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0134 EAST BAY ROAD - Health
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Y 4'�1:�3,wa.E, k�NSs �#�J Health'Master Detail 4 Page 1 of 1 _ r z« F �H alt� r' Logged In As: TOWN\malkusk Health :Master Master Detail Wednesday, November 28 2018 Application Center Parcel Lookup Selection Items Parcel Septic Perc Well - Fuel Tank - Parcel: 140-164 Location: 134 EAST BAY ROAD, Osterville Owner: EVANS, RICHARD H & BLYTHE O, TRS Business name: ( Business phone: Rental property: ❑ Deed restricted: ❑ Number of bedrooms Contaminant released: ❑ _ Fuel storage tank permit: ❑ Save Parcel Changes r Return to Lookup I Parcel Info Parcel ID: 140-164 Developer lot:LOT 2 Location: 134 EAST BAY ROAD Primary frontage: 130 Secondary road: - Secondary frontage: village:Osterville Fire district:C-O-MM Town sewer exists at this address:No Road index:0468 Asbuilt Septic Scan: 1401641 Interactive map AP (Aquifer Dlst Protection Overlay Town zone of contribution: ) State zone of contribution:OUT EVANS RICHARD H & BLYTHE RICHARD H EVANS & BLYTHE 0 Owner Info owner: 0, TRS Co-owner:EVANS TRUST 255 MASSACHUSETTS AVE APT Streetl: 518 Street2: city: BOSTON -State:MA zip:;02115 country: Deed date:6/9/2017 Deed reference:C213147 Land Info Acres: 0.86 use: Single Fam MDL-01 zoning:SPLIT RC;RF=1 Neighborhood: 0117 Topography:Level Road:Paved Utilities:Septic,Gas,Public Water Location: Construction Info Building N ear Buil Gross Are Living Area Bedrooms lBathrooms 1 N17 75 P76 N44 Bedroom 2 Full-1 Half1 76 44 0 Full-0 Half Buildings value:$149,800.00 Extra features: $30,200.00 'Land value: $987,000.00 3 5ZDU 1 14tp:Hissgl2/intranet/healthMaster/HealthMasterDetail.aspx?ID-140164 11/28/2018 i i I Town of Barnstable Barnstable ..: Board of Health j°�"�j ,BA S. 200 Main Street, Hyannis MA 02601 039. �0 2007 fD MA A Office: 508-862-4644 Paul Canniff,D.M.D. FAX: 508-790-6304 Junichi Sawayanagi Donald Guadagnoli,M.D. June 13, 2018 Mr. John O'Dea Sullivan Engineering, Inc. P.O. Box 659 Osterville MA 02655 RE: ' ,134 East Bay Road, Osterville A = uo-164 Dear Mr. O'Dea, You are granted a variance on behalf of your clients, Richard and Blythe Evans, to construct an onsite sewage disposal system at 134 East Bay Road, Osterville. The variances are granted as follows: SECTION 360-45: To build an addition to the dwelling thereby constructing a total of four bedrooms with a wastewater discharge of 440 gallons per day on a 0.86 acre parcel located within a Saltwater Estuary Protection District, in lieu of the maximum of 330 gallons per day wastewater discharge allowed on a parcel of this size. This variance is granted with the following conditions: (1) No more than four (4) bedrooms maximum 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 four (4) 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 FAST system components and septic system components shall be installed in strict accordance with the revised engineered plans dated March 7, 2018. Q:\WPFILES\OdeaEvans 134EastBayRoadVariances20l 8.docx I � (4) The designing engineer 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 revised plans dated March 7, 2014. (5) All of the conditions contained within the revised ten-page 'Certification for General Use' document issued by the Massachusetts Department of Environmental Protection for the FAST treatment system, dated March 20, 2015, shall be strictly adhered to. (6) The system owner shall strictly adhere to Section IV, on pages 4 through 8 of the revised approval letter issued by the Department of Environmental Protection for the FAST treatment system entitled 'Certification for General Use' dated March 20, 2015. (7) The company shall strictly adhere to Section V on pages 8 and 9 of the revised approval letter issued by the Department of Environmental Protection (DEP) for the FAST treatment system entitled 'Certification for General Use' dated March 20, 2015. (8) The system designer shall strictly adhere to Section VI on page 9 of the revised approval letter issued by the Department of Environmental Protection (DEP) for the FAST treatment system entitled 'Certification for General Use' dated March 20, 2015. (9) The effluent shall be sampled for TN quarterly during the first year, then a minimum of twice per year thereafter, at least five months apart with at least one sample taken between December 1st and March 1st each year. (10) Both the four bedroom deed restriction and the required Deed Notice (as required per page 9 of the DEP 'Certification for General Use' letter) shall be recorded at the County Registry of Deeds. Copies of these recorded documents shall be submitted to the Health Division Office prior to issuance of the certificate of compliance for the disposal works construction permit. This variance is granted because the proposed innovative-alternative system is designed to provide a greater degree of environmental protection with only one additional bedroom compared to a standard design in conformance with the State Environmental Code, Title 5. Sincerely yours, AJ. a i ,' tt-by- - Vq Chairman Q:\WPFILES\OdeaEvansl34EastBayRoadVariances2Ol8.doex Q DATE: 1 b FEE: J_✓ ..s • BARNSTABLE, v sb MASS.. �0� REC.BY: li V C'P Town of Barnstable SCHED.DATE: Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Paul J.Canniff,D.M.D. FAX: 508-790-6304 Junichi Sawayanagi Donald A.Guadagnoli,M.D. Alternate:.Cecile Sullivan,RN,MSN VARIANCE REQUEST FORM LOCATION a ' Property Address: Assessor's Map and Parcel Number: I Size of Lot: Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name: APPLICANT'S NAME: RK a-r ' v &L &Ias Phone �`� 8b T Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME ,, CONTACT PERSON � ^ Name: �Q \Uy-� �l�(3 Y 12 C aS Name: lbn aL SQuIvan "we r i I W Address:S 61 436 Addressl &W M, . (/b (VI 11L NA r� Phone: � 1LIr V M f"� 6 2lil65 Phone: (6N)Ha�- 5�4q EMAIL: 1(1 D 11, _VARIANCE FROM REGULATION(List Reg.) REASON FOR V AN (May attach if more 94ce needed) 1,e 0L V(bk&,bono C NATURE OF WORK: House Addition House Renovation LJ Repair of Failed Septic System LJ Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in S separate,collated packets. Five(5)copies of the completed,variance request form Five(5)copies of engineered plan submitted(e.g.septic system plans) Five(5)copies of MA DEP approval letter for I/A septic systems only. Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans.or restaurant kitchen plans) A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only). $95.00 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/lessee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) ✓ Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman . NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Donald A.Guadagnoli,M.D. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary , Internet Files\Content.Outlook\BMQD49H2\VARIREQ Rev APR2017.DOC M&DATE: J 4. FEE: / * en[txsrns[.e. REC.By: dJ�� Town of Barnstable SCHED.DATE- Board of Health 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Paul J.Canniff,D.M.D. FA X: 508 790 6304 Junichi Sawayanagi Donald A.Guadagnoli,M.D. Alternate:Cecile Sullivan,RN,MSN VARIANCE REQUEST FORM LOCATION Property Address: Assessor's Map and Parcel Number: Size of Lot: Wetlands Within 300 Ft. Yes Business Name: No Subdivision Name: -/ APPLICANT'S NAME: RK"al-r ' &L A,►n, Phone ob -76gC Did the owner of the property authorize you to represent him or her? Yes No PROPERTY OWNER'S NAME ,, � CONTACT PERSON [� Name: Y r(� Oki y Y It L-VaaS Name: lb & SU 16 ec r 2 a Address:SO, JJ(31l 4J") Address: 1 [c CLtc M, . 0skIr �i ICM v Q �p r,, - IMF Phone: (�, L 1U1 c b ZW 55 Phone: a� 5�q EMAIL,: jobvio1 l� VARIANCE FROM REGULATION(List Reg.) REASON FOR VAJANn(May attach if more 9Ace needed) G K L -y 4er t e Nbkchon o NATURE OF WORK: House Addition House Renovation LJ Repair of Failed Septic System LJ Checklist (to be completed by office staff-person receiving variance request application) Please submit copies in S separate,collated packets. Five(5)copies of the completed variance request form Five(5)copies of engineered plan submitted(e.g.septic system plans) Five(5)copies of MA DEP approval letter for I/A septic systems only. Five(5)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) .�/ A completed seven(7)page checklist confirming review of engineered septic system plan by submitting engineer or registered sanitarian Signed letter stating that the property or business owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified mail at least ten days prior to meeting date at applicant's expense(for Title V and/or local sewage regulation variances only) Full menu—Five(5)copies of full menu submitted(for grease trap variance requests only). $95.00 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/lessee only],and variances to repair failed sewage disposal systems[only if no expansion to the building proposed]) Variance request submitted at least 15 days prior to meeting date VARIANCE APPROVED Paul J.Canniff,Chairman NOT APPROVED Junichi Sawayanagi REASON FOR DISAPPROVAL Donald A.Guadagnoli,M.D. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\BMQD49H2\VARIREQ Rev APR2017.DOC • Engineering & Sullivanconsulting Inc 4 (508)428-3344 P.O. Box 659 • ? Parker Road,Osterville, MA 02655 seci@su.Ilivanengin..com wwmsullivanenginxoni . r,A'S �nt March 8, 2018 Board of Health Town of Barnstable 200 Main Street Hyannis, MA 02601 RE: Richard H. &Blythe O.Evans, Trustees 134 East Bay Road, Osterville Dear Board, Please find attached the variance request form, engineered plan, seven-page checklist, floor plans, owner authorization letter, draft deed restriction, and abutter notification letter. Monitoring and Maintenance Plans are being prepared by the supplier and will be provided. The applicants purchased the property in June 2017. This property has been developed since 1875 according to the assessor's records. The septic system was upgraded around 1996 for a 3 bedrooms dwelling. The system received a conditional pass at the time of transfer lacking the Town's required 4' separation to groundwater. A permit to repair that condition has been issued, and a building permit has been signed off to rebuild the garage with living above and an addition. The original intent of the renovations was to leave the first floor of the existing historic dwelling as is, have a guest room on the first floor in the addition seaward of the garage in Inc of an existing undersized room on the second floor previously used as a bedroom, and a bonus play area above the garage for grandkids. In order for the signoff on the building permit permit the Health Department required openings be provided to the existing breakfast room and office on the first floor, and the design has to be changed for the room above the garage to be considered the 3`d bedroom because there was no way to avoid "privacy", and the guest room changed to a sunroom. The owners would very much like to return to the original design intent, but understanding the concern of the room over the garage meeting the definition of a bedroom - have asked us to explore the potential of a 4 bedroom design. The property is located with the Saltwater Estuary and lacks sufficient area for a 4' bedroom by right. A variance to the Town of Barnstable Chapter 360-45 Interim Regulations for the Protection of Saltwater Estuaries is being requested. As required by the regulation - Town sewer is not available. Although the site does not, and cannot meet a 5 ppm concentration of nitrate/nitrogen, a Fast Septic system is proposed to provide greater than the same degree of environmental protection as a design in full conformance with the regulation as required. With the 660 nitrogen credit available with these systems, the site could support 5 bedrooms if it were located within State Page 1 of 2 designated Nitrogen Sensitive Area. Even with the additional bedroom the system results in a reduction of allowable design flow of over 10%and a reduction of nitrogen loading of almost 30%. There be additional benefit from increased separation to the wetland resources, and increased separation to groundwater. As further required by the regulations, we believe that not allowing the septic improvements as proposed would do manifest injustice to the environment. It is understood that a deed restriction will be required, and we would hope that with that openings would not be required along the entrance hall to the breakfast room and office - which the owners believe will change the character of the historic dwelling. A perc test has not been peformed at this time, but can be prior to applying for a septic permit if the variance request is approved. Augured test holes have been used to determine groundwater and confirm soil suitability. I trust this meets your present needs. Please feel free to contact me with any questions. Very truly yours, iohn O'Dea, P.E. Sullivan Engineering& Consulting, Inc. Page 2 of 2 AI Bm 4a5 ?4Ui t slwd, 0201 Mose arcept,&i;kOr as a" iut-i It w'a fIt'llrva,1 t ve '° j4�ijft, f, W iiip Oxistilu i cs rupmall us.Rictwd& 1, E: ,g,'l°tt. tc ,-q orO,� � � �s ut d1 l glfli !c qt s 1` artt tx us. ,ta r cr,t aert=attrtPkawcont "ta t " . # ..._.