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0080 EVANS STREET - Health
. a . ° 80' Evans Street ° a L86 Osterville . ° A ° ° ^ ° ° u 0 a ° ° ^ TOWN OF BARNSTABLE — UNDERGROUND FUEL AND CHEMICAL STORAGE REGISTRATION MAP NO. PARCEL NO. 6 ADDRESS OF TANK: V I LLAGE: Numbdwr MAILING ADDRESS ( IF DIFFERENT FROM ABOVE ) : OWNER NAME: ' 4 `'' PHONE: INSTALLATION DATE: BY:, INSTALLER ADDRESS: - CERT.NO. *TANK LOCATION: r / '"r� 1, �� w • r ,et'. f+'. d _ � ; (Cl�CRiat TANK LOCATION WITH PItSPiCT TO HU2LDSN0) CAPACITY TYPE OF TANK AGE YRS. FUEL/CHEMICAL TESTING CERTIFICATION [ ] PASS [ ] FAIL DATE t t LEAK DETECTION [ ] CHECK IF N/A TYPE/BRAND ZONE OF CONTRIBUTION [ ] YES [ NO DATE TO BE REMOVED FIRE DEPT. PERMIT ISSUED [ ] YES [ ] NO DATE CONSERVATION [ ] CHECK IF N/A DATE HOARD OF HEALTH TAG N0. [ ] DATE + PLEASE PROVIDE A SKETCH SHOWING THE TANK LOCATION ON THE BACK OF THIS CARD sc���� o�L � Tk � �—..:., � ����`f � �°°� No. / Fee ' HE COMMONWEALTH OF MASSACHUSETTS Entered in computer: Yes PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS 21pplitation for Misposal *pBtem Construction permit Application for a Permit to Construct( ) Repair( ) Upgrade(✓j Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No. 60 EW43 ST• Owner's Name,Address,and Tel.No. (1'91) 310- I b75 051TE dILL.E, NSA Oa*0-0+ 13AM74 W1.1-0 Assessor's Map/Parcel I AJ2. 5D SPUNPar-S AD., NoltwDcO MR 07-002 Installer's Name,Address and Tel.No. (sps) 341 it- 1911 Designer's Name,Address,and Tel.No. (sas) 3t02-4 SAP C,C.. CDNStR,umoni, INC. 'powW"O 0QCj1W61un9,MnC-.-- "DAW18L_ QsAt • s- D)Rt- oNDS PA-rH s.DENN1S' AA IqM µk,Nsr PaIPT, MA 07-015- Type of Building: Dwelling No.of Bedrooms Lot Size 3`t ��ES sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) gpd Design flow provided gpd. Plan Date Number of sheets 1 Revision Date 0 Title 51TV Pj*N - ID a✓ANs sr. Size of Septic Tank I,500 Ca'AUA3! Type of S.A.S. 600 (A-I I,CW LM&4 C4+Af tg�, Description of Soil NIA- Nature of Repairs orAlterations(Answer when applicable) 1 ee&04 VW 0& P-6eLAZ6(QW' wt-k-bt N6W GVen L--r*UfG 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 Certificate of Compliance has been issued by this Boa f Heal /-7*-.$i-gned Date Application Approved b Af A 1A11 iLb t DateAow Application Disapproved by Y Date for the following reasons Permit No. Date Issued No. A Feel/ HE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Yes 01pplitation for Disposal 6pstem Construction Permit t Application for a Permit to Construct( ) Repair( ) Upgrade(+j Abandon( ) ❑Complete System ❑Individual Components Location Address or Lot No.6!0 EVA N S ST. - Owner's Name,Address,and Tel.No. ('I°y) 3s'0- I l0`7 MA G.pwrku�+ i3vcr,p�} �vpl Assessor's Map/Parcel 2 5U Situ v PE VS x D, i4 U u wcwr.> MA 07 oto.Z Installer's Name,Address,and Tel No. (15r,S) 31:P3-- '4 f Designer's Name,Address,and Tel.No. ("'t`-0 - r. � 'SjP?llC*iLhl, i1ti;(- E �wUpJC'�l!)c L-NCJJNe: Vi.,j xoL.- 'DA"imi- (.')At,A 15 DI ND< ?A-i-H S. OCi\IOA" Nam- L.Z ST (+7twA ) /AV1L((tiTH etltf, XVI 6)24t757 Type of Building: Dwelling No.of Bedrooms w Lot Size '` AC.k e sq.ft. Garbage Grinder( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) ^I- gpd Design flow provided gpd t Plan Date -3 11• ! .2 y i Number of sheets 1 Revision Date Title Irl pl/-i w - 90 C4Ai�,1; ST• Size of Septic Tank 1.`�VG' Cr?A-L Lx Type of S.A.S. '500 Ct 6 Description of Soil !v/A � Nature of Repairs or Alterations(Answer when applicable) (It L' e'A-- o o mZ ( C A/1 t it t ty c um � r L 171 U k ' s ate last inspected: 4greement: . The undersigned agrees td.ensur the construction and maintenance of the afore described on-site sewage disposal'system in may.. ._ , w, accofdance with the provisions of Title 5 of the Environmental Code and,not to place the system in operation until a Certificate of Compliance has been issued liy this Boa 'ilIea 1 ' Signed ". :. DateON- ! ! Application Approved b ,r n / Date A A lication Disa roved b !U Date PP PP Y r for the following reasons Permit No. Date Issued J ' _ - - --- ----- - --- ----- -- - - - - -- - -------------- ----------------- THE COMMONWEALTH OF MASSACHUSETTS j. 0 BARNSTABLE,MASSACHUSETTS Nq Certificate of Compliance , TFUS IS TO CERTIFY,that the On-site Sewage Dis osall'syste Constructs (� ) Repaired( ) Upgraded(. Abandoned( )by t , 0 �. / 1 a. 1 I/rh , � x at --� ._.�� _ ._, i //f 1 "'has been construct d in cordance _ with the provisions of Title 5 and the for Disposal System Construction Permit No. dated Installer Designer 4sw #`bedrooms Approved design fi`oow gpd The issuance of this permit shall nbt be construed as a guarantee that the system will functio, a$d8 igned. Date Ins ector ' . --------------------- I---------.-_-.------ No 4n Fee THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION- BARNSTABLE,MASSACHUSETTS Disposal *pstrm Construction Permit Permission is hereby granted to Construct( ) Repair,� ) Upgrade( ) � Abandon System located at and as described in the above Application for Disposal System Construction Permit. The applicant recognized his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction b t b . J eted within three years of the date of this permit. Date Approved b r "} Town of Barnstable O�THERegulatory Services Y . Thom-as F. Geiler,Director AUS& ®� Public Health Division 1659. q� Thomas McKean,Director 20O.Main Street,Hyannis,MA 02607E Office: 508-862-4644 Fax: 508-790-6304 Installer&Desigger Certification]Form Date:. a a) Sewage Permit# J1 o 2 0 z't- Assessor's MapWarcel �a Designer:' bow r\ C:6ee cn lecrl Installer: CC Address: 7,31 N, r• St Address: i S y r 4-t 0-t bJ PTry. On -t 15-l Z- �-�'"'I sT�vu,�^? j,/L was issued a permit to install a (date) (installer) septic system at FS O EVAYW St- based on a design drawn by (address) �anI 0`0,14. ICE .Alm dated 7— 7- / 11 esigaer) certify that the septic system referenced above was installed substantially according to the design, which may include.minor approved changes such as lateral relocation of the distribution box and/or septic tank. I certify that the septic system referenced above was installed with major.changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance with State&Local Regulations. Plan revision or certified as-built b esigner to follow. OF t er s Signaturey \. n APNE H. ,^ ,. g OJALA _,.. cg CIVIL ��f'` No. 30792 f" L c (Desi er's Signature) (Affix t �rV tamp Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH IDMSION CERTMCA.TE OF CQWLL4NCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS-IBUJILT CARD ARE RECEM D BY THE BARNSTA.BLE PUBLIC HEALTH DIVISION THANK YOU Q:Health/Septic/Designer Certification Form 3-26-04.doc TOWN OF BARNSTABLE toC ION 796 SEWAGE# ZX6-l1(c VILLAGE �ASSESSOR'S MAP&PARCEL )k(-L 6'9(® INSTALLERS NAME&PHONE NO. 6tiL S1fjF LS NO176-16sy SEPTIC TANK CAPACITY i T6 O LEACHING FACILITY.