The URL can be used to link to this page

Home My WebLink About1063 MAIN STREET (OST.) - Health 10 Maier,St -eet 63 «y1 i ,,r��, >.v '' •��'�-"" �. ;��.f ��.,. ,,..�y t .,v _ <��rt �q� � � ,tf.? f= �V< •a.�� .ff.:. ;..1, a' iFl t'. - ,8:,.,: , �u-'' 'h i "A'- �10' � ®1;�'� �� t,:jYtiY'�S € aT7�,"#: & �yY, YE1dr •� . " Y $i;,__ �"`-+.Saxes+.-s,-+.-�s.,r�.,l._W�-:a..��„,i ,_ t ." o _ � • I " , o T _ ` ny t yy F. • a C` _ 4 ° n , b:• , oF� ►ok TOWN OF BARNSTABLE HEALTH INSPECTOR'S Establishment Name: f /� Date: 7 2� ,Page:_ ( of. OFFICE HOURS PUBLIC HEALTH DIVISION - 800-9:30A.M. i BARNSTABLE. • 200 MAIN STREET 33o-a:3o F.M. Item Code C-Critical Item DESCRIPTION OF VIOLATION/PLAN OF CORRECTION Date Verified MASS. g. MON.-FRI. ,639•e m HYANNIS,MA 02601 _ 508-862-4644 No Reference, .R-Red Item : PLEASE PRINT CLEARLY 'FOM FOOD ESTABLISHMENT INSPECTION REPORT Name I f �-1 Date 7 Type of Tyne of Inspection Operation(s) Routine Address f T�, Risk Food Service Re-inspection ` Ka�n v� Level Ret ' Previous Inspection Ak Telephone cilesidential Kitche Date: Pre-operation Owner HACCP Y/N Temporary' Suspect Illness Caterer eneral Complain Person in Charge(PIC) Time Bed&Breakfast H In: Other Inspector yt C-bJLK> Out: Each violation checked requires an explanation on the narrative page(s)and a citation of specific provision(s)violated. Violations Related to Foodborne Illness Interventions and Risk Factors(Red Items) Anti-Choking 590.009(E) ❑ � �r Violations marked may pose an imminent health hazard and require immediate corrective Tobacco 590.009(F) ❑ `d Action as determined by the Board of Health. Allergen Awareness 590.009(G) ❑ FOOD PROTECTION MANAGEMENT ❑ 12.Prevention of Contamination from Hands D y ❑ 1.PIC Assigned/Knowledgeable 1 Duties ❑ 13.Handwash Facilities G/d aq EMPLOYEE HEALTH PROTECTION FROM CHEMICALS ❑ 2.Reporting of Diseases by Food Employees and PIC ❑ 14.Approved Food or Color Additives ❑ 3.Personnel with Infectious Restricted/Excluded ❑ 15. Toxic Chemicals _ ` a� s FOOD FROM APPROVED SOURCE TIMEITEMPERATURE CONTROLS(Potentially Hazardous Foods) �p a ❑4.Food and Water from Approved Source ❑ 16.Cooking Temperatures Kt LVlJ E l hir ❑ 5.Receiving/Condition ❑ 17.Reheating y_2g f (f ❑ 6.Tags/Records/Accuracy of Ingredient Statements ❑ 18.Cooling /� / „_ ❑ 7.Conformance with Approved Procedures/HACCP Plans ❑ 19.Hot and Cold Holding PROTECTION FROM CONTAMINATION ❑20.Time As a Public Health Control ❑ 8.Separation/Segregation/Protection REQUIREMENTS FOR HIGHLY SUSCEPTIBLE POPULATIONS(HSP) CJ6 t vt Pave a ❑ 9.Food Contact Surfaces Cleaning and Sanitizing ❑21.Food and Food Preparation for HSP ❑ 10.Proper Adequate Handwashing CONSUMER ADVISORY ` L ❑ 11.Good Hygienic Practices ❑ 22.Posting of Consumer Advisories Violations Related to Good Retail Practices(Blue Items) Total Number of Critical Violations Critical(C)violations marked must be corrected immediately. (blue S red items) Corrective Action Required: ❑ No ❑ Yes t� Non-critical(N)violations must be corrected immediately or lyn within 90 days as determined b the Board of Health. Overall Rating y y � ❑ Voluntary Compliance ❑ Employee Restriction/Exclusion ❑ Re-inspection Scheduled ❑ Emergency Suspense n C N Official Order for Correction: Based on an inspection today,the items Embargo Emergency Closure Voluntary Disposal checked indicate violations of 105 CMR 590.000/Federal Food Code. ❑ g ❑ g y ❑ rY p ❑ Other: 23.Management and Personnel (FC-2)(590.003) This report,when signed below by a Board of Health member or its agent A=Zero critical violations and no more than 3 non-critical violations. F=3 or more critical violations.9 or more non-critical violations, 24.Food and Food Preparation (FC-3)(590.004) constitutes an order of the Board of Health. Failure to correct violations regardless of the number of critical,results in an F. 25.Equipment and Utensils B=One critical violation and less than 4 non-critical violations 9 (FC-4)(590.005) cited in this report may result in suspension or revocation of the food if no critical violations observed,4 to 6 non-critical violations=B. Seriously Critical Violation=F is scored automatically if: no hot 26.Water,Plumbing and Waste (FC-5)(590.006) establishment permit and cessation of food establishment operations. If 27.Physical Facility (FC-6)(590.007) aggrieved by this order,you have a right to a hearing. Your request must C=2 critical violations and less than 9 non-critical. If no critical ' water,sewage back-up,infestation of rodents or insects,or lack of ( )( ) be in writing and submitted to the Board of Health at the above address violations observed,7 to 8 non-critical violations. If 1 critical refrigeration. 28.Poisonous or Toxic Materials FC-7 590.008 9 ' = 29.Special Requirements (590.009) within 10 days of receipt of this order. violation,4 to Snon-critical violatins C. 30.Other DATE OF RE-INSPECTION: Inspector's Signature Print: 31.Dumpster screened from public view Permit Posted? Y N Grease Trap Previous Pumping Date Grease Rendered Y N / #Seats Observed Frozen Dessert Machines: Outside Dining Y N PIC's Signature Print: Self Service Wait Service Provided Grease Trap Size Variance Letter Posted Y IN Dumpster Screen? Y N .,�- _.,r�r-ate.. '. ...�-_..i.s-! 'rs-s.3.-'-r.,..^-.--� -[^ „- - .f•s...+t .-._ .. !.,_ ....-- .. - . ,. _ .. _ _ . .- - ... _.:_+.-a-__ n. --.s,_-. . - ... ,--. ';�.,,- _ i Violations related to Foodborne Illness Violation Related to Foodborne Illness Interventions Interventions and Risk Factors(Red Items 1-22) and Risk Factors(Red Items 1-22) (Cont.) FOOD PROTECTION MANAGEMENT PROTECTION FROM CONTAMINATION PROTECTION FROM CHEMICALS �J 3-501.14(C) PHFs Received at Temperatures According to 1 590.003(A) JAssignment of Responsibility* F 8 Cross-contamination 14 Food or Color Additives Li� Law Cooled to 41°F/45°F Within 4 Hours* * 3-501.15 Cooling Methods for PHFs590.003(B) Demonstration of Knowledge* 3-302.11(A)(1) Raw Animal Foods Separated from 3-202.12 Additives2-103.11 Person-in-Charge Duties - Cooked and RTE Foods* 3-302.14 Protection from Unapproved Additives* P_HF Hot and Cold Holding - Contamination from Raw Ingredients \(�/ 3-501.16(B) Cold PHFs Maintained At or Below 41°F/45°F 1=51$ Poisonous or Toxic Substances `vr 590.004(F) EMPLOYEE HEALTH 3-302.1](A)(2) Raw Animal Foods Separated from Each 7-101.11 Identifying Information-Original Containers* /^t Other* V 3-501.16(A) Hot PHFs Maintained At or Above 140°F* 2 590.003(C) Responsibility of the Person-in-Charge to 7-102.11 Common Name-Working Containers* Require Reporting by Food Employees and Contamination from the Environment 3-501.16(A) Roasts Held At or Above 130°F* 7-201.11 _ Se azation-Storage* Applicants* --- " 3-302.11(A) Food Protection* p g 20 Time as a Public Health Control 7-202.11 Restriction-Presence and Use* 590.003(F) Responsibility of A Food Employee or An 3-302.15 Washing Fruits and Vegetables 3-501.19 Time as a Public Health Control* Applicant To Report To The Person In Charge* 7.202.12 Conditions of Use* 590.004 11 Variance Re uirements 3-304.11 Food Contact with Equipment and Utensils* 7-203.11 Toxic Containers-Prohibitions* ( ) q 590.003(G) Reporting by Person in Charge* Contamination from the Consumer 3 590.003(D) Exclusions and Restrictions* 7-204.11 Sanitizers,Criteria-Chemicals* REQUIREMENTS FOR - 3-306.14(A)(B)Returned Food and AdulteReserrated or of Food* 7-204.12 Chemicals for Washing Produce,Criteria* HIGHLY SUSCEPTIBLE POPULATIONS HSP 590.003(E) Removal of Exclusions and Restrictions g � ) Disposition ofAdulterated or Contaminated -Food 7.204.14 Drying Agents,Criteria* 21 3-801.11(A) Unpasteurized Pre-Packaged Juices and FOOD FROM APPROVED SOURCE 3-701.11 Discarding or Reconditioning Unsafe Food* 7-205.11 Incidental Food Contact,Lubricants* Beverages with Warning Labels* 4 Food and Water From Regulated Sources - 9 Food Contact Surfaces 7-206.11 Restricted Use Pesticides,Criteria* 3-801.11(B) Use of Pasteurized Eggs* 590.004(A-B) Compliance with Food Law* * 3-801.11(D) Raw or Partially Cooked Animal Food and _ P -* -- -- 4-501.111- Manual Warewashing-Hot Water 7.206.12 Rodent Bait Stations 3-201.12 Food in a Hermetically Sealed Container Sanitization Temperatures 7-206.13 Tracking Powders,Pest Control and Raw Seed Sprouts Not Served* 3-201.13 Fluid Milk and Milk Products* - 4-501.112 Mechanical Warewashing-Hot Water Monitoring* 3-801.11(C) Unopened Food Package Not Re-Served 3-202.13 Shell Eggs* _ _ _ _ Sanitization Temperatures* TIME/TEMPERATURE CONTROLS 3-202.14 Eggs and Milk Products,Pasteurized* 4-501.114 Chemical Sanitization-Temp.,pH. ` ' 16 Proper Cooking Temperatures for PHFs CONSUMER ADVISORY 3-202.16 Ice Made From Potable Drinking Water* - Concentration and Hardness* 3-401.11 A(1)(2) Eggs-155°F 15 sec 22 3-603.11 Consumer Advisory Posted for Consumption of 4-601.11(A) Clean Utensils and Food Contact Surfaces of Eggs-Immediate Service 145°F 15 sec* Animal Foods That are Raw,Undercooked or 5-101.11 Drinking Water from an Approved.System* Not Otherwise Processed to Eliminate Equipment* ( )( ) Pathogens*590.006(A) i Bottled Drinking Water* 3-401.11 A 2 Comminuted Fish,Meals&Game g * Effective uuzooi 4-602.11 Cleaning Frequency of.Utensils and Food Animals-155°F 15 sec* 590.006(B) Water Meets Standards in 310 CMR 22.0* Contact Surfaces of Equipment* * 3-302.13 Pasteurized Eggs Substitute for Raw Shell Shellfish and Fish From an Approved Source 3-401.11(B)(1)(2) Pork and Beef Roast-1 1 min Eggs* ' 4-702:11 - Frequency of Sanitization of Utensils and Food 3-401.11(A)(2) Ratites,Injected Meats-155 155°F 15 sec* 3-201.14 Fish and Recreationally Caught Molluscan Contact Surfaces of Equipment* Shellfish* - ' 3-401.11(A)(3) Poultry,Wild Game,Stuffed PHFs SPECIAL REQUIREMENTS •' 4-703.11 Methods of Sanitization-Hot Water and Stuffing Containing Fish,Meat,Poultry or 3-201.15 Molluscan Shellfish from NSSP Listed Chemical* g g 590.009(A)-(D) Violations of Section 590.009(A)-(D)in cater- * Ratites-165°F 15 sec* in mobile food,temporary and residential Sources 10 Proper,Adequate Handwashing * g' PY - ---Game and Wild Mushrooms Approved By - ----- _ * 3-0Ol.11(C)(3) Whole-muscle,Intact Beef Steaks 145°F kitchen operations should be debited under Regulatory Authority 2-301.11 Clean Condition-Hands and Arms 3-401.12 Raw Animal Foods Cooked in a Microwave the appropriate sections above if related to * f d me illness interventions and risk factors. 