° III i DEED RESTRICTION Richard & Blythe Evans,Trustees of the Richard H. Evans & Blythe 0. Evans Trust, owner of 134 East Bay Road, Barnstable (Osterville), by deed (certificate#213147) recorded at the Barnstable Registry of Deeds, Land Court, agree that until such time as technology changes and/or the Barnstable Board of Health changes its regulations or otherwise grants permission, structures built on the premises of 134 East Bay Road, Osterville, shall have no more than a total of four (4) bedrooms. Richard Evans, Trustee Blythe Evans, Trustee Richard H. Evans & Blythe 0. Evans Trust Richard H. Evans & Blythe 0. Evans Trust COMMONWEALTH OF MASSACHUSETTS Barnstable County On this day of March, 2018, before me,the undersigned notary public, personally appeared Jennifer Newberg proved to me through satisfactory evidence of identification, which was: To be the person whose name is signed on this document and acknowledged to me that he signed it voluntarily for its stated purpose. Notary Public My commission expires: cop '�. . Q Commonwealth of Massachusetts Executive Office of Energy &Environmental Affairs Department of Environmental Protection One Winter Street Boston, MA 62108.617-292-5500 Charles D.Baker Matthew A.Beaton Governor Secretary Karyn E.Polito Martin Suuberg Lieutenant Governor Commissioner CERTIFICATION FOR GENERAL USE Pursuant to Title 5, 310 CMR 15.000 Name and Address of Applicant: Bio-Microbics, Inc. LL 8450 Cole Parkway Shawnee, KS 66227 Trade name of technology and models: FAST Treatment Systems with Nitrogen Reduction including models MicroFASM 0.5, 0.75, 0.9, 1.5, 3.0, 4.5, 9.0, HighStrengthFAST® 1.0, 1.5, 3.0, 4.5, 9.0 and NitriFASM 0.5, 0.75, 1.0, 1.5, 3.0, 4.5, 9.0 (all hereinafter the "System") for facilities with design flows less than 2,000 gallons per day(GPD). Schematic drawings illustrating the models and an Inspection Checklist are part of this Certification. Transmittal Number: X232831 Date of Issuance: December 29,2010,revised March 20,2015 Authority for Issuance: Pursuant to Title 5 of the State Environmental Code, 310 CMR 15.000,the Department of Environmental Protection(hereinafter"the Department")hereby issues this'General Use Approval to: Bio-Microbics, Inc., 8450 Cole Parkway, Shawnee, KS 66227 (hereinafter"the Company"), approving the above referenced FAST technology(hereinafter"the Technology"or"System")for use in the Commonwealth of Massachusetts subject to the conditions herein. Sale and use of the Technology are subject to compliance by the Company, the Designer,the System Installer,the Operator, and the System Owner with the terms and conditions herein. Any noncompliance with the terms or conditions of this Certification constitutes a violation of 310 CMR 15.000. March 20, 2015 David Ferris,Director Date Wastewater Management Program Bureau of Water Resources I. Purpose This information is available in alternate format.Call Michelle waters-Ekanem,Diversity Director,at 617-292-5751.TTY#MassRelay Service 1.800-439-2370 MassDEP trdebsite:vww.mass.gov(dep Printed on Recycled Paper Certification for General Use Page 2 of 10 Bio-Microbics FAST<2,000 GPD Nitrogen Reducing 1. Subject to the conditions of this Approval and any other local requirements,the purpose of this Approval is to allow the use of the System in Massachusetts on a General Use basis. With the necessary permits and approvals required by 310 CMR 15.000,this Certification authorizes the installation and use of the System in Massachusetts. 2. The System may be installed for residential facilities with design flow less than 2,000 GPD where a system in compliance with 310 CMR 15.000 exists on-site or could be built and for which a site evaluation in compliance with 310 CMR 15.000 has been approved by the local approving authority; or by the Department if Department approval is required by 310 CMR 15.000. This Approval allows for the use of the System as an equivalent alternative technology in accordance with 310 CMR 15.202 on facilities for nitrogen reduction in a Department designated nitrogen sensitive or limited area as defined in 310 CMR 15.214 and 15.215. Non-residential facilities are not allowed under this approval.Non-residential facilities include properties with businesses and/or commercial establishments. 3. The technology shall meet or exceed the following effluent discharge requirements: • Effluent Total Nitrogen(TN)concentration of 19 mg/L(for 660 gallons per day per acre -gpda-loading) or 25 mg/L(for 550 gpda loading). • Effluent pH range shall be 6.0 to 9.0. • The System is approved for use at facilities with a maximum design flow less than 2,000 GPD. 4. The System Owner or the designated System Operator(or `Operator')has responsibility for oversight and sampling of the System if the property served was allowed to increase the discharge rate per acre above 440 gpda in an area subject to Nitrogen Loading Limitations. The System Owner will be required to repair,replace,modify or take any other action as required by the Department or the local approving authority, if the Department or the local approving authority determines that the System is not capable of meeting the required reduction in nitrogen in the effluent. The Company is responsible for the approved technology as described below. II. General Description of the Technology and Design Standards 1. The tank containing the FAST®insert is installed between the building sewer and the soil absorption system(SAS). The SAS shall be designed and constructed in accordance with 310 CMR 15.100- 15.279 and subject to the provisions of this Certification. 2. Technology Description-The FAST® system is an aerobic wastewater treatment system that utilizes a completely submerged fixed film process to treat organics and nitrify, and a passive recycle system for denitrification. Each model contains submerged media specific to the application. Microorganisms grow on the media and remove soluble contaminants from the wastewater,utilizing them as a source of energy for growth and production of new microorganisms. The FAST® system insert consists of a liner around the media and an airlift to provide aeration and mixing within the confines of the liner. The area outside the liner in the septic tank remains anoxic for denitrification and a passive recirculation system Certification for General Use Page 3 of 10 Bio-Microbics FAST<2,000 GPD Nitrogen Reducing moves the aerated wastewater to the outside of the liner to obtain denitrification. The aeration and circulation inside the liner are provided by a blower that pumps air into a draft tube that extends down the center of the media. Treated effluent passes out of the aerobic zone of the treatment plant through a pipe connected directly to a baffled quiescent area in the liner. Final effluent is discharged to a soil absorption system. Specific model considerations are as follows: • The MicroFAST® 0.5, 0.75 and�0.9, HighStrengthFAST® 1.0 and NitriFAST® 0.5, 0.75 and 0.9 are installed in the second compartment of a two-compartment tank with a total liquid capacity of at least 1,500 gallons constructed in accordance with 310 CMR 15.226. • The N icroFAST®,HighStrengthFAST® and NitriFAST® 1.5 are installed in the second compartment of a two compartment 3000-gallon tank constructed in accordance with 310 CMR 15.226. • The N icroFAST®,HighStrengthFAST®and NitriFAST® 3.0 is installed in a separate tank constructed in accordance with 310 CMR 15.226 and located between a standard Title 5 septic tank, designed in accordance with 310 CMR 15.223 and 15.224, and the soil adsorption system(SAS). In this larger system, an additional recycle pump may be needed to send nitrified effluent back to the septic tank for added denitrification. Consult the Company for proper layout. • The NitriFAST®models can also be used for additional nitrification in series after the MicroFAST®models or HighStrengthFAST®models. In this configuration the tanks used for the NitriFAST® shall be constructed in accordance with 310 CMR 15.226 and meet the minimum dimensions and volumes required by the Company. • Flow equalization may also be employed prior to the FAST®system depending on the type of facility. Consult Company for proper layout. 3. All access ports and manhole covers shall be readily removable, of durable material and installed and maintained at grade to allow for maintenance of the System.No structures shall be located directly upon or above the access locations which could interfere with performance, access, inspection,pumping, or repair. Sufficient access for infrequent maintenance of the System treatment media and all other treatment works shall be evaluated, and addressed in the System design if necessary,by the designer. System control panel(s) including alarms shall be mounted in a location accessible to the operator of the System. 4. Wastewater Loading and Effluent Concentration Design Standards For new residential construction in an area subject to the Nitrogen Loading Limitations of 310 CMR 15.214, and the facility does not meet with the Nitrogen Loading Limitations pursuant to the aggregation provisions of 310 CMR 15.216, an increase in calculated nitrogen loading per acre is allowed for facilities with design flow less than 2000 gpd with limitations as follows: - • The design flow shall not exceed 660 gallons per day per acre(gpda) and the total nitrogen(TN)concentration in the effluent shall not exceed 19 milligrams per liter (mg/L); or l_ Certification for General Use Page 4 of 10 Bio-Microbics FAST<2,000 GPD Nitrogen Reducing • The design flow shall not exceed 550 gallons per day per acre(gpda) and the total nitrogen(TN)concentration in the effluent shall not exceed 25 milligrams per liter jl (mg/L) • TN is measured as the total of TKN(Total Kjeldhal Nitrogen),NO3-N(Nitrate nitrogen)and NO2-N (Nitrite nitrogen). III. General Conditions 1. The provisions of 310 CMR 15.000 is applicable to the use and operation of this System, the System owner and the Company, except those that specifically have been. varied by the terms of this Certification. 2. Any required operation and maintenance, monitoring and testing shall be performed in accordance with a Department approved plan. Any required sample analysis shall be conducted by an independent U.S. EPA or DEP approved testing laboratory, or a DEP approved independent university laboratory,unless otherwise provided in the Department's written approval. It shall be a violation of this Certification to falsify any data collected pursuant to an approved testing plan, to omit any required data or to fail to submit any report required by such plan. 3. The facility served by the System and the System itself, shall be open to inspection and sampling by the Department and the local approving authority at all reasonable times. 4. In accordance with applicable law, the Department and the local approving authority may require the System owner to cease operation of the system and/or to take any other action as it deems necessary to protect public health, safety, welfare or the environment. 5. The Department has not determined that the performance of the System will provide a level of protection to public health and safety and the environment that is at least equivalent to that of a sanitary sewer system. Accordingly,no System shall be upgraded or expanded,if it is feasible to connect the facility to a sanitary sewer,unless as allowed by 310 CMR 15.004. 6. Design, installation, and use of the System shall be in strict conformance with the Company's DEP approved plans and specifications and 310 CMR 15.000, subject to this Certification. IV. Conditions Applicable to the System Owner 1. The System owner shall at all times have the System properly operated and maintained by a Company approved Operator in accordance with this Certification,the designer's operation and maintenance requirements and the Company's approved procedures. 2. The System is certified only in connection with the discharge of sanitary wastewater from facilities with a design flow of less than 2000 gpd. Any non-sanitary wastewater generated and/or used at the facility served by the System shall not be introduced into the System and shall be lawfully disposed of. Certification for General Use Page 5 of 10 Bio-Microbics FAST<2,000 GPD Nitrogen Reducing 3. The System Owner shall provide access to the site for the System Operator to perform inspections,maintenance,repairs,responding to alarm events, field testing, and sampling as may be required by the Approval. Operation and Monitoring Requirements 4. System effluent total nitrogen(TN) concentrations shall not exceed 19 or 25 mg/L and effluent pH shall not be less than 6.0 or more than 9.0. Field test observations of dissolved oxygen(DO) shall equal or exceed 2 mg/L and for Turbidity shall be equal or less than 40 N TU. 5. All samples shall be taken at a flowing discharge point,i.e. distribution box,pipe entering a pump chamber or other Department approved location from the treatment unit. 6. Inspection,operation and maintenance(O&M), sampling, and field testing of the System required by the Approval shall be performed by a Company approved Operator who has been certified at a minimum of Grade Level 4(four)by the Board of Registration of Operators of Wastewater Treatment Facilities, in accordance with Massachusetts regulations 257 CMR 2.00 an d d is an approved Title 5 System Inspector in accordance with 310 CMR 15.340. 