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0016 ROUTE 130 - Health
16 ROUTE 13.0 Cotuit A— 01.0 — 009 '�i i NOTICE OF DEED RESTRICTION (RESIDENTIAL) The Barnstable Board of Health requires, as a condition of their approval of variances requested at their March 12,2013 hearing,the following restrictions: Existing dwelling be restricted to 3 bedrooms. be placed on the property located at 16 Route 130, Cotuit, MA 02615, Assessors Map: 010 Parcel: 009, consisting of Registered Land in Deed Book 10381, Page 211, shown as Lot"B" in Plan Book 304 Page 059, filed at the Barnstable County Registry of Deeds, as it deems those restrictions necessary to protect public health and safety and the environment, Per the State Environmental Code,310 CMR 15.413(1) I, A R , as owner/owners representative of the property referenced above acknowledge the deed restriction(s)being placed on the property. L er/Owner's epres tive ignature Date ����� G: �'' ✓ The person named above: G �p�-�'cj� acknowledges the foregoing instrument to be his/her a act and deed bef me. GG N Pub 1iC LISA E.MYCOCK {:1 totary Pub11c Massachusetts Commission Expires Mar 10,2017 My Commission expires: BARNSTABLE REGISTRY OF DEEDS EXCERPT FROM THE BOARD OF HEALTH RESULTS - 3/12/13 I. Septic Variance — New: A. Darren Meyer representing Margaret Savery, owner— 16 Route 130, Cotuit, Map/ Parcel 010-009, 2.52 acre parcel, multiple variances, failed septic. Granted Variance. The Board voted to grant the variances listed on plan dated 2/25/13 with the following conditions: (1) record a 3 bedroom deed restriction at the Barnstable County Registry of Deeds, and (2) submit an official copy of the deed restriction to the Public Health Division. r. t �r F Town of Barnstable Barnstable Board of Health 'ea j i '"`M `y� 200 Main Street, Hyannis MA 02601 I i639 �� 2007 fD MP'I A Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi April 1, 2013 Mr. Darren Meyer P.O. Box 981 E. Sandwich, MA 02537 RE...16_Route 130„°Cotu�t.. .,... 5 k Dear Mr. Meyer, You are granted a conditional variance-on behalf of your client, Margaret Savery, to construct an onsite sewage disposal system at 16 Route 130, Cotuit. The variances granted are as follows: Section 360-1 of the Town of Barnstable Code: To install a soil absorption system 86 feet away from the edge of a bog, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install a septic tank 46 feet away from the edge of a bog, in lieu of the minimum 100 feet separation distance required. Section 360-1 of the Town of Barnstable Code: To install a distribution box 89 feet away from the.edge of a bog, in lieu of the minimum 100 feet separation distance required. Section 397-8 (E) of the Town of Barnstable Code: To install a leaching facility 131 feet away from an onsite private well, in lieu of the minimum 150 feet separation distance required. 310 CMR 15:227 (7): To install a soil absorption system 5.9 feet below grade, in lieu of the requirement to install the leaching facility no more than 36 inches below grade. Q:\WPFIL-ES\MeyerSaveryl6Routel3OVariancesGranted2Ol3.doc These variances are granted with the following conditions: (1) No more than three (3) bedrooms are authorized at this property. Dens, study rooms, offices, finished attics, sleeping lofts, and similar-type rooms are considered "bedrooms" according to the MA Department of Environmental Protection. (2) The applicant shall record a properly worded deed restriction, signed by the owner of the property, at the Barnstable County Registry of Deeds restricting the property to three bedrooms maximum. A copy of the recorded deed restriction shall be submitted to the Health Agent prior to obtaining a disposal works construction permit. (3) The septic system shall be installed in strict accordance with the engineered plans dated February 25, 2013. (4) The designing registered sanitarian shall supervise the construction of the onsite sewage disposal system and shall certify in writing to the Board of Health that the system was installed in substantial compliance with the plans dated February 25, 2013. These variances are granted because the proposed plan appears to meet the maximum feasible design standards contained within the State Environmental Code, Title 5 and local Health Regulations. The registered sanitarian designed the septic system to be located in an area to attempt to maximize setbacks to private wells used for drinking water and to wetlands. Sinc rely yours, Way n Miller, M.D. Chai an Q:\WPHLESNeyerSaveryl6Route 130VariancesGranted2013.doe pFt �pw DATE: 2 13 P� ti i : FEE: $ I5 V0 * BARN STABLE, y MASS �A 1639. ��� REC. BY A Town of Barnstable ? SCHED. DATE: V ►�II,� Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Wayne A.Miller,M.D. FAX: 508-790-6304 Junichi Sawayanagi Paul J.Canniff,D.M.D. VARIANCE REQUEST FORM LOCATION 2 Property Address: U-rF— '-/ Assessor's Map and Parcel Number: Q 1 c) UU Size of Lot: Wetlands Within 300 Ft. Yes f Business Name: --,,No Subdivision Name: APPLICANT'S NAME I olrrgn MC1Cr4 Met1fri&M:► 14cPhone 3Ga0- 331 r Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME CONTACT PERSON Name: � '�Q�� ��tU IL Name: a.(ft !"((ti1 e� �C y el'� °n 9 14C- , Address:F0 F-�OC 7&q, CM t7 ►`�, 02-(45- Address: Phone: SOI q 2 s " (0 l(0(i Phone: 6�0 9 VARIANCE FROM REGULATION(List Reg.) REASON FOR VARIANCE(May attach if more space needed) T a S R1 - N' SES IfiTf 4wfy Sfx� P-*� KsikFES NATURE OF WORK: House Addition ElHouse Renovation ElRepair of Failed Sej�tt 'System P r Checklist (to be completed by office staff-person receiving variance request application) M= Please submit copies in 4 separate completed sets. a Four(4)copies of the completed variance request form Four(4)copies of engineered plan submitted(e.g.septic system plans) Completed seven(7)page checklist confinning review of engineered septic system plan by submitting engineer or regiftered sanitarian Rai Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) Signed letter stating that the property owner authorized you to represent hum/her for this request _ Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense (for Title V and/or local sewage regulation variances only) Full menu submitted(for grease trap variance requests only) Variance request application fee collected(no fee for lifeguard modification renewals,grease trap variance renewals[same owner/lessee only], outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) -- — — - HL 11UdbL 155 ulays prior to mee mg Cate — --- -- VARIANCE APPROVED Wayne Miller,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Paul J.Canniff,D.M.D. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BAJ9P9B7\VARIREQ.DOC op—ki MEYER & SONS, INC. PO Box 981 E.SANDWICH, MA 02537 508-362-2922 The Following Variances are requested for the septic system upgrade at: 16 Route 130, Cotuit, MA R PER 310 CMR 15.405 —MAXIMUM FEASIBLE COMPLIANCE 1) Per 310 CMR 15.405(1)(b), variance from 310 CMR 15.227(7) too allow leaching To be 5.91 feet below grade vs. required 3 feet. PER TOWN OF BARNSTABLE BOARD OF HEALH TITLE 5 REGULATIONS 1) Per Barnstable Board of Health Regulations, 14 foot variance to allow leaching to be 86 feet from edge of bog vs. required 100 feet. 2) Per Barnstable Board of Health Regulations, 46 foot variance to allow septic tank to be 54 feet from edge of bog vs. required 100 feet. 3) Per Barnstable Board of Health Regulations, 11 foot variance to allow distribution box to be 89 feet from edge of bog vs. required 100 feet. 4) Per Barnstable Board of Health Regulations, 18.31 foot variance to allow leaching to be 131.69 feet from private (on site) drinking water well vs. required 150 feet. Submitted By: Darren M. Meyer, R.S. Meyer& Sons, Inc. ARCHITECTURE ENGINEERING SURVEYING COMPLETE •N COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete I A. Signatu item 4 if Restricted Delivery is desired. ❑Agent ■ Print your and address on the reverse X ❑A dressee: so that we can return the card gu.,; B. Re eivegby(M'V e) C. D e Delivery . ® Attach this card to the back of t e mailpiece, : ''//or on the front if space permits. V� L D. Is delivery address different from item 1? ❑ es 1. Article Addressed to: If YES;enter delivery address below: ❑No � "J 35- 3. Se�iceType. [5d Certifled,Mali O Express Mail ❑Registered O Return Receipt for Merchandise ❑Insured Mail V C.O.D., 0 L,103 4. Restricted Delivery?(Extra Fee) _.. ❑Yes 2. Article Number, (Transferfrom service fabkel) ' t ` 7 0 0 9 0880 0001 015 4. 