3-202.18 Shellstock Identification Present* - 2301.12 Cleaning Procedure 165°F* oo bo * 2-301.14 When to Wash* 3-401.11(A)(1)(b) All Other PHFs-145°F 15 sec* Other es should violations relating to good retail _ 590.004(C) Wild Mushrooms _- - _ - 3-201.17 Game Animals* 11 Good Hygienic Practices 1 Reheating for Hot Holding practices should be debited under#29-Special Requirements. 2 401.11 Eating,Drinking or Using Tobacco* 3-403.11 A&D PHFs 165°F 15 sec* $ Receiving/Condition - - - ' -- ( ) ( ) 3-202.11 PHF's Received at Proper Temperatures* 2-401.12 Discharges From the Eyes,Nose and Mouth* 3 403.11(B) Microwave-165°F 2 Minute Standing Time* VIOLATIONS RELATED TO GOOD RETAIL PRACTICES * 3-301.12 Preventing Contamination When Tasting* 3-403.11(C) Commercially Processed RTE Food-140°F* (Blue Items 23-30) 3-202.15 Package Integrity Critical and non-critical violations,which do not relate to the foodborne 3-101.11 Food Safe and Unadulterated* 12 Prevention of Contamination from Hands 3-403.11(E) Remaining Unsliced Portions of Beef Roasts* illness interventions and risk factors listed above,can be found in the C Tags/Records:Shellstock 590.004(E) Preventing Contamination from Employees* 18 Proper Cooling of PHFs following sections of the Food Code and 105 CMR 590.000 3-202.18 Shellstock Identification* 13 Handwashing Facilities 3-501.14(A) Cooling Cooked PHFs from 140°F to 70°F Conveniently Located and Accessible Within 2 Hours and From 70°F to 41°F/45°F Item Good Retail Practices FC 590.000 3-203.12 Shellstock Identification Maintained* * 23. Management and Personnel FC-2 .003 Tags/Records:Fish Products 5-203.11 Numbers and Capacities* Within 4 Hours 9 5-20411 Location and Placement* 3-501.14(B) Cooling PHFs Made from Ambient 24. Food and Food Protection FC-3 .004 . 3-402.11 Parasite Destruction* Temperature Ingredients to 41°F/45°F 25. Equipment and Utensils FC-4 .005 3-402.12 Records,Creation and Retention* 5-205.11 Accessibility,Operation and Maintenance Within 4 Hours* 26. Water,Plumbing and Waste FC-5 .006 590.004(J) labeling of Ingredients* Supplied with Soap and hand Drying Devices 27. Physical Facility FC-6 .007 7 Conformance with Approved Procedures/ 6-301.11 Handwashing Cleanser,Availability 28. Poisonous or Toxic Materials FC-7 .008 HACCP Plans 6-301.12 Hand Drying Provision 29. Special Requirements 009 3-502.11 Specialized Processing Methods* 30. Other 3-502.12 1 Reduced-Oxygen Packaging.Criteria* 8-103.12 1 Conformance with Approved Procedures* S:590Formback6-2doc 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 'Denotes critical item in the federal 1999 Food Code or 105 CMR 590.000. 7/15/2021 Punky'Kitchen-1 Recommendation-Osterville,MA Sign in (/login/?next=%2Fpages%2Fpunky-kitchen-ostervil le-ma%2F&is_logged_out=true) ,t. 1k' a 1S I d Punky' Kitchen r 1 Recommendation Caterer(/topic/17827) ZI Recommend Q contact Overview(/pages/punky- Recommendations(/pages/punky- Photos(/pages/punky- kitchen- kitchen-osterville- kitchen- osterville-ma/) ma/recommendations/) osterville- ma/photos/) Photo gallery https://nextdoor.com/pages/punky-kitchen-osterville-ma/ 1/2 7/15/2021 Punky'Kitchen-1 Recommendation-Osterville, MA ti r K a%2F&is_logged_out=true) Nextdoor Neighbors About (/about_us/) Get Started (/choose_address/) News (/press/) Events (/events/calendar/) Media Assets (https://about.nextdoor.com/us-media/) Neighborhoods (/find-neighborhood/) Investor Relations (https://investors.nextdoor.com/) Guidelines (/neigh borhood_guidelines/#guidelines) Blog (https://blog.nextdoor.com/) Anti-Racism Resources Careers (/jobs/) (https://about.nextdoor.com/antiracism/) Help (/help/) Agencies Business Public Agencies (/agency/) Local Business (https://business.nextdoor.com/local) Public Agencies Blog Enterprise (https://business.nextdoor.com/enterprise) (https://medium.com/nextdooragencyresources/) Real Estate (https://business.nextdoor.com/local/real- estate/) Local Business Blog (https://business.nextdoor.com/local/resources/) Self-Service Ad Terms (/self-service-advertising-terms-of- service/) Nonprofits Privacy (/privacy policy/) Sell for Good (https://go.us.nextdoor.com/nonprofits) Legal &Terms (https://help.nextdoor.com/s/legal) Cookies (/cookie_policy/) Get the app: (https://itunes.apple.com/us/app/nextdoor/id640360962?ls=1&mt=8) (https://play.google.com/store/apps/details?id=com.nextdoor) Made by your neighbors in San Francisco, CA. © Nextdoor 2021. https://nextdoor.com/pages/punky-kitchen-osterville-ma/ 2/2 ® 77 #. Eile Edit Yew lnsert Fqrmat Becords Iools Endow Help % - � � � � Type a question I.,help - 4SPECTH Daiabasz t?cs z2">r70f{fe= m tT .w..., m _ � ..renew Resign New 0bjeda, Name Dacnptibn Modred.... b Tables. ® POOL PERMIT SPECIAL ANNUAL 11/5/2018&0&49PM - ®- POOL PERMITSPECIAL SEASONAL Oueries i�Restau�anti- " - _ .i.:.F.JL°." - B POOL PERMIT WHIRLPOOL ANNUAL ^- �. Forms ® POOL PERMITWHIRLPDOL SEASONAL ._...... - .. I ,ResleWerd lido fees Pamds Reports ® Motel Licenu ry Pa ® Permits No Seating One-Landscape DBA Pemut Numbu: 348,:. 9a ® SharonsR dl - Pemut FOOD SERVICE Ittue Dote: 2/8/2008 ® Macros eP�Pt.mds No Seeing eating Annual SavSale ® Permits No Seating One-Portrait NAME1 IMING ZHOU EXPIRATION DATE 01262023 Groups ® 'Permits No Seating Seasonal 'NAME2 HONG CFiAN HUANG - EXP DATE2 I 03/252026 Favorites ® Permits Seatng Annual NAME3' �---- EXPDATE3: ® Pe miLs Seabng rtr One Poait .' NAMEd ONG EXP DATE4: $ ,G ® Permits Seating One-Portrait-sk2 NAMES. LX L)ATES: a q,. g. q ..+ f, ® Permits Seating One-Landsmpe NAMES IMA EXP DATE&r— ® Permits Seating Seasonal Imapeow Data 1 OS/10-21i Score1 Re lmpedron ® Rat Total Fees(Annua0 � � Avaage Score ® Rat Total Fees Seasonal letter i Inspection Date2 .04/202021a '- Scora2� �, ;d - g b 4 n $ Inspection Date 3. 02/19/2021 Score 3 , ® Rat Total Fea Ann-L LETTER _ - ® Motel LkemeSeasonal ® Motel L One ® Motel Licenw A -.al ® T.ba—Permit _ <rT :tea 7.&,.,� a.,..' .,,,a,,».A ." _ _ -.: ,P - # 's` s' •'', ,r $ �P v m "'�; Pti x Annual Pwnits ;. PmaAmvePamee �P�aseao�Pex $ K ` jjF set H Fr.t nD J < T # g r $ $p „ .c $ .: 4 4, , r . , .... :: NUM Farm V - - - f� Type hereto search r -'/t 1 OpenGov 1063 MAIN STREET (OST.) Osterville, MA 02655 1 a' d fit. � t Name Name this location... Property Owner Name ZHOU, ZHIMING &HUANG, ZHONGCHAN TRS ZHOU &HUANG TRUST Phone Email https://barnstablema.viewpointcloud.io/#/explore/locations/46478 1/3 �FIKE roq. Town of Barnstable Regulatory Services, • snaxsrnsz e. ASS. i639. Public Health Division �0 AjEp�,�A Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 Date: February 8, 2017 Bar(s): 79630 Name of Offender: Michael Ashley Location of Violation: 1063 Main Street Osterville, MA Date(s) of Violation: 6-17-16 Violation(s): State of Massachusetts Sanitary Code 105 CMR 410.00 Facts: The Town of Barnstable Health Division has acknowledged 'compliance on the violation (Bar# 79630) issued to above offender and wishes to void the ticket issued on June 17, 2016. This compliance has been achieved by obtaining a building permit(B-16-2144) and installing an egress window in accordance with State of Massachusetts Sanitary Code 105 CMR 410.00. Respectfully Su bmi d; FIX ,.Q i Timothy B. O'Connell, RS Health Inspector Town of Barnstable 200 Main Street Hyannis, MA 02601 (508) 862-4644 Violation History AcctNo 254546 Ashley,Michael 02-08-2017 1063 Main Street Osterville Issue Date BAR No Fine Date Paid Amt Paid Disp Total Due Notice2 Final Hearing Arraign Offense 02-18-2015 79026 100.00 03-03-2015 100.00 Paid 0.00 Illegal apartment in. basement 03-02-2015 79036 100.00 06-18-2015 100.00 Paid - 0.00 04-15-2015 05-15-2015 basement apartment 03-14-2016 79376 100.00 06-03-2016 100.00 Paid 0.00 047-20-2016 05-16-2016 illegal apartment 06-17-2016 78367 100.00 10-28-2016 100.00 Paid 0.00 07-15-2016 08-15-2016 Failure to correct egress violation in bedroom of basement apartment. 10-25-2016 79630 100.00 ` Void: 0.00 1 1-15-2016 12-15-2016 Failure to correct egress violation in bedroom of basement apartment �500.00 400.00 0.00 NAM OF OFFENDER D A D 7 6 30 TOWN OF A DR6OFOFFENDER BARNSTABLE CITY,STATE,ZIP CODE �tNE tq, MV/MB REGISTRATION NUMBER O,tF�,F,+ENSEy1 yq 'tp�1py/ (��j �fJf �q.} ��y" /y+� NANNASS.Il.. { " `'4.1 R 1 0✓ \W1^'�V�+"' �"N'*~� 7 tOLAwr'w V jY �i1�✓l� 0 W C rEOMK+` Ski " ' I 'lr LLI TIME AND DATE OF VIOLA ^� LOCATION OF VIOLATION Z LU NOTICE OF U'0 .at / P.M.)ON 1 7 20 Ur11� J� 1�'�+'� SIGNAT OF ENFOe PING PERS N ENFORCING DEPT. BADGE NO. W VIOLATION OF TOWN /I HEREBY q NOWLEDGE RECEIPT OF CITATION X a ORDINANCE I9 Unable to obtain si nat re of offender. , ��' ►a— bate mailed ;Ltd THE N M N L.FI FOR THIS OFFENSE IS S W OR YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF IS MATTER.EITHER OPTION( OR OPTION(2)WILL OPERATE AS A FINAL CL DISPOSITION WITH NO RESULTING CRIMINAL RECORD. W REGULATION (1)You may elect to pay the above fine,either by app n in pers n etw�prl 8: M.and 4:0 rou Friday,legal holidays excepted, W before:The Barnstable Clerk,200 Main Street,Hyannis, 02601, b (nailing a or or o Barnstable Clerk,P.O.Box 2430, d Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS F THIS N ,(2)If you desire to contest this matter in a noncriminal proceeding,yoU m o so by making written request to DISTRICT COURT DEPARTMENT,FIRST BARNSTABLE DIVISION,COURT COMPOUND,' STREET,BARNS ABLE,MA 02630,A In 21 D Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or if you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature NA E OF OFFENDER r.. CIR Astit 'TOWN VF', ADDRESS OFrOFFEN E .*- BARNSTABLE CIfiY,S TEE,,III COD t11E ip� MV/MB REGISTRATION NUMBER OFFENSE (,v+y /� ,j,�.'