7. Prior to commencement of construction of the System, the System Owner shall provide to the local approving authority a copy of a signed O&M Agreement that meets the requirements of paragraph IV(8). 8. The System Owner shall maintain, at all times, an O&M Agreement with a qualified System Operator approved by the Company. The Agreement shall be at least for one year and include the following provisions: a) The name of a System Operator who is an approved System Inspector in accordance with 310 CMR 15.340 and who meets any additional qualification requirements specified in the Approval; b) The System Operator must inspect the Alternative System as required by paragraph IV(9) and(12); c) The System Operator shall be responsible for submitting the monitoring results to the System Owner in accordance with paragraph IV(13) and to the local approving authority in accordance.with paragraph IV(14); and d) In the case of a System failure, an equipment failure, alarm event, components not functioning as designed, or violations of the Approval, procedures and responsibilities of the System Operator and System Owner shall be clearly defined for corrective measures to be taken immediately. The System Operator shall. agree to provide written notification within five days, describing corrective measures taken,to the System Owner and the local board of health. 9. The System Owner shall comply with the following monitoring requirements if the System is subject to a TN concentration limit in accordance with paragraph II (4): I Certification for General Use Page 6 of 10 Bio-Microbics FAST<2,000 GPD Nitrogen Reducing a) Year-round installations shall be inspected and have effluent sampled for at least the TN parameter quarterly for the first year,then a minimum of twice/year thereafter,at least 5 months apart and with at least one sample taken between December 1 and March 1 of each year. Field testing shall be completed per paragraph IV(11)below, and as determined necessary by the System Operator. See DEP Field Testing Protocol at http://www.mass.govldep/water/laws/policies. htm#t5pols. Wastewater flow shall be recorded at each inspection, see `Flow Metering' paragraph IV(10). b) Seasonal installations shall be inspected and have effluent sampled for at least the TN parameter a minimum of twice/year. At least one sample must be taken 30 to. 60 days after each seasonal occupancy begins. A second sample must be taken no less than 2 months after the first sample. Field testing shall be completed per paragraph IV(11)below, and as determined necessary by the System Operator. Wastewater flow shall be recorded at each inspection, see `Flow Metering' paragraph IV(10). c) Systems in operation prior to issuance of this Approval,which have received approval of sampling reduction from the Department may continue with that System monitoring frequency. Properties occupied at least 6 months per year are considered year-round properties. Properties occupied less than 6 months per year are considered seasonal properties. TN is measured as the total of TKN(Total Kjeldhal Nitrogen),NO3-N(Nitrate nitrogen) and NO2-N(Nitrite nitrogen). 10: Flow Metering: Reporting of residential System water use is not required,however it is recommended the Operator record water meter readings if available at all inspections, or otherwise estimate System flow, to assist in addressing possible operational problems or issues. Flow measurement when recorded shall be based on: a) actual metering data of wastewater flow to the System or actual water meter data of flow to fixtures that discharge to the wastewater system; or b) actual water meter data for the total facility with either actual meter data or estimated flows for non-wastewater usage subtracted from the total facility water usage. If estimating the wastewater portion of metered water,usage,the System Operator shall provide a best estimate of wastewater discharged to the System with the method of estimating, such as pump run times, occupancy rates, adjustment due to seasonal outdoor watering use, etc.;or c) for Systems installed under a prior Approval that did not include a wastewater flow data reporting requirement,if no flow meters are available,the System Operator shall provide a best estimate of wastewater discharged to the System with the method of estimating, such pump run times, occupancy rate, etc. 11. Field Testing: Temperature,turbidity,pH and DO shall be measured and recorded in the field whenever the effluent is sampled for TN. See applicable sections of the Department's Field Testing Protocol at http://www.mass.govldep/water/laws/ policies.htm#t5pols. Certification for General Use Page 7 of 10 Bio-Microbics FAST<2,000 GPD Nitrogen Reducing 12. At a minimum, the System Operator shall inspect the System: a) quarterly for the first year then two times per year thereafter; b) in accordance with the approved O&M manual,the Designer's operation and maintenance requirements, and the requirements of the local approving authority; and c) any time there is an alarm event, equipment failure, or system failure. Recordkeeping and Reporting 13. Within 60 days of any site visit, the System Operator shall submit an O&M report and inspection checklist to the System Owner and the Company. It is recommended the System Owner and Company maintain copies of these items for possible Department audit. The O&M report shall-include,—at a-minimum: a) for a System failing, any corrective actions taken; b). wastewater analyses, wastewater flow data, field testing results and inspection checklists; c) any violations of the Approval; d) any determinations that the System or its components are not functioning as designed or in accordance with the Company specifications; and e) any other corrective actions taken or recommended. 14. By February 15th of each year the System Owner or the System Operator if designated by the owner, shall submit to the local approving authority all monitoring results with all O&M reports and inspection checklists completed by the System Operator during the previous 12 months. 15. Upon determining that the System has failed, as defined in 310 CMR 15.303, the System Operator shall notify the System Owner immediately. 16. Upon determining that the System has failed, as defined in 310 CMR 15.303, the System Owner and the System Operator shall be responsible for the notification of the local approving authority within 24 hours of such determination. 17. The System Owner shall notify the Approving Authority and the Company in writing within seven days of any cancellation, expiration or any other change in the terms and/or conditions of the O&M Agreement required by Paragraph IV(8). 18. Violations of the TN concentration in the System effluent shall not constitute a failure of the System for the purposes of 24-hour notification or 5-day written reporting as required in Paragraphs IV(16) and(8). 19. The System owner shall provide a copy of this Approval,prior to the signing of a purchase and sale agreement for the facility served by the System or any portion thereof, to the proposed new owner. Certification for General Use Page 8 of 10 Bio-Microbics FAST<2,000 GPD Nitrogen Reducing 20. The System owner shall.f imish the Department any information that the Department requests regarding the System,within 21 days of the date of receipt of that request. 21. Prior to issuance of a Certificate of Compliance of the System, and after recording and/or registering the Notice required by 310 CMR15.287(10),the System Owner shall provide to the Local Approving Authority a copy of. (i) a certified Registry copy of the Notice bearing the book and page/or document number; and(ii) if the property is unregistered land, a Registry copy of the System Owner's deed to the property, bearing a marginal reference on the System Owner's deed to the property. The Notice to be recorded shall be in the form of the Notice provided by the Department. 22. Prior to signing any agreement to transfer any or all interest in the property served by the System, or any portion of the property, including any possessory interest,the System Owner shall provide written notice of all conditions contained in the Approval to the transferee(s). Any and all instruments of transfer and any leases or rental agreements shall include as an exhibit attached thereto and made a part of thereof a copy of the Approval for the System. The System Owner shall send a copy of such written notification(s)to the Local Approving Authority within 10 days of giving such notice to the transferee(s). V. Conditions Applicable to the Company 1. The Company shall notify the Director of the Wastewater Management Program at least 30 days in advance of the proposed transfer of ownership of the technology for which this Certification is issued. Said notification shall include the name and address of the proposed new owner and a written agreement between the existing and proposed new owner containing a specific date for transfer of ownership, responsibility, coverage and liability between them. All provisions of this Certification applicable to the Company shall be applicable to successors and assigns of the Company,unless the Department determines otherwise. 2. The Company shall develop maintain and update as necessary the following: minimum installation requirements; an operating manual, including information on substances that should not be discharged to the System; a maintenance checklist; and a recommended schedule for maintenance of the System consistent with the Department's requirements essential to consistent successful performance of the installed Systems. 3. The Company shall institute and maintain a program of operator training and continuing education. The Company shall maintain and annually update, and make available the list of qualified operators by February 15th and make the list known to local approving authorities, the Department and to users of the technology. 4. The Company shall furnish the Department any information that the Department requests regarding the System, within 21 days of the date of receipt of that request. 5. The Company shall include copies of this Certification and the procedures described in Section V(3)with each System that is sold. In any contract executed by the Company for distribution or re-sale of the System, the Company shall require the distributor or re-seller to provide each purchaser of the System with copies of this Certification and the procedures described in Section V(3). f Certification for General Use Page 9 of 10 Bio-Microbics FAST<2,000 GPD Nitrogen Reducing 6. A copy of the wastewater analyses, wastewater flow data, field testing results, and System Operator O&M reports and inspection checklists from each installed System shall be maintained by the Company or its designee for possible Department audit. 7. If the Company wishes to continue this Certification after its expiration date, the Company shall apply for and obtain a renewal of this Certification. The Company shall submit a renewal application at least 180 days before the expiration date of this Certification, unless written permission for a later date has been ranted in writing g by the Department. This Certification shall continue in force until the Department has acted on the renewal application. VI. Conditions Applicable to the System Designer 1. Upon submission of an application for a DSCP,the Designer shall provide to the local approving authority: a) a certification, signed by the owner of record for the property to be served by the System, stating that the property owner: i) has been provided a copy of the Approval,the Owner's Manual, and the Operation and Maintenance Manual,if applicable, and the Owner agrees to comply with all terms and conditions; ii) has been informed of all the owner's costs associated with the operation including,when applicable: power consumption,maintenance, sampling, recordkeeping,reporting, and equipment replacement; iii) understands the requirement for a service contract; iv) agrees to fulfill his responsibilities to provide a Deed Notice as required by 310 CMR 15.287(10)and the Approval; v) agrees to fulfill his responsibilities to provide written notification of the Approval to any new owner, as required by 310 CMR 15.287(5); vi) if the design does not provide for the use of garbage grinders, the restriction is understood and accepted; vii) if the design is for an upgrade of failed or nonconforming system, the System Owner has been provided a copy of the evaluation of the existing system; viii) whether or not covered by a warranty,the System Owner understands the requirement to repair,replace,modify or take any other action as required by the Department or the local approving authority, if the Department or the local approving authority determines that the Alternative System is not capable of meeting the performance standards; and b) a certification, signed by the Designer