(type) C6.6, SDe%1 (size) -NO. OF BEDROOMS OWNER pej Nil Alwtpp PERMIT DATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility{If any wetlands exist within 300 feet of leadin g facility Feet FURNISHED BY ,� S,. Aliz 14 tf H7 ' � ° ;32 Ay; y3° CS: 20' D.5:!o® l 4 I / C(o_ 32 , .Town 'of Barnstable Regulatory Services Thomas F. Geiler,Director KAS& ' Public Health Division , s Thomas McKean,Director 200 Main Street, Hyannis;MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: 4' Sewage Permit# (�76'1,1 Assessor's Map/Parcel 40 NZ 0 Fb Installer& Designer Certification Form Designer: f E. IT�CrIv�t ,� �, S, Installer: 1C i STFc ,u� Address: L L&nt %,i Lit H e Address: 1 lot�`l _©uw ft�6 Z,IMIA-AA p►. 6Z6$ On 2 cc C(_ , was issued a permit to install a dat installer septic system at f?o E'& ..rhY e4 OJ-'r'v+Ile- based on a design drawn by (address) ti,, f1m/'y-i sl kv vi 12.S, dated / (designer V I certify that the septic system referenced above was installed substantially according to the design, which may include minor approved changes such as lateral'relocation of the distribution box and/or'septic tank. Stripout (if required) was inspected and.the soils were found satisfactory. I certify that the septic system referenced above was installed with major changes (i.e. greater than 10' lateral relocation of the SAS or any vertical relocation of any component of the septic system) but in accordance.with State & Local Regulations. Plan revision or certified as-built by designer to follow. Stripout (if require ted and the soils were found satisfactory. ����o� �s�q ER RRI Co - nstaller' ignature) 0. 70 Gm C, ! A C� (Designer's ign re) (Affix Desigh6fV9 p Here) PLEASE RETURN TO BARNSTABLE PUBLIC HEALTH DIVISION. -CERTIFICATE OF COMPLIANCE WILL NOT BE ISSUED UNTIL BOTH THIS FORM AND AS- BUILT CARD ARE RECEIVED BY THE BARNSTABLE PUBLIC HEALTH DIVISION.' THANK YOU. gaoffice formsWesignercertification form.doc I IA f ti 1A, �( IWO Otl i-,) ..— 9 ko I Ul Commonwealth of Massachusetts Title 3 Official inspection Form- Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 80 EVANS ST Property Address ELAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. City/Town State Zip Code Date of Inspection Inspection results must be submitted on this form. Inspection forms may not be altered in any way. Please see completeness checklist at the end of the form. When filling out A.WhGeneral Information, When forms on the I - computer,use 1. Inspector: only the tab key "`,,,•••«<"' to move your. DOUGLAS A.BROWN cursor-do not use the return Name of Inspector key. DOUGLAS A BROWN_ INC Company Name r� P.O. BOX 145 --� Company Address CENTERVILLE MA ' ' City/Town 02632 State Zip.Code 508-420-4534 S14297 ..:, Telephone Number ,y License Number B. Certification 1 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 Inspector's Signature . 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.. t5ins•09/138 r Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 1 of 17 r /� •w 4 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments �p ® 00 EVANS S T Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is required for OSTERVILLE MA every page. Cltyfrown 3/30 11 State Zip Code Date of Inspection Be Certification (cant.) Inspection Summary: Check A,B,C,D or E/always complete all of Section D A) System Passes: ® 1 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 indicated below. Comments: LEACH CHAMBERS ARE DRY AT THIS TIME WITH NO SIGNS OF HYDRAULIC FAILURE I. 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.. Check the box for"yes", "no"or"not determined"(Y, N, ND)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. ❑ Y ❑ N ❑ ND(Explain below): t5ins•09 D8 Title 5 Official Inspection form:Subsurface Sewage Disposal System-Page 2 of 17 . f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments v r< 80EVANS ST Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. Cityfrown State Zip Code Date of Inspection B. Certification (cont.) B) System Conditionally Passes(cont.): ❑ 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 ❑ Y ❑ N -1 ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): ❑ distribution box is leveled or replaced ❑ Y ❑ N ❑ ND(Explain below): ❑ 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 ❑ Y ❑ N ❑ ND(Explain below): ❑ obstruction is removed ❑ Y ❑ N ❑ ND(Explain below): 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 t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 3 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 80 EVANS ST Properly Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. Cdyrrown State Zip Code Date of Inspection B. Certification (font.) 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. ❑ 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: 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 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 4 of 17 r J Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 80 EVANS ST Properly Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. City/Town State Zip Code Date of Inspection B. Certification (Cont.) Yes No EJ ® 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. ❑ ® 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 wellwith 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 10,00o 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 If 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. is�,s•„moo Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 5 of 17 1 Commonwealth of Massachusetts T Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< 80 EVANS ST Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. 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)] D. System Information Residential Flow Conditions: Number of bedrooms(design): 6_ Number of bedrooms(actual): 6 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 660 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 6 of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments '< 80 EVANS ST Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. Cltyrrown State Zip Code Date of Inspection D. System Information Description: ACCORDING TO AS BUILT CARD SYSTEM CONSISTS OF A 1500 GALLON TANK D-BOX AND5 500 GALLON CHAMBERS SURROUNDED WITH STONE 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)): 09-288/10-373 Detail: Sump pump? ❑ Yes ❑ No Last date of occupancy: 2010 Date Commercial/Industrial Flow Conditions: Type of Establishment: 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: l5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 7 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments M a 80 EVANS ST Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. Cltyffown State Zip Code Date of Inspection D. System Information (cont.) Last date of occupancy/use: Date Other(describe below): General Information Pumping Records: Source of information: 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): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 8 of 17 Commonwealth of Massachusetts W Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 80 EVANS ST Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. City/Town State Zip Code Date of Inspection D. Svstem Information icont.) Approximate age of all components, date installed(if known) and source of information: ACCORDING TO AS-BUILT SYSTEM INSTALLED IN MARCH OF 2008 Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: feet Material of construction: ❑cast iron ❑40 PVC ❑other(explain): Distance from private water supply well or suction line: feet Comments(on condition of joints,venting, evidence of leakage, etc.): Septic Tank(locate on site plan): Depth below grade: feet Material of construction: ® concrete ❑ metal ❑fiberglass ❑ polyethylene y ❑other(explain) If tank is metal, list age: years Is age confirmed by a Certificate of Compliance?