�f(,�Q/��fl_, � �.{/ r♦r ,��w/9'f ��yy,� $Q HAH\H1'ABI.E.� ��4 M1.,1� g N-�°'9/'�.J +9^I� 7' ! i./ •> 1 W )IASS. L ,67q. �O ^y y,�y ry {,� C R'" " r«�,J 0'� li kl t ` O Wj TIME AND DATE OF VIOLATION LOCATION OF VI LATION W i NOTICE OF : Ott i('QU P.M.)ON 120 >, .at 'F IfLA-L: S16NATU OF ENFORCING PERSON ENFORCING D PT. BADGE NO. W VIOLATION ..._/''$. ... r::-:.,�.•-• '"'" lfoC OFJOWN WHEREBY ACKNOWLEDGE RECEIPT OF CITATION X ` LU ORDINANCE Q` Unable to obtain s'gnatur of offender. alb ►-- f THE NONCRIMINAL FINE FOR THIS OFFENSE IS S 100 J Date Trailed - i �j f--•� w OR YOU HAVE THE FOLLOWING ALTE NATIVES WITH REGARD TO DISPOSITION OF HfS-AA\TTfR.E17ER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL � DISPOSITION WITH NO RESULTING CRIMINAL RECORD. ) ` J W REGULATION (1)You may elect to pay the above fine,either by appearing in person betwe� 8:80 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, w before:The Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a check,money order or pos note to Barnstable Clerk,P.O.Box 2430, J (Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE rnc DATEOF THIS)I ICE. a BARN STABLE DIVISIONou desire to ,COURT COMPOUN this matter in a riminal D,MAIN REE T,8,4(iNS�ABLE,do so t� 02 nag writt 1 D"on r'y�R�a ngs d enclose a copT COURT y of this citation for a hearing. y FIRST mil/ (3)If you fail to.pay the above offense or to request a hearing within 21 j'',or if you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. ❑ 1 HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature d . TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION Date Time: In Out Owner Tenant Address ��H�i Ill fQ f(A1 Address � �(fU by 04W Compliance Remarks or Regulation# Yes NO Recommendations 2. Kitchen Facilities C'�Q i 3. Bathroom Facilities 4. Water Supply 5. Hot Water Facilities 6. Heating Facilities 7. Lighting and Electrical Facilities 8. Ventilation f 9. Installation and Maintenance of Facilities 10. Curtailment of Service 11. Space and Use 12. Exits 13. Installation and Maintenance of Structural Elements 14. Insects and Rodents 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal 17. Temporary Housing 18. Driveway Width 19. Number of Tenants Observed PART II 37. Placarding of Condemned Dwelling; Removal of Occupants; Demolition Number of Bedrooms Number of Vehi;jos-Allowe (max) Number of Persons Allowed (max) � Person(s) Interviewed Inspector If Public Building such as Store or Hotel/Motel specify here 1 �- TOWN OF BARNSTABLE BOARD OF HEALTH ARTICLE II: MINIMUM STANDARDS FOR HUMAN HABITATION (Date 0 Time: In Out Owner Tenant Address 06"3 (m Ad ress U' 2 /�JWn bq Compliance Remarks or Regulation# Yes" NO Recommendations 2. Kitchen Facilities 7 r . 3. Bathroom Facilities ,.; ' - 4. Water Supply '` 5. Hot Water Facilities tr 6•. Heating Facilities 7. Lighting and Electrical Facilities -8. Ventilation �� 9. Installation.and Maintenance of Facilities r 1 . 10. Curtailment of Service 11,Space and Use 12. Exits T rx 13. Installation and Maintenance of Structural Elements �F. 14. Insects and Rodents . 15. Garbage and Rubbish Storage and Disposal 16. Sewage Disposal ;s 17.Temporary Housing ' 4 . ., .18. Driveway Width 19. Number of Tenants Observed"` A PART II t �� A� 37. Placarding ofyGandemned Dwelling; Removal of Occupants;.Demolitton { Number of Bedrooms ,Number of Vehicles Allowed'(max) Number of Persons Allowed (max.. Person(s) Interviewed t' .. Inspector z -- t If Public Building such as Store or Hotel/Motel specify,here .r s . } � ,oFtrati Town of Barnstab-le Regulatory Services * BARNSTABLE. 9� " . Public Health Division .. prfD MAC A Thomas McKean, Director 20.0 Main Street, Hyannis, MA 02601 Office:. 508-862-4644 Fax: 508-790-6304 August 10,2015 Michael Ashley 1063 Main Street Osterville, MA 02655 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 1063 Main Street (basement apartment), Osterville, MA, was inspected on August 7, 2015 by Jim Parziale R.S., Health Inspector for the Town of Barnstable. This inspection was conducted in accordance with the 2006 Barnstable rental registration ordinance requiring yearly inspections of all rental properties. The following violations of the State Sanitary Code,were observed: 105 CMR 410.500—Owner's Responsibilities to Maintain Structural Elements Unfinished section of wall observed between kitchen and living area. Missing flooring observed between kitchen and living area: You are directed to correct State Sanitary,Code violations listed above within thirty (30) days of your receipt of this notice. 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. PE R OF THE BOA OF ALTH " D Thomas A. McKean, R.S., CHO v Director of Public Health Town of Barnstable r , Town of Barnstable " Regulatory Services BARN STABLE v MAsa Richard Scali, Director Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644, Fax: 508-790-6304 August 10, 2015 Michael Ashley 1063 Main.Street Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION, THE STATE ENVIRONMENTAL CODE, TITLE 5. The property owned. by you located. at 1063 Main Street (basement apartment), Osterville, MA was inspected on August 7, 2015 by Jim Parziale, R.S., Health Inspector for the Town.of Barnstable. This inspection was conducted in accordance with the 2006 Barnstable rental registration ordinance requiring yearly inspections. of all rental properties. The following violations of the State Sanitary Code were observed: 105 CMR 410.450—Means of ELress: Room observed in lower level apartment being used for sleeping lacks adequate secondary egress. You are directed to correct State Sanitary Code violations listed above within twenty four(24) hours of your receipt of this notice. You are directed to cease and desist using above mentioned room for sleeping purposes. 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.. However, these violations must be corrected within twenty four hours regardless of any request for a hearing. s 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. 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. PE Et 0 THE 74ALTH omas A. McKean, R. 0 O Director of Public Health Town of Barnstable - I 1HE Town of Barnstable ; Regulatory Services RARNSTABLE, ` - MAn g Richard Scali, Director A�fDµA'�A Public Health Division Thomas McKean, Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 10, 2015 David Fritz 1063 Main Street Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION, THE STATE ENVIRONMENTAL CODE, TITLE 5. The property occupied by you located at 1063 Main Street (basement, apartment), Osterville, MA was inspected on August 7, 2015 by Jim Parziale, R.S., Health Inspector for the Town of Barnstable. This inspection was conducted in accordance with the 2006 Barnstable rental registration, ordinance requiring yearly inspections of all rental properties'. The.following violations of the State Sanitary Code were observed: 105 CMR 410.450—Means of Egress: Room observed in lower level apartment being used for sleeping lacks adequate secondary egress. You are directed to correct State Sanitary Code violations listed above within twenty four(24) hours of your receipt of this notice. You are directed to cease and desist using above mentioned room for sleeping purposes. 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. However, these violations must be corrected within twenty four.hours regardless of any request for a hearing. F' 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. 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. PE C, Thomas Director of Public Health Town of Barnstable Oct. 02 2017 22:17 HP Fax page 19 Commonwealth of Massachusetts CM Title 5 Official Inspection Form 1.1 Subsurface Sewage Disposal System Form-Not for Voluntary AssessmentsLIM 1063 Main Street Property Address Mike Ashley Owner Owners Name information is required for every osterville MA 02655 9-23-17 (m� 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. Important:Whenfill rms A. General Information on l the comng out oputer. ````�.PjHtOF tM.,14N"�� use on the tab '• �' 1. Inspector. c%-O �y key to move your =O G y cursor-do not James D.Sears = ; JAMES _m use the return Name of Inspector key. Capewide Enterprises ,.•,c, ,o: Company Name 153 Commercial Street �''''hauTp�U��o Company Address Mashpee MA 02649 City/Town State Zip Code 508477-8877 S1623 Telephone Number License 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 9-25-17 I ector'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 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. "Thls 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.doc•rev.5116 Title 5 Official Inspection Form:Subsurface Sawege Disposal System•Page 1 of 17 40 Us Oct 021 2017 22:18 HP Fax page 20 Commonwealth of Massachusetts Title 5 Official Inspection Form, Subsurface Sewage Disposal System Form - Not for Voluntary Assessments y 1063 Main Street Property Address Mike Ashley Owner Owner's Name information is required for every Osterville MA 02655 9-23-17 page. City/Town State Zip Code Date of Inspedion B. Certification (cont,) Inspection Summary: Check A,B,C,D or E 1 always complete all of Section D A) System Passes: Y ® 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 indicated below. Comments: The system is a 1500 Gal. Poly Tank D Box and 15 chamber's, 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 ❑ NO (Explain below): t5ins.doc-rev.6l16 Tits 5 Offtal Inspection Forth:Subsurface Sewage Disposal System•Pape 2 al 17 Oct 02 2017 22:19 HP Fax page 21 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owners Name information Osterville MA 02655 9-23-17 required for every page. CitylTown State Zip Code Date of Inspection B. Certification (cant.) ❑ Pump Chamber pumpslalarms not operational. System will pass with Board of Health approval if pumpslalarms are repaired. 