1408 6 RL,3 d3 �,PS Form 3811,February 2004 Domestic Return Recelpt . .ioz5s5 oz M•asad: 9 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPs Permit No.G-10 • $endert.Please print your name, address; and ZIP+4 in this box v -50n5 ' il P Cy I 9 -SENDER: COMPLETE THIS SECTION IPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also corr*le a S' re ❑Agent item 4 if Restricted Delivery is .desired:' a'X p Addressee` is Print,your name and address on the reverse 4 so that we can return the card to you:, x.6. by( nted�N e) C.Date of'Delivery ■ Attach this card to the back of the mailpiece, ' D 141 -ems j 9=�3 or on the front if space permits. D. Is delivery address different from item 1? ❑Yes' 1. Article Addressed to If YES,enter delivery address below: ❑No,�1, O �7 �., v 3. Se yKce Type " Eff Certified Mail E]ExOress Mail b1 / " _�n, 1�- O Registered ❑RReturnRecelpt for Merchandise wt G ups ' ❑Insured Mail Cl•C.O.D. 4. Restricted Delivery?(Extra Fee) q Yes 2. Article Number 7009 0820 0001 0154 1422 (transfer from service tabeQ 102595.02 M 1540 PS'Form 38111 February 2004 Domestic Return Recelpt i 9 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender;Please print your name, address, and ZIP+4 in this box • Sons lac P o 16Y 9y/ �a 0 as3 r 9 COMPLETE • SECTIONON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature Item 4 if Restricted Delivery Is desired. O ent ■ Print your name and address on the reverse X ddressee so that we can return the card to you. B. Iceived (Printed Name) C. a livery ■ Attach this card to the back of the mailpiece, J` a a 3 or on the front if space permits. D. Is delivery address different from item 1? O es 1. Article Addressed to: If YES,enter delivery'address below: o G Pe►< �1 p0 -76 3 1 3. ; Ie ,fledMall o Express Mall. O Registered O Retum Receipt for Merchandise ❑Insured Mail ❑C.O.D. J 4:Restricted Delivery?(Extra Fee) - ❑Yes... 2. Article Number Crranster from somice;iabeO « 7009 0820 0001 01.54 1392 PS Form 3811,February 2004 Domestic Return Receipt' 102595-02 M 1540`t v UNITED STATES POSTAL SPkGICpE First-Class Mail Postage&Fees Paid LISPS Permit No.G-10 • Sender; Please.print your name, address, and ZIP+4 in this box• !lJ��, ,It'li»,,#r�l } 111��}��I!)t11I1 r�11►l��1��� �t�r��C ,� �� 9 COMPLETESENDER:COMPLETE THIS SECTION 1 1 DELIVERY ® Complete items 1,2,and 3:ft complete A. ignature item 4 if Restricted Delivery is desired. a Print your name and address on the reverse X gent so that we can return the card to you. ❑Addressee m Attach this card to the back of the mailplece, B• Received by(P ted Name C. D e of e' ry or on the front if space permits. 3 1. Article Addressed to: D. Is delivery address drfferent from Rem 1? ❑ es If YES,enter-delivery,address below: ❑No I 'DOr1 tMuS �I Of Ameac" \�D (0 reb(I 3. Se Ice Type /Y�7Certified Mail ❑Express Mail 6 '2 ❑Registered ❑Return Receipt for Merchandise', J ❑Insured Mail ❑'C.O.D: 4: Restricted Delivery?(Exhs Fee) ❑Yes; 2. Article Number -- - -- - _ (Transfer from service labeo 7009 0820 011111 0154 1415 PS Form 3811,February tow `,Domestic Return Receipt 102595-02-W 540 i I v T. - - — —I UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 in this box • I n l` 316)( � � 5"�)w 1 Cfl - I�ZS37 13.0 1 MEYER & SONS, INC. PO Box 981 E. SANDWICH, MA02537 508-362-2922 February 26, 2013 Gail P Pekarski Certified Mail James R.Noyes Return Receipt Requested PO Box 763 Cotuit,MA 02635 RE: Septic System Upgrade—Variance Request 16 Route 130,Cotuit,MA Dear Abutter(Map: 010 Par: 044): '� tr This letter is to notify you of a hearing before the Barnstable Board of Health scheduled on Tuesday March 12,2013,at 3 pm in the Barnstable Town Hall Hearing Room,to present the prooposed septic system upgrade o.a ,, plan and the variance requested for the above referenced site�','The proposed systemfdesign�has taken into lywaccount requirements set forth in 310 CMR 15.000 (T,{itle V)an&the ,Town of Barnstable Board of Health iiil�(�}e�f�rJ Regulations. 'Ij�eoiir°r' a�#RR�'E€ ��itt6LL ,pm"jta ' 3+ n °` 4 LV sq fTt The following variances are requested: PER 310 CMR 15.405—MAXIMUM FEASIBLE COMPLIANCEa: a Vvm,. t ft,� i�,}n t i'�inj, 1) Per 310 CMR 15.405(1)(b),vanaridd," m 310 CMR 15.227(7)too allow leaching To be 5.91 feet below grade vs re'quired'''3 feet. ' �Rpipp �littE 'Vy{�ai.. � f+'f!i+itf PER TOWN OF BARNSTABLE'BOARD OF HEALHTITLE 5 REGULATIONS 1) Per Barnstable Boar dpo'f Healtlf Regulat$ons, 14 foot variance to allow leaching to be 86 feet from edirge of bog vs.required 100 feetk Y i hn- 'fit fi f 1 tE2H 2) Per Barnstable4Board of Health Regulat>'o'A9, 46 foot variance to allow septic tank to ,v0 .--Ng" ,,� a be 54 feet from edge of bog vs'lrequired 100 feet. 3)� Per Barnstable Board;;of;Health Regulations, 11 foot variance to allow distribution box to be �;89 feet fromi Edge of bog,vst}�required 100 feet. 41) Per Barnstable,B'oard. f H oealth Regulations, 18.31 foot variance to allow leaching to be r4 131.69 feet fronipriv te(on site)drinking water well vs.required 150 feet. tik..� .'jf'�4 6�ittta As an abutter'of 1fii `property in;,question state regulations require that you be notified of the hearing a minimum of ten(10)days pRor to1he hearing date. N You can review the application at the Barnstable Health Department, 200 Main Street, Hyannis, MA, M- 9t - F, 8:30am—4pm. If you have any further questions regarding this application, please feel free to contact me at (508) 362- 2922 or attend the hearing on the scheduled date. Sincerely, Darren M.Meyer Registered Sanitarian ARCHITECTURE ENGINEERING SURVEYING f MEYER & SONS, INC. PO BOX 981 E.SANDWICH, MA 02537 508-362-2922 IMMEDIATE ABUTTERS OF ASSESSOR'S MAP 0/0 PARCEL Map O/D Parcel D`� �I C2-� p0 47� I3O) Name: 6AIL, P fCK-kRSV-1 � ,JAWeS IZ , I JoY S Address: 0 196 3 COTM 17—, MA 02(-3s- Map 0/O Parcel O/O—00V (/,S- L0M,/1-1 tJ6 C(/L,(,I.r--) Name: DONA/A :I-, W I LUAM S1 D01VIVA JT. wJU_1"S T2l cs-r Address: 15 L09kA-1 n/C C112GC CoTul r' , MA 02635- Map 0/U Parcel 0/0 —00(, Name: NA NG A • Dt 0LLk U J Tie . f1?w; /MJ Address: 25 6,1ALE7Z)n) PKAVt "F 23Fy I�IA�SNP l:,. i4 6 026 y9- 2a� Map b 1 y Parcel Name: C A-u RjE Scorr Yi7 Te Address: P0 I�OX S35 `l Map 016) Parcel UU 8'-- 00/ N6 76 F4-c� L-� )10 j Name: C4hbo^1 III U5F6t M O/= /�/i'� Address: Y/0 7(, Fir AD. `. CoTUI r ` d 026- Map 010 Parcel 006 C 2 Rou 7= /v10 Name: s4u.A-1 N/ C Address: 4: nF,pT &ou 6 Lot iw o l s b ARCHITECTURE ENGINEERING SURVEYING D r G �O v �ip ... 13 QO 00 7 � � S February 25, 2013 Re: 16 Route 130, Cotuit, MA To Whom it May Concern, I grant permission to Darren Meyer of Meyer & Sons, Inc. to apply as necessary for any and all variances/approvals through the Town of Barnstable Board of Health/Conservation Commission for the purpose of obtaining approvals in conjunction with plans to upgrade/replace the existing on-site sewage system, located at 16 Route 130, Cotuit, MA. Sincerely, argaret E. Savery, Owner 94 "'�1M1a969E6d 86Jb'=a!npesgs6w!--ds!pVa0L191LL99a£IpE =>!vz=lnL/0/npuawy3eUepuoo'lualuoojasna!boo ti'JUawyoeUe-!!ew//:sdUq a DURABLE POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS, that I, MARGARET E. SAVERY, of 16 Route 130, Barnstable (Cotuit) , Barnstable County, Massachusetts, as principal, do hereby constitute and appoint my son, DANA E. SAVERY, of 91 Savery Road, Plymouth, Plymouth County, Massachusetts, my true and lawful attorney with full power to manage, control, invest and reinvest all or any part of my property, real and personal; and in particular, but without in any way limiting the generality of the foregoing, I empower my said attorney for me and in my name and behalf to do the following: 1) To collect and receive any interest, dividends, property, debts or claims and to give receipts for the same; i 2) to deposit in and withdraw from any money market fund, savings or other bank account now or hereinafter standing in my name individually or jointly, also to close any such accounts and ` to open such new accounts in my name individually or jointly as my said attorney deems proper; 3) to have access to any safe deposit box standing in my name individually or jointly and to remove therefrom any assets, papers or other articles standing in my name individually or jointly, to sign and endorse checks, notes, drafts, and letters of credit and to accept drafts; 4) to pay my debts; 5) to sell, purchase or transfer bonds, stocks and other securities and to open and to close brokerage accounts in my name individually or jointly as my said attorney deems proper; 6) to borrow money on such terms as my attorney deems proper and to mortgage or pledge property, real or personal, to secure the same; 7) to prepare, execute and file all required Federal and State income tax returns and other tax returns, to protest assessments, to apply for abatements and to sue upon, defend, compromise or adjust any claims or controversies in connection therewith, and to act in my name in any complaints, proceedings, suits or appeals in connection therewith; 8) to sue upon, defend, compromise or adjust any claims or ;In controversies in connection with any matter in which I may be RAMSEY&HANESI.AN.L.L.P. interested, and to act in my name in any complaints, proceedings, ATTORNEYS AT LAYV suits or appeals; 700 ATIUCIJ L•\tJF.,SUITE IC HYANNIS.MA 02G01 TEL 508.790-4177 Page 1 of 4 ndl' Iv0d U!sa6ew!