that the design conforms to the Approval with Conditions and 310 CMR 15.000. VII. Reporting 1. All notices and documents required to be submitted to the Department by this Certification shall be submitted to: L Certification for General Use Page 10 of 10 Bio-Microbics FAST<2,000 GPD Nitrogen Reducing Director Wastewater Management Program Department of Environmental Protection, One Winter Street- 5th floor Boston,Massachusetts 02,108 VIII. Rights of the Department 1. The Department may suspend,modify or revoke this Certification for cause, including,but not limited to, non-compliance with the terms of this Certification, non-payment of the annual compliance assurance fee, for obtaining the Certification by misrepresentation or failure to disclose fully all relevant facts or any change in or discovery of conditions that would constitute grounds for discontinuance of the Certification,or as necessary for the protection of public health, safety,welfare or the environment, and as authorized by applicable law. The Department reserves its rights to take any enforcement action authorized by law with respect to this Certification.and/or the System against the owner or operator of the System and/or the Company. Transmittal:X232831(formerly W101238) I 44 Commercial Street Raynham, MA 02767 Pam, Jw Tel: (508) MUM Fax: (508) 8807232 August 13, 2018 Barnstable Board of Health 200 Main Street Hyannis, MA 02601 Attention: Board of Health Agent Reference: BioMicrobics FAST Treatment System Serial Number: 0210173 To whom it may concern: Attached please find a copy of the Product Registration Report for the FAST Treatment System, for the startup performed on 8/9/2018 at the home of Richard Evans located at 134 East Bay Road, Osterville, MA. Also, attached is a copy of the fully executed Operations & Maintenance Agreement. If you have any questions or require additional information please do not hesitate to call. Sincerely, Sharon M. Foster Enclosures I f 0RP0�RAT € 9 8450 Cole Parkway Shawnee, KS 66227 Phone-913-422-Q707 * Fax: 912-422-0808 e-mail: onsite .biomicrobics.com**www.biomicrobics.com *k 800-753-FAST(3278) PRODUCT I'GISTRATION REPORT Product Regis tra ion eport must be completed and returned to Bio-Microbics, Inc: in order to effect warranty. Date of Start-Up Date Shipped to End User 8/3/18 Serial# 0210173 OWNER NAME Richard Evans ADDRESS 134 East Bay Road CITY/STATE/ZIP Osterville,MA 02655 PHONE/FAX BIO-MICROBICS DISTRIBUTOR NAME J&R Sales and Service,Inc. ADDRESS 44 Commercial Street CITY/STATE/ZIP Ra nhain, MA 02767 PHONE/FAX 508-823-9566 FAX: 508-880-7232 INSTALLER NAME Burke's Excavatin ADDRESS 23 Middle Pond Path CITY/STATE/ZIP Marston Mills,MA 02648 PHONE/FAX 508-927-2502 CONSULTING ENGINEER if applicable) NAME Sullivan En .&Consulting,Inc. ADDRESS 7 Parker Road CITY/STATE/ZIP Osterville,M 02655 PHONE/FAX 508-428-3344 Good Bad NA Good Bad NA ELECTRICAL PANEL(S) TREATMENT UNIT(S) Visual Alarm Operating Air vent clear. Audio Alarm Operating Septic tank level BLOWER(S) Septic tank meets min. size Wired for correct voltage L3' Septic tank filled to operating level Inlet/outlet piped correctly Air Lift Operation Filter element installed Recirculation tube in place Blower hood secure Fasteners tight Blower works correctly 3 WATER-TIGHT JOINTS Blower located within 100' of 0, Treatment unit to septic tank treatment unit Air line clear �. Entrance tube to insert cover ! Air inlet screen clear 0, Insert to insert cover . Blower hood vents clear 0-' [7) Discharge line connection Factory Authorized Personne: Title: Firm: Wastewater Treatmento Services In'c. Da e:t . 44 Commercial Street Please complete all items marked Raynham, MA including three signatures. Mail 02767 signed original contract to: Wastewater Treatment Services,Inc. Tel: (508) 880-0233 44 Commercial Street Ravnham,MA 02767 Fax: (508)880-7232 INSPECTION-AND EFFLUENT TESTING AGREEMENT Agreement entered into by and between Wastewater Treatment Services,Inc.(herein called WTS)and the FAST"System OWNER(herein called OWNER)for the inspection by WTS of certain equipment of OWNER which is described below. Upon acceptance of this agreement at WTS's office,WTS will render the following services only: Equipment will be inspe ted at least 4 times per year that this Agreement remains in effect,with the first inspections beginning I These inspections will include: 1) Testing of the sludge depth in the septic tank. 2) Inspection,power testing and clean/replace intake filter of the air blower. 3) Inspection of the alarm.system. 4) Inspect overall condition of FAST"System. 5) Notification to OWNER of any problems encountered. 6) Service other than routine maintenance will be billed at an hourly rate,plus travel and parts. WTS shall notify the local Board of Health and Department of Environmental Protection in writing within 24 hours of a system failure or alarm event including corrective measures that have been taken. OWNER will be billed standard WTS charges for any parts used in repairs or maintenance. Any additional labor time will be billed to the OWNER at current labor rates of$80.00 per hour. Emergency service between regular inspections will be provided at standard labor rates during normal business hours;at time and one-half after 5.:00 PM and on Saturdays; and at double time on Sundays and holidays. Emergency service charges will include a minimum four(4)hours of labor, plus standard WTS charges for parts,plus mileage and travel charges. The annual rate includes routine maintenance,but does not include repairs required for damages caused by abuse,accident,theft,acts of third persons,forces of nature, or alterations made to the equipment. WTS shall not be responsible for failure to render the agreed services if caused by strikes, labor disputes, non-cooperation by OWNER, or other factors beyond the control of WTS. OWNER understands and agrees that WTS is not responsible for special, incidental or consequential damages, including but not limited to loss of time, injury to person or property, or equipment failure. OWNER agrees that WTS may enter OWNER's property and have acceptable access to all areas deemed by WTS to be necessary or appropriate for WTS to perform its duties hereunder. i h Current WTS practice is to send OWNER approximately 10 days before expiration of the term of the current contract an invoice for one year of service. It is OWNER's responsibility to timely return the payment. WTS must receive the payment before expiration of the current contract year to assure continuous contract coverage. Failure to return payment may result in suspension of service,cancellation of the contract and/or nullification of warranties,at the election of WTS. OWNER may not assign this contract without the prior written consent of WTS_. It will remain in force until a party cancels by written notice to the other at the address given herein. MANUFACTURER MODEL NO. SERIAL NO. LOCATION ANNUAL RATE Bio-Nlicrobics MieroFAST ®6�-C p 1 7j Osterville,MA $470.00 EQUIPMENT OWNER;' Wastewater Treatment Services.Inc. *Signed by OWNER:. Richard Evans Signed: / , *Address: 134 East Bay Road 44 Commercial Street Raynham,MA 02767 Tele:(508)880-0233 *City: State: Zip: Fax:(508)880-7232 OstervilIe MA 02655 �� f Telephone& sc<15� 05e 19 Effective Date of Agreement E-Mail address: 1 -W JC{yj s]'>'lac C Mi Tt OWNER understands that(I)ANNUAL RATE payment is for one year only commencing on the effective date set forth above and is non-refundable;and(2)Current DEP Regulations require OWNER to maintain a service agreement for the life of the FAST®System;and(3)ANNUAL RATE is subject to change based on current WTS rates. I If R UNDERSTAND THE FOREGOING. *Signed by OWNER: � Effluent Testing Effluent sample taken 4 times per year and delivered to a qualified testing lab for evaluation. Results sent to State and local Agencies as well as the OWNER. OWNER is responsible for providing. acceptable access to effluent to enable a grab sample to be taken for laboratory testing performed. PERMIT: `(PLEASE CHECK ONE) (X )GENERAL ( )REMEDIAL l )PROVISIONAL, *SPECIAL CONDITIONS PER LOCAL BOARD OF HEALTH(Y)or(N)if YES,please attach copy of permit (X)pH,BODs,TSS,Nitrate,Nitrite,TKN ( )Other: *Cost for testing: 5275.00Nisit Operator assigned: Michael Moreau Telephone: 508 880. ,- =- — *Approval for Effluent Testin - IV" Owner's Signature Town of Barnstable Geographic Information System March 12,2018 141123002 14#18 5 141104001 ® 141104005 #30 141097 #e17 #34 °"� #67 141099 141106 #531 #50 141104004 106 '141123001 #110 141110 #53 # #73 141107 - - #100 141131 #146 141109 #41 k1104 8 163 #37 140204 4.134`: ':.'.? ':•;;;;,.,. #87 1401 W #150 140169001 140145 140162 #188 #186 #99 140165 ® #156 140169003 140161`.•'>;..:.:::';`r`.:.i`.j ,-..i:`i: i':'i:;`.;.::. 140167 #206 #170 940148 - - #214 0168 140169002 ''*::'.140160001 rr}ti?.!i[:�','• #202 140169004 140147 140148002 #220 #218 140210001 #242 #167 163007 140159 140210002 #230 A 140160002 #149 It #173� 140161001 #145 140209 <». 140148001 "#25D 438 #232 140157CN D #199 140156001 '140155002 #209 #229 Fe 140149 140160001 140208 1 139 #260 #27 #36 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:140 Parcel:164 Board of Health Selected Parcel boundary determination or regulatory interpretation. Enlargements beyond a scale of Abutter List Type-Direct abutters(no set distance)and the properties located 1"=100'may not meet established map accuracy standards. The parcel lines on this map .:, are only graphic representations of Assessor's tax parcels. They are not true property across the street. Abutters boundaries and do not represent accurate relationships to physical features on the map i:^ such as building locations. Buffer j,✓..;. AbutterReport Page 1 of 1 Board of Health Abutter List for Map & Parcel(s): '146164' Direct abutters(no set distance) and the properties located across the street. Total Count: 5 Close Map&Parcel Owner3 0wner2 Addressi Address 2 Mailing Country Deed CityStateZip 140160001 RYAN, MARY TR MARY L RYAN 2004 137 EAST BAY ROAD OSTERVILLE, MA C211043 REVOCABLE TRUST 02655 140161 BELLANCA, ANTONIA BELLANCA 121 EAST BAY ROAD OSTERVILLE, MA C189600 ANTONIA TR FAMILY TRUST 02655 140163 ASSEMBLY C/O NANCY B 400 ATLANTIC BOSTON, MA 30724/105 REQUIRED LLC SAMIUAN AVENUE 02110 EVANS, RICHARD H RICHARD H EVANS& 255 BOSTON, MA 140164 &BLYTHE 0,TRS BLYTHE 0 EVANS MASSACHUSETTS 02115 C213147 TRUST AVE APT 518 141131 BIANCHI, 46 CHESTNUT BOSTON, MA D1090933 LAWRENCE A STREET 02108 This list by itself does NOT constitute a certified list of abutters and is provided only as an aid to the determination of abutters.If a certified list of abutters is required,contact the Assessing Division to have this list certified.The owner and address data on this list is from the Town of Barnstable Assessor's database as of 3/12/2018. http://maps.townofbamstable.us/arcims/appgeoapp/AbutterReport.aspx?type=BOH 3/12/2018 t � cering suilivan � # ( 8)42S,3344 _ Pa Sm 669, `T Ptr r Rqa , ferv,3t�,3A,A O rs. ****ABUTTER NOTIFICATION LETTER**** RE: Board of Health Public Hearing As a direct abutter of a proposed project,please be advised that a Variance Request has been . filed.with the Town of Barnstable Board of Health. The specific information is as follows: Applicants: Richard &Blythe Evans, Trustees Richard H. Evans &Blythe O. Evans Trust Project Location: 134 East Bay Road, Osterville Map 140 Parcel 164 Proposed Project: Proposed installation of an IA septic system to allow a 41h bedroom requiring a variance from the Town of Barnstable Chapter 360-45 Interim Regulations for the Protection of Salt Water Estuaries. Applicant's Agent: Sullivan Engineering& Consulting, Inc. 7 Parker Road, P O Box 659 Osterville, MA 02655 phone: 508-428-3344 Public Hearing: Date: April 24, 2018 Time: 3:00 PM Place: Barnstable Town Hall, 367 Main Street, Hyannis, MA 2nd Floor Hearing Room Plans and the application describing the proposed activity are on file at the Board of Health office, 200 Main Street, Hyannis and at Sullivan Engineering& Consulting, Inc.'s office. Please call if you have any questions regarding this notification. Please call the Board of Health on the day of the Public Hearing to confirm the location and time for the hearing. RESIDENTIAL NO3-N LOADING EVANS 3 Bedrooms PROJECT: 134 East Bay Road TOWN: Barnstable(Osterville) 3 Bedrooms Title V Wastewater Flow = 330 gpd ASSUMED VALUES Impervious Recharge Rate = 40 in/yr Total Land Area= 34,070 ft2 Roof Runoff Concentration = 0.75 mg/L Road Runoff Concentration = 1.50 mg/L Paved Area = 550 ft2 Lawn Nitrogen Leaching= 25 % Roof Area = 2,495 ft2 Wastewater Concentration = 35 mg/L Lawn Area = 10750 ft2 Average Lawn Size = 5000 ft2 Natural Area = 20275 ft2 Recharge Rate = 18 in/yr Nitrogen Application Rate 3 lbs/1000ft2 CALCULATIONS Title V Wastewater Loading 43716.75 mg ' Title V Wastewater Recharge 1249.05 liters Total Impervious Loading 697.33 mg Roof Loading 483.96 mg Roof Recharge 645.28 liters Paved Loading 213.37 mg Paved Recharge 142.25 liters Lawn Loading 10028.42 mg Natural Area Recharge 3610.80 liters Title V Total Loading 54442.51 mg Title V Total Recharge 5647.38 liters TITLE'V NITROGEN LOADING.CONCENTRATION= 9.64 ppm 19.87 kg/yr RESIDENTIAL NO3-N LOADING EVANS 4 Bedrooms w/ Nitrogen Reduction PROJECT: 134 East Bay Road TOWN: Barnstable(Osterville) 4 Bedrooms Title V Wastewater Flow = 440 gpd ASSUMED VALUES Impervious Recharge Rate = 40 in/yr Total Land Area= 34,070 ft2 Roof Runoff Concentration = 0.75 mg/L Road Runoff Concentration = 1.50 mg/L Paved Area = 550 ft2 Lawn Nitrogen Leaching= 25 % Roof Area = 2,495 ft2 Wastewater Concentration = 25 mg/L Lawn Area = 10750 ft2 Average Lawn Size = 5000 ft2 Natural Area = 20275 ft2 Recharge Rate = 18 in/yr Nitrogen Application Rate 3 lbs/1000ft2 CALCULATIONS Title'V Wastewater Loading 41635.00 mg Title V Wastewater Recharge 1665.40 liters Total Impervious Loading 697.33 mg Roof Loading 483.96 mg Roof Recharge 645.28 liters Paved Loading 213.37 mg Paved Recharge 142.25 liters Lawn Loading 10028.42 mg Natural Area Recharge 3610.80 liters Title V Total Loading 52360.76 mg Title V Total Recharge 6063.73 liters TITLE V NITROGEN LOADING CONCENTRATION= 8.64 ppm 19.11 kg/yr �Yo i0 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 134 East Bay Rd. Property Address NO Cadou Owner's Name .