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 ❑ 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. l 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 L5lns.doc•rev.W16 Title 5 Official Inspection Form:Subsurface Sewage Disposal Svstem•Page 3 of 17 I Oct 02 ,2017 22:19 HP Fax page 22 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information is required for every OSterville MA 02655 9-23-17 page. Cltyfrown State Zip Code Date of Inspection B. Certification (cont.) 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: *4 This system passes if the well water analysis, performed at a OEP 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 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 00millim is less than 6" below invert or available volume is less than '/day L flow f C� Jry 6 N t5ins.dac•rev.8116 Title 5 Official inspection Form:Subsurface Sewage Dlspasal System-Page 4 of 17 Oct 02 ,2017 22:19 HP Fax page 23 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner owners Name information is OSterville required for every MA 02655 9-23-17 page. Citylrown State Zip Code Date of Inspection B. Certification (cont.) Yes No ❑ ® 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 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 II 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, t5lns.doc•rev.&16 Title 5 Official Inspection Form;Subsurface Sewage Disposal System-Page 6 of 17 Oct 02 ,2017 22:20 HP Fax page 24 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information is Osterville MA 02655 9-23-17 required for every page. dilyf7own state Zip Code Date of Inspection C. Checklist Check if the fallowing 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 NIA) ® ❑ 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): 5 Number of bedrooms (actual): 5 DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 550 t5lns.doc•rev.6116 Title 5 Official hs ection Form.Subsurface Sewa ge age Disposal System•Page 8 of 17 Oct 02 2017 2220 HP Fax page 25 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form•Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information is required for every Osterville MA 02655 9-23-17 page, CityfTown State Zip Code Date of Inspection D. System Information Description: 1500 Gal. Poly Tank-D Box and 15 Chambers. Number of current residents: 0 Does residence have a garbage grinder? ❑ Yes ® No Is laundry on a separate sewage system?(Include laundry system inspection ❑ Yes ® No information in this report,) Laundry system inspected? ❑ Yes ® No Seasonal use? ❑ Yes ® No Water meter readings, if available(last 2 years usage (gpd)): 2015-60,000Ga1s 2016-168,OOOGaIs Detail: Sump pump? ❑ Yes ® No Last date of occupancy: NA 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/personslsq.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: 15ins.doc rev.&15 Title 5 Official Inspection Form:Subsurface Sewage Disposal System-Pape 7 of 17 Oct 02 ,2017 2221 HP Fax page 26 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owners Name information is required for every Osterville MA 02655 9-23-17 page. cityrrown 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: NA 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 UA system by system operator under contract ❑ Tight tank.Attach a copy of the DEP approval. ❑ Other(describe): l5ins.doc-rev.6116 Title 5 Official inspection Form:Subsurface Sewage Disposal System Page 8 of 17 Oct 02 ,2017 22:21 HP Fax. page 27 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information i e required for every Osterville MA 02655 9-23-17 page, CitylTown State Zip Code Date of Inspection D. System Information (cont.) Approximate age of all components, date installed (if known) and source of information: 2008 - Permit # 2008-031. Were sewage odors detected when arriving at the site? ❑ Yes ® No Building Sewer(locate on site plan): Depth below grade: 22 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.): Pipeing is 4" PVC SCH -40. Septic Tank (locate on site plan): 1 Depth below grade: feet Material of construction: ❑ concrete ❑ metal ❑fiberglass ® polyethylene ❑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 Gal,Poly Sludge depth: 1" t5ins.doc-rev.5116 Ti11e 5 Official InspWionForm:SutlsurteCe Sewage Oispoeal System-Page a of 17 Oct 02 ,2017 22:21 HP Fax page 28 Commonwealth of Massachusetts Title 5 Official Inspection Form r Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information is required for every Osterville MA 02655 9-23-17 page. City/Town State Zip Code Date of Inspectlon D. System Information (cont) Septic Tank(cont.) Distance from top of sludge to bottom of outlet tee or baffle 28 Scum thickness Oil 8 Distance from top of scum to top of outlet tee or baffle Distance from bottom of scum to bottom of outlet tee or baffle 18" How were dimensions determined? Asbuilt- Plan -Tape Sludge Judge _ Comments (on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels as related to outlet invert, evidence of leakage, etc.): Poly Tank at working level. Tank and covers at 1' below grade. In and outlet Tee's. No sign of leakage or over loading. 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.doc-rev.6116 Title 5 Official htspe:tion Form:Subsurface Sewage Disposal System•Page t o of 17 Oct 02. 2017 22:22 HP Fax page 29 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information is required for every Osterville MA 02655 9-23-17 page. Cityrrown 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 ❑ 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.doc•rev.6/16 Tile 5 Official Insaection Form:Subsurface Sewage Disposal System•Page 11 of 17 Oct 02 2017 22:22 HP Fax page 30 t Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form -Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information is required for every Osterville MA 02555 9-23-17 page. Cityfrown 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 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 is poly at 18" below grade w/three lines Box is clean w/no sign of over loading 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.): If pumps or alarms are not in working order, system is a conditional pass. Soil Absorption System (SAS) (locate on site plan, excavation not required): If SAS not located, explain why: t5ins.doc•rev.6H6 Title 6 Official Inspection Form:Subsurface Sewage Disposal System-Page 12 of 17 Oct 02 2017 2222 HP Fax page 31 Commonwealth of Massachusetts Title 5 Official Inspection Form s Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information is Osterville MA 02655 9-23-17 required for every page. Cityrrown State Zip Code Date of Inspection D. System Information (cont) Type: ❑ leaching pits number: ® leaching chambers number: 15 ❑ leaching galleries number: ❑ leaching trenches number, length: ❑ leaching fields number, dimensions: rf Elove low 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.): Leaching is 3 rows of 5 cultec-stone less. Ck D Box and camera out lines. Clean and dry. 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 Mns.doc-rev.else Tile 5 OfTdal Inspect on Forte Subsurface Sewage Disposal System-Page 13 011 Oct 02 ,2017 2223 HP Fax page 32 Commonwealth of Massachusetts Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information is required for every Osterville MA 02655 9-23-17 page, CitylTown State Zip Code Date of Inspection D. System Information (cont,) 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.): 16ins.doc•rev.6/16 Title 5 Official Inspection Form:SubsuAace Sewage Uisposel System-Page 14 of 17 Oct 02 .2017 2223 HP Fax page 33 �C\ Commonwealth of Massachusetts . Title 5 Official Inspection Form Subsurface Sewage Disposal System Form-Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information is required for every Osterville MA 02655 9-23-17 POW. City/Town 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 r3 LR _A c DNS CPO, ❑ q 8 �� A '7 �.3 A -3 � 13 -y „ i t5ins.doc•rev.6116 Title 5 Official Inspection Form:Subsurface Sewage Disposal System•Page 15 of 17 Oct 02, 2017 2223 HP Fax page 34 Commonwealth of Massachusetts Title 5 official Inspection Form Subsurface Sewage Disposal System Form- Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information required for every Osterville MA 02655 9-23-17 page. City/Town State Zip Code Date of inspection D. System Information (cons.) Site Exam: ❑ Check Slope ❑ Surface water ❑ Check cellar ❑ Shallow wells JVJ 11'+ Estimated depth t high ground water: 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: 12-6-07 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: T.H. on Design plan 12-6-07 1 V+ no G.W.. Bottom of chamber's at 8'+ above T.H. Depth Before filing this Inspection Report, please see Report Completeness Checklist on next page. t5lns.doc-rev,W16 Tltle 5 Officlal Inspect on Form:Subsurface Sewage Disposal System-Page 16 of 17 I� Oct 02. 2017 2223 HP Fax page 35 Commonwealth of Massachusetts o Title 5 Official Inspection Form Subsurface Sewage Disposal System Form - Not for Voluntary Assessments 1063 Main Street Property Address Mike Ashley Owner Owner's Name information required for every Osteryllle MA 02655 9-23-17 page. Cityrrown State Zip Code Date of Inspection E. Report Completeness Checklist ® Inspection Summary: A, 8, 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.doc•rev.6116 Title 5 Official Inspecl'ron Form:Subsurface Sewage Disposal System•Page 17 of 17 Oct 02, 201 T 22:24 HP Fax page 36 LE" boa k o�7- 5.5 I �j *ati Town of Barnstable Regulatory Services r � BARNSmwx a,� - Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 10, 2015 Michael Ashley 1063 Main Street Osterville, MA 02655 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 1063 Main .Street (basement, apartment), Osterville, MA, was inspected on August 7, 2015 by Jim Parziale R.S., Health Inspector for the Town of Barnstable. This inspection was conducted in accordance with the 2006 Barnstable rental registration ordinance requiring yearly inspections of all rental properties. The following violations of the State Sanitary Code were observed: 105 CMR 410:500—Owner's Responsibilities to Maintain Structural Elements Unfinished section of wall observed between kitchen and living area. Missing flooring observed between kitchen and living area. You are directed to correct State Sanitary Code violations listed above within thirty (30) days of your receipt'of this notice. 