(attach a copy of certificate) ❑ Yes ❑ No Dimensions: 1500 Sludge depth: VARYING/LIGHT t5ins•09108 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 9 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments j" 30 EVANS ST Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. Clty(rown State Zip Code Date of Inspection D. System Information (cont.) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle Scum thickness 0 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle How were dimensions determined? Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): WOODEN POLE Grease Trap(locate on site plan): Depth below grade: feet Material of construction: ❑concrete ❑ metal ❑fiberglass ❑polyethylene ❑ other(explain): 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 t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 10 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments f 80 EVANS S T Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. City/Town 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.): 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 El other(explain): 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.): *Attach copy of current pumping contract(required). Is copy attached? ❑ Yes ❑ No t5ins•09108 Title 5 Official Inspection Forth:Subsurface Sewage Dis Pec g posal System•Page 11 of 17 i I Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 80 EVANS ST Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is required for OSTERVILLE MA 3/30 11 every page. City/Town State Zip Code Date of Inspection D. System Information (cont.) Distribution Box(if present must be opened)(locate on site plan): Depth of liquid level above outlet invert 0.1 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.): BOX LEVEL NO LEAKAGE Pump Chamber(locate on site plan): Pumps in working order: ❑ Yes ❑ No Alarms in working order: ❑ Yes ❑ No Comments(note condition of pump chamber, condition of pumps and appurtenances, etc.): Soil Absorption System(SAS)(locate on site plan, excavation not required): If SAS not located, explain why: t5ins•09/08 Title 5 Official Insp ection Form:Subsurface Sewage Disposal System•Page 12 of 17 µ Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments rY 80 EVANS ST Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA every page. City/Town 3l30 11 State Zip Code Date of Inspection D. System Information (cont.) Type: ❑ leaching pits number: ® leaching chambers number: 5 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: ❑ overflow cesspool number: ❑ innovative/altemative system Type/name of technology: Comments(note condition of soil, signs of hydraulic failure, level of ponding, damp soil, condition of vegetation, etc.): CHAMBERS WERE DRY WITH NO SIGNS OF LEAKAGE 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 t5ins-09108 ' Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 13 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments Y 80 EVANS S T Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. City/Town State Zip Code Date of Inspection D. System Information (cunt.) 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.): t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Page 14 of 17 r Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 't 80 EVANS S I Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont.) Sketch Of Sewage Disposal System: Provide a view 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. Check one of the boxes below: ❑ hand-sketch in the area below ® drawing attached separately t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15of 17 f Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 80^EVANS ST Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. Cltyrrown State Zip Code Date of Inspection D. System Information (cons:) Site Exam: ® Check Slope „ ® Surface water ® Check cellar ® Shallow wells Estimated depth to high ground water: GREATER THAN 10 FT feet Please indicate all methods used to determine the high ground water elevation: ® Obtained from system design plans on record If checked, date of design plan reviewed: 3/2011 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: Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5ins•09/08 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 16 of 17 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments rjt SO EVANS ST Property Address BLAGDEN REALTY TRUST Owner Owner's Name information is OSTERVILLE required for MA 3/30 11 every page. City/Town State Zip Code Date of Inspection E. Deport Completeness Checklist ® Inspection Summary:A, B, C, D, or E checked ® Inspection Summary D(System Failure Criteria Applicable to All Systems) completed ® System Information—Estimated depth to high groundwater. ® Sketch of Sewage Disposal System either drawn on page 15 or attached in separate file t5ins•09I08 TRIe 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 17 of 17 i� . New�Page 1 .— 0N I.ed f7 t-ivsk Page 1 of 1 TOWN OYDARNSTABLE %OCA TON .t� Z►riw� �j�. SEWAGE,# VILLAGE ti_ � ASSESSOR'S MAP&.PARCEL ja[Z- b$(o INSTALLERS NAME&PHONE NO. 94 Sir WS /'59) 7760 46sti SEPTIC TANK CAPACITY /D o LEACHING FACILITY.(type)��sl�.s -TO m.J �S i {size} NO.OF BEDROOMS OWNER PERMIT DATE. COMPLIANCE DATE: 3I�z25�f{ Separation Distance Between the: Maximum Adjusted Cnoundwater Table to the Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and-Leaching Facility(If any wetlands exist within 300 feet of leas g facility)17 Feet FURNISHED BY ;i �1 = 1 c .3z ' CS 2c1' �S'. y4 ' At. j http://www.town.barnstable.ma.us/assessing/2011/HMdisplay.as `?mappar--142086&seq=1 3/31/2011 r /p'pTHE'Tp�\ 'own of Barnstable Barnstable i AII-America city �nA S ,ut.e. +. + Board of Health q. i6;9/�i ArFD MA'S A/ 200 Main Street, Hyannis MA 02601 2007 Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Jwiiclii Sawayanagi April 29, 2008 Mr. Glen Harrington, R.S. 9 Leda Rose Lane Marstons Mills, MA 02648 RE: 80 Evans Street, Osterville A= 142-086 Dear Mr. Harrington, You are granted permission, on behalf of your client, Paul Daupbinee, to construct an onsite sewage disposal system designed to be connected to six bedrooms at 80 Evans Street, Osterville. The septic system shall be constructed in accordance with the submitted plans dated January 15, 2008. Sincer yours, Wayne Mi r, M.D. Chairman BOARD OF HEALTH TOWN OF BARNSTABLE Q:\WPFILES\6BeclroomsFIarrington 90 Evans Ost2008.doc y w I i SF3P��� 1 D ATE: / Q �_ FEE: Eg�ae��.j REC. By .�® ;, own r sta e //f/0 Board Of Health' 2.00 Main Street, Hyannis MBA 02601 Office: 70N,W?-464'4 tittsan(.i.1Zask,R.S. VAX:: i08 7O0 630 t' ,. Suntncr KattEnt 3LMl [��J.V�.�. t� l7I'i ' h���i��' Property Address: g'0 diva...o___YkeC if ar -env%Ile Assz 554,i's vlap andParcel �lutnh r: Iy 7 ' 4r(i Size of l,(>l..___. _.._, �_i.7.�/.Z... ..._ Wetlands Within 300 Ft. Yes Business Natit4: !o Subdivision APPLICANT'S NAML- G S oh Phone Dt( t;e.e)wrc r i.l fhs ;c�' 4 rt1 p- p' � e vot.t it)represent him or her? Yes' e�� �authorize PIZO9'€:fEB RY OWNER'S NAME C ONT.ALC"9TEWSON Matl:i: �'r'✓I te'... .y-4%hCC....