-JiewE E6/4Z2 =3rY`Jz10 0cJ aovv=dt+NCS��uw��,��N� �,�LL99aELP£L=ylaAe hB£SEaU��8�1!^eZ=ln�/0/nAu yoeUeuoo•luaiuc;o�asna�6006 real or personal, whether or not the terms ' ofl anyr arrangement may extend beyond the duration of this power, and provide for the proper care and maintenance of such property pay expenses incurred in connection therewith, 10) to assign, set over; transfer or otherwise convey Of my property, real or personal, wherever situate, to Trustee or Trustees of any revocable inter vivos Trust or Tru created by me at any time, and to execute, acknowledge deliver any deed or other instruments of assignment, transfer conveyance, for such purposes; 11) to release any rights of homestead I may have in real estate; 12) to make any contracts or covenants in my name, whet or not the terms of any such arrangement may extend beyond duration of this power; 13) to continue or participate in the operation of business or other enterprise. in which I may have an interest to execute proxies and appear and vote for me in any corporate other meeting; 14) to act in my name in any reorganization proceedi:involving any corporation in which I may have an interest a; stockholder or otherwise; 15) to establish an Individual Retirement Account in name or to make any contribution to or withdraw from an exist: my name; Individual Retirement Account or any other retirement account 16) to roll over the proceeds of a lump-sum distribut: from any qualified pension or profit-sharing into Individual Retirement Account or any other retirement naccount another qualified. pension or profit-sharing plan; 17) to allow any property, real or personal, to be held bearer form or in the name of my said attorney, or in the name r; a nominee or nominees, with or without indication of t character of these properties; but my said attorney shall in t event segregate, to the extent possible, such property and sha keep records identifying such property; 11AMSEYGHANESIAN.L.L.0 18) to employ agents and counsel, including investrne ATTORNEYS nrLAW counsel, and to pay their reasonable compensation and expenses; 700 A17UCIS LANE.SUITE IC HYANNIS.MA 02601 TEL,506-790.1177 Page 2 of 4 E0'��'S.;;i. yd: A' :� u!se6ew!-!ieLuE) 9/t' JtM1(1969£6d 86CJd�!npesgsGw!�Js!pga0U91LL99a£LP£6=41SAe hB£8£aLl4a�6,1!8Z=!nL/o/npuawyoeuehuoa'luajG:�sna!Boo 6'luawyoepe-pLu//:sdllq 1.V ....... .._--_ 20) to take out, maintain or surrender a policy or policies life or on the life of any person in whom I of insurance on my said attorney) and may have an insurable interest (other than MY type of insurance to take out, maintain or cancel any other'withrespect to % t casualty or the like) I iabili t o 1 i her Y capacity)t a(whether c Y ot her conduct of affairs (in an individual or in any have an pinsurablE. with respect to any property in which I may the premiums and other sums duE interest, and in each case to pay privileges or options whicl thereon and to exercise any rights, may be contained in any such insurance contract or policy; 21) to appoint and substitute for my said attorney an, agents or ll of the purposes a attorneys for any or a aforesaid, an( g their authority at pleasure to revoke; <rP 22) to have the authority to employ and discharg physicians and other health care providers, and the authority t make all necessary arrangements for my care at home or at an hospital, hospice, nursing home, or similar establishment; execute, acknowledge, and deliver on my behal 23) to sign, any any deed .of transfer or conveyance covering a e from time toall hay personal or real property in which I Y the followir. an interest, including, without limitation, bequest c gift in advanceme actions: (a) transfer by nt o.f a will or devise to beneficiaries under my in the absence of a wi] £- to my descendants of whatever degree; (b) release of any lii y ift i '. interest, or waiver, renunciation, or declination of rrevocab'. me by will or deed; and (c) transfer owners mean individu of, or change assign the income the beneficiary Y retirement account owned by me; and acknowledge and deliver any and a 24) to execute, or proper to car instruments and do any and all acts necessary out the foregoing powers and in relation to all other matters which I may be interested, as fully and effectively as I could if personally present. This power of attorney shall not be affected by subsequE P rinci al. disability or incapacity of the p SAVERY, shall In the event that my said son, DANA E. attorney-in-fact under tl unable or unwilling to serve as myHA A OUIMETTE, of instrument, then I appoint my daughter, •�tiiajN• IlA ISEY&HANESIAN.L.J.P. Village Drive, Sandwich (East) , Barnstable County, Massachuset Al'l'ORNEI'S AT LAW to serve as such attorney-in-fact . Inability of my attorney - 700ATTLICS LANE.SUITE IC fact to act shall be evidenced by a certificate showing his de HIANNIS.MA 02601 S t TEL 508-790-4177 Page 3 of 4 j 1 .� - .. ; r ....� -. a -Evo 1 u!sa6ew!-!!ewE) £L/SUZ --- -...--, , r_oo-cFrcr-yrae�-•p..•BLtfL�L-IV'�tf�l!�G=!I IL/U/I IAUaUIyOeue�liJUO'lU _jasnal boo b'1uawyoeue-liew//:sdA4 Unwillingness to act shall be evidenced byv ay statements` writing, acknowledged before a notary this document . public, and attached If at any time subsequent to the execution of th instrument protective proceedings shall be brought in any Cou having jurisdiction for the appointment of a conservator of estate, I hereby nominate my said son, DANA E. SAVERY, to conservator and I direct that he serve without bond. sureties on h =4` I hereby covenant and agree on behalf of myself and estate to indemnify and hold harmless any and all persons fr any and all liability resulting from such personsr ns good faith reliance on this power of attorney actio . i r IN WITNESS WHEREOF, I have hereunto set my hand and this 25th day of July, 2011 . se }` Signed, sealed and delivered NV ... Marg p et E. Savery in the presence of: x iY' J COMMONWEALTH LTE OF NLMSACHLTSETTS BARNSTABLE, ss. •.;�:: ' On this 25th dayof Jul j , 2011, before me personally ca, MARGARET E. SAVERY to me known and known to me to be the pers- described in and who executed the foregoing instrument a: acknowledged to me that she executed the same as her free act a: deed. 1; KAMSEYGHANESIAN,L.LP ATTORNEYS AT LMV 700ITTUCKS LANE.SUITE IC No tar a r iC HY.\NNIS.M1 02601 - 4 L.. 1 'sl_IC r: C,nnrsanJ:r. i Page 4 Of r} b• .f� b1y Cmnncc;siCn czpireg; °`�'� �•'' September 13"'F`. �..$,s•@ v. •w"XF ro k. _��`�{'ri�y 4 J z�' ..��. �'l-.4 i' 'i*` _. ._.aJ�r� '` �, �.�.:"rd�S.a'�- t���� V � �u; ;r '�'�;���s}p�J},aft { t 5 p• Lr. ui sabawl-pews £619Z/Z n1rAi APPLICANT: AWA !vl W MtJ tt �Ms `ne. ADDRESS: _�� ip—dMA DESIGN FLOW: gpd REVIEWED BY: DATE: N/A OK NO Le al boundaries denoted [310 CMR 15.220(4)(a)] X Street, Lot, tax parcel number and lot number noted on plan [310 CMR 15.220 Locus Provided [310 CMR 15.2204 t Plan proper scale?(1"=40'for plot plans, 1"=20'or fewer for c omponents) [310 CMR 15.220(4)] X shown [310 CMR 15.220(4)(b)] tem located totally on lot served [310 CMR 15.405(1)(a) for ades]- i not, a variance is required [310 CMR 15.412(4)] x Location of impervious surfaces (driveways,parking areas etc.) [310 CMR 15.220(4)(d)] X Location all buildings existing and proposed 310 CMR 15.220(4)(c)] X Location and dimensions of system components and reserve areas [310 CMR 15.220(4)(e)] S stem Calculations [310 CMR 15.220(4)(f)] dail flow septic tank capacity (required andprovided) X soil abso tion system (required andprovided) X whether system designed for garbage grinder X North arrow [310 CMR 15.220(4)( )] Existing and ro osed contours [310 CMR 15.220(4)( )] Location and log of deep observation holes (existing grade el. on. each test) [310 CMR 15.220(4)(h)] x Names of soil evaluator and BOH representative [310 CMR 15.220(4)(h) and (i)] Location. and date of percolation tests (performed at proper elevation?) [310 CMR 15.220(4)(i)] percolation test results match loading rate?-[310 CMR 15.242] �c Certification st empntby Soil Evaluator [310 CMR 15.220(4) ')] X Observed and Adjusted groundwater(method for adjustment given or indicated) [310 CMR 15.103(3) and 310 CMR 15.220(4)(n)] Location of every water supply,public and private,.