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. PER ORDER OF THE BOARD OF HEALTH Thomas A. McKean, R.S., CHO a Director of Public Health Town of Barnstable OFIW Ta,� Town of Barnstable Regulatory Services r > r r , > BAMMBM 9MAS& `erg Richard Scali,Director Public Health Division Thomas McKean,Director 200 Main Street, Hyannis, MA 02601 Office: 508-862-4644 Fax: 508-790-6304 August 10, 2015 Michael Ashley 1063 Main Street Osterville, MA 02655 NOTICE TO ABATE VIOLATIONS OF 105 CMR 410.000, STATE SANITARY CODE II—MINIMUM STANDARDS OF FITNESS FOR HUMAN HABITATION, THE STATE ENVIRONMENTAL CODE, TITLE 5. The property owned by you located at 1063 Main Street (basement apartment), Osterville, MA was inspected on August 7, 2015 by Jim Parziale, R.S.;Health Inspector for the Town of Barnstable. This inspection was conducted in accordance with the 2006 Barnstable rental registration. ordinance requiring, yearly inspections of all rental properties. The following violations of the State Sanitary Code were observed: 105 CMR 410.450—Means of Egress: Room observed in lower level apartment being used for sleeping lacks adequate secondary egress. You are directed to correct State Sanitary Code violations listed above within twenty four (24) hours of your receipt of this notice. You are directed to cease and desist using above mentioned room for sleeping purposes. 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. However, these violations must be corrected within twenty four hours regardless of any request for.a hearing. 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. 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 BOARD OF HEALTH Thomas A. McKean, R.S., CHO Director of Public Health Town of Barnstable TOWN OF BARNSTABLE LOCATION j O U S VVV o.w% S'E- SEWAGE# ' '© ' °31 VILLAGE ASSESSOR'S MAP&PARCEL INSTALLERS NAME&PHONE NO. S/G Z 4; SEPTIC TANK CAPACITY / 70 0 Ac) LEACHING FACILITY.(type)C/S') C' e/ Ca&C(size) /2 Y Yy NO.OF BEDROOMS S OWNER As' 44y PERMIT DATE: CONKIANCE DATE: 2 —Zoo Separation Distance Between the: Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility ND /! Feet Private Water Supply Well and Leaching Facility(If any wells exist on site or within 200 feet of leaching facility) Feet Edge of Wetland and Leaching Facility(If any wetlands exist within 300 feet of leaching facility) Feet FURNISHED BY K% eA y. :.... /7.0 �.3 �. v �(�� a�k.U , .�, � �� a�•o 63 ad•s_ G Q� a�Y'° � Z ;.��Y � Y /S:S ti y w f '� i -- o. Fee ' THE COMMONWEALTH OF MASSACHUSETTS Entered in computer: PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS es ZppYicatiou for �Dtgogal 6pgtem Con0truction Permit Application for a Permit to Construct( ) Repair(vj Upgrade( ) Abandon( ) ❑.Complete System ❑Individual Components Location Address or Lot No. i Ob3 MA;A STfeii O%T&6 0,e Owner's Name,Address,and Tel.No. Assessor's Map/Parcel 11 0 I 1 I �BG,� ~,h jr/ter ysrcjv Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. 69Pew-dcEwrc:- es ��,c so��lz yo2� 6_as,H�r-,et f—vARes sofq71Sr3 3 Pa• g" -763 Ge.�r�✓LvillC 62632 �+vtSrgyJd Type of Building: Dwelling No.of Bedrooms fJ Lot Size cJ p Z b� sq. ft. Garbage Grinder ( ) Other Type of Building 1W/ ao;* No.of Persons Showers( ) Cafeteria( ) Other Fixtures Design Flow(min.required) S�SO gpd Design flow provided ��/S� gpd Plan Date 1 2-Zi Number of sheets -2— Revision Date j Title % yG3 /►��h Size of Septic Tank jSbo, J?71 Type of S.A.S. eu j-`DZ './,,.,�h.e so.,L> Description of Soil Z6 Nature of Repairs or Alterations(Answer when applicable) Al" Po TWM k -f b 13r,X Tp Date last inspected: 700-7 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 Board of Health. Signed Date Application Approved b Q, Date Qa Application Disapproved by: Date for the following reasons Permit No. Date Issued .. �ti.yyY,�. 1.-..wr�'t^��^^ ,.�Y s-�.. .�}✓./y;x �w-tiTf\i�„�•y..., ...,oy�+r.n.r- ff Fee �/ �, x Entered in computer: r�` - THE COMMONWEALTH OF MASSACHUSETTS PUBLIC HEALTH DIVISION - TOWN OF BARNSTABLE, MASSACHUSETTS Roplication for �Bigpogar 6pgtem Con0trupfion Vertu Application for'a Permit to Construct O Repair(V� Upgrade,( ) Abandon O 0,Complete System ❑Individual Components Location Address or Lot No. 10(o3 /n Ain s-r r c e.5 os-ye(,'0r Owner's Name,Address,and Tel.No. Assessor's MapfParcel /061a •h }r—its9 a51 era_,c� Installer's Name,Address,and Tel.No. Designer's Name,Address and Tel.No. e�PCcu,c��' L=n7tiPi.yti l -C 1; OT q LIQ2 1 .11i,h-eel.I ewo,al(S Sb$ y'77 a~313 Po. 93,C •7(a� �2�'1 C-n (IC 62h32. k% ,l-Cgre>A/c eh Type of Building: Dwelling No.of Bedrooms 5 Lot Size Z b,.sq.ft. Garbage Grinder 'LL Other Type of Building 14,1/1- No.of Persons Showers( ) Cafeteria( ) a z Other Fixtures Design Flow(min.required) .5-5-0 gpd Design flow provided S`/ gpd •, Plan Date 1 2 - 2 r Number of sheets 7, Revision Date ' Title Size of Septic Tank /4"bo Type of S.A.S. /4 /� L'41 ,c rt C/ ,Ld �.� Description of Soil G � 7,4 Nature of Repairs or Alterations(Answer when applicable) A/" Po�, Tfavi k To St ,i, l css Lear,L. p acl Dke last inspected: O '7 Agreement: The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system in t 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 Board of Health. . Signed ' . , Date -- Z —ZD O� 1. fir` Application Approved by �' Date Application Disapproved by: Date `. for the following reasons Permit No. 062) — _ Date Issued ——————————— -—'——————._—————— — ———————————-- ^� THE COMMONWEALTH OYMASSACHUSETTS BARNSTABLE, MASSACHUSETTS G - (Certiftcate of Comphance THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed ( ) Repaired /Upgraded t t t P ( ( ) Abandoned( )by at T1n ? r has been constructed in accordance with the provisions of Title 5 and the for Disposal System Construction Permit No. ( dated Installer ,a„y, /D/I.Sf S Lt e, Designer -&— ,by L j./tNt41 #bedrooms 570 Approved des* n flow gpd G The issuance of tWts perm' shall not be construed as a guarantee that the system I fun ti as dsi elf Date Inspector 1 No. ��i� � Fee THE COMMONWEALTH OF MASSACHUSETTS r PUBLIC HEALTH DIVISION-BARNSTABLE, MASSACHUSETTS x1i5pont 6pgtem Co gtructton Verna Permission is hereby granted to Construct ( ) Repair ( Upgrade ( ) Abandon ( ) System located at ('a M 1N and as described in the above Application for Disposal System Construction Permit.The applicant recognizes his/her duty to comply with Title S and the following local provisions or special conditions. Provided: Fonst ction must be completed within three years of the date of thi pe i . o, Date Approved by Violation History AcctNo 254546 Ashley, Michael 06-16-2017 1063 Main Street Ostervi lle Issue Date BAR No Fine Date Paid Amt Paid Disp Total Due Notice2 Final Hearing Arraign Offense 02-18-2015 79026 100.00 .03-03-2015 100.00 Paid 0.00 - Illegal apartment in basement 03-02-2015 79036 100.00 06-18-2015 100.00 Paid 0.00 04-15-2015 05-15-2015 basement apartment 03-14-2016 79376 100.00 06-03-2016 100.00 Paid_ 0.00 04-20-2016 05-16-2016 illegal apartment 06-17-2016 78367 100.00 10-28-2016 100.00 Paid 0.00 07-15-2016 08-15-2016 Failure to correct egress violation in bedroom of basement apartment. 10-25-2016 79630 100.00 Void 0.00 11-15-2016 12-15-2016 Failure to correct egress violation in bedroom of basement apartment 500.00 400.00 0.00 Town ®f Barnstable. ReWsaqq Services mhoran F. Geiter,Director PUbbe Heats Divielen y Thomas MOeen,Director 200 Maim:Street, yawls,hm 01, 01 Ulgcsa; U84Q.AA4 Fes; 308-79D-63:04 L5LO7 . Sewage ftruaft# 204- 0 3 per"7Ik),- on On 05 was issued a i e init to +!installer) P astall a Q` �' basod oa a desi.ip drawn b y dared � Z-/ 0 - .�t o.septic system referenced above wrW installed �t�l�stapti . box h may include or approved changes such as 1$teral relocation attid/or$optic tank to septic systcira re renced above was iasWled with J�►` 13J' lateral Falocation ti a SAS or aA vo�tic Qr C-(i.e. but in s�ccax ce aith y ideation .aq:01q ip t Stake Local Rcg�latzons, 1a i�ovi�hvm or �0. t by do$'' to fallow, "OF r PETER T, McEf�fT E� E CIVIi. 4 No.36100 4 �SS!ONliL (fix Designer s 3t ) Q t�or 8oadoa,Farm 3-26.04.doc Z0 3Jdd S>QJ0 9NId33NIJN3 EZE9LLV805 6E:90 800Z/9O./ZO 01-25-2008 a 09_ 32cL DEED RESTRICTION WHEREAS, �MIiCl fleL �_.— A5 �-��2 of (owner's name)—�------------- _ O STG fLL v 1��__------- _--MA (address) is the owner of- ID(,,-3 M A Vo s; ecT y STL 2��\� -- located (address) at h O S �k TC a6l —=N -- -- , MA (hereinafter referred to as _— l OCRs ✓l ST. e�T and being shown on a plan.entitled "Subdivision of Land in Qc:�rl jLe-- MA, Property of --_------- et al,---- � -__-_duly recorded in Barnstable County Registry of Deeds in Plan Book - , Page _ t Z� -Or on Land Court Plan Number WHEREAS, — �t,y�L_—� ._AS �, as the owner of said lot has (owner's name) agreed with the Town of Barnstable Boar4 of Health to a restriction as to the number of bedrooms which can be included in any home built on said lot as a pre-condition to obtaining a disposal works. construction permit in compliance with 310 CMR 15.000-State Environmental Code, Title V, Minimum .Requirements for the Subsurface Disposal of Sanitary Sewage; WHEREAS, the Town of Barnstable Board of Health, as a pre-condition to granting a disposal works construction permit for.a septic system in compliance with 310 CMR 15.200, State.Environmental Code, Title V, Minimum Requirements for the Subsurface Disposal of Sanitary Sewage, and authorizing t e issuance o a i`ti'ioarnglefar4l 'fa°evra - � this property, is requiring that the agreement for the restriction on the number of bedrooms in any house constructed on the lot be put on record with the Barnstable County Registry of Deeds by recording this document, deedr i NOW, THEREFORE, —M►�h t, t�s�fjz�_does hereby place the (owner's name) following restriction on his above-referenced land in accordance with his agreement with the Town of Barnstable Board of Health, which restriction shall run with tlp land and be binding upon all successors in title: M A-1 v1"bT ttc�—_b STetd j�k�__may have constructed (address) upon th'e lot a house containing no more than Q-E (5) bedrooms. A�_v _agrees that this shall be permanent deed (owner's name) restriction affecting _ located on Mau mA; ►tctij MA, and being shown on the plan recorded in Plan Book i28q a , Paged _u _--_- Or on_Land, Court Plan ----__--- --------____-- -- For title of _ _ see the following deed: Book i , Page Or Land Court Certificate of Title Number___-----_—_ E ted as a sealed instrument _�,- day of 's signature 0 is signature Owner's signature COMMONWEALTH OF MASSACHUSETTS —_=--_ ss -- --- ---- 20a� Then person Ily s p a d t esbove-named known to me to be the perso who executed the foregoing instrument and acknowlednod the same to be- __ free act and deed, before me, Notary Public ` My commissiori_exptr r, - ----- - P deedr L `pp(HE Tti Barnstable y� 0 Town of Barnstable . kzftd - Y A�-AmeicaC[3v �-�BARMAS& E, k .Hoard of Health16,39. 