� Osterville ✓ MA 02655 4/14/17 Citylrown State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. A. General Informations 1. Inspector: Frank Nunes III Name of Inspector saa Company Name Box 841 Company Address East Falmouth MA 02536 Citylrown State Zip Code 508.272.6433 Telephone Number B. Certification I certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true, accurate and complete as of the time of the inspection. The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems. I am a DEP approved system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000).The system: ® Passes ❑. Conditionally Passes ❑ Fails ❑ Needs Further Evaluation by the Local Approving Authority COMM IZnTS 4�lf z IID?M 4/14/17 Inspecto i na r Date The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000 gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable, and the approving authority. ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. 134 East Bay Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1/of 15 +� f Commonwealth of Massachusetts Title 5 Official Inspection Fora' Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M ,•''v 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® I have not found any information which indicates that any of the failure criteria described in 310 CMR 15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are C indicated below. om - ments: ***** Per BOH agent the sytem is a"Pass"of inspection for the purpose of transfer of title only and no other purposes. The town regulation of a 4'seperation from the bottom of the SAS to groundwater has not been met x B) System Conditionally Passes: ❑ One or more system components as described in the"Conditional Pass"section need to be replaced or repaired. The system, upon completion of the replacement or repair, as approved by the Board of Health, will pass. s Answer yes, no or not determined (Y, N, ND) in the ❑ for the following statements. If"not determined," please explain. ❑ The septic tank is metal and over 20 years old*or the septic tank(whether metal or not) is structurally unsound, exhibits substantial infiltration or exfiltration or tank failure is imminent. System will pass inspection if the existing tank is replaced with a complying septic tank as approved by the Board of Health. *A metal septic tank will pass inspection if it is structurally sound, not leaking and if a Certificate of Compliance indicating that the tank is less than 20 years old is available. ND Explain: n/a ❑ Observation of sewage backup or break out or high static water level in the distribution box due to broken or obstructed pipe(s)or due to a broken, settled or uneven distribution box. System will pass inspection if(with approval of Board of Health): ❑ broken pipe(s) are replaced ❑ . obstruction is removed 134 East Bay Rd•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 2 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 Cityrrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes (cont.): ❑ distribution box is leveled or replaced ND Explain: n/a ❑ The system required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will pass inspection if(with approval of the Board of Health): ❑ broken pipe(s)are replaced ❑ obstruction is removed ND Explain: n/a C) Further Evaluation is Required by the Board of Health: ❑ Conditions exist which require further evaluation by the Board of Health in order to determine if the system is failing to protect public health, safety or the environment. 1. System will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health, safety and the environment: ❑ Cesspool or privy is within 50 feet of a surface water ❑ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System will fail unless the Board of Health (and Public Water Supplier, if any) determines that the system is functioning in a manner that protects the public health, safety and environment: ❑ The system has a septic tank and soil absorption system (SAS)and the SAS is within 100 feet of a surface water supply or tributary to a surface water supply. ❑ The system has a septic tank and SAS and the SAS is within a Zone 1 of a public water supply. ❑ The system has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. 134 East Bay Rd•03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 15 1 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments , 134 East Bay Rd. Property Address Cadou Owners Name Osterville MA 02655 4/14/17 City/Town State Zip Code - Date of Inspection Q. Certification (cont.) C) Further Evaluation is Required by the Board of Health (cont.): ❑ The system has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more from a private water supply well**. Method used to determine distance: **This system passes if the well water analysis, performed at a DEP certified laboratory, for coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered. A copy of the analysis must be attached to this form. 3. Other: n/a D) System Failure Criteria Applicable to All Systems: You must indicate"Yes" or"No"to each of the following for all inspections: Yes No ❑ ® Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool ❑ ® Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool ❑ ® Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool ❑ ® Liquid depth in cesspool is less than 6" below invert or available volume is less than '/day flow ❑ ® Required pumping more than 4 times in the last year NOT due to clogged or obstructed pipe(s). Number of times pumped: ❑ ® Any portion of the SAS, cesspool or privy is below high ground water elevation. ❑ ® Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. 134 East Bay Rd-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 15 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 Cityrrown State Zip Code Date of Inspection B. C l ertlflcatlon (cont.) D) System Failure Criteria Applicable to All Systems (cont.): Yes No ❑ ® Any portion of a cesspool or privy is within a Zone 1 of a public well. ❑ ® Any portion of a cesspool or privy is within 50 feet of a private water supply well. ❑ ® Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water supply well with no acceptable water quality analysis. [This system passes if the well water analysis, performed at a DEP certified laboratory,for fecal coliform bacteria indicates absent and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure criteria are triggered.A copy of the analysis and chain of custody must be attached to this form.] ❑ ® The system is a cesspool serving a facility with a design flow of 2000gpd- 10,000gpd. ❑ ® The system fails. I have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of Health to determine what will be ' necessary to correct the failure. ' E) Large Systems: To be considered a large system the system must serve a facility with a design flow of 10,000 gpd to 15,000 gpd. For large systems, you must indicate either"yes"or"no"to each of the following, in addition to the questions in Section D. Yes No ❑ ❑ the system is within 400 feet of a surface drinking water supply ❑ ❑ the system is within 200 feet of a tributary to a surface drinking water supply ❑ ❑ the system is located in a nitrogen sensitive area (Interim Wellhead Protection Area—IWPA) or a mapped Zone 11 of a public water supply well If you have answered "yes"to any question in Section E the system is considered a significant threat, or answered "yes" in Section D above the large system has failed. The owner or operator of any large system considered a significant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.304. The system owner should contact the appropriate regional office of the Department. 134 East Bay Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M , 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 City/Town State Zip Code Date of Inspection C. Checklist Check if the following have been done. You must indicate"yes" or"no" as to each of the following: Yes No ® ❑ Pumping information was provided by the owner, occupant, or Board of Health ❑ ® Were any of the system components pumped out in the previous two weeks? ❑ ® Has the system received normal flows in the previous two week period? ❑ ® Have large volumes of water been introduced to the system recently or as part of this inspection? ® ❑ Were as built plans of the system obtained and examined? (If they were not available note as N/A) ® ❑ Was the facility or dwelling inspected for signs of sewage back up? ® ❑ Was the site inspected for signs of break out? ® ❑ Were all system components, excluding the SAS, located on site? ® ❑ Were the septic tank manholes uncovered, opened, and the interior of the tank inspected for the condition of the baffles or tees, material of construction, dimensions, depth of liquid, depth of sludge and depth of scum? ® ❑ Was the facility owner(and occupants if different from owner) provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System (SAS)on the site has been determined based on: ® ❑ Existing information. For example, a plan at the Board of Health. ® ❑ Determined in the field (if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable) [310 CMR 15.302(5)] 134 East Bay Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments °M 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 Citylrown State Zip Code Date of Inspection D. System Information Residential Flow Conditions: Number of bedrooms (design): 3 Number of bedrooms (actual): 3 DESIGN flow based on 310 CMR 15.203 (for example: 110 gpd x#of bedrooms): 330 Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system? [if yes separate inspection required] ❑ Yes ® No Laundry system inspected? ❑ Yes ® No Seasonal use? ® Yes ❑ No Water meter readings, if available (last 2 years usage (gpd)): Sump pump? ❑ Yes ® No Last date of occupancy: seasonal Date Commercial/Industrial Flow Conditions: Type of Establishment: n/a Design flow(based on 310 CMR 15.203): Gallons per day(gpd) Basis of design flow(seats/persons/sq.ft., etc.): Grease trap present? ❑ Yes ❑ No Industrial waste holding tank present? ❑ Yes ❑ No Non-sanitary waste discharged to the Title 5 system? ❑ Yes ❑ No Water meter readings, if available: Last date of occupancy/use: Date Other(describe): n/a 134 East Bay Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 7 of 15 I� l i Commonwealth of Massachusetts Title 5 Official Inspection Fora Subsurface Sewage Disposal System Form -Not for Voluntary Assessments M 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) General Information Pumping Records: Source of information: Pumped 2013 per owner Was system pumped as part of the inspection? ❑ Yes ® No If yes, volume pumped: gallons How was quantity pumped determined? Reason for pumping: Type of System: ® Septic tank, distribution box, soil absorption system ❑ Single cesspool ❑ Overflow cesspool ❑ Privy ❑ Shared system (yes or no) (if yes, attach previous inspection records, if any) ❑ Innovative/Alternative technology. Attach a copy of the current operation and maintenance contract(to be obtained from system owner) and a copy of latest inspection of the I/A system by system operator under contract ❑ Tight tank. Attach a copy of the DEP approval. ❑ Other(describe): Approximate age of all components, date installed (if known)and source of information: Original septic tank and leach pit per age of the home. New d-box and chambers 1996 per BOH record Were sewage odors detected when arriving at the site? ❑ Yes ® No 134 East Bay Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form _ Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Building Sewer(locate on site plan): Depth below grade: 2'feet Material of construction: ❑ cast iron ®40 PVC ❑ other(explain): Distance from private water supply well or suction line: >10' feet Comments (on condition of joints, venting, evidence of leakage, etc.): Septic Tank(locate on site plan): � Depth below grade: 18"feet Material of construction: ® concrete ❑ metal ❑ fiberglass ❑ polyethylene ❑ other(explain) Outlet cover raised If tank is metal, list age: years Is age confirmed by a Certificate of Compliance? (attach a copy of certificate) ❑ Yes ❑ No -------------------------------------------------------------------------------------------------------------------------- Dimensions: 1000g Sludge depth: trace Distance from top of sludge to bottom of outlet tee or baffle >12 Scum thickness trace Distance from top of scum to top of outlet tee or baffle >2" Distance from bottom of scum to bottom of outlet tee or baffle >2" How were dimensions determined? Measured 134 East Bay Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 9 of 15 I Commonwealth of Massachusetts Title 5 Official Inspection Form _ a Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 CityrTown State Zip Code Date of Inspection D. System Information (cont.) Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Pumping suggested every 3 yrs to prolong the life of the system Grease Trap (locate on site plan): Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): n/a Dimensions: Scum thickness Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle Date of last pumping: Date Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): n/a Tight or Holding Tank(tank must be pumped at time of inspection) (locate on site plan): Depth below grade: Material of construction: ❑ concrete ❑ metal ❑fiberglass ❑ polyethylene ❑ other(explain): n/a 134 East Bay Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 10 of 15 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments M 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 Citylrown State Zip Code Date of Inspection D. System Information (cont.) Tight or Holding Tank(cont.) Dimensions: Capacity: gallons Design Flow: gallons per day Alarm present: ❑ Yes ❑ No Alarm level: Alarm in working order: ❑ Yes ❑ No Date of last pumping: Date Comments (condition of alarm and float switches, etc.): n/a "Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No Distribution Box(if present must be opened) (locate on site plan): Depth of liquid level above outlet invert 0" Comments (note if box is level and distribution to outlets equal, any evidence of solids carryover, any evidence of leakage into or out of box, etc.): D-box 3'6" below grade, no adverse conditions Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No 134 East Bay Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 11 of 15 Commonwealth of Massachusetts - Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Comments (note condition of pump chamber, condition of pumps and appurtenances, etc.): n/a Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: Type: ® leaching pits number: 1 ® leaching chambers number: 2 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/alternative system Type/name of technology: Comments (note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): 600g H-20 pit in the driveway, cover raised to 1', dry at this time, bottom at 7'. Chambers are dry at this time, cover to 6", bottom at 66". Observed groundwater at 10'6" 134 East Bay Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 12 of 15 F Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Cesspools (cesspool must be pumped as part of inspection) (locate on site plan): Number and configuration Depth—top of liquid to inlet invert Depth of solids layer Depth of scum layer Dimensions of cesspool Materials of construction Indication of groundwater inflow ❑ Yes ❑ No Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): Privy (locate on site plan): Materials of construction: Dimensions Depth of solids Comments (note condition of soil, signs of hydraulic failure, level of ponding, condition of vegetation, etc.): n/a 134 East Bay Rd-03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 15 L Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M , 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building. I 7 J 134 East Bay Rd-03108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 15 r K K� Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M s 134 East Bay Rd. Property Address Cadou Owner's Name Osterville MA 02655 4/14/17 Citylrown State Zip Code Date of Inspection D. System Information (cont.) Site Exam: Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells Estimated depth to high ground water_ 9'feet Please indicate all methods used to determine the high ground water elevation: ❑ Obtained from system design plans on record Y 9 If checked, date of design plan reviewed: Date ® Observed site(abutting property/observation hole within 150 feet of SAS) ❑ Checked with local Board of Health -explain: ❑ Checked with local excavators, installers-(attach documentation) ❑ Accessed USGS database-explain: You must describe how you established the high ground water elevation: 2 holes were augered on site 4/14/17. Standing water was observed at 10'6"during a low tide cycle. Soils were observed to be moist at about 9'. 134 East Bay Rd•03/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 15 TOWN OF BARNSTABLE LOCATION A-W �L` SEWAGE # �a VILLAGE 05wv1uF_ ASSESSOR'S MAP & LOT/ A INSTALLER'S NAME & PHONE NO.8CJ0&o'rJt-6&r 64Ak9_— SEPTIC TANK CAPACITY /QP T LEACHING FACILITY:(type) 77 (size) 9e ef_, AX r NO. OF BEDROOMS PRIVATE WELL OR LIC WATER BUILDER OR OWNER DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED: VARIANCE GRANTED: Yes No 1 A� LID W � h No...?1-115 APPROVED THE COMMONWEALTH OF MASSACHUSETTS ble C Barnstaonimat"oas tBOA R® OF HEALTH --- WN OF BARNSTABLE AppUratilln or �hipviial Vurkg Ton,strurtilan runfit Application is hereby made for a Permit to Construct ( ) or Repair (9<� an Individual Sewage Disposal System at: Loc lion• dress .... "=-`......................................... " ! .t �.....or Lot No ... ���G ... O �y �_ [:s:� cSy Address .... —......• G ........................... ...................................................Gc ................ �................................ Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms......_... .........................Expansion Attic ( ) Garbage Grinder ( ) a`4 Other—Type of Building No. of persons............................ Showers — g91� ------------•----------------•------------•. ( ) Cafeteria ( ) Other fixtures . .. ----------------•---•--------- W Design Flow................. ......_.._..gallons per person per day. Total daily flow.._........... ...............gallons. WSeptic Tank—Liquid capacityJO.l Q.gallons Length................ Width................ Diameter---------------- Depth................ Disposal Trench—No. .................... Width.................... Total Length.................... Total leaching area....................sq. ft. 1 Seepage Pit No.___.__.___.l____ Diameter.... . ....... Depth below inlet.......1,�- --- Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) ~' Percolation Test Results Performed by.......................................................................... Date........................................ 1 Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water......................... 44 Test Pit No. 2................minutes per inch Depth of Test Pit---:................ Depth to ground water........................ a ----------------------------- ............................... 0Description of Soil-------------- --...4E -"-- FA . .... ._ � � V - ....--------------------•--•-------•-----------_.....•--------•--------------.....•-----_..•-•-----------•---------------•--•----------------------------•---------------•-------.......----......_-•---- W UNature of Repairs or Alterations Answer when applicable.__110' .!/yl.....4-el 10��_GL .__', - - l'usr- cf - o�c� ` ' ! Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees not to place the system in operation until a Certificate of Complianceghaben is ued y t e board of healthSigned.. ....... . ..... .......... ApplicationApproved BY .............. ... ..0111111111 -- ........................------------ ....� Dace Application Disapproved for the following reasons- ------------- --------------------------- - ---------- - ------------------ --- --------------- -------------- --- ---- ---------------------------------------------------------------------------------------------------------- ---- ---------------- -- -- ---- ---------------------------------------------- --- - ........................ -----:.:. PermitNo. ............C�..1- .-5 �)--------------- Issued ......................................................... Date ' r ' HIM TffM alIDMAUMMMMUM ( (OF / .. 4/ F 1. �i/F H-HEAILIrH / (( TGWM GF BAROMISTAWBILE li�fomn iss H�a�y made ffur�H�Aagriit tt�C�rs�tatoRt (( )) offr R�aair ((>`�}) aan lhrtii�iitlt�l �faa�e I)llil Ilooegtm�r�1hldi�eess omrIIo6tAI�bo. 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(�tiearITli thxif6antlmo�c(( )) Masil1gtterik(( )) H&anmdtiirarr Ua3It Mutts I%ifivanmeH mh' ---------------------------•---.. ,.� U05tt II3tt MD.11---------------rrnm ttLIS iii&h HDgg1h off Uos#IEft--------------------1mqftth ttu WnurrH wear---------------.-.---.--- f#s, ME&Mft INm.7Z---------------mimdwsHmr iinrtir MbRith Off 7Tffilt ER t--------------------IDD41tth ttn.gMXMH watter------------------------ ------------------------------------------------------------------------------------------------------------------------------------------------------- ® Mmrioinn off Sill------------- ------./ fir_---- ----- s ---1-lQ - Itu�eadflaai�am 1�lt�afw�rw�tlean lu�iibe_�riD _ L --- !t,"-L�css,`�'b�s �; 'IIl'ioe umt�s�a ttu ii�ll tii�afftt�H IIrrHi�ii$dail lI'Ffil m iin�vaiiiii diwffmD issimodf'IIIIIIffIi 55 off dtw,%Vt TnwnwnnwrttdlCCorai 2—Uiwumibmgpw iffuxHmragilmnwttt]Dglh=2ttiw rnimo iirmuntiIIaa(Cmrtiff odfC(mrIiI m i w7 ffi 9 w n i' timBNM- offH AtHr. 7! II:#ee II3o¢e t�}tilaa�totrrrl)� �ffx�rt�ff�l�i2rsrr�rr�ar�°ra'.r: . - lldoae - H&YniitMD - -- - / �r L/ Il H. ®tee EBM%MM h k (MFTH TOMOF MUffIff7M(CMMEW,,UiTittdiiEeflTiflimdiudl%m dl wrrssmmba li c.( o 14y- IdasBtler Ha�sH niir llrgliiin r wcii#trtfi�e�row�iisi c ff IIIIJT111 55off Uiw I£nuiiru nwn-trilCa&camdbmnilioaldiin ri�a�llaaaiiunffurIU�i1�CCa�¢r�iianl�rmitI�. - - at-a�ii. - 11Nff I �F liiH� FiB E�Hi4Qilt1 !E tCimf�IR�E®A S AAMAIM. ffiv=tur.— (�114QIi09Qit11�11Ni9QQ�11iFff $114�A�AIllilflllOtffi�l /' �� -'+�����/�'�`�-•— /�'��,��'�. ..,,�-i��. r�� .� (WF 8 EOULM c, IFDMGFBARVNSTAMLE ram.../..:.... Him.... MdT iiSIIFn its Hw*y ffmitb"`................ ..... --v ...............-.......................................—..... tbo C mntawtt(( )) mr Darr(K))aan HrrHixviHm it Snv ]M* 051, �� .r IJiL At r�bo. �' - ` -...._..----�-- ---------1 '�................................................ 'HteeEt ' �s�tmvctnamtti� iiradfimrffm]IIi> l bmlf�s((am tawtfimr Hbnniit No//___��5--IIH.......................................... r --------- � --- U HlwddadfFH�ibh >� ................�a--------- ........----- - TOWN OF B,AAWNST '.DLE LbCA I11N /3 q >`' �' ��l 1,1V SEWAGE # Z�-'/.p� /YLLAGE [9��°�1�/1/�' ASSESSOR'S MAP&LOT / INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY / S®d LEACHING FACMrrY: (type) 0- `sAr 9l1' G size)) a•f X-2f l0 NO.OF BEDROOMS 3 BUILDER OR OWNER PERMTTDATE: /J`00-7� COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility f Feet Private Water Supply Well and Leaching Facility (If any wells exist Feet on site or within 200 feet of leaching facility) /Wit Edge of Wetland and Leaching Facility(If any wetlands exist _ within 300 feet of leaching facility), - Feet Furnished by �r4-6 �o s w • U w O 12� � I w w o No. ►= Fee THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: [_ Yes PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MASSACHUSETTS 01ppricatfon for -Migpogal *pgtem Comgtruction 3Permit Application for a Permit to Construct( )Repair(Upgrade( )Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 13LI , �J-���/� Owner's 1 A es and Tel.No. Assessor's Map/Parcel Q�J kI vlll e AG� � o®w d `7 Installer's Name,Address and Tel No. Designer's Name,Address and Tel.No. ,806'J�Old 1o% e;r6� Z� Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) Other Type of Building 8 G�No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow // © gallons per day. Calculated daily flow gallons. Plan Date Number of sheets Revision Date Title Size of Septic Tank I&Re Type of S.A.S. Z'✓`~�� �° IeQL'� C •te r,$ Description of Soil Nature o5 Repairs gr 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 iss of alt ued t ' - Signed Date 1 15�' Application Approved by Date /,LJQ Application Disapproved fort followl g reasons Permit No. �� �- �/ Date Issued '..,, ,- +. .' ••.. •_ r .j ._ .tom .. •.• _. _. r . 6 .. - i - No. 4144 Fee �rc d" THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes ' PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 01pprication for Miooal *p.5tem Construction Pettit Application for a Permit to Construct( )Repair(/Upgrade( )Abandon( ) ❑Complete System ❑Individual Components I Location Address or Lot No. Owner's.Name,Address and Tel.No. o Assessor's Ma /Parcel �C�Cr C a olw Z/b" p as frrv�°/� i Installer's Name,Address,and Tel.No. Designer's Name,Address and eh No. ,r [ Type of Building: Dwelling No.of Bedrooms Lot Size sq.ft. Garbage Grinder( ) r Other Type of Building 05&!j2,,`'n&WeL No.of Persons Showers( ) Cafeteria( ) f. Other Fixtures Design Flow. //0 gallons per day..Calculated daily flow 3 3d gallons. Plan Date z7,.Nurnberofsheeis Revision Date Title +� Size of Septic Tank /r9�n/ Type of S.A.S. 2- Description of Soil ; Nature of Repairs or Alterations(Answer when applicable) i Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore desonbed(on)site sewage disposal system in accordance with the provisions of Title 5 of the Environmental Code and not t .puce&-system in operation until a Certifi- cate of Compliance has been issue�this ;f;ge;al;th. .