[310 CMR 15.220(4)(k)] X Address Powte tw (r Sheet I of 7 within 400 feet of the proposed system location in the case of surface water supplies and grayel packed public water supply X within 250 feet of the piioposed system location in the case within 150 feet of the proposed system location in the case x of private water supply.wells Location of all surface waters and wetlands located up to 100 ft. beyond setbacks listed.in 310 CMR 15.211 and any catch basins X located within 50 ft. [310 CMR 15.220(4)(1)] . ' Water lines-and c theF subsurface i filities located [310 CMR X 15.220(4)(m) (if water line cross see 310 CMR 15.211(1)[1]) Profile of system showing invert elevations of all system components and the bottom of the SAS [310 CMR15.220(4)(6)] . Stamp of designer 310 CMR 15.220 1 and 310 CMR 15.220(2)] Stamp of Registered Land Surveyor(required if construction activities within 5 ft. of lot line) [310 CMR 15.220(3)] X Test Holes adequate (two in each of the primary and reserve unless trenches as permitted in 310 CMR 15.102(2) or as X approved for an upgrade under LUA at 310 CMR 15.405(1)(k)] Test hole adequate to demonstrate four feet of suitable material? 310 CMR 15.103(4)] X Test Holes adequate to confirm adequate groundwater separation? [310 CMR 1.5.103(3)] x Benchmark within 50-75' of system [310 CMR 15.220(4)( )] Materials specifications noted? [various sections of 310 CMR 15.000] x System components not> 36" deep (unless Local Upgrade Approval or LUA.requested){310 CMR 15.405(1(b) X Address (� PAI, & COTLIIT�N+"t`T Sheet 2 of 7 PSize OK? '[310 CMR 15.223(1)J Inlet tee located ten inches below flow line 310 CMR 15.227(6)) Outlet tee 14" or 14"+5"per foot for increase R depth [31.0 CMR 15.227(6)] X Outlet tee with gas baffle or approved filter [310 CMR 15.227(4)] X, Note regarding installation on stable compacted base [310 CMR 15.228(1)] X Separation between inlet and outlet tees (no less than liquid depth) 310.CMR 15.227(2)] _ X Inlet/Outlet elevations at least 12" above high groundwater (except as described 310 CMR 15.227(5)) or permitted for upgrades under LUA [310 CNM 15.405(1)(k)) •x Minimum cover 9" (Tanks buried more than 9" must have risers on all openings and on the d-box) [310 CMR 15.2228(1) and 310 CMR 15.232(3)(0) X Three access covers (inlet and outlet must be 20" or greater) - middle access at least 8" (b 7/07) [310 CMR 15.228(2)] X Access to Within 6 ""of grade - one port for systerris<1000gpd, ' two fors stems>1000 gpd 310 CMR 15.228(2)) x All at-grade covers secured to unauthorized access? [310 CMR X 15.228(2)] > 10 ft from building foundation [310 CMR 15.211(1)] Buoyancy calculation Required/Done 310 CMR 15.221.(8)) X H-20 Where. a ro riate? [310 CMR 15.226(3)] Setbacks from resources [310 CMR 15.211] X` _ Required when otherthan single-family dwelling or flow>1000 d [310 CMR 15.223(1)(b)) �( First compartment 200%daily flow; Second compartment 100% daily flow 310 CMR 15.224(2) and'(3)] X "U"pipe through or over baffle, outlet of each compartment with as baffle or approved filter[310 CMR 15.224(4)] Address yfe, ( 7— AM Sheet 3 of 7 Located at least ten feet from any water line? [310 CMR 15.222(2)] Disposal piping at leasf 18"below water line (when water and sewer cross, see 310 CMR 15.211(1)[1]) + Cleanouts re aired/ rovided ? [310 CMR 15.222(8)] Thrust blocks specified in force mains? 310 CMR 15.221(6)(c)] Slope of sewer line not less than 0.01 (1/8"/ft) 0.02 preferable [310 CMR 15.222(6)] Proper pitch on all runs? (.005 within gravity-distributed trenches and beds) [310 CMR 15.251(9) and 310 CMR 15.252(2)(c)] x Siphon problem/ leachfield below um chamber) Endca s or vent manifolds specified? Size and orientation of discharge holes specified? (not smaller than 3/8" not larger than 5/8") [310 CMR 15.251(8) and 310 k CMR 15.252(2)(h)] \ Material's specified (310 CMR 15.251(5) specifies various pipe t es allowed) Stable compacted base [310 CMR 15.22](2) and 310 CMR LRiserifdee ] or baffle tee required on inlet/provided? (when er to d-box or steep pitch of gravity sewer) [310 (3)(a)] �( er than 9" [310 CMR 15.232(13)(0] Inside minimum dimension 12" [310 CMR 15.232(2)(b)] Minimum:.sum 6" [310 CMR15.232(3)(e)] X Watertight cover if<2000gpd); waterproof manhole if>2000gpd [310 CMR 15.232(3)(d)] �( Capacity (emergency storage above working=design flow)? [310 CMR 231(2)] X IProper setbacks [310 CMR 15.211 (same as se tic tank s)] Watertight 20-in minium access manhole at least 20"MUST BE TO GRADE [310 CMR 15.231(5)] x Service components accessible (not too deep,with piping, diEExceeds accessible) x - alarm on circuit separate from pumps specified? units must have two pumps operating in lead-lag CMR 15.231(6) and (8)J X Stable Compacted Base [310 CMR 15.221(2)] X Buoyancy calculations needed ?Provided? [310 CMR 15.221(8)] X Address ((p 1:�O , CMIT M4 Sheet 4 of 7 Calculations corrects = 4 feet of naturally occurring material demonstrated?[310 CMR 15.240(1)]Required separation to oundwater? 310 CMR 15.212)] Aggregate specified-as double washed [310 CMR 15.247(2)] System Venting required/provided? (system under driveway or >W!deep) [310 CMR 15.241] r . Inspection ports specified and within 3"final grade? [310 CMR 15.240(13) Breakout requirements met?=Vi[3 olation of breakout elevation within 15 ft of SAS unless ba ) 10 CMR 15.211(1)[4] and. X Guidance Document] FAM Chambers and Gal. in trench configuration supplied with inlet every 20 ft. [310 CMR 15.253(6)] X Each struclure with one inspection manhole (if>2000 gpd must X be tograde) 310'CMR 15.253(2)] Aggregate 1'minimum-4'maximum. [310 CMR,15.253 1)(b)] X 2' sidewall credit.maximum,[310 CMR 15.253(1)(a)) k In bsd configuration, inlet every 40 s ft. [310 CMR 15.253(6)] x Width 2'minimum 3'maximum [310 CMR 15.251(1)(b)) X 100 feet-maximum length [310 CMR 15.251 1)(a)' Minimum separation 2x effective depth or width whichever X eater(3x if reserve between trenches [310 CMR 251 1)(d)] Situated along contours [310 CMR 15.251(2)] X Breakout OK? [310 CMR 15.211(1)[4].and Guidance Document] �( minimum 2 distribution lines [310 CMR 15.252(2)(a)] X Maximum separation between lines 6' 310 CM R15.252 2 (d)] Maximum separation between lines and.outside of bed 4' [310 CMR 15.252(2)(e)] X Aggregate depth below discharge pipes 6" minimum, 12" x maximum. [310 CMR 15.252(2)(g)] Separation between beds 10'.minimum. [310 CMR 15.252(2)(f)] �( Bottom area used in calculations only 310 CMR 15.252(2)(i)] X Address N9 2a Leta✓ /30 C077V 7, Sheet 5 of 7 Pressure Dosed System ? Provided pump and piping calculations as re uired,.[310 CMR 15:220 4 (r)] Pressure dosing required on all systems>2000gpd or alternative systems and nedial approval [310 CMR 15.254(2)and IIA Remedial Use Approvals] If used in gravelless system -make sure jet is directed as not to I our soil interface [Guidance Document]spections once per year(systems<2000 gpd) or quarterly / (>2000 d ood to note on plan [310 CMR 15.254(2)(d)] Construction in fill -Did the plan specify that the fill shall meet the s ecification of 310 CMR 15:255(3)? X [impervious barrier and/or retainin wall ? [Guidance,Document] Impervious barrier installation must be supervised by x desi ner [310 CMR 15.255(2)(b)] Retaining wall must be designed by Registered Professional Engineer [310 CMR 15.255(2)(a)] X Side slo e not exceed 3:1 ? 310 CMR 15.255(2)] Breakout requirements met? [310 CMR 15.252(2)and X Guidance Document '\ At least 5 ft. from impervious barrier to edge of SAS (10 ft. ly St recommended) 1310 CMR 15.255 (2)(e)] Check DEP Approval letters for credits and design conditions x If used with pressure dosing do not allow pressure discharge to scour soil interface x SWAM Was.DEP Approval Letter provided and/or have you' reviewed the letter for conditions? Is the technology being properly applied and does it meet all DEP Approval Conditions? Is there a note on the plan regarding the requirement for ,perpetual maintenance agreement? Any alarms involved on separate circuits Did the applicant submit an operation and maintenance manual? Hasa elicant submitted a copy of a maintenance 1Are the variances listed on the plan ? [310 CMR 15.220 L (4)(g)] �1 RLS Stamp necessary on plan if a component is within five feet of property line [310 CMR 15.412(4)] New construction or increased flow proposed - [Refer to 310 x CMR 15.414] Address Sheet 6 of 7 I Is the system in a Designated Nitrogen Sensitive Area(Zone 11 fo a public supply well)? [310 CMR 15.214, 310'CMR 15.215 and 310 CMR 15.216 - also refer to Policy regarding upgrades of such ` existing systems] Is the system proposed on the same lot as served by private well ? y [310 CMR 15.214(2)] �1 Are the nitrogen loads proposed in compliance? [310 CMR 15.216(1)] Pum in to septic tank? [ 310 CMR 15.229 Shared System [310 CMR 15.290 r•. Address e Ak 1304 / Sheet 7 of 7 I W Town of -nstalbie P# 7�7 Department of Regulatory Services E Public Health Division �xxerear.� Pu = _ Bate l -98.9. tee$ 200 Main Street'.Hyannis MA 02601 Date Scheduled I Time Fee Pd. oil ,suitability Assessraiegt for S I)isposal nn e// /1 ' �/t' Witnessed By: i, Performed By. .. t i LOCATION & GENERAL'INFORMATION��� Location Address Owner's Name IY �'j Address Engineer's tr Assessor's Ma Icel!P r I F Name o GUI �� J , r P � C?