1 � A'Fo�yA 200 Main Street, Hyannis MA 02601 2007. Office: 508-862-4644 Wayne Miller,M.D. FAX: 508-790-6304 Paul Canniff,D.M.D. Junichi Sawayanagi January 22, 2007 Mr. Peter McEntee, P.E. Engineering Works 12 West Crossfield Road , Forestdale, MA 02644 RE: 1063 Main Street, Osterville A . 118 011; Dear Mr. McEntee, - You are granted°variances, on behalf of your client, Michael Ashley, to construct an onsite sewage disposal system at 1063 Main Street, Osterville. The variances granted are as follows: 310 CMR 15.405(1)(b): To place five (5) feet of soil cover over the top of the soil absorption system, in lieu of the three feet maximum allowed: . Section 360-1, Town of Barnstable Code: To construct a soil absorption system 77 feet away from a coastal bank, in.lieu of the minimum .100 feet separation distance required. Section 360-1, Town of Barnstable Code: To construct a septic tank 62 feet away from a coastal bank, in lieu.of the minimum 100 feet separation distance required. The variances are granted with the following,conditions: (1) No more than-five (5) 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 five (5) bedrooms maximum. A copy of the recorded deed. restriction shall be submitted to the Health Inspector prior to obtaining a disposal works construction permit. Q..\WPFILES\McEnteeAshley1063MainStreet0sterville2008.doc (3) The septic system shall be installed in strict accordance with the revised engineered plans dated December 21, 2007. (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 submitted plans dated December 21, 2007. This variance is granted because physical.constraints at the site severely restrict the location of a soil absorption system due it's close proximity to vegetated wetlands. The proposed system appears to be designed to meet the maximum feasible compliance standards contained within the State Environmental Code, Title V. Sin er, ly yours, Tape Tiller, M.D. -Chairman QAWPFILES\McEnteeAshley1063MainStreetOsterville2008.doC I ^g� DATE: t r • lASNBTABu,' toss.' :► REC. $Y Town of Barnstable d, SC88D. DATE;�� Board of Health 200 Main Street,Hyannis MA 02601 Office: 508-962A644 FAX: 508-790-6304 Wayne A.Miller,M.D. Paul J.Cannif�D:MD. VARIANCE REQUEST FORM LOCATION Property Address: 10(3 /2A r✓) s�-YLee-t ns�-Q),LQ MA Assessor's Map,and Parcel Number: Il �' " 0. 1 J Size of Lot: 9 B Z 6 $, Wetlands Within 300 Ft. Yes ✓ Business Name: /V 1A No Subdivision Name:, APPLICANT'S NAME: Phone Did the owner:of the property authorize you to represent him or her? `Yes _l" No PROPERTY_OWNER'SNAME/ CONTACT PERSON Name: /�l rcAoLe /7S�i�y /"e'er✓ Name: /0(0 3 M 01 A tree�- he��'� CNo��i L.(1 Address: � _�g� 9 Address: Phone: Phone: /�T yj )—do, �? MA VARIANCE:.FROM REGULATION(Listft.) _REASON FOR VARIANCE SCS ac _ -s 3 i3(May attach if more space needed) 310 e%l X Ili(6) 5.)fie Ct►.r s 3-ra ,01 x Cacgl Clt f 0-A1�Gf-C ) at"4-e CQ a t-s Local eh�P�-,. `.36n - c Ll to 1 NATURE_OF WORK: House Addition ❑00000 House Renovation ❑ Repair of Failed Septic System a Checklist (to be completed by office sta f=person receiving variance request applica#on) Please submit:coples in.4.separate completed sets. Four(4)copies of the completed variance request form wry Four(4)copies of engineered plan submitted(e.g.septic system plans) 3 Cq Four(4)copies of labeled dimensional floor plans submitted(e.g.house plans or restaurant kitchen plans) C�Vf Signed letter.stating that the property owner authorized you to represent him/her for this request Applicant understands that the abutters must be notified by certified matt at least ten days prior to meeting date at ap Is expel(forT V and/or local sewage regulation variances only) Full menu submitted for ease > "*( grease trap variance requests only) Go _ Variance request application fee collected(no fee for iifeguard modification renewals,grease trap variance renewals[ owner/I or ] outside dining variance renewals[same owner/leasee only],and variances to repair failed sewage disposal systems[only if no a ion to .buildi g prop]) Variance request submitted at least 15 days prior to meeting date . VARIANCE APPROVED Wayne Miller;Chairman NOT APPROVED Paul) Cannif,:D.M.D. REASON FOR DISAPPROVAL C:\Documents and Settings\decollik\Local Settings\Temporary Internet Fi1es\0LKl\VARIREQ.D0C U JIT D STAT9 ,P.O.,S L Y:rf}."}'fir. A " ;�} � ��st3,g�&)�e8s Paid P. Sender: Please print your name,address, and ZIP+4 in this box V I V I I Engineering Works I 12 West Crossfield Road I Forestda le, MA 02644 I I I' L TFTHIS SECTION VERY ■ Complete items 1,2,and 3.Also complete A Sign re >h .St item 4 if Restricted Delivery is desired. Agent ■ Print your.name and address on the reverse X ❑Addressee so that we�can return the card to you. B. Received by(Printed Name) C. Date of Delivery j ■ Attach this card to the back of the mailpiece, or on the front if space permits. A D. Is delivery address different from item 1? ❑"Yes 1. Article Addressed to: If YES,enter delivery address below: M440 Prop TD:118014 UNITED METHODIST CHURCH 57 POND ST OSTERVILLE,MA 02655 3. Se ice Type Certified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number , 7007•,0220 0001 •7844, 90566 (transfer from service label) 11 1�,_• i. i•S i Ail ii l i 1 1 i 1 c i{; PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS Permit No.G-10 I • Sender: Please print your name, address, and ZIP+4 in this box • y Engineering Works 12 West Crossfteld Road Forestdale, MA 62644 !lliiil`i Mill Ii ill Ailfltl111VIllit?t!►1111*illAlillll I il i 6 � ■ Complete items 1,2,and 3.Also complete A WSure item 4 if Restricted Delivery is desired. ❑Agent 'rint your name and address on the reverse ❑Addressee so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. -i D. Is delivery address different from item 1? ❑Yes Article Addressed to: If YES,enter delivery address below: ❑No Prop iD:118011 ASHLEY,MICHAEL R ,,•, C/O ASHLEY,MICHAEL R 1063 MAIN ST 3. Service Type OSTERVILLE MA 02655 D&rtified Mail ❑Express Mail ❑Registered ❑Return Receipt for Merchandise ❑ Insured Mail ❑C.O.D. �+ , y, , '"� " 4. Restricted Delivery?(Extra Fee) ❑Yes umb F 0 02 .yi7844 97 (Trans s 032 iPiz PS F6 kl Domestic Return Recei pt 102595-02-M-1540 .� UNITED STATES FOSTAL SM L; yf?r age&� Rd. • Sender: Please print your name, address, and ZIP+4 in this box • Engineering Works 12 West Crossfield Road Forestdale, MA 02644 t9{ti2°i�' '1lll�� ,ttS�ttt i�:itt�': s(•}}4e iiie"�t:f��lli:lsl.�s .liil t c•Ili �l .i ■ Complete items 1,2,and 3.Also complete 7Signature item 4 if Restricted Delivery is desired. / ❑Agent ■ Print your name and address on the reverse ❑Addressee so that we can return the card to you. g ecel ed by(Prin d ame) C. Date of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. D. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑No prop 1D:118124003 WYGONSKI,ROBERT JOSEPH& WYGONSKI,ALYSON KEENEY WYGONSKI FAMILY INVESTMENT I 3. �Servil Type 51 SEAPUIT RD I�Certified Mail ❑Express Mail OSTERVILLE,MA 02655 ❑Registered ❑Return Receipt for Merchandise_ - ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number l ( 1; 7 0 0-71�0 2 2 0 10 0 01 7 8 4 4,19 1 09 (Transfer from service la PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 Engineering Works 12 West crossfield Raad, Forestdale, MA 02644 Tel/Fax(508)477-5313 December 21, 2007 Re: 1063 Main Street, Osterville, MA(Assessors Map 118, Parcel 11) Construction Title 5 Septic System Dear Sir/Mam: Please be advised that an application for variances from the Massachusetts Department, of Environmental Protection, Title 5, and Local Regulations have been submitted to the Barnstable Health Department for approval. The following variances are being requested: • 310 CMR 15.405(1)(b Contents of Local I- Upgrade PJ Approval 1. A 2' variance to the 3' maximum cover requirement over an S.A.S. for 5' of cover. • LOCAL REGULATION, Chapter 360,Article 1 —Setback Requirements 1. An 8' variance, Septic Tank to Bordering Vegetated Wetland, fora 62' setback. 2. A 23' variance, S.A.S. to Bordering Vegetated Wetland, for a 77' setback. The application and plans are available for review at the Barnstable Health Department, 200 Main Street, Hyannis, MA; Monday through Friday (excluding holidays)from 8:30 a.m. to 4:30.p.m. A public hearing will be held, to discuss the proposed work, on Tuesday,. January 8, 2008, at 3:00 p.m. The hearing will be held at the following.location: Town Hall Hearing Room Second Floor 367 Main Street Hyannis, MA S'ncerely, G Peter T. McEntee P.E. Engineering Works 12 West Crossfield Read, Forestdale, MA 02644 Tel/Fax(508)477-5313 December 21, 2007 Barnstable-Board of Health 200 Main Street Hyannis,.MA 02601 Re: 1063,Main Street, Osterville, MA, Title 5 Septic Upgrade Representation Authorization Dear Board,members: I hereby.authorize Peter McEntee PE to represent my interests for the subject project. Signed, G' /id Michael Ashley Board of Health Abutter List for Map & Parcel(s): '118011' Direct abutters(no set distance)and the properties located across the street. s M1 • Total Count: 4 Close Rap&Parcel Ownerl Owner2 Addressl Address 2 Mailing CityStateXip 118010 OSHEA,COLM 12 VINCENT ST NEWTON, MA 02465 � 118011 ASHLEY,MICHAEL R C/O ASHLEY, 1063 MAIN ST OSTERVILLE,MA MICHAEL R 02655 -'UNITED i 118014 METHODIST 57 POND ST OSTERVILLE,MA CHURCH 02655 118124003 WYGONSKI WYGONSKI' S1 SEAi'UIT RD ALYSON WYGONSKI FAMILY OSTERVILLE MA j � ROBERT JOSEPH& KEENEY INVESTMENT-TR 02655 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 12/21/2007. 