�� Signed Date Application Approved by Date .1 v�- 4 Application Disapproved fort followiAg reasons Permit No. 94 Date Issued - - 1 r THE COMMONWEALTH OF MASSACHUSETTS 1 BARNSTABLE, MASSACHUSETTS l k ' i Certificate of Compliance THIS IS TO CERTIFY,-that the On-site Sewage Disposal System Constructed( ),Repaired ( r <Upgraded( ) i Abandoned( )by_.Ar fo,/_,v*i 14,/O7, at i 3u 4�z:fn� 4Z 2:,2645,��iff�r. has been constructed in accordance i. with the provisions of Title 5 and the for Disposal System Construction Permit No. _ 41 Lj dated_4/-J_A Installer Designer The issuance of this permit shall not be construed as a guarantee that the system will function as desig.ed. Date - T� Inspector , ' -------------------------------------- No. 4gzp / I�� Fee ) THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - BARNSTABLE, MASSACHUSETTS ,- i Mwiooar 6p$tem Con$truction Permit Permission is hereby granted to Construct( )Repair(Upgrade Abandon( ) Systemv located at ' rrx�ii` 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. 4 r, Provided: Construction must be completed within three years of the date of this permit. ` v Date: / -,CA, Approved by I G �t� CERTIFICATION OF SKET01 AND APPLICATION FOR DISPOSAL WORKS CONS FRUCTION PERIIITT 0VTTHOU•1. DESIGNED M%NSI I, ®�jar�' J . Am hereby certify that the application_for disposal works construction permit signed by me dated /j Yl� ,conceming the property located at f ,�'g� y�a D� r� e meets all of the following criteria: t/ ,-� � n �e�sc fc syst em tcrc arc no �.yctland_ vttinn _. � fc^_, of .hc arono in . " v ' r ire n rivate n•cils within 0 tcct of the proposed sevild system / ce� c no P po 'icobsuvcd ¢ro�mdcv ler f^nie s .fe^. ,r -eater x!ow the aoftom of the !main$:racrlity Cre is no incrcise in 'Tow ina'nr.natt¢e .n ']se ,ir000sed ;Mere are no,nrinnccs rcotiesie^_'.,r aecded. SIGNED : DATE: 4Q/o LICENSED SEPTTC.SYSTEM INSTALLER IN THE TOWN OF BARNSTABLE"NUMBER f hunch a sketch plan of the proposed system. Also If the licensed Installer posesses a certified plol plan, this plan should be submiltedj: . _. ..f.:>:.... .saes. .. TOWN OF BARNSTABLE L I" SEWAGE # LOCATION �a' t '�� � � - O��°��11i�/rr' ASSESSOR'S MAP & LOT VILLAGE INSTALLER'S NAME&PHONE NO. � �LD�zs�` 7� SEPTIC TANK CAPACITY LEACHING FACILITY: (type) Z `S D'O 9D' 7G�b'size)s NO.OF BEDROOMS 3 BUILDER OR OWNER PERMITDATE: COMPLIANCE DATE: Separation Distance Between the: Feet Maximum Adjusted Groundwater Table and Bottom of Leaching Facility S f Private Water Supply Well and Leaching Facility (If any wells exist /W k� Feet on site or within 200 feet of leaching facility) Edge of Wetland and Leaching Facility(If any wetlands exist �- Feet within 300 feet of leaching facility) Furnished by Gaga Oily 1 o. �1 WAY � f S 1-N L I LL. �jl I I! 0 o + 'il , � Q I.. HALF SAT I TI p,En nw : Q C. 6'E•X3 1 1 O G LLI__ .�i Q I i ( LL i it .I m J .,i. - AnEA of s�ovED CE uuc > 4 fi'II h.EOh..G- IUEo[uotEsescuuuc O H� BEDROOM 3 - C. OFFICE a' LU LLI fn Q CD .--I 0 I o V I _ C. BDRM2 TITLE: E°_-- —� 1z•a-x 1e•-9• ROOF PITCH:B © k 1° z® , _ I 0 _ O _ ATH1T PLANS 6 tY =s^ I I - =m SECOND FLOOR PLAN COVERED ENTRY— O O O ^Z € / \ 9-0%6-0 _ Tu 10 r� 0 - --- OFFICE .. wM I6A•,%B 5� ,-II KITCHEN/ O__O._ B'-U'%1U'BBREAKFAST. r 17.-0.E13.-7. .. 0 EF . "-1 �v sL tx5 0 NEW GARAGE _Au UDR orEu uc L V CHEN/LIVING RM - 4 1B'-0•X2B'-0" m 27.1 X 15'A' _ b '`— BENCH/HOOKS OUTLINE OF ©' EXISTING _E DES GARAGE TO BE C DEMOLISHED 1 0 1 — BATuI I _1,_II ——— I H1ALL 's - � - DATE: DINING ROOM? 1saxla PERMI T: 12.11.2- 017 — 51.X 11.46enrH1 w..c. HALL — f U ;P. °.B°r EEIAE °E ii e sro g,o wEur — „ MASTER BEDROcl OM I LIN. 48 48" LE II ® O SH /GLA ————— a E IX SU ND SUNROOM 15'-0•X 12'£• e x r EXISTING STONE RAISE PATIO I — BATH DETAIL PROPOSEDBWESTONEPATIO �1 FIRST FLOOR PLAN av-0•X14'-0 PERMIT SET • ■ 1 I �I� t5 AREA CALCULATIONS: z EXTG CONDITIONED SPACE: PROPOSED CONDITIONED SPACE: Q FIRST FLOOR: 1680 SF EXTG FIRST FLOOR: 1660 SF W SECOND FLOOR: 554 SF PROPOSED FIRST FLR: 400 SF Ce TOTAL: 2234 U EXTG SECOND FLOOR: 554 SF Q PROPOSED SECOND FLR: 476 SF TWE, a EXTG UNCONDITIONED SPACE: TOTAL: 3090 SF Z = Q --ec="" ° GARAGE: 340 SF U EXTG UNCONDITIONED SPACE: '""' Q W PROPOSED GARAGE 505 SF Q m J "I FREE" w"P new <\".• mww�wl Di J EAR wn Too a >.o s as""o ' ° ?- '.WMDOW&DOOR SCHEDULE' I I Q W V) > 4 °"'�°"°°'°'°— •"F° - 1hY OTY FRAME SI2E ROUGH OPENING MODEL _ MANUFMTURER STYLE HUNT. REEAARN6 ' xau m•BCF°oT 4 zr«E" _" oPvawn 4 72'SW X4-07B Y-01B XV-07B• TW2fi42 ANDERSEN 400 AS HUNG B LrrEs .. _. _ Uj = W LLJ smwwwc Isl.s nsaw •: ;.'. B 10 2'-03B%3-0 2-07B X3'-012' `CW13 ANDERSEN400' —CASEMENT --BLffES� � _ aai°smu TOTAL 14 LL w,w s°CO1rm u (n i 8-1112 X8103B 8'-0'XS-11• FWH90811 ANDERSEN400. HINGED TRIPLE 16 LRES ONNG ROCXI-z OPERATE J M "E.w.. - Q m ,-H O pl.s"sa." •,- ®swv 1 8'-1112'X6-1038' 9'-0•%6'-11' FWH90611 ANDERSEN 600 HNGEDTRPLE 16LffE5 011E6T ROOM-zOPEMTE meooT - 1 -6'-0•X T-O' TIED TED TED _ OVERHEAD - - ®' s°xO1 1 9•a•X7•4" TBD TED TED OVERHEAD TRANsoM TITLE: T"Prurn°s.rwx°nnww. "- -" -1 ---7-0•XW.8- TIED- -TIED THERMATRU HNGEDFRERATED —4PANELS _IHRFmERA1wG__ .cwuc. 1 Y-W X W-10• TIED TED SMPSON HINGED 314 LRE W14 LRES PANTED] w 1 MATCH EXSTNG MATCH EXISTING _ TSD SMPSON ___HNGED_ 2 LITES ---REPLACE FRONT WOR,WODOi AL W WOdNs SHALL BE ANDERSEN 000.AR60N BETWEEN 1HE GLASS.WIM 60Lt }.VERIFY ALL TEMPEPNG LATHE FIELD I WALL TYPES SCHEDULES PLANS r- A« °Ak LIST OF DRAWINGS: p I ° SITE PLAN BY SULLIVAN ENGINEERING - p `COVERED ENTRY I A1.0 FOUNDATION PLAN f L —__ A1.1 FLOOR PLANS A2.0 ELEVATIONS I I i A3.0 SECTIONS z x a SABONGRADE' I I I S1.1 FRAMING PLANS IEXISTING -_ y EX1 EXISTING a, t= OUTLINE OF NEW CRAWL SPACE FIELD VERIFY •/—�O E Ff GARAGE TO BE EXISTING FOOTINGS V F F. IDEMOUSHED N FIELD,PROVIDE C) IE r NEW PRSIFOOTINGS © AS REQUIRED :I I :I I b naw cre -�rt I I' L----- ---J;:1 oe —— _ :-..'.:• _'J C DATE: PERMIT: 11.27.2017 I :1 I II _____ `NEW CRAWL SPACE EXISTING WALL TO BE DEMOLISHED: NEW 2X WALL — ------ — a EXISTING WALL TO REMAIN: PROPOSED PATIO ABOVE WALL KEY �1 FOUNDATION PLAN A1 . 0- "1 b PERMIT SET f _ n I to I e o I g o �,} oo k�7fi ® IIII( li i I ..0 ® o �t 11 oo❑ I' �,� i! D III I,, D 1 i., ri ❑ I III { OD ort III II f: o I:I' I z Q ({ lu t �- III l �, I 61� frl III II. $ V m N li�, t n �ii�I I t }}r II+ IIII I44 ,�I II �® r®Y IIII it {.`1J#+tr IIII II ® t ;II F t' IIII lly (IIII"III, I a 1 } p g 5 oo❑ ill'I Irl o l oo❑ llllli Ii; =EP l � ttluz���i I.II II i ° III I I c ur o l3{I-` �,� 111111 IIII � ,,hill I'fli ' i I h�I I�111 I I I ��'l l fit,�.� III•!! II� _ m I D M� m �m 831 Main Sveet r r- A3 architects inc DennisMAllZ- < m A RENOVATION FOR: A , > SOB.694J887 hone BLYTHE&RICHARD EVANS ' v Residential Commercial Net Zero P D www.a3architeccsinccom 134 EAST BAY ROAD OSTERVILLE MA Fs"E I ea3� s m O o N o n 0 s -n �4 F gib gp i I II III $ a m y o kN �0 -o Zn bZn a � g Z t; FSg € =go s D Po 3 rn 831 Main S[reet m m \ A3 architects inc Dennis MA02638 c� A RENOVATION FOR: 10,1.a3a887o_1 o BLYTHE&RICHARD EVANS Residential Commercial Net Zero www a3architectsinc.com O ■ lZ^ 134 EAST BAY ROAD O n, Axo- °-11..1-11ann'n N�rnm O[1[U min n��'Birrtn iT:N'¢nT ni V/ .. ,a,rm,„�^�_°� OSTERVILLE MA V In z o- g pg WIN Q' w o O LL L) w 0.6 w mac• aoa , ,sue;",5� 5 n - — _ \z w V) � Lu LLJ a TTuILJ° _ TITLE: WEST ELEVATIONEAST ELEVATION- _ .. �/t a•-t'-o• EXl /ie•-+.o- EXISTING FIRST FLOOR PLAN PLANS & ELEV E AREA CALCULATIONS: MAIN FLR PLAN: 1680 SQFT �t.0 " 2ND FLR PLAN: 554 SQFT "o^t TOTAL: 2234 SQFT ==m M GARAGE: 342 SQFT O C" I N - I Z.w z _ I sue. e u d �E F Vo F € V F _ F SECOND FLOOR PLAN — — -- — — — EXi �/ta•-r-o• -_ _ _ G DATE: _ ,:t -ah —r—' '--•-i-=�� - t..-s'' .�-a�'',�ti X� �, s'� PERMIT: 11.10.2017 SOUTH ELEVATION �S- ��1 NORTH ELEVATION EX1 Exi >/+a•-+'--a- PERMIT SET t, z Lu O p p cj� ¢ z0 = � ¢ U �_ 2 ¢ m Lu O wJ V) 2 Q W Lu [r � ¢ coMo , nP�,Eoan..,s sEEE��<nw } ; } TITLE: _-- Rwa I FRAMING ,I PLANS /71 Elilllll ,. Lit li// ��I 4 --- I o o I oa oa of O oa WaNan� 3 �//�/�i� aooEi00aua w�540PE I .I I I s� _ - -- yI,,,w•eo. E,00bos.e,Io /lifi® iirs `I _ -- J a. Z i I7 E e= — J—E p " r Lu t iil .i it I I dt - DATE: PERMIT: 11.27.2017 �1 ROOF FRAMING PLAN FLOOR FRAMING PLAN _ [a1 1ST FLOOR FRAMING PLAN NOTES 1.DIMENSIONS ARE TO CENTERLINE OF INTERIOR WALLS AND OUTSIDE FACE OF STUD OF EXTERIOR WALLS,UNLESS OTHERWISE NOTED. 2.CONTACT ARCHITECT IF THERE ARE ANY DISCREPANCIES IN THE DRAWINGS. 3.ALL NAILING AND CONNECTIONS SHALL BE IN ACCORDANCE WITH WFCM GUIDE TO WOOD FRAME CONSTRUCTION IN11 O MPH ZONE. SEE ATTACHED CHECKLIST FOR SPECIFIC REQUIREMENTS. 4.ALL HEADERS TO BE(3)2X6s UNLESS NOTED OTHERWISE S1 . 1 5..XK,XJ=#OF KING AND JACK STUDS @ OPENING. USE 2K,1J UNLESS NOTED OTHERWISE. PERMIT SET 40 No.---- � _.... Fas..... :....o. THE COMMONWEALTH OF MASSACHUSETTS j1pl )(pq BOARD OF HEALTH 7,ft4✓L........OF........6 ..... ... ApplirFatintt -for Uiiipnittl Works Towitrurtiott Pprinit Application is hereby made for a Permit to Construct ( ) or Repair ( n Individual Sewage Disposal System at: _ °-----...-•------ - ------------------------ �• Locati A r s or Lot No. •. Owner- -•-...Address a -4---•- ---------------------------------------- ----------------•------- ........................................... Installer Address Type of Build Size Lot............................Sq. feet V Dwelling No. of Bedrooms--------------------------------------------Expansion Attic ( ) Garbage Grinder ( ) Other—Type of Building ---------------------------- No. of persons.--------------------------- Showers ( ) — Cafeteria ( ) a' Other fixtures ______ _______________ _ W Design Flow----------------- ............... ......gallons per person per day. Total daily flow........._____..___.__..._.......___.__..___gallons. IY4 Septic Tank—Liquid capacity------------gallons Length................ Width................ Diameter-----........... Depth---------------- Disposal Trench—No- ____________________ Width-------------------- Total Length-------_----------_ Total leaching area--------------------sq. ft. Seepage Pit No_____________________ Diameter.....................Depth below inlet-------------------- Total leaching area------- ----------sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '-, Percolation Test Results Performed by------ ------------------------------------------------------------------- Date.------.---------------------------.... a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water..-.-.---_-----..-._.._. G=, Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water-_---._--_-_-__---..__. a' ------------------------------------- 0 Description of Soil---------------------------------- ' x x ----------------------------------------------------------- V Nature of Repairs or Alterations—Answer when applicable.-'—---� _._. --_-T ------------------------------------------------------------------------------------------------------------------------------------ Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary C — The undersigned further agre s not to place the system in- operation until a Certificate of Compliance has b n is oard Ofelth: jSigne ._.. .. -- ------- --- Date .Application Approved By......... ... . �✓ -- 4Z--- -----7- I�ace A lication Disapproved or the following reasons:--•------------------------------ -----•------------------------------------•------------------- PP PP f f 9 ..---•---•------------------------------------------------------------------------------•---------------•...----------------------------------------- ------ ------------------------------------ -- Date Permit No......................................................... Issued----- . --- � ai ��..�..--- - - ---- - - --- -- - ------------------------------------------ --- ------------------------------- No..... f: Fsic............................ THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH Applirtttion -for Uiipuiittl Workii Cnotwlrurfion Puniit Application is hereby made for a Permit to Construct ( ) or Repair (e) ,an Individual Sewage Disposal System at: C,....._-__-1 _A_ --------•••----•- Locaf efi A r s or Lot No. ----. c.----- -------r-�----",� --- __---------------------------- ________________•-------------•--•---^__---•----_-______--•---•---------•-----•-___________----- ` f Owner Address •---------• ---•-••-••------`...............----------- •------------------------- •---•-:----•-•------•----•----•----•--•-•----•----------•••------••---------------••-••--------- Installer Address d Type of Build ii}� Size Lot____________________________Sq. feet U Dwelling�No. of Bedrooms___________________________________________Expansion Attic ( ) Garbage Grinder ( ) a -Other—Type of Building ____________________________ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) QI Other fixtures ------------- ---- W Design Flow................. __._:_ --------------- per person per day. Total daily flow............................................gallons. 