/ r . J NEW CONSTRU( '1710N REPAIR '` Telephone# g t Land Use �� n 1Z�y Slopes(4'0) /0 �� ' Surfa"Stones �d Distances from: Open Water Body. !06 Ft Possible Wet! ��� ft Drinking Water Well �66-0 ft I y �y v ` 7'�O ft Other ft Drainage Way. ft. Prope'rty Linc jt t SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proxitnity to holes) �� ✓J�n o z�zs� � I i i Parent material(gedlogic) G S'l Depth to BedrockAlL N �f I _ Depth to GroundwaKdr. Standing Water in Hole: Weeping l i P g from Pit Fpoe • Estimated Seasonal High Groundwater Dt ATION FOR SEASONAL HIGH WATER T"LE. Method Used: I. in. Depth to sell mottles: ln. 1 Depth Observed standing in obs.hole: P it j Depth[oiweeping from side of obs.hole: i in. ©rounrlwater AdJustment Index Well# Reading Date: Index Well 1eve1 -- A�, f1d0f _.___ AdJ.Oraunciwnterl Level. e � I _ PERCOLATION TEST . Date Time•__._. Observation Tirne flt 9" -- ...� Hole# Time at G" Depth of Pere { (v d S I Time(V-6") Start Pre-soak Time.@ g End Pre-soak Rate MinJlnch --1L I Additional Testing Needed(YIN) Site Suitability Assessment: Site Passed Site Failed:___ Original:.Public Hedlth Division Observation Hole Data To Be Completed on Back— f ***If percolag6n test is to be cond*acted within 100' of wetland,:you must first notify the Barnstable Conservation Division at least one (1) wedk prior to beginning. ' 1 I DEEP OBSERVATION HOLE LOG Hole#_ Depth from Soil Horizon Soil Texture Soil Color t Soil Other .Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistenc %Gravel V • I I DEEP OBSERVATION HOLE LOG Hole# j Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel) 1 - 2 [Awh ti ► DEEP OBSERVATION HOLE LOG Hole# 1 Depth from Soil Horizon Soil Texture Soil Color Soil ter . Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistency,%Gravel I I I j i I DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USD (Munsell) Mottling (Structure,Stones.Boulders. Consistency, ra I I i i 1 I { I Flood Insurance Rate Map: Above 500 year flood boundary No— Yes _ / t Within 500 year boundary No`r Yes Within 100 year flood boundary No J Yes I Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perv' s material exist,in all areas observed throughout the area proposed for the soil absorption system. If not,what is the depth of naturally occurring pervious material? Certification I certify that on ! (date)I have passed the soil evaluator examination approved by the Department of Envirolimental Protection and that the above analysis was performed by me consistent with the required t 'Wing,expertise and experience described in 3:10 CMR 15.017. Signature �. Date Q:\.SEPTICIPERCFORM.DOC 13c) 4 No. V / / Fee V`� THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes I PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 9pplitation for Bisposal lbpstrm Construction Permit Application for a Permit to Construct( ) Repair(4 Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. Tt 3 0 Owner's Name,Address,and Tel.No. J Assessor's Map/Parcel (� --'� � Installer's Nam,Address,a�Tel.No. 9T4 oz�0 Designer's Name,Address,a el.No. pt-rNA o 5 o Lt Z_.e_ p pvzai ij Ail t—�— Pi o.3o' Mpr/Lt c NIL" So -3to z- Z9 2-7— Type of Building: Dwelling No.of Bedrooms 3 Lot Size Z, Garbage Grinder( ) Other Type of Building i EEgj T FEZ.- No.of Persons Showers( ) Cafeteria( ) Other Fixtures ? Design Flow(min.required) J J gpd Design flow provided 3 3 Z gpd Plan Date Zj 13 Number of sheets Revision Date Title nn ,1 Size of Septic Tank ('5-0 0 Type of S.A.S.. AtZ4 3 lP Description of Soil Nature of Repairs or Alterations(Answer when applicable) KjgLJ 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 ode and not to place the system in operation until a Certificate of Compliance has been issued by this Board Health. Signed Date Z o 3 Application Approved by Date If d .5 r� Application Disapproved by Date for the following reasons Permit No. 9 � Date Issued _5 t, No. V ' 1 ` ^ E�,, ` Fee V"� THE COMMONW LTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION -,TOWN OF BARNSTABLE, MASSACHUSETTS' Yes 01ppIiiation for 33isposar Epstein Construction Permit Application for a Permit to Construct( ) Repair(,/f Upgrade( ) Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. / Owner's Name,Address,and Tel.No. 'RowrE 1%0 -PA J Ac Sit✓e Assessor's Map/Parcel ` 6 ---� f Installer's Name,Address,and Tel.No. Designer's Name,Address,and Tel.No. S {�L L.t.>✓� � �O Z�b DAB i.1 Type of Building: Dwelling No.of Bedrooms 3 Lot Size Garbage Grinder( ) Other Type of Building ��1 -r A--L No.of Persons Showers( ) Cafeteria( ) Other Fixtures i Design Flow(min.required) gpd Design flow provided 3 3 Z- gpd Plan Date 13 Number of sheets Revision Date IJ Title Size of Septic Tank (5,6 p ! A Type of S.A.S. V; A/ZC 31a 4C- Description of Soil SO;7- L44 Nk Nature of Repairs or Alterations(Answer when applicable) Y�tw S vmgL41 _rvl G- L 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 ode and not to,place the system in operation until a Certificate of Compliance has been issued by this Board Health. Signed _ Date 7— t 3 . Application Approved by Date _ — r? Application Disapproved by Date for the following reasons Permit No. e90 Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,MASSACHUSETTS (Certificate of Compliance THIS IS TO CERTIFY,that the On-site Sewage Disposal system Constructed( ) Repaired( ✓� Upgraded( ) Abandoned( )by JAL,"_OL L So tj CO►JS`f e1A^.7rj at 16 2.0 yre;' 1 3 O C-0-Tu 1 -r has been constructed in accordance c with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer A-OA e5 t-tot.� - Designer —7J M #bedrooms 3 Approved design gow 91 gpd The issuance of Ihis permit shall not be construed as a guarantee that the system ll i lction as d signed. Date U Inspector ), Y�� ) � - - -------------g--------------------------------------------------------------------------------------------------------------------------- No. o 13 — 111 Fee 1610 THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION -BARNSTABLE,MASSACHUSETTS Misposal 6pstem Construction Permit Permission is hereby granted to Construct( ) Repair( ✓) Upgrade( ) Abandon( ) System located at OL 9D I)T:g- 13 O CD-rV(-r 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. s Provided:Construction must be completed within three years of the date of this permit" " Date�' 7 �� Approved by 'own of Barnstable � E Regulatory Services Thomas F. Geiler, Director I S3AFLVSPABLE. Pub lic Health DIV1S10)<l Thomas McKean, Director 200 Blain Street,Hyannis,MA 02601 Office: 08-362-464A Fax: 508-790-6304 Installer & Designer Certification Form J ^ ` Date: i Sewage Permit# 2-�'r-3— 11( Assessor's Map\Parcel Designer: e ,� l i ?�f�ri5 11nl� Installer: J�✓�l. J 110l Address: ( sl �1 :address: 'Rc 43oi '76 Z__ Or. `T- 5—,- -3 _�l�a'�'t ��' 1�-�U7$,t,as issued a permit to install a (date) / (installer) septic syst U/em at l RO ��� C�3]A lr based on a design drawn by (address) "L� �'' -S V✓t L• dated 2 13 A (designer) 1 certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral relocation or:-f distribution box ands or septic tank. I certify that the septic system referenced above was installed with major changes (i.e. Greater than 1G' lateral relocation of the SAS or am vertical relocation of-any component of the septic system) but in accordance with State & Local Regulations. Plan revision or certified as-built by designer to follow. of Mgss9C �A � IT Signature) " No. 1140 RFG/S1E � SANITW�`� (Designer's Signature) (Affix Designer's Stamp Here) PLEASE RETURN TO BARNST: LE PUBLIC HEALTH DIVISION. CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-BUILT CARD ARE RECEIVED BY THE BARNST.ABLE PUBLIC HEALTH DIVISION THANK YOU Q: Heal ttvSeptic,Desi;ner Certification Form 3-26-041doc i 'down of Ba"Mstable P# 7 "7 Department of Regulatory Services t�r,►,3r = Public Health Division Bate nrnse i6�9 tee$ 200 Main Stree4 Hyannis MA 02601 . 1 Date Scheduled / Time Fee Pd.- i oil �`r�ztali�lily Assessraieni for Se Disposal Performed Bylk,1 e Witnessed By: • LOCATION & GENERAL INFORTV1ATIO/d���T Location Address Owner's Name /��fj Otv G 5 l Address ' ax Assessor's Map/Parcel: Engineer's Name Gf.�n d . ( 7 j J �-' Ll NEW CONSIRU(�`I,,ION REPAIR '\ � Telephone# � g � � � �'� Land Use I i Dry Slopes(90) '/�4� ' Surface Stones N - Distances from: Open Water Bod 7 !46 ft Passible Wee Area 71� ft . Drinking Water Well ?�O ft i Drainage Way ft Property Lin c O ft Other ft SKETCH:(Street name,dimensions of lot,exact locations of test holes&Pere tests,locate wetlands in proximity to holes) L,�rJ ►� O Z`ZS� � - ISO Parent material(ge(ilogie) �!'f G S"1 Depth to Bedrock ' Depth to Groundwater. Standing W ter in Hole: Weeping from Pit Face - Estimated SeasonaI,1 igh Groundwater DtTUMDUTION FOR SEAS6ITAL HIGH WATER TALE Method Used: Depth 00perved standing in obs.hole: in. Depth to soil mottles: tt R Depth toirveeping from side of obs.hole: " in. aroundwnter Adjustment Index Well#_ Reading Da� Index Well level - _ Adj.f►etor, Adj,droundwaterievel.,,.,e. PERCOLATION TEST n$tp------a Observation I Tirne at V HOIe# Time at 6" ....