� i`iattte: (yf4t, Address: t�G�+-�)_ Jfi Add e1p OvI-C C'-t� 1P j 1f/%- A-U _--- Address: Phf�tte: Phone: Z 4 t.ruJ� V,tL 9,4NC E F9CCkM RLC:ULATION tt.t.(t.�t ) €t!?9�aCDN>Ft9[d Vfi�lANC:IE tht attach i f ntorc space ucedcd) � dry, NATURE'OF W"O RK: House Addition l l 9`).'7'7'1House Renovation Repair of Failed Septic System !F ib'Jp �' �'1tC(.}.d�d.4 ft(�h�-?,;'{iP)ljr)l i''i('r,/f)'t ()ffife.S ftf/f-inE'7 son receiving wri(!nce regfest[Lf'plti'G1 ion) ,.,_ rn • ��E'13.51:.Y�136zPa1{.e7FBf .6 XP1�.4'L'�')C?'L'de['rBAIPF�dr�'/Ntd y£'��'. ,'� _...._._ Four(4)copies of[he eontpieted variance request.form. Four(41 copies of engineered plan sntimilted(4:.g septic syst(m plans) _ t'ott� (t1 cc})si. c,i ttah(.I'f{ tin141lSif =:.zl iloc)r t3l�tnti�uhtttitt4,(I(c.i;.house plan~nr r,;5t3utant 6:tkch,.i)ttl,uts) . __. Si n,.d i4,1iet staun6 that the prop f�wnir authorirccl yritr[a represent hitnihrt I'm tIiis request Applicara afluersPullds that the ahuucrs must he notified by certitied mail at least ten days prior to meeting date at applicants cK.pf nsf } (for title V and/or local sewage regulation varian4:es only) — full menu submitted(for grease trap va;lance requests only', rn(A' 'e ct .�4 t'i(' \LOc t Sr, _t-.inyr ,'fulttpU' ,fy Irtt i n.:C ' -- z J-n'Cd Ci--Lf C L . BEDROOM Bath „ study' ', f own BEDRO-OM 3EDRQO i SEC D , EL�OOR L no , state Bath . : � • • _ q , Dining Kitchen MBR Ch Room r down s Stu • d Roos =wing up foyer .a „ . . � + . . , • V . FIR .. ST FLOOR , .- no' scale T • N. A(:e: Ore kfinisheol roar i the: baser�en-t >, fp s r . ., q, ft1 with d ceil'ing .eight of 6 '- 4 Room = is heat-e�ll . TOWN OF BARNSTABLE LOCATION BD EVANS STRUT 0SAU111GGF SEWAGE# _20 T_61 I VILLAGE BhUSTA-61-,6 ASSESSOR'S MAP&PARCEL 531 i936G INSTALLER'S NAME&PHONE NO. C•C LOwSTRt/Grw/, /NG. S08.33 9•/81/ SEPTIC TANK CAPACITY 1500 64U.P?4J LEACHING FACILITY:(type) 6H4k6EX (size) NO.OF BEDROOMS OWNER EAwgab Sc,PLE PERMIT DATE: f t"4-2.y SrN, 2d; COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility A(h Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) AA Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 0 300 feet of aching f cili Feet FURNISHED B /�Illd k J A 31` 3 29` p E.GI� $4- C.0 4006C R9 t3 TAmK VF,%VEWAy DID 1 A No. j 66# 3 ND "'A- D� • -��1 '' S Fee T��COMMO4WEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MIASSACHUSETTS Yes Zipplicactiou for ]Di9;poga1 6pgtem Cou5truction Permit Application for a Permit to Construct( ) Repair( ) Upgrade(V/�Abandon( ) ❑ Complete System ❑Individual Components Location Address or Lot No. $ &V2n6 S7- Owner's Name,Address,and Tel.Noo.pda Assessor's Map/Parcel ,--o Installer's Name,Address,and Tel.No. 1^Rrc, SA'CVVAY*, Designer's Name,Address and Tel.No. P61%;( 7 t s-km ` ASS 64e" q6m' Lek Type of Building: Dwelling No.of Bedrooms Lot Size 12, -79 2 sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) �y(�(, gpd Design flow provided (6 7"7 gpd Plan Date iT �G Number of sheets . Revision Date Title Size of Septic Tank )'Y(Q Type of S.A.S. Seal , Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Environ ental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board ofHluSIC-- SignedDate r?"Z&_021 Application Approved by ? Date 7—® Application Disapproved b Date T for the following reasons Permit No. Olt — Date Issued 7^Gd c.k..a:�...--=ems•.. ;�,.i v+•v. ;i-i :_ .. v..-•+w�y.w-•:... �,: *;-..--.-m-...—••--�...- _ .. _ - _ R v .r,./- '.•�..,.�,., �..-- ,. '..,-'w- 5."'-..- .�:i:::r :.,;•.;.y.:.,T.i .,ds.�.•p.w,w•�-..:K.-�.ar-r. y�,.yaY..� :„�, - ..... - w-r.= stir'-•-..:.,.�yartir^'':.;-^.;. / l No. �� ' 1 N ;<i��/t✓t?�' '✓ " ! / Fee DV v Entered in computer: �THE'COMMONWEALTH O MASSACHUSETTS PUBLIC HEALTH DIVISION PTO..N 'OF BARNSTABLE,,,)OASSACHUSETTS Yes 2pplicatioH for TDisSpo!6Ar`'*p!9tem CoH5truction Permit Application for a Permit to Construct O Repair O Upgrade. Abandon O ❑Complete System ❑Individual Components Location Address or Lot No. gU £V2nS Owner's Name,Address,and Tel.No.po—a ihe� s� Ems .QS�►>,'��� . Assessor's Map/Parcel S�. ��� — � Installer's Name,Address,and Tel.No.IF RN C- `STCVf W4 Designer's Name,Address and Tel.No. PA X "7 l �Aay, tv>,Us 1n A,cczr4v s 3776'9a st G-ler► Ele„�, Type of Building: Dwelling No.of Bedrooms Lot Size 12, •71 Z sq.ft. Garbage Grinder ( ) Other Type of Building No.of Persons Showers( ) Cafeteria( ). Other Fixtures Design Flow(min'.required) 6104a gpd Design flow provided (477 gpd Plan Date I 1 S 1 O Number of sheets Revision Date Title Size of Septic Tank J4S6C_% Type of S.A.S. SOGG�2` Description of Soil Nature of Repairs or Alterations(Answer when applicable) Date last inspected: Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in accordance with the provisions of Title 5 of the Env iron ental Code and not to place the system in operation until a Certificate of Compliance has been issued by this Board of alth. Signed --�-` T• / � Date 3'Z(g-U¢) Application Approved by I „5 rt Date Application Disapproved by` Date for the following reasons A Permit No. Doug- ��[ Date Issued THE COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, MASSACHUSETTS - Certificate of Compliance THIS IS�'O CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired ( ) Upgraded ( ) f Abandoned( )by QtC SMEUFLS at !_A 15er`A\e has been constructed in accordance with'the provisions of Title 5 and the for Disposal System Construction Permit No. C)LLt' ���_ dated 3 Installer (;JZNc SCf''uP-1J Designer 6:1Qt,, -\Z)Ilyl , t?� #bedrooms G Approved des. signflow p� gpd Q The issuance of this permit shagl not -construed as.a guarantee that the system fil f nction as signed. (/ ��� ;Gf/ld Date Inspector , a 1 No. ! Fee THE COMMONWEALTH OF MASSACHUSETTS 7 PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS Oigomt *p5tem Construction permit Permission is hereby granted to Construct O Repair Upgrade) Upgrade (1/ ) Abandon ( ) ¢, System located at 611 aws Sv. and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title 5 and the following local provisions or special conditions. Provided:Construction must be completed within three years of the date 11 of=this p i` Date 2 / r Approved by � Town of Barnstable unxrtsca�ta�. 69. g Regulatory Services Department Public Health Division 200 Main Street, Hyannis MA 02601 Office: 508-862-4644 Thomas F.Geiler,Director FAX: 508-790-6304 Thomas A.McKean,CHO May 5, 2008 Mr. Patrick Paige 1780 Main Street West Barnstable, Massachusetts 02668 Re: 21 Buttonwood Lane West Barnstable, MA Dear Mr. Paige: ' This letter will confirm the results of a discussion that was held on May 2 between Brian Dudley of DEP,myself, Dr. Miller and Tom Geiler. You submitted an application on March 24 asking for a variance from 310 CMR 15.104 to substitute a sieve analysis for percolation tests in the C4 layer of test pit# 6 on your property. Brian Dudley was consulted as to the feasibility of this approach. After our first consultation with Brian and apparently at your request, he asked to meet with us to discuss it and we agreed. The outcome of that discussion was as follows. 