - 2 b"x3 0 -'( ——— — 2 6"xb' $" Nt `� I IR I i I 115 h [� <m FRAME STUD , 2' 8'xb'-8" pocket door _ — cased op g , <t I I I I I ( I NARROW END° _ DOUBLE STUD N — 10 I I I I I I I ! ! STAIR#1 _ MULLION iv N HALL - - - - - - T-0"x6-8' z 112 r„ ' ' 11 i.' �« h" :� f a, p m GUEST tl �� s. PANTRY 'O 777' I I I I THR®OM B `� BATHROO �F x 110 2'-7" 3'-5" AS AS I I I 14R 18 ao ! 'f. OUTDOOR 104 Z Y W W I ! 11, I I ( I 2'-4'x6'-8" SHOWER _ N — . V ( o _ _ R n r Sri 120 X V V x 4' 0"xb'8" O � 2'-5"xb'-8" 3'-9" 5'-6" IO'-8" b'-2" I o — —, r—°�- —————— i M N 1— CV CE OF STUD _ _ _ _ _ - _— _ _ _ _ _ _)4F, i FIRST FLOOR D b' b" II 10'-5 I/2" 5'-11 1/2" 5'-0" EQUAL EQUAL ! ! 10 , 10'-5 1/2" 5'-O' S'-i l I/2' � it b: 14'-I" 7'-4" 12'-1" 14'-O" 2'-10 1/2" 12'-6 1/2" 6'-0" VERIFY THAT WINDOWS ! VERIFY THAT WINDOWS p ARE PLACED SYMMETRICAL i POSTS ARE NON-STRUCTURAL 2X6 WALL ! ARE PLACED SYMMETRICAL ,< ABOUT RIDGELINE. ABOUT RIDGELINE. ' ' EXACT DESIGN WILL BE PROVIDED O SCALE: 1/4" = 1'-0" ( ! AT LATER DATE GARAGE , 11 DATE: 10/27/00 ! ! I OIT REVISI S: 406-Lo- zo ' .y t 121 0 A 10 r � �1 p ,bllc Health®lvisl06 O Town of Barnstable ! Po Box534 setts 025�1� Hyannis,Massachu Av FIRST ( , 31775-33Q4 n r, ! E FLOOR 2 6 2-6 PLAN V45 `-�e- AY -) FACE OF STUD ' - -- (D, FIRST FLOOR CONSTRUCTION ! SET A .2 0 0 p p0 ° py }WA�.V, O M F U SALT r ,,_h? s' . E><\sT. DRIVIEW 57 02 ,� MARSH o r RIP RAP GROIN BASIN �• 'a ay M Ul \\\ NLAW �Mo„E Ex\ST Jj LOCUS PLAN N rN Scale: 1 20001 ,,'' �A ; ® t M Assessors Map 74 b Parcel G Groundwater Protection Zone AP Z� Zoning RF Setbacks F ont 301 Side 15' /mil �� / ,w / �,� sn\N•1 6 � � - 1<< 1 �'�t � ~ Rear 15 � J O \ —05kA vvv ° "/ 0 0 I ti , 1 .B. FOUNLt\ ��` m uu ► \ N / p w 0 ° zo ARCEL B �, q 0 \ =� - ALL COMPONENTS OF THE 0 "`f' LL -20 � /•�; � � "-�m � � Z •w� _ 24804 .F. SEPTIC SYSTEM SHA BE H ,. 's� >; (by Pl K I o t / ED' Q o - h LOT 1 0 se° -� ,- 3 3631 S.F. P GRo�o CrPQA � Oy PJ'an) v G � t�R\vc.'wA / ? // �C9�rF • V c let Y/ t A�,s�- GENERAL NOTES.'4 0 WORK Lltv\ITS RESOURCE AREAS ('LAGGED BY.' 5TAKP-HAS/W� ` (0 ENV / 13gL.E5 ' 50• I STATE ROAD RuFFaR ,� SAGAMORE BEACH, MA i DATUM IS NGYD BASED ON RM 41, EL. a 48. 60 0_01 V* SEE PLAN BOOK 228 PAGE J! 329 22 DESIGN DATA PLAN VIEW Existing developed area within the 50 Single Family-4 Bedroom Scale: I-' 20I foot buffer to remain unchanged. No Garbage Grinder F.G.21.0 RsviStDrt.ANsa0a1rII7Twi. Daily Flow: I10x4 =440 gpd F.G. 17.0 Septic Tank:440 gpd x 200%=880ral � Use a 1500. Galion Septic Tank. All new runoff to be recharged �, ' )Q LEACHING AREA 19.0 15.0 kc,rl,v 1�l�a{1F2 440 gpd/0.74= 5,95.s.f.Required 1500 Gallon Top El.16.0 Sidewa,,.2(12 t44 )2=224 s.f. 15.8 Septic Tank 15.6 AFpL[CAN!