------ Depth of Perc S d v d Time(9"-6") _— -- Start Pre-soak Time.@ (, g End Pre-soak Rate MinJlnch Additional Testing Needed(YIN) Site Suitability Assessment Site PI ssed Site Failed: — Origins[:.Public e;elth Division Observation Hole Data To Be Completed on Back------ ***If percolation testis to be conducted within 100' of wetland,you must first notify the px'ior to beginning. Barnstable C4nservatiCII Division at least one (1) week I DEEP OBSERVATION HOLE LOG Hole#_ Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel MAW DEEP OBSERVATION HOLE LOG Hole# Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel) L ti �l 2, 7 DEEP OBSERVATION HOLE LOG Hole# Depth from' Soil Horizon Soil Texture Soil Color Soil �Iher Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders. Consistent %Gravel DEEP OBSERVATION HOLE LOG Hole Depth from Soil Horizon Soil Texture Soil Color Soil Other Surface(in.) (USD (Munsell) Mottling (Structure,Stones,Boulders. Consistency. ra I F F Flood Insurance Rate Map: it Above 500 year flood boundary No— Yes J Within 500 year boundary No Yes Within 100 year flood boundary No v- Yes 1 Depth of Naturally Occurring Pervious Material Does at least four feet of naturally occurring perv' s material exist in all areas observed throughout the area proposed for the soil absorption system? If not,what is the depth of naturally occurring pervious material? . - Certification I certify that on 10/19 (date)1 have passed the soil evaluator examination approved by the Department of Enviro mental Protection and that the above analysis was performed by me consistent with the required t mng, p• expertise and experience described in 3,10 CNIR 15.017. Signature kill Date 1� l2 I Q:\.SEPTICVERCFORM.DOC TOWN OF BARNSTABLE LOCATION O � � 130 SEWAGE# 1013— /it VILLAGE CO-r1d IT ASSESSOR'S &PARCEL aA 0 00 INSTALLER'S NAME&PHONE NO. J A M�r Oc.Lgp— S� '0 SEPTIC TANK CAPACITY f YCO 4 Lik" LEACHING FACILITY-(type) 71A�Sk— GEtf&N8M$ (size) 99C 32- NO.OF BEDROOMS OWNER PERMIT DATE: �' e f COMPLIANCE DATE: . �o t3 _ Separation Distance Between the: �. r Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on 1 site or within 200 feet of leaching facility) /3 1 Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY ��� k '1 Ai Z 32-6 3 q7_13 , S 2 S,5'-o 3 6 4-0 'L3 4 -14-a � 3 tog-0 q(o ^� t, z Rug �rAT ION S EVYE PERMIT N0. =- Zj VILLAG f T INSTALLER'S NAME & ADDRESS t.__.o. �r. B U Il D E R OR OWNER , DATE �P R 1 ISSUED 7-� DATE COMPLIANCE ISSUED �' �-` �,�"r J THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH �� ,! ,/ e�✓ O F................... /¢ /cS,r - ......... Appliratiun -fur Rupuiitt1 World Ton,itrurtiun Prrmit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: �f• f fa�dd0 � /d!'U// " y DlTG. Cr T .. .v� -•--•-... rLocat Ares Lot No. l--,!° . 1 �iP -------------- -------------�-�=..... o ......../ - G--S--,Sa�tS r9-vTvi eri O Addr ss ............... s � -----------------•--... --------------------------- Insta Address i U Type of Building �d�Ei /}.tT X13G d7'X"�� Size Lot.... .�?� .__._:. . Dwelling—No. of Bedrooms..-_.----\_?........... ...............Expansion Attic Garbage Grinder {y� Other—Type of Building ._ Gam, yp g �� 'o--_ No. of pe ---------- _____________ Showers ( /S — Cafeteria (�) d Other fixtures ...... -Gl ..��. ls. .__. (1!_LT---D�w (✓_�� /iY/ JGe�ic� W Design Flow................. _Q...................gallons per person per day. Total daily flow............................................gallons. WSeptic Tank•- Liquid capacity .OV®gallons Length................ Width................ Diameter................ Depth---------------- Disposalx Trench .� _ Width-------------------- Total Length-------------------- otal leaching area_aa�._ .. q. ft. p k__.. Iameter.................... Depth below inlet...ro Total leaching area.---_.-.-_ ..----sq. ft. Z Other Distribution box ( ) Dosing tank �4,Ve ~" Percolation Test Results Performed by---------------- ........ � ' �......._. Date_ -__ _.__ _.____._..-- ,� Test Pit No. 1................minutes per inch Depth of Test Pit_.-_-__--_-...____-. IXpth to ground water------------------------ rXq Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water------------------------ a+' ------------------ O Description of Soil------------------- zl2y&�- -----0--r� %------------------------------------------------------- ------------------ x w x -----------------------------------------------------------•-------•------------••••------•-•••---- ------------••---..... --------- ------------------ -------------- ---••-•-----•--•--•-•------ V Nature of Repairs or Alterations—Answer when applicable----------------X� -..._,_____ Agreement: d.�� ,�/ • The undersigned agrees to install the aforedescribed Individual Sewage Disposal Syste in� cFia`� f�. the provisions of Article XI of the State Sanitary Code— The undersigned further agrees not to ce the system in 11 operation until a Certificate of Compliance has be n ed by t boar of alth. Signed-- ------- --t -•--... -------•---•-- - - -- ---- - --------• •-----•-. -•-� •--�-ate Application Approved By------ ,� ......-• .�".7 ......... Application Disapproved for the following reasons---= .----------------------------------------•---._..._. -•-•--•---•---------------.--.--...Date --•------.---. --------------------------------------------------------------••-•-....------------------•------------------•--••--•-------•-----•-----------------•-----•••-•------------•--•--••-•----------••-•------ Date PermitNo.......................................................... issued....................................................... Date No.........., ...... Fine ..:....f.... { THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH ....../G --OF..................../ 6Qfl/sr .1- , Appliratioo -for J%qp ial Works Tutuitrurtion Vrrmft Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: ' r �ti= A Gv7G /_,C� S �1// ................-----------•--•--•�--------••--••---•--•---...' -S5;; -•� •--••------ •-•--•---•--------� ----------- - Location Addres I or Lot No. �� GC�ir'r rq�/f '1 G �'ovT /,�c ,.i�ii v�i fir:_._._ (......._.. •• -•- - --6- •--- `) O er ,- - Addr ss Instal i Address d Type of Building /���`/G (S1111Gi Jlec J 5 Size Lot .v � Dwelling—No. of Bedrooms--.-_----\2----------------------------Expansion Attic (/&�o Garbage Grinder (� a Other—Type of Building ����' /v.. No. of pers@11s------------ ------------- Showers Cafeteria VtlS' d Other fixtures ... el47 t`�S/i j_.._%GiL T..._..�`Gc��1l�`/_ v � er/re� W Design Flow----------------- _Q..................gallons per person per day. Total daily flow............................................gallons. WSeptic Tcuik- Liquid capacity�UU Ugallons Length---------------- Width.............--- Diameter------.--------. Depth-.__-_-_--- x Disposal Trench Width-------------------- Total Length.................... Total leaching area-2_-C.-?f__Tq. ft. is pe�� ________________---- Iameter-------------------- Depth below inlet... Total leaching area.___...__________sq. ft. z Other Distribution box ( ) Dosing tank ( Percolation Test Results Performed by-----------------AlLZ--------- Date..... --- ---------- W Test Pit No. 1----------------minutes per inch Depth of Test Pit--------------_..... pth to ground w Pr..___..._._------------ f4 Test Pit No. 2----------------minutes per inch Depth of Test Pit-------------------- Depth to ground water-_._-.--_-___-.--.---. - Ix ------- -------------------------------------------------------------------- O Description of Soil----------------- �i1� �--- -1?�_ �. =----- -----------•------------------------------------------------------- x U w V Nature of Repairs or Alterations—Answer when applicable.-.--------------- -- - i. .__ ---------- - ------------ Agreement: _ The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in . n asc-4�2 v • W41711/f the provisions of Article XI of the State Sanitary Code—The undersign further agrees not to cue the system in operation until a Certificate of Compliance has be, ed by th )oar of_ lth. 01, Signed----- -------- ---------------- --- ----------- --- --- - - ---------- -------- - ate Application Approved By........ •---------------------- ....7.------------------------------- Date Application Disapproved for the following reasons:----••-----------••-----•--------•--------••---••-------------•-----------•----•------------•-----------•------- -•---•---•-••--=----------------------------------------------•-------------•-----...................