1. A certified soil evaluator needs to schedule and perform a second percolation test at the above referenced site in the C2 layer(in undisturbed soil) as per Title V (310 CMR 15.104(4), witnessed by the Board of Health or agent(s) of the Board of Health. 2. If the C2 layer percolates satisfactorily again in a second location, and the Board is satisfied that the C2 and C4 layers are essentially the same, or the Board of Health would have to be satisfied by the soil evaluator that the C4.layer is less restrictive than the C2 layer. 3. If# 1 and 2 above pass, you could proceed with an application fora variance from the. Town of Barnstable Marginal Lot Regulation as if the lot percolated satisfactorily: in other words; you would not need the sieve analysis variance you now have pending. For the Marginal Lot Variance, the Board requires submission of fully designed septic and site plans, designed by-a professional engineer or registered sanitarian, which includes a strip out of the C3 layer. f 4. If the Board of Health grants you the Marginal Lot Variance requested, you can then proceed with an application for a disposal works construction permit for this property. If you wish to undertake this approach,you should have your soil evaluator and/or registered sanitarian contact me to acknowledge and make arrangements. In that event, you would not need to continue seeking the variance for sieve analysis. If you do not wish to take this approach, you could proceed with your sieve analysis variance request, but it appears from all our conversations with Brian Dudley that DEP would not approve such a variance which would make any Board approval moot. Very truly yours, s c ean, R.S., HO Director of Public Health tm/ejw gApaige,button wood\05.02.081tr to paige re septic system.doc _ a � l Certified Mail#7005 1160 0000 0191 2496 ,�srowti Town of Barnstable Regulatory Services + IIAFtNSTAt3LE, 90� nAss. Thomas F. Geiler,Director O i6Sq. ♦� A MAC Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 May 21, 2007 Paul & Patricia Dauphneu 4 Eel River Road Falmouth, MA 02536 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II — MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION AND THE TOWN OF BARNSTABLE CODE CHAPTER 170. The property owned by you located at 80 Evans Street Osterville, was inspected on May 18, 2007 by Meredith Morgan, Health Inspector for the Town of Barnstable. This inspection was conducted on the basis of the rental registration in accordance with Chapter 170 of the Town of Barnstable Code. The following violations of the State Sanitary Code were observed: 105 CMR 410.300 & 310.15—Title V. Six (6) bedrooms observed when record only shows four (4) bedrooms You are directed to correct the violations listed above within thirty (30) days of your receipt of this notice by removing two (2) bedrooms by removing beds and opening room entrance to a minimum of five (5) feet wide; or within two (2) years by pulling permits and upgrading system to satisfy requirements of a six (6) bedroom dwelling. You may request a hearing before the Board of Health if written petition requesting same is received within ten(10) days after the date the order is served. Non-compliance will result in a fine of $100.00 per violation. Each day's failure to comply with an order shall constitute a separate violation. QAOrder letters\Housing violations\Rental ordinance\80 Evans Streekdcc Should you have any questions regarding the above violations,please contact the Town Health Division and ask to speak with the inspector who performed the inspection. PER ORDER OF THE B ARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable Cc: Meredith Morgan, Health Inspector Kevin & Tammy Humphrey, Tenants Q:\Order letters\Housing violations\Rental ordinance\80 Evans Street.doc FORM30 CHW HOBBS&WARREN'M THE COMMONWEALTH OF MASSACHUSETTS �-' BO D OF HE LTH ro Y CITY/TOWN W b 1 D PARTMTT ADDRESS p�M SVBy`ew TELEPHONE Address " y I^ Occupa Floor Apartm�j No. No. of Occu is No.of Habitable Rooms /� No.Sleeping Rooms No.dwelling or rooming units No.Storys Name and address of owner Remarks Reg. Vio. YARD Out Bld s.: Fences: Garbage and Rubbish Containers: Drainage Infestation Rats or other: STRUCTURE EXT. Steps,Stairs, Porches: Dual Egress:and Obst'n.: ❑ B ❑ F ❑ M Doors,Windows: Roof Gutters, Drains: Walls: Foundation: Chimney: BASEMENT Gen.Sanitation: Dampness: Stairs: Li htin : e 1� STRUCTURE INT. Hall,Stairway: Y J Obst'n.: Hall, Floor,Wall,Ceiling: Hall Lighting: Hall Windows: HEATING Chimneys: . Central ❑ Y ❑ N Equip. Repair TYPE: Stacks, Flues,Vents: PLUMBING: Supply Line: ❑ MS ❑ ST ❑ P Waste Line: H.W.Tanks Safety and Vent(s) ELECTRICAL Panels, Meters,Cir.: ❑ 110 ❑ 220 Fusing,Grnd.: AMP: Gen. Cond. Distrib. Box: Gen. Basement Wiring: DWELLING UNIT Ventil. L to . Outlets Walls Ceils. Wind. Doors Floors Locks Kitchen Bathroom Pantry Den Living Room Bedroom 1 Bedroom 2 Bedroom 3 Bedroom 4 Z Hot Water Facil. Sup. en.,Gas, Oil, Elect.: Stacks, Flues,Ve ts,Safeties: Kitchen Facilities Sink Stove Bathing,Toilet Facil. Vent., Plumb.,Sanit'n.: Wash Basin,Shower or Tub: Infestation Rats, Mice, Roaches or Other: Egress Dual and Obst'n: General Building Posted Locks on Doors: ONE OR MORE OF THE VIOLATIONS CHECKED ABOVE IS A CONDITION WHICH MAY MATERIALLY IMPAIR THE HEALTH OR SAFETY AND WELL-BEING OF THE OCCUPANT AS DETERMINED BY 105CMR 410.750 OF THE CODE OR THE AUTHORIZED INSPECTOR.(See Over) "THIS IN P CTI REPORT IS SIGNED AND CERTIFIED UNDER THE PAINS AND PENAL Y " INSPECTOR TITLE Q DATE TIME / " 00 ym-. A.M. THE NEXT SCHEDULED REINSPECTION �4� P.M. f� r . 410.750: Conditions Deemed to Endanger or Impair Health or Safety The following conditions, when found to exist in residential premises, shall be deemed conditions which may endanger or impair the health, or safety and well-being of a person or persons occupying the premises. This listing is composed of those items which are deemed to always have the potential to endanger or materially impair the health or safety, and well-being of the occupants or the public. Because Chapter 11, 105 CMR 410.100 through 410.620 state minimum requirements of fitness for human habitation, any other violation has the potential to fall within this category in•any given specific situation but may not do so in every case and therefore is not included in this listing. Failure to include shall in no way be construed as a determination that other violations or conditions may not be found to fall,within this category. Nor shall failure to include affect the duty of the local health official to order repair or correction of such violation(s) pursuant to 105 CMR 410.830 through 410.833 nor shall failure to include affect the legal obligation of the person to whom the order is issued to comply with such order. (A) Failure to provide a supply of water sufficient in quantity, pressure and temperature, both hot and cold,to meet the ordinary needs of the occupant in accordance with 105 CMR 410.180 and 410.190 for a period of 24 hours or longer. (B) Failure to provide heat as required by 105 CMR 410.201 or improper venting or use of a space heater or water heater as prohibited by 105 CMR 410.200(B) and 