5 • ' 3 Town of Barnstable Geographic Information System December 21,2007 09 118138 118120 #181388 118017 111 a= #80 #0 a° t3a #28 Yfl #22 096012002 ,. ,. 118091 118032 #114. 118012 V118013CND" 1 1 80 300 01 #106 #113 #1122 5 "#1112 097 1 + 118198all 801s, > 11903000! "^- ��i 1y �} aV 118D2B #9B 086012001 #110 994 r #16 >€ #77 t 118136 #44 110102 118134 ty. .wa z #120 00 M, . fk: if err , 4 103 119121001 , 6 1#i 8�1 1 0400 #126 1i811e001 116124002 007 #27 11812A001 i9:8U16�ND ' it$082 D9150130015 #89 149 41801YS. 118106 9 To- ' #30 119124006p #1p5y 118104002 118129 #46 042 #0 118008001 118121002 11A 0 #1046 0109 118009002 #93 118118 #1039` D95013006 #86 aerr�,�, 181 118008 4 iiwei x #fi q 9 #1031 #0 `118079 s` #106 , .118007 118106 �A �4 118070 *1017 118004 118003 #34"` 118006 118008 118D77, 042 #22 #12" �y 118127 #123: 118124004 118002 118107. ;s. 0 43 k` #980 #6i #B0 118128 118001 119108 # 8. #13 0g. Nose 119110 i �''. #880' #4 116111 119109 118072 #37' #48 a #97271. 117p61 117006 1181114 118113 e« 117160 1170501#38 #89 $' 'g >, 068 *491, 119112 117 Z8 'w+ss #� 118073 117008 1 0 28 040 a #67 0 3 FE@t 117009 #7B �U is #see ,11 M 7 117004 117010 #110 117179 w 117163 4 117069CNDr #63 #80 #881 #866 #98 't:, DISCLAIMERS:This map Is for planning purposes only. It Is not adequate for legal Map:118 Paroal:011 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 V-100'may not meet establlehad map accuracy standards.The parcel lines on this map are only graphic representations or 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 Buffer as bulling locations. F Engineering 'Works EXISTING. FLOOR PLAN 12A Crossfield Road 1063 Main St, OsterviW6, MA Forestdole, MA 02644, Job No. 249-07 Date: 12/21 /07 (508) 477-5313 . Pci9 1 of 1 BED RM. ROOF DECK (12'x13') DECK CL- LIV: RM. BED. RM. BED RM. KITCHEN DIN. RM. HALL (1O'x12) (10'x12') (16'x32') (13'x15`) (12'x12') ® CL. CL_ - BATH CL- HALL BATH KfiTCE IEN CL- CL- ® ROBE BATH LIV. RM. HALL` o BED RM. 0Nx26') R CL. KI A (16'x32') ENT- STORAGE • ENT. HALL GARAGE DOOR FIRST ' FLOOR SECOND FLOOR' ENCLOSED PORCH ENT. ENT.(� CL -} KITCHEN BED RM. (13'x1S') (10'x12') Q R 0 d CELLAR BATIK STORAGE a � KITCHEN DEN Q (13'x15') (8'x11') _ CL. NO VANDOW BASEMENT FLOOR 3 APARTMENTS 5 BEDROOMS TOTAL SPPuit Rd EXISTING CESSPOOLS TO BE PUMPED, FILLED..IWITH SAND X' �6 88 ao AND ABANDONED, OR REMOVED. lshem �� LOCUS a moo; to ` - `�8 ,2 Pond !I StnUon WY g 0 24 a WYGONSKI, ROBERT JOSEPH & 221~ — UNITED METHODIST CHURCH WYGONSKI, ALYSON KEENEY 20 _ �` --� I MAP 118, PARCEL 14 MAP 118,' PARCEL- 124-003 76 p \ ar c v 72— ` ` 87,4rJ `n ytceet n 7 G-_ - x�5.2 / / North `�, env L2X 27,45 a �Y I o ✓ET/V---1Q,4 IN, 2't 87.7 ,� �, LOCUS MAP 10a,. \ ��,,•►� .� I r` r ,. !`�` �- ...._ -„ '�' NOT TO SCALE sEwR- Drive , INV,=7s E8.03 TP 2TP 1 ` ", el Poor Floor E/ev. ' GENERAL NOTES: / 20.00 (NG t lr) / '� � • "_ (o �' Map 118 CS 1 ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL x 8,66 �� • ; S //W/ P q •/ BOARD OF HEALTH AND THE DESIGN ENGINEER. . • �� ' ' ' Parcel ! ! 0 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS r 'F/i i / 'i f s :"� OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE 8,18 22' t t� _� 9,026E S. �� LOCAL RULES AND REGULATIONS EXCEPT AS REQUEST BELOW: alllt _ d t�,�� ' INV'=18.00—+ L L E •WET/V 103 \ t t�� ` } / / / t 310-CMR 15.405(1)(b): EX/ST/NG µ 4 1) A 1' variance to the 3' maximum cover requirement, for 4' of • r ` �b ��/ / { W max. cover. S.A.S. shall be vented and H-2O Rated. ©�/SE (#1063)'f LOCAL REGULATION Chapter 360, Article 1 - Setback Requirements �{t 1 2 ' / �1C= ,� 1\ \ • 470E-29, ¢ j;� �1- 2) An 8' variance, Septic lank to B.V.W., fora 92' setback. (NGVD)/1 3) A 23' variance, S.A.S. to B.V.W., far a 77' setback. • G��` O,' t „ �10 i i 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED.PRIOR r9� INSTALL A 40 MIL POLY LIN R ASS OWN ,11C TN� C :,, 4 y/i- %i' ' 88'88 TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE . © AND SET BETWEE EL.=16. Sc 13.0� .�. / ; DESIGN ENGINEER. 1t1•N�r-''fit � v' Concrete 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING ' 1 ;1 t t k� Drive FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN X 8 54 ` t`�tt l 4 fir }"r� - 'If{i ay ENGINEER BEFORE CONSTRUCTION CONTINUES. ' ® f1'` O y. ALL ELEVATIONS BASED ON NGVD. VENT 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF / I _ �cb THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF yyWET/V_108 ) ` �' // 7� j l HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. WOR LIIy) T - -Si p FENCE �TY . / 27 f 7. WATER SUPPLY PROVIDED BY TOWN WATER. • ��' /! CfFiON P OR TS` Post ROE' Fence 8. THERE ARE NO ABUTTING WELLS LOCATED WITHIN 150' OF THE S.A.S. INSPE 6' roNE /ALL �I 9. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED / f t , / BY PROVIDING LOAM & SEED IN LAWN AREAS AND REPAIR OF PAVED AREAS IF REQUIRED, OR, AS DIRECTED BY APPROVING AUTHORITIES.- 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY AL THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING �y �� OSHEA, COLM CONSTRUCTION. WET/V-101N, '` �� MAP 118, PARCEL 10 y 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE,ALL UNSUITABLE SOILS " IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. LEGEND AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3), 12. SUBJECT SITE LIES WITHIN THE WP OVERLAY DISTRICT AND STATE — - 74 —--- EXISTING CONTOUR OF REGULATED ZONE n. x 37.11 EXISTING SPOT GRADE P MAS�9 FLOOD PLAIN DATA �� y Benchmark Set 14 PROPOSED CONTOUR FIRM PANEL #250001 0016 D PETER T., s PROPOSED SEPTIC SYSTEM UPGRADE Left cor. footing ® REVISED: JULY 2, 1992 Mc CIVIL 1 EL.=20.87 NGVD 1063 MAIN STREET, OSTERVILLE, MA TEST PIT ZONES B &. C � CIVIL � v' W EXISTING WATER SERVICE No. 35109 — EXISTING GAS SERVICE IS1E`� '�� Prepared for: Michael Ashley, 1063 Main Street, Osterville, MA 02655 —G WETLAND DELINEATION `t� Engineering by: Surveying by: SCALE DRAWN JOB. NO. O.H.W.— EXIST. OVERHEAD WIRES VACCARO Environmental Consulting FSS/ EN EngineWngWorkv WARNER SURVEYING 1"=20' P.T.M. 249-07 5.31 x WETLAND FLAG P.O. Box 955,- Sondwich, MA 02563 22 Long Road WET/V-205 Forestdole, MA 02644 Harwich, MA 02645(508) 888-5855 Z /� 12DATE21 C7 CHECKED SHEET NO. WETLAND SYMBOL l / , (508) 477-5313 (508) 432-8309 P.T.M. 1 Of 2 NOTE: TO PREVENT BREAKOUT, A 40 MIL POLY T.O.F LINER SHALL BE INSTALLED AS SHOWN VENT EXISTING ON SHEET 1 AND SET BETWEEN EL.=16 EXISTING F.G. EL:=16.7t /— F.G. EL: 16.7t AND EL.=13 F.G. EL: 20.0 �MAX�) �.' MAINTAIN 2% MIN SLOPE OVER S.A.S. INSTALL RISERS OVER INLET & OUTLET INSTALL RISER OVER D-BOX TO II L1=15'� TO WITHIN 6" OF FINISH GRADE i WllhilN 6" OF FINISH GRADE —INSPECTION PORT TO BE PLACED ON END UNIT L2=30 5 L`3 L=8' 4' SCH 40 PVC 4" SCH 40 PVC 4" SCH 40 PVC a S- 211% (MIN.) 10,, 14" 14" ® S= 1 (MIN.) * 40" LIQ. INVERT . " e LEVEL INV.=}4.$O INV.=14.63 16' INV.=15.0$ GAS GAS PROPOSED ROWS OF 5-CULTEC C-4 UNITS x 8" UNIT=40' BAFFLE BAFFLE' II IN V.=14.55 (USE C-4 HD UNITS y- H-20 RATED) CONNECT TO EXISTING SEWER J.0% in INV.=14,83 SPLASH PAD TO CONSIST OF OUTLETS AT OR ABOVE: F'RQPQSEQ 15O0 GALLON `s Pn TANK • EXTENDING 6 IN FILTER TART 501L ABSORPTION' $,�'STE�J (PROFILE) EXTENDING 16" IN FROM START I NV.=15,40 SEWER-1 OF ROW INV.=15.70 SEWER-2� FRALO ST1500 GALLON PLASTIC TANK-ACTUAL CAPACIIY=1771 .GALLONS COMPARTMENT NO, 1 1100 GALLON MINIMUM STORAGE � COMPARTMENT NO. 2 - 550 GALLON -MINIMUM STORAGEF G. EL: 20.p (0 (MIN.) ESTABLISH VEGETATIVE COVER CULTEC N0, 410 FILTER FABRIC F.G. EL: 0. MAX.) BACKFILL.WITH CLEAN SAND (NATIVE OR PERC SAND) 12" NOTES: 1 CONTRACTOR SHALL'VERIFY ALL EXISTING -PIPE BREAKOUT=TOP OF UNIT —4" (rnin.) ® PtlLYSEAL OUTLETS 21' INVERTS PRIOR TO CONSTRUCTION. . TOP OF CHAMBER ELEV.=15:0 2,. 2 a- ° aoLYSEAL INLETS R 2) SEPTIC TANK AND D®BOX SHALL BE.SET LEVEL INV.ELEV,=14.55 Ira "s 1 AND TRUE TO GRADE ON A MECHANICALLY COMPACTED BOTTOM ELEV.=14.3_. "`"` � III Ilil�lllll I ' SIX INCH.CRUSHED STONE BASE, AS SPECIFIED IN } s TER EXISTING SUITABLE ,^ P`� r 7 310 CMR 15.221(2). Y 48" (TYPICAL) MATERIAL 0 LJ 3) INSTALL INLET & OUTLET.TEES AS REOUIEiEd. 4' MIN. A60VE 80TTOM OF eEXCAVATION OR G.W. EFFECTIVE WIDTH=12.0' cv q '� 4) GAS BAFFLE TO BE INSTALLED? ON OUTLET TEES, T.P.T,P MSHGW EL: 9.3 USE 3 ROWS OF 5-CULTEC C-4 FIELD DRAIN UNITS N To view Sa�tion ��G f I I C SYSTEM PROFILE WITH NO SEPARATION BE EACH ROW & NO STONE B YY OIL ABSORPTION SYSTEM (SECTION) _ N.T.S. � . . ALTERNATE: FRALO PLASTIC "MONSTER D-BOX" , LsuL �°r CONTACTOR FIELD DRAIN C ® SOIL. L.OG DESIGN CRITERIA - NUMBER OF BEDROOMS: 5 BEDROOMS' MODEL FD C_4 R STARTER 4". 4" DIA. aINSPEClION PORT GATE:SOIL EVALUAi DECEMBER 6, 2,007 (REF'# 11,032) D�F�: PETER McENTE PE CSE SOIL,TEXTURAL CLASS: CLASS i SMALL RIB LARGE RIB e « a . « . . � � WITNESS: DONNA MIORANDI—HEALTH AGENT DESIGN PERCOLATION RATE: < 2'MIN/INCH DAILY FLOW: , 550 GPO ��, Elev. T '"" Oe th` .Elev. T�" —2 Oe th DESIGN FLOW: 550 GPD « 12.92 0" 12.67 U' GARBAGE GRINDER: NO MODEL FD C--4 E MIDDLE/END « LEACHING AREA REQUIRED: (550)'= 743.2 -S.F. FILL FILL SMALL RIB LARGE RIB 48" { 74 5T500 (1771 GALLON ACTUAL CAPAC ° I`, 10.75 -- - 26" 4U0.8 24 ITY) ' PROPOSED SEPTIC TANK: FRALO " « C � C 2 COMPARTMENTS: 1a0O/550 GALLON MINIMUM STORAGE. SPLIT 44" USE 3 ROWS OF 5 CULTEC C-4 UNITS WITH NO' STONE PERC OR AN S.A.S. --HAVING THE DIMENSIONS:. 