---•--------•--------------------------------------••-•--•----------------------••--------------- Date PermitNo......................................................... Issued....................... ................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH TOL�/ln................OF..........�..G � L'!.G .......................... wrrtifiratr of fompiionrr b T �S IS 0 CERTIFY, That the Individual Sewage Disposal System constructed ( or Repaired ( ) y _ - r _ ...... ------------------------------ --- - ---------•-------------------------------------------------------------•-•-----•••-•..- J�Install at..._...16, ---- -----f�=� has been installed in accordance with tWe provisions of : I e XI of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.__--.--...Z-y/_________________ dated.- __-7._..7.'..7_.L ............. THE ISSUANCE OF THIS CERTIFICATE SHALL. NOT BE CONSTRUE® AS GUARANTEE THAT THE SYSTEM WILL,�FUNCTIO SATISFACTORY. DATE----- � Inspector.......... --.... ...... ------ = .. . �------------------ THE COMMONWEALTH OF MASSACHUS S 7G BOARD OF HEALTH ........OF....... ----••------------- No......................... FEE./ )- Di-Itralia��-IlrkpQlxwitrurffvn Vrrmit Permission is hereb ranted-------- hereby , to Constr t Repair ( ) an In i*idu Se,,ge •sposal ystem /� �. at No._-X)(1 - �`''�^- `�. =1 = t1 1 Street as shown on the application for Disposal Works Construction Per it No.._..._...._� ___ Dated___ _-'.---7"_..7L_ U =-------------------- o�of Health DATE................................................................................ FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS a - J ` I r r I � r 2,0 Ge-e,a A)8591111 ti RICHARD CMG�T t7I—1 — 1 �T t� IT A. AAD 1LAIG & -ZS/_1G 9No,24 NS O 6TrLR��yQ t LAW �CF t2F�JGE �0 0_ sic PlA1J FOR ;nUAY p 771,4f T'HL {�lJ�tlD�4T/DN TEtj AA A,� 13 $ kTEtZ N�tc t�.Ic., o,c- rl4a rroA/ O c 8,4e Sr &,-- Ee&4STf=-fE© L AutS SOP—Vejoe5 Jove zs; In. O'exeZ , I 1 O M A55 p r � _�r-�r►��Ice.. St>WArzt; S • 5 a\-/wz, G r• BARNE1TB ALE COUNTY HEALTH DEPARTMENT BARNSTAB]LE, MASS. 02030 TCLKPHONte 362-2511 Ext. 331 Date: July 79 1976 To: Mr. Robert G. Savery Off Rte 130 Santuit, Mass. 02635 On the basis of a sanitazy survey and a.laboratoxy examination on the sample of water taken from a ..VVII.. ... ...... . .. ... ... . . . . ... ... . .. ....... . located on the premises of . .. .. .... . . . . . . ... located at ... . .Off.Rte.130..3aatui.t.... ... . .. ..: .... so .. .. . . . . .. .. .. . ... .. on.......bly.O•.1970.......9......... this supply is approved for domestic purposes at the time the examination was made. If you wish further inf'ormatiom regarding this supply, please contact us at the County Court House, Barnstable, Massachusetts (Tel: 362-2511 Fact. 331) and we will be glad to assist you in any way possible. Signed.. .. . e� . . Publ c Health Sanitarian LO `CATION SIWA �-E PERMIT N0. VILLAG INSTAlLER'S NAME �& ADDRESS Ax A' B U I•L`D E R � OR OWNER ® E PAR 1T ISSUE ® DATE COMPLIANCE I S S U _ i ED s -- I �r1�' LEGEND ' COTUIT PARCEL ID: PROPOSED CONTOUR s 010/044 r TOWN WATER O ® PROPOSED SPOT GRADE PARCEL ID: � LOCUS: 010/044 �, EAAINA SEMENT rm ' N r, N 98 —' 16 RTE. 130. _ EXISTING CONTOUR M y — -�00, .Q i 20"0 Z + 96.52 EXISTING SPOT GRADE W w`eo��} _ -_- -4 r• W— EXISTING WATER SERVICE 150' - TIERS 5 WELL)- � 5 '.:��--- 4..P -j TEST PIT a (FROM ABu 50 � a O i 49 \� Q TBM: i :,o` . 14"P TOP OF SPIKE y ELEV=40.31 L MSP-P� . ;`,. PARCEL ID: PROP. 1 ,500 GAL + TP �,;4'CEt) 010/010-006 ' ''� (VACANT) �(� lP 5EPTIC TANK so, 0 �9.. ....,G.. ..t 1 �'' IF' !i," T.W. AVAIL O �l PARCEL ID: epG B4,VW T. a ( �! `.� �� LOCUS MAP 010/09 �° `Ir'�` ': �� \ S� \14"�ct` AREA=2.52 ACRES v, • '12 p. \`, a'\`\\\\ J \ ` ; ' LOCUS INFORMATION \ UPOLE W v'j 00 1 i i % `� \\ �, --- jr I PLAN REF: 304/59 .-. Z ': ` TITLE REF: 10381/262 3s �\ \ a s -''Mr ---- PARCEL PARCEL ID: MAP 010 PAR. 009 ZONING: "RF" ..................................... ..... �\ .�� ` �� \ �9 � FLOOD ZONE: "C„ < P COMMUNITY PANEL- 250001-0021-D DATED:07/02/92 TOF=46.00 - SEPTIC SYSTEM AIL REPAIR PLAN �, ' _ #16 _ LOCATED AT: AL AL ' ,�9. a = _ #16 ROUTE 130 IrclGENERAL NOTES: CRANBERRY _-- COTUIT, MA. AL 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL ,L BOG � PREPARED FOR BOARD OF HEALTH AND THE DESIGN ENGINEER. %%may ° ` M A R G A R E T E. SAVER Y 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS `� ,� '°: 3 OF THE STATE ENVIRONMENTAL CODE, TITLE V. AND ANY APPLICABLEAL LOCAL RULES AND REGULATIONS, EXCEPT AS NOTED BELOW. O\, , FEBRUARY 25, 2013 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR `w TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. o \ / OF MgsS 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING UPOLE FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN ' / WELL DA E yG ENGINEER BEFORE CONSTRUCTION CONTINUES. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. v �, 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF 11 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF I HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. 7. PROPERTY IS SERVICED BY PRIVATE WELL. 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED TA 25 r3 TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 10. EXISTING CESSPOOLS TO BE PUMPED, CRUSHED AND REMOVED.REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5 SPECS. VARIANCE REQUESTS - MAXIMUM FEASIBLE COMPLIANCE MEYER & SONS, INC. 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY PER 310 CMR 15.405 - MAXIMUM FEASIBLE COMPLIANCE P.O. BOX 981 AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 1) PER 310CMR15.405 (1)(b). VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING TO BE 5.91' BELOW GRADE 13. PROPERTY IS WITHIN AN AQUIFER PROTECTION DISTRICT. VS. REQUIRED 3.00 Fr. (H2O/VENT PROVIDED) EAST SANDWICH, M A. 02537 14. ALL PIPE TO BE 4" SCH 40 ® 1/8"/FT (UNLESS SPEC. OTHERWISE) PER TOWN OF BARNSTABLE BOH TITLE V REGULATIONS { 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW 1) A 14 FT. VARIANCE TO ALLOW LEACHING TO BE 86' FROM EDGE OF BOG VS. REQUIRED 100 Fr. (508)362-2922 FOR THE USE OF A GARBAGE GRINDER 2) A 46 FT. VARIANCE TO ALLOW SEPTIC TANK TO BE 54' FROM EDGEiOF BOG VS. REQUIRED 100 Fr. 3) A 11 FT. VARIANCE TO ALLOW DISTRIBUTION BOX TO BE 89' FROM EDGE OF BOG VS. REQUIRED 100 FT. 4) A 18.31 FT. VARIANCE TO ALLOW LEACHING TO BE 131.69' FROM ON-SITE PRIVATE WELL VS. REQ'D 150 Fr. 4 SCALE: 1"=30' SHEET 1 OF 2 J 1484 I NOTE: TO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:41.09 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. t. T.O.F. EL.=46.0 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER 14" OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MINI) AND SET TO 3" OF F.G. vENT INSTALLED TF.G. EL.=44.Of F.G. EL.=43.50t F.G. EL: 47.Of RG. EL: 47.00(MAX.) LENGTH ���� OF �4Ss9 M9.45" DA N M 9" MIN COVER/ 1 �_ L = 25'f 36" MAX COVER 1 L 35' L = I0'(MAX) INSTALL TWO INSPECTION PORTS (MIN.) 1237' No. 1140 "' ® S=1% (MIN.) EL. = 42.50 ® S=1% (MIN.) 0 S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC 10� 6 10.75" TO 1aNITAR�� INV.=41.50 4s'uoui0 INVERT LEVEL INV.= 41.25 INV.= 40.63 COUPLER DETAIL "ill GAS BAFFLE PROPOSED D-BOX INV.=40.73 3 ROWS OF 6 UNITS ® 5'/UNIT + 1 COUPLERS ® 1.16'/UNIT = 31.16'/ROW INV.=40.9DB- C, SOIL ABSORPTION SYSTEM (PROFILE) PROPOSED 1,500 GALLON SEPTIC TANK 20) 1 F�STININV.=42.0 G SEWER OUTLET I RESTORE VEGETATIVE COVER BACKFILL WITH CLEAN PERC SAND TO TOP OF CHAMBERS 60" ' I BREAKOUT=TOP ELEV.=41.09 NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING INV. ELEV.= 40.63 PIPE INVERTS PRIOR TO CONSTRUCTION 2) TANK AND D-BOX SHALL BE SET LEVEL AND BOTTOM ELEV.= 39.76 EXISTING SUITABLE TRUE TO GRADE ON A MECHANICALLY COMPACTED 2.88' MATERIAL SIX INCH CRUSHED STONE BASE, AS SPECIFIED 5' MIN. ABOVE BOTTOM OF IN 310 CMR 15.221(2) T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH 3 x 2.88' = 8.64' 3) INSTALL INLET & OUTLET TEES W/ (5.16' PROVIDED) USE 3 ROWS OF 6-ADS ARC 36HC BOTTOM OF TESTHOLE EL.=34.60 _ (H20) UNITS NO STONE W/ 1 COUPLERS GAS BAFFLE AS REQUIRED I IN EACH ROW SEPTIC SYSTEM PROFILE TYPICAL SECTION • N.TS 16" N.T.S. SOIL LOG P#:13787 DESIGN CRITERIA _ DATE: NOVEMBER 26, 2012 SOIL EVALUATOR: DARREN M. MEYER, R.S., CSE 1614 SECTION 10.75" NUMBER OF BEDROOMS: 3 BEDROOM DESIGN # INVERT WITNESS: DONALD DESMARAIS, BARNSTABLE BOH HEIGHT END CAP SOIL TEXTURAL CLASS: CLASS I DESIGN PERCOLATION RATE: <2 MIN/IN i DAILY FLOW: 110 G.P.D/BR. DESIGN FLOW: 330 G.P.D. Elev. TP-1 Depth Elev. TP-2 Depth ADS - ARC 36HC CHAMBER (H20 LOAD) GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 45.60 A LOAMY SAND 0" 46.40 0" 1oYR 3/2 A LOAMY SAND MODEL ARC 36HC SEPTIC TANK: 330 gpd x 200% = 660 gpd USE NEW 1,500 GALLON SEPTIC TANK 44.93 8"` 39.13 1OYR 3/2 8" B NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT LOAD SAND r LOAMY SAND TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY 1OYR 6/6 EFFECTIVE LENGTH 60" LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. 