410.202. (C) Shutoff and/or failure to restore electricity or gas. (D) Failure to provide the electrical facilities required by 105 CMR 410.250(B), 410.251(A), 410.253 and the lighting in com- mon area required by 105 CMR 410.254. (E) Failure to provide a safe supply of water. (F) Failure to provide a toilet and maintain a sewage disposal system in operable condition as required by 105 CMR 410.150(A)(1)and 410.300. (G) Failure to provide adequate exits, or the obstruction of any exit, passageway or common area caused by any object, including garbage or trash,which prevents egress in case of an emergency 105 CMR 410.450, 410.451 and 410.452. (H) Failure to comply with the security requirements of 105 CMR 410.480(D). r (1) Failure to comply with any provisions of 105 CMR 410.600, 410.601 or 410.602 which results in any accumulation of gar- bage, rubbish, filth or other causes of sickness which may provide a food source or harborage for rodents, insects or other pests. or otherwise contribute to accidents:or to the creation or spread of disease. (J) The presence of leadbased paint on a dwelling or dwelling unit in violation of the Massachusetts Department of Public Health Regulations for Lead Poisoning Prevention and Control, 105 CMR 460.000. (See M.G.L-c.-111 @@ 190 through 199.) (K) Roof,foundation, or other structural defects that may expose the occupant or anyone else to fire, burns, shock, accident or other dangers or impairment to health or safety.• (L) Failure to install electrical, plumbing, heating and gas-burning facilities in accordance with accepted plumbing, heating, gas-fitting and electrical wiring standards or failure to maintain such facilties as are required by 105 CMR 410.351 and 410.352, so as to expose the occupant or anyone else to fire, burns, shock, accident or other danger or impairment to health or safety. (M) Any defect in asbestos material used as insulation or covering on a pipe, boiler or furnace which may result in the release of asbestos dust or which may result in the release of powdered, crumbled or pulverized asbestos material in violation of 105 CMR 410.353. (N) Failure to provide a smoke detector required by 105 CMR 410.482. (0) Any of the following conditions which remain uncorrected for a period of five or more days following the notice to or knowledge of the owner of said condition or conditions: (1) Lack of a kitchen sink of sufficient size and capacity for washing dishes and kitchen utensils or lack of a stove and oven or any defect that renders either inoperable. (2) Failure to provide a washbasin and shower or bathtub as required in 105 CMR 410.150(A)(2) and 410.150(A)(3)or any defect which renders them inoperable. (3) Any defect in the electrical, plumbing or heating system which makes such system or any part thereof in violation of generally accepted plumbing, heating, gasfitting, or electrical wiring standards that do not create an immediate hazard. (4) Failure to maintain a safe handrail or protective railing for every stairway, porch balcony, roof or similar place as required by 105 CMR 410.503(A)and 410.503(B). (5) Failure to eliminate rodents, cockroaches, insect infestations and other pests as required by 105 CMR 410.550. (P) Any other violation of 105 CMR 410.000 not enumerated in 105 CMR 410.750(A)through (0)shall be deemed to be a con- dition which.may endanger or materially impair the health or safety and well-being of an occupant upon the failure of the owner to remedy said condition within the time so ordered by the Board of Health. THE COMMONWEALTH OF MASSACHUSETTS BOAR® OF HEALTH rZ------- ---- ..-1`K!!.........OF..... l....�. ....../-�----------------------------- .� .plirFation for Uiipuaal Works Towitrnrtinn rantit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at: e��s ................. .. d - -•-•--, ------------------------------------------ Loca'o ddress No. ............................................. .P..........._.._--.......................... .................... .. ...................................................... Installer Address Type of Building Size Lot............................Sq. feet U Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pa,, Other—Type of Building ............................ No. of persons.....................--.--.. Showers ( ) — Cafeteria ( ) a' Other fixtures ---------------------------••-- - Design Flow.............................................gallons per person per day. Total daily flow............................................gallons. W W Septic Tank—Liquid*capacity............gallons Length................ Width................ Diameter................ Depth............ " x 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........................................ aTest Pit No. 1................minutes per inch Depth of Test Pit---................. Depth to ground water.......--............--. -. (i Test Pit No. 2................minutes per inch Depth of Test Pit-----------------... Depth to ground water........................ •---•---•--------------- ------------- -............ ---.-------------------------------- ------- -------------------- ....... ---------------- •----- o Description of Soil f '?... ----------------•---••------------ ---------•---------------------------------- ^ x ._ UNature of Repairs or Alterations—Answer when p ble-----_/�-s-«-��--._--° ��®� L oLe Agreement The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with- the provisions of iITILL 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of CompliISigned has b iss led,by the board of heal --••-•-- -•-•--•.................... Date Application Approved By-•••............. �e �..=���� `-----.... Date Application Disapproved for the following reasons:................................................................................................................ ......................................................................................................................................................................................................... Date PermitNo......................................................... Issued....................................................... Date L-Cr;CATION 4> SEWAGE PERMIT NO. VILLAGE I 4- L C) '3-6' f C� INSTA LLER'..S NA III E 6 ADDRESS ,o4K l / r 8 U-1 L DIE R OR OWN ER , DATE PERMIT ISSU--ED 72 DATE COMPt1A-NCE ISSUED �ZtAIL or 000 NO................^_4 i EiB...... ..} .......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH .................. ........OF...... ,n s�J .SY¢�i... Appliration for Uispoii al Works Tonntrnrtion Prrutit Application is hereby made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal System at:20 5 L t�nddress t...... l•f /' O 37 er Addr a ....-•-••-._...-•••-•-•....... Installer Address d Type of Building Size Lot............................Sq. feet V Dwelling—No. of Bedrooms............................................Expansion Attic ( ) Garbage Grinder ( ) pa.1 Other—Type of Building ____________________________ No. of persons............................ Showers ( ) — Cafeteria ( ) Q' Other fixtures ................................................................................................ W Design Flow............................................gallons per person per day. Total daily flow---------_..................................gallons. WSeptic Tank—Liquid capacity............gallons Length................ Width................ Diameter................ Depth................ x 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........................................ Test Pit No. l................minutes per inch Depth of Test Pit.................... Depth to ground water........................ fs, Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water-- _------_-----__----. P •-------------- -------- '�,14,;� --- - ••-----•----- --•---.....__...------•----...-------.....---.....----...--•---.......-----•---------------------- D Description of Soil..........................x ------------------••-•-----------------------------------------------------------------------•-----------------••------•----- W ••••-•----------•----------•---•••-------------•••---------------------•-------•••-•-•---••-----•-•---•------------•...••. -� V Nature of Repairs or Alterations—Answer when a ----------a........................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITLZL 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has b r-.iss d by the board of healt ; Signed........ - Application Approved By-•-•-••-•-••-•-_----� "° /1 r ¢/,f' ----------. == `�� �-------- Date Application Disapproved for the following reasons________________________•-_-________-___--__-____._.-__-_-_--___-_-------_-_-_-______.___-_._______'._........__ .---------••--•-------•----•--------------•---------•---------•---•--------------•-------...------.....------------------------------...---•----•--...---------•--•-------------•-••-- ................. Date PermitNo......................................................... Issued....................................................... Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ................................I.........OF..................................................................................... Crrtifiratr of f ompliFanre � THIS ISO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by---------------- = ---If....... t,'! '_-------------------------------------------------------------------------------------------------------------------------------------- Installer ate'' ` .�'-------------------------------------------•-------------•---------------•-•--------------- has been installed in accordance with the provisions of TITLE, 5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No.--- ______________ dated--.............................................. THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE .............. Inspector_.. ................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH No FEE........................ Disposal nrkn Tnnntrnrtion rrntit Permissionis hereby granted................. =..................------------------------------------------------------------------------- to Construct ( or Repair ( �n Indrvidual Sewage. Disposal System at No................. d....... .........F, ...------- .F�:,-___---'--------------------------------------•--------------------------- -------- ---_______________ Street / as shown on the application for Disposal Works Construction Permit No..................... D tecL_- -l-�.. ....................... --o--•••-••--------•-- ---- DATE / --------- _ Board of Health FORM 1255 HOBBS & WARREN, INC., PUBLISHERS ;5ffax:T f � 1 l 00 r - �r Ile cl, 117 III7°�v y utiJt ewe O 1 6 ug.-I lb l' AWAJ J-� Ayy ® ►Z!LJG k i VA ni i - - cl t b fi?LO 90 S E,P FQc v A T r c)&),5 OF e o F VA N s S r, ` O ST -V i'�_. c-(. , Sr �� a l C P.o v � e � `f �b8 775"- i S-2, p T� NoVj,ZZ zo kb t �.r I i CvP CLa i ��rtff PvLL D6w W - - To � s -------------- ST`ii l� 2 Np So eY•MNS S T;, oS rO-V F4A I i j i . T- coo . Ct_-o j�s�Tt•f 'i-o �,� C�v�¢F r-- + C-4f P 6F-4P O Iv, Pt r# us .�y; c r'o A7"e f a/ 4, t �?�JLL D6w 4 S�� IR-S b^L MAJ ro e A-j - - f ! .. I. Bev 12-eocr4 1 � Pis EG Z .."S 7 . ._ LF— �`t�►'YI�S5 �� t-f�,6t�-�4 t� f GHEE I FgAj C- SA v r✓ D , D RY I s�uK Aw> i I c � . r � Y N.p� 2opW� ',G Q. - - ffrRI vT` L t�' Roo an O o o a IS T'rOJ G 4 r SYSTEM STEM PROFILE AL SYSTEM COMPONENTS SHALL BE MARKED WITH MAGNETIC TAPE 0 - PROVIDE -MIN. 20" DIAM. WATERTIGHT (NOT TO SCALE) COMPARABLE MEANS FOR FUTURE LOCATION. ACCESS COVERS TO WITHIN 6' OF FIN. GRADE TOP FOUND. EL. 43.35 SAVE EXIST. OBOX 2" PEASTONE OR GEOTEXTILE LEGEND- MINIMUM .� OR REPLACE IF FILTER FABRIC OVER STONE a o � \ _ REQUIRED. � o 37.22% SLOPE REQUIRED OVER SYSTEM 36.0 �o �y y JS OF COVER OVER PRECAST 99 — EXISTING- CONTOUR Q lv��'J► i PRECAST H-10 MORTAR ALL " a�\ RISERS �) COMPONENTS THICKNESS REQUIRED X 99.1 EXIST. SPOT ELEV. ( ) 0 H0PV NOTE: 2" MIN. WALL SC 4 C \2 e PIPES LEVEL 1ST 2' .= 6" MIN. SULTP —[g9]— PROPOSED CONTOUR • •• �••�- 12" MIN. IIM. *39.0 RELOCATED OR NEW as ro�a r"o a° — 198.41 PROPOSED SPOT EL. b s� < 10" 14" o o a o `+ a`° o oG b .;: 34.55'/*. TEE 1500 GAL H-10 TEE 34.3' ®®®® O Fn®®EJIr ®® — --®�®® ���p0000 TH1 sou o ` SEPTIC TANK h v 0 0 0 0 o a°o°oao° ®®®I�®®®®®®® ®® ®®�®® 'o°o°o°o° a4• UO. LEVEL o°o°o°o°o° ° WATERTEHT D'BOX o 0 0 0 � o o0 0 ° o 0 , ° ° ° ° o a„ GAS 8Af}tE .. °o°o?+°0-°- FOR LEVELNESS0o a o TEST HOLE53 4 PVC AT 2� ACME oR EQUAL .Qaoaoaoo MIN. *34.0' 33.8' oaoaoaoa, aoa00000 qa G° o 0 0 0 SLOPE OF GROUND a o°a°:°:°:°:°:°:°:°:°:°:°:°:°:°:°:°:°:°:°:°:°o �e9 00000°ono°o�o,o�ono°0000000�o�o�o„o�o°00000. EXISTING LEACHING TO REMAIN �0 „ C Q, UTILITY POLE 6 4 PVC AT 2% 6" CRUSHED STONE OR MECHANICAL ARE HYDRANT o� *THE INSTALLER SHALL VERIFY THE COMPACTION. (15.221 (2]) HOSE NOT ALL srMeas MAY APPEAR w uw►xnNc LOCATIONS OF ALL UTILITIES AND ALL A�o BENDITSH( YPV?R TO GRADE l �9� BUILDING SEWER OUTLETS AND ELEVATIONS PRIOR TO INSTALLING ANY PORTION OF SEPTIC SYSTEM NOTES 1. VERTICAL DATUM IS LOCUS LOCU MAP (EXISTING S/T INVERT OUT EL. 38:1) ( SCALE 1 1. ADEQUATE PITCH, MAINTAIN 2% MI ASSESSORS MA\ 2. THIS PLAN IS FOR PROPOSED WORK ONLY AND NOT TO RS MA't ( ) BE USED FOR LOT LINE STAKING OR ANY OTHER P 142 PARCEL 86 PURPOSE. � 3. CONTRACTOR SHALL BE RESPONSIBLE FOR CALLING LOCUS IS WITHIN FEMA FLOOD ZONE X{AREA OF MINIMAL FLOOD HAZARD) DIGSAFE (1-888-344-7233) AND VERIFYING THE LOCATION OF ALL UNDERGROUND & OVERHEAD UTILITIES PRIOR TO COMMENCEMENT OF WORK. ZONING SUMMARY -✓ 4. EXISTING SEPTIC LOCATION PER TIE-CARD ON FILE WITH TOWN. NO CHANGE IN BEDROOMS PROPOSED. ZONING DISTRICT: RC DISTRICT EXISTING 2008 SEPTIC LEACHING TO REMAIN- 6 BR. — EXISTING SEPTIC PERMIT #2008-116 MIN. LOT SIZE 43,560 S.F. 5. POOL FENCE SHALL HAVE SELF-CLOSING MIN. LOT FRONTAGE 20' 29 M P 142 PCL 85 � ¢ SELF-LATCHING GATES, SIZE AND MATERIALS TO MEET MIN. FRONT SETBACK 20' 4 EVANS ST 33 LOCAL AND STATE BUILDING CODE, ALL DWELLING MIN. SIDE SETBACK 10' / J's �o DOORSu' OPENING TO POOL SHALL BE ALARMED TO MIN. REAR SETBACK 10' 28 .99," ! 0 "� .N CODE. MAX. BUILDING HEIGHT 30' �PR .i �'- 6. ANY RETAINING WALL WITH GREATER THAN 30" GRADE SITE IS LOCATED WITHIN THE RESOURCE - , sM8,� �� � o, � PROTECTION OVERLAY DISTRICT DIFFERENCE BETWEEN HIGH AND LOW SIDES WITH VkNT E OCA ED WALKWAY WITHIN 2 OF WALL SHALL HAVE A CODE S PTI OA COMPLIANT FENCE OR GUARD RAIL. C� SITE IS LOCATED WITHIN THE AQUIFER TANKf 7. EXACT GRADING AND DRAINS FOR. POOL DECK BY PROTECTION OVERLAY DISTRICT T 3 S� ,�' A� OTHERS. (MAINTAIN 25 FROM SEPTIC LEACHING SAS TO �+ p - Zg 1 2/OCL 6 �� �� `. 