12.0 . x 40 0 6 BOTTOM AREA. GENERA USE APPROVAL FOR 6. F OF C UNIT) 5"' OTTO (GENERAL A VA 7 SF/L -4 T) 5 NI x T 40 0 FT 8.0/UNI =U TS . " MED. SAND - 3 ROWS x 40.0 x 6.7 SF/L'F 804.0 SF 3 4 DID. 2 5Y 6/4D $•Q' - 2,5Y 6�4 DESIGN FLOW PROVIDED: 0.74(804.0 S.F.) = 595.0 G.P.D. 5 8 « « « « « « « « « « « « « « « BEDROOM COUNT AS DETERMINED BY SITE INSPECTION OF BOARD OF HEALTH. « « « a SMALL RIB LARGE RI 9,30 ADJ. Gw _ 9.30 ADJ, GW PROPOSED SEPTIC SYSTEM UPGRADE 4.00 STG, GW 107" 4.00 STG. GW 104" 1063 MAIN STREET, OSTERVILLE, MA 2.9 134" 2.67 134" Prepared for: Michael Ashley, 1063 Main Street, Osterville, MA 02655 CULTEC CONTACTOR FIELD DRAIN C-4 CHAM&ER STORAGE 7.69 ✓2 CF F7 . . ALL•CONTACTOR FIELD DRAW C-4HD HEAVY DUTY UNITS ARE MARKED 107H A COLOR STRIPC FORMED INTO THE PART ALONG THE LENGTH OF THE CHAM6'ER, PERC RATE G2 MIN/IN. ("C" HORIZON) Engineering by: Surveying by: SCALE DRAWN J08. N0. CULTEC,Inc. Tm STANDING GROUNDWATER AT 131" Engineering Work WARNER SURVEYING 1"=20' P.T.M. 249-07 PH: (203) 775-4416 g g P.O.8ox 280 pH: ($00) 4-CULTEC CULTEC Contactor®and Recharge*. INDEX WELL MIW-149 - ZONE C 22 Long Rood DATE CHECKED SHEET NO. 678 Federal Road FX: (203) 775-1462 Plastic Septic and Stormwater Chambers WATER LEVEL 9.7' NOV,3 2007 (508)Fores dale, 53 02644 Norwich, 2- 02645 Sroob9dd,CT08804 USA www.CUltec.com CUL7LC p GW ADJUSTMENT = 5.3` (506) 477-5313 (508) 432-8309 12�21/07 P.T.M. Of 2 IN e b PU't Rd � EXISTING CESSPOOLSI 2 N p ova TO BE PUMPED, FILLED tWITH SAND X �6,88 `© AND ABANDONED, OR REMOVED. /gh '�� LOCUS ^ A ` ? )2 .2 Pond it `e Stotton 24 WYGONSKI, ROBERT JOSEPH & \ 22t- UNITED METHODIST CHURCH WYGONSKI, ALYSON KEENEY 20 _ ro MAP 118, PARCEL 14 MAP 118, PARCEL 124-003 76 78 I~ ' Q \ -� 74 _ _ — _. I' X �0,�a 4 o- — c N g 4 72 _ -� - / / ! I 27,45 \\\ m �oY S\reel �O X-D51 ,8 9 / 7 4 5 c�� North `, x 4 8\ '� / X 2 BB I 1 2 / 8 7.7 �.., ___-� �, LOCUS MAP • `g ��, ` ..'�""'� O 1 S y`� /r C>>'o el -„ 'z NOT TO SCALE } -. SEWEf7-1' Drive ve -28 n iNV.=? of _ 3 28.03 TP 2TP l Fri Cellos Floor Elev.- 0 GENERAL NOTES: 20.00 (NGVD)l A ® t 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL • X 8,t �i I ` "` �• ii �gj //- j Mop �`� coo BOARD OF HEALTH AND THE DESIGN ENGINEER. Parcel 11 tv_ 3 T 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS SEWER-2 / Q�026f 4,� 1't , • ` OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE \11UE`T SE =18:00 / M LOCAL RULES AND REGULATIONS EXCEPT AS REQUEST BELOW: /V-103 I ` \ O( )� \ �— \ / / �� l 310 CMR 15.405 1 b 1 EXISTING-. i 1) A 1' variance to the 3' maximum cover requirement, for 4' of • \\� L��\-✓t j ,� / ',�`�; w max. cover. S.A.S. shall be vented and H-20 Rated. ,HOUSE (#1063) ' i� 1 � LOCAL REGULATION Cha ter 360, Article i — Setback Requirements Sin\ \ , / i " TOF=29.43// �'� k' ) An 8' variance, Septic Tank to B.V.W., for a 92' setback. `�\ \ ��r'j 1%(NGVD) j j� `,' - 3) A 23' variance, S.A.S. to B.V.W., for a 77' setback. • �`" w I O.\ \�!�-- -10 / , 28.82 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR INSTALL A 40 MIL POLY LIN R AS S OWN \r -T� \ \ ` a5 ► :� ,' 70 INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE AND SET BETWEE EL.=16. & 13.0� { \ 1 \q\ \ \ DESIGN ENGINEER. \1lul -A 1 �+ Concrete 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING ?l� r I 1 \ • 1 FROM THOSE SHOWN HEREON SHALL BE REPORTED 70 THE DESIGN r \ Drive I � � \ 1 \ \ �- a..�= •:; ;� � � ENGINEER BEFORE CONSTRUCTION CONTINUES. ® 8,5� ,ti ....... , , .� y 5. ALL ELEVATIONS BASED ON NGVD. 7! o°°� � J VENT fv } 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF // �� THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF f W E T/V `T 08 / / I / -i t l HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. • r r W©R' Lam— Si •P FENCE �TY � ,r 121�t fT ��..�.GL..OR" .��,..�.,... . .' 7. WATER SUPPLY PROVIDED BY TOWN WATER. /� FOSt dG 1. 8. THERE ARE NO ABUTTING WELLS LOCATED WITHIN 150' OF THE S.A.S. • INSPECTION PORT/ f�pll-Fer10E? � 9. ALL AREAS DISTURBED DURING CONSTRUCTION SHALL BE RESTORED•TONE UI�ALL kt BY PROVIDNG LOAM & SEED IN LAWN AREAS AND REPAIR OF PAVED AREAS IF REQUIRED, OR, AS DIRECTED BY APPROVING AUTHORITIES. 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY THE LOCATION OF ALI. UNDERGROUND UTILITIES, PRIOR TO BEGINNING ti OSHEA, COLM CONSTRUCTION. WET/V-101~ ry MAP 118, PARCEL 10 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS IN THE AREA BENEATH AND FOR 5 FT. ON ALL SIDES OF THE S.A.S. LEGEND AND REPLACE WITH CLEAN FILL AS SPECIFIED IN 310 CMR 255(3). 12. SUBJECT SITE LIES WITHIN THE WP OVERLAY DISTRICT AND STATE 14 --- EXISTING CONTOUR 1� Of �qs REGULATED ZONE II. x 37,11 EXISTING SPOT GRADE �� J9 FLOOD PLAIN DATA �� y Benchmark Set PROPOSED SEPTIC SYSTEM UPGRADE 14 PROPOSED CONTOUR FIRM PANEL #250001 0016 D o' PETER T. �� Left cor. footing ® TEST PIT REVISED:ZONES B && C 2, 1932 M CIVIL N EL.=20.87 (NGVD 1063 MAIN STREET, OSTERVILLE, MA W EXISTING WATER SERVICE No. 35109 Prepared for: Michael Ashley, 1063 Main Street, Osterville, MA 02655 —G— EXISTING GAS SERVICE WETLAND DELINEATION S1ER �`� Engineering by: Surveying by: SCALE DRAWN JOB. NO. O.H.W.— EXIST. OVERHEAD WIRES VACCARO Environmental ConsUlting s AL Engineering Works WARNER SURVEYING 1"=20' P.T.M. 249-07 5.31 x WETLAND FLAG P.O. Box 955, Sandwich, MA 02563 �; 22 Long Road WET/V-205 (506) 888-5855 2(21 J Forestdole, MA 02644 Harwich, MA 02645 A E21 07 CHECKED SHEET NO. 12 ' WETLAND SYMBOL I / r / (508) 477-5313 (508) 432-8309 / / P.T.M. 1 of 2 - 1 NOTE: TO PREVENT BREAKOUT, A 40 MIL POLY T.O.F LINONESHEETLL BE 1 AND SET BED AS ETWEENSEOWN6 VENT EXISTING AND EL.=13 F.G. EL: 16.0 MIN.) EXISTING F.G. EL:=16.7t F.G. EL: 16.7t F.G. EL: 20.0 MAX.) MAINTAIN 2% MIN SLOPE OVER S•A.S. INSTALL RISERS OVER INLET & OUTLET INSTALL RISER OVER D-BOX TO II L1=15' TO WITHIN 6" OF FINISH GRADE WITHIN 6" OF FINISH GRADE -•-INSPECTI PORT TO BE PLACED ON ENO UNIT L2=30 ON L=3' L=8' 4" SCH 40 PVC 4" SCH 40 PVC 1 3"" i 4" SCH 40 PVC Cs11 S= 2% (MIN.) 10"' 14"" 14" ® S= 1% (MIN.) a ® S= 1% (MIN.) 3" TO . . . . . o . . . . . a . . . . . 40" LIQ, LEVEL INV.=14.80 INV.=14.63 INVERT 16 " INV.=15,08 GAS GAS PROPOSED 3 ROWS OF 5--CULTEC C-4 UNITS x A" UNITW40' BAFFLE BAFFLE INV.=14.5 5 �,�OX ; (USE C-4 HD UNITS - H-20 RATED) CONNECT TO EXISTING SEWER INV.=14.83 SPLASH PAD To CONSIST of ! OUTLETS AT OR ABOVE: UNDERLAYMENT OF FILTER FABRIC OIL ABSORPTIONSYSTEM (PROFILE) INV.=15.40 SEWER-1 PROPO ED' 150 G6LLON SEPTIC TANK i EXTENDING 16' � IN FROM START INV.=15.70 SEWER-1 FRALO ST15oo GALLON PLASTIC TANK-ACTUAL CAPACITY=1771 GALLONS OF ROW N.ts. COMPARTMENT NO, 1 - 1100 GALLON MINIMUM STORAGE F.G. EL: 16.0 MIN.) ESTABLISH VEGETATIVE COVER COMPARTMENT NO. 2 - 550 GALLON MINIMUM STORAGE CULTEC NO, 410 FILTER FABRIC F.G. EL: 20.0 MAX.) BACKFILL WITH CLEAN SAND (NATIVE OR PERC SAND) 12" NOTES: 1 CONTRACTOR SHALL VERIFY ALL EXISTING PIPE BREAKOUT=TOP OF UNIT 6-4" POLYSEAL OUTLETS " 21 INVERTS PRIOR TO CONSTRUCTION. TOP OF CHAMBER ELLV.=1 5.0 2" 2„ .i f 1 4' POLYSEAL INLETS 2) SEPTIC T K E N B A OXS ALL B MECHANICALLY INV.ELEV.=14.55 1 COMPACTED BOTTOM ELEV.=14.3 --- uumu EXISTING SUI TABLE • SIX INCH CRUSHED STONE BASE, AS SPECIFIED W I 48"_(TYPICAL) �rMATERIAL 310 CMR 15.221(2), '. 0 3) INSTALL INLET & OUTLET TEES AS REQUIRED. � `�� MIN. ABOVE BOTTOM N OF I a O i 4) GAS BAFFLE 70 BE INSTALLED ON OUTLET TEES. T.P. EXCAVATION OR G.W. r EFFECTIVE WIDTH=12.0' 100 MSHGW EL: 9.3 USE 3 ROWS OF 5-CULTEC c 4 FIELD DRAIN UNITS N To View Section SEPTIC SYSTEM PROFILE WITH NO SEPARATION BETWEEN EACH ROW & NO STONE D--BOX SOIL ABSORPTION SYSTEM �S CTION) G7 -N.T.S. ALTERNATE: FRALO PLASTIC "MONSTER 0-BOX" CULTEC CONTACTOR FIELD DRAIN C-4(HDI SOIL LOG .- DESIGN CRITERIA MODEL FD C--4 R STARTER 4" DIA. INSPECTION PORT DATE: DECEMBER 6, 2007 (REF# 12,032) NUMBER OF BEDROOMS: 5 BEDROOMS- MODEL EVALLIATOR:* PETER MCENTEE PE CSE SOIL TEXTURAL CLASS: CLASS I . . . NNA MIORANDI�-HEALTH AGENT DESIGN PERCOLATION RATE: < 2 MIN/INCH . . ' DAILY FLOW: 550 GPD r e,v.- T '- - SMALL .RIB LARGE RIB 1:1 a . o � . " a o " WITNESS: 301 Di_j �� Elevr,• T�®°'� De yth R DESIGN FLOW: 550 GPD MODEL F !1 g 0" 12.67 U"' GARBAGE GRINDER: NO 12.92 D C-4 E MIDDLE END LEACHING AREA REQUIRED: (550) = 743.2 S.F. SMALL RIB LARGE RIB 48"' FILL FILL . _ .74 JL PROPOSED SEPTIC TANK: FRALO ST500 (1771 GALLON ACTUAL CAPACITY) 10.75 C - -- 26" 100.8 C 24' 2 COMPARTMENTS: 1100/550 GALLON MINIMUM STORAGE SPLIT 44" USE 3 ROWS OF 5 CULTEC C-4 UNITS WITH NO STONE 12 P. P. E PERC' FOR AN S.A.S. HAVING THE DIMENSIONS: 12.0' x 40.0% 56" BOTTOM AREA:. (GENERAL USE APPROVAL FOR 6.7 SF/LF OF C-4 UNIT) 8.51 ( 5 UNITS x 8.0'/UNIT = 40.0 FT .4" DIA MED. SAND MED• SAND 3 ROWS x 40.0' x 6.7 SF/LF = 804.0 SF 3; S 0 2.5Y 6/4 2.5Y 6/4 DESIGN FLOW PROVIDED: 0.74(804.0 S.F.) = 595.0 G.P.D. �5„ B G BEDROOM COUNT AS DETERMINED BY SITE INSPECTION OF BOARD OF HEALTH. . . . n . � . o b . ti . ti SMALL RIBkg 9,30 ADJ, W _ 9.30 ADJ. GW .` PROPOSED SEPTIC SYSTEM UPGRADE 4.00 STG. GW - 107" 4.00 STG, GW _ 104" 1063 MAIN STREET, OSTERVILLE, MA CULTEC CONTACTOR FIELD DRAIN C-4 CHAMHEk STORAGE a 1.692 cf 2.92 134" 2.67 134" /fT � Prepared for: Michael Ashley, 1063 Main Street, Osterville, MA 02655 ALL CONTACTOR FIELD DRAIN C-4HD HEAVY DUTY UNITS ARE MARKED WITH A COLOR STRIPE FORMED INTO THE PART ALONG THE LENGTH OF THE CHAMHER. PERC RATE <2 MIN/IN. ("C" HORIZON) Engineering by: Surveying by: SCALE DRAWN JOB. NO, CULTEC,Inc. PH: (203) 775-4416 STANDING GROUNDWATER AT 131" EngineeringWorla WARNER SURVEYING 1"=20' P.T.M. 249-07 CULTEC Contactor®and Recha erS INDEX WELL MIW-149 -• ZONE C 22 Lon Road P.O.Booc280 PH: (800) 4-CULTEC 9 DATE CHECKED SHEET NO. 878 Federal Road FX: (203 775-1462 Mask Septic and Stormwater Chambers WATER LEVEL EN - NOV,3 2007 (508)Fores dale, 53 02644 Norwich, MA 02645 Brookfield,CT on"USA www.cultec.com Cuu»C p ° Gw ADJUSTMENT = 5.3' (508) 477-5313 (508) 432-8309 12�21/07 P.T.M. 1 of 2 I