43.10 C 30 43.73 C 32" SIDE WALL HEIGHT 10.75" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. DISTRIBUTION BOX: 3 OUTLETS (MINIMUM) OVERALL HEIGHT 16' MEDIUM-COARSE MEDIUM-COARSE OVERALL WIDTH 34.5" 4640 TRUEMAN BLVD PRIMARY S.A.S. PERC 0 41.44 SAND SAND 10.7 CF E HILLIARD, OHIO 43026 USE 3 ROWS OF 6 - ADS ARCHC 3616 H2O UNITS-NO STONE 2.5Y 7/3 2.5Y 7/3 CAPACITY AND EXTENDED 1.16' WZ COUPLER IN EACH ROW 80.0 GAL ADVANCED DRaNA°E srsrEMs INC. BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF CHAMBER) PROPOSED SEPTIC SYSTEM/SITE PLAN (CHAMBERS: 6/ROW)18 UNITS x 5.0 LF x 4.80 SF/LF = 432.00 SF 34.60 132" 35.40 132' 16 ROUTE 130 COTUIT MA. (COUPLER: 1/ROW) 3 UNITS x 1.16 LF x 4.80 SF/LF = 16.70 SF - > > 0 TOTAL AREA = 448.70 SF Prepared for: Savery PERC RATE <2 MIN/IN. (-Cl- HORIZON) DESIGN FLOW PROVIDED: 0.74GPD/SF(448.70SF) = 332.03 GPD > 330 GPD req'd NO GROUNDWATER OBSERVED Engineering by: Surveying by: SCALE DRAWN DATE: r 9 9 Meyer&Sons,Inc. dlecDougau survey NTS D.M.M. 02/25/13 I. Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 po BOX 981 (508) 419-1086 to conduct soil evaluations and that the above analysis has been performed by me consistent with the EASTSANDWICH,MA02537 REV. DATE: CHECKED SHEET N0. requirements of 310 CMR 15.017. 1 further certify that I have passed the Soil Eval. Exam in October. 1999. 5os,W zs22 D.M.M. 2 of 2 LEGEND COTUIT PARCEL ID: PROPOSED CONTOUR i TOWN ER o ' ® PROPOSED SPOT GRADE PARCEL ID: LOCUS: 010/044 �, ERAINAGE ASEM EXISTING CONTOUR ENT N N 16 RTE. 130 _ 10p, OF ; 20"0 y + 96.52 EXISTING SPOT GRADE ,lp0e.q` ; lie c W— EXISTING WATER SERVICE - - -` `_ 53s = M "� 3.- 4 TEST PIT FROM ABUTTERS WELL)- 550K._ ;:\;4'�F 'QpG �5! a ( $ p 50 ` -- �\ � ' 9 - TOP OF SPIKE ELEV=40.31 PARCEL ID: pO PROP. 1 ,500 GAL :, ~\ TPA'4 CED 010/010-006 �O v9 j i i (VACANT) SEPTIC TANK so' OFF' . ; �. . t., j'• ?F !! T.W. AVAIL PARCEL ID: e0G %7 \` 4 '• FPS. 010/09 '�;;.1. '•i, I(( C d, ' 14'L� LOCUS MAP AREA=2.52 ACRES /' ,� ,�••� ��. '• .� 01S' LOCUS INFORMATION o . •...., �_�- 2 �,'o �F PLAN REF: 304/59 1 \ ; TITLE REF: 1 0381/26 2 PARCEL ID: MAP 010 PAR. 009 ZONING: "RF" .� ` Q \ FLOOD ZONE: "C" „_. "•� \ `? �� COMMUNITY PANEL: 250001-0021-D DATED:07/02/92 TOF=46.00 SEPTIC SYSTEM REPAIR PLAN AL AL #16 LOCATED AT: #16 ROUTE 130 AL GENERAL NOTES: CRANBERRY --OA o' __ _ oQ COTU I T, MA. IA _ % PREPARED FOR � 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOG BOARD OF HEALTH AND THE DESIGN ENGINEER. M A R G A R E T E. SAVER Y 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS �� °� : 3 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE AL �� -� FEBRUARY 25, 2013 LOCAL RULES AND REGULATIONS, EXCEPT AS NOTED BELOW. I O 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE DESIGN ENGINEER. f wo \� OF , 3 4 FROM THANY OSE SHOENCOUNTERED N O EREON DSHALLNBE REPORTED IOTO THE DESIGN u�� WELL ENGINEER BEFORE CONSTRUCTION CONTINUES. /� D G 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF NO. 1140 THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. I RfG�SiE 7. PROPERTY IS SERVICED BY PRIVATE WELL. 8. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED ' NITAR��`� TO A CONDITION AGREED UPON BETWEEN OWNER AND CONTRACTOR. 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. 10. EXISTING CESSPOOLS TO BE PUMPED, CRUSHED AND REMOVED. REPLACE WITH CLEAN MEDIUM SAND PER TITLE 5 SPECS. I VARIANCE REQUESTS - MAXIMUM FEASIBLE COMPLIANCE MEYER & SONS, INC. 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 12. THIS PLAN IS TO BE USED FOR SEPTIC SYSTEM PURPOSES ONLY PER 310 CMR 1 405 — MAXIMUM FEMALE COMPLIANCE I! P.O. B 0 X 981 AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY 1) PER 310CMR15.405 (1)(b), VARIANCE FROM 310CMR15.221(7) TO ALLOW LEACHING TO BE 5.91' BELOW GRADE 13. PROPERTY IS WITHIN AN AQUIFER PROTECTION DISTRICT. VS. REQUIRED 3.00 Fr. (H20/VENT PROVIDED) EAST SANDWICH, - MA. 02537 14. ALL PIPE TO BE 4" SCH 40 0 1/8"/FT (UNLESS SPEC. OTHERWISE) PER TOWN OF BARNSTABLE BOH TITLE V REGULATIONS 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW 1) A 14 FT. VARIANCE TO ALLOW LEACHING To BE 86' FROM EDGE OF BOG VS: REQUIRED 100 Ff. (50 8)3 6 2—2 9 2 2 FOR THE USE OF A GARBAGE GRINDER 2) A 46 FT. VARIANCE TO ALLOW SEPTIC TANK TO BE 54' FROM EDGE IOF BOG VS. REQUIRED 100 FT. 3) A 11 FT. VARIANCE TO ALLOW DISTRIBUTION BOX TO BE 89' FROM EDGE OF BOG VS. REQUIRED 100 FT. 4) A 18.31 FT. VARIANCE TO ALLOW LEACHING TO BE 131.69' FROM ON-SITE PRIVATE WELL VS. REQ'D 150 FT. SCALE: 1"=30' SHEET 1 OF 2 J 1484 I t NOTE1 TO PREVENT BREAKOUT, THE PROPOSED NOTE: MAGNETIC TAPE TO BE PLACED OVER ALL COVERS FINISH GRADE SHALL NOT BE < EL:41.09 FOR A DISTANCE OF 15' AROUND THE PERIMETER OF THE S.A.S. SEPTIC TANK PROPOSED D-BOX PROPOSED S.A.S. I T.O.F. EL.=46.0 INSTALL RISERS & COVERS OVER INLET & INSTALL RISER & COVER INSTALL A 4" DIAMETER INSPECTION PORT OVER 14" OUTLET AND SET TO 6" OF FINISH GRADE SET TO 6" OF GRADE ONE CHAMBER (MIN:) AND SET TO 3" OF F.G. VENT INSTALLED F.G. EL.=44.Of LENGTH/ OF F.G. EL.=43.SOf F.G. EL: 47.Ot F.G. EL: 47.00(MAX.) �� MgS'r9C' 9.45 DA ys 9" MIN COVER/ L = 25't 36" MAX COVER L = 35' L = IO'(MAX) INSTALL!TWO INSPECTION PORTS (MIN.) 1237. " No. 1140 ® S=1% (MIN.) EL. 42.50 0 S=1% (MIN.) ® S=1% (MIN.) INVEF 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC • SfE�� 10" s 10.75" SgNITAR�P� 1a• \INV.=41.50 48'UQ ID INV.= 41 225 INV.= 40.63T COUPLER DETAIL PROPOSED t GAS LEVEL BAFFLE D-BO,� INV.=40.73 3 ROWS OF 6 UNITS 0 5'/UNIT + 1 COUPLERS 0 1.16'/UNIT = 31.16'/ROW INV.=40.9 p o SOIL ABSORPTION SYSTEM (PROFILE) PROPOSED 1.500 GALLON SEPTIC TANK EXISTING SEWER OUTLET RESTORE VEGETATIVE COVER INV.=42.0 BACKFILL WITH CLEAN PERC SAND TO TOP OF CHAMBERS 60" BREAKOUT=TOP ELEV.=41.09 NOTES: 1) CONTRACTOR SHALL VERIFY ALL EXISTING INV. ELEV.= 40.63 PIPE INVERTS PRIOR TO CONSTRUCTION 2) TANK AND D-BOX SHALL BE SET LEVEL AND BOTTOM ELEV.= 39.76 EXISTING SUITABLE TRUE TO GRADE ON A MECHANICALLY COMPACTED 2.88' MATERIAL SIX INCH CRUSHED STONE BASE, AS SPECIFIED 5' MIN. ABOVE BOTTOM OF T.P. EXCAVATION OR G.W. EFFECTIVE WIDTH = 3 x 2.88' = 8.64' IN 310 CMR 15.2212 - ( ) (5.16' PROVIDED) USE 3 ROWS OF 6-ADS ARC 36HC 3) INSTALL INLET & OUTLET TEES W/ BOTTOM OF TESTHOLE EL.=34.60 = (H20) UNITS - NO STONE W/ 1 COUPLERS GAS BAFFLE AS REQUIRED IN EACH ROW r SEPTIC SYSTEM PROFILE TYPICAL "SECTION N.T.& 16" N.T.S. SOIL LOG P#:13787 DESIGN CRITERIA DATE: NOVEMBER 26, 2012 SOIL EVALUATOR: DARREN M. MEYER, R.S., CSE 1614 SECTION Ya75" NUMBER OF BEDROOMS: 3 BEDROOM DESIGN # INVERT SOIL TEXTURAL CLASS: CLASS i DESIGN PERCOLATION RATE: <2 MIN/IN WITNESS: DONALD DESMARAIS, BARNSTABLE BOH HEIGHT END CAP DAILY FLOW: 110 G.P.D/BR. DESIGN FLOW: 330 G.P.D. E1ev TP- 1 Depth Elev. TP-2 Depth ADS - ARC 36HC CHAMBER H2O LOAD) GARBAGE GRINDER: NO (NOT DESIGNED FOR GARBAGE GRINDER) 45.6o A LOAMY SAND 0". 46.40 e" 1DYR 3/2 A LOAMY SAND MODEL ARC 36HC SEPTIC TANK: 330 gpd x 200% = 660 gpd USE NEW 1,500 GALLON SEPTIC TANK 44.93 8" 39.13 IOYR 3/2 8„ B LOAMY SAND B LENGTH 63" NOTE: UNIT CONFIGURATION AND AVAILABILITY SUBJECT 10YR 6/6 L�OYR SAN6/6 DEFFECTIVE LENGTH 60" TO CHANGE WITHOUT NOTICE. PRODUCT DETAIL MAY LEACHING AREA REQUIRED: (330)/0.74 = 445.94 S.F. 43.10 � 30" 43.73 C 32" DIFFER SLIGHTLY FROM ACTUAL PRODUCT APPEARANCE. SIDE WALL HEIGHT 10.75" DISTRIBUTION BOX: 3 OUTLETS (MINIMUM) OVERALL HEIGHT 16" MEDIUM-COARSE MEDIUM-COARSE OVERALL WIDTH 34.5" 4640 TRUEMAN BLVD PRIMARY S.A.S. PERC 0 41'44 SAND SAND 10.7 CF s HILLIARD, OHIO 43026 USE 3 ROWS OF 6 - ADS ARCHC 3616 H2O UNITS-NO STONE 2.5Y 7/3 2.5Y 7/3 CAPACITY 80.0 GAL ADVANCED ORaNACE SYSTEMS. INC. AND EXTENDED 1.16 W/ COUPLER IN EACH ROW p ! SITE PLAN BOTTOM AREA: (GENERAL USE APPROVAL FOR 4.80 SF/LF OF CHAMBER) PROPOSED SEPTIC SYSTEM/ (CHAMBERS: 6/ROW)18 UNITS x 5.0 LF x 4.80 SF/LF = 432.00 SF 34.60 132" 35.40 132' 16 ROUTE 130 COTU IT, MA �t (COUPLER: 1/ROW) 3 UNITS x 1.16 LF x 4.80 SF/LF = 16.70 SF 4 TOTAL AREA = 448.70 SF PERC RATE.<2 MIN/IN. (*Cl" HORIZON) Prepared for: Savery DESIGN FLOW PROVIDED: 0.74GPD/SF(448.70SF) = 332.03 GPD > 330 GPD req'd NO GROUNDWATER OBSERVED Engineering by: Surveying by SCALE DRAWN DATE: Meyer&Sons,Inc. AracDougau Survey NTS D.M.M. 02/25/13 1, Darren M. Meyer, R.S., CSE, hereby certify that I am currently approved by MADEP pursuant to 310 CMR 15.017 PO BOX 981 (508) 419-1086 to conduct soil evaluations and that the above analysis has been performed by me consistent with the REV. DATE: CHECKED requirements of 310 CMR 15.017. 1 further certifythat I hove EAST SANDWICH,MA 02537 SHEET N0. passed the Soil Eval. Exam in October, 1999. 1508-3622922 D.M.M. 2 Of 2