•,SNAt�. Bottom Area:12'x 44'= 528 s.f. 15 4 iY ' 15 2 Bot.Et. 13.0 `c ` 752.sf.Total Provided d! PR0=rL0CA=N: LEACHING CHAMBER DESIGN Bedding as Ground Water a Less Than t-t- All Pipes to be Schedule 40 PVC.Use 5 Per Title 5 E1.5.0 Per T.O.B.Ground This-500GalionLeachingChambersina Water projga 12'x 44'washed Stone Field as Shown. DELVELOPED PROFILE OF PROPOSED SEPTIC SYSTEM _. Not to Scale OR ChedcC°' NOTES L Water Supply ForThis Lot is Municipal-Water. FI"YA°ndi Order OtC00diti00i neta9ued ❑ 2.Location of Utilities Shown on This Pion Are Approx. Filter : Cb At Least 72 Hours Prior to Any Excavation ForThis _ F°e.b nq°a.e Fin �H OF M This pla will be Oapp �dp as Project The ContractorSholl Make The Required was \ Notification to Dig Safe(1-800-322-4844) PA q�y 3 The Contractor is Required to Secure Appropriate b RYLL SITE PLAN Permits From Town A encies For Construction •i •' L'0C"�"a a.- . 3i4•.1 tis•. 0 -, Defined byThis Plan. 9 �� °' Chamber �M•w� Existing By Canal Conditions Surveying " ,N�°•32448 � PROPOSED SITE IMPROVEMENTS P 4 Install Risers as Requiredto Within 12 of 1 �� I y g � Q. AT Finished Grade. 12''Q" --� Buzzards Bay �'"oSURv�`° 100 POINT ISABELLAROAD 5.All Structures Bused Four Feet or More or Subject' CROSS SECTION OF CHAMBER to Vehicular Traffic tobe H-20 Loading. COTU I T , MASS. Cx Septic System to be Installed in Accordance With '-.;NOT TO SCALE. FOR- 310 C M R 15.00 Latest,Revision And The Town of 01//11/01 Rev-t.Ace L.EACH.tama w/ LsACN, CRAMOIL t KEV I N M AH ER Barnsta¢le Board of Health Regulations. ., 2/6/<X (RLOCATE :,L-PTI(.-rAWK+p-sox SCALE: AS SHOWN DATE:JULY 28t 2000 7. All Piping to be Sch40 PVC DATE P ND F SSI NAL L URY YOR SULLIVAN ENGINEERING INC. ROViitow 8/23/OD Acooso CON66mv. cY.MMI.S104 COMMUN'r.5 OSTERVILLE MASS. ATTACHMENT A 20028 c ® F GENERAL NOTES All DIMENSIONS ARE MEASURED FROM THE EXTERIOR FACE OF p oe Z, O �'p Z �'p EXTERIOR FRAMING TO THE CENTERLINE OF INTERIOR PARTITIONS z O =,( h I O I O w I H(U. O AND TO THE CENTERLINE OF OPENINGS UNLESS OTHERWISE NOTED. O f U. O VERIFY THAT WINDOWS U. O I LL y o f O t N WORK @ GARAGE& BREEZEWAY SHALL NOT BE STARTED h o ARE PLACED SYMMETRICAL w wLu w nc � 13'-5 I/4" n: ABOUT IAl76ELISFl4" U °C 26'-i" U � °= 21'-5" U oc UNTIL FURTHER NOTICE. <n1=4N Ucl— . ® o ® �+ t� 3'-0 3/4" `�/`�✓ �./ 10'+7" 2'-8 1!4" 13'-0 1/2" 13'-0 1/2" 2'-8 I/4" AB AE 1017" 31-0 3/4" 5'-I" Trio � A e . e . e , e . Y✓� C+ 61 t o BUILT IN :� I t AG AH AJ � BUILT IN (:DLO CE O STUD ' CASEWORK ` - ' WINDOW SEAT - I - - - _ _ _ _ _ _ _ WINDOW SEAT CASEWORK — - - - �n , �. —� FIRST LOOK I / t ° I SINGLE STUD ' SINGLE STUD I a Ed AC MULLION I o ( \ / I I MULLION I I 10 I 02 02 m I I a SINGLE STUD t I \ / AK �_ I o �' I `� A SINGLE STUD / IzL I I I p W e AC / �' \ MULLION / � I t f SINGLE STUDI O t , \ I N I ' O tL� O i BEDROOM #1 10 CAC 207 �- FRAME STUD �� 7 0' 7 0 ON NARROW END f o I I ';' - FACE OF STUD , A 00 1-0 \ // � 0 1 v��O 1 F O y en , x; / PROJECT #: 2013.00 d 12'-7 I/2" , 7'--91/2" \ \ A I / I , , t .