38 / , B F D Y Y DRAIN LEACHING COMPONENTS) OWNER OF RECORD 0 VJAN �\ / r SEPTIC COMPONENTS NOT TO BE BACKFILLED OR LCP 1, 3 6 I � �- p o ` A CONCEALED WITHOUT INSPECTION BY BOARD OF EDWARD AND BRENDA SOPLE �� 1 'S71 SF) ,moo �Ol HEAL THt AND PERMISSION OBTAINED FROM BOARD 50 SAUNDERS ROAD �o. A' OF HEALTH. REBUILD ANY DISTURBED SAS STONE. NORWOOD, MA 02062 `y REA OF EXISTING TANK TO BE COMPACTED CLEAN FILL. PA D DRIVE C� 39kp ����." ��nlc3p N� o Np `� REFERENCES CTF 194121 Ix o GRAVEL SURFACE DRIVE o� o LOT 53 LCP 18366 1 f pp i o CB FN D, \ EXIST. DWELL. 'o `U1 TOP FNDN. EL. 43.35 `no f Z BENCHMARK: USE CORNER OF RETAININ ALL AT o �P J E• v �� y �� ELEVATION 4 4�5'� o. ip�� { o y" FN 36r� PPpRO�, A/C cN E. /PRO G GP•SLIN KED) GASLNE G NpT M�j 41. SITE PLAN of W� LOT 52 fM6AP 142 PCL 87 80 EVANS STREET - OSTERVILLE s F PREPARED FOR sH._ +� off 508-362-4541 cF fax 5os-362—s880Q��: E L < � EDWARD SOPLE I downcope.com © f Lt1 fII LR. down co a en iheerin Inc. 14 �� IJ�L - /� 81 Ida 4 90 V C11TL �� ��a62 a: DATE: 2/2/2018 civil engineers eersF at 9 r>rST � land surveyors r�� 01 ,NA L % _ �N 939 Main Street. ( Rte 6A) „mod y � tr- Scale:1"= 20' YARMOUTHPORT MA 02675 1 -2.-•Za�t ---- � j 1 1 7-463 DATE DANIEL A. OJALA, P.E., P.L.S. 0 10 20 30 40 50 FEET —------------------------- SITE PLAN a� N SCALE: 1"=20' S, BENCH MARK ON C.B. FND AS SHOWN ON 6 �-�• SITE SITE PLAN ELEV.-100.00' ASSUMED SIRE $ t-2e OWL A*2113 MAHME •. �( ARE�T g S 7, I'' � O � 34" v �x e2.33' x 8 % 1 O C G7 O24" p cDonna ca FIL4er91 .STEM REINFORCED PRECAST CONCRETE 2 H-20 500 gal, chambers63.64' '' PLAN VIEW END-SECTION 4L H-20 500 GALLON CHAMBER' M 9A NOT TO SCALE "OSTERVILLE" t3� ! USE ACME PRECAST OR EQUAL w s� TH01 C. LOCUS te SCALE: AS SHOWN ea EA rr as,d t 96 '�` TH R4 � 0.16' 94A 91 �0 ��` Design Calc6lations a s9.ta Number of Bedrooms: 6 Existing y ! Garbage Grinder: NO, GRINDER NOT ALLOWED WITH THIS DESIGN or e t 9 acit Septic Tank Ca x o`'1 Septic Tank Capac y Required: 660 gpd X 200% = 1,320 gpd $ b Leaching . ' 1,500 gallon H-10 Loading Proposed Capacity a equired: 660 Gal./Day Leaching Area Required: 660 'Gal.AO.74 Gal./Sq.Ft.)=892 Sq.Ft. a #01 0`\ # Proposed Leaching ;Area Provided: 50.0' X 13' X 2.0' = 915 SQ.FT. $ e w G BENCH MARK Total LeachingCa 'Tacit 677 d > 660 d. re 'd. e7.31• vat'°d a�^je E �S�L %/' � P y' 9P 9P q eta / O��/���•9e95� 2' � 99a , $$ " /17//i t��to� t 96.27• 2 ' p p :rt LOT 5309 � GENERAL NOTES n N AR - 12,79 SO-FT. sees, �� 1. ADDRESS: #80 EVANS STREET, OSTERVILLE s 2. ASSESSORS NUMBER: 142-086 s-2r MUM.AOXIS MN*013 3. DEVELOPER'S LOT- LOT 53 1u 1 96 4• 4. TOPOGRAPHIC INFORMATION WAS COMPILED FROM AN ON THE GROUND INSTRUMENT SURVEY. 5. TOWN WATER IS PROVIDED TO SITE at SURROUNDING-PROPERTIES. 6. REFERENCE PLAN:I LAND COURT PLAN 18366-i reu• f 3 7. NO WETLANDS ARE LOCATED WITHIN 200 FEET OF SAS. c oa ,w 8. NO ABUTTING PO LE WELLS ARE LOCATED WITHIN 150 FEET Ol' SAS. SIV �• �� STEEL REINFORCED PRECAST CONCRETE s9.9r s� PLAN VIE'vti' �sr tAEvovAeur ornaes C.O N STR U C,! C�N N O}l tS 1 1. Contractor is responsible for Digsafe notification .. ,, and protection of all underground utilities and pipes. ca F �ti•d.aana ,r ,„�,; 2. The septic„tank distribution box shall be set FUT w r-►� +M.t ee aa.L r` Tlevel on 6 of 3 4'-11/2' stone. 4•mA 3. Backfill should be dean sand or gravel with no r „ � ., r :size. . PERK TEST & SOIL EVALUATI O`N ` CAS eAFftE Y: J.-v� Lr-tl• 4 by sGs n tEm Nerr b;ect to inspection during installation Inn, R.S. DATE OF PERC TEST & SOIL EVAL.: NOVEMBER 29, 2007 _ �. * j 5. The contractor shilll install this system In accordance TEST PERFORMED BY: GLEN E. HARRINGTON, R.S. •"' with Title V of tM Massachusetts Environmental Code EXCAVATED BY: R do H CONSTRUCTION, PHIL, OPERATOR and the Regulations of the Town of BARNSTABLE. PERK RATE: USE 2 MPI FOR DESIGN PURPOSES IN C1. CROSS SECTION END-SECTION 6, Provide an Acme Precast H-10 1,500 gallon septic tank, one H-20 D8-5 H-10 1500 GALLON SEPTIC TANK distribution box and 5-500 gallon H-20 leaching chambers or equal. Test Hole Test Hole Test Hole Test Hole P 1 2024 7. No vehicle or heavy machinery shall drive over the NOT TO SCALE se tics stem unless noted as H-20 se tic components. onents. No. 1 NO. 2 Na. 3 No. 4 Ir p ' y P ' P DEP SOILS ELEV. SOILS ELEV SOILS ELEV. DEPTHSOILS ELEV. �$ USE ACME PRECAST OR EQUAL 8. Install gas baffle Orequal on septic tank outlet tee end. Perk Test a t T.H. /+ 1 M 9. All existing invert., and site conditions shall be verified by contractor. + + + + Depth period h to perk hole- 30-48" I 10. BOARD OF HEALTH AND DESIGNER E TO INSPECTp D ;CERTIFY INSTALLATION. i� 24 gals added In less than 15 minute soak 11. The`existing, cesspools and leach it shall be pumped um ed and removed. e LOAMY SAM 21JIZ 3' LOAMY SAND 2= t ' LOAMY SAND= t4• LOAMY SAND MM 12. Provide one 4" dia. SCH 40 PVC vent with carbon filter as shown in site plan. Bw Bw Flw Bw I 13. Existing shed is to be relocated. ,oTRRs/e +LTdro�e HIM/61~ Perk Test at T.H. #3 14. Provide one 40 milpoly/vinyl/rubber membrane as shown on site Ian. " LOAMY SANG - LOAMY SAND " LOAMY sm 34 .LOAMY SM w p T TIZM Tom, m,., Depth to perk hole- 40-58 N . 24 gals added in less than 15 minute soak period Bs" IS 23Ye/4 T " ZSTe/4 T " Zme/a Zata/a 1, C2 C2 C2 C2 I "WWI "Sew nnw "am LEGEND ��,��®���� PROPOSED SEPTIC SYSTEM UPGRADE .one ."we .... .aw i • 1144-1 Z3YR7/4 15YR7/4 ZSW/4 •. - '/4 ., PREPARED FOR �NO GROUNDWATER ENCOUNTERED NO GROUNDWATER ENCOUNTERED PERK TEST LOCATION H eRl RIC STEVENS/STEVENS CONSTRUCTION EXISTING CESSPOOL TO BE AT PUMPED AND REMOVED *NOTE: ALL"PIPES ARE TO BE 4" OW SCHEDULE 40 P.V.C. #80 EVANS STREET *NOTE: INSTALL GAS BAFFLE OR EQUAL ON SEPTIC TANK OUTLET TEE. FG'�S•C��* Provide 4" dia. SCH 40 PVC vent with carbon filter ' EXISTING LEACH PIT TO 9E '9Ar PUMPED AND REMOVED 1TA_ BARNSTABLE (OSTERVILLE), MA house 0' in.from tank Finished grade over system-2X slope away O Existing House Mti�tn 9t'oT a e greadi* H-20 O O O PROPOSED 1500 GAL 5 HALE ONE a+Ar1eER new=Mitt be r t F H-10 SEPTIC TANK PREPARED BY: O-�X Sev.►nwst M slthln a ExistingGrade E1ev.=88 �: GLEN E. HARRINGTON, R.S. fU 1 S_ D-13 6 of must Orods Mtn 2—, — X ,04.46 IX/SA OE MT.Box oar �, + ,; MOTES EXISTING � SPOT GRADE 9 LE DA ROSE LANE cellar ,�r ''°- To Pea stone I v.=85.5't ttiw> o.,,.-es.00' Po 2B MN s� uem 95 EXISTING cOlvraUR MARSTO N S MILLS, MA 02 648 DEEP TEST HOLE SEPTIC TANK _ r = o o � o :.•�.N + TEL: 508-428-3862 Cat AL3r.•-„ Bottom Of Leach APPROX. LOCATION Existin =92.08 6•aF s/4•-„/s•STONE P= ),5� DOUBLE—wASNED 5 LEACH TRENCH Trench Elev,=83.00 EXISTING WATER LINE FAX: 508-428-3862 - e.Ltd„"r AM.r�l.v.-Ls+.a• P=90.80 9'f - APPROX. LOCATION SCALE: 1"=20' DRAWN BY: GEH JAN. 15, 2008 SYSTEM .PROFILE 6•or 3/4•-,l/s•STOWEXISTING GAS LINE Not to scale BOTTOM OF T.H. #4 ELEV.=72' DATUM: ASSUMED ILL: STEVENSDAUPHINEE SHEET 1 OF 1 r Wd LZ:0Z: 1801Z 11Z- 13 J'dd A:31S 80 Z l Z N OlJ N I d dVH l l'dW 3 O-M-M