9 Septic Tank—Liquid capacity-_..........gallons Length................ Width......-......... Diameter___-_-_--_____ Depth-_--______-_-_- xDisposal Trench—No_ ____________________ Width....................`Total Length-------------------- Total leaching area....................sq. ft. Seepage Pit No..................... Diameter____________________ Depth below inlet____________________ Total leaching area-__-________.__sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by---- ---------------------------------••---------------------------------- Date------------------------------------ Test Pit No. 1................minutes per inch •Depth of "Pest Pit.................... Depth to ground water:-_______-__-__-__--. rLI Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water_..-_-__-__-___-__-__04 -. le -••---------------=---------------- D Description of Soil--------------------------------- - ''---=--------------------- a U Nature of Repairs or Alterations—Answer when applicable._-`-____'°�__dt__�%::_ _F._� Agreement: The undersigned agrees to install the aforcdescribed Individual Sewage Disposal System in accordance with the provisions of Article XI of the State Sanitary —The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been is board ofe lth 41 Sig;?1 ...... kA Date Application Approved B .: ram`-_• Application Disapproved for the following reasons-................................ --------------------------------------------------'----------------- •••••---•----•---•--------------------•----•-----•---•-------------------------------------------•----------•---•--•----._._.---____•-------------------__...---•-----•-----------------•---....•------- Date PermitNo......................................................... Issued........................................................ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF; HEALTH �.. ee?" ......I........OF..... ,r K-.- ................ Trrtifirtttr of Tompliaure THI TO C ' TIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired by - .....0-,-- ;^ -I.....................- �J }}� Instal f�` V has been installed in accordance with the provisions of Article XI of T to Sanitary Code as descriiW in the application for Disposal Works Construction Permit No------------------- dated----- / f .._.._. .' THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUE© AS A GU RANTEE THAT THE SYSTEM WILL'- FUNCTION SATISFACTORY. DATE............................................................................... Inspector.................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF EALTH 1 '�'' p f,r No..... FEE__ 2......... f Big watt Workli 111ot ion Perg 't Permission is hereby granted -( ) it ( a ndI'dual S' a Dispo2SE yste to Construc or Rat No.-" ---.. �-----� -• ----- ----- - •- Cet as shown on the application for Disposal orks Const ruction ,riixit N ;. ated__. .± -�`________ ---- . - .. Board'of HealthN DATE------ - ----- _ . FORM 1255 HOBBS & WARREN. INC.: PUBLISHERS ................... ........................................... ........................... r. ...............- ...................................... . .......... 00 .......... ................... .................. 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N www.a3architecu BLYTHE & RICHARD EVANSinc.com � NO„Iz OFW NG[S TGH6 PE „• 134 EAST BAY ROAD TI IIS DRAWING 6711E PROPERTY OFT)If.1RQ IFRLT i[AS OEflV PREPARED SI'E(7flQ11\'FOR TI If N OWNER FOR ECT PO A3 A AT THIS SITE AND 6 NOT TO RE USED 1YFFHOIR WRITTEN CONSCNT OF OSTE RVI LLE M A THE ARCHITECT O A3 ARG}IFfECF�MC 2017 V ' is I tI: �Z in D� m ~V pp.•• A r m s55 O m D 3va 0 o O p mo Sm p O� V Z. S a m O m piD � Dpq IA� 41I�yil r0 yy gmy J f/1 �-1f mN �3 �ZD D AA � AO p� G)2R! m Zn O X. \� a o" q z f. 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Q - m fa Np _ .. i bo , f 3 - S3SKJNOOFI S3S7JN008 ,.. ..F . �._ • `� 3 r-{r 831 Main Street r r m in A RENOVATION FOR: Dennis MA `` Residential Commercial Net Zero 508.694.7887 phone Z N www.a3architectsint.com to BLYTHE & RICHARD EVANS µ TH5DRAF`°"""� 134 EAST BAY ROAD N OW DRAWING 6 THE ECr AT OF THE AND NOT HAS BEEN PREPARED SPEm•mEN FOR N OWNER FOR THIS Pc A3 A AT THIS SIINAND¢NOT TO BE ILSEO WRHOUF WM-IIN CONSENT OF - - ' �"° ` °�ARIN°z°" OSTERVILLE MA i I ZONE: . ._ RF-1 b Area (min.) 43,560 SF t ALLOWABLE FLOW SEPTIC NOTES Frontage (min) 20' .. Width min 125 Lot Area=34,488 SF � ,. 1.Location of Utilities Shown on This Plan Are Approx.At Least 72 Hours TEST HOLE EL.15.2 Setbacks: 330 GPD Approved Prior to An Excavation For This Project the Contractor Shall Make �1 1 •• ;,. .j ,. ,: ..,g 344 GPD Allowed y Front 30 the Required Notifications to Dig Safe(1-888-344-7233)and contact LOAM Side 15' Sullivan'En ' eerie &Consulting Inca 508-428-3344. . g 8 ( ) 17° 13s •yet Rear 15' 440 GPD Proposed- Town of Barnstable 360-45(Saltwater Estuaries)Waiver Required 2.The Contractor is Required to Secure Appropriate Permits From Town Agencies For Construction Defined by This Plan. FILL.1 e °{ �; ' a:• q..fix 660 GPD(WI NITROGEN CREDIT x 34 488 SF/40,000 SF=569 GPD 3.Wherever Sewer Lines Must Cross Water Su lv Lines Both Lines Shall 1, (�' ) PP. 39 .......... 11.9 Be Constructed of Class 150 Pressure Pipe and Shall be Water Tested to B.LAYER MR S/6.. ' . Assure Watertightness. In General,Water Lines Shall be Constructed in YE>LOWI$H BRQWN DESIGN DATA Coordination With COMM Water,and Shall be in Accordance 6 " p LOAMYSAIVD �1)L ROp yr ;� With 248 CMIt 1.00-7.00&310 CMIR 15.00. C LAYER 2.5Y 6/4 ED 1 I I, Single Family 1�I OS 4 Bedroom 110 GPD „ e S �° 4.AMinimum of of Cover is Required for All Components. LIGHT YELLOWISHBROWN No Garbage Grinder g 5.All Structures Buried Three Feet or More or Subject. MED SAND Total Daily Flow=440 GPD to Vehicular Traffic to be H-20 Loading.It is the Engineer's Use a 1500 Gal Septic Tank Recommendation that H-20 Always be Used. ` 6.Install Watertight Risers and Covers to Within 6 ofFinished Grade 3 5 _ .. � " 144 AEI .2 RA-0 gi LEACHING AREA Over septic Tank lnle4 D-sox,and one Leaching Chamber. f: 440 GPD/0.74(LTAR)=595 SF Required All covers are to be maximum 18"for concrete or 24"Cast Iron. B VW Flagged b ENSR L OCA T�ON MA'P. Sidewall=2(12'40"+32'-6")2'=181 SF 7.Septic System to be Installed in Accordance With 310 CAR 15.00& I I� RA-04 / as shown on Bottom Area=02'40"x 32'-6")=416 SF 248 CAR 1.00-7.00 Latest Revision and the Town ofBanvstable o Proposed Boardwalk Plan 1 =2,OOOf Total Provided=597 SF Board of Health Regulations. �111 �I l I' o / / 3113120008. /'� 9.All Piping Shall be Sca Minimum Inside Dimension RA-03 REFERENCES. P g F / cb/dh LEACHING CHAMBER DESIGN n of 12",and a Minimum �11 i, fnd All Pipes to be Schedule 40. Use Sump of6". / n .7. . Deed: C 213147 ASSESSORS REF.: Plan: LCP 16265-A Lot 2 3-500 Gal.Leaching Chambers in a t �iaw - 13 e Map 140 Parcel 164 ,111; 12'40"x 32'4"Double Washed Stone Field as Shown. RA-02 �EIeJ 12 OVERLAY DISTRICT.- Finish Grade -J �..� I AP - Aquifer Protection District 3' Max. E .__ 9" lu Min - Compacted Fill Filter RA-01 - "'` 100,Remnant FLOOD ZONE. � Fabric �._. . And/Or Foundation >✓ �i Zone AE Elev. 13, AE Elev 12, 2" 1/8„ - _ �� X (0.2% Annual Chance) &X Mina Flood Hazard Pea Stone ,r - __ �' - � 3' 314" - 1 112 r' _ f ( ) LEACHING Double Washed `� _. _ _. / / '%��e Community Panel No. CHAMBER Stone _ f'10 ° - #250001 0544 'J own ,•J{{et �, July 16, 2014 CROSS SECTION OF CHAMBER Utility�' .�. Lawrence A. Bianchi •• y DIRECTIONS: NOT TO SCALE � ., ` -. , _ _ .9-- Poie From Hyannis - Follow Main Street to the West End Rotary; Take third exit onto Scudder Ave. 100' Buffer to ---------- of <►..: _ [ _ ._._ ._. `�- _ _ Turn right onto smith street at the stop sign. � To nBank - � .T 1z�1n_S ate Bak Continue on to Croigville Beach Road and left -- _---- '•'�''"' i -- onto South Main Street. Continue over the 0.0' �`% Rood. to O sse odic, and onto East Ba �' g y � # 1 Provide 2DD' O�O 6co X Clean Out (YP) W h' Lawn O. y See Note 6 t EL. 15.0 F.G. EL. 15.00 N fy p Existing Se N cn L� � b w per as built co < ,1 TO'-BE�ABAN N D Flow Equilizers L P W o O N EL. 13.5 f As Required m ROl//DE S/L T / 100.0' OR R�1Gt0 ED N r.,,r Gravel / 0 o 7co ConfirmInstal PriorPor er To EL 1 0 1500 G lion Z RE oCATEO FjCF FOR To Any Work Septic ark EL. 12.25 T� EL. 12.25 S SE -St-' _ OF W PRO Drive /N /T 1 / d A on O .... l//D cV T atio ( ADD/T/p NAGe ( FAST DETAIL) (�-Box EL. 11.58 ll( y P e Rf1 FOR E ORA/ i 11.25 & R/NS y PA T/ i 2 Leaching R OV pR E�rAT/O To Be Installed On Chamber OPOSED N Stable Compactedase Bedding,.,T,.S n/f. U EPA no e( Inspection Port, if Er Countered 1�ertiove c RepLoCe.; Nancy B Samoan Trustee 1 x. 'patio J{{ o0t & Boffels At. Unsu,tcibie sous :kVitnm 120 East Bay Realty Trust PR as Per Title 5 '� SE The Owter Penmater of Tne System._ !! �R\"Z EL. 3.8 + #134 Groundwater l Per Monitoring Well 1� Sty w/f P PROFILE FIL F SYSTEM P P Dwellin DEVELOPED O E O S S ° OPos PRO Dwelling ,, 15 MITIGATION CALCS. PROPOSED D_BOX D �U4 BENCH M 0-50' Buffer: NOT TO SCALE 3,, O oPos x 1 s. i 1 I ENT e oPos /\NK \ �� \ Patio To Be Removed = -51 SF 50-100' Buffer: a= ROPOSE Patio To Be Removed - -326 SF ----- - - DD/r/ON �M� F,1,7 Cho 200' Buffet River Driveway To Be Removed = -159 SF aZo�e J Proposed Patio = 518 SF Proposed Addition = 33 SF t : N ' _ a) ^ ` Conservation Total = +66 SF NOTES M N ROP Extent. °f Jurisdiction I.t MIN MIN Openin for FAST T-13>ower piping to FAST®may not exceed 100 FT 30.5m total T SA. / omm�ss'on State Bank Mitigation module fo sit on tank length and ue 4 elbows maximum.For distances greater than S 42 / 32' 0' Buffer to LEGEND: 100 FT[305m]-consult factory.Blower must be located above g cb�d ht:, ° ' /oog RE / t (4)(-51 SF) + (3)(66 SF) _ -6 SF CDT Cedar Tree A Gallon flood/standing water levels on a concrete base. E F. Settling 2. Vent to be located above finish rade or higher to avoid ° Gravel HT Holly Tree Zone m � g � ropose infiltration.Cap with vent grate with at least `V2 sq ln.of open E e of Drive Drive »-c, w2 wt MIN MIN surface area.Secure with stainless steel screws see sheet 3 of 73f. 9 a DT Deciduous Tree cc 3 FAST Details.)_L2 or t 0 See Note 4- �� B Gallon Run vent to desired location and cover opening with vent 4o,w h X „ CT Coniferous Tree - - -11 grate with at least V2 sq in.of open surface area.Secure with Utl ity stainless steel screws.Vent piping must not allow excess le �� Utility Pole moisture build up or back pressure. s - ' sb/dh -E- Electric All tank penetrations 3. All appurtenances to FAST®(e.g.tank pumpouts,etc.)must ' fnd -G- Gas t�� 9e o .._.-'� ectrical conduit from blower must be water conform to all country,state,province;and local plumbing Edge of P �J ave� �' l> Wetland Flag control system steno flog r/blower lonupP�on/Pump tight and electrical codes.The blower control system Is provided by aye f --4d' lyde /gD �/ Light Post seer note 3,5,&6 6"0 115] Bio-Microbics,Inc. Q�(/ Inspection 4. Either the influent pipe tee shall be fitted with a pipe cap or the El CB/DH Port;%ntsee p p P p p 4646 OHW- Overhead Wires note 2,5,&6 baffle separating the two zones shall be extended to the to of N 3�• the tank.if choosingto use the pipe car;drill a 1/4" 0.6cmJp 2S, 4D 25 Elevation Contour v10 e N MIN vent vent hole in the ca and the'bffle shall be at least 3'[8]higher ti "W pipe see Note 2 a 6 than the water level as shown on the drawing. 5. r� p parts must be secured to or �ttl,�. Joints must be All inspection,viewing pump out �qs water tight prevent accidental or unauthorized access 6. Tank,anchors,piping,conduit,blower housing pad and vents Jo DEA �� T MIN 0 7 MAX See 3/16[43.61 M see note 8 are provided by others. C'In II_ [5cm MIN]0 7. All piping and ancillaryry equipment installed after FASTS must t rs Plower not impede or restrict free flow of effluent. �� 2 p 6 1/2[16.31 See Noe 1 8. No more than 4 FT[1.2 m]of fill maybe placed over unit lid. a me 90 p CA° 51/8±1/8[38.4±0. Refer to installation manual for more details. s I0 lEjt . e,�„• 9. See sheet 3 of 4 for required dimensions. Influent New Septic 03107118 See Note 15[38]MIN REV.: Repair Septic 112108117 NOTES: PREPARED FOR: PREPARED BY. TITLE: ; Settling 1 3/16[104.6]MIN Site Plan Zone Richard H. Evans & 2315/16[60.8 M N • •1 1.) This plan is for permitting purposes only. ProposedIm s Improvements �[10 Blythe 0. Evans Trustees Engineering 81 p I See note 3 [� 2.) The property line information shown hereon was UA Treatment 915/16 25 MIN FAST compiled from available record information. Richard Hunt Evans and " Con,sultin � lnC. /y Zone [ 1 �effluent see note 7 3.) The topography shown is from an on the ground Blythe OWnes Evans Trust (508)428-3344 • P.O. Box 659 7 Parker Road,Osterville,MA 02655 I -4 East Bev Roar T� survey performed In September 2017. The datum i J sec[Qsulllvanengincom wwwsullivanengin.com Mass.used is NAVD 88 per RTx bench mark. Gams. abl VQ (Osterville)FAST DETAILW NOT TO SCALE 20 0 10 20 40 80 Draft: CTR Field: W Review: JOD _ Comp.: DATE: November 3, 2017 SCALE: 1 rr_20r cr) Project: 37010 Project