• U. u. M O Ir x M �� ( � I I O !_ ' ' 2'-4" 10'-3 1/2" 3-I ao �� n�` w a`�t DRAWN BY: PNC e , , xs MASTER BEDROOM � <I u. 208 I a\ "I COPYRIGHTED 2000 ' — IVAN BEREZNICKI ASSOC., INC. o- I O O o 0 OPEN TOI BELOW BATHROOM #1 iv � ;o AK 206r ao 4'-8 I/2" o I a i t ,� M N 8'-0"CLG. `r s `� 2'-8 1/4" e � s 4'-7 3/4" e Ln - - - - a Sri. e , ' Ln o 'I t Q tlo0 O .i'.` 'S RIDGE LI E _ - - - - - - - - - - - - - - - - - - - - W,.. - `u " ' FOYER #1 ao $ i n, �� o00 0 w UPPER HALLWAY g cased op g cased opg ———————— a o a 203 ao 36 201 I FOYER #2 04 I x � 8'-0"CLG. "' e 212 m HALL ``4 I 1 4 0 2'-8"x6'-8" ' v� 3'-6" 8'-0"CLG. 214 c� CLOSET #2 Ln ,' t BATHROOM #2 0` DN. 209 pi N 5t 0 ,� ao -0" CLG. 205 �; Q r �,_ 8 O r- M '`` 8'-0' CLG, ( O 4'-8 1/2 ( — I oI a I'-8"x6'-8" a I I M I-8 xb-8' I CLOSET #1 � �', U. U. CAA 8-0 CLG. ki; 1a SIDELIGHT �.' I �� �" , , r? , o ' �, SIDELIGHT I w PULL OUT 211 ;b I I U)►n . IRONING BD _ a e `� SINGLE STUD I `�' 8 0 CLG. +� I'_0„ a U`; W t `� zo I // INTERIOR 8 \\ I 8'-0„ 6'-I I/4" �( 4`-0" a? 7'-7" I 4 EQUAL w WINDOW SET cc I / FRENCH DOOR \ I 'T —— ———_—� EQUAL I t� I LAUNDRY #2 `" ,,i , SINGLE STUD Z `� ►t0 213 - *` o I AA O AA r MULLION I ® Ca ,o `� OFFICE Q I a ao ;, )FACEOFSTUD t I \ 8 ,0 CLG. , /Q/�� ' / U i�arz —'U_ d � 202 z ('o +� FIRST FLOOR PLACE W I I N. TO ACHIEVE EQU I I D \ I I MASTER BATHROOM ADJOINING JAMBS w I V I °° , a E�1 (ALIGN W1 WINDOWS BELOW! ' 1 � � I Cot-) ` 210 � BEDROOM # 2 / A _ SINGLE STUD o " I ------�. MULLION 204 a /� , ( 42" HIGH WALL * PA OPEN TO BELOW _ 04 i zoOAK az N ° I AP o ' Y to I M h• „r .r o ,;k •{I C14 1 co O STUD _ _ _ - - - - - - - - - -- - - - FACE 3> � �,r, , ,x. d� FIRST LOOR 5'-I1 I!2" AN 10'-5 1/2" j 5'-II i/2" AN 5'-0" 13'-0 1/2 13'-0 1/2" 5'-O" 10-5 V2" , 2'-8 1/4" 5'-1" I3'-7 3/4" T-2 1/4" 13'-7 1/2" 5'-3 1/4" 7'-I" 9'-4" 5'-0" VERIFY THAT WINDOWS w VERIFY THAT WINDOWS _ FACE OF CHEEKWALL � I I ARE PLACED SYMMETRICAL ' I o ARE PLACED SYMMETRICAL ( I I ABOUT RIDGELINE 8 0 \ ABOUT RIDGELINE. ' \ SCALE: 1/4" = 1'-0" tt \ \ DATE: 10/27/00 `0 SINGLE STUD AFi I , LLION / REVISIONS: A 11-20-00 ASI-04 _ FACE OF CHEEKWALL 0 12-5-00 9, A LOFT o 0 214 E FACE OF CHEEKWALL I \ co 60iC Health®iytSion I SI LE STUD / SECOND (� LION // Town of Barnstable �✓ / / PO Box 534 / pp SINGLE STUD ( FLOOR Hyannis,Massachusetts 0260`1 —J/ FACE OF CHEEKWALL ULLION Fn !F,0,P1775-3344 PLAN &FACE OF STUD FIRST FLOOR `- 0 �2 c EQUAL EQUAL I CONSTRUCTION 1 I I SET A2o2 _,_